Sample records for agent guidelines table

  1. Endoscopy and antiplatelet agents. European Society of Gastrointestinal Endoscopy (ESGE) Guideline.

    PubMed

    Boustière, C; Veitch, A; Vanbiervliet, G; Bulois, P; Deprez, P; Laquiere, A; Laugier, R; Lesur, G; Mosler, P; Nalet, B; Napoleon, B; Rembacken, B; Ajzenberg, N; Collet, J P; Baron, T; Dumonceau, J-M

    2011-05-01

    With the increasing use of antiplatelet agents (APA), their management during the periendoscopic period has become a more common and more difficult problem. The increase in use is due to the availability of new drugs and the widespread use of drug-eluting coronary stents. Acute coronary syndromes can occur when APA therapy is withheld for noncardiovascular interventions. Guidelines about APA management during the periendoscopic period are traditionally based on assessments of the procedure-related risk of bleeding and the risk of thrombosis if APA are stopped. New data allow better assessment of these risks, of the necessary duration of APA discontinuation before endoscopy, of the use of alternative procedures (mostly for endoscopic retrograde cholangiopancreatography [ERCP]), and of endoscopic methods that can be used to prevent bleeding (following colonic polypectomy). This guideline makes graded, evidence-based, recommendations for the management of APA for all currently performed endoscopic procedures. A short summary and two tables are included for quick reference. © Georg Thieme Verlag KG Stuttgart · New York.

  2. Medical table: A major tool for antimicrobial stewardship policy.

    PubMed

    Roger, P-M; Demonchy, E; Risso, K; Courjon, J; Leroux, S; Leroux, E; Cua, É

    2017-09-01

    Infectious diseases are unpredictable, with heterogeneous clinical presentations, diverse pathogens, and various susceptibility rates to anti-infective agents. These features lead to a wide variety of clinical practices, which in turn strongly limits their evaluation. We have been using a medical table since 2005 to monitor the medical activity in our department. The observation of heterogeneous therapeutic practices led to drafting up our own antibiotic guidelines and to implementing a continuous evaluation of their observance and impact on morbidity and mortality associated with infectious diseases, including adverse effects of antibiotics, duration of hospital stay, use of intensive care, and deaths. The 10-year analysis of medical practices using the medical table is based on more than 10,000 hospitalizations. It shows simplified antibiotic therapies and a reduction in infection-related morbidity and mortality. The medical table is a major tool for antimicrobial stewardship, leading to constant benefits for patients. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  3. Guidelines for the care of pregnant women living with HIV and interventions to reduce perinatal transmission: executive summary.

    PubMed

    Money, Deborah; Tulloch, Karen; Boucoiran, Isabelle; Caddy, Sheila

    2014-08-01

    This guideline reviews the evidence relating to the care of pregnant women living with HIV and the prevention of perinatal HIV transmission. Prenatal care of pregnancies complicated by HIV infection should include monitoring by a multidisciplinary team with experts in this area. OUTCOMES evaluated include the impact of HIV on pregnancy outcome and the efficacy and safety of antiretroviral therapy and other measures to decrease the risk of vertical transmission. Published literature was retrieved through searches of PubMed and The Cochrane Library in 2012 and 2013 using appropriate controlled vocabulary (HIV, anti-retroviral agents, pregnancy, delivery) and key words (HIV, pregnancy, antiretroviral agents, vertical transmission, perinatal transmission). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies published in English or French. There were no date restrictions. Searches were updated on a regular basis and incorporated in the guideline to June 2013. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table 1).

  4. 40 CFR Table 1 to Subpart Cb of... - Nitrogen Oxides Guidelines for Designated Facilities

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 6 2011-07-01 2011-07-01 false Nitrogen Oxides Guidelines for... September 20, 1994 Pt. 60, Subpt. Cb, Table 1 Table 1 to Subpart Cb of part 60—Nitrogen Oxides Guidelines for Designated Facilities Municipal waste combustor technology Before April 28, 2009,nitrogen oxides...

  5. 40 CFR Table 1 to Subpart Cb of... - Nitrogen Oxides Guidelines for Designated Facilities

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 7 2013-07-01 2013-07-01 false Nitrogen Oxides Guidelines for... September 20, 1994 Pt. 60, Subpt. Cb, Table 1 Table 1 to Subpart Cb of Part 60—Nitrogen Oxides Guidelines for Designated Facilities Municipal waste combustor technology Before April 28, 2009,nitrogen oxides...

  6. Impact of the new American and British guidelines on the management and treatment of dyslipidemia in a Spanish working population.

    PubMed

    Brotons, Carlos; Calvo-Bonacho, Eva; Moral, Irene; García-Margallo, María Teresa; Cortés-Arcas, María Victoria; Puig, Mireia; Vázquez-Pirillo, Gastón; Ruilope, Luis Miguel

    2014-11-01

    The guidelines of the American College of Cardiology/American Heart Association and the British National Institute for Health and Clinical Excellence on the management and treatment of dyslipidemia recommend significant changes, such as the abolition of therapeutic targets and the use of new risk tables. This study aimed to evaluate the impact of the use of these new guidelines compared with the application of European guidelines. Observational study conducted among Spanish workers. We included all workers registered with the Sociedad de Prevención de Ibermutuamur in 2011 whose cardiovascular risk could be evaluated. Cardiovascular risk was calculated for each worker using the Systematic Coronary Risk Evaluation cardiovascular risk tables for low-risk countries, as well as the tables recommended by the American and British guidelines. A total of 258,676 workers were included (68.2% men; mean age, 39.3 years). High risk was found in 3.74% of the population according to the Systematic Coronary Risk Evaluation tables and in 6.85% and 20.83% according to the British and American tables, respectively. Treatment would be needed in 20 558 workers according to the American guidelines and in 13,222 according to the British guidelines, but in only 2612 according to the European guidelines. By following the American guidelines, the cost of statins would increase by a factor of 8. The new recommendations would result in identifying more high-risk patients and in treating a larger fraction of the population with lipid-lowering drugs than with the European recommendations, which would result in increased costs. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  7. Guidelines for lighting of plants in controlled environments

    NASA Technical Reports Server (NTRS)

    Dietzer, Gerald; Langhans, Robert; Sager, John; Spomer, Art; Tibbitts, Ted

    1994-01-01

    These guidelines for lighting of plants, established by the organizing committee, provided a focus for the discussions at the workshop. The guidelines served as a basis for discussion amongst the workshop attendees and led to a number of recommendations that were recorded by the session chairpersons. The organizing committee indicated they would incorporate the recommendations and suggestions into a revised set of guidelines for additional discussion. It was understood that these guidelines will not be standards and will require upgrading and modifications as lamps and equipment become available and as new insights are obtained on plants' response to light. Revised draft guidelines are included as Tables 1 and 2 that have been developed by the organizing committee following the suggestions obtained at the workshop. The guidelines for growth chambers are in Table 1 and guideines for greenhouses are given in Table 2. These have been distributed to the participants who indicated a willingness to review proposals that were developed. It is hoped that these proposals will lead to the development of guidelines that will have general acceptance by plant scientists.

  8. Guidelines for lighting of plants in controlled environments

    NASA Astrophysics Data System (ADS)

    Dietzer, Gerald; Langhans, Robert; Sager, John; Spomer, Art; Tibbitts, Ted

    1994-03-01

    These guidelines for lighting of plants, established by the organizing committee, provided a focus for the discussions at the workshop. The guidelines served as a basis for discussion amongst the workshop attendees and led to a number of recommendations that were recorded by the session chairpersons. The organizing committee indicated they would incorporate the recommendations and suggestions into a revised set of guidelines for additional discussion. It was understood that these guidelines will not be standards and will require upgrading and modifications as lamps and equipment become available and as new insights are obtained on plants' response to light. Revised draft guidelines are included as Tables 1 and 2 that have been developed by the organizing committee following the suggestions obtained at the workshop. The guidelines for growth chambers are in Table 1 and guideines for greenhouses are given in Table 2. These have been distributed to the participants who indicated a willingness to review proposals that were developed. It is hoped that these proposals will lead to the development of guidelines that will have general acceptance by plant scientists.

  9. Guidelines for use of fishes in research: revised and expanded

    USGS Publications Warehouse

    Jenkins, Jill A.; Bart, Henry L.; Bowker, James D.; Bowser, Paul R.; MacMillan, J. Randy; Nickum, John G.; Rachlin, Joseph W.; Rose, James D.; Sorensen, Peter W.; Warkentine, Barbara E.; Whitledge, Greg W.

    2014-01-01

    The Guidelines for the Use of Fishes in Research (2014; 2014 Guidelines), now available through the American fisheries Society (AFS) website and in print from the AFS bookstore, is a resource to aid researchers and regulatory authorities regarding responsible, scientifically valid research on fish and aquatic wildlife. The Guidelines for the Use of Fishes in Field Research (American Society of Ichthyologists and Herpetologists [ASIH] et al. 1987, 1988) emphasized field research and was followed by the 2004 Guidelines including laboratory research topics. Each version of the Guidelines has been jointly endorsed and/or published by the ASIH, the American Institute of Fishery Research Biologists (AIFRB), and AFS--each focusing on the scientific understanding, global conservation, and sustainability of aquatic animals, fisheries, and ecosystems. Changes with time necessitate revisions to make the Guidelines consistent with contemporary practices and scientific literature so to remain relevant as a technical resource. This document provides not only general principles relevant for field and laboratory research endeavors but includes specific requirements for researchers working within the United States and outside of the country. Within the scope of their expertise, the 2014 Uses of Fishers in Research (UFR) Committee members updated and revised sections, resulting in a 90-page 2014 Guidelines having undergone through peer review. As before, topical areas were addressed (see Table of Contents on page 416). Expanded coverage was provided on U.S. and international agencies and programs relevant to research with fishes. The Surgical Procedures and the Marking and Tagging section received special focus by a UFR Subcommittee. Feeds and Feeding and the Administration of Drugs, Biologics and Other Chemicals are just some of the newly added topics. The 2014 Guidelines is user-friendly by way of hyperlinks to external Internet sites, intradocument sections, and tables of acronyms with corresponding terms, low regulatory priority drugs, and Office of International des Epizooties notifiable disease agents. Again, the Institutional Animal Care and Use Committee (IACUC) role is explained, expectations for research are provided, and a brief checklist for IACUC readiness is included. Overall, the ,i>2014 Guidelines is the taxon-specific resource for our professional societies and is a principal document for standards on the care and use of fish and aquatic vertebrates in research.

  10. 27 CFR 555.220 - Table of separation distances of ammonium nitrate and blasting agents from explosives or blasting...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... distances of ammonium nitrate and blasting agents from explosives or blasting agents. 555.220 Section 555... ammonium nitrate and blasting agents from explosives or blasting agents. Table: Department of Defense... Not over Minimum separation distance of acceptor from donor when barricaded (ft.) Ammonium nitrate...

  11. 27 CFR 555.220 - Table of separation distances of ammonium nitrate and blasting agents from explosives or blasting...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... distances of ammonium nitrate and blasting agents from explosives or blasting agents. 555.220 Section 555... ammonium nitrate and blasting agents from explosives or blasting agents. Table: Department of Defense... Not over Minimum separation distance of acceptor from donor when barricaded (ft.) Ammonium nitrate...

  12. 27 CFR 555.220 - Table of separation distances of ammonium nitrate and blasting agents from explosives or blasting...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... distances of ammonium nitrate and blasting agents from explosives or blasting agents. 555.220 Section 555... ammonium nitrate and blasting agents from explosives or blasting agents. Table: Department of Defense... Not over Minimum separation distance of acceptor from donor when barricaded (ft.) Ammonium nitrate...

  13. 27 CFR 555.220 - Table of separation distances of ammonium nitrate and blasting agents from explosives or blasting...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... distances of ammonium nitrate and blasting agents from explosives or blasting agents. 555.220 Section 555... ammonium nitrate and blasting agents from explosives or blasting agents. Table: Department of Defense... Not over Minimum separation distance of acceptor from donor when barricaded (ft.) Ammonium nitrate...

  14. 27 CFR 555.220 - Table of separation distances of ammonium nitrate and blasting agents from explosives or blasting...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... distances of ammonium nitrate and blasting agents from explosives or blasting agents. 555.220 Section 555... ammonium nitrate and blasting agents from explosives or blasting agents. Table: Department of Defense... Not over Minimum separation distance of acceptor from donor when barricaded (ft.) Ammonium nitrate...

  15. Translating Guidelines Into Practice: Interpreting the 2016 ACC Expert Consensus Decision Pathway on the Role of Non-Statin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk.

    PubMed

    Waite, Laura H; Phan, Yvonne L; Spinler, Sarah A

    2017-10-01

    In 2016, the American College of Cardiology released a decision pathway, based on expert consensus, to guide use of non-statin agents in the management of atherosclerotic cardiovascular disease risk. The purpose of this article is to assist practitioners, health systems and managed care entities with interpreting this consensus statement in order to simplify implementation of the recommendations into patient care. Major themes from the consensus statement are briefly summarized and explained. Drug therapy recommendations are condensed into a single algorithm, while tables correlate each recommended regimen with the appropriate patient population from both a patient-level and systems-level perspective. Finally, a patient case with evidence-based decision support is explored. These tools allow practitioners to make appropriate patient-specific decisions about the use of non-statin pharmacotherapy and enable health systems and managed care entities to more readily identify guideline-appropriate use of these agents upon review of patient profiles or prescribing patterns. This article provides resources for healthcare providers that facilitate uptake of these recommendations into clinical practice.

  16. 50 CFR Table 1a to Part 660... - 2013, Specifications of OFL, ABC, ACL, ACT and Fishery Harvest guidelines (weights in metric tons)

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 13 2013-10-01 2013-10-01 false 2013, Specifications of OFL, ABC, ACL, ACT and Fishery Harvest guidelines (weights in metric tons) 1a Table 1a to Part 660, Subpart C... Part 660, Subpart C—2013, Specifications of OFL, ABC, ACL, ACT and Fishery Harvest guidelines (weights...

  17. 50 CFR Table 1a to Part 660... - 2013, Specifications of OFL, ABC, ACL, ACT and Fishery Harvest guidelines (weights in metric tons)

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 50 Wildlife and Fisheries 13 2014-10-01 2014-10-01 false 2013, Specifications of OFL, ABC, ACL, ACT and Fishery Harvest guidelines (weights in metric tons) 1a Table 1a to Part 660, Subpart C... Part 660, Subpart C—2013, Specifications of OFL, ABC, ACL, ACT and Fishery Harvest guidelines (weights...

  18. 50 CFR Table 1b to Part 660... - 2009, Harvest Guidelines for Minor Rockfish by Depth Sub-groups (weights in metric tons)

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 9 2010-10-01 2010-10-01 false 2009, Harvest Guidelines for Minor Rockfish by Depth Sub-groups (weights in metric tons) 1b Table 1b to Part 660, Subpart G Wildlife and... 660, Subpart G—2009, Harvest Guidelines for Minor Rockfish by Depth Sub-groups (weights in metric tons...

  19. 50 CFR Table 2b to Part 660... - 2010, and Beyond, Harvest Guidelines for Minor Rockfish by Depth Sub-groups (weights in metric tons)

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 9 2010-10-01 2010-10-01 false 2010, and Beyond, Harvest Guidelines for Minor Rockfish by Depth Sub-groups (weights in metric tons) 2b Table 2b to Part 660, Subpart G Wildlife... Part 660, Subpart G—2010, and Beyond, Harvest Guidelines for Minor Rockfish by Depth Sub-groups...

  20. 50 CFR Table 2a to Part 660... - 2012, and beyond, Specifications of OFL, ABC, ACL, ACT and Fishery Harvest guidelines (weights in...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 50 Wildlife and Fisheries 13 2012-10-01 2012-10-01 false 2012, and beyond, Specifications of OFL, ABC, ACL, ACT and Fishery Harvest guidelines (weights in metric tons) 2a Table 2a to Part 660, Subpart... Table 2a to Part 660, Subpart C—2012, and beyond, Specifications of OFL, ABC, ACL, ACT and Fishery...

  1. 50 CFR Table 2a to Part 660... - 2014, and Beyond, Specifications of OFL, ABC, ACL, ACT and Fishery Harvest guidelines (weights in...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 50 Wildlife and Fisheries 13 2014-10-01 2014-10-01 false 2014, and Beyond, Specifications of OFL, ABC, ACL, ACT and Fishery Harvest guidelines (weights in metric tons) 2a Table 2a to Part 660, Subpart... Table 2a to Part 660, Subpart C—2014, and Beyond, Specifications of OFL, ABC, ACL, ACT and Fishery...

  2. Solar cell efficiency tables (version 48): Solar cell efficiency tables (version 48)

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

    Green, Martin A.; Emery, Keith; Hishikawa, Yoshihiro

    Consolidated tables showing an extensive listing of the highest independently confirmed efficiencies for solar cells and modules are presented. Guidelines for inclusion of results into these tables are outlined, and new entries since January 2016 are reviewed.

  3. Solar cell efficiency tables (version 50)

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

    Green, Martin A.; Hishikawa, Yoshihiro; Warta, Wilhelm

    Consolidated tables showing an extensive listing of the highest independently confirmed efficiencies for solar cells and modules are presented. Guidelines for inclusion of results into these tables are outlined, and new entries since January 2017 are reviewed.

  4. Solar cell efficiency tables (version 49)

    DOE PAGES

    Green, Martin A.; Emery, Keith; Hishikawa, Yoshihiro; ...

    2016-11-28

    Consolidated tables showing an extensive listing of the highest independently confirmed efficiencies for solar cells and modules are presented. Here, guidelines for inclusion of results into these tables are outlined, and new entries since June 2016 are reviewed.

  5. Solar cell efficiency tables (version 49)

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

    Green, Martin A.; Emery, Keith; Hishikawa, Yoshihiro

    Consolidated tables showing an extensive listing of the highest independently confirmed efficiencies for solar cells and modules are presented. Here, guidelines for inclusion of results into these tables are outlined, and new entries since June 2016 are reviewed.

  6. 40 CFR Table 3 to Subpart Ffff of... - Model Rule-Operating Limits for Incinerators and Wet Scrubbers

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Emission Guidelines and Compliance Times for Other Solid Waste Incineration Units That Commenced Construction On or Before December 9, 2004 Pt. 60, Subpt. FFFF, Table 3 Table 3 to Subpart FFFF of Part 60...

  7. 40 CFR Table 3 to Subpart Ffff of... - Model Rule-Operating Limits for Incinerators and Wet Scrubbers

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Emission Guidelines and Compliance Times for Other Solid Waste Incineration Units That Commenced Construction On or Before December 9, 2004 Pt. 60, Subpt. FFFF, Table 3 Table 3 to Subpart FFFF of Part 60...

  8. 40 CFR Table 3 to Subpart Ffff of... - Model Rule-Operating Limits for Incinerators and Wet Scrubbers

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Emission Guidelines and Compliance Times for Other Solid Waste Incineration Units That Commenced Construction On or Before December 9, 2004 Pt. 60, Subpt. FFFF, Table 3 Table 3 to Subpart FFFF of Part 60...

  9. 45 CFR Appendix A to Part 1611 - Legal Services Corporation 2010 Poverty Guidelines *

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Legal Services Corporation 2010 Poverty Guidelines... Corporation 2010 Poverty Guidelines * Legal Services Corporation 2010 Income Guidelines * Size of household 48...: 4,675 5,850 5,375 * The figures in this table represent 125% of the poverty guidelines by household...

  10. A proposed protocol for hand and table sanitizing in chiropractic clinics and education institutions

    PubMed Central

    Evans, Marion Willard; Ramcharan, Michael; Floyd, Rod; Globe, Gary; Ndetan, Harrison; Williams, Ronald; Ivie, Ronald

    2009-01-01

    Abstract Objective By nature, chiropractic is a hands-on profession using manipulation applied to the joints with direct skin-to-skin contacts. Chiropractic tables are designed with a face piece to accommodate the prone patient's head in a neutral position and hand rests to allow for relaxed shoulders and upper spine so treatment is facilitated. The purpose of this article is to present a proposed guideline for hand and treatment table surface sanitizing for the chiropractic profession that is evidence-based and can easily be adopted by teaching institutions and doctors in the field. Methods A review of the chiropractic literature demonstrated that pathogenic microbes are present on treatment tables in teaching clinics at multiple facilities, yet no standardized protocols exist in the United States regarding table sanitizing and hand hygiene in chiropractic clinics or education institutions. This article reviews the scientific literature on the subject by using several search engines, databases, and specific reviews of documents pertaining to the topic including existing general guidelines. Results The literature has several existing guidelines that the authors used to develop a proposed protocol for hand and table sanitizing specific to the chiropractic profession. Recommendations were developed and are presented on hand hygiene and table sanitizing procedures that could lower the risk of infection for both clinical personnel and patients in chiropractic facilities. Conclusion This article offers a protocol for hand and table sanitizing in chiropractic clinics and education institutions. The chiropractic profession should consider adoption of these or similar measures and disseminate them to teaching clinics, institutions, and private practitioners. PMID:19646384

  11. Erratum to: Circulating tumor markers: a guide to their appropriate clinical use | Comparative summary of recommendations from clinical practice guidelines (PART 1), (PART 2), (PART 3).

    PubMed

    2017-10-31

    Erratum To: Circulating tumor markers: a guide to their appropriate clinical use | Comparative summary of recommendations from clinical practice guidelines (PART 1) Gion M, Trevisiol C, Rutjes AW, Rainato G, Fabricio AS. Int J Biol Markers. 2016 Dec 23;31(4):e332-e367. doi: 10.5301/jbm.5000251. Circulating tumor markers: a guide to their appropriate clinical use | Comparative summary of recommendations from clinical practice guidelines (PART 2).Gion M, Trevisiol C, Rutjes AWS, Rainato G, Fabricio ASC. Int J Biol Markers. 2017 Mar 2;32(1):e1-e52. doi: 10.5301/ijbm.5000259. Circulating tumor markers: a guide to their appropriate clinical use | Comparative summary of recommendations from clinical practice guidelines (PART 3).Gion M, Trevisiol C, Rutjes AWS, Rainato G, Fabricio ASC. Int J Biol Markers. 2017 May 4;32(2):e147-e181. doi: 10.5301/ijbm.5000272. We report an amendment in the Detailed summary tables pages of the three parts of the guidelines above. The correct definition of detailed summary tables is reported below. Definition and target audience Detailed summary tables are tables prepared for every tumor type which report recommendations and supplementary information from different guidance documents with enough details to be useful for health care providers, policy makers (for potential adaptation to specific settings) and staff developing educational material informed by available evidence.

  12. Item-Writing Guidelines for Physics

    ERIC Educational Resources Information Center

    Regan, Tom

    2015-01-01

    A teacher learning how to write test questions (test items) will almost certainly encounter item-writing guidelines--lists of item-writing do's and don'ts. Item-writing guidelines usually are presented as applicable across all assessment settings. Table I shows some guidelines that I believe to be generally applicable and two will be briefly…

  13. 78 FR 59475 - Architectural Barriers Act Accessibility Guidelines; Outdoor Developed Areas

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-26

    ... following outdoor constructed features provided at these facilities: Picnic tables, fire rings, grills... requirements for picnic tables, fire rings, grills, fireplaces, wood stoves, trash and recycling receptacles... have required 50 percent of picnic tables, fire rings, grills, and benches to comply with the...

  14. 45 CFR Appendix A to Part 1611 - Legal Services Corporation 2012 Income Guidelines

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 4,950 6,188 5,688 * The figures in this table represent 125% of the poverty guidelines by household... Poverty Guidelines Size of household 48 Contiguous States and the District ofColumbia Alaska Hawaii 1 $22...

  15. 45 CFR Appendix A to Part 1611 - Legal Services Corporation 2011 Income Guidelines *

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...: 4,775 5,975 5,488 * The figures in this table represent 125% of the poverty guidelines by household... Poverty Guidelines Size of household 48 Contiguous States and the District ofColumbia Alaska Hawaii 1 $21...

  16. COS Target Acquisition Guidelines, Recommendations, and Interpretation

    NASA Astrophysics Data System (ADS)

    Keyes, Charles (Tony) D.; Penton, Steven V.

    2010-06-01

    Based upon analysis of SMOV and Cycle 17 observations through April 2010, this ISR expands, updates, and supersedes recommendations and information provided about target acquisitions (TA) in the COS Instrument Handbook version 2. This ISR provides an overview of COS TA, presents general guidelines and recommendations for crafting COS TAs, establishes COS TA centering accuracy requirements to achieve COS photometric, velocity, and resolution objectives, and summarizes the performance of the COS on-board TA modes as compared to these centering requirements. Updated TA strategy recommendations are given where appropriate, a user-oriented table lists where to find important quantities for the analysis and interpretation of COS TAs, and a brief appendix with additional supporting information is included. An overview of COS TA strategies is provided in Section 2 and Table 1; important updates to ACQ/SEARCH requirements and SEARCH-SIZE recommendations as a function of target coordinate accuracy are given in Tables 2 and 3; COS TA performance by mode is described in Section 5; important header keywords that are useful for evaluating the quality of COS TAs are listed in Table 5 along with where to find them; Table 6 gives a summary of COS TA modes, options, and recommended values; Section 7 summarizes updated recommendations and guidelines for COS TA; and Appendix A provides additional useful COS TA information.

  17. 12 CFR Appendix B to Part 30 - Interagency Guidelines Establishing Information Security Standards

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Establishing Information Security Standards Table of Contents I. Introduction A. Scope B. Preservation of... Security Program B. Objectives III. Development and Implementation of Customer Information Security Program.... Introduction The Interagency Guidelines Establishing Information Security Standards (Guidelines) set forth...

  18. [Management of Patients on Antithrombotic Agents Undergoing Endoscopy].

    PubMed

    Kim, Joon Sung; Kim, Byung Wook

    2018-05-25

    Antithrombotic agents are used increasingly in Asia. The management of patients on antithrombotics undergoing elective or emergency endoscopy has become an increasing clinical challenge for gastroenterologists. Current practice guidelines have been developed by societies from western countries. On the other hand, these guidelines cannot meet the specific needs of the Asian Pacific region, raising the need for separate guidelines in Asia. This review compares the recommendations of previous guidelines with the most recently published Asian guidelines regarding the management of patients on antithrombotic agents undergoing elective and emergency endoscopy.

  19. Thermal Inactivation of Viruses

    DTIC Science & Technology

    1977-10-01

    thermal inactivation . 12 Bibliography 20 Table 3. Thermal inactivation of viruses in foods 25 Bibliography 31 Table 4, Agents modifying...the presence of protective agents that reduce the lethal effect of heat on the viruses at temperatures below 60 C In addition, whtn solid foods...systems but were observed j when animal inoculation was utilized. It is possible that free virus nucl’lc < acid may have been the causative agent in

  20. Some Exact Conditional Tests of Independence for R X C Cross-Classification Tables

    ERIC Educational Resources Information Center

    Agresti, Alan; Wackerly, Dennis

    1977-01-01

    Exact conditional tests of independence in cross-classification tables are formulated based on chi square and other statistics with stronger operational interpretations, such as some nominal and ordinal measures of association. Guidelines for table dimensions and sample sizes for which the tests are economically implemented on a computer are…

  1. Solar Cell Efficiency Tables (Version 51)

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

    Levi, Dean H; Green, Martin A.; Hishikawa, Yoshihiro

    Consolidated tables showing an extensive listing of the highest independently confirmed efficiencies for solar cells and modules are presented. Guidelines for inclusion of results into these tables are outlined and new entries since July 2017 are reviewed, together with progress over the last 25 years. Appendices are included documenting area definitions and also listing recognised test centres.

  2. Graphical displays for effective reporting of evidence quality tables in research syntheses.

    PubMed

    Mignini, Luciano; Champaneria, Rita; Mishanina, Ekaterina; Khan, Khalid S

    2016-03-09

    When generating guidelines, quality of the evidence is tabulated to capture its several domains, often using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. We developed a graphic display to capture deficiencies, outliers and similarities across comparisons contained in GRADE tables. Based on a systematic literature review capturing the effects of 32 different therapeutic comparisons on dysmenorrhoea, we synthesised evidence quality in tables and graphs. We evaluated time taken to accurately assess evident quality and preference for tables vs. graphs. The plots provided visually striking displays of strengths and weaknesses of the evidence across the spectrum of comparisons on a single page. Equivalent tabulated information spread over 4 pages. Participants preferred and interpreted graphs quicker and more accurately than tables. The graphic approach we developed makes interpreting evidence easier. Large tables are dry and cumbersome to read and assimilate. When guideline statements are accompanied by these plots, they have the scope for improving the credibility of the recommendations made, as the strength of the evidence used can be clearly seen. Further empirical research will establish the place for graphic displays.

  3. Oak Regeneration Guidelines for the Central Appalachians

    Treesearch

    Kim C. Steiner; James C. Finley; Peter J. Gould; Songlin Fei; Marc McDill

    2008-01-01

    This article presents the first explicit guidelines for regenerating oaks in the central Appalachians. The objectives of this paper are (1) to describe the research foundation on which the guidelines are based and (2) to provide users with the instructions, data collection forms, supplementary tables, and decision charts needed to apply the guidelines in the field. The...

  4. Formatting modifications in GRADE evidence profiles improved guideline panelists comprehension and accessibility to information. A randomized trial.

    PubMed

    Vandvik, Per Olav; Santesso, Nancy; Akl, Elie A; You, John; Mulla, Sohail; Spencer, Frederick A; Johnston, Bradley C; Brozek, Jan; Kreis, Julia; Brandt, Linn; Zhou, Qi; Schünemann, Holger J; Guyatt, Gordon

    2012-07-01

    To determine the effects of formatting alternatives in Grading of Recommendations Assessment, Development, and Evaluation (GRADE) evidence profiles on guideline panelists' preferences, comprehension, and accessibility. We randomized 116 antithrombotic therapy guideline panelists to review one of two table formats with four formatting alternatives. After answering relevant questions, panelists reviewed the other format and reported their preferences for specific formatting alternatives. Panelists (88 of 116 invited [76%]) preferred presentation of study event rates over no study event rates (median 1 [interquartile range (IQR) 1] on 1-7 scale), absolute risk differences over absolute risks (median 2 [IQR 3]), and additional information in table cells over footnotes (median 1 [IQR 2]). Panelists presented with time frame information in the tables, and not only in footnotes, were more likely to correctly answer questions regarding time frame (58% vs. 11%, P<0.0001), and those presented with risk differences and not absolute risks were more likely to correctly interpret confidence intervals for absolute effects (95% vs. 54%, P<0.0001). Information was considered easy to find, easy to comprehend, and helpful in making recommendations regardless of table format (median 6, IQR 0-1). Panelists found information in GRADE evidence profiles accessible. Correct comprehension of some key information was improved by providing additional information in table and presenting risk differences. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. 40 CFR Table 3 to Subpart Cb of... - Municipal Waste Combustor Operating Guidelines

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false Municipal Waste Combustor Operating... and Compliance Times for Large Municipal Waste Combustors That are Constructed on or Before September 20, 1994 Pt. 60, Subpt. Cb, Table 3 Table 3 to Subpart Cb of Part 60—Municipal Waste Combustor...

  6. Survey of rheumatologists on the use of the Philippine Guidelines on the Screening for Tuberculosis prior to use of Biologic Agents.

    PubMed

    Aquino-Villamin, Melissa; Tankeh-Torres, Sandra; Lichauco, Juan Javier

    2016-11-01

    The use of biologic agents has become an important option in treating patients with rheumatoid arthritis. However, these drugs have been associated with an increased risk of tuberculosis (TB) reactivation. Local guidelines for TB screening prior to the use of biologic agents were developed to address this issue. This study is a survey describing the compliance of Filipino rheumatologists to these guidelines. Eighty-seven rheumatologists in the Philippines were given the questionnaire and responses from 61 rheumatologists were included in the analysis. All respondents agree that patients should be screened prior to giving the biologic agents. Local guidelines recommend screening with tuberculin skin test (TST) and chest radiograph. However, cut-off values considered for a positive TST and timing of initiation of biologic agents after starting TB prophylaxis and treatment varied among respondents. In addition, screening of close household contacts were only performed by 41 (69.5%) respondents. There were 11 respondents who reported 16 patients developing TB during or after receiving biologic agents, despite adherence to the guidelines. This survey describes the compliance rate of Filipino rheumatologists in applying current local recommendations for TB screening prior to initiating biologic agents. The incidence of new TB cases despite the current guidelines emphasizes the importance of compliance and the need to revise the guidelines based on updated existing literature. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  7. Guidelines for the Student with Diabetes: A School Policy.

    ERIC Educational Resources Information Center

    Clark, Loretta M.; And Others

    1992-01-01

    This paper describes development of recommended guidelines, by a subcommittee of the American Diabetes Association, concerning in-school management of hypoglycemia. Two tables replicate a portion of the guidelines related to: (1) the recognition and treatment of hypoglycemia, and (2) adjustment to school. Other information included in the…

  8. Southern Great Plains Rapid Ecoregional Assessment: pre-assessment report

    USGS Publications Warehouse

    Assal, Timothy J.; Melcher, Cynthia P.; Carr, Natasha B.

    2015-01-01

    An overview on the ecology and management issues for each Conservation Element is provided, including distribution and ecology, landscape structure and dynamics, and associated species of management concern affiliated with each Conservation Element. For each Conservation Element, effects of the Change Agents are described. An overview of potential key ecological attributes and potential Change Agents are summarized by conceptual models and tables. The tables provide an organizational framework and background information for evaluating the key ecological attributes and Change Agents in Phase II.

  9. Airborne exposure limits for chemical and biological warfare agents: is everything set and clear?

    PubMed

    Sabelnikov, Alex; Zhukov, Vladimir; Kempf, C Ruth

    2006-08-01

    Emergency response strategies (guidelines) for biological, chemical, nuclear, or radiological terrorist events should be based on scientifically established exposure limits for all the agents or materials involved. In the case of a radiological terrorist event, emergency response guidelines (ERG) have been worked out. In the case of a terrorist event with the use of chemical warfare (CW) agents the situation is not that clear, though the new guidelines and clean-up values are being generated based on re-evaluation of toxicological and risk data. For biological warfare (BW) agents, such guidelines do not yet exist. In this paper the current status of airborne exposure limits (AELs) for chemical and biological warfare (CBW) agents are reviewed. Particular emphasis is put on BW agents that lack such data. An efficient, temporary solution to bridge the gap in experimental infectious data and to set provisional AELs for BW agents is suggested. It is based on mathematically generated risks of infection for BW agents grouped by their alleged ID50 values in three categories: with low, intermediate and high ID50 values.

  10. Expert Systems, Job Aids, and the Future of Instructional Technology; and Decision Tables, the Poor Person's Answer to "Expert Systems."

    ERIC Educational Resources Information Center

    Harmon, Paul; Pipe, Peter

    1986-01-01

    Describes design and presents examples of industrial use of small expert systems and guidelines for choosing problems which lend themselves to small tool solutions. Use of microcomputer facilitated decision tables to diagnose and categorize people, things, and issues is suggested, and development of three decision table formats is described. (MBR)

  11. Older driver highway design handbook : recommendations and guidelines

    DOT National Transportation Integrated Search

    1996-06-01

    The purpose of this report is to document the preparation of the 1994 Table VM-1, including data sources, assumptions, and estimating procedures. Table VM-1 describes vehicle distance traveled in miles, by highway category and vehicle type. VM-1 depi...

  12. Australian and New Zealand Anaesthetic Allergy Group Perioperative Anaphylaxis Investigation Guidelines.

    PubMed

    Scolaro, R J; Crilly, H M; Maycock, E J; McAleer, P T; Nicholls, K A; Rose, M A; The, Rih

    2017-09-01

    These guidelines are a consensus document developed by a working party of the Australian and New Zealand Anaesthetic Allergy Group (ANZAAG) to provide an approach to the investigation of perioperative anaphylaxis. They focus primarily on the use of skin testing as it is the investigation with the greatest clinical utility for the identification of the likely causative agent and potentially safer alternatives. The practicalities and process of skin testing, its limitations, and the place of other tests are discussed. These guidelines also address the roles of graded challenge and in vitro testing. The implications of anaphylaxis associated with neuromuscular blocking agents, beta-lactam antibiotics, local anaesthetic agents and chlorhexidine are discussed. Evidence for the recommendations is derived from literature searches using the words skin test, allergy, anaphylaxis, anaesthesia, and each of the individual agents listed in these guidelines. The individual articles were then reviewed for suitability for inclusion in these guidelines. Where evidence was not strong, as is the situation for many perioperative agents, expert consensus from the ANZAAG working party was used. These guidelines are intended for use by specialists involved in the investigation of perioperative allergy. They have been approved following peer review by members of ANZAAG and are available on the ANZAAG website: http://www.anzaag.com/anaphylaxis-management/testing-guidelines.pdf.

  13. Customized Clinical Practice Guidelines for Management of Adult Cataract in Iran

    PubMed Central

    Rajavi, Zhaleh; Javadi, Mohammad Ali; Daftarian, Narsis; Safi, Sare; Nejat, Farhad; Shirvani, Armin; Ahmadieh, Hamid; Shahraz, Saeid; Ziaei, Hossein; Moein, Hamidreza; Motlagh, Behzad Fallahi; Feizi, Sepehr; Foroutan, Alireza; Hashemi, Hassan; Hashemian, Seyed Javad; Jabbarvand, Mahmoud; Jafarinasab, Mohammad Reza; Karimian, Farid; Mohammad-Rabei, Hossein; Mohammadpour, Mehrdad; Nassiri, Nader; Panahi-Bazaz, Mahmoodreza; Rohani, Mohammad Reza; Sedaghat, Mohammad Reza; Sheibani, Kourosh

    2015-01-01

    Purpose: To customize clinical practice guidelines (CPGs) for cataract management in the Iranian population. Methods: First, four CPGs (American Academy of Ophthalmology 2006 and 2011, Royal College of Ophthalmologists 2010, and Canadian Ophthalmological Society 2008) were selected from a number of available CPGs in the literature for cataract management. All recommendations of these guidelines, together with their references, were studied. Each recommendation was summarized in 4 tables. The first table showed the recommendation itself in clinical question components format along with its level of evidence. The second table contained structured abstracts of supporting articles related to the clinical question with their levels of evidence. The third table included the customized recommendation of the internal group respecting its clinical advantage, cost, and complications. In the fourth table, the internal group their recommendations from 1 to 9 based on the customizing capability of the recommendation (applicability, acceptability, external validity). Finally, customized recommendations were sent one month prior to a consensus session to faculty members of all universities across the country asking for their comments on recommendations. Results: The agreed recommendations were accepted as conclusive while those with no agreement were discussed at the consensus session. Finally, all customized recommendations were codified as 80 recommendations along with their sources and levels of evidence for the Iranian population. Conclusion: Customization of CPGs for management of adult cataract for the Iranian population seems to be useful for standardization of referral, diagnosis and treatment of patients. PMID:27051491

  14. IFLA General Conference, 1990. Division of Libraries Serving the General Public: Section on Public Libraries; Section of Children's Libraries, Children's Literature Documentation Centres, Round Table; Section of School Libraries; Section of Libraries for the Blind; INTAMEL, Round Table; Mobile Libraries, Round Table. Booklet 3.

    ERIC Educational Resources Information Center

    International Federation of Library Associations, The Hague (Netherlands).

    The 28 papers in this collection were presented at meetings of four sections and three round tables within the Division of Libraries Serving the General Public: (1) "Rural Community Information Services: Guidelines for Researching Need, Setting Up Services and Evaluating Performance" (Elaine Kempson); (2) "Library Activities at the Workplace"…

  15. Dispensing patterns for antidiabetic agents in New Zealand: are the guidelines being followed?

    PubMed

    Murray, Peter; Norris, Hew; Metcalfe, Scott; Betty, Bryan; Young, Vanessa; Locke, Bronwyn

    2017-11-10

    Type 2 diabetes mellitus (T2DM) is a significant public health issue in New Zealand. Effective management and glycaemic control is critical for reducing diabetes-related complications. Treatment guidelines are well established in New Zealand. Using dispensing data as a proxy for prescribing data, this paper aims to describe the pattern of first- and second-line antidiabetic agent (AA) dispensing for T2DM in New Zealand and assess adherence with treatment guidelines. Analysis of national dispensing data for AA medications using the Pharmaceutical Collection database from 2007/08 to 2015/16. Metformin monotherapy remains the most commonly prescribed first-line T2DM medication prescribed, accounting for 85% of initial agents prescribed. Sulfonylureas are the most common second-line agents used, accounting for 70% of all second-line agents. There is a high degree of adherence with the T2DM treatment guidelines in New Zealand.

  16. 45 CFR Appendix A to Part 1611 - Income Level for Individuals Eligible for Assistance

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...: 5,075 6,350 5,838 * The figures in this table represent 125% of the poverty guidelines by household size as determined by DHHS. Reference Chart—200% of DHHS Federal Poverty Guidelines Size of household...

  17. Guidelines on genetic evaluation and management of Lynch syndrome: a consensus statement by the US Multi-Society Task Force on colorectal cancer.

    PubMed

    Giardiello, Francis M; Allen, John I; Axilbund, Jennifer E; Boland, C Richard; Burke, Carol A; Burt, Randall W; Church, James M; Dominitz, Jason A; Johnson, David A; Kaltenbach, Tonya; Levin, Theodore R; Lieberman, David A; Robertson, Douglas J; Syngal, Sapna; Rex, Douglas K

    2014-08-01

    The Multi-Society Task Force, in collaboration with invited experts, developed guidelines to assist health care providers with the appropriate provision of genetic testing and management of patients at risk for and affected with Lynch syndrome as follows: Figure 1 provides a colorectal cancer risk assessment tool to screen individuals in the office or endoscopy setting; Figure 2 illustrates a strategy for universal screening for Lynch syndrome by tumor testing of patients diagnosed with colorectal cancer; Figures 3-6 provide algorithms for genetic evaluation of affected and at-risk family members of pedigrees with Lynch syndrome; Table 10 provides guidelines for screening at-risk and affected persons with Lynch syndrome; and Table 12 lists the guidelines for the management of patients with Lynch syndrome. A detailed explanation of Lynch syndrome and the methodology utilized to derive these guidelines, as well as an explanation of, and supporting literature for, these guidelines are provided. Copyright © 2014 American Gastroenterological Association, American College of Gastroenterology, the American Society of Colon and Rectal Surgeons, and the American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  18. 45 CFR Appendix A to Part 1611 - Income Level for Individuals Eligible for Assistance

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...: 5,025 6,288 5,775 * The figures in this table represent 125% of the poverty guidelines by household... Poverty Guidelines Size of household 48 ContiguousStates and the District of Columbia Alaska Hawaii 1 22...

  19. Proposed Methodology for Application of Human-like gradual Multi-Agent Q-Learning (HuMAQ) for Multi-robot Exploration

    NASA Astrophysics Data System (ADS)

    Narayan Ray, Dip; Majumder, Somajyoti

    2014-07-01

    Several attempts have been made by the researchers around the world to develop a number of autonomous exploration techniques for robots. But it has been always an important issue for developing the algorithm for unstructured and unknown environments. Human-like gradual Multi-agent Q-leaming (HuMAQ) is a technique developed for autonomous robotic exploration in unknown (and even unimaginable) environments. It has been successfully implemented in multi-agent single robotic system. HuMAQ uses the concept of Subsumption architecture, a well-known Behaviour-based architecture for prioritizing the agents of the multi-agent system and executes only the most common action out of all the different actions recommended by different agents. Instead of using new state-action table (Q-table) each time, HuMAQ uses the immediate past table for efficient and faster exploration. The proof of learning has also been established both theoretically and practically. HuMAQ has the potential to be used in different and difficult situations as well as applications. The same architecture has been modified to use for multi-robot exploration in an environment. Apart from all other existing agents used in the single robotic system, agents for inter-robot communication and coordination/ co-operation with the other similar robots have been introduced in the present research. Current work uses a series of indigenously developed identical autonomous robotic systems, communicating with each other through ZigBee protocol.

  20. Seismic verification of nuclear plant equipment anchorage: Volume 1, Development of anchorage guidelines: Final report

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

    Czarnecki, R M

    1987-05-01

    Guidelines have been developed to evaluate the seismic adequacy of the anchorage of various classes of electrical and mechanical equipment in nuclear power plants covered by NRC Unresolved Safety Issue A-46. The guidelines consist of screening tables that give the seismic anchorage capacity as a function of key equipment and anchorage fasteners, inspection checklists for field verification of anchorage adequacy, and provisions for outliers that can be used to further investigate anchorages that cannot be verified in the field. The screening tables are based on an analysis of the anchorage forces developed by common equipment types and on strength criteriamore » to quantify the holding power of anchor bolts and welds. The strength criteria for expansion anchor bolts were developed by collecting and analyzing a large quantity of test data.« less

  1. Guidelines for Contracting Microfilming Services.

    ERIC Educational Resources Information Center

    Byrne, Sherry

    1986-01-01

    Outlines the process involved in selecting an outside filming agent for the purpose of preserving a library's or archive's holdings. Guidelines include project planning, selecting a filming agent, and contract preparation and maintenance. A sample contract is included. (Author/EM)

  2. 40 CFR 161.108 - Relationship of Pesticide Assessment Guidelines to data requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 25 2013-07-01 2013-07-01 false Relationship of Pesticide Assessment... AGENCY (CONTINUED) PESTICIDE PROGRAMS DATA REQUIREMENTS FOR REGISTRATION OF ANTIMICROBIAL PESTICIDES How To Use Data Tables § 161.108 Relationship of Pesticide Assessment Guidelines to data requirements...

  3. 40 CFR 161.108 - Relationship of Pesticide Assessment Guidelines to data requirements.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 25 2012-07-01 2012-07-01 false Relationship of Pesticide Assessment... AGENCY (CONTINUED) PESTICIDE PROGRAMS DATA REQUIREMENTS FOR REGISTRATION OF ANTIMICROBIAL PESTICIDES How To Use Data Tables § 161.108 Relationship of Pesticide Assessment Guidelines to data requirements...

  4. 12 CFR Appendix B to Part 364 - Interagency Guidelines Establishing Information Security Standards

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Part 364—Interagency Guidelines Establishing Information Security Standards Table of Contents I... Customer Information A. Information Security Program B. Objectives III. Development and Implementation of Customer Information Security Program A. Involve the Board of Directors B. Assess Risk C. Manage and...

  5. Nofoam System Technology for Aircraft Hangar Fire Suppression Foam System

    DTIC Science & Technology

    2011-07-01

    use of a firefighting agent that meets Military Specification MIL - F - 24385 [Reference 2]. Significant amounts of AFFF wastewater is generated...rates, Table 3, were the established baseline for comparison. Table 3 theoretical flow rates were derived from Military Specification MIL - F - 24385 [Reference...flow rates, Table 3, was the established baseline for comparison. Table 3 theoretical flow rates were derived from Military Specification MIL - F - 24385 [Reference

  6. 40 CFR 60.34b - Emission guidelines for municipal waste combustor operating practices.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... approval, a State plan shall include emission limits for carbon monoxide at least as protective as the emission limits for carbon monoxide listed in table 3 of this subpart. table 3 provides emission limits for the carbon monoxide concentration level for each type of designated facility. (b) For approval, a...

  7. 10 CFR Appendix III to Part 960 - Application of the System and Technical Guidelines During the Siting Process

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... presents a table that specifies how the guidelines of subparts C and D are to be applied at certain... Characteristics ......do 3 5-2-9(d) ......do Disqualifying 1 5-2-10(a) Hydrology Qualifying 3 5-2-10(d) ......do...

  8. 12 CFR Appendix B to Part 170 - Interagency Guidelines Establishing Information Security Standards

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Security Standards B Appendix B to Part 170 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF... Part 170—Interagency Guidelines Establishing Information Security Standards Table of Contents I... Customer Information A. Information Security Program B. Objectives III. Development and Implementation of...

  9. 12 CFR Appendix B to Part 170 - Interagency Guidelines Establishing Information Security Standards

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Security Standards B Appendix B to Part 170 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF... Part 170—Interagency Guidelines Establishing Information Security Standards Table of Contents I... Customer Information A. Information Security Program B. Objectives III. Development and Implementation of...

  10. Developing and Using Ada Parts in Real-Time Embedded Applications

    DTIC Science & Technology

    1990-04-27

    ARCHTECTURAL DESIGN Guideline #3-a: Avoid duplication of data types packages. Guideline #3-b: Minimize variant proliferation. Concentrate on developing a...of SOFTWARE REUSE DEVELOPING and USING ADA PARTS in RTE APPUCATIONS ARCHTECTURAL DESIGN Table 5-10 illustrates the use of this more strongly data typed

  11. Assimilating evidence quality at a glance using graphic display: research synthesis on labor induction.

    PubMed

    Fox, Caroline E; Tirlapur, Seema A; Gülmezoglu, Ahmet Metin; Souza, João Paulo; Khan, Khalid S

    2012-08-01

    Evidence profiled in the World Health Organization induction of labor guideline extended to 84 tables and 116 pages, which is hard to assimilate. Summarizing this evidence graphically can present information on key outcomes succinctly, illustrating where the gaps, strengths and weaknesses lie. For induction of labor, graphic representation clearly showed that evidence was lacking on maternal complications when comparing oxytocin with other agents, evidence was strong on birth within 24 h when comparing vaginal prostaglandins with placebo or no treatment, but again it was weak on uterine hyperstimulation when comparing oxytocin with vaginal prostaglandins. These graphs/plots allow readers to capture the essence of the information gathered at a glance. The use of graphical displays when interpreting and publishing data on several comparisons and outcomes is encouraged. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

  12. Canadian HIV Pregnancy Planning Guidelines: No. 278, June 2012.

    PubMed

    Loutfy, Mona R; Margolese, Shari; Money, Deborah M; Gysler, Mathias; Hamilton, Scot; Yudin, Mark H

    2012-10-01

    Four main clinical issues need to be considered for HIV-positive individuals and couples with respect to pregnancy planning and counselling: (1) pre-conceptional health; (2) transmission from mother to infant, which has been significantly reduced by combined antiretroviral therapy; (3) transmission between partners during conception, which requires different prevention and treatment strategies depending on the status and needs of those involved; and (4) management of infertility issues. The objective of the Canadian HIV Pregnancy Planning Guidelines is to provide clinical information and recommendations for health care providers to assist HIV-positive individuals and couples with their fertility and pregnancy planning decisions. These guidelines are evidence- and community-based and flexible, and they take into account diverse and intersecting local/population needs and the social determinants of health. Intended outcomes are (1) reduction of risk of vertical transmission and horizontal transmission of HIV, (2) improvement of maternal and infant health outcomes in the presence of HIV, (3) reduction of the stigma associated with pregnancy and HIV, and (4) increased access to pregnancy planning and fertility services. PubMed and Medline were searched for articles published in English or French to December 20, 2010, using the following terms: "HIV" and "pregnancy" or "pregnancy planning" or "fertility" or "reproduction" or "infertility" or "parenthood" or "insemination" or "artificial insemination" or "sperm washing" or "IVF" or "ICSI" or "IUI." Other search terms included "HIV" and 'horizontal transmission" or "sexual transmission" or "serodiscordant." The following conference databases were also searched: Conference on Retroviruses and Opportunistic Infections, International AIDS Conference, International AIDS Society, Interscience Conference on Antimicrobial Agents and Chemotherapy, the Canadian Association of HIV/AIDS Research, and the Ontario HIV Treatment Network Research Conference. Finally, a hand search of key journals and conferences was performed, and references of retrieved articles were reviewed for additional citations. Subsequently, abstracts were categorized according to their primary topic (based on an outline of the guidelines) into table format with the following headings: author, title, study purpose, participants, results and general comments. Finally, experts in the field were consulted for their opinions as to whether any articles were missed. The quality of evidence was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care. Recommendations for practice were ranked according to the method described in that report (Table) and through use of the Appraisal of Guidelines Research and Evaluation instrument for the development of clinical guidelines. The Society of Obstetricians and Gynecologists of Canada, Women and HIV Research Program, Women's College Research Institute, Women's College Hospital, University of Toronto, Abbott Laboratories Canada, the Ontario HIV Treatment Network, the Canadian Institutes of Health Research, and the Canadian HIV Trials Network.

  13. Guidelines for Managing Suspected Chemical and Biological Agent Incidents in Rail Tunnel Systems

    DOT National Transportation Integrated Search

    2002-03-01

    These emergency management guidelines are designed to help transit managers (1) prepare and implement standard operating procedures (SOPs) for handling potential and actual chemical or biological agent attacks in their rail tunnel system and (2) unde...

  14. Pharmacological management of anticancer agent extravasation: A single institutional guideline.

    PubMed

    Kimmel, Jaime; Fleming, Patrick; Cuellar, Sandra; Anderson, Jennifer; Haaf, Christina Mactal

    2018-03-01

    Although the risk of extravasation of a chemotherapy (anticancer) medication is low, the complications associated with these events can have a significant impact on morbidity and health care costs. Institutions that administer anticancer agents should ideally have a current guideline on the proper management of the inadvertent administration of these toxic medications into tissues surrounding blood vessels. It is imperative that the health care team involved in administering drugs used to treat cancer be educated on the risk factors, preventative strategies and treatment of anticancer extravasations, as well as practice safe and proper administration techniques. Anticancer agents are generally divided into classes based on their ability to cause tissue damage. The review of current published guidelines and available literature reveals a lack of consensus on how these medications should be classified. In addition, many recently approved drugs for the treatment of cancer may lack data to support their classification and management of extravasation events. The treatment of the majority of extravasations of anticancer agents involves nonpharmacological measures, potentially in the ambulatory care setting. Antidotes are available for the extravasation of a minority of vesicant agents in order to mitigate tissue damage. Due to the limited data and lack of consensus in published guidelines, a working group was established to put forth an institutional guideline on the management of anticancer extravasations.

  15. Evaluation of risk assessment guideline levels for the chemical warfare agents mustard, GB, and VX.

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

    Hartmann, H.; Environmental Assessment

    2002-06-01

    The U.S. Army has estimated acute lethality guideline levels for inhalation of the chemical warfare agents mustard, GB, and VX. These levels are expressed as dosages measured in milligram-minutes per cubic meter (mg-min/m3). The National Advisory Council has also proposed acute emergency guideline levels (AEGLs) for the agents. The AEGLs are threshold exposure limits for the general public for mild effects, serious adverse effects, and lethality. They are expressed as air concentrations (in units of mg/m3) and are applicable to emergency exposure periods ranging from 10 min to 8 h. The report discusses strengths and deficiencies in the levels, importantmore » parameters (i.e., exposure time, breathing rate) that need to be explicitly addressed in deriving the guideline levels, and possible impacts that could result from using AEGLs instead of guideline dosages in future assessments.« less

  16. Preventive treatment in migraine and the new US guidelines

    PubMed Central

    Estemalik, E; Tepper, S

    2013-01-01

    Migraine headaches are among the most common headache disorders seen in various practices. The prevalence of migraine headaches is 18% in women and 6% in men. While millions of Americans suffer from migraine headaches, roughly 3%–13% of identified migraine patients are on preventive therapy, while an estimated 38% actually need a preventive agent. The challenge among physicians is not only when to start a daily preventive agent but which preventive agent to choose. Circumstances warranting prevention have been described in the past, and in 2012, a new set of guidelines with an evidence review on preventive medications was published. A second set of guidelines provided evidence on nonsteroidal anti-inflammatory drugs, herbs, minerals, and vitamins for prevention of episodic migraine. This article describes the updated US guidelines for the prevention of migraines and also outlines the major studies from which these guidelines were derived. PMID:23717045

  17. 40 CFR 455.42 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) The discharger will meet the requirements of the Pollution Prevention Alternative listed in Table 8 to... in Table 8 of this part 455); (2) The discharger will notify its NPDES permit writer at the time of... discharger will submit to its NPDES permitting authority a periodic certification statements as described in...

  18. 40 CFR 455.42 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...) The discharger will meet the requirements of the Pollution Prevention Alternative listed in Table 8 to... in Table 8 of this part 455); (2) The discharger will notify its NPDES permit writer at the time of... discharger will submit to its NPDES permitting authority a periodic certification statements as described in...

  19. 40 CFR 455.44 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...) The discharger will meet the requirements of the Pollution Prevention Alternative listed in Table 8 to... on Table 8 of this part 455); (2) The discharger will notify its NPDES permitting authority at the....41(a); (3) The discharger will submit to its NPDES permit writer a periodic certification statement...

  20. 40 CFR 455.43 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... meet the requirements of the Pollution Prevention Alternative listed in Table 8 to this part 455 (or received a modification by Best Professional Judgement for modifications not listed in Table 8 of this part... submit to its NPDES permitting authority a periodic certification statement as described in § 455.41(b...

  1. 40 CFR 455.44 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) The discharger will meet the requirements of the Pollution Prevention Alternative listed in Table 8 to... on Table 8 of this part 455); (2) The discharger will notify its NPDES permitting authority at the....41(a); (3) The discharger will submit to its NPDES permit writer a periodic certification statement...

  2. 40 CFR 455.42 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) The discharger will meet the requirements of the Pollution Prevention Alternative listed in Table 8 to... in Table 8 of this part 455); (2) The discharger will notify its NPDES permit writer at the time of... discharger will submit to its NPDES permitting authority a periodic certification statements as described in...

  3. 40 CFR 455.43 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... meet the requirements of the Pollution Prevention Alternative listed in Table 8 to this part 455 (or received a modification by Best Professional Judgement for modifications not listed in Table 8 of this part... submit to its NPDES permitting authority a periodic certification statement as described in § 455.41(b...

  4. 40 CFR 455.44 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) The discharger will meet the requirements of the Pollution Prevention Alternative listed in Table 8 to... on Table 8 of this part 455); (2) The discharger will notify its NPDES permitting authority at the....41(a); (3) The discharger will submit to its NPDES permit writer a periodic certification statement...

  5. 40 CFR 455.43 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... meet the requirements of the Pollution Prevention Alternative listed in Table 8 to this part 455 (or received a modification by Best Professional Judgement for modifications not listed in Table 8 of this part... submit to its NPDES permitting authority a periodic certification statement as described in § 455.41(b...

  6. 40 CFR Table 5 to Subpart Dddd of... - Model Rule-Summary of Reporting Requirements a

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false Model Rule-Summary of Reporting Requirements a 5 Table 5 to Subpart DDDD of Part 60 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial...

  7. 40 CFR Table 5 to Subpart Dddd of... - Model Rule-Summary of Reporting Requirements a

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 6 2011-07-01 2011-07-01 false Model Rule-Summary of Reporting Requirements a 5 Table 5 to Subpart DDDD of Part 60 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial...

  8. 40 CFR Table 4 to Subpart Mmmm of... - Model Rule-Operating Parameters for Existing Sewage Sludge Incineration Units a

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Existing Sewage Sludge Incineration Units a 4 Table 4 to Subpart MMMM of Part 60 Protection of Environment... SOURCES Emission Guidelines and Compliance Times for Existing Sewage Sludge Incineration Units Pt. 60... Sewage Sludge Incineration Units a For these operating parameters You must establish these operating...

  9. 40 CFR Table 4 to Subpart Mmmm of... - Model Rule-Operating Parameters for Existing Sewage Sludge Incineration Units a

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Existing Sewage Sludge Incineration Units a 4 Table 4 to Subpart MMMM of Part 60 Protection of Environment... SOURCES Emission Guidelines and Compliance Times for Existing Sewage Sludge Incineration Units Pt. 60... Sewage Sludge Incineration Units a For these operating parameters You must establish these operating...

  10. 30 CFR 203.84 - What is in a net revenue and relief justification report?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... cash flow data for 12 qualifying months, using the format specified in the “Guidelines for the...) The cash flow table you submit must include historical data for: (1) Lease production subject to...) Transportation and processing costs. (b) Do not include in your cash flow table the non-allowable costs listed at...

  11. 30 CFR 203.84 - What is in a net revenue and relief justification report?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... cash flow data for 12 qualifying months, using the format specified in the “Guidelines for the...) The cash flow table you submit must include historical data for: (1) Lease production subject to...) Transportation and processing costs. (b) Do not include in your cash flow table the non-allowable costs listed at...

  12. 30 CFR 203.84 - What is in a net revenue and relief justification report?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... cash flow data for 12 qualifying months, using the format specified in the “Guidelines for the...) The cash flow table you submit must include historical data for: (1) Lease production subject to...) Transportation and processing costs. (b) Do not include in your cash flow table the non-allowable costs listed at...

  13. 40 CFR Table 5 to Subpart Mmmm of... - Model Rule-Toxic Equivalency Factors

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 7 2013-07-01 2013-07-01 false Model Rule-Toxic Equivalency Factors 5 Table 5 to Subpart MMMM of Part 60 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines and Compliance Times for Existing Sewage Sludge...

  14. 40 CFR Table 5 to Subpart Mmmm of... - Model Rule-Toxic Equivalency Factors

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 7 2014-07-01 2014-07-01 false Model Rule-Toxic Equivalency Factors 5 Table 5 to Subpart MMMM of Part 60 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines and Compliance Times for Existing Sewage Sludge...

  15. 40 CFR Table 5 to Subpart Dddd of... - Model Rule-Summary of Reporting Requirements a

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 7 2013-07-01 2013-07-01 false Model Rule-Summary of Reporting Requirements a 5 Table 5 to Subpart DDDD of Part 60 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial...

  16. 40 CFR Table 5 to Subpart Dddd of... - Model Rule-Summary of Reporting Requirements a

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 7 2014-07-01 2014-07-01 false Model Rule-Summary of Reporting Requirements a 5 Table 5 to Subpart DDDD of Part 60 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial...

  17. 40 CFR Table 5 to Subpart Dddd of... - Model Rule-Summary of Reporting Requirements a

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 7 2012-07-01 2012-07-01 false Model Rule-Summary of Reporting Requirements a 5 Table 5 to Subpart DDDD of Part 60 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial...

  18. 30 CFR 203.84 - What is in a net revenue and relief justification report?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) Transportation and processing costs. (b) Do not include in your cash flow table the non-allowable costs listed at... cash flow data for 12 qualifying months, using the format specified in the “Guidelines for the... cash flow table you submit must include historical data for: (1) Lease production subject to royalty...

  19. Alternative Fuels Data Center

    Science.gov Websites

    Tables Fuel-Efficient Vehicle Acquisition Requirements The Maine State Purchasing Agent may not purchase purposes the State Purchasing Agent designates are exempt from this requirement. (Reference Maine Revised

  20. Teacher-Made Adapted Devices for Archery, Badminton, and Table Tennis.

    ERIC Educational Resources Information Center

    Cowart, Jim

    1978-01-01

    The newsletter offers guidelines for adapting physical education classes to meet the needs of handicapped students. Adaptations should be within a student's ability range, allow a student to participate within guidelines established by his/her physician, allow a student to participate in the development of an adaptation and be positive toward its…

  1. FAO/INFOODS Guidelines for Checking Food Composition Data Prior to the Publication of a User Table/Database, Version 1.0

    USDA-ARS?s Scientific Manuscript database

    Food composition data play an essential role in many sectors, including nutrition, health, agriculture, environment, food labeling and trade. Over the last 25 years, International Network of Food Data Systems (INFOODS) has developed many international standards, guidelines and tools to obtain harmo...

  2. Gap Between Official Guidelines and Clinical Practice for the Treatment of Rheumatoid Arthritis in São Paulo, Brazil.

    PubMed

    de Camargo, Iara Alves; Almeida Barros, Bruna Cipriano; do Nascimento Silveira, Miriam Sanches; Osorio-de-Castro, Claudia Garcia Serpa; Guyatt, Gordon; Lopes, Luciane Cruz

    2016-05-01

    Biological agents used for the treatment of rheumatoid arthritis (RA) are associated with serious adverse events. Guidelines provide standards for the prescribing and monitoring of these drugs. In São Paulo, health litigation for access to medicines has fueled the demand for biological therapy. The extent to which biological agents are being appropriately prescribed and patients are being appropriately monitored is uncertain. Our goal was to determine whether RA clinical guidelines are being translated into clinical practice for patients receiving treatment as a result of lawsuits against the government. We identified patients through records of the State Secretary of Health of São Paulo from 2003 to 2011. We consulted guidelines from 5 countries and chose those recommendations endorsed by all of the guidelines reviewed as standards. Pharmacy records provided data regarding biologic use. The guidelines recommended the use of biological agents only when patients had been receiving treatment with at least 1 disease-modifying antirheumatic drug (DMARD) and recommended annual monitoring of laboratory blood tests. Of the 238 patients identified in the database, 216 patients were interviewed, and 124 (57.4%) patients were still using biological agents at the time of the survey. Of the patients interviewed, 167 patients (77.3%) started biological treatment when using ≥2 DMARDs before, 22 patients (10.2%) were using 1 DMARD before, and 27 patients (12.5%) had never taken a DMARD. Of the 124 patients still taking biological drugs, 117 patients (94.3%) had visited a doctor at least once per year, but 28 patients (22.6%) did not undergo the recommended laboratory blood testing. Only 43 of the 124 patients (34.7%) still taking biological agents met the guideline criteria for both the use of previous agents and the appropriate monitoring. An important gap between clinical practice and the national guidelines exists among treatments prescribed for plaintiffs obtaining medicines for RA in São Paulo. The results suggest the need for intervention by health authorities. Copyright © 2016 Elsevier HS Journals, Inc. All rights reserved.

  3. 21 CFR 168.180 - Table sirup.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... percent soluble sweetener solids by weight and is prepared with or without added water. It may contain one..., or buffering agents. (11) Defoaming agents. (12) Any other ingredient (e.g., shredded coconut, ground...

  4. 21 CFR 168.180 - Table sirup.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... percent soluble sweetener solids by weight and is prepared with or without added water. It may contain one..., or buffering agents. (11) Defoaming agents. (12) Any other ingredient (e.g., shredded coconut, ground...

  5. 21 CFR 168.180 - Table sirup.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... percent soluble sweetener solids by weight and is prepared with or without added water. It may contain one..., or buffering agents. (11) Defoaming agents. (12) Any other ingredient (e.g., shredded coconut, ground...

  6. Nutrition Labeling and Portion Size Information on Children's Menus in Fast-Food and Table-Service Chain Restaurants in London, UK

    ERIC Educational Resources Information Center

    Reeves, Sue; Wake, Yvonne; Zick, Andrea

    2011-01-01

    Objective: To investigate meals, price, nutritional content, and nutrition and portion size information available on children's menus in fast-food and table-service chain restaurants in London, since the United Kingdom does not currently require such information but may be initiating a voluntary guideline. Methods: Children's menus were assessed…

  7. 40 CFR Table 4 to Subpart Bbbb of... - Model Rule-Class II Emission Limits for Existing Small Municipal Waste Combustion Unit a

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Existing Small Municipal Waste Combustion Unit a 4 Table 4 to Subpart BBBB of Part 60 Protection of... NEW STATIONARY SOURCES Emission Guidelines and Compliance Times for Small Municipal Waste Combustion... Part 60—Model Rule—Class II Emission Limits for Existing Small Municipal Waste Combustion Unit a For...

  8. 40 CFR Table 2 to Subpart Bbbb of... - Model Rule-Class I Emission Limits for Existing Small Municipal Waste Combustion Units a

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Existing Small Municipal Waste Combustion Units a 2 Table 2 to Subpart BBBB of Part 60 Protection of... NEW STATIONARY SOURCES Emission Guidelines and Compliance Times for Small Municipal Waste Combustion... Part 60—Model Rule—Class I Emission Limits for Existing Small Municipal Waste Combustion Units a For...

  9. 40 CFR Table 4 to Subpart Bbbb of... - Model Rule-Class II Emission Limits for Existing Small Municipal Waste Combustion Unit a

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Existing Small Municipal Waste Combustion Unit a 4 Table 4 to Subpart BBBB of Part 60 Protection of... NEW STATIONARY SOURCES Emission Guidelines and Compliance Times for Small Municipal Waste Combustion... Part 60—Model Rule—Class II Emission Limits for Existing Small Municipal Waste Combustion Unit a For...

  10. 40 CFR Table 4 to Subpart Bbbb of... - Model Rule-Class II Emission Limits for Existing Small Municipal Waste Combustion Unit a

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Existing Small Municipal Waste Combustion Unit a 4 Table 4 to Subpart BBBB of Part 60 Protection of... NEW STATIONARY SOURCES Emission Guidelines and Compliance Times for Small Municipal Waste Combustion... Part 60—Model Rule—Class II Emission Limits for Existing Small Municipal Waste Combustion Unit a For...

  11. 40 CFR Table 2 to Subpart Bbbb of... - Model Rule-Class I Emission Limits for Existing Small Municipal Waste Combustion Units a

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Existing Small Municipal Waste Combustion Units a 2 Table 2 to Subpart BBBB of Part 60 Protection of... NEW STATIONARY SOURCES Emission Guidelines and Compliance Times for Small Municipal Waste Combustion... Part 60—Model Rule—Class I Emission Limits for Existing Small Municipal Waste Combustion Units a For...

  12. 40 CFR Table 2 to Subpart Bbbb of... - Model Rule-Class I Emission Limits for Existing Small Municipal Waste Combustion Units a

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Existing Small Municipal Waste Combustion Units a 2 Table 2 to Subpart BBBB of Part 60 Protection of... NEW STATIONARY SOURCES Emission Guidelines and Compliance Times for Small Municipal Waste Combustion... Part 60—Model Rule—Class I Emission Limits for Existing Small Municipal Waste Combustion Units a For...

  13. 40 CFR Table 2 to Subpart Bbbb of... - Model Rule-Class I Emission Limits for Existing Small Municipal Waste Combustion Units a

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Existing Small Municipal Waste Combustion Units a 2 Table 2 to Subpart BBBB of Part 60 Protection of... NEW STATIONARY SOURCES Emission Guidelines and Compliance Times for Small Municipal Waste Combustion... Part 60—Model Rule—Class I Emission Limits for Existing Small Municipal Waste Combustion Units a For...

  14. 40 CFR Table 2 to Subpart Bbbb of... - Model Rule-Class I Emission Limits for Existing Small Municipal Waste Combustion Units a

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Existing Small Municipal Waste Combustion Units a 2 Table 2 to Subpart BBBB of Part 60 Protection of... NEW STATIONARY SOURCES Emission Guidelines and Compliance Times for Small Municipal Waste Combustion... Part 60—Model Rule—Class I Emission Limits for Existing Small Municipal Waste Combustion Units a For...

  15. 40 CFR Table 4 to Subpart Bbbb of... - Model Rule-Class II Emission Limits for Existing Small Municipal Waste Combustion Unit a

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Existing Small Municipal Waste Combustion Unit a 4 Table 4 to Subpart BBBB of Part 60 Protection of... NEW STATIONARY SOURCES Emission Guidelines and Compliance Times for Small Municipal Waste Combustion... Part 60—Model Rule—Class II Emission Limits for Existing Small Municipal Waste Combustion Unit a For...

  16. 40 CFR Table 4 to Subpart Bbbb of... - Model Rule-Class II Emission Limits for Existing Small Municipal Waste Combustion Unit a

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Existing Small Municipal Waste Combustion Unit a 4 Table 4 to Subpart BBBB of Part 60 Protection of... NEW STATIONARY SOURCES Emission Guidelines and Compliance Times for Small Municipal Waste Combustion... Part 60—Model Rule—Class II Emission Limits for Existing Small Municipal Waste Combustion Unit a For...

  17. Contamination of groundwater by outdoor highway deicing agent storage

    NASA Astrophysics Data System (ADS)

    Ostendorf, David W.; Hinlein, Erich S.; Rotaru, Camelia; DeGroot, Don J.

    2006-07-01

    This research quantifies the impact of outdoor highway deicing agent storage on groundwater quality. Data and theory realize the objective at a well characterized salt/premix storage facility on a glacial drumlin comprised of clayey sand till. Tritium and tritiogenic helium were observed in 17 monitoring wells in 2003, while chloride concentrations were measured in 43 monitoring wells from 1998 through 2004. The 3He/ 3H ratios confirm an analytical model of drumlin hydraulics (Ostendorf, D.W., DeGroot, D.J., Shelburne, W.M., and Mitchell, T.J., 2004. Hydraulic head in a clayey sand till over multiple timescales. Can. Geotech. J. 41, 89-105.), and support advective travel time estimates from the monitoring well screens back to the water table. An advective balance of recharge, precipitation, and surface runoff routes the water table Cl - concentrations inwards to the outdoor storage pile maintained at the site from the 1960s to the mid 1980s. Concentrations as high as 320 meq Cl -/L were observed in groundwater, although the deicing agent contamination had not yet reached the bottom of the drumlin in the study area. The travel time simulations yield a 200 meq Cl -/L water table isopleth in 1985 under the prior outdoor storage pile. The recharge concentration model matches the radial decrease of Cl - water table concentrations from the pile, and implies that 4400 kg of Cl - leached into the groundwater in 1985. This is about 0.3% of the deicing agent Cl - stored at the site each year. These results suggest that outdoor storage of highway deicing agents significantly impacted groundwater quality near the pile. The groundwater quality began to recover after source removal however: the leached Cl - flux dropped to 2,300 kg in 1992, more than 5 years after elimination of the outdoor storage pile.

  18. Irritable bowel syndrome--the main recommendations.

    PubMed

    Andresen, Viola; Keller, Jutta; Pehl, Christian; Schemann, Michael; Preiss, Jan; Layer, Peter

    2011-11-01

    Irritable bowel syndrome is characterized by chronic abdominal symptoms and irregular bowel movements without any cause than can be revealed by routine diagnostic assessment. In recent years, its pathophysiology has come to be much better understood, and new therapeutic approaches have been developed. These advances were taken into consideration and assessed for their relevance to clinical practice in the framework of a new interdisciplinary S3 guideline. A systematic search of the literature retrieved a total 5573 articles, from which 243 were selected on the basis of criteria relating to their form and content, individually assessed, and summarized in evidence tables. The recommendations formulated in this way were discussed in a Delphi procedure and a consensus conference, then accordingly modified and finalized. Variable symptom constellations are caused by disturbances of gastrointestinal regulation at multiple levels. The diagnosis of irritable bowel syndrome requires both chronic bowel symptoms that interfere with everyday life and the exclusion of relevant differential diagnoses. Its treatment is based on general therapeutic principles, dietary recommendations, psychological components, and symptomatic medication. Bulking agents, laxatives, spasmolytics, loperamide, and probiotic agents are recommended (with variable recommendation strengths), as are--for selected patients--antidepressants, 5-HT4 agonists, 5-HT3 antagonists, and topical antibiotics. The first German S3 guideline on irritable bowel syndrome translates up-to-date scientific knowledge as represented in current publications into concrete recommendations for diagnosis and treatment in clinical practice. In the future, it is likely that further causative pathophysiological mechanisms will be discovered; this should lead, in turn, to the development of new, causally directed treatments, which will supplement or replace the traditional, purely symptomatic treatments that are still in use today.

  19. The New Dietary Guidelines and Kids: Will They Sit at the Same Table?

    ERIC Educational Resources Information Center

    Merrill, Diana

    1997-01-01

    In November 1996, the American School Foodservice Association surveyed 600 school district food service directors to determine how meeting the new dietary guidelines for school lunch and breakfast programs would affect cost, student participation, and wasted food. Most directors felt that meal cost will rise and that including less popular foods…

  20. Antihypertensive prescribing--a survey of general practice supervisors and registrars.

    PubMed

    Eastman, Peter

    2008-11-01

    Hypertension is a common problem in general practice. Prescribing guidelines vary, but generally favour thiazide diuretics as first line treatment for uncomplicated essential hypertension. This study looks at antihypertensive prescribing habits of primary care practitioners and their knowledge of prescribing guideline recommendations. General practitioner supervisors and registrars from the Sydney Institute of General Practice Education and Training completed an online survey between April and July 2007. In response to a clinical vignette, participants indicated which agent they would use as first line therapy. In addition, they described what they knew about existing prescribing guidelines for essential hypertension. One hundred and thirty-eight surveys were sent and 31 were returned completed. Angiotensin converting enzyme inhibitors were favoured as first line agents. Most believed current guidelines recommend more than one class of antihypertensive agent as appropriate for the initiation of single agent therapy. Angiotensin converting enzyme inhibitors were nominated most often as first line treatments recommended by guidelines. The study is limited by a small sample size, a low response rate and the fact that participants all came from a similar location. Prescribing habits in the study group were not consistent with two out of three Australian guidelines on management of hypertension. Further research may allow generalisation to the wider Australian general practice community and indicate underlying reasons for this inconsistency. Hypertension management is an important educational topic for general practice registrars and GPs.

  1. World Health Organization Guidelines for treatment of cervical intraepithelial neoplasia 2-3 and screen-and-treat strategies to prevent cervical cancer.

    PubMed

    Santesso, Nancy; Mustafa, Reem A; Schünemann, Holger J; Arbyn, Marc; Blumenthal, Paul D; Cain, Joanna; Chirenje, Michael; Denny, Lynette; De Vuyst, Hugo; Eckert, Linda O'Neal; Forhan, Sara E; Franco, Eduardo L; Gage, Julia C; Garcia, Francisco; Herrero, Rolando; Jeronimo, José; Lu, Enriquito R; Luciani, Silvana; Quek, Swee Chong; Sankaranarayanan, Rengaswamy; Tsu, Vivien; Broutet, Nathalie

    2016-03-01

    It is estimated that 1%-2% of women develop cervical intraepithelial neoplasia grade 2-3 (CIN 2-3) annually worldwide. The prevalence among women living with HIV is higher, at 10%. If left untreated, CIN 2-3 can progress to cervical cancer. WHO has previously published guidelines for strategies to screen and treat precancerous cervical lesions and for treatment of histologically confirmed CIN 2-3. Guidelines were developed using the WHO Handbook for Guideline Development and the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach. A multidisciplinary guideline panel was created. Systematic reviews of randomized controlled trials and observational studies were conducted. Evidence tables and Evidence to Recommendations Tables were prepared and presented to the panel. There are nine recommendations for screen-and-treat strategies to prevent cervical cancer, including the HPV test, cytology, and visual inspection with acetic acid. There are seven for treatment of CIN with cryotherapy, loop electrosurgical excision procedure, and cold knife conization. Recommendations have been produced on the basis of the best available evidence. However, high-quality evidence was not available. Such evidence is needed, in particular for screen-and-treat strategies that are relevant to low- and middle-income countries. Copyright © 2015. Published by Elsevier Ireland Ltd.

  2. 21 CFR 178.3295 - Clarifying agents for polymers.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 3 2014-04-01 2014-04-01 false Clarifying agents for polymers. 178.3295 Section... Production Aids § 178.3295 Clarifying agents for polymers. Clarifying agents may be safely used in polymers... polymers contact food only of types I, II, IV-B, VI-B, VII-B, and VIII as identified in Table 1 of § 176...

  3. Symposium on Toxic Substance Control: Decontamination, April 22 - 24, 1980, Columbus, Ohio.

    DTIC Science & Technology

    1981-06-01

    standard decontaminants is used. TABLE 1. Standard Chemical Decontaminants Decontaminant Agents Used On STB Blister and nerve agents DS-2 All chemical... agents M258 Kit Sodium Hydroxide, Ethanol, G-Series nerve agents Phenol, Water Chloramine B, ZnCI2, Blister ana V-Series Ethanol, Water nerve agents A...is a point source alarm that actively samples ambient air and reacts to low concentrations of nerve agents . The M-8 alarm detector also detects several

  4. Construction, Analysis, and Data-Driven Augmentation of Supersaturated Designs

    DTIC Science & Technology

    2013-09-01

    guidelines and considerations. 27 Table 7. Supersaturated Design Example with 8 Runs and 14 Factors Design Factors Run x1 x2 x3 x4 x5 x6 x7 x8 x9 x10 x11...much larger than the guidelines proposed by Marley 55 and Woods (2010). They recommend the factor-to-run ratio should be less than 2. Because our ratio...established approach in experimental design: Box (1992) provided general guidelines to consider, and traditional augmentation strategies like fold-over

  5. International Continence Society guidelines on urodynamic equipment performance.

    PubMed

    Gammie, Andrew; Clarkson, Becky; Constantinou, Chris; Damaser, Margot; Drinnan, Michael; Geleijnse, Geert; Griffiths, Derek; Rosier, Peter; Schäfer, Werner; Van Mastrigt, Ron

    2014-04-01

    These guidelines provide benchmarks for the performance of urodynamic equipment, and have been developed by the International Continence Society to assist purchasing decisions, design requirements, and performance checks. The guidelines suggest ranges of specification for uroflowmetry, volume, pressure, and EMG measurement, along with recommendations for user interfaces and performance tests. Factors affecting measurement relating to the different technologies used are also described. Summary tables of essential and desirable features are included for ease of reference. It is emphasized that these guidelines can only contribute to good urodynamics if equipment is used properly, in accordance with good practice. © 2014 Wiley Periodicals, Inc.

  6. 33 CFR Appendix C to Part 154 - Guidelines for Determining and Evaluating Required Response Resources for Facility Response Plans

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... plan must be designed to operate in the conditions expected in the facility's geographic area. These... handling, storing, or transporting oil in more than one operating environment as indicated in Table 1 of... § 154.106), or other tests approved by the Coast Guard. 2.4Table 1 of this appendix lists criteria for...

  7. 33 CFR Appendix C to Part 154 - Guidelines for Determining and Evaluating Required Response Resources for Facility Response Plans

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... plan must be designed to operate in the conditions expected in the facility's geographic area. These... handling, storing, or transporting oil in more than one operating environment as indicated in Table 1 of... § 154.106), or other tests approved by the Coast Guard. 2.4Table 1 of this appendix lists criteria for...

  8. 40 CFR Table 5 to Part 455 - BAT and NSPS Effluent Limitations for Priority Pollutants for Direct Discharge Point Sources That...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 30 2011-07-01 2011-07-01 false BAT and NSPS Effluent Limitations for Priority Pollutants for Direct Discharge Point Sources That Do Not Use End-of-Pipe Biological Treatment 5 Table 5 to Part 455 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS PESTICIDE CHEMICALS...

  9. 40 CFR Table 5 to Part 455 - BAT and NSPS Effluent Limitations for Priority Pollutants for Direct Discharge Point Sources That...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 29 2010-07-01 2010-07-01 false BAT and NSPS Effluent Limitations for Priority Pollutants for Direct Discharge Point Sources That Do Not Use End-of-Pipe Biological Treatment 5 Table 5 to Part 455 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS PESTICIDE CHEMICALS...

  10. 40 CFR Table 5 to Part 455 - BAT and NSPS Effluent Limitations for Priority Pollutants for Direct Discharge Point Sources That...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 30 2014-07-01 2014-07-01 false BAT and NSPS Effluent Limitations for Priority Pollutants for Direct Discharge Point Sources That Do Not Use End-of-Pipe Biological Treatment 5 Table 5 to Part 455 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED)...

  11. 40 CFR Table 5 to Part 455 - BAT and NSPS Effluent Limitations for Priority Pollutants for Direct Discharge Point Sources That...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 31 2012-07-01 2012-07-01 false BAT and NSPS Effluent Limitations for Priority Pollutants for Direct Discharge Point Sources That Do Not Use End-of-Pipe Biological Treatment 5 Table 5 to Part 455 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED)...

  12. 40 CFR Table 5 to Part 455 - BAT and NSPS Effluent Limitations for Priority Pollutants for Direct Discharge Point Sources That...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 31 2013-07-01 2013-07-01 false BAT and NSPS Effluent Limitations for Priority Pollutants for Direct Discharge Point Sources That Do Not Use End-of-Pipe Biological Treatment 5 Table 5 to Part 455 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED)...

  13. 78 FR 67303 - Americans With Disabilities Act (ADA) Accessibility Guidelines for Buildings and Facilities...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-12

    ... continuing on page 59501, in the first column, Table 208.2--PARKING SPACES is corrected to read as follows: Table 208.2--Parking Spaces Total number of parking spaces provided in Minimum number of required parking facility accessible parking spaces 1 to 25 1. 26 to 50 2. 51 to 75 3. 76 to 100 4. 101 to 150 5...

  14. Anticlotting agents and the surgical management of glaucoma.

    PubMed

    Sozeri, Yasemin; Salim, Sarwat

    2018-03-01

    A large subset of patients with glaucoma uses anticlotting agents. No standardized guidelines currently exist for managing these agents in the specific perioperative setting of glaucoma surgery. The present review focuses on currently available anticlotting agents, their influence on hemorrhagic complications following glaucoma surgery, and management strategies for their use in the perioperative period RECENT FINDINGS: Anticlotting agents increase the risk of perioperative hemorrhagic complications following glaucoma surgery. Other factors that increase that risk have been identified as well, including the type of glaucoma surgery, preoperative intraocular pressure, postoperative hypotony, previous ocular surgeries, and race. Although general guidelines in the perioperative management of blood thinning agents exist, the best way to apply these guidelines specifically to glaucoma surgery remains unclear. Blood thinners are widely used and can increase the risk of hemorrhagic complications in patients undergoing glaucoma surgery. Managing these agents in the perioperative setting is challenging and should be done in collaboration with the patient's primary care provider, hematologist, or cardiologist. Management strategies should be tailored to each individual's risk of hemorrhage versus thromboembolism. Additionally, surgical plans can be modified to help minimize hemorrhagic outcomes, especially in patients who are deemed to be at high risk for perioperative bleeding.

  15. Cloth-covered chiropractic treatment tables as a source of allergens and pathogenic microbes.

    PubMed

    Evans, Marion W; Campbell, Alan; Husbands, Chris; Breshears, Jennell; Ndetan, Harrison; Rupert, Ronald

    2008-03-01

    Vinyl chiropractic tables have been found to harbor pathogenic bacteria, but wiping with a simple disinfection agent can significantly reduce the risk of bacteria. The aim of this study was to assess the presence of microbes and other allergens or pathogens on cloth chiropractic tables. Cloth-covered tables in a chiropractic college teaching clinic were selected. Samples were taken from the facial piece and hand rests with RODAC plates containing nutrient agar, followed by confirmatory testing when indicated. Numerous microbacteria strains were found, including Staphylococcus aureus and Propionibacterium. Allergen-producing molds, including Candida, were also found. Cloth tables were shown to contain pathogenic microbacteria and allergens. The chiropractic profession should establish an infection control protocol relevant to treatment tables and discard use of cloth-covered treatment tables in this process.

  16. 75 FR 22400 - Draft Test Guidelines; Reopening of Comment Period

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-28

    ... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-OPP-2009-0681; FRL-8822-3] Draft Test Guidelines... draft test guidelines for product performance of public health uses of antimicrobial agents. EPA...-8437-2). In that document, EPA announced the availability of four draft test guidelines for product...

  17. 77 FR 15750 - Final Test Guidelines; OCSPP 810 Series; Notice of Availability

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-16

    ... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-OPP-2009-0681; FRL-9332-4] Final Test Guidelines; OCSPP.... SUMMARY: EPA is announcing the availability of the final test guidelines for Series 810--Product Performance Test Guidelines, specifically public health uses of antimicrobial agents (OCSPP 810.2000...

  18. 40 CFR 158.2082 - Experimental use permit biochemical pesticides residue data requirements table.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... biochemical agents in the biochemical human health assessment data requirements, § 158.2050. 2. The same... human or livestock consumption. 12. Data on fish are required for all pesticides applied directly to... pesticides residue data requirements table. 158.2082 Section 158.2082 Protection of Environment ENVIRONMENTAL...

  19. 40 CFR 158.2082 - Experimental use permit biochemical pesticides residue data requirements table.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... biochemical agents in the biochemical human health assessment data requirements, § 158.2050. 2. The same... human or livestock consumption. 12. Data on fish are required for all pesticides applied directly to... pesticides residue data requirements table. 158.2082 Section 158.2082 Protection of Environment ENVIRONMENTAL...

  20. 40 CFR 158.2082 - Experimental use permit biochemical pesticides residue data requirements table.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... biochemical agents in the biochemical human health assessment data requirements, § 158.2050. 2. The same... human or livestock consumption. 12. Data on fish are required for all pesticides applied directly to... pesticides residue data requirements table. 158.2082 Section 158.2082 Protection of Environment ENVIRONMENTAL...

  1. 40 CFR 158.2082 - Experimental use permit biochemical pesticides residue data requirements table.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... biochemical agents in the biochemical human health assessment data requirements, § 158.2050. 2. The same... human or livestock consumption. 12. Data on fish are required for all pesticides applied directly to... pesticides residue data requirements table. 158.2082 Section 158.2082 Protection of Environment ENVIRONMENTAL...

  2. 40 CFR 158.2082 - Experimental use permit biochemical pesticides residue data requirements table.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... biochemical agents in the biochemical human health assessment data requirements, § 158.2050. 2. The same... human or livestock consumption. 12. Data on fish are required for all pesticides applied directly to... pesticides residue data requirements table. 158.2082 Section 158.2082 Protection of Environment ENVIRONMENTAL...

  3. Detection and molecular characterization of Methicillin Resistant Staphylococcus aureus from table eggs

    USDA-ARS?s Scientific Manuscript database

    Background: Table eggs are nutritionally important food consumed globally. Despite being protected inside the hard shell and a semi-permeable membrane, the egg contents may be contaminated with microbes and thus become a possible carrier of infectious agents to humans. A number of medically signific...

  4. Detection and molecular characterization of methicillin resistant Staphylococcus aureus from table eggs

    USDA-ARS?s Scientific Manuscript database

    Table eggs are nutritionally important food consumed globally. Despite being protected inside the hard shell and a semi-permeable membrane, the egg contents may be contaminated with microbes and thus become a possible carrier of infectious agents to humans. A number of medically significant bacteria...

  5. 76 FR 57031 - Draft Harmonized Test Guidelines; Notice of Availability and Request for Comments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-15

    ...EPA is announcing the availability of the draft test guidelines for Series 810--Product Performance Test Guidelines for Public Health Uses of Antimicrobial Agents, concerning specifically air, textiles, and water.

  6. Library Journals: How to Edit Them--Guidelines Prepared for the IFLA Round Table of Editors of Library Journals. IFLA Professional Reports No. 13.

    ERIC Educational Resources Information Center

    Borchardt, Dietrich H.

    Developed as the direct result of the August 1982, International Federation of Library Associations (IFLA) Seminar on Better Journals for the Library Profession held in Montreal, Canada, this report is designed to provide broad guidelines for the editors of library journals through an examination of the fundamental problems of editing journals for…

  7. Guidelines for the Prevention of Infections Associated With Combat-Related Injuries: 2011 Update

    DTIC Science & Technology

    2011-08-01

    of information, including suggestions for reducing this burden, to Washington Headquarters Services , Directorate for Information Operations and...Infectious Disease Service (MCHE-MDI),3851 Roger Brooke Drive,Fort Sam Houston,TX,78234 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING...Guidelines TABLE 1. GRADE* Systematic Weighting of the Quality of Evidence and Grading of Recommendations Strength of Recommendation and Quality of

  8. Saudi lung cancer management guidelines 2017

    PubMed Central

    Jazieh, Abdul Rahman; Al Kattan, Khaled; Bamousa, Ahmed; Al Olayan, Ashwaq; Abdelwarith, Ahmed; Ansari, Jawaher; Al Twairqi, Abdullah; Al Fayea, Turki; Al Saleh, Khalid; Al Husaini, Hamed; Abdelhafiez, Nafisa; Mahrous, Mervat; Faris, Medhat; Al Omair, Ameen; Hebshi, Adnan; Al Shehri, Salem; Al Dayel, Foad; Bamefleh, Hanaa; Khalbuss, Walid; Al Ghanem, Sarah; Loutfi, Shukri; Khankan, Azzam; Al Rujaib, Meshael; Al Ghamdi, Majed; Ibrahim, Nagwa; Swied, Abdulmonem; Al Kayait, Mohammad; Datario, Marie

    2017-01-01

    BACKGROUND: Lung cancer management is getting more complex due to the rapid advances in all aspects of diagnostic and therapeutic options. Developing guidelines is critical to help practitioners provide standard of care. METHODS: The Saudi Lung Cancer Guidelines Committee (SLCGC) multidisciplinary members from different specialties and from various regions and healthcare sectors of the country reviewed and updated all lung cancer guidelines with appropriate labeling of level of evidence. Supporting documents to help healthcare professionals were developed. RESULTS: Detailed lung cancer management guidelines were finalized with appropriate resources for systemic therapy and short reviews highlighting important issues. Stage based disease management recommendation were included. A summary explanation for complex topics were included in addition to tables of approved systemic therapy. CONCLUSION: A multidisciplinary lung cancer guidelines was developed and will be disseminated across the country. PMID:29118855

  9. Saudi lung cancer management guidelines 2017.

    PubMed

    Jazieh, Abdul Rahman; Al Kattan, Khaled; Bamousa, Ahmed; Al Olayan, Ashwaq; Abdelwarith, Ahmed; Ansari, Jawaher; Al Twairqi, Abdullah; Al Fayea, Turki; Al Saleh, Khalid; Al Husaini, Hamed; Abdelhafiez, Nafisa; Mahrous, Mervat; Faris, Medhat; Al Omair, Ameen; Hebshi, Adnan; Al Shehri, Salem; Al Dayel, Foad; Bamefleh, Hanaa; Khalbuss, Walid; Al Ghanem, Sarah; Loutfi, Shukri; Khankan, Azzam; Al Rujaib, Meshael; Al Ghamdi, Majed; Ibrahim, Nagwa; Swied, Abdulmonem; Al Kayait, Mohammad; Datario, Marie

    2017-01-01

    Lung cancer management is getting more complex due to the rapid advances in all aspects of diagnostic and therapeutic options. Developing guidelines is critical to help practitioners provide standard of care. The Saudi Lung Cancer Guidelines Committee (SLCGC) multidisciplinary members from different specialties and from various regions and healthcare sectors of the country reviewed and updated all lung cancer guidelines with appropriate labeling of level of evidence. Supporting documents to help healthcare professionals were developed. Detailed lung cancer management guidelines were finalized with appropriate resources for systemic therapy and short reviews highlighting important issues. Stage based disease management recommendation were included. A summary explanation for complex topics were included in addition to tables of approved systemic therapy. A multidisciplinary lung cancer guidelines was developed and will be disseminated across the country.

  10. Characteristics of Tables for Disseminating Biobehavioral Results.

    PubMed

    Schneider, Barbara St Pierre; Nagelhout, Ed; Feng, Du

    2018-01-01

    To report the complexity and richness of study variables within biological nursing research, authors often use tables; however, the ease with which consumers understand, synthesize, evaluate, and build upon findings depends partly upon table design. To assess and compare table characteristics within research and review articles published in Biological Research for Nursing and Nursing Research. A total of 10 elements in tables from 48 biobehavioral or biological research or review articles were analyzed. To test six hypotheses, a two-level hierarchical linear model was used for each of the continuous table elements, and a two-level hierarchical generalized linear model was used for each of the categorical table elements. Additionally, the inclusion of probability values in statistical tables was examined. The mean number of tables per article was 3. Tables in research articles were more likely to contain quantitative content, while tables in review articles were more likely to contain both quantitative and qualitative content. Tables in research articles had a greater number of rows, columns, and column-heading levels than tables in review articles. More than one half of statistical tables in research articles had a separate probability column or had probability values within the table, whereas approximately one fourth had probability notes. Authors and journal editorial staff may be generating tables that better depict biobehavioral content than those identified in specific style guidelines. However, authors and journal editorial staff may want to consider table design in terms of audience, including alternative visual displays.

  11. [A general description of the clinical guideline for the management of febrile neutropenia].

    PubMed

    Takamatsu, Yasushi

    2013-06-01

    The most serious adverse event in cancer patients who receive anti-neoplastic agents is febrile neutropenia(FN). The clinical guideline for the use of antimicrobial agents in managing patients with FN was published by the Infectious Diseases Society of America. However, the dosage and administration of antimicrobial agents are not completely adapted for Japanese insurance coverage. The Japanese Society of Medical Oncology therefore decided to develop a clinical guideline for the management of FN in Japanese patients. In this study, we provide a general description of the guideline. According to the guideline, fever is defined as a single axillary temperature of B37. 5°C(or an oral temperature of B38°C)and neutropenia is defined as a neutrophil count of <500/mL or <1, 000/mL if the count is expected to decrease to <500/mL within the next 48 h. In patients who develop FN, empirical anti-pseudomonal b-lactam agent monotherapy should be administered promptly at the onset of fever. Antibiotic therapy should continue until patients become afebrile and their neutrophil counts recover to B500/mL. If fever persists for 4-7 days under antibiotic therapy in high-risk patients, empirical antifungal therapy should be considered. Granulocyte colony-stimulating factor prophylaxis should be considered for high-risk patients with an anticipated risk of FN of B20%.

  12. Management of stable angina: A commentary on the European Society of Cardiology guidelines.

    PubMed

    Ambrosio, Giuseppe; Mugelli, Alessandro; Lopez-Sendón, José; Tamargo, Juan; Camm, John

    2016-09-01

    In 2013 the European Society of Cardiology (ESC) released new guidelines on the management of stable coronary artery disease. These guidelines update and replace the previous ESC guidelines on the management of stable angina pectoris, issued in 2006. There are several new aspects in the 2013 ESC guidelines compared with the 2006 version. This opinion paper provides an in-depth interpretation of the ESC guidelines with regard to these issues, to help physicians in making evidence-based therapeutic choices in their routine clinical practice. The first new element is the definition of stable coronary artery disease itself, which has now broadened from a 'simple' symptom, angina pectoris, to a more complex disease that can even be asymptomatic. In the first-line setting, the major changes in the new guidelines are the upgrading of calcium channel blockers, the distinction between dihydropyridines and non-dihydropyridine calcium channel blockers, and the presence of important statements regarding the combination of calcium channel blockers with beta-blockers. In the second-line setting, the 2013 ESC guidelines recommend the addition of long-acting nitrates, ivabradine, nicorandil or ranolazine to first-line agents. Trimetazidine may also be considered. However, no clear distinction is made among different second-line drugs, despite different quality of evidence in favour of these agents. For example, the use of ranolazine is supported by strong and recent evidence, while data supporting the use of the traditional agents appear relatively scanty. © The European Society of Cardiology 2016.

  13. 40 CFR 455.47 - Pretreatment standards for new sources (PSNS).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) EFFLUENT GUIDELINES AND STANDARDS PESTICIDE CHEMICALS Pesticide Chemicals Formulating and Packaging... Best Engineering Judgement for modifications not listed in Table 8 to this part 455); (2) The...

  14. 40 CFR 455.47 - Pretreatment standards for new sources (PSNS).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) EFFLUENT GUIDELINES AND STANDARDS PESTICIDE CHEMICALS Pesticide Chemicals Formulating and Packaging... Best Engineering Judgement for modifications not listed in Table 8 to this part 455); (2) The...

  15. Cloth-covered chiropractic treatment tables as a source of allergens and pathogenic microbes☆

    PubMed Central

    Evans, Marion W.; Campbell, Alan; Husbands, Chris; Breshears, Jennell; Ndetan, Harrison; Rupert, Ronald

    2008-01-01

    Abstract Objective Vinyl chiropractic tables have been found to harbor pathogenic bacteria, but wiping with a simple disinfection agent can significantly reduce the risk of bacteria. The aim of this study was to assess the presence of microbes and other allergens or pathogens on cloth chiropractic tables. Methods Cloth-covered tables in a chiropractic college teaching clinic were selected. Samples were taken from the facial piece and hand rests with RODAC plates containing nutrient agar, followed by confirmatory testing when indicated. Results Numerous microbacteria strains were found, including Staphylococcus aureus and Propionibacterium. Allergen-producing molds, including Candida, were also found. Conclusion Cloth tables were shown to contain pathogenic microbacteria and allergens. The chiropractic profession should establish an infection control protocol relevant to treatment tables and discard use of cloth-covered treatment tables in this process. PMID:19674718

  16. Risk Assessment

    EPA Pesticide Factsheets

    How the EPA conducts risk assessment to protect human health and the environment. Several assessments are included with the guidelines, models, databases, state-based RSL Tables, local contacts and framework documents used to perform these assessments.

  17. 40 CFR 455.46 - Pretreatment standards for existing sources (PSES).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) PESTICIDE CHEMICALS Pesticide Chemicals Formulating and... listed in Table 8 to this part 455 (or received a modification by Best Engineering Judgement for...

  18. 40 CFR 455.46 - Pretreatment standards for existing sources (PSES).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) EFFLUENT GUIDELINES AND STANDARDS PESTICIDE CHEMICALS Pesticide Chemicals Formulating and Packaging... listed in Table 8 to this part 455 (or received a modification by Best Engineering Judgement for...

  19. 40 CFR 455.47 - Pretreatment standards for new sources (PSNS).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) PESTICIDE CHEMICALS Pesticide Chemicals Formulating and... received a modification by Best Engineering Judgement for modifications not listed in Table 8 to this part...

  20. 40 CFR 455.46 - Pretreatment standards for existing sources (PSES).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) PESTICIDE CHEMICALS Pesticide Chemicals Formulating and... listed in Table 8 to this part 455 (or received a modification by Best Engineering Judgement for...

  1. 40 CFR 455.47 - Pretreatment standards for new sources (PSNS).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) PESTICIDE CHEMICALS Pesticide Chemicals Formulating and... received a modification by Best Engineering Judgement for modifications not listed in Table 8 to this part...

  2. 40 CFR 455.46 - Pretreatment standards for existing sources (PSES).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) EFFLUENT GUIDELINES AND STANDARDS PESTICIDE CHEMICALS Pesticide Chemicals Formulating and Packaging... listed in Table 8 to this part 455 (or received a modification by Best Engineering Judgement for...

  3. Assessment of the impacts of pit latrines on groundwater quality in rural areas: A case study from Marondera district, Zimbabwe

    NASA Astrophysics Data System (ADS)

    Dzwairo, Bloodless; Hoko, Zvikomborero; Love, David; Guzha, Edward

    In resource-poor and low-population-density areas, on-site sanitation is preferred to off-site sanitation and groundwater is the main source of water for domestic uses. Groundwater pollution potential from on-site sanitation in such areas conflicts with Integrated Water Resources Management (IWRM) principles that advocate for sustainable use of water resources. Given the widespread use of groundwater for domestic purposes in rural areas, maintaining groundwater quality is a critical livelihood intervention. This study assessed impacts of pit latrines on groundwater quality in Kamangira village, Marondera district, Zimbabwe. Groundwater samples from 14 monitoring boreholes and 3 shallow wells were analysed during 6 sampling campaigns, from February 2005 to May 2005. Parameters analysed were total and faecal coliforms, NH4+-N, NO3--N, conductivity, turbidity and pH, both for boreholes and shallow wells. Total and faecal coliforms both ranged 0-TNTC (too-numerous-to-count), 78% of results meeting the 0 CFU/100 ml WHO guidelines value. NH4+-N range was 0-2.0 mg/l, with 99% of results falling below the 1.5 mg/l WHO recommended value. NO3--N range was 0.0-6.7 mg/l, within 10 mg/l WHO guidelines value. The range for conductivity values was 46-370 μS/cm while the pH range was 6.8-7.9. There are no WHO guideline values for these two parameters. Turbidity ranged from 1 NTU to 45 NTU, 59% of results meeting the 5 NTU WHO guidelines limit. Depth from the ground surface to the water table for the period February 2005 to May 2005 was determined for all sampling points using a tape measure. The drop in water table averaged from 1.1 m to 1.9 m and these values were obtained by subtracting water table elevations from absolute ground surface elevation. Soil from the monitoring boreholes was classified as sandy. The soil infiltration layer was taken as the layer between the pit latrine bottom and the water table. It averaged from 1.3 m to 1.7 m above the water table for two latrines and 2-3.2 m below it for one pit latrine. A questionnaire survey revealed the prevalence of diarrhoea and structural failure of latrines. Results indicated that pit latrines were microbiologically impacting on groundwater quality up to 25 m lateral distance. Nitrogen values were of no immediate threat to health. The shallow water table increased pollution potential from pit latrines. Raised and lined pit latrines and other low-cost technologies should be considered to minimize potential of groundwater pollution.

  4. Radio Frequency Signal Reception Via Distributed Wirelessly Networked Sensors Under Random Motion

    DTIC Science & Technology

    2009-09-01

    100. Agent position in Pythagoras modeling in first phase level showing individual unit member interaction where each dot is an individual agent...181 Figure 101. Detail position in Pythagoras modeling in second phase showing detail group interaction where each blue dot is a unit...Table 5. Estimated reset time values and associated change percentage from Pythagoras agent motion

  5. [Revised Japanese guidelines for the clinical management of bacterial meningitis].

    PubMed

    Ishikawa, Harumi; Kamei, Satoshi

    2014-01-01

    Improvement of outcomes represents the most important problem in the treatment of bacterial meningitis. To achieve such improvement, revision of the guidelines for the clinical management of bacterial meningitis in Japan has been carried out, and these revised Japanese guidelines will soon be published. The choice of specific antimicrobial agents for initial treatment in bacterial meningitis is influenced by a number of factors, including patient age, systemic symptoms, and local patterns of bacterial resistance. In the revised Japanese guidelines, antimicrobial agents based on current knowledge of the epidemiology in Japan are recommended. Bacterial meningitis is a medical emergency, and patients with this disease require immediate medical assessment and appropriate treatment. Rapid diagnosis and treatment of bacterial meningitis reduces mortality and neurological sequelae. We describe the revised Japanese guidelines for the clinical management of bacterial meningitis 2014, with a focus on adults.

  6. [Graphic synopsis of implementation of German guideline clearing reports in national disease management guidelines].

    PubMed

    Thole, Henning

    2011-01-01

    While methods for the production of guidelines (evidence analysis, assessment, adaptation) have been continually refined throughout the past years, there is a lack of instruments for the production of easily understandable synopses. Definition of a methodological approach to encompass synopses by Spidernet diagrams. Tables of synopses can be generated with distinct information to bring down the main results in one Spidernet diagram. This is possible for both the entire synopsis and parts of it. Guideline comparisons require detailed analyses on the one hand and easily understandable presentations of their results on the other. Guideline synopses can be substantially supported by graphic presentation of the results of synopsis. Graphic synopsis is also helpful in other cases; it may be used, for example, to summarise HTA reports, systematic reviews or guidelines. Copyright © 2011. Published by Elsevier GmbH.

  7. Seismic verification of nuclear plant equipment anchorage: Volume 2, Anchorage inspection workbook: Final report

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

    Czarnecki, R M

    1987-05-01

    Guidelines have been developed to evaluate the seismic adequacy of the anchorage of various classes of electrical and mechanical equipment in nuclear power plants covered by NRC Unresolved Safety Issue A-46. The guidelines consist of screening tables that give the seismic anchorage capacity as a function of key equipment and anchorage fasteners, inspection checklists for field verification of anchorage adequacy, and provisions for outliers that can be used to further investigate anchorages that cannot be verified in the field. The screening tables are based on an analysis of the anchorage forces developed by common equipment types and on strength criteriamore » to quantify the holding power of anchor bolts and welds. The strength criteria for expansion anchor bolts were developed by collecting and analyzing a large quantity of test data.« less

  8. DEVELOPMENTAL NEUROTOXICITY TESTING GUIDELINES: A QUALIFICATIVE RETROSPECTIVE ANALYSIS OF POSITIVE CONTROL DATA.

    EPA Science Inventory

    The USEPA Developmental Neurotoxicity (DNT) Study Test Guideline calls for both functional and neuropathological assessments in offspring during and following maternal exposure. This guideline also requires data from positive control (PC) agents. Submission of these data permit e...

  9. Group Care for Young Children: Considerations for Child Care and Health Professionals, Public Policy Makers, and Parents. Pediatric Round Table: 12. Summary of a Conference (Key Biscayne, Florida, October 1986).

    ERIC Educational Resources Information Center

    Gunzenhauser, Nina, Ed.; Caldwell, Bettye M., Ed.

    Participants in this pediatric round table met to (l) detrivialize child care; (2) advance the concept of child care as a continuum of services; (3) establish the role of health care professionals in the design and implementation of high quality child care; and (4) develop action guidelines for use by professionals attempting to provide high…

  10. New medicinal products for chronic heart failure: advances in clinical trial design and efficacy assessment.

    PubMed

    Cowie, Martin R; Filippatos, Gerasimos S; Alonso Garcia, Maria de Los Angeles; Anker, Stefan D; Baczynska, Anna; Bloomfield, Daniel M; Borentain, Maria; Bruins Slot, Karsten; Cronin, Maureen; Doevendans, Pieter A; El-Gazayerly, Amany; Gimpelewicz, Claudio; Honarpour, Narimon; Janmohamed, Salim; Janssen, Heidi; Kim, Albert M; Lautsch, Dominik; Laws, Ian; Lefkowitz, Martin; Lopez-Sendon, Jose; Lyon, Alexander R; Malik, Fady I; McMurray, John J V; Metra, Marco; Figueroa Perez, Santiago; Pfeffer, Marc A; Pocock, Stuart J; Ponikowski, Piotr; Prasad, Krishna; Richard-Lordereau, Isabelle; Roessig, Lothar; Rosano, Giuseppe M C; Sherman, Warren; Stough, Wendy Gattis; Swedberg, Karl; Tyl, Benoit; Zannad, Faiez; Boulton, Caroline; De Graeff, Pieter

    2017-06-01

    Despite the availability of a number of different classes of therapeutic agents with proven efficacy in heart failure, the clinical course of heart failure patients is characterized by a reduction in life expectancy, a progressive decline in health-related quality of life and functional status, as well as a high risk of hospitalization. New approaches are needed to address the unmet medical needs of this patient population. The European Medicines Agency (EMA) is undertaking a revision of its Guideline on Clinical Investigation of Medicinal Products for the Treatment of Chronic Heart Failure. The draft version of the Guideline was released for public consultation in January 2016. The Cardiovascular Round Table of the European Society of Cardiology (ESC), in partnership with the Heart Failure Association of the ESC, convened a dedicated two-day workshop to discuss three main topic areas of major interest in the field and addressed in this draft EMA guideline: (i) assessment of efficacy (i.e. endpoint selection and statistical analysis); (ii) clinical trial design (i.e. issues pertaining to patient population, optimal medical therapy, run-in period); and (iii) research approaches for testing novel therapeutic principles (i.e. cell therapy). This paper summarizes the key outputs from the workshop, reviews areas of expert consensus, and identifies gaps that require further research or discussion. Collaboration between regulators, industry, clinical trialists, cardiologists, health technology assessment bodies, payers, and patient organizations is critical to address the ongoing challenge of heart failure and to ensure the development and market access of new therapeutics in a scientifically robust, practical and safe way. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

  11. 40 CFR 414.41 - Effluent limitations representing the degree of effluent reduction attainable by the application...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS ORGANIC CHEMICALS, PLASTICS, AND SYNTHETIC FIBERS Thermoplastic... concentration listed in the following table. Effluent characteristics BPT Effluent Limitations 1 Maximum for any...

  12. 40 CFR 414.51 - Effluent limitations representing the degree of effluent reduction attainable by the application...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS ORGANIC CHEMICALS, PLASTICS, AND SYNTHETIC FIBERS Thermosetting... concentration listed in the following table. Effluent characteristics BPT effluent limitations 1 Maximum for any...

  13. Thermophysical Properties of Selected Aerospace Materials. Part 1. Thermal Radiative Properties

    DTIC Science & Technology

    1976-01-01

    discusses the available data and information, the theoretical guidelines and other factors on which the critical evaluation, analysis, and synthesis of...text and a specification table. The former reviews and discusses the available data and information, the theoretical guidelines and other factors on...conditions 6’ Zenith angle for viewing conditions A6 Half angle of acceptance of optical system K Loss value factor X Wavelength p Reflectance p

  14. Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of adult isthmic spondylolisthesis.

    PubMed

    Kreiner, D Scott; Baisden, Jamie; Mazanec, Daniel J; Patel, Rakesh D; Bess, Robert S; Burton, Douglas; Chutkan, Norman B; Cohen, Bernard A; Crawford, Charles H; Ghiselli, Gary; Hanna, Amgad S; Hwang, Steven W; Kilincer, Cumhur; Myers, Mark E; Park, Paul; Rosolowski, Karie A; Sharma, Anil K; Taleghani, Christopher K; Trammell, Terry R; Vo, Andrew N; Williams, Keith D

    2016-12-01

    The North American Spine Society's (NASS) Evidence-Based Clinical Guideline for the Diagnosis and Treatment of Adult Isthmic Spondylolisthesis features evidence-based recommendations for diagnosing and treating adult patients with isthmic spondylolisthesis. The guideline is intended to reflect contemporary treatment concepts for symptomatic isthmic spondylolisthesis as reflected in the highest quality clinical literature available on this subject as of June 2013. NASS' guideline on this topic is the only guideline on adult isthmic spondylolisthesis accepted in the Agency for Healthcare Research and Quality's National Guideline Clearinghouse. The purpose of the guideline is to provide an evidence-based educational tool to assist spine specialists when making clinical decisions for adult patients with isthmic spondylolisthesis. This article provides a brief summary of the evidence-based guideline recommendations for diagnosing and treating patients with this condition. This is a guideline summary review. This guideline is the product of the Adult Isthmic Spondylolisthesis Work Group of NASS' Evidence-Based Clinical Guideline Development Committee. The methods used to develop this guideline are detailed in the complete guideline and technical report available on the NASS website. In brief, a multidisciplinary work group of spine care specialists convened to identify clinical questionsto address in the guideline. The literature search strategy was developed in consultation with medical librarians. Upon completion of the systematic literature search, evidence relevant to the clinical questions posed in the guideline was reviewed. Work group members utilized NASS evidentiary table templates to summarize study conclusions, identify study strengths and weaknesses, and assign levels of evidence. Work group members participated in webcasts and in-person recommendation meetings to update and formulate evidence-based recommendations and incorporate expert opinion when necessary. The draft guidelines were submitted to an internal peer review process and ultimately approved by the NASS Board of Directors. Upon publication, the Adult Isthmic Spondylolisthesis guideline was accepted into the National Guideline Clearinghouse and will be updated approximately every 5 years. Thirty-one clinical questions were addressed, and the answers are summarized in this article. The respective recommendations were graded according to the levels of evidence of the supporting literature. The evidence-based clinical guideline has been created using techniques of evidence-based medicine and best available evidence to aid practitioners in the diagnosis and treatment of adult patients with isthmic spondylolisthesis. The entire guideline document, including the evidentiary tables, literature search parameters, literature attrition flowchart, suggestions for future research, and all of the references, is available electronically on the NASS website at https://www.spine.org/ResearchClinicalCare/QualityImprovement/ClinicalGuidelines.aspx and will remain updated on a timely schedule. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Dental cements for definitive luting: a review and practical clinical considerations.

    PubMed

    Hill, Edward E

    2007-07-01

    Dental cement used to attach an indirect restoration to a prepared tooth is called a luting agent. A clinically relevant discussion of conventional and contemporary definitive luting agents is presented in this article. Physical properties are listed in table form to assist in comparison and decision-making. Additional subtopics include luting agent requirements, classifications, retention and bonding, cement considerations for implant-supported teeth, and fatigue failure.

  16. Mass-Rearing Hydrellia Pakistanae Deonier and H. balciunasi Bock for the Management of Hydrilla verticillata

    DTIC Science & Technology

    2009-06-01

    capability. Mass Rearing: The ability to mass-produce large numbers of high quality insect biocontrol agents can be a tremendous asset when...implementing a biocontrol program. Common sense would dictate that releasing a high number of agents allows for higher establishment success, more rapid...varying densities of biocontrol agent (costs estimated using a constant weight). Table 1. Hypothetical calculation of Hydrellia pakistanae production cost

  17. Agents Overcoming Resource Independent Scaling Threats (AORIST)

    DTIC Science & Technology

    2004-10-01

    20 Table 8: Tilted Consumer Preferences Experiment (m=8, N=61, G=2, C=60, Mean over 13 experiments...probabilities. Non-uniform consumer preferences create a new potential for sub-optimal system performance and thus require an additional adaptive...distribu- tion of the capacities across the sup- plier population must match the non- uniform consumer preferences . The second plot in Table 8

  18. A Prospective Analysis to Determine the Management Strategies Necessary to Successfully Implement the TRICARE Program at Kenner Army Health Clinic.

    DTIC Science & Technology

    1998-06-01

    FOR THE MAJORITY OF THE POPULATION RECEIVNG CARE IN FY 95 AND FY 96 37 TABLE 4: COMPARISION OF GOVERNMENT COSTS PER EPISODE IN CIVILIAN AND MILITARY ...FACKLTITES 40 TABLE 5: COMPARISION OF TOTAL GOVERNMENT COSTS IN CIVILIAN AND MILITARY FACILITIES 41 TABLE 6: SUMMARY OF PROJECTED TOTAL GOVERNMENT...is managed by an executive military health care staff, known as the Lead Agent, in each of 14 geographic regions in the U.S., Europe and Pacific

  19. 40 CFR 414.31 - Effluent limitations representing the degree of effluent reduction attainable by the application...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS ORGANIC CHEMICALS, PLASTICS, AND SYNTHETIC FIBERS Other Fibers... concentration listed in the following table. Effluent characteristics BPT effluent limitations 1 Maximum for any...

  20. 40 CFR 414.21 - Effluent limitations representing the degree of effluent reduction attainable by the application...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS ORGANIC CHEMICALS, PLASTICS, AND SYNTHETIC FIBERS Rayon Fibers... concentration listed in the following table. Effluent characteristics BPT effluent limitations 1 Maximum for any...

  1. Linear solvation energy relationships (LSER): 'rules of thumb' for Vi/100, π*, Βm, and αm estimation and use in aquatic toxicology

    USGS Publications Warehouse

    Hickey, James P.

    1996-01-01

    This chapter provides a listing of the increasing variety of organic moieties and heteroatom group for which Linear Solvation Energy Relationship (LSER) values are available, and the LSER variable estimation rules. The listings include values for typical nitrogen-, sulfur- and phosphorus-containing moieties, and general organosilicon and organotin groups. The contributions by an ion pair situation to the LSER values are also offered in Table 1, allowing estimation of parameters for salts and zwitterions. The guidelines permit quick estimation of values for the four primary LSER variables Vi/100, π*, Βm, and αm by summing the contribtuions from its components. The use of guidelines and Table 1 significantly simplifies computation of values for the LSER variables for most possible organic comppounds in the environment, including the larger compounds of environmental and biological interest.

  2. Guidelines: Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on the Role of Cranial Molding Orthosis (Helmet) Therapy for Patients With Positional Plagiocephaly.

    PubMed

    Tamber, Mandeep S; Nikas, Dimitrios; Beier, Alexandra; Baird, Lissa C; Bauer, David F; Durham, Susan; Klimo, Paul; Lin, Alexander Y; Mazzola, Catherine; McClung-Smith, Catherine; Mitchell, Laura; Tyagi, Rachana; Flannery, Ann Marie

    2016-11-01

    No evidence-based guidelines exist on the role of cranial-molding orthosis (helmet) therapy for patients with positional plagiocephaly. To address the clinical question: "Does helmet therapy provide effective treatment for positional plagiocephaly?" and to make treatment recommendations based on the available evidence. The US National Library of Medicine Medline database and the Cochrane Library were queried by using MeSH headings and key words relevant to the objective of this systematic review. Abstracts were reviewed, after which studies meeting the inclusion criteria were selected and graded according to their quality of evidence (Classes I-III). Evidentiary tables were constructed that summarized pertinent study results, and, based on the quality of the literature, recommendations were made (Levels I-III). Fifteen articles met criteria for inclusion into the evidence tables. There was 1 prospective randomized controlled trial (Class II), 5 prospective comparative studies (Class II), and 9 retrospective comparative studies (Class II). There is a fairly substantive body of nonrandomized evidence that demonstrates more significant and faster improvement of cranial shape in infants with positional plagiocephaly treated with a helmet in comparison with conservative therapy, especially if the deformity is severe, provided that helmet therapy is applied during the appropriate period of infancy. Specific criteria regarding the measurement and quantification of deformity and the most appropriate time window in infancy for treatment of positional plagiocephaly with a helmet remains elusive. In general, infants with a more severe presenting deformity and infants who are helmeted early in infancy tend to have more significant correction (and even normalization) of head shape. The full guidelines document can be located at https://www.cns.org/guidelines/guidelines-management-patients-positional-plagiocephaly/Chapter_5.

  3. [Research on the marketing status of antimicrobial products and the use of antimicrobial agents indicated on product labels from 1991 through 2005].

    PubMed

    Nakashima, Harunobu; Miyano, Naoko; Matsunaga, Ichiro; Nakashima, Naomi; Kaniwa, Masa-aki

    2007-05-01

    To clarify the marketing status of antimicrobial products, descriptions on the labels of commercially available antimicrobial products were investigated from 1991 through 2005, and the results were analyzed using a database system on antimicrobial deodorant agents. A classification table of household antimicrobial products was prepared and revised, based on which target products were reviewed for any changes in the product type. The number of antimicrobial products markedly increased over 3 years starting from 1996, among which there were many products apparently not requiring antimicrobial processing. More recently, in the 2002 and 2004 surveys, while sales of kitchenware and daily necessities decreased, chemical products, baby articles, and articles for pets increased; this poses new problems. To clarify the use of antimicrobial agents in the target products, a 3-step (large, intermediate, small) classification table of antimicrobial agents was also prepared, based on which antimicrobial agents indicated on the product labels were checked. The rate of identifying the agents increased. However, this is because of the increase of chemical products and baby articles, both of which more frequently indicated the ingredient agents on the labels, and the decrease of kitchenware and daily necessities, which less frequently indicated them on the labels. Therefore there has been little change in the actual identification rate. The agents used are characterized by product types: quaternary ammonium salts, metal salts, and organic antimicrobials are commonly used in textiles, plastics, and chemical products, respectively. Since the use of natural organic agents has recently increased, the safety of these agents should be evaluated.

  4. Guidelines for Reproductive Toxicity Risk Assessment

    EPA Pesticide Factsheets

    These guidelines discuss the scientific basis for concern about exposure to agents that cause reproductive toxicity and describe the principles and procedures to be followed in conducting risk assessments for reproductive toxicity.

  5. EASE Guidelines for Authors and Translators of Scientific Articles to be Published in English

    PubMed Central

    2014-01-01

    This concise and readable set of editorial guidelines was first published by the European Association of Science Editors (EASE) in 2010 and is updated annually. It is freely available in more than 20 languages at http://ease.org.uk/publications/author-guidelines. The document is aimed to help scientists worldwide in successful presentation of their research results and in correct translation of manuscripts into English. Moreover, it draws attention to ethical issues, like authorship criteria, plagiarism, conflict of interests, etc. Eight appendices provide examples or more detailed information on selected topics (Abstracts, Ambiguity, Cohesion, Ethics, Plurals, Simplicity, Spelling, and Text-tables). Widespread use of EASE Guidelines should increase the efficiency of international scientific communication. PMID:25132718

  6. EASE Guidelines for Authors and Translators of Scientific Articles to be Published in English.

    PubMed

    2014-06-01

    This concise and readable set of editorial guidelines was first published by the European Association of Science Editors (EASE) in 2010 and is updated annually. It is freely available in more than 20 languages at http://ease.org.uk/publications/author-guidelines. The document is aimed to help scientists worldwide in successful presentation of their research results and in correct translation of manuscripts into English. Moreover, it draws attention to ethical issues, like authorship criteria, plagiarism, conflict of interests, etc. Eight appendices provide examples or more detailed information on selected topics (Abstracts, Ambiguity, Cohesion, Ethics, Plurals, Simplicity, Spelling, and Text-tables). Widespread use of EASE Guidelines should increase the efficiency of international scientific communication.

  7. Efficacy Comparison of Six Chemotherapeutic Combinations for Osteosarcoma and Ewing's Sarcoma Treatment: A Network Meta-Analysis.

    PubMed

    Zhang, Tao; Zhang, Song; Yang, Feifei; Wang, Lili; Zhu, Sigang; Qiu, Bing; Li, Shunhua; Deng, Zhongliang

    2018-01-01

    This study aimed to address the insufficiency of traditional meta-analysis and provide improved guidelines for the clinical practice of osteosarcoma treatment. The heterogeneity of the fixed-effect model was calculated, and when necessary, a random-effect model was adopted. Furthermore, the direct and indirect evidence was pooled together and exhibited in the forest plot and slash table. The surface under the cumulative ranking curve (SUCRA) value was also measured to rank each intervention. Finally, heat plot was introduced to demonstrate the contribution of each intervention and the inconsistency between direct and indirect comparisons. This network meta-analysis included 32 trials, involving a total of 5,626 subjects reported by 28 articles. All the treatments were classified into six chemotherapeutic combinations: dual agent with or without ifosfamide (IFO), multi-agent with or without IFO, and dual agent or multi-agent with IFO and etoposide. For the primary outcomes, both overall survival (OS) and event-free survival (EFS) rates were considered. The multi-agent integrated with IFO and etoposide showed an optimal performance for 5-year OS, 10-year OS, 3-year EFS, 5-year EFS, and 10-year EFS when compared with placebo. The SUCRA value of this treatment was also the highest of these six interventions. However, multi-drug with IFO alone had the highest SUCRA value of 0.652 and 0.516 when it came to relapse and lung-metastasis. It was efficient to some extent, but no significant difference was observed in both outcomes. Chemotherapy, applied as induction or adjuvant treatment with radiation therapy or surgery, is able to increase the survival rate of patients, especially by combining multi-drug with IFO and etoposide, which demonstrated the best performance in both OS and EFS. As for relapse and the lung-metastasis, multiple agents with IFO alone seemed to have the optimal efficiency, although no significant difference was observed here. J. Cell. Biochem. 119: 250-259, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  8. Materials Compatibility and Agent Operational Validation for Halon 1211 Replacement: Phases 1 2, and 3. Volume 1

    DTIC Science & Technology

    1993-03-01

    KC-135 Gl-epoxy Winglet 1 *1 = experimental; 2 = prototype development; 3 = production 9 TABLE 3. ADVANCED COMPOSITES IN MILITARY AIRCRAFT (CONCLUDED...specially blended for related agent testing and would not be available, due to its high production cost, for regular distribution.1 ’Personal

  9. WORKSHOP ON EMERGING INFECTIOUS DISEASE AGENTS AND ISSUES ASSOCIATED WITH ANIMAL MANURES, BIOSOLIDS, AND OTHER SIMILAR BY-PRODUCTS: THE REST OF THE STORY

    EPA Science Inventory

    This presentation will:

    Discuss the purpose of the workshop
    Discussion publication of "Contemporary Perspectives on Infectious Disease Agents in Sewage Sludge and Manure.
    Present Table of Contents
    Discuss summary
    Discuss synthesis document

  10. 21 CFR 178.3860 - Release agents.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... bran wax For use only in plastics intended for contact with dry foods identified as Type VIII in table... 21 Food and Drugs 3 2012-04-01 2012-04-01 false Release agents. 178.3860 Section 178.3860 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN...

  11. 21 CFR 178.3860 - Release agents.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... bran wax For use only in plastics intended for contact with dry foods identified as Type VIII in table... 21 Food and Drugs 3 2013-04-01 2013-04-01 false Release agents. 178.3860 Section 178.3860 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN...

  12. [Guidelines for the treatment of constipation].

    PubMed

    Park, Moo In; Shin, Jeong Eun; Myung, Seung Jae; Huh, Kyu Chan; Choi, Chang Hwan; Jung, Sung Ae; Choi, Suck Chei; Sohn, Chong Il; Choi, Myung Gyu

    2011-02-01

    While constipation is a common symptom in Korea, there are no existing treatment guidelines. Although constipation may occur as a result of organic cause, there is no obstructive mucosal or structural cause in the vast majority of patients with constipation. The present paper deals with only the management of functional constipation: lifestyle changes; bulking agents and stool softeners; osmotic agents; stimulant laxatives; prokinetics; biofeedback and surgical treatments. Exercise and dietary fiber are helpful in some patients with constipation. Laxatives including bulking agents, stool softeners, osmotic agents, and stimulant laxatives have been found to be more effective than placebo at relieving symptoms of constipation. New enterokinetic agents that affect peristalsis through selective interaction with 5-hydroxytryptamine-4 receptors can be effective in patients with constipation who cannot get adequate relief from current laxatives. Biofeedback can relieve symptoms in selected patients with pelvic floor dyssynergia. Surgical treatments can be helpful in some patients with refractory constipation.

  13. Impact of Pharmacy-Led Dyslipidemia Interventions on Medication Safety and Therapeutic Failure in Patients

    DTIC Science & Technology

    2005-05-01

    Center (PEC) guidelines on therapeutic failure. Such guidelines recommend atorvastatin as an alternative agent in patients who had a bona fide failure...on simvastatin. Failures requiring atorvastatin as an alternate agent were defined as (a) patients not at their LDL goal on maximal doses of...simvastatin 20 atorvastatin 20 med changed 3 (2%) simvastatin 10 atorvastatin 10 med changed 1 (0.7%) simvastatin 10 atorvastatin 20 med changed 5 (3.3

  14. Design guidelines for horizontal drains used for slope stabilization.

    DOT National Transportation Integrated Search

    2013-03-01

    The presence of water is one of the most critical factors contributing to the instability of hillslopes. A common : solution to stabilize hillslopes is installation of horizontal drains to decrease the elevation of the water table : surface. Lowering...

  15. Developing Database Files for Student Use.

    ERIC Educational Resources Information Center

    Warner, Michael

    1988-01-01

    Presents guidelines for creating student database files that supplement classroom teaching. Highlights include determining educational objectives, planning the database with computer specialists and subject area specialists, data entry, and creating student worksheets. Specific examples concerning elements of the periodic table and…

  16. Guidelines for biosafety laboratory competency: CDC and the Association of Public Health Laboratories.

    PubMed

    Delany, Judy R; Pentella, Michael A; Rodriguez, Joyce A; Shah, Kajari V; Baxley, Karen P; Holmes, David E

    2011-04-15

    These guidelines for biosafety laboratory competency outline the essential skills, knowledge, and abilities required for working with biologic agents at the three highest biosafety levels (BSLs) (levels 2, 3, and 4). The competencies are tiered to a worker's experience at three levels: entry level, midlevel (experienced), and senior level (supervisory or managerial positions). These guidelines were developed on behalf of CDC and the Association of Public Health Laboratories (APHL) by an expert panel comprising 27 experts representing state and federal public health laboratories, private sector clinical and research laboratories, and academic centers. They were then reviewed by approximately 300 practitioners representing the relevant fields. The guidelines are intended for laboratorians working with hazardous biologic agents, obtained from either samples or specimens that are maintained and manipulated in clinical, environmental, public health, academic, and research laboratories.

  17. Proceedings of the U.S. Army Chemical Research, Development and Engineering Center Scientific Conference on Chemical Defense Research Held in Aberdeen Proving Ground, Maryland on 14-17 November 1989

    DTIC Science & Technology

    1990-08-01

    to react in a similar electrochemical manner to the agent 2,21- dichlorodiethylsulfide (Mustard gas or HD). As a simulant for the nerve agents ...attack which may permit effective discrimination of pesticides from nerve agents in a chemical agent detector. Table 1 shows the results of film badge...amount of CASARM agent ( GA , GB, HD or VX) was placed into a 5 mm O.D. Pyrex NMR tube and 1.0 ml of the decontaminating solution was added. The tube was

  18. Sunscreening Agents

    PubMed Central

    Martis, Jacintha; Shobha, V; Sham Shinde, Rutuja; Bangera, Sudhakar; Krishnankutty, Binny; Bellary, Shantala; Varughese, Sunoj; Rao, Prabhakar; Naveen Kumar, B.R.

    2013-01-01

    The increasing incidence of skin cancers and photodamaging effects caused by ultraviolet radiation has increased the use of sunscreening agents, which have shown beneficial effects in reducing the symptoms and reoccurrence of these problems. Many sunscreen compounds are in use, but their safety and efficacy are still in question. Efficacy is measured through indices, such as sun protection factor, persistent pigment darkening protection factor, and COLIPA guidelines. The United States Food and Drug Administration and European Union have incorporated changes in their guidelines to help consumers select products based on their sun protection factor and protection against ultraviolet radiation, whereas the Indian regulatory agency has not yet issued any special guidance on sunscreening agents, as they are classified under cosmetics. In this article, the authors discuss the pharmacological actions of sunscreening agents as well as the available formulations, their benefits, possible health hazards, safety, challenges, and proper application technique. New technologies and scope for the development of sunscreening agents are also discussed as well as the role of the physician in patient education about the use of these agents. PMID:23320122

  19. Total, Free, and Added Sugar Consumption and Adherence to Guidelines: The Dutch National Food Consumption Survey 2007-2010.

    PubMed

    Sluik, Diewertje; van Lee, Linde; Engelen, Anouk I; Feskens, Edith J M

    2016-01-28

    A high sugar intake is a subject of scientific debate due to the suggested health implications and recent free sugar recommendations by the WHO. The objective was to complete a food composition table for added and free sugars, to estimate the intake of total sugars, free sugars, and added sugars, adherence to sugar guidelines and overall diet quality in Dutch children and adults. In all, 3817 men and women (7-69 years) from the Dutch National Food Consumption Survey 2007-2010 were studied. Added and free sugar content of products was assigned by food composition tables and using labelling and product information. Diet was assessed with two 24-h recalls. Diet quality was studied in adults with the Dutch Healthy Diet-index. Total sugar intake was 22% Total Energy (%TE), free sugars intake 14 %TE, and added sugar intake 12 %TE. Sugar consumption was higher in children than adults. Main food sources of sugars were sweets and candy, non-alcoholic beverages, dairy, and cake and cookies. Prevalence free sugar intake <10 %TE was 5% in boys and girls (7-18 years), 29% in women, and 33% in men. Overall diet quality was similar comparing adults adherent and non-adherent to the sugar guidelines, although adherent adults had a higher intake of dietary fiber and vegetables. Adherence to the WHO free sugar guidelines of <5 %TE and <10 %TE was generally low in the Netherlands, particularly in children. Adherence to the added and free sugar guidelines was not strongly associated with higher diet quality in adults.

  20. Total, Free, and Added Sugar Consumption and Adherence to Guidelines: The Dutch National Food Consumption Survey 2007–2010

    PubMed Central

    Sluik, Diewertje; van Lee, Linde; Engelen, Anouk I.; Feskens, Edith J. M.

    2016-01-01

    A high sugar intake is a subject of scientific debate due to the suggested health implications and recent free sugar recommendations by the WHO. The objective was to complete a food composition table for added and free sugars, to estimate the intake of total sugars, free sugars, and added sugars, adherence to sugar guidelines and overall diet quality in Dutch children and adults. In all, 3817 men and women (7–69 years) from the Dutch National Food Consumption Survey 2007–2010 were studied. Added and free sugar content of products was assigned by food composition tables and using labelling and product information. Diet was assessed with two 24-h recalls. Diet quality was studied in adults with the Dutch Healthy Diet-index. Total sugar intake was 22% Total Energy (%TE), free sugars intake 14 %TE, and added sugar intake 12 %TE. Sugar consumption was higher in children than adults. Main food sources of sugars were sweets and candy, non-alcoholic beverages, dairy, and cake and cookies. Prevalence free sugar intake <10 %TE was 5% in boys and girls (7–18 years), 29% in women, and 33% in men. Overall diet quality was similar comparing adults adherent and non-adherent to the sugar guidelines, although adherent adults had a higher intake of dietary fiber and vegetables. Adherence to the WHO free sugar guidelines of <5 %TE and <10 %TE was generally low in the Netherlands, particularly in children. Adherence to the added and free sugar guidelines was not strongly associated with higher diet quality in adults. PMID:26828518

  1. Do children with obesity have worse table manners? Associations between child table manners, weight status and weight gain.

    PubMed

    Briones, Naomi F; Cesaro, Robert J; Appugliese, Danielle P; Miller, Alison L; Rosenblum, Katherine L; Pesch, Megan H

    2018-06-01

    Children with obesity experience stigma stemming from stereotypes, one such stereotype is that people with obesity are "sloppy" or have poor manners. Teaching children "proper table manners" has been proposed as an obesity prevention strategy. Little is known about the association between children's weight status and table manners. To examine correlates of child table manners and to examine the association of child table manners with child obese weight status and prospective change in child body mass index z-score (BMIz). Mother-child dyads (N = 228) participated in a videotaped laboratory eating task with cupcakes. Coding schemes to capture child table manners (making crumbs, chewing with mouth open, getting food on face, shoving food in mouth, slouching, and getting out of seat), and maternal attentiveness to child table manners, were reliably applied. Anthropometrics were measured at baseline and at follow-up two years later. Regression analyses examined the association of participant characteristics with child table manners, as well as the associations of child table manners with child obese weight status, and prospective change in BMIz/year. Predictors of poorer child table manners were younger child age, greater cupcake consumption, and greater maternal attentiveness to child table manners. Poorer child table manners were not associated with child obese (vs. not) weight status, but were associated with a prospective decrease in BMIz/year in children with overweight/obesity. Obesity interventions to improve table manners may be perpetuating unfavorable stereotypes and stigma. Future work investigating these associations is warranted to inform childhood obesity guidelines around table manners. Copyright © 2018 Elsevier Ltd. All rights reserved.

  2. Technical Guidance Manual: Contaminant Flux Reduction Barriers for Managing Difficult-to-Treat Source Zones in Unconsolidated Media

    DTIC Science & Technology

    2017-06-20

    was to evaluate if inexpensive flow reduction agents delivered via permeation grouting technology could help manage difficult-to-treat chlorinated...30  Table 4.  Description of Case Study Site ................................................................................... 30  Table 5...Intentionally Left Blank ES-1 EXECUTIVE SUMMARY Project Objective The overall objective of this project was to evaluate if inexpensive flow reduction

  3. Treatability of Aqueous Film-Forming Foams Used for Fire Fighting.

    DTIC Science & Technology

    BIODETERIORATION, *FIRE EXTINGUISHING AGENTS, SURFACE ACTIVE SUBSTANCES, FLUORINATED HYDROCARBONS, FOAM , ACTIVATED SLUDGE PROCESS, ACTIVATED CARBON, TOXICITY, WASTE DISPOSAL, TABLES(DATA), ADSORPTION.

  4. A randomized open-label study of guideline-driven antiemetic therapy versus single agent antiemetic therapy in patients with advanced cancer and nausea not related to anticancer treatment.

    PubMed

    Hardy, Janet; Skerman, Helen; Glare, Paul; Philip, Jennifer; Hudson, Peter; Mitchell, Geoffrey; Martin, Peter; Spruyt, Odette; Currow, David; Yates, Patsy

    2018-05-02

    Nausea/vomiting (N/V) not related to anti-cancer treatment is common in patients with advanced cancer. The standard approach to management is to define a dominant cause, and treat with an antiemetic selected through pathophysiologic knowledge of emetic pathways. High rates of N/V control have been reported using both etiology-based guideline-driven antiemetic regimens and an empiric approach using single agents in uncontrolled studies. These different approaches had never been formally compared. This randomized, prospective, open label, dose-escalating study used readily available antiemetics in accordance with etiology-based guidelines or single agent therapy with haloperidol. Participants had a baseline average nausea score of ≥3/10. Response was defined as a ≥ 2/10 point reduction on a numerical rating scale of average nausea score with a final score < 3/10 at 72 h. Nausea scores and distress from nausea improved over time in the majority of the 185 patients randomized. For those who completed each treatment day, a greater response rate was seen in the guideline arm than the single agent arm at 24 h (49% vs 32%; p = 0.02), but not at 48 or 72 h. Response rates at 72 h in the intention to treat analysis were 49 and 53% respectively, with no significant difference between arms (0·04; 95% CI: -0·11, 0·19; p = 0·59). Over 80% of all participants reported an improved global impression of change. There were few adverse events worse than baseline in either arm. An etiology-based, guideline-directed approach to antiemetic therapy may offer more rapid benefit, but is no better than single agent treatment with haloperidol at 72 h. Australian New Zealand Clinical Trials Registry: ANZCTRN12610000481077 .

  5. HEW to Set Laboratory Safety Standards.

    ERIC Educational Resources Information Center

    Chemical and Engineering News, 1978

    1978-01-01

    Describes Department of Health, Education and Welfare (HEW) proposed guidelines for laboratories using chemical carcinogens. The guidelines are designed to provide protection for laboratory workers and their environment from exposure to all types of carcinogenic agents. (GA)

  6. Teaching an Endangered Species Unit.

    ERIC Educational Resources Information Center

    Quilty, Joan; And Others

    1986-01-01

    Describes how a student speech activity can serve as a culminating exercise in a unit on endangered species. Offers suggestions and guidelines for researching, formatting, and delivering the speech. A table is also included explaining the causes and prevention of species endangerment. (ML)

  7. Computerization of guidelines: a knowledge specification method to convert text to detailed decision tree for electronic implementation.

    PubMed

    Aguirre-Junco, Angel-Ricardo; Colombet, Isabelle; Zunino, Sylvain; Jaulent, Marie-Christine; Leneveut, Laurence; Chatellier, Gilles

    2004-01-01

    The initial step for the computerization of guidelines is the knowledge specification from the prose text of guidelines. We describe a method of knowledge specification based on a structured and systematic analysis of text allowing detailed specification of a decision tree. We use decision tables to validate the decision algorithm and decision trees to specify and represent this algorithm, along with elementary messages of recommendation. Edition tools are also necessary to facilitate the process of validation and workflow between expert physicians who will validate the specified knowledge and computer scientist who will encode the specified knowledge in a guide-line model. Applied to eleven different guidelines issued by an official agency, the method allows a quick and valid computerization and integration in a larger decision support system called EsPeR (Personalized Estimate of Risks). The quality of the text guidelines is however still to be developed further. The method used for computerization could help to define a framework usable at the initial step of guideline development in order to produce guidelines ready for electronic implementation.

  8. Evaluation of mortality factors using life table analysis of Gratiana boliviana, a biological control agent of tropical soda apple in Florida

    USDA-ARS?s Scientific Manuscript database

    Tropical soda apple (TSA), Solanum viarum Dunal (Solanaceae), has invaded many pastures and natural areas in Florida. The biological control agent Gratiana boliviana Spaeth (Coleoptera: Chrysomelidae) is providing adequate control of TSA stands in South and Central Florida. However, poor or no es...

  9. [New guidelines for the assessment of mental disorders--from a standpoint of lawyer].

    PubMed

    Yamaguchi, Koichiro

    2012-01-01

    In the field of Workers' Compensation Law, new guidelines were issued by the Ministry of Health, Labour and Welfare (Circular 26 Dec. 2011). This article briefly explains its content and function. Compared with medical insurance, a worker's compensation solely covers the diseases arising "out of employment", and the guidelines prescribe the criteria in order to decide on a causal relationship (nessocausale) between work and a mental disorder. By doing so, the guidelines aim to secure the fair and appropriate administration of compensation. The guidelines set the "Table" by which the events at the workplace are evaluated. When the event is "strong", the compensation is to be given. There are several other events which are, by themselves, "strong" (ex., work-related death). In parallel with the events, the working time (especially overtime) is also measured as a factor showing the heaviness of the work.

  10. Literature Review on Systems of Systems (SoS): A Methodology With Preliminary Results

    DTIC Science & Technology

    2013-11-01

    Appendix H. The Enhanced ISAAC Neural Simulation Toolkit (EINSTein) 73  Appendix I. The Map Aware Nonuniform Automata (MANA) Agent-Based Model 81...83  Figure I-3. Quadrant chart addressing SoS and associated SoSA designs for the Map Aware Nonuniform Automata (MANA) agent...Map Aware Nonuniform Automata (MANA) agent-based model. 85  Table I-2. SoS and SoSA software component maturation scores associated with the Map

  11. Chemical and Biological Sensor Standards Study

    DTIC Science & Technology

    2005-01-01

    that is utilized in lieu of Bacillus anthracis in testing biological agent sensors; both are gram positive, spore forming bacteria that have similar...for a given agent dosage is as follows: C = D r 3 f B Tη4π 3 ρ See the table for the variable designation. Using Bacillus anthracis as an example...e.g., genetic similarity, aerosol dynamics, size, shape, etc.) of the agent of interest. For example, Bacillus globigii is a widely used bacterium

  12. 31 CFR 549.313 - Financial, material, or technological support.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... transmission of value; weapons or related materiel; chemical or biological agents; explosives; false..., formulae, tables, engineering designs and specifications, manuals, or other recorded instructions. ...

  13. 31 CFR 548.313 - Financial, material, or technological support.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... transmission of value; weapons or related materiel; chemical or biological agents; explosives; false..., formulae, tables, engineering designs and specifications, manuals, or other recorded instructions. ...

  14. 31 CFR 549.313 - Financial, material, or technological support.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... transmission of value; weapons or related materiel; chemical or biological agents; explosives; false..., formulae, tables, engineering designs and specifications, manuals, or other recorded instructions. ...

  15. 31 CFR 548.313 - Financial, material, or technological support.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... transmission of value; weapons or related materiel; chemical or biological agents; explosives; false..., formulae, tables, engineering designs and specifications, manuals, or other recorded instructions. ...

  16. 31 CFR 537.327 - Financial, material, or technological support.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... transmission of value; weapons or related materiel; chemical or biological agents; explosives; false..., formulae, tables, engineering designs and specifications, manuals, or other recorded instructions. ...

  17. 31 CFR 548.313 - Financial, material, or technological support.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... transmission of value; weapons or related materiel; chemical or biological agents; explosives; false..., formulae, tables, engineering designs and specifications, manuals, or other recorded instructions. ...

  18. 31 CFR 548.313 - Financial, material, or technological support.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... transmission of value; weapons or related materiel; chemical or biological agents; explosives; false..., formulae, tables, engineering designs and specifications, manuals, or other recorded instructions. ...

  19. 31 CFR 549.313 - Financial, material, or technological support.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... transmission of value; weapons or related materiel; chemical or biological agents; explosives; false..., formulae, tables, engineering designs and specifications, manuals, or other recorded instructions. ...

  20. 31 CFR 548.313 - Financial, material, or technological support.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... transmission of value; weapons or related materiel; chemical or biological agents; explosives; false..., formulae, tables, engineering designs and specifications, manuals, or other recorded instructions. ...

  1. 31 CFR 549.313 - Financial, material, or technological support.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... transmission of value; weapons or related materiel; chemical or biological agents; explosives; false..., formulae, tables, engineering designs and specifications, manuals, or other recorded instructions. ...

  2. Investigations of chemical warfare agents and toxic industrial compounds with proton-transfer-reaction mass spectrometry for a real-time threat monitoring scenario.

    PubMed

    Kassebacher, Thomas; Sulzer, Philipp; Jürschik, Simone; Hartungen, Eugen; Jordan, Alfons; Edtbauer, Achim; Feil, Stefan; Hanel, Gernot; Jaksch, Stefan; Märk, Lukas; Mayhew, Chris A; Märk, Tilmann D

    2013-01-30

    Security and protection against terrorist attacks are major issues in modern society. One especially challenging task is the monitoring and protection of air conditioning and heating systems of buildings against terrorist attacks with toxic chemicals. As existing technologies have low selectivity, long response times or insufficient sensitivity, there is a need for a novel approach such as we present here. We have analyzed various chemical warfare agents (CWAs) and/or toxic industrial compounds (TICs) and related compounds, namely phosgene, diphosgene, chloroacetone, chloroacetophenone, diisopropylaminoethanol, and triethyl phosphate, utilizing a high-resolution proton-transfer-reaction time-of-flight mass spectrometry (PTR-TOFMS) instrument with the objective of finding key product ions and their intensities, which will allow a low-resolution quadrupole mass spectrometry based PTR-MS system to be used with high confidence in the assignment of threat agents in the atmosphere. We obtained high accuracy PTR-TOFMS mass spectra of the six compounds under study at two different values for the reduced electric field in the drift tube (E/N). From these data we have compiled a table containing product ions, and isotopic and E/N ratios for highly selective threat compound detection with a compact and cost-effective quadrupole-based PTR-MS instrument. Furthermore, using chloroacetophenone (tear gas), we demonstrated that this instrument's response is highly linear in the concentration range of typical Acute Exposure Guideline Levels (AEGLs). On the basis of the presented results it is possible to develop a compact and cost-effective PTR-QMS instrument that monitors air supply systems and triggers an alarm as soon as the presence of a threat agent is detected. We hope that this real-time surveillance device will help to seriously improve safety and security in environments vulnerable to terrorist attacks with toxic chemicals. Copyright © 2012 John Wiley & Sons, Ltd.

  3. Development of Sampling Methods for Powders and Soil for Detection of Biothreat Agents by Electrochemiluminecence

    DTIC Science & Technology

    2007-06-01

    DEC03; dairy creamer, lot number DPG 13MAY04; and flour , lot number DPGLJ24MAY05. In addition, flour (white, enriched , all purpose, Safeway brand...8 Table 2. M IM assay of dairy creamer, flour , and soil from swabs................................... 10 Table 3. M...IM assays of flour and soil in triplicate.................................................... 10 vi DRDC Suffield TM 2007-172 Acknowledgements The

  4. Estimation of groundwater consumption by phreatophytes using diurnal water table fluctuations: A saturated‐unsaturated flow assessment

    USGS Publications Warehouse

    Loheide, Steven P.; Butler, James J.; Gorelick, Steven M.

    2005-01-01

    Groundwater consumption by phreatophytes is a difficult‐to‐measure but important component of the water budget in many arid and semiarid environments. Over the past 70 years the consumptive use of groundwater by phreatophytes has been estimated using a method that analyzes diurnal trends in hydrographs from wells that are screened across the water table (White, 1932). The reliability of estimates obtained with this approach has never been rigorously evaluated using saturated‐unsaturated flow simulation. We present such an evaluation for common flow geometries and a range of hydraulic properties. Results indicate that the major source of error in the White method is the uncertainty in the estimate of specific yield. Evapotranspirative consumption of groundwater will often be significantly overpredicted with the White method if the effects of drainage time and the depth to the water table on specific yield are ignored. We utilize the concept of readily available specific yield as the basis for estimation of the specific yield value appropriate for use with the White method. Guidelines are defined for estimating readily available specific yield based on sediment texture. Use of these guidelines with the White method should enable the evapotranspirative consumption of groundwater to be more accurately quantified.

  5. Design highwater clearances for highway pavements appendix : volume II, appendix, August 2008.

    DOT National Transportation Integrated Search

    2008-08-01

    High groundwater table exerts detrimental effects on the roadway base and the whole pavement. Base clearance guidelines have been developed to prevent water from entering the pavement system in order to reduce its detrimental effects. In these guidel...

  6. Design highwater clearances for highway pavements : volume I, final report, August 2008.

    DOT National Transportation Integrated Search

    2008-08-01

    High groundwater table exerts detrimental effects on the roadway base and the whole pavement. Base : clearance guidelines have been developed to prevent water from entering the pavement system in order to : reduce its detrimental effects. In these gu...

  7. 31 CFR 594.317 - Financial, material, or technological support.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... other transmission of value; weapons or related materiel; chemical or biological agents; explosives..., diagrams, models, formulae, tables, engineering designs and specifications, manuals, or other recorded...

  8. 31 CFR 542.304 - Financial, material, or technological support.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... other transmission of value; weapons or related materiel; chemical or biological agents; explosives..., diagrams, models, formulae, tables, engineering designs and specifications, manuals, or other recorded...

  9. 31 CFR 588.312 - Financial, material, or technological support.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... other transmission of value; weapons or related materiel; chemical or biological agents; explosives..., diagrams, models, formulae, tables, engineering designs and specifications, manuals, or other recorded...

  10. 31 CFR 594.317 - Financial, material, or technological support.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... other transmission of value; weapons or related materiel; chemical or biological agents; explosives..., diagrams, models, formulae, tables, engineering designs and specifications, manuals, or other recorded...

  11. 31 CFR 594.317 - Financial, material, or technological support.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... other transmission of value; weapons or related materiel; chemical or biological agents; explosives..., diagrams, models, formulae, tables, engineering designs and specifications, manuals, or other recorded...

  12. 31 CFR 588.312 - Financial, material, or technological support.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... other transmission of value; weapons or related materiel; chemical or biological agents; explosives..., diagrams, models, formulae, tables, engineering designs and specifications, manuals, or other recorded...

  13. 31 CFR 594.317 - Financial, material, or technological support.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... other transmission of value; weapons or related materiel; chemical or biological agents; explosives..., diagrams, models, formulae, tables, engineering designs and specifications, manuals, or other recorded...

  14. 31 CFR 594.317 - Financial, material, or technological support.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... other transmission of value; weapons or related materiel; chemical or biological agents; explosives..., diagrams, models, formulae, tables, engineering designs and specifications, manuals, or other recorded...

  15. 31 CFR 588.312 - Financial, material, or technological support.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... other transmission of value; weapons or related materiel; chemical or biological agents; explosives..., diagrams, models, formulae, tables, engineering designs and specifications, manuals, or other recorded...

  16. 31 CFR 588.312 - Financial, material, or technological support.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... other transmission of value; weapons or related materiel; chemical or biological agents; explosives..., diagrams, models, formulae, tables, engineering designs and specifications, manuals, or other recorded...

  17. [Extravasation of chemotherapeutic agents: prevention and therapy].

    PubMed

    Jordan, K; Grothe, W; Schmoll, H-J

    2005-01-07

    Based on the potential to cause local tissue injury drugs are classified as vesicant, irritant and non-irritant. The frequency of extravasation is considered to be between 0.6 % and 6 %. More frequently an inflammatory reaction is caused by thrombophlebitis or a local hypersensitivity reaction following chemotherapy administration rather than by an extravasation. A number of factors are known to increase the risk of extravasation. By the consideration of these risk factors preventive guidelines for the safe administration of chemotherapeutic agents have been published. Central venous devices significantly reduce the risk of extravasation. To date there are no generally approved treatment guidelines for the management of extravasations. Treatment is mostly empirical. Nevertheless some general measures are to be recommended: Firstly, aspiration of the extravasated fluids should be attempted. Furthermore local supportive care such as intermittent topical warming or cooling is at least palliative and to a certain degree reduces the extent of the injury. Beside these non pharmacological therapies the beneficial effects of Dimethylsulfoxid (DMSO) -- or Hyaluronidase-administration dependent on the type of paravasation have been proven. The use of sodium bicarbonate, sodium thiosulfate or corticosteroids is no longer recommended. In the case of extravasation rapid and correct management is crucial for the benefit of any treatment. Therefore, written guidelines for both the handling of cytotoxic agents and also the management of an extravasation should be present in all Departments where cytotoxic agents are administered. In addition to these guidelines an extravasation kit including all necessary materials and drugs to treat extravasations should be available.

  18. Guideline summary review: An evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spondylolisthesis.

    PubMed

    Matz, Paul G; Meagher, R J; Lamer, Tim; Tontz, William L; Annaswamy, Thiru M; Cassidy, R Carter; Cho, Charles H; Dougherty, Paul; Easa, John E; Enix, Dennis E; Gunnoe, Bryan A; Jallo, Jack; Julien, Terrence D; Maserati, Matthew B; Nucci, Robert C; O'Toole, John E; Rosolowski, Karie; Sembrano, Jonathan N; Villavicencio, Alan T; Witt, Jens-Peter

    2016-03-01

    The North American Spine Society's (NASS) Evidence-Based Clinical Guideline for the Diagnosis and Treatment of Degenerative Lumbar Spondylolisthesis features evidence-based recommendations for diagnosing and treating degenerative lumbar spondylolisthesis. The guideline updates the 2008 guideline on this topic and is intended to reflect contemporary treatment concepts for symptomatic degenerative lumbar spondylolisthesis as reflected in the highest quality clinical literature available on this subject as of May 2013. The NASS guideline on this topic is the only guideline on degenerative lumbar spondylolisthesis included in the Agency for Healthcare Research and Quality's National Guideline Clearinghouse (NGC). The purpose of this guideline is to provide an evidence-based educational tool to assist spine specialists when making clinical decisions for patients with degenerative lumbar spondylolisthesis. This article provides a brief summary of the evidence-based guideline recommendations for diagnosing and treating patients with this condition. A systematic review of clinical studies relevant to degenerative spondylolisthesis was carried out. This NASS spondyolisthesis guideline is the product of the Degenerative Lumbar Spondylolisthesis Work Group of NASS' Evidence-Based Guideline Development Committee. The methods used to develop this guideline are detailed in the complete guideline and technical report available on the NASS website. In brief, a multidisciplinary work group of spine care specialists convened to identify clinical questions to address in the guideline. The literature search strategy was developed in consultation with medical librarians. Upon completion of the systematic literature search, evidence relevant to the clinical questions posed in the guideline was reviewed. Work group members used the NASS evidentiary table templates to summarize study conclusions, identify study strengths and weaknesses, and assign levels of evidence. Work group members participated in webcasts and in-person recommendation meetings to update and formulate evidence-based recommendations and incorporate expert opinion when necessary. The draft guidelines were submitted to an internal peer review process and ultimately approved by the NASS Board of Directors. Upon publication, the Degenerative Lumbar Spondylolisthesis guideline was accepted into the NGC and will be updated approximately every 5 years. Twenty-seven clinical questions were addressed in this guideline update, including 15 clinical questions from the original guideline and 12 new clinical questions. The respective recommendations were graded by strength of the supporting literature, which was stratified by levels of evidence. Twenty-one new or updated recommendations or consensus statements were issued and 13 recommendations or consensus statements were maintained from the original guideline. The clinical guideline was created using the techniques of evidence-based medicine and best available evidence to aid practitioners in the care of patients with degenerative lumbar spondylolisthesis. The entire guideline document, including the evidentiary tables, literature search parameters, literature attrition flow chart, suggestions for future research, and all of the references, is available electronically on the NASS website at https://www.spine.org/Pages/ResearchClinicalCare/QualityImprovement/ClinicalGuidelines.aspx and will remain updated on a timely schedule. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Guidelines for the diagnosis and management of migraine in clinical practice

    PubMed Central

    Pryse-Phillips, W E; Dodick, D W; Edmeads, J G; Gawel, M J; Nelson, R F; Purdy, R A; Robinson, G; Stirling, D; Worthington, I

    1997-01-01

    OBJECTIVE: To provide physicians and allied health care professionals with guidelines for the diagnosis and management of migraine in clinical practice. OPTIONS: The full range and quality of diagnostic and therapeutic methods available for the management of migraine. OUTCOMES: Improvement in the diagnosis and treatment of migraine, which will lead to a reduction in suffering, increased productivity and decreased economic burden. EVIDENCE AND VALUES: The creation of the guidelines followed a needs assessment by members of the Canadian Headache Society and included a statement of objectives; development of guidelines by multidisciplinary working groups using information from literature reviews and other resources; comparison of alternative clinical pathways and description of how published data were analysed; definition of the level of evidence for data in each case; evaluation and revision of the guidelines at a consensus conference held in Ottawa on Oct. 27-29, 1995; redrafting and insertion of tables showing key variables and data from various studies and tables of data with recommendations; and reassessment by all conference participants. BENEFITS, HARMS AND COSTS: Accuracy in diagnosis is a major factor in improving therapeutic effectiveness. Improvement in the precise diagnosis of migraine, coupled with a rational plan for the treatment of acute attacks and for prophylactic therapy, is likely to lead to substantial benefits in both human and economic terms. RECOMMENDATIONS: The diagnosis of migraine can be improved by using modified criteria of the International Headache Society as well as a semistructured patient interview technique. Appropriate treatment of symptoms should take into account the severity of the migraine attack, since most patients will have attacks of differing severity and can learn to use medication appropriate for each attack. When headaches are frequent or particularly severe, prophylactic therapy should be considered. Both the avoidance of migraine trigger factors and the application of nonpharmacological therapies play important roles in overall migraine management and will be addressed at a later date. VALIDATION: The guidelines are based on consensus of Canadian experts in neurology, emergency medicine, psychiatry, psychology, family medicine and pharmacology, and consumers. Previous guidelines did not exist. Field testing of the guidelines is in progress. PMID:9145054

  20. A survey of psychiatrists' attitudes toward treatment guidelines.

    PubMed

    Healy, Daniel J; Goldman, Mona; Florence, Timothy; Milner, Karen K

    2004-04-01

    We developed a survey to look at psychiatrists' attitudes toward psychotropic prescribing guidelines, specifically the Texas Medication Algorithm Project (TMAP) algorithms. The 22-page survey was distributed to 24 psychiatrists working in 4 CMHC's; 13 completed the survey. 90% agreed that guidelines should be general and flexible. The majority also agreed that guidelines should define how to measure response to a specific agent; fewer agreed guidelines should specify dosage, side effect management, or augmentation strategies. Psychiatrists were familiar with TMAP; none referred to it in their practice. In spite of this, psychiatrists' medication preferences were similar to those suggested by guidelines.

  1. 31 CFR 547.313 - Financial, material, or technological support.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., or any other transmission of value; weapons or related materiel; chemical or biological agents..., diagrams, models, formulae, tables, engineering designs and specifications, manuals, or other recorded...

  2. 31 CFR 546.313 - Financial, material, or technological support.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...; weapons or related materiel; chemical or biological agents; explosives; false documentation or..., tables, engineering designs and specifications, manuals, or other recorded instructions. [77 FR 6465, Feb...

  3. 31 CFR 543.313 - Financial, material, or technological support.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... transmission of value; weapons or related materiel; chemical or biological agents; explosives; false..., formulae, tables, engineering designs and specifications, manuals, or other recorded instructions. [77 FR...

  4. 31 CFR 546.313 - Financial, material, or technological support.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...; weapons or related materiel; chemical or biological agents; explosives; false documentation or..., tables, engineering designs and specifications, manuals, or other recorded instructions. [77 FR 6465, Feb...

  5. 31 CFR 546.313 - Financial, material, or technological support.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...; weapons or related materiel; chemical or biological agents; explosives; false documentation or..., tables, engineering designs and specifications, manuals, or other recorded instructions. [77 FR 6465, Feb...

  6. 31 CFR 547.313 - Financial, material, or technological support.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., or any other transmission of value; weapons or related materiel; chemical or biological agents..., diagrams, models, formulae, tables, engineering designs and specifications, manuals, or other recorded...

  7. 31 CFR 595.317 - Financial, material, or technological support.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... transmission of value; weapons or related materiel; chemical or biological agents; explosives; false..., formulae, tables, engineering designs and specifications, manuals, or other recorded instructions. [78 FR...

  8. 31 CFR 543.313 - Financial, material, or technological support.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... transmission of value; weapons or related materiel; chemical or biological agents; explosives; false..., formulae, tables, engineering designs and specifications, manuals, or other recorded instructions. [77 FR...

  9. 31 CFR 595.317 - Financial, material, or technological support.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... transmission of value; weapons or related materiel; chemical or biological agents; explosives; false..., formulae, tables, engineering designs and specifications, manuals, or other recorded instructions. [78 FR...

  10. 31 CFR 543.313 - Financial, material, or technological support.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... transmission of value; weapons or related materiel; chemical or biological agents; explosives; false..., formulae, tables, engineering designs and specifications, manuals, or other recorded instructions. [77 FR...

  11. 31 CFR 547.313 - Financial, material, or technological support.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., or any other transmission of value; weapons or related materiel; chemical or biological agents..., diagrams, models, formulae, tables, engineering designs and specifications, manuals, or other recorded...

  12. Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on the Role of Cranial Molding Orthosis (Helmet) Therapy for Patients With Positional Plagiocephaly.

    PubMed

    Tamber, Mandeep S; Nikas, Dimitrios; Beier, Alexandra; Baird, Lissa C; Bauer, David F; Durham, Susan; Klimo, Paul; Lin, Alexander Y; Mazzola, Catherine; McClung-Smith, Catherine; Mitchell, Laura; Tyagi, Rachana; Flannery, Ann Marie

    2016-11-01

    No evidence-based guidelines exist on the role of cranial-molding orthosis (helmet) therapy for patients with positional plagiocephaly. To address the clinical question: "Does helmet therapy provide effective treatment for positional plagiocephaly?" and to make treatment recommendations based on the available evidence. The US National Library of Medicine Medline database and the Cochrane Library were queried by using MeSH headings and key words relevant to the objective of this systematic review. Abstracts were reviewed, after which studies meeting the inclusion criteria were selected and graded according to their quality of evidence (Classes I-III). Evidentiary tables were constructed that summarized pertinent study results, and, based on the quality of the literature, recommendations were made (Levels I-III). Fifteen articles met criteria for inclusion into the evidence tables. There was 1 prospective randomized controlled trial (Class II), 5 prospective comparative studies (Class II), and 9 retrospective comparative studies (Class II). There is a fairly substantive body of nonrandomized evidence that demonstrates more significant and faster improvement of cranial shape in infants with positional plagiocephaly treated with a helmet in comparison with conservative therapy, especially if the deformity is severe, provided that helmet therapy is applied during the appropriate period of infancy. Specific criteria regarding the measurement and quantification of deformity and the most appropriate time window in infancy for treatment of positional plagiocephaly with a helmet remains elusive. In general, infants with a more severe presenting deformity and infants who are helmeted early in infancy tend to have more significant correction (and even normalization) of head shape. The full guidelines document can be located at https://www.cns.org/guidelines/guidelines-management-patients-positional-plagiocephaly/Chapter_5.

  13. [Anglo-Saxon guidelines for the treatment of community-acquired pneumonia applicable in The Netherlands as well].

    PubMed

    Hoepelman, I M; Sachs, A P; Visser, M R; Lammers, J W

    1997-08-16

    There are three Anglo-Saxon guidelines for the management of patients with a community-acquired pneumonia: an American, a British and a Canadian one. The guidelines correspond fairly well. There is a subdivision into categories according to whether the patients are treated at home (formerly healthy patients younger than 60 years versus patients with pre-existent disease or aged 60 years and more) or in the hospital (patients not needing intensive care versus those who do need it). For each category the most common causative micro-organisms are listed together with recommended antibiotic treatment. The Canadian guidelines have nursing home patients as a separate category because of slightly different causative organisms due to frequent microaspiration. The guidelines are applicable to the situation in the Netherlands, with a few exceptions: antibiotic resistance is not a major problem in the Netherlands (as yet), and contrary to what the guidelines state an agent with activity against Pseudomonas aeruginosa is not necessary; the same agents as in category III can be prescribed in these patients. A macrolide or azalide antibiotic is advisable for intensive care patients in view of the possibility of infection with Legionella pneumophila or Mycoplasma pneumoniae.

  14. Innovation Agents: Vocational Education and Training Skills and Innovation in Australian Industries and Firms. Volume 2

    ERIC Educational Resources Information Center

    Toner, Phillip; Marceau, Jane; Hall, Richard; Considine, Gillian

    2004-01-01

    This volume is a companion to "Innovation Agents: VET Skills and Innovation in Australian Industries and Firms. Volume 1". The detailed report of the project is contained in Volume 1 while Volume 2 contains the appendices: (1) Data tables for construction of the composite index of innovation; (2) Case study interview schedule; and (3)…

  15. Antiretroviral treatment for HIV infection: Swedish recommendations 2016.

    PubMed

    Eriksen, Jaran; Albert, Jan; Blaxhult, Anders; Carlander, Christina; Flamholc, Leo; Gisslén, Magnus; Josephson, Filip; Karlström, Olof; Navér, Lars; Svedhem, Veronica; Yilmaz, Aylin; Sönnerborg, Anders

    2017-01-01

    The Swedish Medical Products Agency and the Swedish Reference Group for Antiviral Therapy (RAV) have jointly published recommendations for the treatment of HIV infection on seven previous occasions (2002, 2003, 2005, 2007, 2009, 2011 and 2014). In February 2016, an expert group under the guidance of RAV once more revised the guidelines. The most important updates in the present guidelines are as follows: Tenofovir alafenamide (TAF) has recently been registered. TAF has several advantages over tenofovir disoproxilfumarate (TDF) and is recommended instead of TDF in most cases. First-line treatment for previously untreated individuals includes dolutegravir, boosted darunavir or efavirenz with either abacavir/lamivudine or tenofovir (TDF/TAF)/emtricitabine. Pre-exposure prophylaxis (PrEP) is recommended for high-risk individuals. As in the case of the previous publication, recommendations are evidence-graded in accordance with the Oxford Centre for Evidence Based Medicine ( http://www.cebm.net/oxford-centre-evidence-based-medicine-levels-evidence-march-2009/ ) ( Table 1 ). This document does not cover treatment of opportunistic infections and tumours. [Table: see text].

  16. Evaluation of Pharmacologic Agents to Suppress Intraocular Cellular Proliferation Following Trauma. Revision.

    DTIC Science & Technology

    1986-07-01

    following enucleation e.q . . .. - .° -15- TABLE 3 METHYLTREXATE 2 m& 2 day post pharm. Clinical Tractional Detacnent* animal op uveiti agent- # (1-4) or...op uveiti agent - - # (1-4) or control 1 wk 2 wk 4 wk 6 wk 12 wk Grogs "aam** __. editta njection of’ drug Orange 31 3 C Reflex / S 2 C R IF 1 C E D...1.0 mg *2 day pobt pharm. Clinical Tractional Detachment* animal op uveitis agent Si (1-4) or control 1 wk 2 wk 4 wk 6 wk 12 wk Groud Exum** Imeie

  17. Antibiotic Agents

    MedlinePlus

    ... residue-producing ). Common examples of this group are triclosan, triclocarban, and benzalkonium chloride. See the Table of ... soaps from 10 states in the US contained triclosan and approximately 30% of bar soaps contained triclocarban. ...

  18. People and Environment: Understanding Global Relationships.

    ERIC Educational Resources Information Center

    Clearing: Nature and Learning in the Pacific Northwest, 1984

    1984-01-01

    Discusses impacts of global resources and environment, focusing on food, fisheries, forests, energy, water, and air. Includes graphs, charts, maps, and tables of the current environmental situation; they are suitable for classroom use. Also includes suggested guidelines for implementing a global studies program and an annotated list of resource…

  19. 10 CFR Appendix I to Part 960 - NRC and EPA Requirements for Postclosure Repository Performance

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... multiplied by 10. The basis for Table 2 is an upper limit on long term risks of 1,000 health effects over 10... areas; and design of disposal systems to allow future recovery of wastes. The guidelines will be revised...

  20. 10 CFR Appendix I to Part 960 - NRC and EPA Requirements for Postclosure Repository Performance

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... multiplied by 10. The basis for Table 2 is an upper limit on long term risks of 1,000 health effects over 10... areas; and design of disposal systems to allow future recovery of wastes. The guidelines will be revised...

  1. 10 CFR Appendix I to Part 960 - NRC and EPA Requirements for Postclosure Repository Performance

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... multiplied by 10. The basis for Table 2 is an upper limit on long term risks of 1,000 health effects over 10... areas; and design of disposal systems to allow future recovery of wastes. The guidelines will be revised...

  2. Reporting Guidelines: Optimal Use in Preventive Medicine and Public Health

    PubMed Central

    Popham, Karyn; Calo, William A.; Carpentier, Melissa Y.; Chen, Naomi E.; Kamrudin, Samira A.; Le, Yen-Chi L.; Skala, Katherine A.; Thornton, Logan R.; Mullen, Patricia Dolan

    2012-01-01

    Numerous reporting guidelines are available to help authors write higher quality manuscripts more efficiently. Almost 200 are listed on the EQUATOR (Enhancing the Quality and Transparency of Health Research) Network’s website and they vary in authority, usability, and breadth, making it difficult to decide which one(s) to use. This paper provides consistent information about guidelines for preventive medicine and public health and a framework and sequential approach for selecting them. EQUATOR guidelines were reviewed for relevance to target audiences; selected guidelines were classified as “core” (frequently recommended) or specialized, and the latter were grouped by their focus. Core and specialized guidelines were coded for indicators of authority (simultaneous publication in multiple journals, rationale, scientific background supporting each element, expertise of designers, permanent website/named group), usability (presence of checklists and examples of good reporting), and breadth (manuscript sections covered). Discrepancies were resolved by consensus. Selected guidelines are presented in four tables arranged to facilitate selection: core guidelines, all of which pertain to major research designs; guidelines for additional study designs, topical guidelines, and guidelines for particular manuscript sections. A flow diagram provides an overview. The framework and sequential approach will enable authors as well as editors, peer reviewers, researchers, and systematic reviewers to make optimal use of available guidelines to improve the transparency, clarity, and rigor of manuscripts and research protocols and the efficiency of conducing systematic reviews and meta-analyses. PMID:22992369

  3. Clinical Practice Guidelines for Irritable Bowel Syndrome in Korea, 2017 Revised Edition

    PubMed Central

    Song, Kyung Ho; Jung, Hye-Kyung; Kim, Hyun Jin; Koo, Hoon Sup; Kwon, Yong Hwan; Shin, Hyun Duk; Lim, Hyun Chul; Shin, Jeong Eun; Kim, Sung Eun; Cho, Dae Hyeon; Kim, Jeong Hwan; Kim, Hyun Jung

    2018-01-01

    In 2011, the Korean Society of Neurogastroenterology and Motility (KSNM) published clinical practice guidelines on the management of irritable bowel syndrome (IBS) based on a systematic review of the literature. The KSNM planned to update the clinical practice guidelines to support primary physicians, reduce the socioeconomic burden of IBS, and reflect advances in the pathophysiology and management of IBS. The present revised version of the guidelines is in continuity with the previous version and targets adults diagnosed with, or suspected to have, IBS. A librarian created a literature search query, and a systematic review was conducted to identify candidate guidelines. Feasible documents were verified based on predetermined inclusion and exclusion criteria. The candidate seed guidelines were fully evaluated by the Guidelines Development Committee using the Appraisal of Guidelines for Research and Evaluation II quality assessment tool. After selecting 7 seed guidelines, the committee prepared evidence summaries to generate data exaction tables. These summaries comprised the 4 main themes of this version of the guidelines: colonoscopy; a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols; probiotics; and rifaximin. To adopt the core recommendations of the guidelines, the Delphi technique (ie, a panel of experts on IBS) was used. To enhance dissemination of the clinical practice guidelines, a Korean version will be made available, and a food calendar for patients with IBS is produced. PMID:29605976

  4. A study on expertise of agents and its effects on cooperative Q-learning.

    PubMed

    Araabi, Babak Nadjar; Mastoureshgh, Sahar; Ahmadabadi, Majid Nili

    2007-04-01

    Cooperation in learning (CL) can be realized in a multiagent system, if agents are capable of learning from both their own experiments and other agents' knowledge and expertise. Extra resources are exploited into higher efficiency and faster learning in CL as compared to that of individual learning (IL). In the real world, however, implementation of CL is not a straightforward task, in part due to possible differences in area of expertise (AOE). In this paper, reinforcement-learning homogenous agents are considered in an environment with multiple goals or tasks. As a result, they become expert in different domains with different amounts of expertness. Each agent uses a one-step Q-learning algorithm and is capable of exchanging its Q-table with those of its teammates. Two crucial questions are addressed in this paper: "How the AOE of an agent can be extracted?" and "How agents can improve their performance in CL by knowing their AOEs?" An algorithm is developed to extract the AOE based on state transitions as a gold standard from a behavioral point of view. Moreover, it is discussed that the AOE can be implicitly obtained through agents' expertness in the state level. Three new methods for CL through the combination of Q-tables are developed and examined for overall performance after CL. The performances of developed methods are compared with that of IL, strategy sharing (SS), and weighted SS (WSS). Obtained results show the superior performance of AOE-based methods as compared to that of existing CL methods, which do not use the notion of AOE. These results are very encouraging in support of the idea that "cooperation based on the AOE" performs better than the general CL methods.

  5. A novel bioassay to evaluate Beauveria bassiana strain NI8 and the insect growth regulator, novaluron, against Lygus lineolaris on a non-autoclaved solid artificial diet

    USDA-ARS?s Scientific Manuscript database

    Detailed life-tables studies or more quantitative estimates of the impact of control agents on TPB life history require a bioassay option to study the impact of prolonged exposure for weeks following contact with the control agent. This is difficult with plant tissue that must be routinely replaced ...

  6. Optimal designs of bioretention cells in shallow groundwater

    NASA Astrophysics Data System (ADS)

    Zhang, K.; Chui, T. F. M.

    2017-12-01

    Bioretention cells, as one representative low impact development practices, have been proved to be effective in controlling surface runoff, removing pollutants and recharging groundwater. However, they are often not recommended in shallow groundwater areas due to potential groundwater pollution, reduction in runoff control performance and groundwater drainage through the underdrain. Most design guidelines only require a minimum distance between bioretention cell bottom and seasonal high groundwater table without guiding the design of bioretention cells to mitigate the problem of shallow groundwater. This study therefore proposed some design recommendations of bioretention cells for different rainfall runoff loads, native soil types and initial water table depths. A variably saturated flow model was employed to conduct event-based simulations on one single hypothetical bioretention cell in shallow groundwater, which was calibrated using experimental and simulation data of an on-site bioretention cell. A wide range of climatic and geophysical factors (i.e. initial groundwater depths, native soils, rainfall runoff loads) and bioretention designs (i.e. media soil types and underdrain sizes) were considered. Surface runoff reduction, time before groundwater mound formation, as well as maximum height of groundwater mound were evaluated. Less-permeable media types (i.e. sandy loam) are recommended in areas with many extreme rainfall events (i.e. 40 - 70 mm/h or larger) and of shallower groundwater, which can better protect groundwater from mounding and possibly contamination although may slightly compromise the runoff control performance. For areas having seasonal high groundwater table of 0 - 1 m below bioretention bottom, underdrain is recommended to maintain good infiltration capacity without draining groundwater. However, underdrain is not recommended for areas of groundwater table always near or above the bioretention bottom, only if an impermeable sheet is added. Generally, groundwater interference is a concern only when groundwater table is above 1 - 2.5 m below bioretention bottom and runoff loads are very high. The results of this study overall could benefit the implementation of bioretention cells in shallow groundwater areas, and the establishment of relevant design guidelines.

  7. The Clinical Development of Thalildomide as an Angiogenesis Inhibitor Therapy for Prostate Cancer

    DTIC Science & Technology

    2005-10-01

    regulation of cell adhesion molecules LFA-1 and ICAM-1 after in vitro treatment with the anti- TNF - alpha agent thalidomide . Settles B, Stevenson A...Plasma levels of circulating TNF -α and VEGF measured in 16 thalidomide treated patients seemed to increase after treatment (Table 2). Serum levels of...Logothetis, Christopher J. Page 6 Table 2. Levels of circulating VEGF, bFGF, TNF -α and IL-6 before and after thalidomide treatment. Comparison of

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

    PubMed

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

    2012-08-01

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

  9. Adolescents and Exercise Induced Asthma

    ERIC Educational Resources Information Center

    Hansen, Pamela; Bickanse, Shanna; Bogenreif, Mike; VanSickle, Kyle

    2008-01-01

    This article defines asthma and exercise induced asthma, and provides information on the triggers, signs, and symptoms of an attack. It also gives treatments for these conditions, along with prevention guidelines on how to handle an attack in the classroom or on the practice field. (Contains 2 tables and 1 figure.)

  10. Prescribing silvicultural treatments in hardwood stands of the Alleghenies. (Revised)

    Treesearch

    David A. Marquis; Richard L. Ernst; Susan L. Stout

    1992-01-01

    This publication brings together the results of 20 years of research and experience in the silviculture of hardwood forests in the Allegheny region. It provides a summary of silvicultural knowledge, and guidelines, decision tables, and step-by-step instructions for determining silviculutural prescriptions in individual stands.

  11. Test Specifications and Blueprints: Reality and Expectations

    ERIC Educational Resources Information Center

    AlFallay, Ibrahim S.

    2018-01-01

    This study investigates to what extend do teachers of English as a school subject (ESS) in Saudi schools follow recommendations and guidelines suggested by language testing specialists in developing tables of specifications and preparing blueprints to their formative and summative language tests. To answer the study questions, a thirteen-statement…

  12. 40 CFR 420.23 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... wet air pollution control system. The following table presents BAT limitations for sintering operations with wet air pollution control systems: Subpart B—Effluent Limitations (BAT) Regulated parameter... water is co-treated with ironmaking wastewater. 3 Applicable only when sintering process wastewater is...

  13. 40 CFR 420.23 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... wet air pollution control system. The following table presents BAT limitations for sintering operations with wet air pollution control systems: Subpart B—Effluent Limitations (BAT) Regulated parameter... water is co-treated with ironmaking wastewater. 3 Applicable only when sintering process wastewater is...

  14. What's in the Walls: Copper, Fiber, or Coaxial Wiring?

    ERIC Educational Resources Information Center

    Weiss, Andrew M.

    1995-01-01

    Presents planning guidelines for wiring specifications for K-12 schools by reviewing advantages and disadvantages of using copper, fiber-optic, and coaxial wire. Addresses the future of network wiring and educational technology, and makes recommendations. A sidebar describes the physical appearance of different types of wire and a table compares…

  15. Letter Writing as a Tool To Increase Client Motivation To Change: Application to an Inpatient Crisis Unit.

    ERIC Educational Resources Information Center

    Tubman, Jonathan G.; Montgomery, Marilyn J.; Wagner, Eric F.

    2001-01-01

    Describes the application of a letter writing exercise as a motivational technique for group counseling in contemporary crisis unit settings. Discusses guidelines and implications for clinical practice with clients with multiple, chronic problems. (Contains 37 references and 1 table.) (GCP)

  16. Organizing for Better School Food.

    ERIC Educational Resources Information Center

    Center for Science in the Public Interest, Washington, DC.

    The ideal school cafeteria includes a salad bar and serving tables with healthy food items. Certain cafeteria pitfalls, such as a noisy or stuffy atmosphere, can be avoided by good administration. Specific guidelines on campaigning for better school food consist of building a community coalition that holds public meetings, learning about the…

  17. 40 CFR 158.2174 - Experimental use permit microbial pesticides nontarget organisms and environmental fate data...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... describe how to use this table to determine the terrestrial and aquatic nontarget organisms data... this section. (b) Use patterns. Aquatic uses include: food and feed, nonfood uses (e.g., outdoor... Organisms and Environmental Fate Data Requirements Guideline Number Data Requirement Use Patterns Aquatic...

  18. 77 FR 28225 - Sentencing Guidelines for United States Courts

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-11

    ... (2d Cir. 2011). The amendment establishes a marijuana equivalency for BZP offenses in the Drug...). The marijuana equivalency established by the amendment provides that 1 gram of BZP equals 100 grams of marijuana. Prior to the amendment, the Drug Equivalency Table did not include a marijuana equivalency for...

  19. Identifying Autism in Children with Blindness and Visual Impairments.

    ERIC Educational Resources Information Center

    Gense, Marilyn H.; Gense, D. Jay

    1994-01-01

    This paper offers guidelines to compare the characteristics observed in children with autism and blindness and those observed in children with blindness alone. It distinguishes between stereotypic behaviors (blindisms) in blind individuals and similar stereotypic behaviors of children with autism. A table presents typical behavior patterns of…

  20. Methodology and reporting quality of reporting guidelines: systematic review.

    PubMed

    Wang, Xiaoqin; Chen, Yaolong; Yang, Nan; Deng, Wei; Wang, Qi; Li, Nan; Yao, Liang; Wei, Dang; Chen, Gen; Yang, Kehu

    2015-09-22

    With increasing attention put on the methodology of reporting guidelines, Moher et al. conducted a review of reporting guidelines up to December 2009. Information gaps appeared on many aspects. Therefore, in 2010, the Guidance for Developers of Health Research Reporting Guidelines was developed. With more than four years passed and a considerable investment was put into reporting guideline development, a large number of new, updated, and expanded reporting guidelines have become available since January 2010. We aimed to systematically review the reporting guidelines published since January 2010, and investigate the application of the Guidance. We systematically searched databases including the Cochrane Methodology Register, MEDLINE, and EMBASE, and retrieved EQUATOR and the website (if available) to find reporting guidelines as well as their accompanying documents. We screened the titles and abstracts resulting from searches and extracted data. We focused on the methodology and reporting of the included guidelines, and described information with a series of tables and narrative summaries. Data were summarized descriptively using frequencies, proportions, and medians as appropriate. Twenty-eight and 32 reporting guidelines were retrieved from databases and EQUATOR network, respectively. Reporting guidelines were designed for a broad spectrum of types of research. A considerable number of reporting guidelines were published and updated in recent years. Methods of initial items were given in 45 (75%) guidelines. Thirty-eight (63%) guidelines reported they have reached consensus, and 35 (58%) described their consensus methods. Only 9 (15%) guidelines followed the Guidance. Only few guidelines were developed complying with the Guidance. More attention should be paid to the quality of reporting guidelines.

  1. Oral antiplatelet agents for the management of acute coronary syndromes: A review for nurses and allied healthcare professionals.

    PubMed

    Gesheff, Tania; Barbour, Cescelle

    2017-02-01

    We review the use of oral antiplatelet (OAP) therapies in acute coronary syndrome (ACS) management for nurse practitioners (NPs), focusing on current guideline recommendations. Treatment guidelines and clinical articles from PubMed. Guidelines recommend that dual antiplatelet therapy with a P2Y 12 inhibitor and aspirin be initiated for ACS management. The P2Y 12 inhibitor clopidogrel has established efficacy, but is associated with suboptimal and delayed platelet inhibition and variability in response. The newer P2Y 12 inhibitors prasugrel and ticagrelor have demonstrated superior efficacy outcomes versus clopidogrel. Consequently, non-ST-segment elevation ACS (NSTE-ACS) guidelines now recommend that ticagrelor be used in preference to clopidogrel for patients treated with stents or managed medically. Because of their higher potency, prasugrel and ticagrelor are associated with increased bleeding rates versus clopidogrel, but with no increased risk of severe or life-threatening bleeding. Guidelines recommend dual antiplatelet therapy be continued ≥12 months in both medically managed and stented ACS patients, and in some cases beyond this, in absence of high bleeding risk. Updated guidelines assign preference to ticagrelor over clopidogrel for maintenance therapy in patients with NSTE-ACS and ST-elevation myocardial infarction. Enhanced NP understanding of OAP agents and current guidelines could contribute to improved ACS patient management. ©2017 American Association of Nurse Practitioners.

  2. Laboratory security and emergency response guidance for laboratories working with select agents. Centers for Disease Control and Prevention.

    PubMed

    Richmond, Jonathan Y; Nesby-O'Dell, Shanna L

    2002-12-06

    In recent years, concern has increased regarding use of biologic materials as agents of terrorism, but these same agents are often necessary tools in clinical and research microbiology laboratories. Traditional biosafety guidelines for laboratories have emphasized use of optimal work practices, appropriate containment equipment, well-designed facilities, and administrative controls to minimize risk of worker injury and to ensure safeguards against laboratory contamination. The guidelines discussed in this report were first published in 1999 (U.S. Department of Health and Human Services/CDC and National Institutes of Health. Biosafety in microbiological and biomedical laboratories [BMBL]. Richmond JY, McKinney RW, eds. 4th ed. Washington, DC: US Department of Health and Human Services, 1999 [Appendix F]). In that report, physical security concerns were addressed, and efforts were focused on preventing unauthorized entry to laboratory areas and preventing unauthorized removal of dangerous biologic agents from the laboratory. Appendix F of BMBL is now being revised to include additional information regarding personnel risk assessments, and inventory controls. The guidelines contained in this report are intended for laboratories working with select agents under biosafety-level 2, 3, or 4 conditions as described in Sections II and III of BMBL. These recommendations include conducting facility risk assessments and developing comprehensive security plans to minimize the probability of misuse of select agents. Risk assessments should include systematic, site-specific reviews of 1) physical security; 2) security of data and electronic technology systems; 3) employee security; 4) access controls to laboratory and animal areas; 5) procedures for agent inventory and accountability; 6) shipping/transfer and receiving of select agents; 7) unintentional incident and injury policies; 8) emergency response plans; and 9) policies that address breaches in security. The security plan should be an integral part of daily operations. All employees should be well-trained and equipped, and the plan should be reviewed annually, at least.

  3. 27 CFR 555.206 - Location of magazines.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... in the table of distances for storage of explosive materials in § 555.218. (2) Ammonium nitrate and... for the separation of ammonium nitrate and blasting agents in § 555.220. However, the minimum...

  4. 27 CFR 555.206 - Location of magazines.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... in the table of distances for storage of explosive materials in § 555.218. (2) Ammonium nitrate and... for the separation of ammonium nitrate and blasting agents in § 555.220. However, the minimum...

  5. 27 CFR 555.206 - Location of magazines.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... in the table of distances for storage of explosive materials in § 555.218. (2) Ammonium nitrate and... for the separation of ammonium nitrate and blasting agents in § 555.220. However, the minimum...

  6. 27 CFR 555.206 - Location of magazines.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... in the table of distances for storage of explosive materials in § 555.218. (2) Ammonium nitrate and... for the separation of ammonium nitrate and blasting agents in § 555.220. However, the minimum...

  7. NATO Planning Guide for the Estimation of Chemical, Biological, Radiological, and Nuclear (CBRN) Casualties (AMedP-8(C)) - Parameters for Estimation of Casualties from Exposure to Specified Biological Agents. Addenda to Allied Medical Publication 8

    DTIC Science & Technology

    2011-01-01

    glanders, Q fever, and tularemia , as well as the biotoxin staphylococcal enterotoxin B. Incorporating these five agents into the published NATO guide will...Specified Biological Agents: Brucellosis, Glanders, Q Fever, SEB, and Tularemia . This document describes the research methods used by the study authors...enterotoxin B (SEB), and tularemia . Several editorial changes, such as renumbering figures and tables, updating the corresponding references in the text, and

  8. 2015 update of the evidence base: World Allergy Organization anaphylaxis guidelines.

    PubMed

    Simons, F Estelle R; Ebisawa, Motohiro; Sanchez-Borges, Mario; Thong, Bernard Y; Worm, Margitta; Tanno, Luciana Kase; Lockey, Richard F; El-Gamal, Yehia M; Brown, Simon Ga; Park, Hae-Sim; Sheikh, Aziz

    2015-01-01

    The World Allergy Organization (WAO) Guidelines for the assessment and management of anaphylaxis provide a unique global perspective on this increasingly common, potentially life-threatening disease. Recommendations made in the original WAO Anaphylaxis Guidelines remain clinically valid and relevant, and are a widely accessed and frequently cited resource. In this 2015 update of the evidence supporting recommendations in the Guidelines, new information based on anaphylaxis publications from January 2014 through mid- 2015 is summarized. Advances in epidemiology, diagnosis, and management in healthcare and community settings are highlighted. Additionally, new information about patient factors that increase the risk of severe and/or fatal anaphylaxis and patient co-factors that amplify anaphylactic episodes is presented and new information about anaphylaxis triggers and confirmation of triggers to facilitate specific trigger avoidance and immunomodulation is reviewed. The update includes tables summarizing important advances in anaphylaxis research.

  9. Antibiotic Prescribing Practices for Prevention of Surgical Site Infections in Australia: Increased Uptake of National Guidelines after Surveillance and Reporting and Impact on Infection Rates.

    PubMed

    Bull, Ann L; Worth, Leon J; Spelman, Tim; Richards, Michael J

    2017-10-01

    Antimicrobial prophylaxis is the single most effective intervention to reduce risk of surgical site infections (SSIs); however, prescribing practices should be aligned with accepted and recommended surgical antibiotic prophylaxis (SAP) regimens to be effective. As part of a comprehensive surveillance network, SAP data are collated and analyzed for compliance with recommendations. Results are reported to hospitals for quality improvement purposes. In this study, statewide results were analyzed to ascertain changes over time and whether improved compliance was associated with a reduction in risk for SSI. A standardized tool for monitoring SAP and SSIs was used in Victorian healthcare facilities. For the current study, data submitted for the period 2003-2015 were analyzed. Compliance with national recommendations (Australian Therapeutic Guidelines-Antibiotic) was used as the reference standard for antibiotic selection, timing, and duration Results: A total of 144,075 surgical procedures were surveyed during the study period. During this period, the proportion of patients receiving antibiotic agents according to national guidelines increased. Across all surgical groups, the odds ratio (OR) for appropriate SAP choice increased by 13%/year. Greatest improvement was seen for colorectal procedures (19%/year), with the smallest change observed for cholecystectomy and cardiac operations (9%/year). The OR for receiving an antibiotic agent at the recommended time increased by 12%/year and the odds of the antibiotic agent being discontinued within 24 hours by 27%/year. Non-compliance with a recommended SAP agent and timing was associated with an increased risk of SSI across all procedure groups (OR 1.33, 95% confidence interval 1.24-1.43). Sustained improvements in prescribing practices for SAP have been demonstrated through a comprehensive surveillance and reporting system. Non-compliance with SAP guidelines is associated with an increased risk for SSI. Quality improvement programs must focus on uptake and implementation of evidence-based guidelines.

  10. Supportive Care in Hemato-Oncology: A Review in Light of the Latest Guidelines

    PubMed Central

    Gündüz, Eren; Gülbaş, Zafer

    2012-01-01

    Recent developments in cancer therapy have resulted in increases in treatment success rates and survival. One of thebasic goals of such therapy is improving patient quality of life. Chemotherapy protocols for solid or hematologicalmalignancies-most of which include multiple agents-negatively impact patient quality of life. Additionally, there havebeen developments in supportive care, which seeks to ameliorate or minimize the negative effects of chemotherapy.Herein we present a review and brief summarization of some of the agents used for supportive care in cancer patientsin light of the latest guidelines. PMID:24744617

  11. Radionuclide administration to nursing mothers: mathematically derived guidelines

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

    Romney, B.M.; Nickoloff, E.L.; Esser, P.D.

    We determined a formula to establish objective guidelines for the administration of radionuclides to nursing mothers. The formula is based on the maximum permissible dose to the infant's critical organ, serial measurements of breast milk activity, milk volume, and dose to the critical organ per microcurie in milk. Using worst-case assumptions, we believe that cessation of nursing for 24 hours after administration of technetium labeled radiopharmaceuticals is sufficient for safety. Longer-lived agents require greater delays. Iodine-123 radiopharmaceuticals are preferable to iodine-131 agents and should always be used when studying the unblocked thyroid.

  12. Times and locations of explosions; U.S. Geological Survey 1962 field season

    USGS Publications Warehouse

    Roller, John C.

    1962-01-01

    The U.S. Geological Survey detonated 86 large charges of chemical explosives in the western United States from 6 June to 9 August 1962, in a study of crustal structure in the western United States. This Technical Letter consists of two tables containing information about these explosions. Table I gives a brief geographical description of the shotpoints, and Table II gives the date, time, location, charge size, surface elevation, and some general information about the shots. In the Remarks column (Table II), the configuration and depth of most of the charges are given. This part of the table is not complete, as some of this information has not yet been compiled. Three types of explosives were used in the program. These were: Nitramon WW, a carbo-nitrate blasting agent; Composition B, a mixture of RDX and TNT; and Tovex-Gel, a non-nitroglycerin blasting slurry. The loading, firing, and surveying was done by United ElectroDynamics, Inc., of Pasadena, California. The timing was done by the U.S. Geological Survey.

  13. An evidence-based clinical guideline for the diagnosis and treatment of lumbar disc herniation with radiculopathy.

    PubMed

    Kreiner, D Scott; Hwang, Steven W; Easa, John E; Resnick, Daniel K; Baisden, Jamie L; Bess, Shay; Cho, Charles H; DePalma, Michael J; Dougherty, Paul; Fernand, Robert; Ghiselli, Gary; Hanna, Amgad S; Lamer, Tim; Lisi, Anthony J; Mazanec, Daniel J; Meagher, Richard J; Nucci, Robert C; Patel, Rakesh D; Sembrano, Jonathan N; Sharma, Anil K; Summers, Jeffrey T; Taleghani, Christopher K; Tontz, William L; Toton, John F

    2014-01-01

    The objective of the North American Spine Society's (NASS) Evidence-Based Clinical Guideline for the Diagnosis and Treatment of Lumbar Disc Herniation with Radiculopathy is to provide evidence-based recommendations to address key clinical questions surrounding the diagnosis and treatment of lumbar disc herniation with radiculopathy. The guideline is intended to reflect contemporary treatment concepts for symptomatic lumbar disc herniation with radiculopathy as reflected in the highest quality clinical literature available on this subject as of July 2011. The goals of the guideline recommendations are to assist in delivering optimum efficacious treatment and functional recovery from this spinal disorder. To provide an evidence-based educational tool to assist spine specialists in the diagnosis and treatment of lumbar disc herniation with radiculopathy. Systematic review and evidence-based clinical guideline. This guideline is a product of the Lumbar Disc Herniation with Radiculopathy Work Group of NASS' Evidence-Based Guideline Development Committee. The work group consisted of multidisciplinary spine care specialists trained in the principles of evidence-based analysis. A literature search addressing each question and using a specific search protocol was performed on English-language references found in Medline, Embase (Drugs and Pharmacology), and four additional evidence-based databases to identify articles. The relevant literature was then independently rated using the NASS-adopted standardized levels of evidence. An evidentiary table was created for each of the questions. Final recommendations to answer each clinical question were developed via work group discussion, and grades were assigned to the recommendations using standardized grades of recommendation. In the absence of Level I to IV evidence, work group consensus statements have been developed using a modified nominal group technique, and these statements are clearly identified as such in the guideline. Twenty-nine clinical questions were formulated and addressed, and the answers are summarized in this article. The respective recommendations were graded by strength of the supporting literature, which was stratified by levels of evidence. The clinical guideline has been created using the techniques of evidence-based medicine and best available evidence to aid practitioners in the care of patients with symptomatic lumbar disc herniation with radiculopathy. The entire guideline document, including the evidentiary tables, suggestions for future research, and all the references, is available electronically on the NASS Web site at http://www.spine.org/Pages/PracticePolicy/ClinicalCare/ClinicalGuidlines/Default.aspx and will remain updated on a timely schedule. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Bioterrorism and Biocrimes: The Illicit Use of Biological Agents Since 1900

    DTIC Science & Technology

    2001-02-01

    to white supremacist groups, including the Aryan Nation and the Christian Identity movement, he 5 involve allegations of covert state activities ...toxin to poison livestock in what is now Kenya. The full extent of these activities is not known. Polish Resistance: Multiple reports suggest that...thorough reporting of Aum’s biological warfare activities . See page 47 for additional details. Table 1: Confirmed cases of illicit biological agent activity

  15. Methicillin-Resistant Staphylococcus aureus in Wound Cultures Recovered from a Combat Support Hospital in Iraq

    DTIC Science & Technology

    2010-07-01

    analyzed. Antimicrobial resistance testing was determined by broth microdilution and the BD Phoenix Automated Microbiology System. The genotypic pattern was... trimethoprim -sulfamethoxazole (94%), and clindamy- cin (94%). Of agents not typically recommended as monotherapy, 98% of isolates were susceptible to rifampin...was van- comycin (Table 1). The most active oral antistaphylococcal agents were tetracycline (95.2% of isolates susceptible) and trimethoprim

  16. Test and Evaluation of Commercially Available Halon 1211 Hand-Portable Fire Extinguishers for Use in Habitable and Cargo Compartments of USAF Aircraft

    DTIC Science & Technology

    1981-05-01

    an endorsement or rejection of these products by the Air Force, nor can it be used for advertising a product . SThis report has been reviewed by the... Fvii 41¢,I LIST OF TABLES TABLE TITLE PAGE 1 Baseline Data ............. ......................... .... 24 2 Post-Test Performance - Low Temperature...through its pyrolysis products , when used in the confined crew station or cargo areas of military aircraft. (b) The replacement agent should permit

  17. Mesolimbic and Nigrostriatal Dopaminergic Systems: Behavioral Neuropharmacology.

    DTIC Science & Technology

    1985-08-01

    presented in Table Table III List of drugs D ru gVeh i c l e Intracerebral infusions Dopamine agonist~s Apomorphine hydrochloride 0.1% Na metabisulfite...saline GABA 0.9% saline Picrotoxin 0 .9%saline Systemic injections Dopamine agents d-Amphetamine sulfate 0.9% saline Aponiorphine hydrochloride 0.9...3H)methionine (15 Ci/mmole, lmCi/ml. 16 Amersham), 122 ul of freshly prepared pargyline hydrochloride (10.2 mM), 326 ul of I M Tris pH 10.8, 246 ul

  18. The Potential Application and Risks Associated With the Use of Predatory Bacteria as a Biocontrol Agent Against Wound Infections

    DTIC Science & Technology

    2013-10-01

    were isolated and their ability to prey on S . maltophilia (Table-1 and 2) or S . epidermidis (Table-3 and 4) was examined. All experiments were...bacteria ( S . maltophilia or S . epidermidis ) and the host bacteria E. coli strain WM3064, a diaminopimelic acid (DAP) auxotroph. The specific E. coli...times, in each cycle the fraction of the host E. coli was reduced. Finally, Bdellovibrio cells were isolated and their ability to prey on S

  19. The Potential Application and Risks Associated With the Use of Predatory Bacteria as a Biocontrol Agent Against Wound Infections

    DTIC Science & Technology

    2014-09-01

    host bacteria ( S . maltophilia or S . epidermidis ) and the host bacteria E. coli strain WM3064, a diaminopimelic acid (DAP) auxotroph. The specific E...repeated 11 times, in each cycle the fraction of the host E. coli was reduced. Finally, Bdellovibrio cells were isolated and their ability to prey on S ...maltophilia (Table-1 and 2) or S . epidermidis (Table-3 and 4) was examined. All experiments were conducted in triplicates. Data represent the average

  20. Pre-Clinical Testing of a Real-Time PCR Assay for Diahhreal Disease Agent Cryptosporidium

    DTIC Science & Technology

    2014-05-16

    ETEC, Shigella , and CR assays are shown in Table 4. Standard curves are shown in Figures 1 - 5. Limit of detection estimation derived from standard...curve are shown in Table 5. These data include results from both ‘JBAIDS ETEC/ Shigella ’ and ‘JBAIDS Cryptospordium’ projects. Standard cuve for... Shigella -ipaH 0.088 1.5 × 10 8 Isolates of Cryptosporidium parvum from Waterborne Inc., using Qiagen extraction kit Parasite NanoDrop

  1. General practitioner diagnosis and management of acute knee injuries: summary of an evidence-based guideline.

    PubMed

    Robb, Gillian; Reid, Duncan; Arroll, Bruce; Jackson, Rod T; Goodyear-Smith, Felicity

    2007-02-16

    To summarise evidence and key recommendations for general practitioner diagnosis and management of acute soft-tissue knee injuries, based on the New Zealand guideline. A multidisciplinary team developed the guideline by critically appraising and grading retrieved literature using the Graphic Appraisal Tools for Epidemiology, Clinical decision rules and the Scottish Intercollegiate Guideline Network. Recommendations were derived from resulting evidence tables. For both diagnosis and management there is a paucity of good evidence to support diagnosis and treatment of internal derangements of the knee, hence some aspects of the guideline are guideline team consensus. Good evidence supports the use of the Ottawa Knee rules to guide decisions about the use of X-ray, and the Lachman test in diagnosing anterior cruciate ligament (ACL) tears. Evidence supports inclusion of proprioceptive training in rehabilitation programmes following ACL reconstruction and in people with ACL-deficient knees. There is good evidence that ultrasound is of little benefit, and there is no evidence that physiotherapy be routinely advocated following meniscectomy. This guideline provides an evidence-based framework for diagnosis and management of internal derangements of the knee following acute injury. Moreover, its development highlights significant gaps in the evidence base and identifies priorities for new research.

  2. Prescription practice of biological drugs in rheumatoid arthritis during the first 3 years of post-marketing use in Denmark and Norway: criteria are becoming less stringent

    PubMed Central

    Hjardem, E; Hetland, M; Ostergaard, M; Krogh, N; Kvien, T

    2005-01-01

    Objective: To investigate changes in prescription practice during the first 3 years of post-marketing use of biological drugs, and to determine the proportion of patients who would not have received tumour necrosis factor (TNF) blocking agents if the prescription guidelines of the UK and the Netherlands had been applied. Methods: Patients with rheumatoid arthritis (RA) receiving TNF blocking agents from Denmark (n = 823, median age 56.0, 72.2% women) and Norway (n = 371, median age 52.5, 75.4% women) were studied. Prescription guidelines in the UK and the Netherlands were applied to the data. Results: Baseline disease activity and number of previous DMARDs declined significantly during the 3 years (median baseline DAS28 decreased from 5.8 to 5.2 in Denmark (p<0.001) and from 6.0 to 5.6 in Norway (p<0.01)). 47.9% and 41.3% of the Norwegian and Danish patients, respectively, did not meet the UK criteria for using TNF blocking agents, and 10.5% and 5.7% did not meet the Dutch criteria. Conclusion: Danish and Norwegian prescription practices of biological treatments in RA were similar, and became less stringent from 2000 to 2003. Prescriptions agreed well with the Dutch guidelines, but almost half the patients did not meet the UK guidelines. PMID:15640272

  3. The Role of Affective and Motivational Factors in Designing Personalized Learning Environments

    ERIC Educational Resources Information Center

    Kim, ChanMin

    2012-01-01

    In this paper, guidelines for designing virtual change agents (VCAs) are proposed to support students' affective and motivational needs in order to promote personalized learning in online remedial mathematics courses. Automated, dynamic, and personalized support is emphasized in the guidelines through maximizing "interactions" between VCAs and…

  4. Consensus on the guidelines for the dietary management of classical galactosemia.

    PubMed

    Kerckhove, Kristel Vande; Diels, Marianne; Vanhaesebrouck, Sigrid; Luyten, Karin; Pyck, Nancy; De Meyer, An; Van Driessche, Marleen; Robert, Martine; Corthouts, Karen; Caris, Ariane; Duchateau, Emilie; Dassy, Martine; Bihet, Genevieve

    2015-02-01

    Worldwide there is scientific discussion about the dietary management of galactosemia. The dietary management is very different in several countries among Europe, the US and Canada. The main points of discussion are related to the fact that i) despite a strict diet some patients still have poor outcomes; ii) there is lack of scientific knowledge about the role of endogenous production of galactose on disease evolution, with or without diet. The aim of the current work was the creation of a Belgian consensus on dietary guidelines for the management of galactosemia. A step-wise approach was used to achieve a consensus, including: a workshop, a Delphi round, discussion groups and a round table of different Belgian experts. The consensus is an agreement between strict guidelines (strict limitation of fruits, vegetables and soybean products/French guidelines) and the more liberal guidelines (comparable with a diet free of lactose/guidelines of UK and the Netherlands). The consensus document consists of different modules, including the medical context, the theoretical background of dietary guidelines and the age-specific practical dietary guidelines. A Belgian consensus on the guidelines for the dietary management of classical galactosemia was developed despite the uncertainties of the efficacy and practical application of these guidelines. The final consensus is based on scientific knowledge and practical agreement among experts. In the future, regular revision of the guidelines is recommended and a uniform European guideline is desirable. Copyright © 2014 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

  5. Table-top job analysis

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

    Not Available

    1994-12-01

    The purpose of this Handbook is to establish general training program guidelines for training personnel in developing training for operation, maintenance, and technical support personnel at Department of Energy (DOE) nuclear facilities. TTJA is not the only method of job analysis; however, when conducted properly TTJA can be cost effective, efficient, and self-validating, and represents an effective method of defining job requirements. The table-top job analysis is suggested in the DOE Training Accreditation Program manuals as an acceptable alternative to traditional methods of analyzing job requirements. DOE 5480-20A strongly endorses and recommends it as the preferred method for analyzing jobsmore » for positions addressed by the Order.« less

  6. Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society 2017.

    PubMed

    MacMahon, Heber; Naidich, David P; Goo, Jin Mo; Lee, Kyung Soo; Leung, Ann N C; Mayo, John R; Mehta, Atul C; Ohno, Yoshiharu; Powell, Charles A; Prokop, Mathias; Rubin, Geoffrey D; Schaefer-Prokop, Cornelia M; Travis, William D; Van Schil, Paul E; Bankier, Alexander A

    2017-07-01

    The Fleischner Society Guidelines for management of solid nodules were published in 2005, and separate guidelines for subsolid nodules were issued in 2013. Since then, new information has become available; therefore, the guidelines have been revised to reflect current thinking on nodule management. The revised guidelines incorporate several substantive changes that reflect current thinking on the management of small nodules. The minimum threshold size for routine follow-up has been increased, and recommended follow-up intervals are now given as a range rather than as a precise time period to give radiologists, clinicians, and patients greater discretion to accommodate individual risk factors and preferences. The guidelines for solid and subsolid nodules have been combined in one simplified table, and specific recommendations have been included for multiple nodules. These guidelines represent the consensus of the Fleischner Society, and as such, they incorporate the opinions of a multidisciplinary international group of thoracic radiologists, pulmonologists, surgeons, pathologists, and other specialists. Changes from the previous guidelines issued by the Fleischner Society are based on new data and accumulated experience. © RSNA, 2017 Online supplemental material is available for this article. An earlier incorrect version of this article appeared online. This article was corrected on March 13, 2017.

  7. 29 CFR Appendix B to Subpart L of... - National Consensus Standards

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 5 2010-07-01 2010-07-01 false National Consensus Standards B Appendix B to Subpart L of... Appendix B to Subpart L of Part 1910—National Consensus Standards The following table contains a cross-reference listing of those current national consensus standards which contains information and guidelines...

  8. 29 CFR (non - mandatory) Appendix A to Subpart L of Part 1926-Scaffold Specifications

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... this part. An employer may use these guidelines and tables as a starting point for designing scaffold..., and the employer is still responsible for designing and assembling these components in such a way that... components with other dimensions, etc.) must be designed and constructed in accordance with the capacity...

  9. DRDC Toronto Guidelines for Compensation of Subjects Participating in Research Studies

    DTIC Science & Technology

    2008-09-01

    research subject, it is increasingly likely to amount to an undue incentive for participation.” The Tri-Council Policy statement also describes in... spirometry equipment 0 Tilt table restrictive posture 1 Wrist actigraphy 0 Use of active heating or cooling vests to prevent the fall or rise of core

  10. The How To of Badminton from Player to Teacher.

    ERIC Educational Resources Information Center

    Hicks, Virginia

    This book is designed to help beginning and advanced students learn to play badminton in physical education classes, and to provide guidelines for the physical education instructor teaching badminton. It includes chapters on how to perform all the basic skills and advanced techniques, and provides a table which lists common errors and suggestions…

  11. North Carolina Marine Education Manual, Unit Three: Coastal Ecology.

    ERIC Educational Resources Information Center

    Mauldin, Lundie; Frankenberg, Dirk

    Two dozen activities on the ecology of coastal areas, with special emphasis on North Carolina's coastline, comprise this manual for junior high school science teachers. Provided are a table correlating these lessons with state curriculum guidelines, and a summary of the unit's goals and behavioral objectives. Among the topics included are coastal…

  12. Roles for School Nurses in Adolescent Pregnancy: Prevention, Intervention and Support.

    ERIC Educational Resources Information Center

    Iverson, Carol J.; Klahn, Julie K.

    The 1994 Nebraska Governor's round table subcommittee established the goal of lowering teenage pregnancies in the state by the year 2000. School nurses are in key positions to provide continuous support and surveillance of adolescent health through graduation. This publication presents guidelines and resources to encourage and assist school nurses…

  13. 12 CFR Appendix B to Part 3 - Risk-Based Capital Guidelines; Market Risk Adjustment

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... management systems at least annually. (c) Market risk factors. The bank's internal model must use risk factors sufficient to measure the market risk inherent in all covered positions. The risk factors must... risk weighting factor indicated in Table 2 of this appendix. The specific risk capital charge component...

  14. Kids and Manners - A Ticket to Success. Kindergarten-6th.

    ERIC Educational Resources Information Center

    Cunningham, Patricia; And Others

    Arranged into six parts, the booklet offers practical and motivating techniques for teaching elementary school students the basic rules of etiquette. The areas of general etiquette, cleanliness, introductions, table manners, telephoning, and thank you notes are included. Each section contains simple guidelines on how to act and react in social…

  15. Active Queue Management Mechanisms for Real-Time Traffic in MANETs

    DTIC Science & Technology

    2001-12-01

    characteristics do not change much over a short period of time, substituting indices and/or gains is possible. This study aims to provide general guidelines about... bpf for FEC and 1 bpf to provide future expansion(s) of the coder. Table 6. Federal Standard 1016 characteristics (After Ref. [37]). a...

  16. 76 FR 24960 - Sentencing Guidelines for United States Courts

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-03

    ... 2010, Public Law 111-220 (the ``Act''). The Act reduced the statutory penalties for cocaine base... other drugs, i.e., the base offense levels for crack cocaine are set in the Drug Quantity Table so that..., offenses involving 28 grams or more of crack cocaine are assigned a base offense level of 26, offenses...

  17. Guidelines for designing short-term bird monitoring projects

    Treesearch

    Jonathan Bart

    2005-01-01

    The Coordinated Bird Monitoring Program (Bart and Ralph, this volume) program is helping biologists around the country design short-term monitoring projects for birds. We have found that addressing a series of questions (table 1), in a systematic way, helps insure that projects are well planned. The process is being used by several States and...

  18. 40 CFR Table 1 to Subpart Cb of... - Nitrogen Oxides Guidelines for Designated Facilities

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions... (parts per million by volume) a Mass burn waterwall 205 205. Mass burn rotary waterwall 250 210. Refuse-derived fuel combustor 250 250. Fluidized bed combustor 180 180. Mass burn refractory combustors No limit...

  19. 40 CFR Table 1 to Subpart Cb of... - Nitrogen Oxides Guidelines for Designated Facilities

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions... (parts per million by volume) a Mass burn waterwall 205 205. Mass burn rotary waterwall 250 210. Refuse-derived fuel combustor 250 250. Fluidized bed combustor 180 180. Mass burn refractory combustors No limit...

  20. 40 CFR Table 1 to Subpart Cb of... - Nitrogen Oxides Guidelines for Designated Facilities

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions... (parts per million by volume) a Mass burn waterwall 205 205. Mass burn rotary waterwall 250 210. Refuse-derived fuel combustor 250 250. Fluidized bed combustor 180 180. Mass burn refractory combustors No limit...

  1. ACOEM practice guidelines: elbow disorders.

    PubMed

    Hegmann, Kurt T; Hoffman, Harold E; Belcourt, Roger M; Byrne, Kevin; Glass, Lee; Melhorn, J Mark; Richman, Jack; Zinni, Phillip; Thiese, Matthew S; Ott, Ulrike; Tokita, Kylee; Passey, Deborah Gwenevere; Effiong, Atim Cecelia; Robbins, Riann Bree; Ording, Julie A

    2013-11-01

    The American College of Occupational and Environmental Medicine has updated the treatment guidelines in its Elbow Disorders chapter through revision processes begun in 2006. This abbreviated version of that chapter highlights some of the evidence and recommendations developed. Comprehensive systematic literature reviews were accomplished with article abstraction, critiquing, grading, evidence table compilation, and guideline finalization by a multidisciplinary expert panel and extensive peer-review to develop evidence-based guidance. Consensus recommendations were formulated when evidence was lacking and often relied on analogy to other disorders for which evidence exists. A total of 108 high- or moderate-quality trials were identified for elbow disorders. Guidance has been developed for 13 major diagnoses and includes 270 specific recommendations. Quality evidence is now available to guide treatment for elbow disorders, particularly for lateral epicondylalgia.

  2. ACOEM practice guidelines: opioids and safety-sensitive work.

    PubMed

    Hegmann, Kurt T; Weiss, Michael S; Bowden, Kirk; Branco, Fernando; DuBrueler, Kimberly; Els, Charl; Mandel, Steven; McKinney, David W; Miguel, Rafael; Mueller, Kathryn L; Nadig, Robert J; Schaffer, Michael I; Studt, Larry; Talmage, James B; Travis, Russell L; Winters, Thomas; Thiese, Matthew S; Harris, Jeffrey S

    2014-07-01

    ACOEM has updated the treatment guidelines concerning opioids. This report highlights the safety-sensitive work recommendation that has been developed. Comprehensive literature reviews were accomplished with article abstraction, critiquing, grading, evidence table compilation, and guideline finalization by a multidisciplinary expert panel to develop evidence-based guidance. A total of 12 moderate-quality studies were identified to address motor vehicle crash risk, and none regarding other work among opioid-using patients. Acute or chronic opioid use is not recommended for patients who perform safety-sensitive jobs. These jobs include operating motor vehicles, other modes of transportation, forklift driving, overhead crane operation, heavy equipment operation and tasks involving high levels of cognitive function and judgment. Quality evidence consistently demonstrates increased risk of vehicle crashes and is recommended as the surrogate for other safety-sensitive work tasks.

  3. Construct Demo Input Deck

    DTIC Science & Technology

    2010-06-01

    information diffusion patterns when bridging agents span two otherwise separate groups ? and then how such a simulation would be simulated using ...All users may find it more useful to use the table of contents in order to read sections of interest and reference chain to other parts of the...expression evaluates to 0+20-1 = 19, which would be the end-value expected for a zero-indexed group of twenty agents. Similar calculation can be used to

  4. Antipsychotic-induced hyperprolactinemia: synthesis of world-wide guidelines and integrated recommendations for assessment, management and future research.

    PubMed

    Grigg, Jasmin; Worsley, Roisin; Thew, Caroline; Gurvich, Caroline; Thomas, Natalie; Kulkarni, Jayashri

    2017-11-01

    Hyperprolactinemia is a highly prevalent adverse effect of many antipsychotic agents, with potentially serious health consequences. Several guidelines have been developed for the management of this condition; yet, their concordance has not been evaluated. The objectives of this paper were (1) to review current clinical guidelines; (2) to review key systematic evidence for management; and (3) based on our findings, to develop an integrated management recommendation specific to male and female patients who are otherwise clinically stabilised on antipsychotics. We performed searches of Medline and EMBASE, supplemented with guideline-specific database and general web searches, to identify clinical guidelines containing specific recommendations for antipsychotic-induced hyperprolactinemia, produced/updated 01/01/2010-15/09/2016. A separate systematic search was performed to identify emerging management approaches described in reviews and meta-analyses published ≥ 2010. There is some consensus among guidelines relating to baseline PRL screening (8/12 guidelines), screening for differential diagnosis (7/12) and discontinuing/switching PRL-raising agent (7/12). Guidelines otherwise diverge substantially regarding most aspects of screening, monitoring and management (e.g. treatment with dopamine agonists). There is an omission of clear sex-specific recommendations. Systematic literature on management approaches is promising; more research is needed. An integrated management recommendation is presented to guide sex-specific clinical response to antipsychotic-induced hyperprolactinemia. Key aspects include asymptomatic hyperprolactinemia monitoring and fertility considerations with PRL normalisation. Further empirical work is key to shaping robust guidelines for antipsychotic-induced hyperprolactinemia. The integrated management recommendation can assist clinician and patient decision-making, with the goal of balancing effective psychiatric treatment while minimising PRL-related adverse health effects in male and female patients.

  5. Creating a table of authorization to empower staff.

    PubMed

    Freed, D H

    1997-11-01

    Empowering frontline managers to make and accept accountability for decisions poses a significant challenge, especially for integrated delivery systems (IDSs) where multiple organizational layers and complex management structures can create confusion about roles and responsibilities. Without a clear set of guidelines for independent action, attempts to achieve staff empowerment are likely to fail. To achieve its empowerment goals, Overlook Hospital in Summit, New Jersey, a part of the Atlantic Health System, a New Jersey-based IDS, developed the "Table of Authorization for the Commitment or Expenditure of the System's Physical or Financial Resources." This management tool clarifies the degree to which frontline managers may make decisions and initiate actions without the need for senior management or board approval. The table provides an effective means of promoting a uniform basis for decision making across the system and encourages improved customer service vital in competitive markets.

  6. [Formaldehyde-reducing efficiency of a newly developed dissection-table-connected local ventilation system in the gross anatomy laboratory room].

    PubMed

    Shinoda, Koh; Oba, Jun

    2010-03-01

    In compliance with health and safety management guidelines against harmful formaldehyde (FA) levels in the gross anatomy laboratory, we newly developed a dissection-table-connected local ventilation system in 2006. The system was composed of (1) a simple plenum-chambered dissection table with low-cost filters, (2) a transparent vinyl flexible duct for easy mounting and removal, which connects the table and the exhaust pipe laid above the ceiling, and (3) an intake creating a downward-flow of air, which was installed on the ceiling just above each table. The dissection table was also designed as a separate-component system, of which the upper plate and marginal suction inlets can be taken apart for cleaning after dissection, and equipped with opening/closing side-windows for picking up materials dropped during dissection and a container underneath the table to receive exudate from the cadaver through a waste-fluid pipe. The local ventilation system dramatically reduced FA levels to 0.01-0.03 ppm in the gross anatomy laboratory room, resulting in no discomforting FA smell and irritating sensation while preserving the student's view of room and line of flow as well as solving the problems of high maintenance cost, sanitation issues inside the table, and working-inconvenience during dissection practice. Switching ventilation methods or power-modes, the current local ventilation system was demonstrated to be more than ten times efficient in FA reduction compared to the whole-room ventilation system and suggested that 11 m3/min/table in exhaust volume should decrease FA levels in both A- and B-measurements to less than 0.1 ppm in 1000 m3 space containing thirty-one 3.5%-FA-fixed cadavers.

  7. Changeable HA to improve MIPv6 protocol

    NASA Astrophysics Data System (ADS)

    Hu, Qing-gui

    2015-12-01

    For mobile IPv6, home agent (HA) plays an important role. Each mobile node (MN) has a home IP address, it will be not changeable. Also, the home agent (HA) of MN is not changeable. This rule provides the convenient for the ongoing communication without interruption. But it has some obvious drawbacks. Here, the new variable HA scheme is proposed. Every MN has a dynamic cache table, recording the information such as its home address, care-of address, and history address etc. If the accumulated time in one region exceeds that in the hometown, the foreign agent (FA) could become home agent (HA), the home agent could become history agent. Later, the performance of the new protocol is simulated with OPNET software, whose result shows the performance of the new protocol works better than that of the traditional protocol.

  8. Diagnosis and treatment of chronic constipation – a European perspective

    PubMed Central

    Tack, J; Müller-Lissner, S; Stanghellini, V; Boeckxstaens, G; Kamm, M A; Simren, M; Galmiche, J-P; Fried, M

    2011-01-01

    Background Although constipation can be a chronic and severe problem, it is largely treated empirically. Evidence for the efficacy of some of the older laxatives from well-designed trials is limited. Patients often report high levels of dissatisfaction with their treatment, which is attributed to a lack of efficacy or unpleasant side-effects. Management guidelines and recommendations are limited and are not sufficiently current to include treatments that became available more recently, such as prokinetic agents in Europe. Purpose We present an overview of the pathophysiology, diagnosis, current management and available guidelines for the treatment of chronic constipation, and include recent data on the efficacy and potential clinical use of the more newly available therapeutic agents. Based on published algorithms and guidelines on the management of chronic constipation, secondary pathologies and causes are first excluded and then diet, lifestyle, and, if available, behavioral measures adopted. If these fail, bulk-forming, osmotic, and stimulant laxatives can be used. If symptoms are not satisfactorily resolved, a prokinetic agent such as prucalopride can be prescribed. Biofeedback is recommended as a treatment for chronic constipation in patients with disordered defecation. Surgery should only be considered once all other treatment options have been exhausted. PMID:21605282

  9. Guidelines of care for the management of psoriasis and psoriatic arthritis Section 3. Guidelines of care for the management and treatment of psoriasis with topical therapies

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

    Menter, A.; Korman, N.J.; Elmets, C.A.

    2009-04-15

    Psoriasis is a common, chronic, inflammatory, multi-system disease with predominantly skin and joint manifestations affecting approximately 2% of the Population. In this third of 6 sections of the guidelines of care for psoriasis, we discuss the use of topical medications for the treatment of psoriasis. The majority of patients with psoriasis have limited disease (<5% body surface area involvement) and can be treated with topical agents, which generally provide a high efficacy-to-safety ratio. Topical agents may also be used adjunctively for patients with more extensive psoriasis undergoing therapy with either ultraviolet light, systemic or biologic medications. However, the use ofmore » topical agents as monotherapy in the setting of extensive disease or in the setting of limited, but recalcitrant, disease is not routinely recommended. Treatment should be tailored to meet individual patients' needs. We will discuss the efficacy and safety of as well as offer recommendations for the use of topical corticosteroids, vitamin D analogues, tazarotene, tacrolimus, pimecrolimus, emollients, salicylic acid, anthralin, coal tar, as well as combination therapy.« less

  10. Monitoring of Nonsteroidal Immunosuppressive Drugs in Patients With Lung Disease and Lung Transplant Recipients

    PubMed Central

    Meyer, Keith C; Nathanson, Ian; Angel, Luis; Bhorade, Sangeeta M; Chan, Kevin M; Culver, Daniel; Harrod, Christopher G; Hayney, Mary S; Highland, Kristen B; Limper, Andrew H; Patrick, Herbert; Strange, Charlie; Whelan, Timothy

    2012-01-01

    Objectives: Immunosuppressive pharmacologic agents prescribed to patients with diffuse interstitial and inflammatory lung disease and lung transplant recipients are associated with potential risks for adverse reactions. Strategies for minimizing such risks include administering these drugs according to established, safe protocols; monitoring to detect manifestations of toxicity; and patient education. Hence, an evidence-based guideline for physicians can improve safety and optimize the likelihood of a successful outcome. To maximize the likelihood that these agents will be used safely, the American College of Chest Physicians established a committee to examine the clinical evidence for the administration and monitoring of immunosuppressive drugs (with the exception of corticosteroids) to identify associated toxicities associated with each drug and appropriate protocols for monitoring these agents. Methods: Committee members developed and refined a series of questions about toxicities of immunosuppressives and current approaches to administration and monitoring. A systematic review was carried out by the American College of Chest Physicians. Committee members were supplied with this information and created this evidence-based guideline. Conclusions: It is hoped that these guidelines will improve patient safety when immunosuppressive drugs are given to lung transplant recipients and to patients with diffuse interstitial lung disease. PMID:23131960

  11. Consensus guidelines for dosing of amoxicillin-clavulanate in melioidosis.

    PubMed

    Cheng, Allen C; Chierakul, Wirongrong; Chaowagul, Wipada; Chetchotisakd, Ploenchan; Limmathurotsakul, Direk; Dance, David A B; Peacock, Sharon J; Currie, Bart J

    2008-02-01

    Melioidosis is an infectious disease endemic to northern Australia and Southeast Asia. In response to clinical confusion regarding the appropriate dose of amoxicillin-clavulanate, we have developed guidelines for the appropriate dosing of this second-line agent. For eradication therapy for melioidosis, we recommend 20/5 mg/kg orally, three times daily.

  12. Guidelines for the Clinical Evaluation of Psychoactive Drugs in Infants and Children.

    ERIC Educational Resources Information Center

    Food and Drug Administration (DHEW), Washington, DC.

    These guidelines are intended to help those who design and conduct investigations of psychopharmacologic agents in children. A progression of studies in four phases is advocated. First, early short term studies should establish single and multiple dose safety baselines. Second, early pilot efficacy studies may be initiated jointly with longer…

  13. [Prospective multi-institutional analysis according to the "Japanese guidelines for prevention of perioperative infections in urological field"].

    PubMed

    Wada, Koichiro; Uehara, Shinya; Kira, Shinichiro; Matsumoto, Masahiro; Sho, Takehiko; Kurimura, Yuichiro; Hashimoto, Jiro; Uehara, Teruhisa; Yamane, Takashi; Kanamaru, Sojun; Togo, Yoshikazu; Taoka, Rikiya; Takahashi, Akira; Yamada, Yusuke; Yokomizo, Akira; Yasuda, Mitsuru; Tanaka, Kazushi; Hamasuna, Ryoichi; Takahashi, Satoshi; Hayami, Hiroshi; Watanabe, Toyohiko; Monden, Koichi; Kiyota, Hiroshi; Deguchi, Takashi; Naito, Seiji; Tsukamoto, Taiji; Arakawa, Soichi; Fujisawa, Masato; Yamamoto, Shingo; Kumon, Hiromi; Matsumoto, Tetsuro

    2013-05-01

    The "Japanese guidelines for prevention of perioperative infections in urological field" was edited by the Japanese Urological Association in 2007. They are the first Japanese guidelines for antimicrobial prophylaxis specifically to prevent perioperative infections in the urological field. We report here the results of a multicenter prospective study conducted to examine the validity and usefulness of these guidelines. The subjects were 513 patients who had undergone urological surgeries between July and September 2008 at 10 nationwide university institutions in the Japanese Society of UTI Cooperative Study Group. These surgeries were transurethral resection of bladder (TURBT), transurethral resection of prostate (TURP), adrenalectomy, nephrectomy, nephroureterectomy, radical prostatectomy and total cystectomy. Analysis was performed on patient information, surgical procedures, types and durations of administration of prophylactic antibiotic agents, and the presence of surgical site infections (SSI) and remote infections (RI). Of 513 patients, 387 (75.4%) were administered prophylactic antibiotic agents according to the guidelines. In these patients, the incidences of SSI and RI were 5.9% and 4.1%, respectively. Multivariate analysis showed that significant factors for SSI were the surgical risk (according to the ASA physical status classification system), diabetes, and operation time, and that the only significant factor for RI was the operation time. More large-scale study and evidences are necessary in order to demonstrate the validity and usefulness of these guidelines.

  14. EAU Guidelines on Non-Muscle-invasive Urothelial Carcinoma of the Bladder: Update 2016.

    PubMed

    Babjuk, Marko; Böhle, Andreas; Burger, Maximilian; Capoun, Otakar; Cohen, Daniel; Compérat, Eva M; Hernández, Virginia; Kaasinen, Eero; Palou, Joan; Rouprêt, Morgan; van Rhijn, Bas W G; Shariat, Shahrokh F; Soukup, Viktor; Sylvester, Richard J; Zigeuner, Richard

    2017-03-01

    The European Association of Urology (EAU) panel on Non-muscle-invasive Bladder Cancer (NMIBC) released an updated version of the guidelines on Non-muscle-invasive Bladder Cancer. To present the 2016 EAU guidelines on NMIBC. A broad and comprehensive scoping exercise covering all areas of the NMIBC guidelines published between April 1, 2014, and May 31, 2015, was performed. Databases covered by the search included Medline, Embase, and the Cochrane Libraries. Previous guidelines were updated, and levels of evidence and grades of recommendation were assigned. Tumours staged as TaT1 or carcinoma in situ (CIS) are grouped as NMIBC. Diagnosis depends on cystoscopy and histologic evaluation of the tissue obtained by transurethral resection of the bladder (TURB) in papillary tumours or by multiple bladder biopsies in CIS. In papillary lesions, a complete TURB is essential for the patient's prognosis. If the initial resection is incomplete, there is no muscle in the specimen, or a high-grade or T1 tumour is detected, a second TURB should be performed within 2-6 wk. The risks of both recurrence and progression may be estimated for individual patients using the European Organisation for Research and Treatment of Cancer (EORTC) scoring system and risk tables. The stratification of patients into low-, intermediate-, and high-risk groups is pivotal to recommending adjuvant treatment. For patients with a low-risk tumour and intermediate-risk patients at a lower risk of recurrence, one immediate instillation of chemotherapy is recommended. Patients with an intermediate-risk tumour should receive 1 yr of full-dose bacillus Calmette-Guérin (BCG) intravesical immunotherapy or instillations of chemotherapy for a maximum of 1 yr. In patients with high-risk tumours, full-dose intravesical BCG for 1-3 yr is indicated. In patients at highest risk of tumour progression, immediate radical cystectomy (RC) should be considered. RC is recommended in BCG-refractory tumours. The long version of the guidelines is available at the EAU Web site (www.uroweb.org/guidelines). These abridged EAU guidelines present updated information on the diagnosis and treatment of NMIBC for incorporation into clinical practice. The European Association of Urology has released updated guidelines on Non-muscle-invasive Bladder Cancer (NMIBC). Stratification of patients into low-, intermediate-, and high-risk groups is essential for decisions about adjuvant intravesical instillations. Risk tables can be used to estimate risks of recurrence and progression. Radical cystectomy should be considered only in case of failure of instillations or in NMIBC with the highest risk of progression. Copyright © 2016. Published by Elsevier B.V.

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

    PubMed

    Ryom, L; Boesecke, C; Gisler, V; Manzardo, C; Rockstroh, J K; Puoti, M; Furrer, H; Miro, J M; Gatell, J M; Pozniak, A; Behrens, G; Battegay, M; Lundgren, J D

    2016-02-01

    The European AIDS Clinical Society (EACS) guidelines are intended for all clinicians involved in the care of HIV-positive persons, and are available in print, online, and as a free App for download for iPhone and Android. The 2015 version of the EACS guidelines contains major revisions in all sections; antiretroviral treatment (ART), comorbidities, coinfections and opportunistic diseases. Among the key revisions is the recommendation of ART for all HIV-positive persons, irrespectively of CD4 count, based on the Strategic Timing of AntiRetroviral Treatment (START) study results. The recommendations for the preferred and the alternative ART options have also been revised, and a new section on the use of pre-exposure prophylaxis (PrEP) has been added. A number of new antiretroviral drugs/drug combinations have been added to the updated tables on drug-drug interactions, adverse drug effects, dose adjustment for renal/liver insufficiency and for ART administration in persons with swallowing difficulties. The revisions of the coinfection section reflect the major advances in anti-hepatitis C virus (HCV) treatment with direct-acting antivirals with earlier start of treatment in individuals at increased risk of liver disease progression, and a phasing out of interferon-containing treatment regimens. The section on opportunistic diseases has been restructured according to individual pathogens/diseases and a new overview table has been added on CD4 count thresholds for different primary prophylaxes. The diagnosis and management of HIV infection and related coinfections, opportunistic diseases and comorbidities continue to require a multidisciplinary effort for which the 2015 version of the EACS guidelines provides an easily accessable and updated overview. © 2015 British HIV Association.

  16. Distribution of peanut allergen in the environment.

    PubMed

    Perry, Tamara T; Conover-Walker, Mary Kay; Pomés, Anna; Chapman, Martin D; Wood, Robert A

    2004-05-01

    Patients with peanut allergy can have serious reactions to very small quantities of peanut allergen and often go to extreme measures to avoid potential contact with this allergen. The purpose of this study was to detect peanut allergen under various environmental conditions and examine the effectiveness of cleaning agents for allergen removal. A monoclonal-based ELISA for Arachis hypogaea allergen 1 (Ara h 1; range of detection, 30-2000 ng/mL) was used to assess peanut contamination on cafeteria tables and other surfaces in schools, the presence of residual peanut protein after using various cleaning products on hands and tabletops, and airborne peanut allergen during the consumption of several forms of peanut. After hand washing with liquid soap, bar soap, or commercial wipes, Ara h 1 was undetectable. Plain water and antibacterial hand sanitizer left detectable Ara h 1 on 3 of 12 and 6 of 12 hands, respectively. Common household cleaning agents removed peanut allergen from tabletops, except dishwashing liquid, which left Ara h 1 on 4 of 12 tables. Of the 6 area preschools and schools evaluated, Ara h 1 was found on 1 of 13 water fountains, 0 of 22 desks, and 0 of 36 cafeteria tables. Airborne Ara h 1 was undetectable in simulated real-life situations when participants consumed peanut butter, shelled peanuts, and unshelled peanuts. The major peanut allergen, Ara h 1, is relatively easily cleaned from hands and tabletops with common cleaning agents and does not appear to be widely distributed in preschools and schools. We were not able to detect airborne allergen in many simulated environments.

  17. Agent-Based Models in Empirical Social Research

    ERIC Educational Resources Information Center

    Bruch, Elizabeth; Atwell, Jon

    2015-01-01

    Agent-based modeling has become increasingly popular in recent years, but there is still no codified set of recommendations or practices for how to use these models within a program of empirical research. This article provides ideas and practical guidelines drawn from sociology, biology, computer science, epidemiology, and statistics. We first…

  18. Challenges and Practices in Building and Implementing Biosafety and Biosecurity Programs to Enable Basic and Translational Research with Select Agents.

    PubMed

    Jonsson, Colleen B; Cole, Kelly Stefano; Roy, Chad J; Perlin, David S; Byrne, Gerald

    2013-04-29

    Select agent research in the United States must meet federally-mandated biological surety guidelines and rules which are comprised of two main components: biosecurity and biosafety. Biosecurity is the process employed for ensuring biological agents are properly safeguarded against theft, loss, diversion, unauthorized access or use/release. Biosafety is those processes that ensure that operations with such agents are conducted in a safe, secure and reliable manner. As such, a biological surety program is generally concerned with biological agents that present high risk for adverse medical and/or agricultural consequences upon release outside of proper containment. The U.S. Regional and National Biocontainment Laboratories (RBL, NBL) represent expertise in this type of research, and are actively engaged in the development of programs to address these critical needs and federal requirements. While this comprises an ongoing activity for the RBLs, NBLs and other facilities that handle select agents as new guidelines and regulations are implemented, the present article is written with the goal of presenting a simplified yet comprehensive review of these requirements. Herein, we discuss the requirements and the various activities that the RBL/NBL programs have implemented to achieve these metrics set forth by various agencies within the U.S. Federal government.

  19. Information security for compliance with select agent regulations.

    PubMed

    Lewis, Nick; Campbell, Mark J; Baskin, Carole R

    2015-01-01

    The past decade has seen a significant rise in research on high-consequence human and animal pathogens, many now known as "select agents." While physical security around these agents is tightly regulated, information security standards are still lagging. The understanding of the threats unique to the academic and research environment is still evolving, in part due to poor communication between the various stakeholders. Perhaps as a result, information security guidelines published by select agent regulators lack the critical details and directives needed to achieve even the lowest security level of the Federal Information Security Management Act (FISMA). While only government agencies are currently required to abide by the provisions of FISMA (unless specified as preconditions for obtaining government grants or contracts--still a relatively rare or narrowly scoped occurrence), the same strategies were recently recommended by executive order for others. We propose that information security guidelines for select agent research be updated to promulgate and detail FISMA standards and processes and that the latter be ultimately incorporated into select agent regulations. We also suggest that information security in academic and research institutions would greatly benefit from active efforts to improve communication among the biosecurity, security, and information technology communities, and from a secure venue for exchange of timely information on emerging threats and solutions in the research environment.

  20. Information Security for Compliance with Select Agent Regulations

    PubMed Central

    Lewis, Nick; Campbell, Mark J.

    2015-01-01

    The past decade has seen a significant rise in research on high-consequence human and animal pathogens, many now known as “select agents.” While physical security around these agents is tightly regulated, information security standards are still lagging. The understanding of the threats unique to the academic and research environment is still evolving, in part due to poor communication between the various stakeholders. Perhaps as a result, information security guidelines published by select agent regulators lack the critical details and directives needed to achieve even the lowest security level of the Federal Information Security Management Act (FISMA). While only government agencies are currently required to abide by the provisions of FISMA (unless specified as preconditions for obtaining government grants or contracts—still a relatively rare or narrowly scoped occurrence), the same strategies were recently recommended by executive order for others. We propose that information security guidelines for select agent research be updated to promulgate and detail FISMA standards and processes and that the latter be ultimately incorporated into select agent regulations. We also suggest that information security in academic and research institutions would greatly benefit from active efforts to improve communication among the biosecurity, security, and information technology communities, and from a secure venue for exchange of timely information on emerging threats and solutions in the research environment. PMID:26042864

  1. Challenges and Practices in Building and Implementing Biosafety and Biosecurity Programs to Enable Basic and Translational Research with Select Agents

    PubMed Central

    Jonsson, Colleen B.; Cole, Kelly Stefano; Roy, Chad J.; Perlin, David S.; Byrne, Gerald

    2014-01-01

    Select agent research in the United States must meet federally-mandated biological surety guidelines and rules which are comprised of two main components: biosecurity and biosafety. Biosecurity is the process employed for ensuring biological agents are properly safeguarded against theft, loss, diversion, unauthorized access or use/release. Biosafety is those processes that ensure that operations with such agents are conducted in a safe, secure and reliable manner. As such, a biological surety program is generally concerned with biological agents that present high risk for adverse medical and/or agricultural consequences upon release outside of proper containment. The U.S. Regional and National Biocontainment Laboratories (RBL, NBL) represent expertise in this type of research, and are actively engaged in the development of programs to address these critical needs and federal requirements. While this comprises an ongoing activity for the RBLs, NBLs and other facilities that handle select agents as new guidelines and regulations are implemented, the present article is written with the goal of presenting a simplified yet comprehensive review of these requirements. Herein, we discuss the requirements and the various activities that the RBL/NBL programs have implemented to achieve these metrics set forth by various agencies within the U.S. Federal government. PMID:24900945

  2. Management of bleeding and coagulopathy following major trauma: an updated European guideline

    PubMed Central

    2013-01-01

    Introduction Evidence-based recommendations are needed to guide the acute management of the bleeding trauma patient. When these recommendations are implemented patient outcomes may be improved. Methods The multidisciplinary Task Force for Advanced Bleeding Care in Trauma was formed in 2005 with the aim of developing a guideline for the management of bleeding following severe injury. This document represents an updated version of the guideline published by the group in 2007 and updated in 2010. Recommendations were formulated using a nominal group process, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) hierarchy of evidence and based on a systematic review of published literature. Results Key changes encompassed in this version of the guideline include new recommendations on the appropriate use of vasopressors and inotropic agents, and reflect an awareness of the growing number of patients in the population at large treated with antiplatelet agents and/or oral anticoagulants. The current guideline also includes recommendations and a discussion of thromboprophylactic strategies for all patients following traumatic injury. The most significant addition is a new section that discusses the need for every institution to develop, implement and adhere to an evidence-based clinical protocol to manage traumatically injured patients. The remaining recommendations have been re-evaluated and graded based on literature published since the last edition of the guideline. Consideration was also given to changes in clinical practice that have taken place during this time period as a result of both new evidence and changes in the general availability of relevant agents and technologies. Conclusions A comprehensive, multidisciplinary approach to trauma care and mechanisms with which to ensure that established protocols are consistently implemented will ensure a uniform and high standard of care across Europe and beyond. Please see related letter by Morel et alhttp://ccforum.com/content/17/4/442 PMID:23601765

  3. Quantification of the Effect of Shuttling on Computed Tomography Perfusion Parameters by Investigation of Aortic Inputs on Different Table Positions From Shuttle-Mode Scans of Lung and Liver Tumors.

    PubMed

    Ghosh, Payel; Chandler, Adam G; Hobbs, Brian P; Sun, Jia; Rong, John; Hong, David; Subbiah, Vivek; Janku, Filip; Naing, Aung; Hwu, Wen-Jen; Ng, Chaan S

    The aim of this study was to quantify the effect of shuttling on computed tomography perfusion (CTp) parameters derived from shuttle-mode body CT images using aortic inputs from different table positions. Axial shuttle-mode CT scans were acquired from 6 patients (10 phases, 2 nonoverlapping table positions 1.4 seconds apart) after contrast agent administration. Artifacts resulting from the shuttling motion were corrected with nonrigid registration before computing CTp maps from 4 aortic levels chosen from the most superior and inferior slices of each table position scan. The effect of shuttling on CTp parameters was estimated by mean differences in mappings obtained from aortic inputs in different table positions. Shuttling effect was also quantified using 95% limits of agreement of CTp parameter differences within-table and between-table aortic positions from the interaortic mean CTp values. Blood flow, permeability surface, and hepatic arterial fraction differences were insignificant (P > 0.05) for both within-table and between-table comparisons. The 95% limits of agreement for within-table blood volume (BV) value deviations obtained from lung tumor regions were less than 4.7% (P = 0.18) compared with less than 12.2% (P = 0.003) for between-table BV value deviations. The 95% limits of agreement of within-table deviations for liver tumor regions were less than 1.9% (P = 0.55) for BV and less than 3.2% (P = 0.23) for mean transit time, whereas between-table BV and mean transit time deviations were less than 11.7% (P < 0.01) and less than 14.6% (P < 0.01), respectively. Values for normal liver tissue regions were concordant. Computed tomography perfusion parameters acquired from aortic levels within-table positions generally yielded higher agreement than mappings obtained from aortic levels between-table positions indicating differences due to shuttling effect.

  4. Identifying the effective evidence sources to use in developing Clinical Guidelines for Acute Stroke Management: lived experiences of the search specialist and project manager.

    PubMed

    Parkhill, Anne; Hill, Kelvin

    2009-03-01

    The Australian National Stroke Foundation appointed a search specialist to find the best available evidence for the second edition of its Clinical Guidelines for Acute Stroke Management. To identify the relative effectiveness of differing evidence sources for the guideline update. We searched and reviewed references from five valid evidence sources for clinical and economic questions: (i) electronic databases; (ii) reference lists of relevant systematic reviews, guidelines, and/or primary studies; (iii) table of contents of a number of key journals for the last 6 months; (iv) internet/grey literature; and (v) experts. Reference sources were recorded, quantified, and analysed. In the clinical portion of the guidelines document, there was a greater use of previous knowledge and sources other than electronic databases for evidence, while there was a greater use of electronic databases for the economic section. The results confirmed that searchers need to be aware of the context and range of sources for evidence searches. For best available evidence, searchers cannot rely solely on electronic databases and need to encompass many different media and sources.

  5. A Detailed Comparison of Maxicalculators. Illinois Series on Educational Applications of Computers. Number 6.

    ERIC Educational Resources Information Center

    Doring, Richard; Hicks, Bruce

    A comparison is made of four maxicalculators and two minicomputers with an emphasis on two, the HP 9830 and the Wang 2200. Comparisons are in the form of a table with individual guidelines for analysis followed by the specific characteristics of the particular calculator. Features compared include: manual input facilities, screen, secondary…

  6. 75 FR 58023 - Guidelines Establishing Test Procedures for the Analysis of Pollutants Under the Clean Water Act...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-23

    ... http://www.regulations.gov or e-mail. The http://www.regulations.gov Web site is an ``anonymous access... preceding FOR FURTHER INFORMATION CONTACT section. B. What should I consider as I prepare my comments for... VCSB: Voluntary Consensus Standards Body WET: Whole Effluent Toxicity Table of Contents I. Statutory...

  7. The Aztec, Frida Kahlo, and Cinco de Mayo: Mexico in Children's Literature

    ERIC Educational Resources Information Center

    Bauml, Michelle; Field, Sherry L.

    2012-01-01

    The authors provide an overview of children's books published in the United States during the last decade (2000-2010) that deal with Mexico and Mexican people. Suggested guidelines for selecting quality books and a list of award-winning titles are included as resources for teaching about Mexico. (Contains 2 tables and 4 figures.)

  8. Handbook for the Development of a Cooperative Adult Basic Education Program in Industry.

    ERIC Educational Resources Information Center

    Felton, Mimi Edge

    Based on experience gained during the development of the Planters Employee Training (PET) program in cooperation with the Suffolk City Schools, Virginia, this handbook provides guidelines for similar cooperative adult basic education (CABE) programs. The table of contents is arranged in the order in which the CABE/PET program was developed and…

  9. Radiolabelled D2 agonists as prolactinoma imaging agents

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

    Otto, C.A.

    1991-12-31

    Research conducted in this terminal year of support centered on three distinct areas: mAChR ligand localization in pancreas and the effect of Ca{sup +2} on localization, continuation of assessment of quaternized and neutral mAChR ligands for possible use as PET myocardial imaging agents, and initiation of a study to determine the relationship of the nAChR receptor to the cellular receptor for measles virus. Several tables and figures illustrating the results are included.

  10. [French Society of Vascular Medicine good medical practice guidelines on safety and environment in vascular medicine: Treatment of varicose veins].

    PubMed

    Giordana, P; Miserey, G

    2014-12-01

    These guidelines proposed by the French Society of Vascular Medicine define the optimal environment for vascular medicine practice: outpatient clinic; equipment, layout and maintenance of the care center; infection risk prevention (hand hygiene, individual protective measures, exposure to blood, ultrasound apparatus, etc.); common interventions and techniques (liquid and foam sclerotherapy, endovenous thermal treatments). These guidelines do not include phlebectomy and use of ultrasound contrast agents. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  11. Short Report: Consensus Guidelines for Dosing of Amoxicillin-Clavulanate in Melioidosis

    PubMed Central

    Cheng, Allen C.; Chierakul, Wirongrong; Chaowagul, Wipada; Chetchotisakd, Ploenchan; Limmathurotsakul, Direk; Dance, David A. B.; Peacock, Sharon J.; Currie, Bart J.

    2009-01-01

    Melioidosis is an infectious disease endemic to northern Australia and Southeast Asia. In response to clinical confusion regarding the appropriate dose of amoxicillin-clavulanate, we have developed guidelines for the appropriate dosing of this second-line agent. For eradication therapy for melioidosis, we recommend 20/5 mg/kg orally, three times daily. PMID:18256414

  12. A collaborative approach to adopting/adapting guidelines - The Australian 24-Hour Movement Guidelines for the early years (Birth to 5 years): an integration of physical activity, sedentary behavior, and sleep.

    PubMed

    Okely, Anthony D; Ghersi, Davina; Hesketh, Kylie D; Santos, Rute; Loughran, Sarah P; Cliff, Dylan P; Shilton, Trevor; Grant, David; Jones, Rachel A; Stanley, Rebecca M; Sherring, Julie; Hinkley, Trina; Trost, Stewart G; McHugh, Clare; Eckermann, Simon; Thorpe, Karen; Waters, Karen; Olds, Timothy S; Mackey, Tracy; Livingstone, Rhonda; Christian, Hayley; Carr, Harriette; Verrender, Adam; Pereira, João R; Zhang, Zhiguang; Downing, Katherine L; Tremblay, Mark S

    2017-11-20

    In 2017, the Australian Government funded the update of the National Physical Activity Recommendations for Children 0-5 years, with the intention that they be an integration of movement behaviours across the 24-h period. The benefit for Australia was that it could leverage research in Canada in the development of their 24-h guidelines for the early years. Concurrently, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group published a model to produce guidelines based on adoption, adaption and/or de novo development using the GRADE evidence-to-decision framework. Referred to as the GRADE-ADOLOPMENT approach, it allows guideline developers to follow a structured and transparent process in a more efficient manner, potentially avoiding the need to unnecessarily repeat costly tasks such as conducting systematic reviews. The purpose of this paper is to outline the process and outcomes for adapting the Canadian 24-Hour Movement Guidelines for the Early Years to develop the Australian 24-Hour Movement Guidelines for the Early Years guided by the GRADE-ADOLOPMENT framework. The development process was guided by the GRADE-ADOLOPMENT approach. A Leadership Group and Consensus Panel were formed and existing credible guidelines identified. The draft Canadian 24-h integrated movement guidelines for the early years best met the criteria established by the Panel. These were evaluated based on the evidence in the GRADE tables, summaries of findings tables and draft recommendations from the Canadian Draft Guidelines. Updates to each of the Canadian systematic reviews were conducted and the Consensus Panel reviewed the evidence for each behaviour separately and made a decision to adopt or adapt the Canadian recommendations for each behaviour or create de novo recommendations. An online survey was then conducted (n = 302) along with five focus groups (n = 30) and five key informant interviews (n = 5) to obtain feedback from stakeholders on the draft guidelines. Based on the evidence from the Canadian systematic reviews and the updated systematic reviews in Australia, the Consensus Panel agreed to adopt the Canadian recommendations and, apart from some minor changes to the wording of good practice statements, keep the wording of the guidelines, preamble and title of the Canadian Guidelines. The Australian Guidelines provide evidence-informed recommendations for a healthy day (24-h), integrating physical activity, sedentary behaviour (including limits to screen time), and sleep for infants (<1 year), toddlers (1-2 years) and preschoolers (3-5 years). To our knowledge, this is only the second time the GRADE-ADOLOPMENT approach has been used. Following this approach, the judgments of the Australian Consensus Panel did not differ sufficiently to change the directions and strength of the recommendations and as such, the Canadian recommendations were adopted with very minor alterations. This allowed the Guidelines to be developed much faster and at lower cost. As such, we would recommend the GRADE-ADOLOPMENT approach, especially if a credible set of guidelines, with all supporting materials and developed using a transparent process, is available. Other countries may consider using this approach when developing and/or revising national movement guidelines.

  13. Advanced lighting guidelines: 1993. Final report

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

    Eley, C.; Tolen, T.M.; Benya, J.R.

    1993-12-31

    The 1993 Advanced Lighting Guidelines document consists of twelve guidelines that provide an overview of specific lighting technologies and design application techniques utilizing energy-efficient lighting practice. Lighting Design Practice assesses energy-efficient lighting strategies, discusses lighting issues, and explains how to obtain quality lighting design and consulting services. Luminaires and Lighting Systems surveys luminaire equipment designed to take advantage of advanced technology lamp products and includes performance tables that allow for accurate estimation of luminaire light output and power input. The additional ten guidelines -- Computer-Aided Lighting Design, Energy-Efficient Fluorescent Ballasts, Full-Size Fluorescent Lamps, Compact Fluorescent Lamps, Tungsten-Halogen Lamps, Metal Halidemore » and HPS Lamps, Daylighting and Lumen Maintenance, Occupant Sensors, Time Scheduling Systems, and Retrofit Control Technologies -- each provide a product technology overview, discuss current products on the lighting equipment market, and provide application techniques. This document is intended for use by electric utility personnel involved in lighting programs, lighting designers, electrical engineers, architects, lighting manufacturers` representatives, and other lighting professionals.« less

  14. Guidelines for safe handling of hazardous drugs: A systematic review

    PubMed Central

    Bernabeu-Martínez, Mari A.; Ramos Merino, Mateo; Santos Gago, Juan M.; Álvarez Sabucedo, Luis M.; Wanden-Berghe, Carmina

    2018-01-01

    Objective To review the scientific literature related to the safe handling of hazardous drugs (HDs). Method Critical analysis of works retrieved from MEDLINE, the Cochrane Library, Scopus, CINHAL, Web of Science and LILACS using the terms "Hazardous Substances", "Antineoplastic Agents" and "Cytostatic Agents", applying "Humans" and "Guidelines" as filters. Date of search: January 2017. Results In total, 1100 references were retrieved, and from those, 61 documents were selected based on the inclusion and exclusion criteria: 24 (39.3%) documents related to recommendations about HDs; 27 (44.3%) about antineoplastic agents, and 10 (33.3%) about other types of substances (monoclonal antibodies, gene medicine and other chemical and biological agents). In 14 (23.3%) guides, all the stages in the manipulation process involving a risk due to exposure were considered. Only one guide addressed all stages of the handling process of HDs (including stages with and without the risk of exposure). The most described stages were drug preparation (41 guides, 67.2%), staff training and/or patient education (38 guides, 62.3%), and administration (37 guides, 60.7%). No standardized informatics system was found that ensured quality management, traceability and minimization of the risks associated with these drugs. Conclusions Most of the analysed guidelines limit their recommendations to the manipulation of antineoplastics. The most frequently described activities were preparation, training, and administration. It would be convenient to apply ICTs (Information and Communications Technologies) to manage processes involving HDs in a more complete and simpler fashion. PMID:29750798

  15. European Practice for CDI Treatment.

    PubMed

    Fitzpatrick, Fidelma; Skally, Mairead; Brady, Melissa; Burns, Karen; Rooney, Christopher; Wilcox, Mark H

    2018-01-01

    Clostridium difficile infection (CDI) remains a significant cause of morbidity and mortality worldwide. Historically, two antibiotics (metronidazole and vancomycin) and a recent third (fidaxomicin) have been used routinely for CDI treatment; convincing data are now available showing that metronidazole is the least efficacious agent. The European Society of Clinical Microbiology and Infectious Diseases CDI treatment guidelines outline the treatment options for a variety of CDI clinical scenarios, including use of the more traditional anti-CDI therapies (e.g., metronidazole, vancomycin), the role of newer anti-CDI agents (e.g., fidaxomicin), indications for surgical intervention and for non-antimicrobial management (e.g., faecal microbiota transplantation, FMT). A 2017 survey of 20 European countries found that while the majority (n = 14) have national CDI guidelines that provide a variety of recommendations for CDI treatment, only five have audited guideline implementation. A variety of restrictions are in place in 13 (65%) countries prior to use of new anti-CDI treatments, including committee/infection specialist approval or economic review/restrictions. Novel anti-CDI agents are being evaluated in Phase III trials; it is not yet clear what will be the roles of these agents. Prophylaxis is an optimum approach to reduce the impact of CDI especially in high-risk populations; monoclonal antibodies, antibiotic blocking approaches and multiple vaccines are currently in advanced clinical trials. The treatment of recurrent CDI is particularly troublesome, and several different live bio therapeutics are being developed, in addition to FMT.

  16. Guidelines for safe handling of hazardous drugs: A systematic review.

    PubMed

    Bernabeu-Martínez, Mari A; Ramos Merino, Mateo; Santos Gago, Juan M; Álvarez Sabucedo, Luis M; Wanden-Berghe, Carmina; Sanz-Valero, Javier

    2018-01-01

    To review the scientific literature related to the safe handling of hazardous drugs (HDs). Critical analysis of works retrieved from MEDLINE, the Cochrane Library, Scopus, CINHAL, Web of Science and LILACS using the terms "Hazardous Substances", "Antineoplastic Agents" and "Cytostatic Agents", applying "Humans" and "Guidelines" as filters. Date of search: January 2017. In total, 1100 references were retrieved, and from those, 61 documents were selected based on the inclusion and exclusion criteria: 24 (39.3%) documents related to recommendations about HDs; 27 (44.3%) about antineoplastic agents, and 10 (33.3%) about other types of substances (monoclonal antibodies, gene medicine and other chemical and biological agents). In 14 (23.3%) guides, all the stages in the manipulation process involving a risk due to exposure were considered. Only one guide addressed all stages of the handling process of HDs (including stages with and without the risk of exposure). The most described stages were drug preparation (41 guides, 67.2%), staff training and/or patient education (38 guides, 62.3%), and administration (37 guides, 60.7%). No standardized informatics system was found that ensured quality management, traceability and minimization of the risks associated with these drugs. Most of the analysed guidelines limit their recommendations to the manipulation of antineoplastics. The most frequently described activities were preparation, training, and administration. It would be convenient to apply ICTs (Information and Communications Technologies) to manage processes involving HDs in a more complete and simpler fashion.

  17. Evolving therapies for the management of chronic and acute decompensated heart failure.

    PubMed

    Cook, Jennifer C; Tran, Richard H; Patterson, J Herbert; Rodgers, Jo E

    2016-11-01

    The pharmacology, clinical efficacy, and safety profiles of evolving therapies for the management of chronic heart failure (HF) and acute decompensated heart failure (ADHF) are described. HF confers a significant financial burden despite the widespread use of traditional guideline-directed medical therapies such as angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, β-blockers, and aldosterone receptor antagonists, and the rates of HF-related mortality and hospitalization have remained unacceptably high. In response to a demand for novel pharmacologic agents, several therapeutic compounds have recently gained approval or are currently under review by the Food and Drug Administration. Sacubitril-valsartan has demonstrated benefit in reducing cardiovascular mortality and HF-related hospitalizations in clinical trials, while ivabradine and ferric carboxymaltose have proven efficacious in reducing HF-related hospitalizations. Lastly, the role of serelaxin in ADHF is currently under investigation in an ongoing Phase III study. While large, outcome-driven clinical trials are fundamental in informing the clinical application of these therapeutic agents, careful patient selection is imperative to ensuring similar outcomes postmarketing. In addition, optimization of current guideline-directed medical therapy remains essential as new therapies emerge and are incorporated into guideline recommendations. Additional therapeutic agents currently undergoing investigation include bucindolol hydrochloride, cimaglermin alfa, nitroxyl, omecamtiv mecarbil, TRV027, and ularitide. Clinical practitioners should remain abreast of emerging literature so that new therapeutic entities are optimally applied and positive patient outcomes are achieved. Recently introduced agents for the treatment of patients with HF include sacubitril-valsartan, ivabradine, and ferric carboxymaltose. Additional agents worthy of attention include serelaxin and other therapies currently under investigation. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  18. The efficacy of disinfectants on abattoirs’ Candida albicans isolates in Niger Delta region

    PubMed Central

    Olorode, Oluwayemisi A

    2012-01-01

    This study was conducted to evaluate the antimicrobial activities of common disinfectants- these are (parachlorometaxylenol) dettol, savlon purit and jik (sodium hypochlorite) on  Candida albicans isolated from displaying and cutting tables in five different abattoirs in Port Harcourt (Niger Delta region); the abattoirs include Trans Amadi, Agip, Woji, Rumuokoro, and Rumuodara. This research was carried out between January 2005 and June 2006. Swab samples were collected from abattoirs cutting tables with sterile swab sticks and immediately transferred and cultured in the laboratory on a selective medium Sabouraud Dextrose Agar (SDA). The disinfectants’ concentrations were prepared at 10%, 20%, 40%, and 70%, in triplicates and the mean values calculated. 0.5 Mc Farland turbidity method of standardization and Agar diffusion method were used for disinfectants testing of the isolates. Statistical analysis of the data showed no significant difference in the effectiveness of these disinfectants at (p<0.05). In conclusion, this study has shown that savlon and dettol were the most potent antimicrobial agents at 10% concentration on  Candida albicans isolates when compared with purit and jik in this study, hence they are good sanitizing agents to be applied on the abattoirs cutting tables, before meat products can be displayed for sale. PMID:24358834

  19. Deep Vein Thrombosis Prophylaxis: State of the Art.

    PubMed

    Lieberman, Jay R

    2018-03-21

    The selection of a prophylaxis regimen to prevent symptomatic pulmonary embolism and deep vein thrombosis is a balance between efficacy and safety. The latest American Academy of Orthopaedic Surgeons guideline recommended that either chemoprophylaxis or mechanical prophylaxis be used after total joint arthroplasty but did not recommend specific agents. However, the latest evidence-based American College of Chest Physicians guideline recommended a variety of chemoprophylaxis and mechanical agents for a minimum of 10 to 14 days after total joint arthroplasty. Risk stratification is the key to the selection of the appropriate prophylaxis regimen for the individual patient, but the optimal risk stratification protocol still needs to be developed. Copyright © 2018. Published by Elsevier Inc.

  20. Comparison between the standard and a new alternative format of the Summary-of-Findings tables in Cochrane review users: study protocol for a randomized controlled trial.

    PubMed

    Carrasco-Labra, Alonso; Brignardello-Petersen, Romina; Santesso, Nancy; Neumann, Ignacio; Mustafa, Reem A; Mbuagbaw, Lawrence; Ikobaltzeta, Itziar Etxeandia; De Stio, Catherine; McCullagh, Lauren J; Alonso-Coello, Pablo; Meerpohl, Joerg J; Vandvik, Per Olav; Brozek, Jan L; Akl, Elie A; Bossuyt, Patrick; Churchill, Rachel; Glenton, Claire; Rosenbaum, Sarah; Tugwell, Peter; Welch, Vivian; Guyatt, Gordon; Schünemann, Holger

    2015-04-16

    Systematic reviews represent one of the most important tools for knowledge translation but users often struggle with understanding and interpreting their results. GRADE Summary-of-Findings tables have been developed to display results of systematic reviews in a concise and transparent manner. The current format of the Summary-of-Findings tables for presenting risks and quality of evidence improves understanding and assists users with finding key information from the systematic review. However, it has been suggested that additional methods to present risks and display results in the Summary-of-Findings tables are needed. We will conduct a non-inferiority parallel-armed randomized controlled trial to determine whether an alternative format to present risks and display Summary-of-Findings tables is not inferior compared to the current standard format. We will measure participant understanding, accessibility of the information, satisfaction, and preference for both formats. We will invite systematic review users to participate (that is clinicians, guideline developers, and researchers). The data collection process will be undertaken using the online 'Survey Monkey' system. For the primary outcome understanding, non-inferiority of the alternative format (Table A) to the current standard format (Table C) of Summary-of-Findings tables will be claimed if the upper limit of a 1-sided 95% confidence interval (for the difference of proportion of participants answering correctly a given question) excluded a difference in favor of the current format of more than 10%. This study represents an effort to provide systematic reviewers with additional options to display review results using Summary-of-Findings tables. In this way, review authors will have a variety of methods to present risks and more flexibility to choose the most appropriate table features to display (that is optional columns, risks expressions, complementary methods to display continuous outcomes, and so on). NCT02022631 (21 December 2013).

  1. Methods for the guideline-based development of quality indicators--a systematic review

    PubMed Central

    2012-01-01

    Background Quality indicators (QIs) are used in many healthcare settings to measure, compare, and improve quality of care. For the efficient development of high-quality QIs, rigorous, approved, and evidence-based development methods are needed. Clinical practice guidelines are a suitable source to derive QIs from, but no gold standard for guideline-based QI development exists. This review aims to identify, describe, and compare methodological approaches to guideline-based QI development. Methods We systematically searched medical literature databases (Medline, EMBASE, and CINAHL) and grey literature. Two researchers selected publications reporting methodological approaches to guideline-based QI development. In order to describe and compare methodological approaches used in these publications, we extracted detailed information on common steps of guideline-based QI development (topic selection, guideline selection, extraction of recommendations, QI selection, practice test, and implementation) to predesigned extraction tables. Results From 8,697 hits in the database search and several grey literature documents, we selected 48 relevant references. The studies were of heterogeneous type and quality. We found no randomized controlled trial or other studies comparing the ability of different methodological approaches to guideline-based development to generate high-quality QIs. The relevant publications featured a wide variety of methodological approaches to guideline-based QI development, especially regarding guideline selection and extraction of recommendations. Only a few studies reported patient involvement. Conclusions Further research is needed to determine which elements of the methodological approaches identified, described, and compared in this review are best suited to constitute a gold standard for guideline-based QI development. For this research, we provide a comprehensive groundwork. PMID:22436067

  2. 40 CFR 158.120 - Determining data requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... requirements for biochemical and microbial pest control agents are contained and are described separately...; PAIRA = pure active ingredient, radiolabeled; Choice = choice of several test substances depending on... down the appropriate general use pattern column in the table and note which tests are required (R...

  3. 40 CFR 158.120 - Determining data requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... requirements for biochemical and microbial pest control agents are contained and are described separately...; PAIRA = pure active ingredient, radiolabeled; Choice = choice of several test substances depending on... down the appropriate general use pattern column in the table and note which tests are required (R...

  4. 40 CFR 158.120 - Determining data requirements.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... requirements for biochemical and microbial pest control agents are contained and are described separately...; PAIRA = pure active ingredient, radiolabeled; Choice = choice of several test substances depending on... down the appropriate general use pattern column in the table and note which tests are required (R...

  5. 40 CFR 158.120 - Determining data requirements.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... requirements for biochemical and microbial pest control agents are contained and are described separately...; PAIRA = pure active ingredient, radiolabeled; Choice = choice of several test substances depending on... down the appropriate general use pattern column in the table and note which tests are required (R...

  6. 40 CFR 158.120 - Determining data requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... requirements for biochemical and microbial pest control agents are contained and are described separately...; PAIRA = pure active ingredient, radiolabeled; Choice = choice of several test substances depending on... down the appropriate general use pattern column in the table and note which tests are required (R...

  7. Controlled Interphases in Glass Fiber and Particulate Reinforced Polymers: Structure of Silane Coupling Agents in Solutions and On Substrates

    DTIC Science & Technology

    1993-01-01

    to dissolve into water. Table 3. Typical industrially used silane coupling agents Organofunctional Chemical Formula Group Cationic styryl CH2...can also react with the surface as some unreacted silanol groups remain in the oligomers. The notion of physisorbed and chemisorbed silanes is used ...silanes use many silanol groups for covalent bonding with the substrate surface whereas the loosely chemisorbed silanes use only a few silanols to bond to

  8. Agent-Based Simulation to Support the Effectiveness, Procurement, and Employment of Non-Lethal Weapon Systems

    DTIC Science & Technology

    2017-06-01

    cases have the most significant impact on reducing the number of lethal shots fired in the simulation. Table 10 shows the reduction in the average...Figure ES-2 was developed to show the results of the focused study on maximum effective range. After analyzing the results of the 1,700 simulated...toward other agents based on whose side they are on at that time. This attribute is critical to this study as the sidedness of the local population is

  9. Dental treatment in the era of new anti-thrombotic agents.

    PubMed

    Sahar-Helft, Sharonit; Chackartchi, Tali; Polak, David; Findler, Mordechai

    2018-06-01

    In recent years, there have been dramatic changes in anti-thrombotic treatment as a result of new anti-thrombotic agents, as well as changes in the indications for their use. As a consequence, dentists are encountering larger numbers of patients who are undergoing anti-thrombotic treatment and who have increased risk for bleeding. The current paper aims to review the literature regarding up-to-date anti-thrombotic treatment and provide information regarding their implications on dentistry. An online search was performed of the literature published between 2000 and 2016. Articles dealing with evidence-based clinical guidelines for anti-thrombotic treatments, as well as literature reporting the use of anti-thrombotic medications were included. The manuscripts were screened according to their relevance to dentistry as well as their treatment protocol guidelines. In total, 5,539 publications were identified: 56 of 554 evidence-based clinical guidelines were found that dealt with treatment protocols with anti-thrombotic agents; and 132 of 5,539 articles describe direct anti-thrombotic medications. Dental treatment includes a risk for bleeding. As a result of the increasing number of patients taking new-generation anti-thrombotic drugs, dentists must be up to date regarding the implications of such drugs on dental treatment as well as the practical means to achieve haemostasis. © 2017 FDI World Dental Federation.

  10. Adjuvant chemotherapy for early female breast cancer: a systematic review of the evidence for the 2014 Cancer Care Ontario systemic therapy guideline

    PubMed Central

    Gandhi, S.; Fletcher, G.G.; Eisen, A.; Mates, M.; Freedman, O.C.; Dent, S.F.; Trudeau, M.E.

    2015-01-01

    Background The Program in Evidence-Based Care (pebc) of Cancer Care Ontario recently created an evidence-based consensus guideline on the systemic treatment of early breast cancer. The evidence for the guideline was compiled using a systematic review to answer the question “What is the optimal systemic therapy for patients with early-stage, operable breast cancer, when patient and disease factors are considered?” The question was addressed in three parts: cytotoxic chemotherapy, endocrine treatment, and human epidermal growth factor receptor 2 (her2)–directed therapy. Methods For the systematic review, the medline and embase databases were searched for the period January 2008 to May 2014. The Standards and Guidelines Evidence directory of cancer guidelines and the Web sites of major oncology guideline organizations were also searched. The basic search terms were “breast cancer” and “systemic therapy” (chemotherapy, endocrine therapy, targeted agents, ovarian suppression), and results were limited to randomized controlled trials (rcts), guidelines, systematic reviews, and meta-analyses. Results Several hundred documents that met the inclusion criteria were retrieved. The Early Breast Cancer Trialists’ Collaborative Group meta-analyses encompassed many of the rcts found. Several additional studies that met the inclusion criteria were retained, as were other guidelines and systematic reviews. Chemotherapy was reviewed mainly in three classes: anti-metabolite–based regimens (for example, cyclophosphamide–methotrexate–5-fluorouracil), anthracyclines, and taxane-based regimens. In general, single-agent chemotherapy is not recommended for the adjuvant treatment of breast cancer in any patient population. Anthracycline–taxane-based polychemotherapy regimens are, overall, considered superior to earlier-generation regimens and have the most significant impact on patient survival outcomes. Regimens with varying anthracycline and taxane doses and schedules are options; in general, paclitaxel given every 3 weeks is inferior. Evidence does not support the use of bevacizumab in the adjuvant setting; other systemic therapy agents such as metformin and vaccines remain investigatory. Adjuvant bisphosphonates for menopausal women will be discussed in later work. Conclusions The results of this systematic review constitute a comprehensive compilation of the high-level evidence that is the basis for the 2014 pebc guideline on systemic therapy for early breast cancer. Use of cytotoxic chemotherapy is presented here; the results addressing endocrine therapy and her2-targeted treatment, and the final clinical practice recommendations, are published separately in this supplement. PMID:25848343

  11. 49 CFR Appendix A to Subpart D of... - Guidelines for Civil Penalties

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... to design qualification testing: 178.601 & Various a. Packing Group I (and § 172.504 Table I... $4,000. 6. Failure to meet one or more of the general design requirements for a package used to ship... the additional design requirements of a Type A package used to ship a Class 7 material 173.412(b)-(i...

  12. 49 CFR Appendix A to Subpart D of... - Guidelines for Civil Penalties

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... to design qualification testing: 178.601 & Various a. Packing Group I (and § 172.504 Table I... $4,000. 6. Failure to meet one or more of the general design requirements for a package used to ship... the additional design requirements of a Type A package used to ship a Class 7 material 173.412(b)-(i...

  13. 49 CFR Appendix A to Subpart D of... - Guidelines for Civil Penalties

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... to design qualification testing: 178.601 & Various a. Packing Group I (and § 172.504 Table I... $4,000. 6. Failure to meet one or more of the general design requirements for a package used to ship... the additional design requirements of a Type A package used to ship a Class 7 material 173.412(b)-(i...

  14. Index to Revised Chapter 6 of the Anglo-American Cataloging Rules (North American Text).

    ERIC Educational Resources Information Center

    Rhee, Eric A., Comp.; Pease, William, Ed.

    As an aid for the descriptive cataloging of monographs, this pamphlet provides guidelines for using Chapter 6 of the Anglo-American Cataloging Rules (AACR), which covers this facet of cataloging practice. A table of contents to Chapter 6 is provided, followed by an alphabetical index of the terms and processes involved in descriptive cataloging…

  15. Recent field experiences with Bacillus thuringiensis in Canada and research needs

    Treesearch

    Oswald N. Morris

    1985-01-01

    The CANUSA working group on the use of B.t. against the spruce budworm has prepared a document entitled "Guidelines for the operational use of Bacillus thuringiensis (B.t.) against the spruce budworm" following six years of extensive cooperative field trials in Canada and the U.S.A. (Morris et al 1984). The document summarized below (Table...

  16. Universal Network Access System

    DTIC Science & Technology

    2003-11-01

    128 Figure 37 The detail of the SCM TX , (LO; local oscillator, LPF; Low-pass filter, AMP; Amplifier, BPF ...with UNAS, ( BPF : band-pass filter, BM Rx; Burst Mode receiver, AWGR; Arrayed waveguide grating router, FBG; Fiber Bragg Grating, TL; Tunable Laser...protocols. Standard specifications and RFCs will be used as guidelines for implementation. Table 1 UNAS Serial I/O Formats Protocol Implement1

  17. How to assess oak regeneration potential in the Missouri Ozarks

    Treesearch

    Ivan L. Sander

    1989-01-01

    The values in tables 1 and 2 apply specifically to oak stands in the Missouri Ozarks and may or may not apply outside this area. Unfortunately, similar values for oak do not exist for other geographic areas. Use the procedures and values cautiously in other areas. Consider them as approximations and compare them to values based on local experience and guidelines.

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

    PubMed

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

    2015-11-01

    The Obstetric Anaesthetists' Association and Difficult Airway Society have developed the first national obstetric guidelines for the safe management of difficult and failed tracheal intubation during general anaesthesia. They comprise four algorithms and two tables. A master algorithm provides an overview. Algorithm 1 gives a framework on how to optimise a safe general anaesthetic technique in the obstetric patient, and emphasises: planning and multidisciplinary communication; how to prevent the rapid oxygen desaturation seen in pregnant women by advocating nasal oxygenation and mask ventilation immediately after induction; limiting intubation attempts to two; and consideration of early release of cricoid pressure if difficulties are encountered. Algorithm 2 summarises the management after declaring failed tracheal intubation with clear decision points, and encourages early insertion of a (preferably second-generation) supraglottic airway device if appropriate. Algorithm 3 covers the management of the 'can't intubate, can't oxygenate' situation and emergency front-of-neck airway access, including the necessity for timely perimortem caesarean section if maternal oxygenation cannot be achieved. Table 1 gives a structure for assessing the individual factors relevant in the decision to awaken or proceed should intubation fail, which include: urgency related to maternal or fetal factors; seniority of the anaesthetist; obesity of the patient; surgical complexity; aspiration risk; potential difficulty with provision of alternative anaesthesia; and post-induction airway device and airway patency. This decision should be considered by the team in advance of performing a general anaesthetic to make a provisional plan should failed intubation occur. The table is also intended to be used as a teaching tool to facilitate discussion and learning regarding the complex nature of decision-making when faced with a failed intubation. Table 2 gives practical considerations of how to awaken or proceed with surgery. The background paper covers recommendations on drugs, new equipment, teaching and training. © 2015 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists of Great Britain and Ireland.

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

    PubMed Central

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

    2015-01-01

    The Obstetric Anaesthetists' Association and Difficult Airway Society have developed the first national obstetric guidelines for the safe management of difficult and failed tracheal intubation during general anaesthesia. They comprise four algorithms and two tables. A master algorithm provides an overview. Algorithm 1 gives a framework on how to optimise a safe general anaesthetic technique in the obstetric patient, and emphasises: planning and multidisciplinary communication; how to prevent the rapid oxygen desaturation seen in pregnant women by advocating nasal oxygenation and mask ventilation immediately after induction; limiting intubation attempts to two; and consideration of early release of cricoid pressure if difficulties are encountered. Algorithm 2 summarises the management after declaring failed tracheal intubation with clear decision points, and encourages early insertion of a (preferably second-generation) supraglottic airway device if appropriate. Algorithm 3 covers the management of the ‘can't intubate, can't oxygenate’ situation and emergency front-of-neck airway access, including the necessity for timely perimortem caesarean section if maternal oxygenation cannot be achieved. Table 1 gives a structure for assessing the individual factors relevant in the decision to awaken or proceed should intubation fail, which include: urgency related to maternal or fetal factors; seniority of the anaesthetist; obesity of the patient; surgical complexity; aspiration risk; potential difficulty with provision of alternative anaesthesia; and post-induction airway device and airway patency. This decision should be considered by the team in advance of performing a general anaesthetic to make a provisional plan should failed intubation occur. The table is also intended to be used as a teaching tool to facilitate discussion and learning regarding the complex nature of decision-making when faced with a failed intubation. Table 2 gives practical considerations of how to awaken or proceed with surgery. The background paper covers recommendations on drugs, new equipment, teaching and training. PMID:26449292

  20. Diabetic Retinopathy Clinical Practice Guidelines: Customized for Iranian Population

    PubMed Central

    Rajavi, Zhale; Safi, Sare; Javadi, Mohammad Ali; Azarmina, Mohsen; Moradian, Siamak; Entezari, Morteza; Nourinia, Ramin; Ahmadieh, Hamid; Shirvani, Armin; Shahraz, Saeid; Ramezani, Alireza; Dehghan, Mohammad Hossein; Shahsavari, Mohsen; Soheilian, Masoud; Nikkhah, Homayoun; Ziaei, Hossein; Behboudi, Hasan; Farrahi, Fereydoun; Falavarjani, Khalil Ghasemi; Parvaresh, Mohammad Mehdi; Fesharaki, Hamid; Abrishami, Majid; Shoeibi, Nasser; Rahimi, Mansour; Javadzadeh, Alireza; Karkhaneh, Reza; Riazi-Esfahani, Mohammad; Manaviat, Masoud Reza; Maleki, Alireza; Kheiri, Bahareh; Golbafian, Faegheh

    2016-01-01

    Purpose: To customize clinical practice guidelines (CPGs) for management of diabetic retinopathy (DR) in the Iranian population. Methods: Three DR CPGs (The Royal College of Ophthalmologists 2013, American Academy of Ophthalmology [Preferred Practice Pattern 2012], and Australian Diabetes Society 2008) were selected from the literature using the AGREE tool. Clinical questions were designed and summarized into four tables by the customization team. The components of the clinical questions along with pertinent recommendations extracted from the above-mentioned CPGs; details of the supporting articles and their levels of evidence; clinical recommendations considering clinical benefits, cost and side effects; and revised recommendations based on customization capability (applicability, acceptability, external validity) were recorded in 4 tables, respectively. Customized recommendations were sent to the faculty members of all universities across the country to score the recommendations from 1 to 9. Results: Agreed recommendations were accepted as the final recommendations while the non-agreed ones were approved after revision. Eventually, 29 customized recommendations under three major categories consisting of screening, diagnosis and treatment of DR were developed along with their sources and levels of evidence. Conclusion: This customized CPGs for management of DR can be used to standardize the referral pathway, diagnosis and treatment of patients with diabetic retinopathy. PMID:27994809

  1. AGENT-BASED MODELS IN EMPIRICAL SOCIAL RESEARCH*

    PubMed Central

    Bruch, Elizabeth; Atwell, Jon

    2014-01-01

    Agent-based modeling has become increasingly popular in recent years, but there is still no codified set of recommendations or practices for how to use these models within a program of empirical research. This article provides ideas and practical guidelines drawn from sociology, biology, computer science, epidemiology, and statistics. We first discuss the motivations for using agent-based models in both basic science and policy-oriented social research. Next, we provide an overview of methods and strategies for incorporating data on behavior and populations into agent-based models, and review techniques for validating and testing the sensitivity of agent-based models. We close with suggested directions for future research. PMID:25983351

  2. Standard operating procedures for ESPEN guidelines and consensus papers.

    PubMed

    Bischoff, Stephan C; Singer, Pierre; Koller, Michael; Barazzoni, Rocco; Cederholm, Tommy; van Gossum, André

    2015-12-01

    The ESPEN Guideline standard operating procedures (SOP) is based on the methodology provided by the Association of Scientific Medical Societies of Germany (AWMF), the Scottish Intercollegiate Guidelines Network (SIGN), and the Centre for Evidence-based Medicine at the University of Oxford. The SOP is valid and obligatory for all future ESPEN-sponsored guideline projects aiming to generate high-quality guidelines on a regular basis. The SOP aims to facilitate the preparation of guideline projects, to streamline the consensus process, to ensure quality and transparency, and to facilitate the dissemination and publication of ESPEN guidelines. To achieve this goal, the ESPEN Guidelines Editorial board (GEB) has been established headed by two chairmen. The GEB will support and supervise the guideline processes and is responsible for the strategic planning of ESPEN guideline activities. Key elements of the SOP are the generation of well-built clinical questions according to the PICO system, a systemic literature search, a classification of the selected literature according to the SIGN evidence levels providing an evidence table, and a clear and straight-forward consensus procedure consisting of online voting's and a consensus conference. Only experts who meet the obligation to disclosure any potential conflict of interests and who are not employed by the Industry can participate in the guideline process. All recommendations will be graded according to the SIGN grading and novel outcome models besides biomedical endpoints. This approach will further extent the leadership of ESPEN in creating up-to-date and suitable for implementation guidelines and in sharing knowledge on malnutrition and clinical nutrition. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  3. Review of invertebrate biological control agent regulation in Australia, New Zealand, Canada and the USA: recommendations for a harmonized European system

    USDA-ARS?s Scientific Manuscript database

    Europe lags far behind Australia, New Zealand, Canada and the USA in terms of implementing regulatory procedures for the import and release of invertebrate biological control agents (IBCAs). A number of standards, documents and guidelines have been produced over recent years in an attempt to harmon...

  4. A comparative review of the pharmacoeconomic guidelines in South Africa.

    PubMed

    Carapinha, João L

    2017-01-01

    To compare the pharmacoeconomic guidelines in South Africa (SA) with other middle- and high-income countries. A comparative review of key features of the pharmacoeconomic guidelines in SA was undertaken using the Comparative Table of Pharmacoeconomic Guidelines developed by the International Society of Pharmacoeconomics and Outcomes Research, and published country-level pharmacoeconomics guidelines. A random sample of guidelines in high- and middle-income countries were analyzed if data on all key features were available. Key features of the pharmacoeconomic guidelines in SA were compared with those in other countries, and divergent features were identified and elaborated. Five upper middle-income countries (Brazil, Colombia, Cuba, Malaysia, and Mexico), one lower middle-income country (Egypt), and six high-income countries (Germany, Ireland, Norway, Portugal, Taiwan, and the Netherlands) were analyzed. The pharmacoeconomic guidelines in SA differ in important areas when compared with other countries. In SA, the study perspective and costs are limited to private health-insurance companies, complex modelling is discouraged and models require pre-approval, equity issues are not explicitly stated, a budget impact analysis is not required, and pharmacoeconomic submissions are voluntary. Future updates to the pharmacoeconomic guidelines in SA may include a societal perspective with limitations, incentivize complex and transparent models, and integrate equity issues. The pharmacoeconomic guidelines could be improved by addressing conflicting objectives with policies on National Health Insurance, incentivize private health insurance companies to disclose reimbursement data, and require the inclusion of a budget impact analysis in all pharmacoeconomic submissions. Further research is also needed on the impact of mandatory pharmacoeconomic submissions in middle-income countries.

  5. Targeted therapy against multi-resistant bacteria in leukemic and hematopoietic stem cell transplant recipients: guidelines of the 4th European Conference on Infections in Leukemia (ECIL-4, 2011)

    PubMed Central

    Averbuch, Diana; Cordonnier, Catherine; Livermore, David M.; Mikulska, Małgorzata; Orasch, Christina; Viscoli, Claudio; Gyssens, Inge C.; Kern, Winfried V.; Klyasova, Galina; Marchetti, Oscar; Engelhard, Dan; Akova, Murat

    2013-01-01

    The detection of multi-resistant bacterial pathogens, particularly those to carbapenemases, in leukemic and stem cell transplant patients forces the use of old or non-conventional agents as the only remaining treatment options. These include colistin/polymyxin B, tigecycline, fosfomycin and various anti-gram-positive agents. Data on the use of these agents in leukemic patients are scanty, with only linezolid subjected to formal trials. The Expert Group of the 4th European Conference on Infections in Leukemia has developed guidelines for their use in these patient populations. Targeted therapy should be based on (i) in vitro susceptibility data, (ii) knowledge of the best treatment option against the particular species or phenotype of bacteria, (iii) pharmacokinetic/pharmacodynamic data, and (iv) careful assessment of the risk-benefit balance. For infections due to resistant Gram-negative bacteria, these agents should be preferably used in combination with other agents that remain active in vitro, because of suboptimal efficacy (e.g., tigecycline) and the risk of emergent resistance (e.g., fosfomycin). The paucity of new antibacterial drugs in the near future should lead us to limit the use of these drugs to situations where no alternative exists. PMID:24323984

  6. Clinical roundtable monograph: New data in emerging treatment options for chemotherapy-induced nausea and vomiting.

    PubMed

    Morrow, Gary R; Navari, Rudolph M; Rugo, Hope S

    2014-03-01

    Chemotherapy-induced nausea and vomiting (CINV) has long been one of the most troublesome adverse effects of chemotherapy, leading to significant detriments in quality of life and functioning, increased economic costs, and, in some cases, the discontinuation of effective cancer therapy. The past 2 decades have witnessed a dramatic increase in the number of effective antiemetic agents, with the introduction of the serotonin (5-hydroxytryptamine [5-HT₃]) receptor antagonists (ondansetron, granisetron, and palonosetron), the neurokinin-1 (NK₁) receptor antagonists (aprepitant and fosaprepitant), and the identification of other agents that have demonstrated efficacy against CINV, including corticosteroids. These agents often provide excellent control of emesis. Nausea, however, has proven more intractable, particularly in the days after administration of chemotherapy. Newer antiemetic agents under study may provide additional CINV control, particularly against delayed nausea. New agents undergoing review by the US Food and Drug Administration for the prevention of CINV include the novel NK₁ receptor antagonist rolapitant and a fixed-dose combination consisting of the novel NK₁ receptor antagonist netupitant and palonosetron (NEPA). Adherence to clinical practice guidelines has been shown to significantly improve CINV control. As antiemetic therapy continues to evolve, it will be important for clinicians to stay informed of new developments and changes in guidelines.

  7. 30 CFR 57.5075 - Diesel particulate records.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Diesel particulate records. 57.5075 Section 57..., Radiation, Physical Agents, and Diesel Particulate Matter Diesel Particulate Matter-Underground Only § 57.5075 Diesel particulate records. (a) The table entitled “Diesel Particulate Matter Recordkeeping...

  8. 30 CFR 57.5075 - Diesel particulate records.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Diesel particulate records. 57.5075 Section 57..., Radiation, Physical Agents, and Diesel Particulate Matter Diesel Particulate Matter-Underground Only § 57.5075 Diesel particulate records. (a) The table entitled “Diesel Particulate Matter Recordkeeping...

  9. An evidence-based clinical guideline for the use of antithrombotic therapies in spine surgery.

    PubMed

    Bono, Christopher M; Watters, William C; Heggeness, Michael H; Resnick, Daniel K; Shaffer, William O; Baisden, Jamie; Ben-Galim, Peleg; Easa, John E; Fernand, Robert; Lamer, Tim; Matz, Paul G; Mendel, Richard C; Patel, Rajeev K; Reitman, Charles A; Toton, John F

    2009-12-01

    The objective of the North American Spine Society (NASS) Evidence-Based Clinical Guideline on antithrombotic therapies in spine surgery was to provide evidence-based recommendations to address key clinical questions surrounding the use of antithrombotic therapies in spine surgery. The guideline is intended to address these questions based on the highest quality clinical literature available on this subject as of February 2008. The goal of the guideline recommendations was to assist in delivering optimum, efficacious treatment with the goal of preventing thromboembolic events. To provide an evidence-based, educational tool to assist spine surgeons in minimizing the risk of deep venous thrombosis (DVT) and pulmonary embolism (PE). Systematic review and evidence-based clinical guideline. This report is from the Antithrombotic Therapies Work Group of the NASS Evidence-Based Guideline Development Committee. The work group was composed of multidisciplinary spine care specialists, all of whom were trained in the principles of evidence-based analysis. Each member of the group was involved in formatting a series of clinical questions to be addressed by the group. The final questions agreed on by the group are the subject of this report. A literature search addressing each question and using a specific search protocol was performed on English language references found in MEDLINE, EMBASE (Drugs and Pharmacology), and four additional, evidence-based databases. The relevant literature was then independently rated by at least three reviewers using the NASS-adopted standardized levels of evidence. An evidentiary table was created for each of the questions. Final grades of recommendation for the answers to each clinical question were arrived at via Web casts among members of the work group using standardized grades of recommendation. When Level I to IV evidence was insufficient to support a recommendation to answer a specific clinical question, expert consensus was arrived at by the work group through the modified nominal group technique and is clearly identified as such in the guideline. Fourteen clinical questions were formulated, addressing issues of incidence of DVT and PE in spine surgery and recommendations regarding utilization of mechanical prophylaxis and chemoprophylaxis in spine surgery. The answers to these 14 clinical questions are summarized in this article. The respective recommendations were graded by the strength of the supporting literature that was stratified by levels of evidence. A clinical guideline addressing the use of antithrombotic therapies in spine surgery has been created using the techniques of evidence-based medicine and using the best available evidence as a tool to assist spine surgeons in minimizing the risk of DVT and PE. The entire guideline document, including the evidentiary tables, suggestions for future research, and all references, is available electronically at the NASS Web site (www.spine.org) and will remain updated on a timely schedule.

  10. American Society of Hematology/American Society of Clinical Oncology clinical practice guideline update on the use of epoetin and darbepoetin in adult patients with cancer.

    PubMed

    Rizzo, J Douglas; Brouwers, Melissa; Hurley, Patricia; Seidenfeld, Jerome; Arcasoy, Murat O; Spivak, Jerry L; Bennett, Charles L; Bohlius, Julia; Evanchuk, Darren; Goode, Matthew J; Jakubowski, Ann A; Regan, David H; Somerfield, Mark R

    2010-11-18

    To update American Society of Hematology/American Society of Clinical Oncology recommendations for use of erythropoiesis-stimulating agents (ESAs) in patients with cancer. An Update Committee reviewed data published between January 2007 and January 2010. MEDLINE and the Cochrane Library were searched. The literature search yielded one new individual patient data analysis and four literature-based meta-analyses, two systematic reviews, and 13 publications reporting new results from randomized controlled trials not included in prior or new reviews. For patients undergoing myelosuppressive chemotherapy who have a hemoglobin (Hb) level less than 10 g/dL, the Update Committee recommends that clinicians discuss potential harms (eg, thromboembolism, shorter survival) and benefits (eg, decreased transfusions) of ESAs and compare these with potential harms (eg, serious infections, immune-mediated adverse reactions) and benefits (eg, rapid Hb improvement) of RBC transfusions. Individual preferences for assumed risk should contribute to shared decisions on managing chemotherapy-induced anemia. The Committee cautions against ESA use under other circumstances. If used, ESAs should be administered at the lowest dose possible and should increase Hb to the lowest concentration possible to avoid transfusions. Available evidence does not identify Hb levels ≥ 10 g/dL either as thresholds for initiating treatment or as targets for ESA therapy. Starting doses and dose modifications after response or nonresponse should follow US Food and Drug Administration-approved labeling. ESAs should be discontinued after 6 to 8 weeks in nonresponders. ESAs should be avoided in patients with cancer not receiving concurrent chemotherapy, except for those with lower risk myelodysplastic syndromes. Caution should be exercised when using ESAs with chemotherapeutic agents in diseases associated with increased risk of thromboembolic complications. Table 1 lists detailed recommendations.

  11. American Society of Clinical Oncology/American Society of Hematology clinical practice guideline update on the use of epoetin and darbepoetin in adult patients with cancer.

    PubMed

    Rizzo, J Douglas; Brouwers, Melissa; Hurley, Patricia; Seidenfeld, Jerome; Arcasoy, Murat O; Spivak, Jerry L; Bennett, Charles L; Bohlius, Julia; Evanchuk, Darren; Goode, Matthew J; Jakubowski, Ann A; Regan, David H; Somerfield, Mark R

    2010-11-20

    To update American Society of Clinical Oncology/American Society of Hematology recommendations for use of erythropoiesis-stimulating agents (ESAs) in patients with cancer. An Update Committee reviewed data published between January 2007 and January 2010. MEDLINE and the Cochrane Library were searched. The literature search yielded one new individual patient data analysis and four literature-based meta-analyses, two systematic reviews, and 13 publications reporting new results from randomized controlled trials not included in prior or new reviews. For patients undergoing myelosuppressive chemotherapy who have a hemoglobin (Hb) level less than 10 g/dL, the Update Committee recommends that clinicians discuss potential harms (eg, thromboembolism, shorter survival) and benefits (eg, decreased transfusions) of ESAs and compare these with potential harms (eg, serious infections, immune-mediated adverse reactions) and benefits (eg, rapid Hb improvement) of RBC transfusions. Individual preferences for assumed risk should contribute to shared decisions on managing chemotherapy-induced anemia. The Committee cautions against ESA use under other circumstances. If used, ESAs should be administered at the lowest dose possible and should increase Hb to the lowest concentration possible to avoid transfusions. Available evidence does not identify Hb levels ≥ 10 g/dL either as thresholds for initiating treatment or as targets for ESA therapy. Starting doses and dose modifications after response or nonresponse should follow US Food and Drug Administration-approved labeling. ESAs should be discontinued after 6 to 8 weeks in nonresponders. ESAs should be avoided in patients with cancer not receiving concurrent chemotherapy, except for those with lower risk myelodysplastic syndromes. Caution should be exercised when using ESAs with chemotherapeutic agents in diseases associated with increased risk of thromboembolic complications. Table 1 lists detailed recommendations.

  12. Application of Toxic Chinese Medicine in Chinese Pharmacopoeia

    NASA Astrophysics Data System (ADS)

    Zhao, Hui; Feng, Yu; Mao, Mingsan

    2018-01-01

    Objective: Explore the application characteristics of proprietary Chinese medicine prescriptions containing toxic herbs in pharmacopoeia. Methods: In this paper, according to the clinical application of pharmacopoeia proprietary Chinese medicine is divided into table agent, Qushu agent, diarrhea agent, heat agent, Wen Li agent, cough and asthma agents, resuscitation agent, Gutian agent, Fuzheng agent, Anshen agent, hemostatic agent, The traditional Chinese medicine prescription and the clinical application of the Chinese herbal medicine containing the toxic Chinese medicine were analyzed and sorted out., Summed up the compatibility of toxic herbs and application characteristics. Results: Toxic Chinese herbal medicine in the cure of traditional Chinese medicine to play a long-standing role, through the overall thinking, dialectical thinking, and thinking of toxic Chinese medicine in the analysis of Chinese medicine that [2], toxic Chinese medicine in the application of proprietary Chinese medicine can not lack. Conclusion: Pharmacopoeia included proprietary Chinese medicine not only in the clinical treatment of good, but also the application of its toxic traditional Chinese medicine and its understanding of the enrichment of the toxic characteristics of traditional Chinese medicine and treatment-related disease pathology between the points of contact for patients with clinical applications Based on and theoretical guidance of Chinese medicine [3].

  13. The role of alternative and natural agents, cryotherapy, and/or laser for management of alimentary mucositis.

    PubMed

    Migliorati, Cesar A; Oberle-Edwards, Loree; Schubert, Mark

    2006-06-01

    To review the literature and update the current guidelines of alternative/natural agents, cryotherapy, and/or laser therapy in the management of alimentary mucositis (AM). The original guidelines developed by the Multinational Association for Supportive Care in Cancer (MASCC)/International Society for Oral Oncology (ISOO) mucositis study group were the basis for this study. A medical librarian conducted an initial Medline search to identify research articles published between 2002 and 2005 in English language. A search term combination that included stomatitis, mucositis, mucous membrane, neoplasm, lasers, complimentary therapies, amino acids, antioxidants, vitamins, minerals, plant extracts, and cryotherapy was conducted. This initial search identified articles with a strong scientific methodology that included both preclinical and clinical research. Using standardized scoring forms, authors reviewed and scored individual articles. A consensus result of the review was achieved in a meeting of reviewers in June of 2005. The initial search identified a total of 167 new articles. Of these, 14 were selected and reviewed: alternative/natural therapy (one preclinical study); cryotherapy (four clinical studies); lasers (two clinical studies); and alternative/natural agents (seven clinical studies). A new guideline could be established for the use of cryotherapy in the management of AM in hematopoietic stem cell transplant (HSCT) patients receiving melphalan in the conditioning phase. The rapid progress in the understanding of AM created a need for new prevention and management protocols. Frequent literature review is now necessary to identify agents and protocols being developed in this important area of supportive care in cancer.

  14. Children’s Hospital Integrated Patient Electronic Record System (CHIPERS) Continuation

    DTIC Science & Technology

    2012-10-01

    decision support, electronic health record, pediatric critical care, neonatal intensive care 17 HFlori@mail.cho.org     3       Table of Contents...and/or shock with the ACCM and  CHRCO Clinical Guidelines for Hemodynamic Support of  Neonates  and Children with  Severe Sepsis and Septic Shock...Hospital & Research Center Oakland Clinical Guidelines for Hemodynamic Support of  Neonates  and Children with Severe Sepsis and Septic Shock. We will

  15. Evaluation of rational nonsteroidal anti-inflammatory drugs and gastro-protective agents use; association rule data mining using outpatient prescription patterns.

    PubMed

    Pattanaprateep, Oraluck; McEvoy, Mark; Attia, John; Thakkinstian, Ammarin

    2017-07-04

    Nonsteroidal anti-inflammatory drugs (NSAIDs) and gastro-protective agents should be co-prescribed following a standard clinical practice guideline; however, adherence to this guideline in routine practice is unknown. This study applied an association rule model (ARM) to estimate rational NSAIDs and gastro-protective agents use in an outpatient prescriptions dataset. A database of hospital outpatients from October 1st, 2013 to September 30th, 2015 was searched for any of following drugs: oral antacids (A02A), peptic ulcer and gastro-oesophageal reflux disease drugs (GORD, A02B), and anti-inflammatory and anti-rheumatic products, non-steroids or NSAIDs (M01A). Data including patient demographics, diagnoses, and drug utilization were also retrieved. An association rule model was used to analyze co-prescription of the same drug class (i.e., prescriptions within A02A-A02B, M01A) and between drug classes (A02A-A02B & M01A) using the Apriori algorithm in R. The lift value, was calculated by a ratio of confidence to expected confidence, which gave information about the association between drugs in the prescription. We identified a total of 404,273 patients with 2,575,331 outpatient visits in 2 fiscal years. Mean age was 48 years and 34% were male. Among A02A, A02B and M01A drug classes, 12 rules of associations were discovered with support and confidence thresholds of 1% and 50%. The highest lift was between Omeprazole and Ranitidine (340 visits); about one-third of these visits (118) were prescriptions to non-GORD patients, contrary to guidelines. Another finding was the concomitant use of COX-2 inhibitors (Etoricoxib or Celecoxib) and PPIs. 35.6% of these were for patients aged less than 60 years with no GI complication and no Aspirin, inconsistent with guidelines. Around one-third of occasions where these medications were co-prescribed were inconsistent with guidelines. With the rapid growth of health datasets, data mining methods may help assess quality of care and concordance with guidelines and best evidence.

  16. Interpretation of diagnostic data: 4. How to do it with a more complex table.

    PubMed

    1983-10-15

    A more complex table is especially useful when a diagnostic test produces a wide range of results and your patient's levels are near one of the extremes. The following guidelines will be useful: Identify the several cut-off points that could be used. Fill in a complex table along the lines of Table I, showing the numbers of patients at each level who have and do not have the target disorder. Generate a simple table for each cut-off point, as in Table II, and determine the sensitivity (TP rate) and specificity (TN rate) at each of them. Select the cut-off point that makes the most sense for your patient's test result and proceed as in parts 2 and 3 of our series. Alternatively, construct an ROC curve by plotting the TP and FP rates that attend each cut-off point. If you keep your tables and ROC curves close at hand, you will gradually accumulate a set of very useful guides. However, if you looked very hard at what was happening, you will probably have noticed that they are not very useful for patients whose test results fall in the middle zones, or for those with just one positive result of two tests; the post-test likelihood of disease in these patients lurches back and forth past 50%, depending on where the cut-off point is. We will show you how to tackle this problem in part 5 of our series. It involves some maths, but you will find that its very powerful clinical application can be achieved with a simple nomogram or with some simple calculations.

  17. Anthropometric evaluation and recommendation for primary schools classroom furniture design in Perlis

    NASA Astrophysics Data System (ADS)

    Shan, Lim Shaiu; Jing, Ewe Hui; Effendi, M. S. M.; Rosli, Muhamad Farizuan

    2017-09-01

    This study was carried out with the objective to obtain the anthropometric data of primary school children from Year 1 to Year 6 and evaluate the children's anthropometry with the current dimensions of classroom furniture (i.e. chair and table). In addition, this study also proposed the design dimensions for the improvement in classroom furniture design with the consideration of children's anthropometric data. A total of 390 children selected from 13 primary schools in Perlis, Malaysia were participated in this study. There were 11 anthropometric measurements of children have been measured in this study, which include stature (St), popliteal height (PH), knee height (KH), thigh thickness (TT), buttock popliteal length (BPL), hip breadth (HB), sitting shoulder height (SSH), sitting elbow height (SEH), forearm-hand length (FHL), height of lumbar point (HLP) and buttock clearance (BC). Besides that, 7 dimensions relating to current classroom chair have been measured, such as seat height (SH), seat depth (SD), seat width (SW), upper edge of backrest (UEB), lower edge of backrest (LEB), S point (SP), overall chair height (OCH). Another 5 dimensions of the existing classroom table have been measured too, which involve table height (TH), table depth (TD), table width (TW), under table height (UH) and seat to table clearance (STC). All the measurements were performed by using metal measuring tape. The anthropometric data of the children were analyzed with the help of Microsoft Excel 2013. Several equations with associated with the anthropometric data and furniture dimensions have been applied in this research. The new design dimensions for classroom furniture that proposed in this paper which based on the collected anthropometric data can be referred as a guideline for classroom furniture design. The implementation of these data may help to create comfortability, safety, suitability and improve performance of children in the classroom.

  18. Castration-resistant prostate cancer: AUA Guideline.

    PubMed

    Cookson, Michael S; Roth, Bruce J; Dahm, Philipp; Engstrom, Christine; Freedland, Stephen J; Hussain, Maha; Lin, Daniel W; Lowrance, William T; Murad, Mohammad Hassan; Oh, William K; Penson, David F; Kibel, Adam S

    2013-08-01

    This Guideline is intended to provide a rational basis for the management of patients with castration-resistant prostate cancer based on currently available published data. A systematic review and meta-analysis of the published literature was conducted using controlled vocabulary supplemented with keywords relating to the relevant concepts of prostate cancer and castration resistance. The search strategy was developed and executed by reference librarians and methodologists to create an evidence report limited to English-language, published peer-reviewed literature. This review yielded 303 articles published from 1996 through 2013 that were used to form a majority of the guideline statements. Clinical Principles and Expert Opinions were used for guideline statements lacking sufficient evidence-based data. Guideline statements were created to inform clinicians on the appropriate use of observation, androgen-deprivation and antiandrogen therapy, androgen synthesis inhibitors, immunotherapy, radionuclide therapy, systemic chemotherapy, palliative care and bone health. These were based on six index patients developed to represent the most common scenarios encountered in clinical practice. As a direct result of the significant increase in FDA-approved therapeutic agents for use in patients with metastatic CRPC, clinicians are challenged with a multitude of treatment options and potential sequencing of these agents that, consequently, make clinical decision-making more complex. Given the rapidly evolving nature of this field, this guideline should be used in conjunction with recent systematic literature reviews and an understanding of the individual patient's treatment goals. In all cases, patients' preferences and personal goals should be considered when choosing management strategies. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  19. 76 FR 41332 - Sentencing Guidelines for the United States Courts

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-13

    ... 1B1.10 that is in effect on the date on which the court reduces the defendant's term of imprisonment.... Part A amended the Drug Quantity Table in 2D1.1 for crack cocaine and made related revisions to... possessed more than 5 grams of crack cocaine was sentenced under 2D1.1.''. The Commentary to 1B1.10...

  20. VA Health Care: VA Spends Millions on Post-Traumatic Stress Disorder Research and Incorporates Research Outcomes into Guidelines and Policy for Post-Traumatic Stress Disorder Services

    DTIC Science & Technology

    2011-01-01

    post - traumatic stress disorder ( PTSD ) and...Veterans Affairs (VA) Intramural Post - Traumatic Stress Disorder ( PTSD ) Research Funding and VA’s Medical and Prosthetic Research Appropriation...Table 6: Department of Veterans Affairs (VA) Research Centers and Programs That Conduct or Support Post - Traumatic Stress Disorder ( PTSD ) Research

  1. Defense Trade. Clarification and More Comprehensive Oversight of Export Exemptions Certified by DOD Are Needed

    DTIC Science & Technology

    2007-09-01

    Identified in DTSA Guidelines for Military Service Certification and ITAR Exemption Description 8 Table 2: GAO Analysis of DOD Exemption... DTSA Defense Technology Security Administration ITAR International Traffic in Arms Regulations NATO North Atlantic Treaty Organization This is...and friendly nations. To clarify exemption use, DOD’s Defense Technology Security Administration ( DTSA )—which is responsible for developing and

  2. Predicting rate of fire spread (ROS) in Arizona oak chaparral: Field workbook

    Treesearch

    James R. Davis; John H. Dieterich

    1976-01-01

    To facilitate field use of the rate of fire spread equation used in Arizona oak chaparral, step-by-step instructions are presented in workbook form. Input data can be either measured or estimated from the tables and figures included; a sample computation form may be duplicated for field use. Solving the equation gives the land manager the guidelines for planning fire...

  3. 50 CFR Table 2a to Part 660... - 2012, and beyond, Specifications of OFL, ABC, ACL, ACT and Fishery Harvest guidelines (weights in...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... ACL of ACT any allocation for the Pacific Coast treaty Indian Tribes, projected research catch... fishery (16 mt) and research catch (5 mt), resulting in a fishery HG of 1,880 mt. c/ Lingcod south... swept area biomass (2003-2008) from the NMFS NWFSC trawl survey, between the northern and southern areas...

  4. 50 CFR Table 2b to Part 660... - 2010, and Beyond, Harvest Guidelines for Minor Rockfish by Depth Sub-groups (weights in metric tons)

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... amount estimated to be taken as research catch and in non-groundfish fisheries is 3,000 mt. The... anticipated to be taken during research activity and 0.14 mt for the amount expected to be taken during EFP... unexploited rockfish population in the California Current ecosystem, a non-quantitative assessment was...

  5. Untangling Web 2.0: Charting Web 2.0 Tools, the NCSS Guidelines for Effective Use of Technology, and Bloom's Taxonomy

    ERIC Educational Resources Information Center

    Diacopoulos, Mark M.

    2015-01-01

    The potential for social studies to embrace instructional technology and Web 2.0 applications has become a growing trend in recent social studies research. As part of an ongoing process of collaborative enquiry between an instructional specialist and social studies teachers in a Professional Learning Community, a table of Web 2.0 applications was…

  6. Overcoming Vocabulary Limitations in Twitter Microblogs

    DTIC Science & Technology

    2012-11-01

    lence footer By BARRY WILNER AP Pro Football Writer - National Football League news Table 2: Sample expansion terms for tweets Tweet Type Number of...written by a different au- thor that was forwarded) or are non- English tweets are non- relevant. Additionally, document expansion requires detect- ing and...retweets as well. 3.4 Language Identification The Microblog Track guidelines stipulate that non- English tweets are non-relevant. Therefore, the

  7. Exploration of the medical periodic table: towards new targets.

    PubMed

    Barry, Nicolas P E; Sadler, Peter J

    2013-06-07

    Metallodrugs offer potential for unique mechanisms of drug action based on the choice of the metal, its oxidation state, the types and number of coordinated ligands and the coordination geometry. We discuss recent progress in identifying new target sites and elucidating the mechanisms of action of anti-cancer, anti-bacterial, anti-viral, anti-parasitic, anti-inflammatory, and anti-neurodegenerative agents, as well as in the design of metal-based diagnostic agents. Progress in identifying and defining target sites has been accelerated recently by advances in proteomics, genomics and metal speciation analysis. Examples of metal compounds and chelating agents (enzyme inhibitors) currently in clinical use, clinical trials or preclinical development are highlighted.

  8. Laboratory-associated infections and biosafety.

    PubMed Central

    Sewell, D L

    1995-01-01

    An estimated 500,000 laboratory workers in the United States are at risk of exposure to infectious agents that cause disease ranging from inapparent to life-threatening infections, but the precise risk to a given worker unknown. The emergence of human immunodeficiency virus and hantavirus, the continuing problem of hepatitis B virus, and the reemergence of Mycobacterium tuberculosis have renewed interest in biosafety for the employees of laboratories and health care facilities. This review examines the history, the causes, and the methods for prevention of laboratory-associated infections. The initial step in a biosafety program is the assessment of risk to the employee. Risk assessment guidelines include the pathogenicity of the infectious agent, the method of transmission, worker-related risk factors, the source and route of infection, and the design of the laboratory facility. Strategies for the prevention and management of laboratory-associated infections are based on the containment of the infectious agent by physical separation from the laboratory worker and the environment, employee education about the occupational risks, and availability of an employee health program. Adherence to the biosafety guidelines mandated or proposed by various governmental and accrediting agencies reduces the risk of an occupational exposure to infectious agents handled in the workplace. PMID:7553572

  9. Stakeholder Buy-In and Physician Education Improve Adherence to Guidelines for Down Syndrome.

    PubMed

    Santoro, Stephanie L; Martin, Lisa J; Pleatman, Stephen I; Hopkin, Robert J

    2016-04-01

    To assess adherence to the 2011 American Academy of Pediatrics (AAP) health supervision guidelines for Down syndrome, to determine whether pediatrician education improves adherence, and to evaluate stakeholder attitudes toward these guidelines. Twenty-two pediatric care sites participated in chart review of adherence to the components of the AAP guidelines for Down syndrome in this longitudinal cohort study. We analyzed universal recommendations which apply to all children with Down syndrome. Thirteen pediatric practices caring for 82 patients with Down syndrome received educational information. Frequency calculations with Bonferroni adjustment of the P value threshold (P = .05/9 = .0056) were performed. Adherence rates were compared between cohorts and within the individual before and after intervention using 2 × 2 contingency tables and goodness-of-fit tests. Pediatricians and parents of children with Down syndrome completed an anonymous survey regarding their attitudes toward the guidelines. Statistically significant increases in adherence were seen in 5 of the 8 universal recommendations following pediatrician education (P ≤ .002), including cardiology and genetics visits, rates of echocardiography, annual audiology testing, and sleep studies by age 4 years. Both physicians and parents reported generally positive views of the guidelines, yet baseline adherence rates were suboptimal. Pediatrician education preferences include directly integrating the guidelines into an electronic medical record system. Stakeholder attitudes reflect a willingness to follow the AAP guidelines for Down syndrome. Providing rapid access to simple, clear reminders of recommended assessments successfully improved adherence to the AAP guidelines for Down syndrome. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Determinants of practice patterns in pediatric UTI management.

    PubMed

    Selekman, R E; Allen, I E; Copp, H L

    2016-10-01

    Urinary tract infection (UTI) affects 10% of girls and 3% of boys by age 16. Both the American Academy of Pediatrics and National Institute for Health and Clinical Excellence Guidelines recommend urine testing prior to initiation of antibiotic treatment and the use of local antibiograms to guide empiric antibiotic therapy. Urine culture results not only provide the opportunity to halt empiric therapy if there is no bacterial growth, but also allow for tailoring of broad-spectrum therapy. Additionally, the use of antiobiograms improves empiric antibiotic selection based on local resistance patterns. However, execution of guideline recommendations has proved challenging. Understanding barriers in implementation is critical to developing targeted interventions aimed to improve adherence to these guidelines. The present study sought to investigate practice patterns and factors that influence urine testing and antibiogram use in the setting of empiric antibiotic treatment of UTI in children to ultimately improve adherence to UTI management guidelines. A random, national sample of physicians caring for children was surveyed from the American Medical Association Masterfile. Participants were queried regarding practice type, length of time in practice, factors influencing urine testing, urine specimen collection method, and antibiogram utilization. Logistic regression was used to assess factors associated with use of urine testing, bagged specimens, and antibiograms. Of respondents who acknowledged contact by surveyors, 47% completed the survey (n = 366). Most respondents (84%) obtain urinalysis and culture prior to treatment for UTI. Physicians report they would more likely order testing if the specimen were easier to collect (46%) and if results were available immediately (48%) (Table). Urine collection by bag was more common in circumcised boys (>30%) compared with girls (20%) and uncircumcised boys (20%) (P = 0.02). The most common reasons for collection by bag were parental refusal for (49%) and difficulty with (42%) catheterization (Table). Of the 70% of respondents reporting antibiogram access (n = 256), 50% report its use the majority of the time with empiric prescription (n = 128). While most practitioners report following guidelines to obtain urine testing prior to antibiotic prescription for UTI, urine collection by bag is common. Additionally, <50% of practitioners adhere to guideline recommendations for empiric antibiotic selection based on local antibiograms. Interventions to improve adherence to UTI management guidelines should focus on (1) improving catheterization practices, (2) educating parents regarding the value of catheterization, and (3) incorporating local antibiograms into electronic medical records. Copyright © 2016 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  11. Radiolabelled D2 agonists as prolactinoma imaging agents. Final technical report, January 31, 1990--August 31, 1991

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

    Otto, C.A.

    1991-12-31

    Research conducted in this terminal year of support centered on three distinct areas: mAChR ligand localization in pancreas and the effect of Ca{sup +2} on localization, continuation of assessment of quaternized and neutral mAChR ligands for possible use as PET myocardial imaging agents, and initiation of a study to determine the relationship of the nAChR receptor to the cellular receptor for measles virus. Several tables and figures illustrating the results are included.

  12. The multi-criteria optimization for the formation of the multiple-valued logic model of a robotic agent

    NASA Astrophysics Data System (ADS)

    Bykovsky, A. Yu; Sherbakov, A. A.

    2016-08-01

    The C-valued Allen-Givone algebra is the attractive tool for modeling of a robotic agent, but it requires the consensus method of minimization for the simplification of logic expressions. This procedure substitutes some undefined states of the function for the maximal truth value, thus extending the initially given truth table. This further creates the problem of different formal representations for the same initially given function. The multi-criteria optimization is proposed for the deliberate choice of undefined states and model formation.

  13. Guide for the Development of Safety Assessment Report (SAR)

    DTIC Science & Technology

    1987-08-01

    Di ’:t ib ityioe I A,;!i~abiiity Codes Dist SpdIt ora bloe INSia OEapy r TABLE OF CONTENTS PAGE III SAFETY ASSESSMENT REPORT...above. Potential hazards associated with the maintenance of the turbine engine (i.e., use of cleaning agents ) are not addressed .in the accompanying

  14. 40 CFR 158.2040 - Biochemical pesticides residue data requirements table.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... for biochemical agents in the biochemical human health assessment data requirements, § 158.2050. 2... be available for human or livestock consumption. 13. Data on fish are required for all pesticides... for human consumption. 14. Data are required when a pesticide is to be applied directly to water that...

  15. 40 CFR 158.2040 - Biochemical pesticides residue data requirements table.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... for biochemical agents in the biochemical human health assessment data requirements, § 158.2050. 2... be available for human or livestock consumption. 13. Data on fish are required for all pesticides... for human consumption. 14. Data are required when a pesticide is to be applied directly to water that...

  16. 40 CFR 158.2040 - Biochemical pesticides residue data requirements table.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... for biochemical agents in the biochemical human health assessment data requirements, § 158.2050. 2... be available for human or livestock consumption. 13. Data on fish are required for all pesticides... for human consumption. 14. Data are required when a pesticide is to be applied directly to water that...

  17. 40 CFR 158.2040 - Biochemical pesticides residue data requirements table.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... for biochemical agents in the biochemical human health assessment data requirements, § 158.2050. 2... be available for human or livestock consumption. 13. Data on fish are required for all pesticides... for human consumption. 14. Data are required when a pesticide is to be applied directly to water that...

  18. 40 CFR 158.2040 - Biochemical pesticides residue data requirements table.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... for biochemical agents in the biochemical human health assessment data requirements, § 158.2050. 2... be available for human or livestock consumption. 13. Data on fish are required for all pesticides... for human consumption. 14. Data are required when a pesticide is to be applied directly to water that...

  19. 46 CFR 153.907 - Cargo information.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... exposed to the cargo. (7) A list of fire fighting procedures and extinguishing agents effective with cargo fires. (8) Shipper's name. (9) Loading point. (10) Approximate quantity of cargo. (11) Tank in which the... of these two tables. (2) The name of the cargo prescribed in the letter authorizing carriage of the...

  20. 46 CFR 153.907 - Cargo information.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... exposed to the cargo. (7) A list of fire fighting procedures and extinguishing agents effective with cargo fires. (8) Shipper's name. (9) Loading point. (10) Approximate quantity of cargo. (11) Tank in which the... of these two tables. (2) The name of the cargo prescribed in the letter authorizing carriage of the...

  1. 46 CFR 153.907 - Cargo information.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... exposed to the cargo. (7) A list of fire fighting procedures and extinguishing agents effective with cargo fires. (8) Shipper's name. (9) Loading point. (10) Approximate quantity of cargo. (11) Tank in which the... of these two tables. (2) The name of the cargo prescribed in the letter authorizing carriage of the...

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

    PubMed

    Ryom, L; Boesecke, C; Bracchi, M; Ambrosioni, J; Pozniak, A; Arribas, J; Behrens, G; Mallon, Pgm; Puoti, M; Rauch, A; Miro, J M; Kirk, O; Marzolini, C; Lundgren, J D; Battegay, M

    2018-05-01

    The European AIDS Clinical Society (EACS) Guidelines have since 2005 provided multidisciplinary recommendations for the care of HIV-positive persons in geographically diverse areas. Major revisions have been made in all sections of the 2017 Guidelines: antiretroviral treatment (ART), comorbidities, coinfections and opportunistic diseases. Newly added are also a summary of the main changes made, and direct video links to the EACS online course on HIV Management. Recommendations on the clinical situations in which tenofovir alafenamide may be considered over tenofovir disoproxil fumarate are provided, and recommendations on which antiretrovirals can be used safely during pregnancy have been revised. Renal and bone toxicity and hepatitis C virus (HCV) treatment have been added as potential reasons for ART switches in fully virologically suppressed individuals, and dolutegravir/rilpivirine has been included as a treatment option. In contrast, dolutegravir monotherapy is not recommended. New recommendations on non-alcoholic fatty liver disease, chronic lung disease, solid organ transplantation, and prescribing in elderly are included, and human papilloma virus (HPV) vaccination recommendations have been expanded. All drug-drug interaction tables have been updated and new tables are included. Treatment options for direct-acting antivirals (DAAs) have been updated and include the latest combinations of sofosbuvir/velpatasvir/voxilaprevir and glecaprevir/pibrentasvir. Recommendations on management of DAA failure and acute HCV infection have been expanded. For treatment of tuberculosis (TB), it is underlined that intermittent treatment is contraindicated, and for resistant TB new data suggest that using a three-drug combination may be as effective as a five-drug regimen, and may reduce treatment duration from 18-24 to 6-10 months. Version 9.0 of the EACS Guidelines provides a holistic approach to HIV care and is translated into the six most commonly spoken languages. © 2018 The Authors. HIV Medicine Published by John Wiley & Sons Ltd on behalf of British HIV Association.

  3. Comparison of Alternative Evidence Summary and Presentation Formats in Clinical Guideline Development: A Mixed-Method Study

    PubMed Central

    Opiyo, Newton; Shepperd, Sasha; Musila, Nyokabi; Allen, Elizabeth; Nyamai, Rachel; Fretheim, Atle; English, Mike

    2013-01-01

    Background Best formats for summarising and presenting evidence for use in clinical guideline development remain less well defined. We aimed to assess the effectiveness of different evidence summary formats to address this gap. Methods Healthcare professionals attending a one-week Kenyan, national guideline development workshop were randomly allocated to receive evidence packaged in three different formats: systematic reviews (SRs) alone, systematic reviews with summary-of-findings tables, and ‘graded-entry’ formats (a ‘front-end’ summary and a contextually framed narrative report plus the SR). The influence of format on the proportion of correct responses to key clinical questions, the primary outcome, was assessed using a written test. The secondary outcome was a composite endpoint, measured on a 5-point scale, of the clarity of presentation and ease of locating the quality of evidence for critical neonatal outcomes. Interviews conducted within two months following completion of trial data collection explored panel members’ views on the evidence summary formats and experiences with appraisal and use of research information. Results 65 (93%) of 70 participants completed questions on the prespecified outcome measures. There were no differences between groups in the odds of correct responses to key clinical questions. ‘Graded-entry’ formats were associated with a higher mean composite score for clarity and accessibility of information about the quality of evidence for critical neonatal outcomes compared to systematic reviews alone (adjusted mean difference 0.52, 95% CI 0.06 to 0.99). There was no difference in the mean composite score between SR with SoF tables and SR alone. Findings from interviews with 16 panelists indicated that short narrative evidence reports were preferred for the improved clarity of information presentation and ease of use. Conclusions Our findings suggest that ‘graded-entry’ evidence summary formats may improve clarity and accessibility of research evidence in clinical guideline development. Trial Registration Controlled-Trials.com ISRCTN05154264 PMID:23372813

  4. Treatment Algorithm for Chronic Idiopathic Constipation and Constipation-Predominant Irritable Bowel Syndrome Derived from a Canadian National Survey and Needs Assessment on Choices of Therapeutic Agents.

    PubMed

    Tse, Yvonne; Armstrong, David; Andrews, Christopher N; Bitton, Alain; Bressler, Brian; Marshall, John; Liu, Louis W C

    2017-01-01

    Background . Chronic idiopathic constipation (CIC) and constipation-predominant irritable bowel syndrome (IBS-C) are common functional lower gastrointestinal disorders that impair patients' quality of life. In a national survey, we aimed to evaluate (1) Canadian physician practice patterns in the utilization of therapeutic agents listed in the new ACG and AGA guidelines; (2) physicians satisfaction with these agents for their CIC and IBS-C patients; and (3) the usefulness of these new guidelines in their clinical practice. Methods . A 9-item questionnaire was sent to 350 Canadian specialists to evaluate their clinical practice for the management of CIC and IBS-C. Results . The response rate to the survey was 16% ( n = 55). Almost all (96%) respondents followed a standard, stepwise approach for management while they believed that only 24% of referring physicians followed the same approach. Respondents found guanylyl cyclase C (GCC) agonist most satisfying when treating their patients. Among the 69% of respondents who were aware of published guidelines, only 50% found them helpful in prioritizing treatment choices and 69% of respondents indicated that a treatment algorithm, applicable to Canadian practice, would be valuable. Conclusion . Based on this needs assessment, a treatment algorithm was developed to provide clinical guidance in the management of IBS-C and CIC in Canada.

  5. Development of Medical Technology for Contingency Response to Marrow Toxic Agents

    DTIC Science & Technology

    2016-10-07

    Guidelines • Collaborated with REMM.nlm.gov on an update of acute radiation syndrome treatment guidelines • Conducted hospital readiness site assessments... Radiation Training, sending a physician to the REAC/TS training, conducting an Acute Radiation Syndrome Medical Grand rounds session, and having a...Information System ARD Antigen Recognition Domain ARRA The American Recovery and Reinvestment Act of 2009 ARS Acute Radiation Syndrome (also known

  6. Use of Guidelines for Reducing Stroke Risk in Patients With Nonvalvular Atrial Fibrillation: A Review From a Latin American Perspective

    PubMed Central

    Silva, Gisele Sampaio; Ameriso, Sebastián F.

    2017-01-01

    Atrial fibrillation (AF) is a prominent risk factor for stroke and a leading cause of death and disability throughout Latin America. Contemporary evidence-based guidelines for the management of AF and stroke incorporate the use of practical and relatively simple scoring methods to estimate both stroke and bleeding risk, in order to assist in matching patients with appropriate interventions. This review examines consistencies and differences among guidelines for reducing stroke risk in patients with AF, assessing the role of user-friendly scoring methods to determine appropriate patients for anticoagulation and other treatment options. Current options include warfarin and direct oral anticoagulants such as dabigatran, rivaroxaban, apixaban, and edoxaban. These agents have been found to be superior or noninferior to standard vitamin K antagonist anticoagulation in large randomized trials. Potential benefits of these agents mainly include lower ischemic stroke rates, reduced intracranial bleeding, no need for regular monitoring, and fewer drug–drug and drug–food interactions. Expert opinions regarding clinical situations for which data are presently lacking, such as emergency bleeding and stroke in anticoagulated patients, are also provided. Enhanced attention and adherence to evidence-based guidelines are essential components for a strategy to reduce stroke morbidity and mortality across Latin America. PMID:28992764

  7. The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the treatment of adolescent sexual offenders with paraphilic disorders

    PubMed Central

    Thibaut, Florence; Bradford, John M. W.; Briken, Peer; De La Barra, Flora; Häßler, Frank; Cosyns, Paul

    2016-01-01

    Abstract The primary aim of these guidelines was to evaluate the role of pharmacological agents in the treatment of adolescents with paraphilic disorders who are also sexual offenders or at-risk of sexual offending. Psychotherapeutic and psychosocial treatments were also reviewed. Adolescents with paraphilic disorders specifically present a different therapeutic challenge as compared to adults. In part, the challenge relates to adolescents being in various stages of puberty and development, which may limit the use of certain pharmacological agents due to their potential side effects. In addition, most of the published treatment programmes have used cognitive behavioural interventions, family therapies and psychoeducational interventions. Psychological treatment is predicated in adolescents on the notion that sexually deviant behaviour can be controlled by the offender, and that more adaptive behaviours can be learned. The main purposes of these guidelines are to improve the quality of care and to aid physicians in their clinical decisions. These guidelines brought together different expert views and involved an extensive literature research. Each treatment recommendation was evaluated and discussed with respect to the strength of evidence for efficacy, safety, tolerability and feasibility. An algorithm is proposed for the treatment of paraphilic disorders in adolescent sexual offenders or those who are at risk. PMID:26595752

  8. [Analysis of microbial flora during operation for cholangitis and other inflammatory deseases of the hepato-billiary system].

    PubMed

    Zhivkov, E; Dimitrova, V; Popov, V; Tosheva, E; Taneva, I

    2006-01-01

    Inflammatory deseases of the billiary system are common in the hepato-billiary surgery. Most serious is the cholangitis. Treatment is based on individual approach of choice of moment of correct surgical intervention and corresponding adequate antibiotic therapy. Retrospective analysis of the experience of our clinic of the positive biliocultures and their antibiograms. 152 positive biliocultures taken intraoperativly, for 10 years period. 48 of them are from patients with cholangitis. Analysis of count and species microbiological agents and their sensitivity to antibiogram antibiotics in table format. The data of the literature reviewed and discussed. Most common microbiological agents are E. coli 60%, Klebsiella 31%, Pseudomonas 24%. In 40% theres are more then one agent. Most common agents have big sensivity to Cefalosporines II-III generation, Amikacin, Ciprofloxacin and Carbapenems.

  9. Guidance on Noncorticosteroid Systemic Immunomodulatory Therapy in Noninfectious Uveitis: Fundamentals Of Care for UveitiS (FOCUS) Initiative.

    PubMed

    Dick, Andrew D; Rosenbaum, James T; Al-Dhibi, Hassan A; Belfort, Rubens; Brézin, Antoine P; Chee, Soon Phaik; Davis, Janet L; Ramanan, Athimalaipet V; Sonoda, Koh-Hei; Carreño, Ester; Nascimento, Heloisa; Salah, Sawsen; Salek, Sherveen; Siak, Jay; Steeples, Laura

    2018-05-01

    An international, expert-led consensus initiative to develop systematic, evidence-based recommendations for the treatment of noninfectious uveitis in the era of biologics. The availability of biologic agents for the treatment of human eye disease has altered practice patterns for the management of noninfectious uveitis. Current guidelines are insufficient to assure optimal use of noncorticosteroid systemic immunomodulatory agents. An international expert steering committee comprising 9 uveitis specialists (including both ophthalmologists and rheumatologists) identified clinical questions and, together with 6 bibliographic fellows trained in uveitis, conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol systematic review of the literature (English language studies from January 1996 through June 2016; Medline [OVID], the Central Cochrane library, EMBASE, CINAHL, SCOPUS, BIOSIS, and Web of Science). Publications included randomized controlled trials, prospective and retrospective studies with sufficient follow-up, case series with 15 cases or more, peer-reviewed articles, and hand-searched conference abstracts from key conferences. The proposed statements were circulated among 130 international uveitis experts for review. A total of 44 globally representative group members met in late 2016 to refine these guidelines using a modified Delphi technique and assigned Oxford levels of evidence. In total, 10 questions were addressed resulting in 21 evidence-based guidance statements covering the following topics: when to start noncorticosteroid immunomodulatory therapy, including both biologic and nonbiologic agents; what data to collect before treatment; when to modify or withdraw treatment; how to select agents based on individual efficacy and safety profiles; and evidence in specific uveitic conditions. Shared decision-making, communication among providers and safety monitoring also were addressed as part of the recommendations. Pharmacoeconomic considerations were not addressed. Consensus guidelines were developed based on published literature, expert opinion, and practical experience to bridge the gap between clinical needs and medical evidence to support the treatment of patients with noninfectious uveitis with noncorticosteroid immunomodulatory agents. Copyright © 2018 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  10. Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV-Exposed and HIV-Infected Children: Recommendations from CDC, the National Institutes of Health, the HIV Medicine Association of the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the American Academy of Pediatrics

    PubMed Central

    Mofenson, Lynne M.; Brady, Michael T.; Danner, Susie P.; Dominguez, Kenneth L.; Hazra, Rohan; Handelsman, Edward; Havens, Peter; Nesheim, Steve; Read, Jennifer S.; Serchuck, Leslie; Van Dyke, Russell

    2010-01-01

    Summary This report updates and combines into one document earlier versions of guidelines for preventing and treating opportunistic infections (OIs) among HIV-exposed and HIV-infected children, last published in 2002 and 2004, respectively. These guidelines are intended for use by clinicians and other health-care workers providing medical care for HIV-exposed and HIV-infected children in the United States. The guidelines discuss opportunistic pathogens that occur in the United States and one that might be acquired during international travel (i.e., malaria). Topic areas covered for each OI include a brief description of the epidemiology, clinical presentation, and diagnosis of the OI in children; prevention of exposure; prevention of disease by chemoprophylaxis and/or vaccination; discontinuation of primary prophylaxis after immune reconstitution; treatment of disease; monitoring for adverse effects during treatment; management of treatment failure; prevention of disease recurrence; and discontinuation of secondary prophylaxis after immune reconstitution. A separate document about preventing and treating of OIs among HIV-infected adults and postpubertal adolescents (Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents) was prepared by a working group of adult HIV and infectious disease specialists. The guidelines were developed by a panel of specialists in pediatric HIV infection and infectious diseases (the Pediatric Opportunistic Infections Working Group) from the U.S. government and academic institutions. For each OI, a pediatric specialist with content-matter expertise reviewed the literature for new information since the last guidelines were published; they then proposed revised recommendations at a meeting at the National Institutes of Health (NIH) in June 2007. After these presentations and discussions, the guidelines underwent further revision, with review and approval by the Working Group, and final endorsement by NIH, CDC, the HIV Medicine Association (HIVMA) of the Infectious Diseases Society of America (IDSA), the Pediatric Infectious Disease Society (PIDS), and the American Academy of Pediatrics (AAP). The recommendations are rated by a letter that indicates the strength of the recommendation and a Roman numeral that indicates the quality of the evidence supporting the recommendation so readers can ascertain how best to apply the recommendations in their practice environments. An important mode of acquisition of OIs, as well as HIV infection among children, is from their infected mother; HIV-infected women coinfected with opportunistic pathogens might be more likely than women without HIV infection to transmit these infections to their infants. In addition, HIV-infected women or HIV-infected family members coinfected with certain opportunistic pathogens might be more likely to transmit these infections horizontally to their children, resulting in increased likelihood of primary acquisition of such infections in the young child. Therefore, infections with opportunistic pathogens might affect not just HIV-infected infants but also HIV-exposed but uninfected infants who become infected by the pathogen because of transmission from HIV-infected mothers or family members with coinfections. These guidelines for treating OIs in children therefore consider treatment of infections among all children, both HIV-infected and uninfected, born to HIV-infected women. Additionally, HIV infection is increasingly seen among adolescents with perinatal infection now surviving into their teens and among youth with behaviorally acquired HIV infection. Although guidelines for postpubertal adolescents can be found in the adult OI guidelines, drug pharmacokinetics and response to treatment may differ for younger prepubertal or pubertal adolescents. Therefore, these guidelines also apply to treatment of HIV-infected youth who have not yet completed pubertal development. Major changes in the guidelines include 1) greater emphasis on the importance of antiretroviral therapy for preventing and treating OIs, especially those OIs for which no specific therapy exists; 2) information about the diagnosis and management of immune reconstitution inflammatory syndromes; 3) information about managing antiretroviral therapy in children with OIs, including potential drug--drug interactions; 4) new guidance on diagnosing of HIV infection and presumptively excluding HIV infection in infants that affect the need for initiation of prophylaxis to prevent Pneumocystis jirovecii pneumonia (PCP) in neonates; 5) updated immunization recommendations for HIV-exposed and HIV-infected children, including hepatitis A, human papillomavirus, meningococcal, and rotavirus vaccines; 6) addition of sections on aspergillosis; bartonella; human herpes virus-6, −7, and −8; malaria; and progressive multifocal leukodystrophy (PML); and 7) new recommendations on discontinuation of OI prophylaxis after immune reconstitution in children. The report includes six tables pertinent to preventing and treating OIs in children and two figures describing immunization recommendations for children aged 0--6 years and 7--18 years. Because treatment of OIs is an evolving science, and availability of new agents or clinical data on existing agents might change therapeutic options and preferences, these recommendations will be periodically updated and will be available at http://AIDSInfo.nih.gov. PMID:19730409

  11. Guidelines for Integrating Helicopter Assets into Emergency Planning

    DTIC Science & Technology

    1991-07-01

    maximum. 35 TABLE 2 HELIPORT INFORMATION SOURCES Professional-and/or industry associations Airborne Law Enforcement Association ( ALEA ) 8060 Balboa Boulevard...Department of Transportation/ Federal Aviation Adminisration ATTN: Hugh Lyon (ASW-611C) Fort Worth, TX 76193-0611 81-624-5600 FAA Northwest Mountain ...indication of wind speed and direction. in areas with swirling or varying winds, such as near buildings or in mountainous areas, two or more wind

  12. Implementing ARFORGEN: Installation Capability and Feasibility Study of Meeting ARFORGEN Guidelines

    DTIC Science & Technology

    2007-07-26

    aligning troop requirements with the Army’s new strategic mission, the force stabilization element of ARFORGEN was developed to raise the morale of...a discrete event simulation model developed for the project to mirror the reset process. The Unit Reset model is implemented in Java as a discrete...and transportation. Further, the typical installation support staff is manned by a Table of Distribution and Allowance ( TDA ) designed to

  13. ALEC (Aggregate Lifecycle Effectiveness and Cost): A Model for Analyzing the Cost-Effectiveness of Air Force Enlisted Personnel Policies. Volume 2. Documentation and User’s Guide.

    DTIC Science & Technology

    1987-08-01

    225686 458892 875261 29791 162090 40137 1791858 IL R -A I.11 i - - - - -- _ _ __ _ _ ...4" .. ... "In m ur ln nm m i -73- V1.OUTPUT MODULE This module...Reenlist bonus 0 29791 29791 Crossflow fees 17271 40137 22865 Total 1417261 1791858 374597 - 75 - Table 7.3 GUIDELINES FOR CHOOSING MANAGEMENT

  14. Different Aspects of Research on Standardization

    DTIC Science & Technology

    1994-11-01

    in different organisational units. (Figure 9) Now it is possible to allocate documents to activities. For this purpose a distinction is made between...the past is documented by an activity matrix and with the allocation document’s activities. As far as the future is concerned, the tables include what...guidelines etc. - Working documents * All documents are related to one or: more activities. * If all allocations document-activity were made, the whole

  15. Resources, Equipment and Logistics in Support of Long-Term Monitoring at Fort Benning

    DTIC Science & Technology

    2005-08-01

    access to cell phone transceivers for data retrieval. Sensor manufacturers, state climatologists, and the EPA provide standards, guidelines...have cell phone access for data retrieval and any software driven maintenance. Figure 3. Typical meteorological data acquisition station Sensor...collect and store data every 30 minutes. Of three current stations, one has a cell phone data link for daily retrieval. Table 2 lists equipment

  16. 50 CFR Table 1a to Part 660... - 2011, Specifications of OFL, ABC, ACL, ACT and Fishery Harvest guidelines (weights in metric tons)

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... for the Pacific Coast treaty Indian Tribes, projected research catch, deductions for fishing mortality...) and research catch (5 mt), resulting in a fishery HG of 2,059 mt. c/ Lingcod south (California). A new... deducted for the incidental open access fishery and research catch, resulting in a fishery HG of 220,995 mt...

  17. 50 CFR Table 1a to Part 660... - 2011, Specifications of OFL, ABC, ACL, ACT and Fishery Harvest guidelines (weights in metric tons)

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... for the Pacific Coast treaty Indian Tribes, projected research catch, deductions for fishing mortality...) and research catch (5 mt), resulting in a fishery HG of 2,059 mt. c/ Lingcod south (California). A new... deducted for the incidental open access fishery and research catch, resulting in a fishery HG of 220,995 mt...

  18. 50 CFR Table 1b to Part 660... - 2009, Harvest Guidelines for Minor Rockfish by Depth Sub-groups (weights in metric tons)

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... research catch and in non-groundfish fisheries is 4,000 mt. The commercial OY is 81,939 mt. Each sector... of 86.4 percent. The OY is reduced by 2.0 mt for the amount anticipated to be taken during research... population in the California Current ecosystem, a non-quantitative assessment was conducted in 2007. The...

  19. [Guidelines for the management of hypertension].

    PubMed

    Prieto-Díaz, Miguel Ángel

    2014-09-01

    In the last year, several scientific societies have published guidelines for the management of arterial hypertension. In Spain, two clinical practice guidelines have had a strong impact and have been closely followed in the last few years: the first is the Guideline of the National Heart, Lung and Blood Institute, although their last report (JNC 7) was published in 2003; the second is the clinical practice guideline for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH), whose latest version was published in 2007, although an update was published in 2009. A new ESC/ESH document, published in 2013, adopts a mainly educational stance, closely rooted in clinical practice. Many of the recommendations maintain the same criteria as previous guidelines. However, the new publication shows greater rigor and contains major contributions such as specification of the level of evidence and grade of recommendation for each recommendation, which was lacking in the previous guidelines of these societies. The document is both practical and easy to consult, consisting of 17 tables, 5 figures and 18 blocks of recommendations. The JNC 8 report, however, has a single objective: to respond to three questions that are considered a priority and which refer exclusively to drug therapy. Nine recommendations are made relating to these three questions. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Medicina Rural y Generalista (SEMERGEN). All rights reserved.

  20. Precise definition of anonymization in genetic polymorphism studies.

    PubMed

    Hamajima, Nobuyuki; Atsuta, Yoshiko; Niwa, Yoshimitsu; Nishio, Kazuko; Tanaka, Daisuke; Yamamoto, Kazuhito; Tamakoshi, Akiko

    2004-01-01

    Anonymization is an essential tool to protect privacy of participants in epidemiological studies. This paper classifies types of anonymization in genetic polymorphism studies, providing precise definitions. They are: 1) unlinkable anonymization at enrollment without a participant list; 2) unlinkable anonymization before genotyping with a participant list; 3) linkable anonymization; 4) unlinkable anonymization for outsiders; and 5) linkable anonymization for outsiders. The classification in view of accessibility to a table including genotype data with directly identifiable data such as names is important; if such tables exist, staff may obtain genotype information about participants. The first three modes are defined here as anonymization unaccessible to genotype data with directly identifiable information for research staff. Anonymization with a key code held by participants is possible with any of the above anonymization modes, by which participants can access to their own genotypes through telephone or internet. A guideline issued on March 29, 2001 with collaboration of three Ministries in Japan defines "anonymization in a linkable fashion" and "anonymization in an unlinkable fashion", "for the purpose of preventing the personal information from being divulged externally in violation of law, the present guidelines or a research protocol", but the contents are not clear in practice. The proposed definitions will be useful when we describe and discuss the preferable mode of anonymization for a given polymorphism study.

  1. Role of ivabradine and heart rate lowering in chronic heart failure: guideline update.

    PubMed

    Chow, Sheryl L; Page, Robert Lee; Depre, Christophe

    2018-06-14

    This review summarizes the current management of heart failure (HF) in patients with reduced ejection fraction and the potential role of heart rate lowering agents in select populations, as recommended in the updated guidelines. Areas covered: PubMed was searched for studies that evaluated the role of heart rate lowering or ivabradine in HF management. Expert commentary: Targeting heart rate may offer benefit when added to renin-angiotensin aldosterone antagonists, and beta-blockers. Ivabradine is a heart rate lowering agent that acts on the funny current (I f ) in the sinoatrial node, thereby reducing heart rate without directly affecting cardiac contraction and relaxation. Clinical data from a phase 3 trial demonstrated that ivabradine reduced the composite endpoint of cardiovascular death or hospital admission for worsening systolic HF, while maintaining an acceptable safety profile in patients receiving standard of care therapy. These data, in addition to more recently published guidelines, suggest ivabradine as a promising new treatment option for lowering heart rate after optimizing standard therapy in select patients with chronic HF.

  2. Mycological Research: instructions and guidelines for authors.

    PubMed

    Hawksworth, David L

    2007-01-01

    Instructions and guidelines for authors submitting papers to Mycological Research are provided. The journal is international and covers all fields of mycology, both fundamental and applied. It publishes news items, reviews, original papers, and book reviews. Contributions should be of interest to a wide spectrum of mycologists or make significant novel contributions. Papers with particularly exciting results are fast-tracked and prioritized for publication. Submission must be made online via the Elsevier Editorial System (ees.elsevier.com/mycres); hard copy submissions are no longer accepted. Information is provided on: scope and timeliness; submission of articles; manuscript preparation; tables; illustrations; spellings, numbers, chemical symbols, and abbreviations; voucher material; molecular data; taxonomic data; references; the decision-making process; copyright; author's copies; proofs; and further questions.

  3. Pragmatically Framed Cross-Situational Noun Learning Using Computational Reinforcement Models

    PubMed Central

    Najnin, Shamima; Banerjee, Bonny

    2018-01-01

    Cross-situational learning and social pragmatic theories are prominent mechanisms for learning word meanings (i.e., word-object pairs). In this paper, the role of reinforcement is investigated for early word-learning by an artificial agent. When exposed to a group of speakers, the agent comes to understand an initial set of vocabulary items belonging to the language used by the group. Both cross-situational learning and social pragmatic theory are taken into account. As social cues, joint attention and prosodic cues in caregiver's speech are considered. During agent-caregiver interaction, the agent selects a word from the caregiver's utterance and learns the relations between that word and the objects in its visual environment. The “novel words to novel objects” language-specific constraint is assumed for computing rewards. The models are learned by maximizing the expected reward using reinforcement learning algorithms [i.e., table-based algorithms: Q-learning, SARSA, SARSA-λ, and neural network-based algorithms: Q-learning for neural network (Q-NN), neural-fitted Q-network (NFQ), and deep Q-network (DQN)]. Neural network-based reinforcement learning models are chosen over table-based models for better generalization and quicker convergence. Simulations are carried out using mother-infant interaction CHILDES dataset for learning word-object pairings. Reinforcement is modeled in two cross-situational learning cases: (1) with joint attention (Attentional models), and (2) with joint attention and prosodic cues (Attentional-prosodic models). Attentional-prosodic models manifest superior performance to Attentional ones for the task of word-learning. The Attentional-prosodic DQN outperforms existing word-learning models for the same task. PMID:29441027

  4. Comparison of different screening methods for blood pressure disorders in children and adolescents.

    PubMed

    Mourato, Felipe Alves; Lima Filho, José Luiz; Mattos, Sandra da Silva

    2015-01-01

    To compare different methods of screening for blood pressure disorders in children and adolescents. A database with 17,083 medical records of patients from a pediatric cardiology clinic was used. After analyzing the inclusion and exclusion criteria, 5,650 were selected. These were divided into two age groups: between 5 and 13 years and between 13 and 18 years. The blood pressure measurement was classified as normal, pre-hypertensive, or hypertensive, consistent with recent guidelines and the selected screening methods. Sensitivity, specificity, and accuracy were then calculated according to gender and age range. The formulas proposed by Somu and Ardissino's table showed low sensitivity in identifying pre-hypertension in all age groups, whereas the table proposed by Kaelber showed the best results. The ratio between blood pressure and height showed low specificity in the younger age group, but showed good performance in adolescents. Screening tools used for the assessment of blood pressure disorders in children and adolescents may be useful to decrease the current rate of underdiagnosis of this condition. The table proposed by Kaelber showed the best results; however, the ratio between BP and height demonstrated specific advantages, as it does not require tables. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  5. Is physician adherence to prescription guidelines a general trait of health care practices or dependent on drug type?--a multilevel logistic regression analysis in South Sweden.

    PubMed

    Ohlsson, Henrik; Merlo, Juan

    2009-08-01

    Therapeutic traditions at health care practices (HCPs) influence physicians' adherence to prescription guidelines for specific drugs, however, it is not known if such traditions affect all kinds of prescriptions or only specific types of drug. Our goal was to determine whether adherence to prescription guidelines is a common trait of HCPs or dependent on drug type. We fitted separate multi-level logistic regression models to all patients in the Skåne region who received a prescription for a statin drug (ATC: C10AA, n = 6232), an agent acting on the renin-angiotensin system (ATC: C09, n = 7222) or a proton pump inhibitor (ATC: A02BC, n = 11 563) at 198 HCPs from July 2006 to December 2006. There was a high clustering of adherence to prescription guidelines at HCPs for the different drug types (MOR(agents acting on the renin-angiotensin system) = 4.72 [95% CI: 3.90-5.92], MOR(Statins) = 2.71 [95% CI: 2.23-3.39] and MOR(Proton pump inhibitors) = 2.16 [95% CI: 1.95-2.45]). Compared with HCPs with low adherence to guidelines in two drug types, those HCPs with the highest level of adherence for these two drug types also showed a higher probability of adherence for the third drug type. Physicians' decisions to follow prescription guidelines seem to be influenced by therapeutic traditions at the HCP. Moreover, these therapeutic traditions seem to affect all kinds of prescriptions. This information can be used as basis for interventions to support rational and cost-effective medication use. Copyright 2009 John Wiley & Sons, Ltd.

  6. Cervical cancer screening and updated Pap guidelines.

    PubMed

    Warren, Johanna B; Gullett, Heidi; King, Valerie J

    2009-03-01

    Cervical cancer and its dysplasia precursors account for significant morbidity and mortality in women worldwide. Human papillomavirus infection is common, preventable, and now widely accepted as the causative agent with oncogenic potential in the development of cervical cancer. Screening via Papanicolaou testing is critical, and interpretation of test results with knowledge of patient risk factors is imperative. Many evidence-based guidelines for screening, interpretation, and management have been developed and are widely available for use.

  7. Guidelines for the Prevention of Infection After Combat-Related Injuries

    DTIC Science & Technology

    2008-03-01

    randomized con - trol trials or cohort studies that could be incorporated into the guidelines. In addition, civilian trauma articles, primarily randomized...when patients are unable to tolerate oral medication, the TCCC also has pro - vided recommendations for intravenous or intramuscular agents to use in...Level I) is typically provided by a physician assistant or a general medical officer (general med- ical officer ( GMO )—physician with at least 1 year of

  8. The advantages and limitations of guideline adaptation frameworks.

    PubMed

    Wang, Zhicheng; Norris, Susan L; Bero, Lisa

    2018-05-29

    The implementation of evidence-based guidelines can improve clinical and public health outcomes by helping health professionals practice in the most effective manner, as well as assisting policy-makers in designing optimal programs. Adaptation of a guideline to suit the context in which it is intended to be applied can be a key step in the implementation process. Without taking the local context into account, certain interventions recommended in evidence-based guidelines may be infeasible under local conditions. Guideline adaptation frameworks provide a systematic way of approaching adaptation, and their use may increase transparency, methodological rigor, and the quality of the adapted guideline. This paper presents a number of adaptation frameworks that are currently available. We aim to compare the advantages and limitations of their processes, methods, and resource implications. These insights into adaptation frameworks can inform the future development of guidelines and systematic methods to optimize their adaptation. Recent adaptation frameworks show an evolution from adapting entire existing guidelines, to adapting specific recommendations extracted from an existing guideline, to constructing evidence tables for each recommendation that needs to be adapted. This is a move towards more recommendation-focused, context-specific processes and considerations. There are still many gaps in knowledge about guideline adaptation. Most of the frameworks reviewed lack any evaluation of the adaptation process and outcomes, including user satisfaction and resources expended. The validity, usability, and health impact of guidelines developed via an adaptation process have not been studied. Lastly, adaptation frameworks have not been evaluated for use in low-income countries. Despite the limitations in frameworks, a more systematic approach to adaptation based on a framework is valuable, as it helps to ensure that the recommendations stay true to the evidence while taking local needs into account. The utilization of frameworks in the guideline implementation process can be optimized by increasing the understanding and upfront estimation of resource and time needed, capacity building in adaptation methods, and increasing the adaptability of the source recommendation document.

  9. [Guidelines for wise utilization of knee imaging].

    PubMed

    Finestone, Aharon S; Eshed, Iris; Freedman, Yehuda; Beer, Yiftah; Bar-Sever, Zvi; Kots, Yavvgeni; Adar, Eliyahu; Mann, Gideon

    2012-02-01

    The knee is a complex structure afflicted with diverse pathologies. Correct management of knee complaints demands wise utilization of imaging modalities, considering their accuracy in the specific clinical situation, the patient's safety and availability and financial issues. Some of these considerations are universal, while others are local, depending on medical and insurance systems. There is controversy and unclearness regarding the best imaging modality in different clinical situations. To develop clinical guidelines for utilizing knee imaging. Leading physicians in specialties associated with knee disease and imaging were invited to participate in a panel on the guidelines. Controversies were settled in the main panel or in sub-panels. The panel agreed on the principles in choosing from the various modalities, primarily medical accuracy, followed by patient safety, availability and cost. There was agreement that the physician is responsible to choose the most appropriate diagnostic tool, consulting, when necessary, on the advantages, limitations and risks of the various imaging modalities. A comprehensive table was compiled with the importance of the different imaging modalities in various clinical situations. For the first time, Israeli guidelines on wise utilization of knee imaging are presented. They take into consideration the clinical situations and also availability and financial issues specific to Israel. These guidelines will serve physicians of several disciplines and medical insurers to improve patient management efficiently.

  10. No. 247-Antibiotic Prophylaxis in Obstetric Procedures.

    PubMed

    van Schalkwyk, Julie; Van Eyk, Nancy

    2017-09-01

    To review the evidence and provide recommendations on antibiotic prophylaxis for obstetrical procedures. Outcomes evaluated include need and effectiveness of antibiotics to prevent infections in obstetrical procedures. Published literature was retrieved through searches of Medline and The Cochrane Library on the topic of antibiotic prophylaxis in obstetrical procedures. Results were restricted to systematic reviews, randomized controlled trials/controlled clinical trials, and observational studies. Searches were updated on a regular basis and articles published from January 1978 to June2009 were incorporated in the guideline. Current guidelines published by the American College of Obstetrics and Gynecology were also incorporated. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The evidence obtained was reviewed and evaluated by the Infectious Diseases Committee of the Society of Obstetricians and Gynaecologists of Canada under the leadership of the principal authors, and recommendations were made according to guidelines developed by the Canadian Task Force on Preventive Health Care (Table 1). Implementation of this guideline should reduce the cost and harm resulting from the administration of antibiotics when they are not required and the harm resulting from failure to administer antibiotics when they would be beneficial. RECOMMENDATIONS. Copyright © 2017. Published by Elsevier Inc.

  11. Guidelines for the Institutional Implementation of Developmental Neuroprotective Care in the Neonatal Intensive Care Unit. Part A: Background and Rationale. A Joint Position Statement From the CANN, CAPWHN, NANN, and COINN.

    PubMed

    Milette, Isabelle; Martel, Marie-Josée; Ribeiro da Silva, Margarida; Coughlin McNeil, Mary

    2017-06-01

    The use of age-appropriate care as an organized framework for care delivery in the neonatal intensive care unit is founded on the work of Heidelise Als, PhD, and her synactive theory of development. This theoretical construct has recently been advanced by the work of Gibbins and colleagues with the "universe of developmental care" conceptual model and developmental care core measures which were endorsed by the National Association of Neonatal Nurses in their age-appropriate care of premature infant guidelines as best-practice standards for the provision of high-quality care in the neonatal intensive care unit. These guidelines were recently revised and expanded. In alignment with the Joint Commission's requirement for health-care professionals to provide age-specific care across the lifespan, the core measures for developmental care suggest the necessary competencies for those caring for the premature and critically ill hospitalized infant. Further supported by the Primer Standards of Accreditation and Health Canada, the institutional implementation of theses core measures requires a strong framework for institutional operationalization, presented in these guidelines. Part A of this article will present the background and rationale behind the present guidelines and their condensed table of recommendations.

  12. Assessment of spore presence for Cercospora beticola as demonstrated by sentinel beets

    USDA-ARS?s Scientific Manuscript database

    Cercospora beticola, the causal agent of Cercospora leaf spot (CLS) in Beta vulgaris (sugar, table, and leaf beet), is an important pathogen globally. Disease forecasting models are widely used to aid in CLS management for sugar beet. Most models rely on weather data to predict infection periods but...

  13. A Seat at the Table: How the Work of Teaching Impacts Teachers as Policy Agents

    ERIC Educational Resources Information Center

    Good, Annalee G.; Fox Barocas, Sadie; Chávez-Moreno, Laura C.; Feldman, Rachel; Canela, Carlos

    2017-01-01

    Policy reflects and shapes society's beliefs about schools, teachers, children, learning, and society, as well as the power structures embedded in our communities and decision-making processes. Although teachers may be central to the "implementation" of education policy, they are marginal to the "design" of policy agendas and…

  14. A Historical Perspective on the Dichotomy of Arsenic as a Poison and Medicinal Agent

    EPA Science Inventory

    Arsenic is one of the most interesting and enigmatic elements of the periodic table. Its use as an intentional poison has been known for centuries and occasionally occurs today. Arsenic has been called the “King of Poisons”, because it had been used to poison royalt...

  15. Nationwide survey on the 2005 Guidelines for the Management of Community-Acquired Adult Pneumonia: validation of differentiation between bacterial pneumonia and atypical pneumonia.

    PubMed

    Watanabe, Akira; Goto, Hajime; Kohno, Shigeru; Matsushima, Toshiharu; Abe, Shosaku; Aoki, Nobuki; Shimokata, Kaoru; Mikasa, Keiichi; Niki, Yoshihito

    2012-03-01

    The Japanese Respiratory Society Guidelines for the Management of Community-Acquired Pneumonia (CAP) in Adults (JRS 2005) was published as a revision of the Basic Concept for the Management of CAP in Adults (JRS 2000). To evaluate the JRS 2005 criteria for differentiating between disease types and assessing the status of antimicrobial agent use in initial treatment, we conducted a prospective survey. The survey was conducted from July 2006 to March 2007 as a nationwide joint study by 200 institutions. The study subjects included patients aged ≥16 years of age who had CAP, and patients who met the inclusion criteria were consecutively enrolled. Disease type differentiation based on JRS 2005 and JRS 2000 was conducted. Disease type diagnosis was also performed based on test results. The sensitivity and specificity of disease type differentiation were calculated. The antimicrobial agents used in the initial treatment were classified as recommended or non-recommended based on JRS 2005. The validity of non-recommended antimicrobial agent use was investigated. A total of 1875 patients were analyzed. Differentiation of atypical pneumonia using the JRS 2005 criteria had higher sensitivity and lower specificity than differentiation using the JRS 2000 criteria. The antimicrobial agents recommended by JRS 2005 were used as initial treatment in a low number of cases. The efficacy of the recommended antimicrobial agents was similar to that of the non-recommended agents. JRS 2005 is advantageous in terms of reducing the number of items used in disease type differentiation. The recommended antimicrobial agents used for the initial treatment are believed to be appropriate. Copyright © 2012 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

  16. Compatibility and infectivity of a Cercospora rodmanii formulation with enhancing agents. Final report

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

    Pennington, J.C.; Theriot, E.A.

    1983-06-01

    A formulation of the fungus Cercospora rodmanii Conway has been produced, as a biocontrol of waterhyacinth (Eichhornia crassipes (Mart.) Solms.). To ensure the most efficient germination of the formulation, 12 potential enhancing agents were tested for addition during the spray application. The agents were aspartic acid, glucose, glutamic acid, gum xanthan, nutrient agar, Ortho X-77 Spreader, Tween 20, Tween 60, Tween 80, sodium alginate, Super Slupper, and yeast extract. Compatibility of test agents and combinations of test agents with two lots of the formulation was determined in the laboratory. All combinations of test agents were compatible with both lots ofmore » the C. rodmanii formulation. The C. rodmanii formulation was sprayed with test agents on waterhyacinth pseudolaminae. Damage was monitored each week for 8 weeks by assigning a disease index to each original and new pseudolaminae. No spots having characteristics suggestive of C. rodmanii infection were observed at any time during the study. Lack of infectivity could be remedied by isolating a virulent strain of C. rodmanii from the field. Agents determined to be compatible in this study could then be reexamined for enhancing infectivity on a virulent C. rodmanii formulation. 14 references, 2 figures, 5 tables.« less

  17. Multi Agent Reward Analysis for Learning in Noisy Domains

    NASA Technical Reports Server (NTRS)

    Tumer, Kagan; Agogino, Adrian K.

    2005-01-01

    In many multi agent learning problems, it is difficult to determine, a priori, the agent reward structure that will lead to good performance. This problem is particularly pronounced in continuous, noisy domains ill-suited to simple table backup schemes commonly used in TD(lambda)/Q-learning. In this paper, we present a new reward evaluation method that allows the tradeoff between coordination among the agents and the difficulty of the learning problem each agent faces to be visualized. This method is independent of the learning algorithm and is only a function of the problem domain and the agents reward structure. We then use this reward efficiency visualization method to determine an effective reward without performing extensive simulations. We test this method in both a static and a dynamic multi-rover learning domain where the agents have continuous state spaces and where their actions are noisy (e.g., the agents movement decisions are not always carried out properly). Our results show that in the more difficult dynamic domain, the reward efficiency visualization method provides a two order of magnitude speedup in selecting a good reward. Most importantly it allows one to quickly create and verify rewards tailored to the observational limitations of the domain.

  18. Saline as the Sole Contrast Agent for Successful MRI-guided Epidural Injections

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

    Deli, Martin, E-mail: martin.deli@web.de; Fritz, Jan, E-mail: jfritz9@jhmi.edu; Mateiescu, Serban, E-mail: mateiescu@microtherapy.de

    Purpose. To assess the performance of sterile saline solution as the sole contrast agent for percutaneous magnetic resonance imaging (MRI)-guided epidural injections at 1.5 T. Methods. A retrospective analysis of two different techniques of MRI-guided epidural injections was performed with either gadolinium-enhanced saline solution or sterile saline solution for documentation of the epidural location of the needle tip. T1-weighted spoiled gradient echo (FLASH) images or T2-weighted single-shot turbo spin echo (HASTE) images visualized the test injectants. Methods were compared by technical success rate, image quality, table time, and rate of complications. Results. 105 MRI-guided epidural injections (12 of 105 withmore » gadolinium-enhanced saline solution and 93 of 105 with sterile saline solution) were performed successfully and without complications. Visualization of sterile saline solution and gadolinium-enhanced saline solution was sufficient, good, or excellent in all 105 interventions. For either test injectant, quantitative image analysis demonstrated comparable high contrast-to-noise ratios of test injectants to adjacent body substances with reliable statistical significance levels (p < 0.001). The mean table time was 22 {+-} 9 min in the gadolinium-enhanced saline solution group and 22 {+-} 8 min in the saline solution group (p = 0.75). Conclusion. Sterile saline is suitable as the sole contrast agent for successful and safe percutaneous MRI-guided epidural drug delivery at 1.5 T.« less

  19. Fluoride content in table salt distributed in Mexico City, Mexico.

    PubMed

    Hernández-Guerrero, Juan Carlos; de la Fuente-Hernández, Javier; Jiménez-Farfán, Maria Dolores; Ledesma-Montes, Constantino; Castañeda-Castaneira, Enrique; Molina-Frechero, Nelly; Jacinto-Alemán, Luís Fernando; Juárez-Lopez, Lilia Adriana; Moreno-Altamirano, Alejandra

    2008-01-01

    The aim of this study was to analyze table salt available in Mexico City's market to identify the fluoride concentrations and to compare these with the Mexican regulations. We analyzed 44 different brands of table salt. All samples were purchased at random in different stores, supermarkets, and groceries from Mexico City's metropolitan area and analyzed in triplicate in three different laboratories (nine determinations per sample) with an Orion 720 A potentiometer and an Orion 9609 BN ion-specific electrode. Fluoride concentration in the samples varied from 0 ppm to 485 ppm. It was found that fluoride concentration varied widely among the analyzed brands. Also, we found that fluoride concentration in 92 percent of the analyzed samples did not match with that printed on the label. Only 6.8 percent of the analyzed samples contained fluoride concentrations that meet Mexican and WHO regulations. The broad variation in the analyzed samples suggests that Mexican Public Health authorities must implement more stringent regulation guidelines and procedures for controlling the distribution of salt and its fluoride concentration for human consumption.

  20. Cost and Selection of Ophthalmic Anti-Vascular Endothelial Growth Factor Agents.

    PubMed

    Li, Emily; Greenberg, Paul B; Voruganti, Indu; Krzystolik, Magdalena G

    2016-05-02

    Anti-vascular endothelial growth factor (anti-VEGF) drugs - ranibizumab, aflibercept, and off-label bevacizumab - are vital to the treatment of common retinal diseases, including exudative age-related macular degeneration (AMD), diabetic macular edema (DME), and macular edema (ME) associated with retinal vein occlusion (RVO). Given the high prevalence of AMD and retinal vascular diseases, anti-VEGF agents represent a large cost burden to the United States (US) healthcare system. Although ranibizumab and aflibercept are 30-fold more expensive per injection than bevacizumab, the two more costly medications are commonly used in the US, even though all three have been shown to be effective and safe for treatment of these retinal diseases. We investigated the availability and content of professional ophthalmic guidelines on cost consideration in the selection of anti-VEGF agents. We found that current professional guidelines were limited in availability and lacked specific guidance on cost-based anti-VEGF drug selection. This represents a missed opportunity to encourage the practice of value-based medicine. [Full article available at http://rimed.org/rimedicaljournal-2016-05.asp, free with no login].

  1. Prudent use guidelines: a review of existing veterinary guidelines.

    PubMed

    Teale, C J; Moulin, G

    2012-04-01

    The World Organisation for Animal Health (OIE) TerrestrialAnimal Health Code considers the prudent use of antimicrobial agents in veterinary medicine to comprise a series of practical measures and recommendations which confer benefits to animal and public health while preserving and maintaining the therapeutic efficacy of antimicrobials. This paper reviews some of the main veterinary prudent use guidelines which have been published in English and the responsibilities of those involved at all levels in the administration of antimicrobials to animals, including national regulatory authorities. The OIE guidelines are considered comprehensive and cover all of those levels, from regulatory authorities to veterinarians and food producers. Guidelines produced by national authorities, professional veterinary associations or farming associations and which are targeted at particular individuals, for example veterinarians or food animal producers, will, obviously, restrict their coverage to those aspects considered relevant for their target audience.

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

    PubMed

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

    2015-11-01

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

  3. Myasthenia gravis: Association of British Neurologists' management guidelines.

    PubMed

    Sussman, Jon; Farrugia, Maria E; Maddison, Paul; Hill, Marguerite; Leite, M Isabel; Hilton-Jones, David

    2015-06-01

    Myasthenia gravis is an autoimmune disease of the neuromuscular junction for which many therapies were developed before the era of evidence based medicine. The basic principles of treatment are well known, however, patients continue to receive suboptimal treatment as a result of which a myasthenia gravis guidelines group was established under the aegis of The Association of British Neurologists. These guidelines attempt to steer a path between evidence-based practice where available, and established best practice where evidence is unavailable. Where there is insufficient evidence or a choice of options, the guidelines invite the clinician to seek the opinion of a myasthenia expert. The guidelines support clinicians not just in using the right treatments in the right order, but in optimising the use of well-known therapeutic agents. Clinical practice can be audited against these 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.

  4. Portuguese guidelines for the use of biological agents in rheumatoid arthritis - March 2010 update.

    PubMed

    Fonseca, João Eurico; Canhão, Helena; Reis, Paulo; Santos, Maria José; Branco, Jaime; Quintal, Alberto; Malcata, Armando; Araújo, Domingos; Ventura, Francisco; Figueiredo, Guilherme; da Silva, José Canas; Patto, José Vaz; de Queiroz, Mário Viana; Santos, Rui André; Neto, Adriano José; de Matos, Alves de; Rodrigues, Ana; Mourão, Ana Filipa; Ribeiro, Ana Sofia; Cravo, Ana Rita; Barcelos, Anabela; Cardoso, Anabela; Vilar, António; Braña, Arecili; Faustino, Augusto; Silva, Candida; Godinho, Fátima; Cunha, Inês; Costa, José António; Gomes, José António Melo; Pinto, José António Araújo; da Silva, J A Pereira; Miranda, Luís Cunha; Inês, Luís; Santos, Luís Maurício; Cruz, Margarida; Salvador, Maria João; Ferreira, Maria Júlia; Rial, Maria; Bernardes, Miguel; Bogas, Mónica; Araújo, Paula; Machado, Pedro; Pinto, Patrícia; de Melo, Rui Gomes; Cortes, Sara; Alcino, Sérgio; Capela, Susana

    2010-01-01

    The authors present the revised version of the Portuguese Society of Rheumatology (SPR) guidelines for the treatment of rheumatoid arthritis (RA) with biological therapies. In these guidelines the criteria for introduction and maintenance of biological agents are discussed as well as the contraindications and procedures in the case of non-responders. Biological treatment should be considered in RA patients with a disease activity score 28 (DAS 28) superior to 3.2 despite treatment with 20mg/week of methotrexate (MTX) for at least 3 months or, if such treatment is not possible, after 6 months of other conventional disease modifying drug or combination therapy. A DAS 28 score between 2.6 and 3.2 with a significant functional or radiological deterioration under treatment with conventional regimens could also constitute an indication for biological treatment. The treatment goal should be remission or, if that is not achievable, at least a low disease activity, characterized by a DAS28 lower than 3.2, without significative functional or radiological worsening. The response criteria, at the end of the first 3 months of treatment, are a decrease of 0.6 in the DAS28 score. After 6 months of treatment response criteria is defined as a decrease of more than 1.2 in the DAS28 score. Non-responders, in accordance to the Rheumatologist's clinical opinion, should try a switch to another biological agent (tumour necrosis factor antagonist, abatacept, rituximab or tocilizumab).

  5. On the engineering design for systematic integration of agent-orientation in industrial automation.

    PubMed

    Yu, Liyong; Schüller, Andreas; Epple, Ulrich

    2014-09-01

    In today's automation industry, agent-oriented development of system functionalities appears to have a great potential for increasing autonomy and flexibility of complex operations, while lowering the workload of users. In this paper, we present a reference model for the harmonious and systematical integration of agent-orientation in industrial automation. Considering compatibility with existing automation systems and best practice, this model combines advantages of function block technology, service orientation and native description methods from the automation standard IEC 61131-3. This approach can be applied as a guideline for the engineering design of future agent-oriented automation systems. Copyright © 2014 ISA. Published by Elsevier Ltd. All rights reserved.

  6. [Pregnancy date disk for inserting into prenatal records].

    PubMed

    Pluta, M; Dudenhausen, J W

    1983-01-01

    A pregnancy calculating disk - a loose-leaf insert for the antenatal record card--is intended to improve and relieve the prenatal service. A pregnancy calculating disk together with tables containing signs of risks and times for consultations helps towards speedy orientation in daily practice. The data displayed in graphic form gives the pregnant women information on the official guide-lines regarding recommended consultations and ultrasonic examinations during the course of a normal pregnancy.

  7. Level II scour analysis for Bridge 23 (WODSTH00180023) on Town Highway 18, crossing North Bridgewater Brook, Woodstock, Vermont

    USGS Publications Warehouse

    Olson, Scott A.; Weber, Matthew A.

    1996-01-01

    Scour depths and rock rip-rap sizes were computed using the general guidelines described in Hydraulic Engineering Circular 18 (Richardson and others, 1993). Scour depths were calculated assuming an infinite depth of erosive material and a homogeneous particle-size distribution. The scour analysis results are presented in tables 1 and 2 and a graph of the scour depths is presented in figure 8.

  8. Technical Review Board Chairperson Guidelines for Conducting Technical Review Boards for Rocket Testing

    DTIC Science & Technology

    2011-08-17

    to create a guide for technical review board chairperson conducting technical review boards for rocket testing performed by the Air Force Research ...BOARDS FOR ROCKET TESTING   TABLE OF CONTENTS List of Acronyms 1 Abstract 2 Chapter 1. Introduction 3 Introduction and Research Question 3...boards for rocket testing performed by the Air Force Research Laboratory’s Space Missile Propulsion Division located at Edwards Air Force Base in

  9. Level II scour analysis for Bridge 22 (CRAFTH00180022) on Town Highway 18, crossing Black River, Craftsbury, Vermont

    USGS Publications Warehouse

    Ayotte, Joseph D.

    1996-01-01

    Scour depths and rock rip-rap sizes were computed using the general guidelines described in Hydraulic Engineering Circular 18 (Richardson and others, 1993). Scour depths were calculated assuming an infinite depth of erosive material and a homogeneous particle-size distribution. The scour analysis results are presented in tables 1 and 2 and a graph of the scour depths is presented in figure 8.

  10. Level II scour analysis for Bridge 31 (ALBATH00380031) on Town Highway 38, crossing the Black River, Albany, Vermont

    USGS Publications Warehouse

    Boehmler, Erick M.

    1996-01-01

    Scour depths and rock rip-rap sizes were computed using the general guidelines described in Hydraulic Engineering Circular 18 (Richardson and others, 1993). Scour depths were calculated assuming an infinite depth of erosive material and a homogeneous particle-size distribution. The scour analysis results are presented in tables 1 and 2 and a graph of the scour depths is presented in figure 8.

  11. Level II scour analysis for Bridge 25 (ALBATH00250030) on Town Highway 25, crossing the Black River, Albany, Vermont

    USGS Publications Warehouse

    Boehmler, Erick M.

    1996-01-01

    Scour depths and rock rip-rap sizes were computed using the general guidelines described in Hydraulic Engineering Circular 18 (Richardson and others, 1993). Scour depths were calculated assuming an infinite depth of erosive material and a homogeneous particle-size distribution. The scour analysis results are presented in tables 1 and 2 and a graph of the scour depths is presented in figure 8.

  12. Level II scour analysis for Bridge 6 (IRASTH00050006) on Town Highway 5, crossing the Black River, Irasburg, Vermont

    USGS Publications Warehouse

    Olson, Scott A.

    1996-01-01

    Scour depths and rock rip-rap sizes were computed using the general guidelines described in Hydraulic Engineering Circular 18 (Richardson and others, 1993). Scour depths were calculated assuming an infinite depth of erosive material and a homogeneous particle-size distribution. The scour analysis results are presented in tables 1 and 2 and a graph of the scour depths is presented in figure 8.

  13. Level II scour analysis for Bridge 2 (CRAFTH00590002) on Town Highway 59, crossing Black River, Craftsbury, Vermont

    USGS Publications Warehouse

    Ayotte, Joseph D.

    1996-01-01

    Scour depths and rock rip-rap sizes were computed using the general guidelines described in Hydraulic Engineering Circular 18 (Richardson and others, 1993). Scour depths were calculated assuming an infinite depth of erosive material and a homogeneous particle-size distribution. The scour analysis results are presented in tables 1 and 2 and a graph of the scour depths is presented in figure 8.

  14. Level II scour analysis for Bridge 26 (CRAFTH00250026) on Town Highway 25, crossing Black River, Craftsbury, Vermont

    USGS Publications Warehouse

    Ayotte, Joseph D.

    1996-01-01

    Scour depths and rock rip-rap sizes were computed using the general guidelines described in Hydraulic Engineering Circular 18 (Richardson and others, 1993). Scour depths were calculated assuming an infinite depth of erosive material and a homogeneous particle-size distribution. The scour analysis results are presented in tables 1 and 2 and a graph of the scour depths is presented in figure 8.

  15. Acute Exposure Guideline Levels (AEGLs) for Time Varying Toxic Plumes

    DTIC Science & Technology

    2014-09-12

    Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway...into the EAGLE system based on a single EPA table given as a 5 x 3 array of real density values (units mg/m3). These routines share the required...and Y. Jin, (2011), Development and testing of a Coupled Ocean-Atmosphere Mesoscale ensemble Prediction System COAMPS- OS). Ocean Dynamics, 61, 1937

  16. Safe handling of antineoplastic drugs.

    PubMed

    Harrison, B R

    1994-07-01

    Managers should be aware of the hazardous properties of antineoplastic drugs and of the procedures and equipment commonly recommended to provide a safe working environment for employees, patients, and visitors. Compliance with the many published guidelines should help ensure passage of the inevitable Occupational Safety and Health Administration (OSHA) or Joint Commission inspection. Acute and chronic toxicities of the antineoplastic drugs, the potential for exposure in the workplace, and the basic guidelines for safe handling of these agents are reviewed.

  17. Waste streams in a crewed space habitat

    NASA Technical Reports Server (NTRS)

    Wydeven, T.; Golub, M. A.

    1991-01-01

    A judicious compilation of generation rates and chemical compositions of potential waste feed streams in a typical crewed space habitat was made in connection with the waste-management aspect of NASA's Physical/Chemical Closed-Loop Life Support Program. Waste composition definitions are needed for the design of waste-processing technologies involved in closing major life support functions in future long-duration human space missions. Tables of data for the constituents and chemical formulas of the following waste streams are presented and discussed: human urine, feces, hygiene (laundry and shower) water, cleansing agents, trash, humidity condensate, dried sweat, and trace contaminants. Tables of data on dust generation and pH values of the different waste streams are also presented and discussed.

  18. No. 279-Female Sexual Health Consensus Clinical Guidelines.

    PubMed

    Lamont, John; Bajzak, Krisztina; Bouchard, Céline; Burnett, Margaret; Byers, Sandra; Cohen, Trevor; Fisher, William; Holzapfel, Stephen; Senikas, Vyta

    2018-06-01

    To establish national guidelines for the assessment of women's sexual health concerns and the provision of sexual health care for women. Published literature was retrieved through searches of PubMed, CINAHL, and the Cochrane Library from May to October 2010, using appropriate controlled vocabulary (e.g., sexuality, "sexual dysfunction," "physiological," dyspareunia) and key words (e.g., sexual dysfunction, sex therapy, anorgasmia). Results were restricted, where possible, to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no language restrictions. Searches were updated on a regular basis and incorporated in the guideline to December 2010. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. Each article was screened for relevance and the full text acquired if determined to be relevant. The evidence obtained was reviewed and evaluated by the members of the Expert Workgroup established by The Society of Obstetricians and Gynaecologists of Canada. The quality of evidence was evaluated and recommendations made using the use of criteria described by the Canadian Task Force on Preventive Health Care (Table). Copyright © 2018. Published by Elsevier Inc.

  19. Validating agent oriented methodology (AOM) for netlogo modelling and simulation

    NASA Astrophysics Data System (ADS)

    WaiShiang, Cheah; Nissom, Shane; YeeWai, Sim; Sharbini, Hamizan

    2017-10-01

    AOM (Agent Oriented Modeling) is a comprehensive and unified agent methodology for agent oriented software development. AOM methodology was proposed to aid developers with the introduction of technique, terminology, notation and guideline during agent systems development. Although AOM methodology is claimed to be capable of developing a complex real world system, its potential is yet to be realized and recognized by the mainstream software community and the adoption of AOM is still at its infancy. Among the reason is that there are not much case studies or success story of AOM. This paper presents two case studies on the adoption of AOM for individual based modelling and simulation. It demonstrate how the AOM is useful for epidemiology study and ecological study. Hence, it further validate the AOM in a qualitative manner.

  20. Yawsonde Tests for Prototypes of the 155mm Intermediate Volatility Agent Projectile

    DTIC Science & Technology

    1982-07-01

    velocities shown in the table have not been corrected back to the muzzle). Time-zero measurements were made using a strain gage attached to the tube...DRXSY-MP, H. Cohen Commander, USATECOM ATTN: DRSTE-TO-F PM SMOKE, Bldg. 324 ATTN: DRCPM- SMK Director, USACSL, EA Bldg. E3516 ATTN: DRDAR-CLB-PA (1 cy

  1. Documentation of Production: Allied Medical Publication 8(B), Volume 2, Medical Planning Guide of NBC Battle Casualties (Biological)

    DTIC Science & Technology

    2006-06-01

    causing Venezuelan Equine Encephalitis (VEE). Dose Range Signs/Symptoms of Illness Category Number (organisms) Typical Description Abbreviation 1...98 Table VIII-8. Number of Infected Personnel after a Venezuelean equine encephalitis (VEE) Attack...tactical scenario, agent (anthrax, botulinum neurotoxin, plague, tularemia, Staphylococcal enterotoxin B, Q fever, Venezuelan Equine Encephalitis

  2. Kenyan Girls as Agents of Peace: Enhancing the Capacity of Future Women Peacebuilders

    ERIC Educational Resources Information Center

    Zanoni, Katie

    2017-01-01

    The role of women in peacebuilding efforts has been recognized through various international instruments that have advanced the ability of women to access the peace table. In order for women to act as leaders, they must possess the capacity to disrupt structural, cultural, and direct forms of violence, engage in peacemaking activities, and employ…

  3. 27 CFR 555.206 - Location of magazines.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... in the table of distances for storage of explosive materials in § 555.218. (2) Ammonium nitrate and... for the separation of ammonium nitrate and blasting agents in § 555.220. However, the minimum... materials in § 555.218. [T.D. ATF-87, 46 FR 40384, Aug. 7, 1981, as amended by T.D. ATF-293, 55 FR 3722, Feb...

  4. No. 357-Immunization in Pregnancy.

    PubMed

    Castillo, Eliana; Poliquin, Vanessa

    2018-04-01

    To review the evidence and provide recommendations on immunization in pregnancy. Outcomes evaluated include effectiveness of immunization and risks and benefits for mother and fetus. The Medline and Cochrane databases were searched for articles published up to January 2017 on the topic of immunization in pregnancy. The evidence obtained was reviewed and evaluated by the Infectious Diseases Committee of the SOGC under the leadership of the principal authors, and recommendations were made according to guidelines developed by the Canadian Task Force on Preventive Health Care (Table 1). Implementation of the recommendations in this guideline should result in more appropriate immunization of pregnant and breastfeeding women, decreased risk of contraindicated immunization, and better disease prevention. Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

  5. The effects of social interactions with in-vehicle agents on a driver's anger level, driving performance, situation awareness, and perceived workload.

    PubMed

    Jeon, Myounghoon; Walker, Bruce N; Gable, Thomas M

    2015-09-01

    Research has suggested that interaction with an in-vehicle software agent can improve a driver's psychological state and increase road safety. The present study explored the possibility of using an in-vehicle software agent to mitigate effects of driver anger on driving behavior. After either anger or neutral mood induction, 60 undergraduates drove in a simulator with two types of agent intervention. Results showed that both speech-based agents not only enhance driver situation awareness and driving performance, but also reduce their anger level and perceived workload. Regression models show that a driver's anger influences driving performance measures, mediated by situation awareness. The practical implications include design guidelines for the design of social interaction with in-vehicle software agents. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  6. Botrytis californica, a new cryptic species in the B. cinerea species complex causing gray mold in blueberries and table grapes.

    PubMed

    Saito, S; Margosan, D; Michailides, T J; Xiao, C L

    2016-01-01

    The Botrytis cinerea species complex comprises two cryptic species, originally referred to Group I and Group II based on Bc-hch gene RFLP haplotyping. Group I was described as a new cryptic species B. pseudocinerea During a survey of Botrytis spp. causing gray mold in blueberries and table grapes in the Central Valley of California, six isolates, three from blueberries and three from table grapes, were placed in Group I but had a distinct morphological character with conidiophores significantly longer than those of B. cinerea and B. pseudocinerea We compared these with B. cinerea and B. pseudocinerea by examining morphological and physiological characters, sensitivity to fenhexamid and phylogenetic analysis inferred from sequences of three nuclear genes. Phylogenetic analysis with the three partial gene sequences encoding glyceraldehyde-3-phosate dehydrogenase (G3PDH), heat-shock protein 60 (HSP60) and DNA-dependent RNA polymerase subunit II (RPB2) supported the proposal of a new Botrytis species, B. californica, which is closely related genetically to B. cinerea, B. pseudocinerea and B. sinoviticola, all known as causal agents of gray mold of grapes. Botrytis californica caused decay on blueberry and table grape fruit inoculated with the fungus. This study suggests that B. californica is a cryptic species sympatric with B. cinerea on blueberries and table grapes in California. © 2016 by The Mycological Society of America.

  7. Needle Decompression of Tension Pneumothorax Tactical Combat Casualty Care Guideline Recommendations

    DTIC Science & Technology

    2012-07-06

    Oxford Centre for Evidence - Based Medicine (OCEBM) method. 11. FINDINGS Thoracic injuries are one of the leading causes of death in trauma...for Evidence - Based Medicine . http://www.cebm.net/index.aspx?o=5653. Accessed on May 24, 2012 12. Davis DP, Pettit K, Rom CD, et al: The safety...TABLE Oxford Centre for Evidence - Based Medicine 2011 Levels of Evidence * Level may be graded down on the basis of study quality, imprecision

  8. Dimensions of Green.

    ERIC Educational Resources Information Center

    Bloech, Henning M.

    2003-01-01

    Discusses how schools can benefit by establishing sustainable purchasing practices for furniture and furnishings. Describes the elements of sustainable purchasing (reduce, reuse, recycle; ingredients/contents; emissions/indoor air quality; and corporate guidelines), and the added vigilance required of purchasing agents. (EV)

  9. A Conceptual Framework for Addressing Residual Atherosclerotic Cardiovascular Disease Risk in the Era of Precision Medicine.

    PubMed

    Patel, Kershaw V; Pandey, Ambarish; de Lemos, James A

    2018-04-11

    Until recently, therapies to mitigate atherosclerotic cardiovascular disease (ASCVD) risk have been limited to lifestyle interventions, blood pressure lowering medications, high intensity statin therapy, antiplatelet agents, and in select patients, coronary artery revascularization. Despite administration of these evidence-based therapies, substantial residual risk for cardiovascular events persists, particularly among individuals with known ASCVD. Moreover, the current guideline-based approach does not adequately account for patient-specific, causal pathways that lead to ASCVD progression and complications. In the past few years, multiple new pharmacological agents, targeting conceptually distinct pathophysiological targets, have been shown in large and well-conducted clinical trials to lower cardiovascular risk among patients with established ASCVD receiving guideline directed medical care. These evidenced-based therapies reduce event rates, and in some cases all-cause and cardiovascular mortality; these benefits confirm important new disease targets and challenge the adequacy of the current "standard of care" for secondary prevention.

  10. A Systematic Evaluation of State Laws Governing Optometric Glaucoma Management in the United States Upto 2015.

    PubMed

    Chodnicki, Kevin; Kalarn, Sachin; Quinn, Laura; Jampel, Henry; Saeedi, Osamah

    2018-03-01

    To describe state laws that govern the optometric practice of glaucoma management in the United States and to correlate those laws with state demographics upto 2015. We performed a cross-sectional ecological study of the 50 United States and the District of Columbia. Regulations governing optometric scope of practice as written by each state Board of Optometry were reviewed. Specific optometric privileges assessed included: ability to manage glaucoma independently, use of diagnostic pharmaceutical agents, use of therapeutic pharmaceutical agents (including topical and oral steroids and other oral pharmaceutical agents), IV injections, intraocular injections, therapeutic lasers, presence of defined referral, and comanagement guidelines, and hours of yearly continuing education needed for glaucoma management. Optometric privilege was compared with demographic and employment information for each state. Optometrists in all states, except for Massachusetts, and the District of Columbia are allowed to manage glaucoma; 16 states have defined comanagement guidelines. Therapeutic lasers are allowed in 3 states: Kentucky, Louisiana, and Oklahoma. States with defined comanagement guidelines had a mean of 6.9±1.9 ophthalmologists per 100,000 people, significantly more than the 5.3±1.1 in states without defined comanagement of glaucoma (P<0.01). Binary logistic regression showed that, accounting for population and area, the higher the number of optometrists in a state, the less likely there is to be defined comanagement [β (SE)=-0.008 (0.003), P=0.02] and the greater the number of ophthalmologists in a given state, the more likely a state has defined comanagement [β (SE)=-0.13 (0.006)]. There is a diversity of regulations that govern optometric management of glaucoma in each of the 50 states and the District of Columbia. The number of optometrists and ophthalmologists in a state may influence state regulations governing optometric practice and referral guidelines.

  11. [Gadolinium-based contrast agents for magnetic resonance imaging].

    PubMed

    Carrasco Muñoz, S; Calles Blanco, C; Marcin, Javier; Fernández Álvarez, C; Lafuente Martínez, J

    2014-06-01

    Gadolinium-based contrast agents are increasingly being used in magnetic resonance imaging. These agents can improve the contrast in images and provide information about function and metabolism, increasing both sensitivity and specificity. We describe the gadolinium-based contrast agents that have been approved for clinical use, detailing their main characteristics based on their chemical structure, stability, and safety. In general terms, these compounds are safe. Nevertheless, adverse reactions, the possibility of nephrotoxicity from these compounds, and the possibility of developing nephrogenic systemic fibrosis will be covered in this article. Lastly, the article will discuss the current guidelines, recommendations, and contraindications for their clinical use, including the management of pregnant and breast-feeding patients. Copyright © 2014 SERAM. Published by Elsevier Espana. All rights reserved.

  12. Biologic agents for IBD: practical insights.

    PubMed

    Danese, Silvio; Vuitton, Lucine; Peyrin-Biroulet, Laurent

    2015-09-01

    Six biologic agents are currently approved for the treatment of IBD: four anti-TNF agents (infliximab, adalimumab, golimumab and certolizumab pegol) and two anti-integrin agents (natalizumab and vedolizumab). In Crohn's disease and ulcerative colitis refractory to standard medications, treatment choice among available biologic agents can be challenging. Several parameters should be taken into account to help physicians through the decision-making process, including the comparative effectiveness and long-term safety profile, availability and labelling in the prescriber's country, international guidelines, and cost, as well as patient preferences (such as the route of administration). Herein, we provide practical insights on the use of biologic agents in IBD. The results of head-to-head trials between biologic agents are eagerly awaited to guide decision-making regarding the choice of first-line biologic agents and to determine whether switching within the same drug class or swapping (switching out of the drug class) is preferable after primary or secondary loss of response to the first biologic agent. In the near future, treatment algorithms might evolve with the launch of new drugs (such as ustekinumab, tofacitinib and etrolizumab) and the increased use of biosimilars.

  13. Portuguese guidelines for the use of biological agents in rheumatoid arthritis - October 2011 update.

    PubMed

    Fonseca, João Eurico; Bernardes, Miguel; Canhão, Helena; Santos, Maria José; Quintal, Alberto; Malcata, Armando; Neto, Adriano; Cordeiro, Ana; Rodrigues, Ana; Mourão, Ana Filipa; Ribeiro, Ana Sofia; Cravo, Ana Rita; Barcelos, Anabela; Cardoso, Anabela; Vilar, António; Braña, Arecili; Faustino, Augusto; Silva, Candida; Duarte, Cátia; Araújo, Domingos; Nour, Dolores; Sousa, Elsa; Simões, Eugénia; Godinho, Fátima; Brandão, Filipe; Ventura, Francisco; Sequeira, Graça; Figueiredo, Guilherme; Cunha, Inês; Matos, J Alves; Branco, Jaime; Ramos, João; Costa, José António; Gomes, José António; Pinto, José; Silva, José Canas; Silva, J A; Patto, José Vaz; Costa, Lúcia; Miranda, Luís Cunha; Inês, Luís; Santos, Luís Maurício; Cruz, Margarida; Salvador, Maria João; Ferreira, Maria Júlia; Rial, Maria; Queiroz, Mário Viana; Bogas, Mónica; Araújo, Paula; Reis, Paulo; Abreu, Pedro; Machado, Pedro; Pinto, Patrícia; André, Rui; Melo, Rui; Garcês, Sandra; Cortes, Sara; Alcino, Sérgio; Ramiro, Sofia; Capela, Susana

    2011-01-01

    The authors present the revised version of the Portuguese Society of Rheumatology (SPR) guidelines for the treatment of Rheumatoid Arthritis (RA) with biological therapies. In these guidelines the criteria for introduction and maintenance of biological agents are discussed as well as the contraindications and procedures in the case of nonresponders. Biological treatment (with a tumour necrosis factor antagonist, abatacept or tocilizumab) should be considered in RA patients with a disease activity score 28 (DAS 28) equal to or greater than 3.2 despite treatment with at least 20mg-weekly-dose of methotrexate (MTX) for at least 3 months or, if such treatment is not possible, after 3 months of other conventional disease modifying drug or combination therapy. A DAS 28 score between 2.6 and 3.2 with a significant functional or radiological deterioration under treatment with conventional regimens could also constitute an indication for biological treatment. The treatment goal should be remission or, if that is not achievable, at least a low disease activity, defined by a DAS28 lower than 3.2, without significative functional or radiological worsening. The response criteria, at the end of the first 3 months of treatment, are a decrease of at least 0.6 in the DAS28 score. After 6 months of treatment res­ponse criteria is defined as a decrease greater than 1.2 in the DAS28 score. Non-responders, in accordance to the Rheumatologist’s clinical opinion, should try a switch to another biological agent (tumour necrosis factor antagonist, abatacept, rituximab or tocilizumab).

  14. Evidence-based review of clinical outcomes of guideline-recommended pharmacotherapies for generalized anxiety disorder.

    PubMed

    Bereza, Basil G; Machado, Márcio; Ravindran, Arun V; Einarson, Thomas R

    2012-08-01

    To quantify the rates of clinical outcomes of Canadian Psychiatric Association (CPA) guideline-recommended pharmacotherapies for generalized anxiety disorder (GAD) by drug classification within each treatment line. Evidence from original research cited by the CPA was included. Pooled analyses, duplicates, and studies with nonextractable data were excluded. Response, remission, and baseline-endpoint or mean reductions scores of the Hamilton Anxiety Rating Scale (HARS) were extracted. The Cochrane Collaboration's computer program, Review Manager, version 5, with a random effects model, was used to pool results. A total of 50 articles were cited as evidence for managing GAD by the CPA. There was sufficient evidence of remission with first- or third-line agents to pool reported rates, and with agents from all 3 treatment lines to pool response rates and reduction in HARS scores. The mean range of effect size varied considerably from study to study within each treatment line. Comparison of pooled remission rates between first- and second-line agents was not possible. While the range of values by drug and drug class overlapped, the summary results for the probability of response and reduction in HARS scores was greater for first-line, compared with second-line, treatments. Drug components for third-line treatments were heterogeneous and produced mixed results. Despite the abundance of evidence in its totality presented in the CPA guidelines, there is inadequate evidence to formulate recommendations based on the pooled results from this study alone. However, such analysis provides an additional resource for clinicians to make more effective treatment decisions for individual patients with GAD.

  15. Pattern Recognition Applications in Chemistry and Pharmacology: A ’Pharmacophore Acetylcholinoreceptor’ Subunit Environment Model,

    DTIC Science & Technology

    1980-06-01

    development and refinement of our model took place in three phases: 1. (a) The 3-dimensional structures of the rigid neuro- muscular blocking agents that...Table 1) is an anticholinesterase agent . Bullock (40) has reported that Soman can attack not only AChE irreversibly, but at high concentrations may... VIol AIiilioh’ 101 H At,% -. H~*\\U,,IN,%ttN *ILLIIILI.IIIA.LLIIAIL A I II LLL’L NlMII’LLL lt N AIIL 1AIIN .11I ’IRM INIIIN 911 ANAL I ILLIALIINIIN tMtINHNIN. 14%1AI4 A IAI11N 119

  16. [Physical properties of resins for veneer crown. (Part 1) Bending strength of thermosetting methacrylic resins (author's transl)].

    PubMed

    Kashiwada, T

    1979-01-01

    The physical properties of thermosetting methacrylic resins contain a kind or more than two kinds of cross linking agents were investigated. Knoop hardness and bending strength after drying, water sorption and thermal cycling were listed in table 4 and 5. Hydrophilic resins absorbed water about 3 times as much as hydrophobic resins. The materials contain a small amount of hydrophobic cross linking agents in MMA indicate comparatively excellent properties after drying, water sorption and thermal cycling. Knoop hardness of resins generally reduced by water sorption, especially in the case of the resin contains a large amount of triethylene glycol dimethacrylate.

  17. Detecting Illicit Trafficking

    DTIC Science & Technology

    2001-09-01

    n , p ’b 9 MeV and up activ.,7.13 s C0 ’Cl( n ,I : Ca thermal prompt Ci 35Cl ( n , n 𔃾 C:)3Ci 3 MeV and up prompt CI 7Ci( n , p )yS 14 MeV activ.,4.9 min 377 ...Octogene 3.95 ppt/ 3x 10- 9 9,1 376 Table 2. Elementary composition of some CW agents (atom number/molecule). Agent Cl P As S F 0 N C H S-Mustard (HD) 2 1...types of sources are used: 252Cf that decays by spontaneous fission and Be(a, n ) sources, where as an a emitter americium, or plutonium,

  18. Simulation of Tasks Distribution in Horizontally Scalable Management System

    NASA Astrophysics Data System (ADS)

    Kustov, D.; Sherstneva, A.; Botygin, I.

    2016-08-01

    This paper presents an imitational model of the task distribution system for the components of territorially-distributed automated management system with a dynamically changing topology. Each resource of the distributed automated management system is represented with an agent, which allows to set behavior of every resource in the best possible way and ensure their interaction. The agent work load imitation was done via service query imitation formed in a system dynamics style using a stream diagram. The query generation took place in the abstract-represented center - afterwards, they were sent to the drive to be distributed to management system resources according to a ranking table.

  19. Clinical and economic evaluation of an evidence-based institutional epoetin-utilization management program.

    PubMed

    Buckley, Mitchell S; Kane-Gill, Sandra L; Patel, Shardool A

    2013-03-01

    Anemia is common in several patient populations, including those with chronic kidney disease, cancer, and HIV/AIDS, and may require treatment with erythropoietin-stimulating agents (ESAs). Given the potential risks of the ESA, epoetin, and the significant costs associated with this agent, a large teaching medical institution developed a the drug-utilization management program using evidence-based guidelines on appropriate use. This study was designed to determine the clinical and financial impact of the drug-utilization management program. This retrospective cohort study was conducted at the medical institution that implemented the program using clinical pharmacists. Patients were included if epoetin was administered during their hospital stay (evaluation period, December 1, 2010, to December 31, 2011). The rate of inappropriate epoetin prescribing and the economic impact of guideline implementation were evaluated using comparisons of data from cohorts prescribed epoetin before and after guideline implementation. Data from 796 patients were included in the analyses (pre-implementation, 496; post-implementation, 300). The proportion of patients prescribed epoetin was significantly smaller after guideline implementation (2.4% vs 1.6%; P < 0.001). The reduction in the total number of epoetin units administered was 45%. The significant reduction (25%) in inappropriate prescribing after guideline implementation was primarily attributed to a 17% decrease in epoetin use in nonspecific anemia. The reduction in inappropriate epoetin prescribing translated into a 23.8% reduction in costs (P < 0.001) associated with inappropriate epoetin use. The estimated annual cost-savings of this program was $198,352 ($16,529/mo). The implementation of a drug-utilization management program using clinical pharmacists who evaluated epoetin was associated with a decrease in inappropriate epoetin prescribing and with significant cost-savings. Copyright © 2013 Elsevier HS Journals, Inc. All rights reserved.

  20. 2016 guideline strategies for the use of antifungal agents in patients with hematological malignancies or hematopoietic stem cell transplantation recipients in Taiwan.

    PubMed

    Ko, Bor-Sheng; Chen, Wei-Ting; Kung, Hsiang-Chi; Wu, Un-In; Tang, Jih-Luh; Yao, Ming; Chen, Yee-Chun; Tien, Hwei-Fang; Chang, Shan-Chwen; Chuang, Yin-Ching; Lin, Dong-Tsamn

    2017-07-25

    The Infectious Diseases Society of Taiwan (IDST), the Hematology Society of Taiwan, the Taiwan Society of Blood and Marrow Transplantation, Medical Foundation in Memory of Dr. Deh-Lin Cheng, Foundation of Professor Wei-Chuan Hsieh for Infectious Diseases Research and Education, and CY Lee's Research Foundation for Pediatric Infectious Diseases and Vaccines cooperatively published this guideline for the use of antifungal agents in hematological patients with invasive fungal diseases (IFDs) in Taiwan. The guideline is the first one endorsed by IDST focusing on selection of antifungal strategies, including prophylaxis, empirical (or symptom-driven) and pre-emptive (or diagnostic-driven) strategy. We suggest a risk-adapted dynamic strategy and provide an algorithm to facilitate decision making in population level as well as for individual patient. Risk assessment and management accordingly is explicitly emphasized. In addition, we highlight the importance of diagnosis in each antifungal strategy among five elements of the antimicrobial stewardship (diagnosis, drug, dose, de-escalation and duration). The rationale, purpose, and key recommendations for the choice of antifungal strategy are summarized, with concise review of international guidelines or recommendation, key original articles and local epidemiology reports. We point out the interaction and influence between elements of recommendations and limitation of and gap between evidences and daily practice. The guideline balances the quality of evidence and feasibility of recommendation in clinical practice. Finally, this version introduces the concept of health economics and provides data translated from local disease burdens. All these contents hopefully facilitate transparency and accountability in medical decision-making, improvements in clinical care and health outcomes, and appropriateness of medical resource allocation. Copyright © 2017. Published by Elsevier B.V.

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