49 CFR 622.301 - Buildings.

Code of Federal Regulations, 2014 CFR

2014-10-01

... TRANSPORTATION ENVIRONMENTAL IMPACT AND RELATED PROCEDURES Requirements for Energy Assessments § 622.301... energy assessment. An energy assessment shall consist of an analysis of the total energy requirements of... costs of this fuel; and (5) Kind of energy to be used, including: (i) Consideration of opportunities for...

49 CFR 622.301 - Buildings.

Code of Federal Regulations, 2010 CFR

2010-10-01

... TRANSPORTATION ENVIRONMENTAL IMPACT AND RELATED PROCEDURES Requirements for Energy Assessments § 622.301... energy assessment. An energy assessment shall consist of an analysis of the total energy requirements of... costs of this fuel; and (5) Kind of energy to be used, including: (i) Consideration of opportunities for...

49 CFR 622.301 - Buildings.

Code of Federal Regulations, 2012 CFR

2012-10-01

... TRANSPORTATION ENVIRONMENTAL IMPACT AND RELATED PROCEDURES Requirements for Energy Assessments § 622.301... energy assessment. An energy assessment shall consist of an analysis of the total energy requirements of... costs of this fuel; and (5) Kind of energy to be used, including: (i) Consideration of opportunities for...

49 CFR 622.301 - Buildings.

Code of Federal Regulations, 2013 CFR

2013-10-01

... TRANSPORTATION ENVIRONMENTAL IMPACT AND RELATED PROCEDURES Requirements for Energy Assessments § 622.301... energy assessment. An energy assessment shall consist of an analysis of the total energy requirements of... costs of this fuel; and (5) Kind of energy to be used, including: (i) Consideration of opportunities for...

49 CFR 622.301 - Buildings.

Code of Federal Regulations, 2011 CFR

2011-10-01

... TRANSPORTATION ENVIRONMENTAL IMPACT AND RELATED PROCEDURES Requirements for Energy Assessments § 622.301... energy assessment. An energy assessment shall consist of an analysis of the total energy requirements of... costs of this fuel; and (5) Kind of energy to be used, including: (i) Consideration of opportunities for...

Developing a Roadmap for Integrating Computational and In Vitro Approaches in Risk-Based Chemical Safety Decisions (SSCT-SweTox)

EPA Science Inventory

Multiple drivers shape the types of chemical assessments performed within many regulatory agencies including economic considerations, data availability, and the ultimate application of the assessment. The result is that chemical assessments are “fit-for-purpose” ranging from pri...

Assessing Ethics in Secondary Science

ERIC Educational Resources Information Center

Reiss, Michael J.

2011-01-01

An increasing number of science courses now include consideration of the ethical implications of science. However, there is little agreement about how ethical reasoning in science should be assessed. This article highlights the conclusions of a seminar on the assessment of ethics in science that was organized by the Nuffield Foundation Curriculum…

Technology Assessment and Policy Analysis

ERIC Educational Resources Information Center

Majone, Giandomenico

1977-01-01

Argues that the application of policy analysis to technology assessment requires the abandonment of stereotyped approaches and a reformulation of analytical paradigms to include consideration of institutional constraints. Available from: Elsevier Scientific Publishing Company, Box 211, Amsterdam, the Netherlands, single copies available.…

Chemical Mixtures and Epidemiologic Fundamentals for Risk Assessment Applications

EPA Science Inventory

Risk management options are increasingly being considered early in the risk assessment process to help scope the considerations and bound the inherent complexities related to potential exposures, risk and future clean-up decisions (including acceptable pollutant levels) related t...

Multi-model inference for incorporating trophic and climate uncertainty into stock assessments

NASA Astrophysics Data System (ADS)

Ianelli, James; Holsman, Kirstin K.; Punt, André E.; Aydin, Kerim

2016-12-01

Ecosystem-based fisheries management (EBFM) approaches allow a broader and more extensive consideration of objectives than is typically possible with conventional single-species approaches. Ecosystem linkages may include trophic interactions and climate change effects on productivity for the relevant species within the system. Presently, models are evolving to include a comprehensive set of fishery and ecosystem information to address these broader management considerations. The increased scope of EBFM approaches is accompanied with a greater number of plausible models to describe the systems. This can lead to harvest recommendations and biological reference points that differ considerably among models. Model selection for projections (and specific catch recommendations) often occurs through a process that tends to adopt familiar, often simpler, models without considering those that incorporate more complex ecosystem information. Multi-model inference provides a framework that resolves this dilemma by providing a means of including information from alternative, often divergent models to inform biological reference points and possible catch consequences. We apply an example of this approach to data for three species of groundfish in the Bering Sea: walleye pollock, Pacific cod, and arrowtooth flounder using three models: 1) an age-structured "conventional" single-species model, 2) an age-structured single-species model with temperature-specific weight at age, and 3) a temperature-specific multi-species stock assessment model. The latter two approaches also include consideration of alternative future climate scenarios, adding another dimension to evaluate model projection uncertainty. We show how Bayesian model-averaging methods can be used to incorporate such trophic and climate information to broaden single-species stock assessments by using an EBFM approach that may better characterize uncertainty.

Social cost considerations and legal constraints in implementing modular integrated utility systems

NASA Technical Reports Server (NTRS)

Lede, N. W.; Dixon, H. W.; King, O.; Hill, D. K.

1974-01-01

Social costs associated with the design, demonstration, and implementation of the Modular Integrated Utility System are considered including the social climate of communities, leadership patterns, conflicts and cleavages, specific developmental values, MIUS utility goal assessment, and the suitability of certian alternative options for use in a program of implementation. General considerations are discussed in the field of socio-technological planning. These include guidelines for understanding the conflict and diversity; some relevant goal choices and ideas useful to planners of the MIUS facility.

Financial planning for major initiatives: a framework for success.

PubMed

Harris, John M

2007-11-01

A solid framework for assessing a major strategic initiative consists of four broad steps: Initial considerations, including level of analysis required and resources that will be brought to bear. Preliminary financial estimates for board approval to further assess the initiative. Assessment of potential partners' interest in the project. Feasibility analysis for board green light.

75 FR 58331 - Revision of Enforcement Procedures

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-24

... recommended that TSA take these factors into account when TSA considers mitigating factors for purposes of... environment. Hence, TSA always considers multiple factors, including financial distress, when assessing civil... should be considered a mitigating factor for assessing penalties. Individuals who spend considerable time...

Basic concepts and techniques of dental implants.

PubMed

Tagliareni, Jonathan M; Clarkson, Earl

2015-04-01

Dental implants provide completely edentulous and partial edentulous patients the function and esthetics they had with natural dentition. It is critical to understand and apply predictable surgical principles when treatment planning and surgically restoring edentulous spaces with implants. This article defines basic implant concepts that should be meticulously followed for predictable results when treating patients and restoring dental implants. Topics include biological and functional considerations, biomechanical considerations, preoperative assessments, medical history and risk assessments, oral examinations, radiographic examinations, contraindications, and general treatment planning options. Copyright © 2015 Elsevier Inc. All rights reserved.

Lessons Learned From an Epidemiologist-Led Countywide Community Assessment for Public Health Emergency Response (CASPER) in Oregon.

PubMed

Repp, Kimberly K; Hawes, Eva; Rees, Kathleen J; Vorderstrasse, Beth; Mohnkern, Sue

2018-06-07

Conducting a large-scale Community Assessment for Public Health Emergency Response (CASPER) in a geographically and linguistically diverse county presents significant methodological challenges that require advance planning. The Centers for Disease Control and Prevention (CDC) has adapted methodology and provided a toolkit for a rapid needs assessment after a disaster. The assessment provides representative data of the sampling frame to help guide effective distribution of resources. This article describes methodological considerations and lessons learned from a CASPER exercise conducted by Washington County Public Health in June 2016 to assess community emergency preparedness. The CDC's CASPER toolkit provides detailed guidance for exercises in urban areas where city blocks are well defined with many single family homes. Converting the exercise to include rural areas with challenging geographical terrain, including accessing homes without public roads, required considerable adjustments in planning. Adequate preparations for vulnerable populations with English linguistic barriers required additional significant resources. Lessons learned are presented from the first countywide CASPER exercise in Oregon. Approximately 61% of interviews were completed, and 85% of volunteers reported they would participate in another CASPER exercise. Results from the emergency preparedness survey will be presented elsewhere. This experience indicates the most important considerations for conducting a CASPER exercise are oversampling clusters, overrecruiting volunteers, anticipating the actual cost of staff time, and ensuring timely language services are available during the event.

Source processes for the probabilistic assessment of tsunami hazards

USGS Publications Warehouse

Geist, Eric L.; Lynett, Patrick J.

2014-01-01

The importance of tsunami hazard assessment has increased in recent years as a result of catastrophic consequences from events such as the 2004 Indian Ocean and 2011 Japan tsunamis. In particular, probabilistic tsunami hazard assessment (PTHA) methods have been emphasized to include all possible ways a tsunami could be generated. Owing to the scarcity of tsunami observations, a computational approach is used to define the hazard. This approach includes all relevant sources that may cause a tsunami to impact a site and all quantifiable uncertainty. Although only earthquakes were initially considered for PTHA, recent efforts have also attempted to include landslide tsunami sources. Including these sources into PTHA is considerably more difficult because of a general lack of information on relating landslide area and volume to mean return period. The large variety of failure types and rheologies associated with submarine landslides translates to considerable uncertainty in determining the efficiency of tsunami generation. Resolution of these and several other outstanding problems are described that will further advance PTHA methodologies leading to a more accurate understanding of tsunami hazard.

Problem formulation for risk assessment of combined exposures to chemicals and other stressors in humans.

PubMed

Solomon, Keith R; Wilks, Martin F; Bachman, Ammie; Boobis, Alan; Moretto, Angelo; Pastoor, Timothy P; Phillips, Richard; Embry, Michelle R

2016-11-01

When the human health risk assessment/risk management paradigm was developed, it did not explicitly include a "problem formulation" phase. The concept of problem formulation was first introduced in the context of ecological risk assessment (ERA) for the pragmatic reason to constrain and focus ERAs on the key questions. However, this need also exists for human health risk assessment, particularly for cumulative risk assessment (CRA), because of its complexity. CRA encompasses the combined threats to health from exposure via all relevant routes to multiple stressors, including biological, chemical, physical and psychosocial stressors. As part of the HESI Risk Assessment in the 21st Century (RISK21) Project, a framework for CRA was developed in which problem formulation plays a critical role. The focus of this effort is primarily on a chemical CRA (i.e., two or more chemicals) with subsequent consideration of non-chemical stressors, defined as "modulating factors" (ModFs). Problem formulation is a systematic approach that identifies all factors critical to a specific risk assessment and considers the purpose of the assessment, scope and depth of the necessary analysis, analytical approach, available resources and outcomes, and overall risk management goal. There are numerous considerations that are specific to multiple stressors, and proper problem formulation can help to focus a CRA to the key factors in order to optimize resources. As part of the problem formulation, conceptual models for exposures and responses can be developed that address these factors, such as temporal relationships between stressors and consideration of the appropriate ModFs.

Implementation of Duchenne Muscular Dystrophy Care Considerations.

PubMed

Andrews, Jennifer G; Conway, Kristin; Westfield, Christina; Trout, Christina; Meaney, F John; Mathews, Katherine; Ciafaloni, Emma; Cunniff, Christopher; Fox, Deborah J; Matthews, Dennis; Pandya, Shree

2018-06-20

Duchenne muscular dystrophy (DMD) is an X-linked disorder characterized by progressive muscle weakness and multisystem involvement. Recent advances in management of individuals with DMD have prolonged survival. Lack of standardized care spurred an international collaboration to develop consensus-based care considerations for diagnosis and management. In this study, we evaluate adherence to considerations at selected sites. We collaborated with the Muscular Dystrophy Surveillance, Tracking, and Research Network. Our sample included males with DMD and Becker muscular dystrophy <21 years as of December 31, 2010, with 1 health care encounter on or after January 1, 2012. We collected data from medical records on encounters occurring January 1, 2012, through December 31, 2014. Adherence was determined when frequency of visits or assessments were at or above recommendations for selected care considerations. Our analytic sample included 299 individuals, 7% of whom (20/299) were classified as childhood-onset Becker muscular dystrophy. Adherence for neuromuscular and respiratory clinician visits was 65% for the cohort; neuromuscular assessments and corticosteroid side effect monitoring measures ranged from 16% to 68%. Adherence was 83% for forced vital capacity and ≤58% for other respiratory diagnostics. Cardiologist assessments and echocardiograms were found for at least 84%. Transition planning for education or health care was documented for 31% of eligible males. Medical records data were used to identify areas in which practice aligns with the care considerations. However, there remains inconsistency across domains and insufficiency in critical areas. More research is needed to explain this variability and identify reliable methods to measure outcomes. Copyright © 2018 by the American Academy of Pediatrics.

Consideration of What May Influence Student Outcomes on Alternate Assessment.

ERIC Educational Resources Information Center

Browder, Diane M.; Fallin, Kathy; Davis, Stephanie; Karvonen, Meagan

2003-01-01

This article describes variables that may influence alternate assessment outcomes for students with disabilities and offers recommendations to enhance student achievement. These variables include technical quality, curriculum access, data collection, instructional effectiveness, risk factors, and resources allocated to instruction. Two of four…

Making communities safer from crime: An undervalued element in impact assessment

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

Glasson, John, E-mail: jglasson@brookes.ac.u; Curtin University, Perth; Cozens, Paul

Crime and safety are significant issues for individuals, communities and businesses but they have tended to be undervalued elements in the consideration of social impacts in impact assessment theory and practice. It has been argued that crime is a form of pollution and an externality of development. In principle, the precautionary impact assessment family of approaches should be very useful here. The paper explores first the coverage of crime and safety issues in both the longer history of EIA, followed by the much shorter history of SEA and Sustainability Appraisal (SA). It then considers several key issues for advancing bettermore » practice. These include: the recognition of the lifecycles of projects and plans and the relevant dimensions of the local safety and crime baseline; the need to employ meaningful data, including 'fear of crime' considerations; and the consideration of innovative approaches to the use of indicators. Evidence and theories from the field of environmental criminology are presented as crucial to understanding crime and its association with land-use. The paper concludes with an exploration of appropriate mitigation measures for anticipating and designing out crime. Examples draw in particular on evolving practice in the UK and Australia.« less

Use of a quality trait index to increase the reliability of phenotypic evaluations in broccoli

USDA-ARS?s Scientific Manuscript database

Selection of superior broccoli hybrids involves multiple considerations, including optimization of head quality traits. Quality assessment of broccoli heads is often confounded by relatively subjective human preferences for optimal appearance of heads. To assist the selection process, we assessed fi...

Use of programme theory to understand the differential effects of interventions across socio-economic groups in systematic reviews-a systematic methodology review.

PubMed

Maden, Michelle; Cunliffe, Alex; McMahon, Naoimh; Booth, Andrew; Carey, Gina Michelle; Paisley, Suzy; Dickson, Rumona; Gabbay, Mark

2017-12-29

Systematic review guidance recommends the use of programme theory to inform considerations of if and how healthcare interventions may work differently across socio-economic status (SES) groups. This study aimed to address the lack of detail on how reviewers operationalise this in practice. A methodological systematic review was undertaken to assess if, how and the extent to which systematic reviewers operationalise the guidance on the use of programme theory in considerations of socio-economic inequalities in health. Multiple databases were searched from January 2013 to May 2016. Studies were included if they were systematic reviews assessing the effectiveness of an intervention and included data on SES. Two reviewers independently screened all studies, undertook quality assessment and extracted data. A narrative approach to synthesis was adopted. A total of 37 systematic reviews were included, 10 of which were explicit in the use of terminology for 'programme theory'. Twenty-nine studies used programme theory to inform both their a priori assumptions and explain their review findings. Of these, 22 incorporated considerations of both what and how interventions do/do not work in SES groups to both predict and explain their review findings. Thirteen studies acknowledged 24 unique theoretical references to support their assumptions of what or how interventions may have different effects in SES groups. Most reviewers used supplementary evidence to support their considerations of differential effectiveness. The majority of authors outlined a programme theory in the "Introduction" and "Discussion" sections of the review to inform their assumptions or provide explanations of what or how interventions may result in differential effects within or across SES groups. About a third of reviews used programme theory to inform the review analysis and/or synthesis. Few authors used programme theory to inform their inclusion criteria, data extraction or quality assessment. Twenty-one studies tested their a priori programme theory. The use of programme theory to inform considerations of if, what and how interventions lead to differential effects on health in different SES groups in the systematic review process is not yet widely adopted, is used implicitly, is often fragmented and is not implemented in a systematic way.

16 CFR 314.4 - Elements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... program. (b) Identify reasonably foreseeable internal and external risks to the security, confidentiality... in place to control these risks. At a minimum, such a risk assessment should include consideration of risks in each relevant area of your operations, including: (1) Employee training and management; (2...

Using Risk Assessment Methodologies to Meet Management Objectives

NASA Technical Reports Server (NTRS)

DeMott, D. L.

2015-01-01

Current decision making involves numerous possible combinations of technology elements, safety and health issues, operational aspects and process considerations to satisfy program goals. Identifying potential risk considerations as part of the management decision making process provides additional tools to make more informed management decision. Adapting and using risk assessment methodologies can generate new perspectives on various risk and safety concerns that are not immediately apparent. Safety and operational risks can be identified and final decisions can balance these considerations with cost and schedule risks. Additional assessments can also show likelihood of event occurrence and event consequence to provide a more informed basis for decision making, as well as cost effective mitigation strategies. Methodologies available to perform Risk Assessments range from qualitative identification of risk potential, to detailed assessments where quantitative probabilities are calculated. Methodology used should be based on factors that include: 1) type of industry and industry standards, 2) tasks, tools, and environment 3) type and availability of data and 4) industry views and requirements regarding risk & reliability. Risk Assessments are a tool for decision makers to understand potential consequences and be in a position to reduce, mitigate or eliminate costly mistakes or catastrophic failures.

Assessing risks and preventing disease from environmental chemicals.

PubMed

Dunnette, D A

1989-01-01

In the last 25 years there has been considerable concern expressed about the extent to which chemical agents in the ambient and work environments are contributing to the causation of disease. This concern is a logical extension of our increased knowledge of the real and potential effects of environmental chemicals and the methodological difficulties in applying new knowledge that could help prevent environmentally induced disease. Chemical risk assessment offers an approach to estimating risks and involves consideration of relevant information including identification of chemical hazards, evaluation of the dose-response relationship, estimation of exposure and finally, risk characterization. Particularly significant uncertainties which are inherent in use of this and other risk models include animal-human and low dose-high dose extrapolation and estimation of exposure. Community public health risks from exposure to environmental chemicals appear to be small relative to other public health risks based on information related to cancer trends, dietary intake of synthetic chemicals, assessment data on substances such as DDT and "dioxin," public health effects of hazardous waste sites and contextual considerations. Because of inherent uncertainty in the chemical risk assessment process, however, we need to apply what methods are available in our efforts to prevent disease induced by environmental chemicals. There are a number of societal strategies which can contribute to overall reduction of risk from environmental chemicals. These include acquisition of information on environmental risk including toxicity, intensity and extensity of exposure, biological monitoring, disease surveillance, improvement in epidemiological methods, control of environmental chemical exposures, and dissemination of hazardous chemical information. Responsible environmental risk communication and information transfer appear to be among the most important of the available strategies for preventing disease induced by chemicals in the environment.

Criteria for the Research Institute for Fragrance Materials, Inc. (RIFM) safety evaluation process for fragrance ingredients.

PubMed

Api, A M; Belsito, D; Bruze, M; Cadby, P; Calow, P; Dagli, M L; Dekant, W; Ellis, G; Fryer, A D; Fukayama, M; Griem, P; Hickey, C; Kromidas, L; Lalko, J F; Liebler, D C; Miyachi, Y; Politano, V T; Renskers, K; Ritacco, G; Salvito, D; Schultz, T W; Sipes, I G; Smith, B; Vitale, D; Wilcox, D K

2015-08-01

The Research Institute for Fragrance Materials, Inc. (RIFM) has been engaged in the generation and evaluation of safety data for fragrance materials since its inception over 45 years ago. Over time, RIFM's approach to gathering data, estimating exposure and assessing safety has evolved as the tools for risk assessment evolved. This publication is designed to update the RIFM safety assessment process, which follows a series of decision trees, reflecting advances in approaches in risk assessment and new and classical toxicological methodologies employed by RIFM over the past ten years. These changes include incorporating 1) new scientific information including a framework for choosing structural analogs, 2) consideration of the Threshold of Toxicological Concern (TTC), 3) the Quantitative Risk Assessment (QRA) for dermal sensitization, 4) the respiratory route of exposure, 5) aggregate exposure assessment methodology, 6) the latest methodology and approaches to risk assessments, 7) the latest alternatives to animal testing methodology and 8) environmental risk assessment. The assessment begins with a thorough analysis of existing data followed by in silico analysis, identification of 'read across' analogs, generation of additional data through in vitro testing as well as consideration of the TTC approach. If necessary, risk management may be considered. Copyright © 2014 Elsevier Ltd. All rights reserved.

Potential economic impact assessment for cattle parasites in Mexico review

USDA-ARS?s Scientific Manuscript database

Here, economic losses caused by cattle parasites in Mexico were estimated on an annual basis. The main factors taken into consideration for this assessment included the total number of animals at risk, potential detrimental effects of parasitism on milk production or weight gain, and records of cond...

Developing and Using Dashboard Indicators in Student Affairs Assessment

ERIC Educational Resources Information Center

Mitchell, Joshua J.; Ryder, Andrew J.

2013-01-01

Dashboard systems are increasingly popular as assessment and performance management tools in higher education. This chapter examines the use of dashboards in student affairs, including examples of key indicators and considerations for developing and implementing these tools. The chapter begins with an overview of the origins of dashboards, from…

Economic considerations in coverting from oil/gas firing to coal

NASA Technical Reports Server (NTRS)

Rau, J. G.

1978-01-01

Economic considerations involved in fuel conversion such as from oil and/or gas firing to coal are discussed including investments costs for new facilities and equipment (including air pollution control equipment), operation and maintenance costs, and purchased fuel costs. An analytical approach to assessing the cost effectiveness of fuel conversion in terms of the annual net cost of conversion, the equivalent annual number of barrels of oil saved, and the integral rate of return of the conversion investment is presented. Illustrative numerical examples are presented for typical utility boilers and industrial boiler facilities. A further consideration addressed deals with the impacts of these costs on the overall financial structure of the firm and the ability of the firm to raise the necessary investment captial.

36 CFR 219.5 - Planning framework.

Code of Federal Regulations, 2014 CFR

2014-07-01

... and allows the Forest Service to adapt to changing conditions, including climate change, and improve... need to change the plan based on the assessment, development of a proposed plan, consideration of the... for amending a plan includes: Preliminary identification of the need to change the plan, development...

36 CFR 219.5 - Planning framework.

Code of Federal Regulations, 2012 CFR

2012-07-01

... and allows the Forest Service to adapt to changing conditions, including climate change, and improve... need to change the plan based on the assessment, development of a proposed plan, consideration of the... for amending a plan includes: Preliminary identification of the need to change the plan, development...

36 CFR 219.5 - Planning framework.

Code of Federal Regulations, 2013 CFR

2013-07-01

... and allows the Forest Service to adapt to changing conditions, including climate change, and improve... need to change the plan based on the assessment, development of a proposed plan, consideration of the... for amending a plan includes: Preliminary identification of the need to change the plan, development...

"No-Go Considerations" for In Situ Simulation Safety.

PubMed

Bajaj, Komal; Minors, Anjoinette; Walker, Katie; Meguerdichian, Michael; Patterson, Mary

2018-06-01

In situ simulation is the practice of simulation in the actual clinical environment and has demonstrated utility in the assessment of system processes, identification of latent safety threats, and improvement in teamwork and communication. Nonetheless, performing simulated events in a real patient care setting poses potential risks to patient and staff safety. One integral aspect of a comprehensive approach to ensure the safety of in situ simulation includes the identification and establishment of "no-go considerations," that is, key decision-making considerations under which in situ simulations should be canceled, postponed, moved to another area, or rescheduled. These considerations should be modified and adjusted to specific clinical units. This article provides a framework of key essentials in developing no-go considerations.

The Role of Vocational Educators in Planning Vocational Assessment Activities for Handicapped Students: An Indepth Review of a Six Step Model.

ERIC Educational Resources Information Center

Stodden, Robert A.; Boone, Rosalie

1986-01-01

Discusses the role of teachers in providing vocational assessment to disabled students. Steps in this process include (1) establish planning team and conduct information search, (2) define purpose, (3) establish basic considerations, (4) formulate assessment model, (5) establish implementation focus, and (6) pilot test and evaluate assessment…

Space transportation system payload status and reimbursement policy

NASA Technical Reports Server (NTRS)

Yardley, J. F.

1977-01-01

The status of the Space Transportation System (STS) is reviewed. The management structure and project planning status are discussed, including considerations of STS utilization, payloads, cost assessments, and pricing policy.

Key Principles of Superfund Remedy Selection

EPA Pesticide Factsheets

Guidance on the primary considerations of remedy selection which are universally applicable at Superfund sites. Key guidance here include: Rules of Thumb for Superfund Remedy Selection and Role of the Baseline Risk Assessment.

Lockheed Martin T-Rex: Preliminary report

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

NONE

1997-07-31

T-Rex is a robot which may be used in toxic or flammable environments. The assessment of the T-Rex conducted at the Lockheed Martin facility was limited in its scope. The scope of the assessment was directed by the type of equipment being used and the amount of accessibility to the equipment. Due to severe time constraints--the assessment was conducted in one day--human factors interface activities were limited. This should be considered a preliminary assessment. This report covers aspects of the technology that were available to the assessment team. Recommendations for future evaluation of this technology are also included. The contentsmore » are as follows: Electrical Considerations; General Electrical Consideration; Trailing Cables; Grounding; Surface High Voltage Distribution; Low and Medium Voltage Alternating Current Circuits; Potential for Harmful Human Factor Incidents and Enterprise Disablement; Exclusion Zone Emergency Maintenance; and Recommendations.« less

ASSESSMENT OF VENOUS THROMBOSIS IN ANIMAL MODELS

PubMed Central

SP, Grover; CE, Evans; AS, Patel; B, Modarai; P, Saha; A, Smith

2016-01-01

Deep vein thrombosis and common complications, including pulmonary embolism and post thrombotic syndrome, represent a major source of morbidity and mortality worldwide. Experimental models of venous thrombosis have provided considerable insight into the cellular and molecular mechanisms that regulate thrombus formation and subsequent resolution. Here we critically appraise the ex vivo and in vivo techniques used to assess venous thrombosis in these models. Particular attention is paid to imaging modalities, including magnetic resonance imaging, micro computed tomography and high frequency ultrasound that facilitate longitudinal assessment of thrombus size and composition. PMID:26681755

Assessment of Venous Thrombosis in Animal Models.

PubMed

Grover, Steven P; Evans, Colin E; Patel, Ashish S; Modarai, Bijan; Saha, Prakash; Smith, Alberto

2016-02-01

Deep vein thrombosis and common complications, including pulmonary embolism and post-thrombotic syndrome, represent a major source of morbidity and mortality worldwide. Experimental models of venous thrombosis have provided considerable insight into the cellular and molecular mechanisms that regulate thrombus formation and subsequent resolution. Here, we critically appraise the ex vivo and in vivo techniques used to assess venous thrombosis in these models. Particular attention is paid to imaging modalities, including magnetic resonance imaging, micro-computed tomography, and high-frequency ultrasound that facilitate longitudinal assessment of thrombus size and composition. © 2015 American Heart Association, Inc.

Conservation assessments for five forest bat species in the Eastern United States

Treesearch

Frank R., III Thompson

2006-01-01

Assesses the status, distribution, conservation, and management considerations for five Regional Forester Sensitive Species of forest bats on national forests in the Eastern United States: eastern pipistrelle, evening bat, southeastern myotis, eastern small-footed myotis, and northern long-eared bat. Includes information on the taxonomy, description, life history,...

Alcohol Measures and Terms: A Perfect Storm for Chronic Confusion

ERIC Educational Resources Information Center

Glassman, Tavis Jared

2010-01-01

Members in the prevention and treatment fields continue to examine how to most effectively assess and label high volume alcohol consumption. Terms such as "binge" drinking have resulted in considerable controversy and debate. Conventionally the criteria for assessing high-risk drinking includes: five or more drinks for men and four or more drinks…

A Framework for Assessing Health Risk of Environmental ...

EPA Pesticide Factsheets

EPA released the final report entitled, A Framework for Assessing Health Risk of Environmental Exposures to Children, which examines the impact of potential exposures during developmental lifestages and subsequent lifestages, while emphasizing the iterative nature of the analysis phase with a multidisciplinary team. Major findings and conclusions: This report outlines the framework in which mode of action(s) (MOA) can be considered across life stages. The framework is based upon existing approaches adopted in the Framework on Cumulative Risk Assessment and identifies existing guidance, guidelines and policy papers that relate to children's health risk assessment. It emphasizes the importance of an iterative approach between hazard, dose response, and exposure analyses. In addition, it includes discussion of principles for weight of evidence consideration across life stages for the hazard characterization database.Key science/assessment issues:This framework addresses the questions of why and how an improved children's health risk assessment will strengthen the overall risk assessment process across the Agency. This approach improves the scientific explanation of children's risk and will add value by: 1) providing for a more complete evaluation of the potential for vulnerability at different life stages, including a focus on the underlying biological events and critical developmental periods for incorporating MOA considerations; 2) evaluating of the potential fo

Carcinogenicity assessments of biotechnology-derived pharmaceuticals: a review of approved molecules and best practice recommendations.

PubMed

Vahle, John L; Finch, Gregory L; Heidel, Shawn M; Hovland, David N; Ivens, Inge; Parker, Suezanne; Ponce, Rafael A; Sachs, Clifford; Steigerwalt, Ronald; Short, Brian; Todd, Marque D

2010-06-01

An important safety consideration for developing new therapeutics is assessing the potential that the therapy will increase the risk of cancer. For biotherapeutics, traditional two-year rodent bioassays are often not scientifically applicable or feasible. This paper is a collaborative effort of industry toxicologists to review past and current practice regarding carcinogenicity assessments of biotherapeutics and to provide recommendations. Publicly available information on eighty marketed protein biotherapeutics was reviewed. In this review, no assessments related to carcinogenicity or tumor growth promotion were identified for fifty-one of the eighty molecules. For the twenty-nine biotherapeutics in which assessments related to carcinogenicity were identified, various experimental approaches were employed. This review also discusses several key principles to aid in the assessment of carcinogenic potential, including (1) careful consideration of mechanism of action to identify theoretical risks, (2) careful investigation of existing data for indications of proliferative or immunosuppressive potential, and (3) characterization of any proliferative or immunosuppressive signals detected. Traditional two-year carcinogenicity assays should not be considered as the default method for assessing the carcinogenicity potential of biotherapeutics. If experimentation is considered warranted, it should be hypothesis driven and may include a variety of experimental models. Ultimately, it is important that preclinical data provide useful guidance in product labeling.

Models, Measurements, and Local Decisions: Assessing and Addressing Impacts from Port Expansion and Traffic Activity

EPA Science Inventory

This presentation includes a combination of modeling and measurement results to characterize near-source air quality in Newark, New Jersey with consideration of how this information could be used to inform decision making to reduce risk of health impacts. Decisions could include ...

42 CFR 418.54 - Condition of participation: Initial and comprehensive assessment of the patient.

Code of Federal Regulations, 2011 CFR

2011-10-01

... take into consideration the following factors: (1) The nature and condition causing admission (including the presence or lack of objective data and subjective complaints). (2) Complications and risk factors that affect care planning. (3) Functional status, including the patient's ability to understand...

Physiological measures and mental-state assessment

NASA Technical Reports Server (NTRS)

Stern, John A.

1988-01-01

General considerations regarding monitoring of operators for alertness are discussed, including who should be monitored and what information should be collected. Measures that have been used to ascertain more general and persistent states of alertness are outlined, including cardiac activity, peripheral vascular activity, skin conductance, electroencephalography, pupillography, oculomotor activity, and body movements.

Methodological and Epistemological Considerations in Utilizing Qualitative Inquiry to Develop Interventions.

PubMed

Duggleby, Wendy; Williams, Allison

2016-01-01

The purpose of this article is to discuss methodological and epistemological considerations involved in using qualitative inquiry to develop interventions. These considerations included (a) using diverse methodological approaches and (b) epistemological considerations such as generalization, de-contextualization, and subjective reality. Diverse methodological approaches have the potential to inform different stages of intervention development. Using the development of a psychosocial hope intervention for advanced cancer patients as an example, the authors utilized a thematic study to assess current theories/frameworks and interventions. However, to understand the processes that the intervention needed to target to affect change, grounded theory was used. Epistemological considerations provided a framework to understand and, further, critique the intervention. Using diverse qualitative methodological approaches and examining epistemological considerations were useful in developing an intervention that appears to foster hope in patients with advanced cancer. © The Author(s) 2015.

Biotechnology: Economic and Behavioral Considerations.

ERIC Educational Resources Information Center

McGhan, William F.; Beardsley, Robert S.

1990-01-01

The paper reviews factors related to effects of biotechnology on the discipline of pharmacy administration including needs assessment, diffusion of technology, cost benefit analysis, marketing, cost containment, patient education and compliance, ethics, and health professions training. (DB)

The International Test Commission Guidelines on the Security of Tests, Examinations, and Other Assessments

ERIC Educational Resources Information Center

International Journal of Testing, 2016

2016-01-01

The amount and severity of security threats have increased considerably over the past two decades, calling into question the validity of assessments administered around the world. These threats have increased for a number of reasons, including the popular use of computerized and online technologies for test administration and the use of almost…

A tale of two health literacies: public health and clinical approaches to health literacy.

PubMed

Pleasant, Andrew; Kuruvilla, Shyama

2008-06-01

Public health concerns underlie a considerable portion of the global burden of disease, increasing the utility and need for promoting and assessing the knowledge about public health issues. Health literacy is generally agreed upon as a means to find, understand, analyze and use information to make better decisions about health and to ultimately reduce inequities in health. A public health literacy knowledge scale was tested in China, Mexico, Ghana and India. A somewhat unexpected finding, which was that experts 'scored' less on the scale than the general public, led to consideration of differences between clinical and public health approaches to health literacy and their implications. These differences in perspective, for instance consideration of single case effects versus impacts at the societal level, pose significant challenges to developing and assessing health literacy. We suggest that a comprehensive approach to health literacy will include both clinical and public health approaches.

[Relationship between assertiveness including consideration for others and adjustment in children].

PubMed

Eguchi, Megumi; Hamaguchi, Yoshikazu

2012-06-01

The relationship between assertiveness and internal and external adjustment was investigated. Elementary school children in grades four to six (n=207) and their classroom teachers (n=8) participated in the study. Internal and external adjustments were measured by using self-ratings, and self- and other- ratings respectively. The children responded to a questionnaires inquiring about assertiveness that included two components of assessment: "self expression" and "consideration for others". Then, the children were divided into 4 groups according to their scores on these two components of assertiveness. The results indicated that children scoring high on both components of assertiveness had higher self-rating scores than those scoring low on both components. Moreover, children that scored high on "consideration for others" tended to have high external adjustment. Also, boys that scored low on "self expression" had lower external adjustment as indicated by the negative ratings of teachers. Furthermore, girls that scored high on "consideration for others" had high external adjustment as indicated by positive ratings of teachers and same-sexed classmates.

47 CFR 1.1311 - Environmental information to be included in the environmental assessment (EA).

Code of Federal Regulations, 2011 CFR

2011-10-01

... environmental and other considerations which led to the selection of the particular site and, if relevant, the..., natural migration paths for birds and other wildlife, and sites of historic, architectural, or...

Ecological Momentary Assessment is a Neglected Methodology in Suicidology.

PubMed

Davidson, Collin L; Anestis, Michael D; Gutierrez, Peter M

2017-01-02

Ecological momentary assessment (EMA) is a group of research methods that collect data frequently, in many contexts, and in real-world settings. EMA has been fairly neglected in suicidology. The current article provides an overview of EMA for suicidologists including definitions, data collection considerations, and different sampling strategies. Next, the benefits of EMA in suicidology (i.e., reduced recall bias, accurate tracking of fluctuating variables, testing assumptions of theories, use in interventions), participant safety considerations, and examples of published research that investigate self-directed violence variables using EMA are discussed. The article concludes with a summary and suggested directions for EMA research in suicidology with the particular aim to spur the increased use of this methodology among suicidologists.

An economic assessment of STOL aircraft potential including terminal area environmental considerations. Volume 2: Appendices

NASA Technical Reports Server (NTRS)

Solomon, H. L.; Sokolsky, S.

1973-01-01

An economic assessment of short takeoff aircraft for short haul air transportation applications is presented. The economic viability and environmental compatibility of short takeoff aircraft service in high density areas were evaluated. The subjects discussed are: (1) aircraft configurations and performance, (2) airfield and terminal requirements, and (3) direct and indirect operating costs.

Barrett Wendell's Theory of Discourse.

ERIC Educational Resources Information Center

Newkirk, Thomas

1991-01-01

Discusses Barrett Wendell's theory of discourse, including a critique of his definitions and an assessment of his discourse scheme. Challenges the image of Wendell as a technocrat who never rose above a consideration of style to examine more significant rhetorical issues. (MG)

Ethics and Privacy.

ERIC Educational Resources Information Center

Brewer, Erin; Eastmond, Nick; Geertsen, Reed; Johnson, Doug; Lewandowski, Judith; Yeaman, Andrew R. J.

2003-01-01

Contains four articles covering trends and issues on ethics and privacy in instructional technology, including: considerations for assessing ethical issues; what schools must do to develop ethical behaviors in students; a privacy primer for educators; and manufacturing technophopia. Each article contains references. (MES)

A Deconstructive Pedagogy

ERIC Educational Resources Information Center

Uba, Laura

2008-01-01

This article describes a four-pronged pedagogical protocol for teaching undergraduates how to deconstruct statements, including a list of deconstructive considerations students learn to apply. The protocol also encourages oral participation in class discussions. Three assessment measures demonstrate the protocol's effectiveness: (1) a qualitative…

Roadway system assessment using bluetooth-based automatic vehicle identification travel time data.

DOT National Transportation Integrated Search

2012-12-01

This monograph is an exposition of several practice-ready methodologies for automatic vehicle identification (AVI) data collection : systems. This includes considerations in the physical setup of the collection system as well as the interpretation of...

Choosing Pre-conception Planning for Women/Families: Counselling and Informed Consent (Part 2) - Pre-conception Reproductive Planning, Lifestyle, Immunization, and Psychosocial Issues.

PubMed

Wilson, R Douglas

2017-12-06

To inform reproductive and other health care providers about pre-conception evaluation, including considerations for reproductive planning, lifestyle modification, immunization status and attitudes, and psychosocial issues. This counselling information can be used for patient education and planning and possible pre-conception and/or prenatal testing. This information may allow for improved risk assessment when pre-conception counselling for individual patients and their families is used. CONSIDERATIONS FOR PRE-CONCEPTION CARE (PART 2) REGARDING PRE-CONCEPTION REPRODUCTIVE PLANNING, LIFESTYLE, IMMUNIZATIONS, AND PSYCHOSOCIAL ISSUES: CONSIDERATION FOR CARE STATEMENTS: For this review article, the Consideration for Care Statements use the Grading of Recommendations, Assessment, Development and Evaluations strength and quality principles because they are comparable for the clinician and the patient/public user. For example, "Strong" for clinicians is defined as "the recommendation would apply to most individuals. Formal discussion aids are not likely to be needed to help individuals make decisions consistent with their values and preferences." For patients/the public, "Strong" is defined as, "we believe most people in this situation would want the recommended course of actions and only a small number would not." Quality of evidence (High, Moderate, Low) is based on the confidence that the true effect lies close to that of the estimate of the effect. In addition, the Canadian Task Force on Preventive Health Care key to evidence statements and grading of recommendations are included. PubMed, Medline, and the Cochrane Database were searched until May 2017, using appropriate key words (i.e., preconception, reproductive planning, lifestyle modification, immunization risks and benefits, psychosocial pregnancy factors/issues). Grey (unpublished) literature was identified through searching websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, and national and international medical specialty societies. The benefits for the patient and her family from receiving this pre-conception counseling would include an increased understanding of the relevant issues for both pre-conception and in early pregnancy as well as better pregnancy outcomes. Harm includes potential increased anxiety or psychological stress associated with the possibility of identifying maternal pregnancy risks. Copyright © 2017 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

Assessment of health risks of policies

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

Ádám, Balázs, E-mail: badam@cmss.sdu.dk; Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, P.O. Box 9, H-4012 Debrecen; Molnár, Ágnes, E-mail: MolnarAg@smh.ca

The assessment of health risks of policies is an inevitable, although challenging prerequisite for the inclusion of health considerations in political decision making. The aim of our project was to develop a so far missing methodological guide for the assessment of the complex impact structure of policies. The guide was developed in a consensual way based on experiences gathered during the assessment of specific national policies selected by the partners of an EU project. Methodological considerations were discussed and summarized in workshops and pilot tested on the EU Health Strategy for finalization. The combined tool, which includes a textual guidancemore » and a checklist, follows the top-down approach, that is, it guides the analysis of causal chains from the policy through related health determinants and risk factors to health outcomes. The tool discusses the most important practical issues of assessment by impact level. It emphasises the transparent identification and prioritisation of factors, the consideration of the feasibility of exposure and outcome assessment with special focus on quantification. The developed guide provides useful methodological instructions for the comprehensive assessment of health risks of policies that can be effectively used in the health impact assessment of policy proposals. - Highlights: • Methodological guide for the assessment of health risks of policies is introduced. • The tool is developed based on the experiences from several case studies. • The combined tool consists of a textual guidance and a checklist. • The top-down approach is followed through the levels of the full impact chain. • The guide provides assistance for the health impact assessment of policy proposals.« less

75 FR 76336 - Notice of Data Availability Regarding Two Studies of Ambient Lead Concentrations Near a General...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-08

... Division, C304-06, Environmental Protection Agency, U.S. EPA (C304-06), AQAD/AAMG, Research Triangle Park... airport where piston-engine aircraft are operated. The study also included an assessment of the maximum 3... piston engine aircraft. Model inputs also included considerations of aircraft-induced wake turbulence...

View of Soviet ionospheric modification research

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

Duncan, L.M.; Showen, R.L.

1990-10-01

We have reviewed and provided a technical assessment of Soviet research of the past five to ten years in ionospheric modification by high-power radio waves. This review includes a comprehensive survey of Soviet published literature, conference proceedings, and direct discussions with the involved Soviet researchers. The current state of the art for Soviet research in this field is evaluated, identifying areas of potential breakthrough discoveries, and discussing implications of this work for emerging technologies and future applications. This assessment is divided into the categories of basic research, advanced research, and applications. Basic research is further subdivided into studies of themore » modified natural geophysical environment, nonlinear plasma physics, and polar geophysical studies. Advanced research topics include the generation of artificial ionization mirrors and high-power oblique propagation effects. A separate comparative assessment of Soviet theoretical work also is included in this analysis. Our evaluation of practical and potential applications of this research discusses the utility of ionospheric modification in creating disturbed radio wave propagation environments, and its role in current and future remote-sensing and telecommunications systems. This technical assessment does not include consideration of ionospheric modification by means other than high-power radio waves. The Soviet effort in ionospheric modification sustains theoretical and experimental research at activity levels considerably greater than that found in comparable programs in the West. Notable strengths of the Soviet program are its breadth of coverage, large numbers of scientific participation, theoretical creativity and insight, and its powerful radio wave transmitting facilities.« less

ASSESSMENT OF MAST IN EUROPEAN PATIENT-CENTERED TELEMEDICINE PILOTS.

PubMed

Ekeland, Anne Granstrøm; Grøttland, Astrid

2015-01-01

Model for ASsessment of Telemedicine Applications (MAST) is a health technology assessment (HTA) inspired framework for assessing the effectiveness and contribution to quality of telemedicine applications based on rigorous, scientific data. This study reports from a study of how it was used and perceived in twenty-one pilots of the European project RENEWING HEALTH (RH). The objectives of RH were to implement large-scale, real-life test beds for the validation and subsequent evaluation of innovative patient-centered telemedicine services. The study is a contribution to the appraisal of HTA methods. A questionnaire was administered for project leaders of the pilots. It included questions about use and usefulness of MAST for (i) preceding considerations, (ii) evaluation of outcomes within seven domains, and (iii) considerations of transferability. Free text spaces allowed for proposals of improvement. The responses covered all pilots. A quantitative summary of use and a qualitative analysis of usefulness were performed. MAST was used and considered useful for pilot evaluations. Challenges included problems to scientifically determine alternative service options and outcome within the seven domains. Proposals for improvement included process studies and adding domains of technological usability, responsible innovation, health literacy, behavior change, caregiver perspectives and motivational issues of professionals. MAST was used according to its structure. Its usefulness in patient centered pilots can be improved by adding new stakeholder groups. Interdependencies between scientific rigor, resources and timeliness should be addressed. Operational options for improvements include process studies, literature reviews and sequential mini-HTAs for identification of areas for more elaborate investigations.

Assessing the Exposome with External Measures: Commentary on the State of the Science and Research Recommendations.

PubMed

Turner, Michelle C; Nieuwenhuijsen, Mark; Anderson, Kim; Balshaw, David; Cui, Yuxia; Dunton, Genevieve; Hoppin, Jane A; Koutrakis, Petros; Jerrett, Michael

2017-03-20

The exposome comprises all environmental exposures that a person experiences from conception throughout the life course. Here we review the state of the science for assessing external exposures within the exposome. This article reviews (a) categories of exposures that can be assessed externally, (b) the current state of the science in external exposure assessment, (c) current tools available for external exposure assessment, and (d) priority research needs. We describe major scientific and technological advances that inform external assessment of the exposome, including geographic information systems; remote sensing; global positioning system and geolocation technologies; portable and personal sensing, including smartphone-based sensors and assessments; and self-reported questionnaire assessments, which increasingly rely on Internet-based platforms. We also discuss priority research needs related to methodological and technological improvement, data analysis and interpretation, data sharing, and other practical considerations, including improved assessment of exposure variability as well as exposure in multiple, critical life stages.

An analysis of Australian graduate critical care nurse education.

PubMed

Gill, Fenella J; Leslie, Gavin D; Grech, Carol; Latour, Jos M

2015-01-01

Preparation of specialist critical care nurses in Australia is at graduate level, although there remains considerable variation in courses offered in relation to qualification, content, assessment and outcomes. As higher education providers must now comply with the Australian Qualifications Framework (AQF) a study was conducted to examine existing critical care courses and graduate practice outcomes. Twenty-two critical care courses were reviewed. Data sources included course provider, websites, course curricula and telephone interviews with course coordinators. A framework approach, was used consisting of five key stages: preliminary immersion of raw data, conceptualising a thematic framework, indexing, charting, mapping and interpretation of data. Analysis revealed considerable variations in course delivery and graduate practice outcomes. Most courses used professional competency standards as a framework for course curricula and clinical assessment, with inconsistency in their translation to graduate practice outcomes. Twenty-one courses included clinical assessment at graduate certificate level with no clinical assessment conducted at master level. The expected practice outcome for fifteen courses was safe practice with graduates not expected to practice at a specialist or team leadership level. Minimum graduate practice standards were not included in three courses as an expected outcome. The AQF requires graduate nurse education to be compliant with academic outcome standards. The findings of our study indicate variations between courses and subsequent graduate practice outcomes. It is therefore timely to establish national critical care education graduate practice standards.

Diagnosis and management of Duchenne muscular dystrophy, part 1: diagnosis, and neuromuscular, rehabilitation, endocrine, and gastrointestinal and nutritional management

PubMed Central

Birnkrant, David J; Bushby, Katharine; Bann, Carla M; Apkon, Susan D; Blackwell, Angela; Brumbaugh, David; Case, Laura E; Clemens, Paula R; Hadjiyannakis, Stasia; Pandya, Shree; Street, Natalie; Tomezsko, Jean; Wagner, Kathryn R; Ward, Leanne M; Weber, David R

2018-01-01

Since the publication of the Duchenne muscular dystrophy (DMD) care considerations in 2010, multidisciplinary care of this severe, progressive neuromuscular disease has evolved. In conjunction with improved patient survival, a shift to more anticipatory diagnostic and therapeutic strategies has occurred, with a renewed focus on patient quality of life. In 2014, a steering committee of experts from a wide range of disciplines was established to update the 2010 DMD care considerations, with the goal of improving patient care. The new care considerations aim to address the needs of patients with prolonged survival, to provide guidance on advances in assessments and interventions, and to consider the implications of emerging genetic and molecular therapies for DMD. The committee identified 11 topics to be included in the update, eight of which were addressed in the original care considerations. The three new topics are primary care and emergency management, endocrine management, and transitions of care across the lifespan. In part 1 of this three-part update, we present care considerations for diagnosis of DMD and neuromuscular, rehabilitation, endocrine (growth, puberty, and adrenal insufficiency), and gastrointestinal (including nutrition and dysphagia) management. PMID:29395989

Attention Deficit Disorder: Diagnosis, Etiology and Treatment.

ERIC Educational Resources Information Center

Barabasz, Marianne; Barabasz, Arreed

1996-01-01

Provides most recent information on attention deficit disorder including: (1) diagnostic considerations according to the latest behavioral criteria and breakthroughs using neurometric EEG assessment; (2) prevalence; (3) etiologies; (4) neurological basis; and (5) treatments. Evaluates alternatives to medication, behavior modification, cognitive…

Resources for the Visually Impaired.

ERIC Educational Resources Information Center

Oseroff, Andrew; And Others

1987-01-01

Suggestions for resource room teachers working with visually impaired learning disabled students include: consideration of students' unique learning needs; assessment of functional vision; use of assistive devices (such as closed-circuit television); classroom arrangement that facilitates organization and movement; and basic skills instruction…

COLLOIDAL-FACILITATED TRANSPORT OF INORGANIC CONTAMINANTS IN GROUND WATER: PART I. SAMPLING CONSIDERATIONS

EPA Science Inventory

Investigations at Pinal Creek, Arizona, evaluated routine sampling procedures for determination of aqueous inorganic geochemistry and assessment of contaminant transport by colloidal mobility. Sampling variables included pump type and flow rate, collection under air or nitrogen,...

Developing Your School Grounds: A Planning Primer.

ERIC Educational Resources Information Center

Clearing, 1998

1998-01-01

Describes the planning steps and other practical considerations to establish successful trails, outdoor classrooms, or other environmental education improvements on school grounds. Steps include determining needs and methods for promoting projects, resources, site assessment, property lines, safety, and maintenance. Possible projects described…

360-degree physician performance assessment.

PubMed

Dubinsky, Isser; Jennings, Kelly; Greengarten, Moshe; Brans, Amy

2010-01-01

Few jurisdictions have a robust common approach to assessing the quantitative and qualitative dimensions of physician performance. In this article, we examine the need for 360-degree physician performance assessment and review the literature supporting comprehensive physician assessment. An evidence-based, "best practice" approach to the development of a 360-degree physician performance assessment framework is presented, including an overview of a tool kit to support implementation. The focus of the framework is to support physician career planning and to enhance the quality of patient care. Finally, the legal considerations related to implementing 360-degree physician performance assessment are explored.

NASA atmospheric effects of aviation projects: Status and plans

NASA Technical Reports Server (NTRS)

Wesoky, Howard L.; Thompson, Anne M.; Stolarski, Richard S.

1994-01-01

NASA's Atmospheric Effects of Aviation Project is developing a scientific basis for assessment of the atmospheric impact of subsonic and supersonic aviation. Issues addressed include predicted ozone changes and climatic impact, and related uncertainties. A primary goal is to assist assessments of United Nations scientific organizations and, hence, consideration of emission standards by the International Civil Aviation Organization. Project focus is on simulation of atmospheric processes by computer models, but studies of aircraft operations, laboratory studies, and remote and in situ observations of chemical, dynamic, and radiative processes are also included.

Biologic Monitoring of Exposure to Environmental Chemicals throughout the Life Stages: Requirements and Issues for Consideration for the National Children’s Study

PubMed Central

Barr, Dana B.; Wang, Richard Y.; Needham, Larry L.

2005-01-01

Biomonitoring of exposure is a useful tool for assessing environmental exposures. The matrices available for analyses include blood, urine, breast milk, adipose tissue, and saliva, among others. The sampling can be staged to represent the particular time period of concern: preconceptionally from both parents, from a pregnant woman during each of the three trimesters, during and immediately after childbirth, from the mother postnatally, and from the child as it develops to 21 years of age. The appropriate sample for biomonitoring will depend upon matrix availability, the time period of concern for a particular exposure or health effect, and the different classes of environmental chemicals to be monitored. This article describes the matrices available for biomonitoring during the life stages being evaluated in the National Children’s Study; the best biologic matrices for exposure assessment for each individual chemical class, including consideration of alternative matrices; the analytical methods used for analysis, including quality control procedures and less costly alternatives; the costs of analysis; optimal storage conditions; and chemical and matrix stability during long-term storage. PMID:16079083

Increasing Scientific Confidence in Adverse Outcome Pathways: Application of Tailored Bradford-Hill Considerations for Evaluating Weight of Evidence.

PubMed

Becker, Richard A; Ankley, Gerald T; Edwards, Stephen W; Kennedy, Sean W; Linkov, Igor; Meek, Bette; Sachana, Magdalini; Segner, Helmut; Van Der Burg, Bart; Villeneuve, Daniel L; Watanabe, Haruna; Barton-Maclaren, Tara S

2015-08-01

Systematic consideration of scientific support is a critical element in developing and, ultimately, using adverse outcome pathways (AOPs) for various regulatory applications. Though weight of evidence (WoE) analysis has been proposed as a basis for assessment of the maturity and level of confidence in an AOP, methodologies and tools are still being formalized. The Organization for Economic Co-operation and Development (OECD) Users' Handbook Supplement to the Guidance Document for Developing and Assessing AOPs (OECD 2014a; hereafter referred to as the OECD AOP Handbook) provides tailored Bradford-Hill (BH) considerations for systematic assessment of confidence in a given AOP. These considerations include (1) biological plausibility and (2) empirical support (dose-response, temporality, and incidence) for Key Event Relationships (KERs), and (3) essentiality of key events (KEs). Here, we test the application of these tailored BH considerations and the guidance outlined in the OECD AOP Handbook using a number of case examples to increase experience in more transparently documenting rationales for assigned levels of confidence to KEs and KERs, and to promote consistency in evaluation within and across AOPs. The major lessons learned from experience are documented, and taken together with the case examples, should contribute to better common understanding of the nature and form of documentation required to increase confidence in the application of AOPs for specific uses. Based on the tailored BH considerations and defining questions, a prototype quantitative model for assessing the WoE of an AOP using tools of multi-criteria decision analysis (MCDA) is described. The applicability of the approach is also demonstrated using the case example aromatase inhibition leading to reproductive dysfunction in fish. Following the acquisition of additional experience in the development and assessment of AOPs, further refinement of parameterization of the model through expert elicitation is recommended. Overall, the application of quantitative WoE approaches hold promise to enhance the rigor, transparency and reproducibility for AOP WoE determinations and may play an important role in delineating areas where research would have the greatest impact on improving the overall confidence in the AOP. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

40 CFR 79.66 - Neuropathology assessment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... are designed to develop data in animals on morphologic changes in the nervous system associated with... take into consideration such factors as the comparative metabolism of the chemical and species... design of the experiment shall be provided. This shall include a short justification explaining any...

40 CFR 79.66 - Neuropathology assessment.

Code of Federal Regulations, 2014 CFR

2014-07-01

... are designed to develop data in animals on morphologic changes in the nervous system associated with... take into consideration such factors as the comparative metabolism of the chemical and species... design of the experiment shall be provided. This shall include a short justification explaining any...

40 CFR 79.66 - Neuropathology assessment.

Code of Federal Regulations, 2011 CFR

2011-07-01

... are designed to develop data in animals on morphologic changes in the nervous system associated with... take into consideration such factors as the comparative metabolism of the chemical and species... design of the experiment shall be provided. This shall include a short justification explaining any...

40 CFR 79.66 - Neuropathology assessment.

Code of Federal Regulations, 2013 CFR

2013-07-01

... are designed to develop data in animals on morphologic changes in the nervous system associated with... take into consideration such factors as the comparative metabolism of the chemical and species... design of the experiment shall be provided. This shall include a short justification explaining any...

40 CFR 79.66 - Neuropathology assessment.

Code of Federal Regulations, 2012 CFR

2012-07-01

... are designed to develop data in animals on morphologic changes in the nervous system associated with... take into consideration such factors as the comparative metabolism of the chemical and species... design of the experiment shall be provided. This shall include a short justification explaining any...

32 CFR 903.3 - Selection criteria.

Code of Federal Regulations, 2010 CFR

2010-07-01

... pass a medical evaluation administered through the Department of Defense Medical Evaluation Review.... (4) Take the Candidate Fitness Assessment. (b) HQ USAFA/RR oversees the holistic review of each viable candidate's record by a panel. This holistic review may include consideration of factors that...

DOSE RECONSTRUCTION FROM URINARY BIOMARKERS

EPA Science Inventory

The use of biomarkers for human health risk assessment is attractive because they are an indicator of the dose that actually entered the body by all mechanisms. This is an important consideration given the need to include aggregate exposures from diet and other pathways for pes...

An example of population-level risk assessments for small mammals using individual-based population models.

PubMed

Schmitt, Walter; Auteri, Domenica; Bastiansen, Finn; Ebeling, Markus; Liu, Chun; Luttik, Robert; Mastitsky, Sergey; Nacci, Diane; Topping, Chris; Wang, Magnus

2016-01-01

This article presents a case study demonstrating the application of 3 individual-based, spatially explicit population models (IBMs, also known as agent-based models) in ecological risk assessments to predict long-term effects of a pesticide to populations of small mammals. The 3 IBMs each used a hypothetical fungicide (FungicideX) in different scenarios: spraying in cereals (common vole, Microtus arvalis), spraying in orchards (field vole, Microtus agrestis), and cereal seed treatment (wood mouse, Apodemus sylvaticus). Each scenario used existing model landscapes, which differed greatly in size and structural complexity. The toxicological profile of FungicideX was defined so that the deterministic long-term first tier risk assessment would result in high risk to small mammals, thus providing the opportunity to use the IBMs for risk assessment refinement (i.e., higher tier risk assessment). Despite differing internal model design and scenarios, results indicated in all 3 cases low population sensitivity unless FungicideX was applied at very high (×10) rates. Recovery from local population impacts was generally fast. Only when patch extinctions occured in simulations of intentionally high acute toxic effects, recovery periods, then determined by recolonization, were of any concern. Conclusions include recommendations for the most important input considerations, including the selection of exposure levels, duration of simulations, statistically robust number of replicates, and endpoints to report. However, further investigation and agreement are needed to develop recommendations for landscape attributes such as size, structure, and crop rotation to define appropriate regulatory risk assessment scenarios. Overall, the application of IBMs provides multiple advantages to higher tier ecological risk assessments for small mammals, including consistent and transparent direct links to specific protection goals, and the consideration of more realistic scenarios. © 2015 SETAC.

Scientific Assessment of NASA's Solar System Exploration Roadmap

NASA Technical Reports Server (NTRS)

1996-01-01

At its June 24-28, 1996, meeting, the Space Studies Board's Committee on Planetary and Lunar Exploration (COMPLEX), chaired by Ronald Greeley of Arizona State University, conducted an assessment of NASA's Mission to the Solar System Roadmap report. This assessment was made at the specific request of Dr. Jurgen Rahe, NASA's science program director for solar system exploration. The assessment includes consideration of the process by which the Roadmap was developed, comparison of the goals and objectives of the Roadmap with published National Research Council (NRC) recommendations, and suggestions for improving the Roadmap.

Joint Workshop on New Technologies for Lunar Resource Assessment

NASA Technical Reports Server (NTRS)

Elphic, Rick C. (Editor); Mckay, David S. (Editor)

1992-01-01

The workshop included talks on NASA's and DOE's role in Space Exploration Initiative, lunar geology, lunar resources, the strategy for the first lunar outpost, and an industry perspective on lunar resources. The sessions focused on four major aspects of lunar resource assessment: (1) Earth-based remote sensing of the Moon; (2) lunar orbital remote sensing; (3) lunar lander and roving investigations; and (4) geophysical and engineering consideration. The workshop ended with a spirited discussion of a number of issues related to resource assessment.

Bulk electric system reliability evaluation incorporating wind power and demand side management

NASA Astrophysics Data System (ADS)

Huang, Dange

Electric power systems are experiencing dramatic changes with respect to structure, operation and regulation and are facing increasing pressure due to environmental and societal constraints. Bulk electric system reliability is an important consideration in power system planning, design and operation particularly in the new competitive environment. A wide range of methods have been developed to perform bulk electric system reliability evaluation. Theoretically, sequential Monte Carlo simulation can include all aspects and contingencies in a power system and can be used to produce an informative set of reliability indices. It has become a practical and viable tool for large system reliability assessment technique due to the development of computing power and is used in the studies described in this thesis. The well-being approach used in this research provides the opportunity to integrate an accepted deterministic criterion into a probabilistic framework. This research work includes the investigation of important factors that impact bulk electric system adequacy evaluation and security constrained adequacy assessment using the well-being analysis framework. Load forecast uncertainty is an important consideration in an electrical power system. This research includes load forecast uncertainty considerations in bulk electric system reliability assessment and the effects on system, load point and well-being indices and reliability index probability distributions are examined. There has been increasing worldwide interest in the utilization of wind power as a renewable energy source over the last two decades due to enhanced public awareness of the environment. Increasing penetration of wind power has significant impacts on power system reliability, and security analyses become more uncertain due to the unpredictable nature of wind power. The effects of wind power additions in generating and bulk electric system reliability assessment considering site wind speed correlations and the interactive effects of wind power and load forecast uncertainty on system reliability are examined. The concept of the security cost associated with operating in the marginal state in the well-being framework is incorporated in the economic analyses associated with system expansion planning including wind power and load forecast uncertainty. Overall reliability cost/worth analyses including security cost concepts are applied to select an optimal wind power injection strategy in a bulk electric system. The effects of the various demand side management measures on system reliability are illustrated using the system, load point, and well-being indices, and the reliability index probability distributions. The reliability effects of demand side management procedures in a bulk electric system including wind power and load forecast uncertainty considerations are also investigated. The system reliability effects due to specific demand side management programs are quantified and examined in terms of their reliability benefits.

Emotions and assessment: considerations for rater-based judgements of entrustment.

PubMed

Gomez-Garibello, Carlos; Young, Meredith

2018-03-01

Assessment is subject to increasing scrutiny as medical education transitions towards a competency-based medical education (CBME) model. Traditional perspectives on the roles of assessment emphasise high-stakes, summative assessment, whereas CBME argues for formative assessment. Revisiting conceptualisations about the roles and formats of assessment in medical education provides opportunities to examine understandings and expectations of the assessment of learners. The act of the rater generating scores might be considered as an exclusively cognitive exercise; however, current literature has drawn attention to the notion of raters as measurement instruments, thereby attributing additional factors to their decision-making processes, such as social considerations and intuition. However, the literature has not comprehensively examined the influence of raters' emotions during assessment. In this narrative review, we explore the influence of raters' emotions in the assessment of learners. We summarise existing literature that describes the role of emotions in assessment broadly, and rater-based assessment specifically, across a variety of fields. The literature related to emotions and assessment is examined from different perspectives, including those of educational context, decision making and rater cognition. We use the concept of entrustable professional activities (EPAs) to contextualise a discussion of the ways in which raters' emotions may have meaningful impacts on the decisions they make in clinical settings. This review summarises findings from different perspectives and identifies areas for consideration for the role of emotion in rater-based assessment, and areas for future research. We identify and discuss three different interpretations of the influence of raters' emotions during assessments: (i) emotions lead to biased decision making; (ii) emotions contribute random noise to assessment, and (iii) emotions constitute legitimate sources of information that contribute to assessment decisions. We discuss these three interpretations in terms of areas for future research and implications for assessment. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

49 CFR 209.329 - Assessment considerations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... frequently repeated; (2) The adverse impact or the potentially adverse impact of the violation on the health... 49 Transportation 4 2010-10-01 2010-10-01 false Assessment considerations. 209.329 Section 209.329... Assessment considerations. (a) Proof of a respondent's willful violation of one of the requirements of parts...

49 CFR 209.329 - Assessment considerations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... frequently repeated; (2) The adverse impact or the potentially adverse impact of the violation on the health... 49 Transportation 4 2014-10-01 2014-10-01 false Assessment considerations. 209.329 Section 209.329... Assessment considerations. (a) Proof of a respondent's willful violation of one of the requirements of parts...

49 CFR 209.329 - Assessment considerations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... frequently repeated; (2) The adverse impact or the potentially adverse impact of the violation on the health... 49 Transportation 4 2013-10-01 2013-10-01 false Assessment considerations. 209.329 Section 209.329... Assessment considerations. (a) Proof of a respondent's willful violation of one of the requirements of parts...

49 CFR 209.329 - Assessment considerations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... frequently repeated; (2) The adverse impact or the potentially adverse impact of the violation on the health... 49 Transportation 4 2012-10-01 2012-10-01 false Assessment considerations. 209.329 Section 209.329... Assessment considerations. (a) Proof of a respondent's willful violation of one of the requirements of parts...

49 CFR 209.329 - Assessment considerations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... frequently repeated; (2) The adverse impact or the potentially adverse impact of the violation on the health... 49 Transportation 4 2011-10-01 2011-10-01 false Assessment considerations. 209.329 Section 209.329... Assessment considerations. (a) Proof of a respondent's willful violation of one of the requirements of parts...

49 CFR 209.111 - Informal response and assessment.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., information or materials, submitted by the respondent and relevant information presented during any conference... consideration of an informal response, including any relevant information presented at a conference, the Chief... written explanations, information or other materials as respondent may desire in answer to the charges or...

Metadata: Pure and Simple, or Is It?

ERIC Educational Resources Information Center

Chalmers, Marilyn

2002-01-01

Discusses issues concerning metadata in Web pages based on experiences in a vocational education center library in Queensland (Australia). Highlights include Dublin Core elements; search engines; controlled vocabulary; performance measurement to assess usage patterns and provide quality control over the vocabulary; and considerations given the…

Safety assessment of probiotics for human use

USDA-ARS?s Scientific Manuscript database

The safety of probiotics is tied to their intended use, which includes consideration of the potential vulnerability of the consumer or patient, dose and duration of consumption, and both the manner and frequency of administration. Unique to probiotics is that they are living organisms when administ...

Street Survival Skills Questionnaire for the Deaf.

ERIC Educational Resources Information Center

McCarron, Lawrence T.; Stall, Colleen H.

Guidelines are given assessing the community living skills of deaf students through an adaptation of the Street Survival Skills Questionnaire (SSSQ), which was originally designed for developmentally disabled or handicapped adolescents and adults. Adaptations include consideration of situational factors (such as visual distractions) and the…

Proceedings of a Workshop on Research Needs in Heterogeneous Tropospheric Chemistry

NASA Technical Reports Server (NTRS)

1983-01-01

The role of heterogeneous reactions and processes in the troposphere is critically assessed. The results of this assessment, including identification and prioritization of a number of important and scientifically tractable processes, as well as recommendations of ways in which they can be incorporated into the existing NASA tropospheric chemistry program are presented. Also presented is a detailed summary of the considerations that led to the group's recommendations.

Depression in primary care: assessing suicide risk

PubMed Central

Ng, Chung Wai Mark; How, Choon How; Ng, Yin Ping

2017-01-01

Major depression is a common condition seen in the primary care setting. This article describes the suicide risk assessment of a depressed patient, including practical aspects of history-taking, consideration of factors in deciding if a patient requires immediate transfer for inpatient care and measures to be taken if the patient is not hospitalised. It follows on our earlier article about the approach to management of depression in primary care. PMID:28210741

Chlorine in solid fuels fired in pulverized fuel boilers sources, forms, reactions, and consequences: a literature review

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

David A. Tillman; Dao Duong; Bruce Miller

2009-07-15

Chlorine is a significant source of corrosion and deposition, both from coal and from biomass, and in PF boilers. This investigation was designed to highlight the potential for corrosion risks associated with once-through units and advanced cycles. The research took the form of a detailed literature investigation to evaluate chlorine in solid fuels: coals of various ranks and origins, biomass fuels of a variety of types, petroleum cokes, and blends of the above. The investigation focused upon an extensive literature review of documents dating back to 1991. The focus is strictly corrosion and deposition. To address the deposition and corrosionmore » issues, this review evaluates the following considerations: concentrations of chlorine in available solid fuels including various coals and biomass fuels, forms of chlorine in those fuels, and reactions - including reactivities - of chlorine in such fuels. The assessment includes consideration of alkali metals and alkali earth elements as they react with, and to, the chlorine and other elements (e.g., sulfur) in the fuel and in the gaseous products of combustion. The assessment also includes other factors of combustion: for example, combustion conditions including excess O{sub 2} and combustion temperatures. It also considers analyses conducted at all levels: theoretical calculations, bench scale laboratory data and experiments, pilot plant experiments, and full scale plant experience. Case studies and plant surveys form a significant consideration in this review. The result of this investigation focuses upon the concentrations of chlorine acceptable in coals burned exclusively, in coals burned with biomass, and in biomass cofired with coal. Values are posited based upon type of fuel and combustion technology. Values are also posited based upon both first principles and field experience. 86 refs., 8 figs., 7 tabs.« less

Review of the Primary National Ambient Air Quality Standards ...

EPA Pesticide Factsheets

The U.S. Environmental Protection Agency (EPA) is conducting a review of the air quality criteria and the primary (health-based) national ambient air quality standards (NAAQS) for nitrogen dioxide (NO2). The major phases of the process for reviewing NAAQS include the following: (1) planning, (2) science assessment, (3) risk and exposure assessment, and (4) policy assessment. As an initial step in the risk and exposure assessment phase, EPA staff has considered the extent to which updated quantitative analyses of NO2 exposures and/or NO2-attributable health risks are warranted in the current review, based on the available scientific evidence and technical information. These considerations focus on the degree to which important uncertainties identified in quantitative analyses from the last review have been addressed by newly available evidence, tools, or information. The purpose of the REA planning document is to present staff's considerations and preliminary conclusions regarding potential updated quantitative analyses in the current review of the primary NO2 NAAQS. Provide opportunity for CASAC feedback on EPA's plans for the risk and exposure assessment for the Nitrogen Oxides NAAQS review

Biosafety considerations for autopsy.

PubMed

Nolte, Kurt B; Taylor, David G; Richmond, Jonathan Y

2002-06-01

An autopsy may subject prosectors and others to a wide variety of infectious agents, including bloodborne and aerosolized pathogens such as human immunodeficiency virus, hepatitis B and C viruses, and Mycobacterium tuberculosis. Other hazards include toxic chemicals (e.g., formalin, cyanide, and organophosphates) and radiation from radionuclides used for patient therapy and diagnosis. These risks can be substantially mitigated through proper assessment, personal protective equipment, appropriate autopsy procedures, and facility design.

12 CFR 263.62 - Relevant considerations for assessment of civil penalty.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Relevant considerations for assessment of civil... Collection of Civil Money Penalties § 263.62 Relevant considerations for assessment of civil penalty. In... the penalty with respect to the financial resources and good faith of the person charged, the gravity...

Medication and monitoring in palliative sedation therapy: a systematic review and quality assessment of published guidelines.

PubMed

Schildmann, Eva Katharina; Schildmann, Jan; Kiesewetter, Isabel

2015-04-01

Palliative sedation therapy (PST) is increasingly used in patients at the end of life. However, consensus about medications and monitoring is lacking. To assess published PST guidelines with regard to quality and recommendations on drugs and monitoring. We searched CINAHL, the Cochrane Library, Embase, PsycINFO, PubMed, and references of included articles until July 2014. Search terms included "palliative sedation" or "sedation" and "guideline" or "policy" or "framework." Guideline selection was based on English or German publications that included a PST guideline. Two investigators independently assessed the quality of the guidelines according to the Appraisal of Guidelines for Research and Evaluation II instrument (AGREE II) and extracted information on drug selection and monitoring. Nine guidelines were eligible. Eight guidelines received high quality scores for the domain "scope and purpose" (median 69%, range 28-83%), whereas in the other domains the guidelines' quality differed considerably. The majority of guidelines suggest midazolam as drug of first choice. Recommendations on dosage and alternatives vary. The guidelines' recommendations regarding monitoring of PST show wide variation in the number and details of outcome parameters and methods of assessment. The published guidelines on PST vary considerably regarding their quality and content on drugs and monitoring. Given the need for clear guidance regarding PST in patients at the end of life, this comparative analysis may serve as a starting point for further improvement. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Performance assessment of small-package-class nonintrusive inspection systems

NASA Astrophysics Data System (ADS)

Spradling, Michael L.; Hyatt, Roger

1997-02-01

The DoD Counterdrug Technology Development Program has addressed the development and demonstration of technology to enhance nonintrusive inspection of small packages such as passenger baggage, commercially delivered parcels, and breakbulk cargo items. Within the past year they have supported several small package-class nonintrusive inspection system performance assessment activities. All performance assessment programs involved the use of a red/blue team concept and were conducted in accordance with approved assessment protocols. This paper presents a discussion related to the systematic performance assessment of small package-class nonintrusive inspection technologies, including transmission, backscatter and computed tomography x-ray imaging, and protocol-related considerations for the assessment of these systems.

Development of California Public Health Goals (PHGs) for chemicals in drinking water.

PubMed

Howd, R A; Brown, J P; Morry, D W; Wang, Y Y; Bankowska, J; Budroe, J D; Campbell, M; DiBartolomeis, M J; Faust, J; Jowa, L; Lewis, D; Parker, T; Polakoff, J; Rice, D W; Salmon, A G; Tomar, R S; Fan, A M

2000-01-01

As part of a program for evaluation of environmental contaminants in drinking water, risk assessments are being conducted to develop Public Health Goals (PHGs) for chemicals in drinking water, based solely on public health considerations. California's Safe Drinking Water Act of 1996 mandated the development of PHGs for over 80 chemicals by 31 December 1999. The law allowed these levels to be set higher or lower than federal maximum contaminant levels (MCLs), including a level of zero if data are insufficient to determine a specific level. The estimated safe levels and toxicological rationale for the first 26 of these chemicals are described here. The chemicals include alachlor, antimony, benzo[a]pyrene, chlordane, copper, cyanide, dalapon, 1,2-dichlorobenzene, 1,4-dichlorobenzene, 2,4-D, diethylhexylphthalate, dinoseb, endothall, ethylbenzene, fluoride, glyphosate, lead, nitrate, nitrite, oxamyl, pentachlorophenol, picloram, trichlorofluoromethane, trichlorotrifluoroethane, uranium and xylene(s). These risk assessments are to be considered by the State of California in revising and developing state MCLs for chemicals in drinking water (which must not exceed federal MCLs). The estimates are also notable for incorporation or consideration of newer guidelines and principles for risk assessment extrapolations.

Use of botanicals in food supplements. Regulatory scope, scientific risk assessment and claim substantiation. 2005.

PubMed

Coppens, P; Delmulle, L; Gulati, O; Richardson, D; Ruthsatz, M; Sievers, H; Sidani, S

2006-01-01

In the European Union, an elaborate legal framework regulates botanical products both under food and medicinal law. The decision as to which legal framework applies to an individual product may differ between the Member States. In the case of botanical food supplements, all food law provisions apply to their manufacturing, composition and marketing, including the new claims legislation. Elements from EU and national law, scientific and other publications are brought together to investigate how to clarify the differentiation between the use of botanicals for medicinal and health-promoting purposes on a scientific basis. Guidance on the safety assessment and quality evaluation of botanicals is proposed in light of the different approaches described in the scientific literature with particular attention to the concept of long-term use as an integral part of safety evaluation. Guidance on claims substantiation is also included, taking into consideration the proposed legislation, the concept of long-term experience and grading of evidence. A model for safety and efficacy assessment of botanical food supplements in the EU is proposed, and should be taken into consideration in the development of legislation and scientific research on botanicals. Copyright 2006 S. Karger AG, Basel.

Recreational Water Contact and Fish Consumption Assessment to Inform Risk Estimates and Evaluate Ecosystem Services

EPA Science Inventory

Background: Surface waters provide invaluable ecosystem services, including drinking water, food, waste water disposal, and recreation. The nature and frequency of recreational contact with surface waters is a critical consideration in evaluating benefits to human well-being (e.g...

Mission roles for the solar electric propulsion stage with the space transportation system

NASA Technical Reports Server (NTRS)

1974-01-01

A briefing outline is presented of the mission roles for the solar electric propulsion stage (SEPS). Topics outlined include operational considerations and mission characteristics, trade studies and technology assessments influencing SEPS configuration definition, program support requirements, and development and operations cost estimates.

DOSE RECONSTRUCTION FROM URINARY BIOMARKERS USING PHARMACOKINETIC MODELS

EPA Science Inventory

The use of biomarkers for human health risk assessment is attractive because they are an indicator of the dose that actually entered the body by all mechanisms. This is an important consideration given the need to include aggregate exposures from diet and other pathways for pes...

Strategic Considerations in Developing Programs at Colleges and Universities.

ERIC Educational Resources Information Center

Barbaro, Fred

1986-01-01

A strategy, based on organizational change literature, for establishing a college program for learning-disabled students includes such crucial steps as assessing the change effort (nature of the change, environmental factors, initiators of change), establishing a campaign plan (program and decision centers), and developing deployment tactics…

Assessment of Individuals with Hearing Impairments: Equity in Testing Procedures and Accommodations.

ERIC Educational Resources Information Center

Gordon, Robin Perkins; And Others

1996-01-01

Reviews research related to testing procedures and accommodations for individuals with hearing impairments, with a special focus on the specific issues that may influence standardized psychological, educational, and work-related testing procedures for people with hearing impairments. Includes considerations for professionals conducting assessments…

78 FR 14111 - Final Candidate Conservation Agreement With Assurances, Final Environmental Assessment, and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-04

... alternative (Alternative 2) for implementation based on multiple environmental and social factors, including... review of the alternatives and their environmental consequences. Implementation of this decision entails... implementation of conservation actions and measures contained in the CCAA, and social and economic considerations...

Advanced imaging of the macrostructure and microstructure of bone

NASA Technical Reports Server (NTRS)

Genant, H. K.; Gordon, C.; Jiang, Y.; Link, T. M.; Hans, D.; Majumdar, S.; Lang, T. F.

2000-01-01

Noninvasive and/or nondestructive techniques are capable of providing more macro- or microstructural information about bone than standard bone densitometry. Although the latter provides important information about osteoporotic fracture risk, numerous studies indicate that bone strength is only partially explained by bone mineral density. Quantitative assessment of macro- and microstructural features may improve our ability to estimate bone strength. The methods available for quantitatively assessing macrostructure include (besides conventional radiographs) quantitative computed tomography (QCT) and volumetric quantitative computed tomography (vQCT). Methods for assessing microstructure of trabecular bone noninvasively and/or nondestructively include high-resolution computed tomography (hrCT), micro-computed tomography (muCT), high-resolution magnetic resonance (hrMR), and micromagnetic resonance (muMR). vQCT, hrCT and hrMR are generally applicable in vivo; muCT and muMR are principally applicable in vitro. Although considerable progress has been made in the noninvasive and/or nondestructive imaging of the macro- and microstructure of bone, considerable challenges and dilemmas remain. From a technical perspective, the balance between spatial resolution versus sampling size, or between signal-to-noise versus radiation dose or acquisition time, needs further consideration, as do the trade-offs between the complexity and expense of equipment and the availability and accessibility of the methods. The relative merits of in vitro imaging and its ultrahigh resolution but invasiveness versus those of in vivo imaging and its modest resolution but noninvasiveness also deserve careful attention. From a clinical perspective, the challenges for bone imaging include balancing the relative advantages of simple bone densitometry against the more complex architectural features of bone or, similarly, the deeper research requirements against the broader clinical needs. The considerable potential biological differences between the peripheral appendicular skeleton and the central axial skeleton have to be addressed further. Finally, the relative merits of these sophisticated imaging techniques have to be weighed with respect to their applications as diagnostic procedures requiring high accuracy or reliability on one hand and their monitoring applications requiring high precision or reproducibility on the other. Copyright 2000 S. Karger AG, Basel.

Does the Recording Medium Influence Phonetic Transcription of Cleft Palate Speech?

ERIC Educational Resources Information Center

Klintö, Kristina; Lohmander, Anette

2017-01-01

Background: In recent years, analyses of cleft palate speech based on phonetic transcriptions have become common. However, the results vary considerably among different studies. It cannot be excluded that differences in assessment methodology, including the recording medium, influence the results. Aims: To compare phonetic transcriptions from…

Space-Time Fusion Under Error in Computer Model Output: An Application to Modeling Air Quality

EPA Science Inventory

In the last two decades a considerable amount of research effort has been devoted to modeling air quality with public health objectives. These objectives include regulatory activities such as setting standards along with assessing the relationship between exposure to air pollutan...

Functional Assessment and Treatment of Migraine Reports and School Absences in an Adolescent with Asperger's Disorder

ERIC Educational Resources Information Center

Arvans, Rebecca K.; LeBlanc, Linda A.

2009-01-01

Psychological interventions for migraines typically include biofeedback training, stress-management training, or relaxation training and are implemented without consideration of environmental variables that might maintain migraines or complaints of migraines. An adolescent with daily reports of migraines that negatively impacted school attendance…

Educators' Conceptions and Practice of Classroom Assessment in Post-Apartheid South Africa

ERIC Educational Resources Information Center

Vandeyar, Saloshna; Killen, Roy

2007-01-01

The changes in post-apartheid South Africa have been accompanied by considerable changes in the education system. The most notable include desegregation of schools, development of a National Qualifications Framework, adoption of new language policies for education, and introduction of outcomes-based curricula. However entrenched assessment…

Correcting for Person Misfit in Aggregated Score Reporting

ERIC Educational Resources Information Center

Brown, Richard S.; Villarreal, Julio C.

2007-01-01

There has been considerable research regarding the extent to which psychometric sound assessments sometimes yield individual score estimates that are inconsistent with the response patterns of the individual. It has been suggested that individual response patterns may differ from expectations for a number of reasons, including subject motivation,…

Recommendations for improved assessment of noise impacts on wildlife

Treesearch

Larry L. Pater; Teryl G. Grubb; David K. Delaney

2009-01-01

Research to determine noise impacts on animals benefits from methodology that adequately describes the acoustical stimulus as well as the resulting biological responses. We present acoustical considerations and research techniques that we have found to be useful. These include acoustical definitions and noise measurement techniques that conform to standardized...

78 FR 66941 - Design Considerations for Pivotal Clinical Investigations for Medical Devices; Guidance for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-07

... assessment. In some cases, a PMA may include multiple studies designed to answer different scientific... designing clinical studies intended to support premarket submissions for medical devices and for FDA staff who review those submissions. This guidance document describes different study design principles...

National Aeronautics and Space Administration's (NASA) Automated Information Security Handbook

NASA Technical Reports Server (NTRS)

Roback, E.

1991-01-01

The NASA Automated Information Security Handbook provides NASA's overall approach to automated information systems security including discussions of such aspects as: program goals and objectives, assignment of responsibilities, risk assessment, foreign national access, contingency planning and disaster recovery, awareness training, procurement, certification, planning, and special considerations for microcomputers.

CAPACITY BUILDING PROCESS IN ENVIRONMENTAL AND HEALTH IMPACT ASSESSMENT FOR A THAI COMMUNITY.

PubMed

Chaithui, Suthat; Sithisarankul, Pornchai; Hengpraprom, Sarunya

2017-03-01

This research aimed at exploring the development of the capacitybuilding process in environmental and health impact assessment, including the consideration of subsequent, capacity-building achievements. Data were gathered through questionnaires, participatory observations, in-depth interviews, focus group discussions, and capacity building checklist forms. These data were analyzed using content analysis, descriptive statistics, and inferential statistics. Our study used the components of the final draft for capacity-building processes consisting of ten steps that were formulated by synthesis from each respective process. Additionally, the evaluation of capacity building levels was performed using 10-item evaluation criteria for nine communities. The results indicated that the communities performed well under these criteria. Finally, exploration of the factors influencing capacity building in environmental and health impact assessment indicated that the learning of community members by knowledge exchange via activities and study visits were the most influential factors of the capacity building processes in environmental and health impact assessment. The final revised version of capacitybuilding process in environmental and health impact assessment could serve as a basis for the consideration of interventions in similar areas, so that they increased capacity in environmental and health impact assessments.

Incorporating Mobile Phone Technologies to Expand Evidence-Based Care

PubMed Central

Jones, Deborah J.; Anton, Margaret; Gonzalez, Michelle; Honeycutt, Amanda; Khavjou, Olga; Forehand, Rex; Parent, Justin

2014-01-01

Ownership of mobile phones is on the rise, a trend in uptake that transcends age, region, race, and ethnicity, as well as income. It is precisely the emerging ubiquity of mobile phones that has sparked enthusiasm regarding their capacity to increase the reach and impact of health care, including mental health care. Community-based clinicians charged with transporting evidence-based interventions beyond research and training clinics are in turn, ideally and uniquely situated to capitalize on mobile phone uptake and functionality to bridge the efficacy to effectiveness gap. As such, this article delineates key considerations to guide these frontline clinicians in mobile phone-enhanced clinical practice, including an overview of industry data on the uptake of and evolution in the functionality of mobile phone platforms, conceptual considerations relevant to the integration of mobile phones into practice, representative empirical illustrations of mobile-phone enhanced assessment and treatment, and practical considerations relevant to ensuring the feasibility and sustainability of such an approach. PMID:26213458

Incorporating Mobile Phone Technologies to Expand Evidence-Based Care.

PubMed

Jones, Deborah J; Anton, Margaret; Gonzalez, Michelle; Honeycutt, Amanda; Khavjou, Olga; Forehand, Rex; Parent, Justin

2015-08-01

Ownership of mobile phones is on the rise, a trend in uptake that transcends age, region, race, and ethnicity, as well as income. It is precisely the emerging ubiquity of mobile phones that has sparked enthusiasm regarding their capacity to increase the reach and impact of health care, including mental health care. Community-based clinicians charged with transporting evidence-based interventions beyond research and training clinics are in turn, ideally and uniquely situated to capitalize on mobile phone uptake and functionality to bridge the efficacy to effectiveness gap. As such, this article delineates key considerations to guide these frontline clinicians in mobile phone-enhanced clinical practice, including an overview of industry data on the uptake of and evolution in the functionality of mobile phone platforms, conceptual considerations relevant to the integration of mobile phones into practice, representative empirical illustrations of mobile-phone enhanced assessment and treatment, and practical considerations relevant to ensuring the feasibility and sustainability of such an approach.

Assessment for the management of NORM wastes in conventional hazardous and nonhazardous waste landfills.

PubMed

Mora, Juan C; Baeza, Antonio; Robles, Beatriz; Sanz, Javier

2016-06-05

Naturally Occurring Radioactive Materials (NORM) wastes are generated in huge quantities in several industries and their management has been carried out under considerations of industrial non-radioactive wastes, before the concern on the radioactivity content was included in the legislation. Therefore these wastes were conditioned using conventional methods and the waste disposals were designed to isolate toxic elements from the environment for long periods of time. Spanish regulation for these conventional toxic waste disposals includes conditions that assure adequate isolation to minimize the impact of the wastes to the environment in present and future conditions. After 1996 the radiological impact of the management of NORM wastes is considered and all the aspects related with natural radiations and the radiological control regarding the management of residues from NORM industries were developed in the new regulation. One option to be assessed is the disposal of NORM wastes in hazardous and non-hazardous waste disposals, as was done before this new regulation. This work analyses the management of NORM wastes in these landfills to derive the masses that can be disposed without considerable radiological impact. Generic dose assessments were carried out under highly conservative hypothesis and a discussion on the uncertainty and variability sources was included to provide consistency to the calculations. Copyright © 2016 Elsevier B.V. All rights reserved.

SSTO vs TSTO design considerations—an assessment of the overall performance, design considerations, technologies, costs, and sensitivities of SSTO and TSTO designs using modern technologies

NASA Astrophysics Data System (ADS)

Penn, Jay P.

1996-03-01

It is generally believed by those skilled in launch system design that Single-Stage-To-Orbit (SSTO) designs are more technically challenging, more performance sensitive, and yield larger lift-off weights than do Two-Stage-To-Orbit designs (TSTO's) offering similar payload delivery capability. Without additional insight into the other considerations which drive the development, recurring costs, operability, and reliability of a launch fleet, an analyst may easily conclude that the higher performing, less sensitive TSTO designs, thus yield a better solution to achieving low cost payload delivery. This limited insight could justify an argument to eliminate the X-33 SSTO technology/demonstration development effort, and thus proceed directly to less risky TSTO designs. Insight into real world design considerations of launch vehicles makes the choice of SSTO vs TSTO much less clear. The presentation addresses a more comprehensive evaluation of the general class of SSTO and TSTO concepts. These include pure SSTO's, augmented SSTO's, Siamese Twin, and Pure TSTO designs. The assessment considers vehicle performance and scaling relationships which characterize real vehicle designs. The assessment also addresses technology requirements, operations and supportability, cost implications, and sensitivities. Results of the assessment indicate that the trade space between various SSTO and TSTO design approaches is complex and not yet fully understood. The results of the X-33 technology demonstrators, as well as additional parametric analysis is required to better define the relative performance and costs of the various design approaches. The results also indicate that with modern technologies and today's better understanding of vehicle design considerations, the perception that SSTO's are dramatically heavier and more sensitive than TSTO designs is more of a myth, than reality.

Towards Integration of Environmental and Health Impact Assessments for Wild Capture Fishing and Farmed Fish with Particular Reference to Public Health and Occupational Health Dimensions

PubMed Central

Watterson, Andrew; Little, David; Young, James A.; Boyd, Kathleen; Azim, Ekram; Murray, Francis

2008-01-01

The paper offers a review and commentary, with particular reference to the production of fish from wild capture fisheries and aquaculture, on neglected aspects of health impact assessments which are viewed by a range of international and national health bodies and development agencies as valuable and necessary project tools. Assessments sometimes include environmental health impact assessments but rarely include specific occupational health and safety impact assessments especially integrated into a wider public health assessment. This is in contrast to the extensive application of environmental impact assessments to fishing and the comparatively large body of research now generated on the public health effects of eating fish. The value of expanding and applying the broader assessments would be considerable because in 2004 the United Nations Food and Agriculture Organization reports there were 41,408,000 people in the total ‘fishing’ sector including 11,289,000 in aquaculture. The paper explores some of the complex interactions that occur with regard to fishing activities and proposes the wider adoption of health impact assessment tools in these neglected sectors through an integrated public health impact assessment tool. PMID:19190356

Aggregate Exposure and Cumulative Risk Assessment--Integrating Occupational and Non-occupational Risk Factors.

PubMed

Lentz, T J; Dotson, G S; Williams, P R D; Maier, A; Gadagbui, B; Pandalai, S P; Lamba, A; Hearl, F; Mumtaz, M

2015-01-01

Occupational exposure limits have traditionally focused on preventing morbidity and mortality arising from inhalation exposures to individual chemical stressors in the workplace. While central to occupational risk assessment, occupational exposure limits have limited application as a refined disease prevention tool because they do not account for all of the complexities of the work and non-occupational environments and are based on varying health endpoints. To be of greater utility, occupational exposure limits and other risk management tools could integrate broader consideration of risks from multiple exposure pathways and routes (aggregate risk) as well as the combined risk from exposure to both chemical and non-chemical stressors, within and beyond the workplace, including the possibility that such exposures may cause interactions or modify the toxic effects observed (cumulative risk). Although still at a rudimentary stage in many cases, a variety of methods and tools have been developed or are being used in allied risk assessment fields to incorporate such considerations in the risk assessment process. These approaches, which are collectively referred to as cumulative risk assessment, have potential to be adapted or modified for occupational scenarios and provide a tangible path forward for occupational risk assessment. Accounting for complex exposures in the workplace and the broader risks faced by the individual also requires a more complete consideration of the composite effects of occupational and non-occupational risk factors to fully assess and manage worker health problems. Barriers to integrating these different factors remain, but new and ongoing community-based and worker health-related initiatives may provide mechanisms for identifying and integrating risk from aggregate exposures and cumulative risks from all relevant sources, be they occupational or non-occupational.

Ethical considerations in clinical research on herbal medicine for prevention of cardiovascular disease in the ageing.

PubMed

Koonrungsesomboon, Nut; Karbwang, Juntra

2016-10-15

Cardiovascular disease (CVD) in the ageing is a major public health problem worldwide. The nature of most CVD is subclinical with pathological processes that can span over years. Use of preventive measures could be an appropriate approach to prevailing over CVD in the ageing, and herbal medicine is one of the promising preventive approaches and is currently of interest among medical societies. In the evidence-based era, herbal medicine is, however, often underestimated and approached with skepticism, mainly due to the paucity of scientific evidence. Properly designed clinical trials on herbal medicine for prevention of CVD in a geriatric population are thus of importance and of clinical value. To review ethical issues and discuss considerations when such research is proposed. Four ethical issues, including the scientific validity of research, risk-benefit assessments, subject selection and vulnerability, and informed consent, are structured and extensively discussed in this article. Ethical core considerations of prevention research of CVD on herbal medicine involve particular attention on the scientific validity of research, risk-benefit assessments, subject selection and vulnerability, and informed consent. These issues and considerations are keys, although they must be adapted to an individual research setting in which a clinical study is proposed. Copyright © 2015 Elsevier GmbH. All rights reserved.

Anesthetic Considerations for Transcatheter Pulmonary Valve Replacement.

PubMed

Gregory, Stephen H; Zoller, Jonathan K; Shahanavaz, Shabana; Chilson, Kelly L; Ridley, Clare H

2018-02-01

The introduction of transcatheter therapy for valvular heart disease has revolutionized the care of patients with valvular disorders. Pathologic regurgitation or stenosis of the pulmonary valve, right ventricular outflow tract, or a right ventricle-to-pulmonary artery conduit represent emerging indications for transcatheter therapy. To date, minimal literature exists detailing the anesthetic management of patients undergoing transcatheter pulmonary valve replacement. In this review, the pathophysiology and indications for transcatheter pulmonary valve replacement and possible complications unique to this procedure are reviewed. Anesthetic management, including preoperative assessment, intraoperative considerations, and early postoperative monitoring, are discussed. Copyright © 2018 Elsevier Inc. All rights reserved.

Value Assessment at the Point of Care: Incorporating Patient Values throughout Care Delivery and a Draft Taxonomy of Patient Values.

PubMed

Armstrong, Melissa J; Mullins, C Daniel

2017-02-01

Incorporation of patient values is a key element of patient-centered care, but consistent incorporation of patient values at the point of care is lacking. Shared decision making encourages incorporation of patient values in decision making, but associated tools often lack guidance on value assessment. In addition, focusing on patient values relating only to specific decisions misses an opportunity for a more holistic approach to value assessment that could impact other aspects of clinical encounters, including health care planning, communication, and stakeholder involvement. In this commentary, we propose a taxonomy of values underlying patient decision making and provide examples of how these impact provision of health care. The taxonomy describes four categories of patient values: global, decisional, situational, and external. Global values are personal values impacting decision making at a universal level and can include value traits and life priorities. Decisional values are the values traditionally conceptualized in decision making, including considerations such as efficacy, toxicity, quality of life, convenience, and cost. Situational values are values tied to a specific moment in time that modify patients' existing global and decisional values. Finally, discussion of external values acknowledges that many patients consider values other than their own when making decisions. Recognizing the breadth of values impacting patient decision making has implications for both overall health care delivery and shared decision making because value assessments focusing only on decisional values may miss important patient considerations. This draft taxonomy highlights different values impacting decision making and facilitates a more complete value assessment at the point of care. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Ecologic Momentary Assessment: Perspectives on Applications and Opportunities in Research and Practice Regarding Nutrition Behaviors.

PubMed

Hand, Rosa K; Perzynski, Adam T

2016-09-01

Retrospective self-reported data have limitations, making it important to evaluate alternative forms of measurement for nutrition behaviors. Ecological momentary assessment (EMA) attempts to overcome the challenges of recalled data with real-time data collection in a subject's natural environment, often leveraging technology. This perspective piece 1) introduces the concepts and terminology of EMA, 2) provides an overview of the methodological and analytical considerations, 3) gives examples of past research using EMA, and 4) suggests new opportunities (including combining assessment and intervention) and limitations (including the need for technology) for the application of EMA to research and practice regarding nutrition behaviors. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Assessment of a Hospital Palliative Care Unit (HPCU) for Cancer Patients; A Conceptual Framework.

PubMed

Rouhollahi, Mohammad Reza; Saghafinia, Masoud; Zandehdel, Kazem; Motlagh, Ali Ghanbari; Kazemian, Ali; Mohagheghi, Mohammad Ali; Tahmasebi, Mamak

2015-01-01

The first hospital palliative care unit (HPCU) in Iran (FARS-HPCU) has been established in 2008 in the Cancer Institute, which is the largest referral cancer center in the country. We attempted to assess the performance of the HPCU based on a comprehensive conceptual framework. The main aim of this study was to develop a conceptual framework for assessment of the HPCU performances through designing a value chain in line with the goals and the main processes (core and support). We collected data from a variety of sources, including international guidelines, international best practices, and expert opinions in the country and compared them with national policies and priorities. We also took into consideration the trend of the HPCU development in the Cancer Institute of Iran. Through benchmarking the gap area with the performance standards, some recommendations for better outcome are proposed. The framework for performance assessment consisted of 154 process indicators (PIs), based on which the main stakeholders of the HPCU (including staff, patients, and families) offered their scoring. The outcome revealed the state of the processes as well as the gaps. Despite a significant improvement in many processes and indicators, more development in the comprehensive and integrative aspects of FARS-HPCU performance is required. Consideration of all supportive and palliative requirements of the patients through interdisciplinary and collaborative approaches is recommended.

Temporary Blinding Limits versus Maximum Permissible Exposure - A Paradigm Change in Risk Assessment for Visible Optical Radiation

NASA Astrophysics Data System (ADS)

Reidenbach, Hans-Dieter

Safety considerations in the field of laser radiation have traditionally been restricted to maximum permissible exposure levels defined as a function of wavelength and exposure duration. But in Europe according to the European Directive 2006/25/EC on artificial optical radiation the employer has to include in his risk assessment indirect effects from temporary blinding. Whereas sufficient knowledge on various deterministic risks exists, only sparse quantitative data is available for the impairment of visual functions due to temporary blinding from visible optical radiation. The consideration of indirect effects corresponds to a paradigm change in risk assessment when situations have to be treated, where intrabeam viewing of low-power laser radiation is likely or other non-coherent visible radiation might influence certain visual tasks. In order to obtain a sufficient basis for the assessment of certain situations, investigations of the functional relationships between wavelength, exposure time and optical power and the resulting interference on visual functions have been performed and the results are reported. The duration of a visual disturbance is thus predictable. In addition, preliminary information on protective measures is given.

Approaches for Establishing Fraud Risk Assessment Programs and Conducting Fraud Audit Risk Assessments Within the Department of Defense

DTIC Science & Technology

2014-07-17

Auditing Health Care Organizations _________ 35 Special Fraud Risk Considerations When Auditing Government Contracts ______________ 36 iv │ DODIG-2014...Auditor Fraud Risk Assessment Special Considerations Special Fraud Risk Considerations When Auditing Health Care Organizations...Learning Opportunities 0 Government Relations (Public Policy and Strategic Relations) Government Relations 0 Health Care Affairs Health Care Affairs 0 Human

Ozone Air Quality over North America: Part II-An Analysis of Trend Detection and Attribution Techniques.

PubMed

Porter, P Steven; Rao, S Trivikrama; Zurbenko, Igor G; Dunker, Alan M; Wolff, George T

2001-02-01

Assessment of regulatory programs aimed at improving ambient O 3 air quality is of considerable interest to the scientific community and to policymakers. Trend detection, the identification of statistically significant long-term changes, and attribution, linking change to specific clima-tological and anthropogenic forcings, are instrumental to this assessment. Detection and attribution are difficult because changes in pollutant concentrations of interest to policymakers may be much smaller than natural variations due to weather and climate. In addition, there are considerable differences in reported trends seemingly based on similar statistical methods and databases. Differences arise from the variety of techniques used to reduce nontrend variation in time series, including mitigating the effects of meteorology and the variety of metrics used to track changes. In this paper, we review the trend assessment techniques being used in the air pollution field and discuss their strengths and limitations in discerning and attributing changes in O 3 to emission control policies.

Towards a systems approach to risk considerations for concurrent design

NASA Technical Reports Server (NTRS)

Meshkat, Leila; Oberto, Robert E.

2004-01-01

This paper describes the new process used by the Project Design Center at NASA's Jet Propulsion Laboratory for the identification, assessment and communication of risk elements throughout the lifecycle of a mission design. This process includes a software tool, 'RAP' that collects and communicates risk information between the various designers and a 'risk expert' who mediates this process. The establishment of this process is an attempt towards the systematic consideration of risk in the design decision making process. Using this process, we are able to better keep track of the risks associated with the design decisions. Furthermore, it helps us develop better risk profiles for the studies under consideration. We aim to refine and expand the current process to enable more thorough risk analysis capabilities in the future.

The Effect of Cleft Lip on Socio-Emotional Functioning in School-Aged Children

ERIC Educational Resources Information Center

Murray, Lynne; Arteche, Adriane; Bingley, Caroline; Hentges, Francoise; Bishop, Dorothy V. M.; Dalton, Louise; Goodacre, Tim; Hill, Jonathan

2010-01-01

Background: Children with cleft lip are known to be at raised risk for socio-emotional difficulties, but the nature of these problems and their causes are incompletely understood; longitudinal studies are required that include comprehensive assessment of child functioning, and consideration of developmental mechanisms. Method: Children with cleft…

It's All About Maps: The Good, the Bad, and the Ugly.

ERIC Educational Resources Information Center

Jacso, Peter; Tiszai, Judit

1996-01-01

Advises educators on judging the quality of maps contained in CD-ROM encyclopedias, atlases, and almanacs. Discussion focuses on spotting inaccuracies and assessing size, color, and fonts. Other considerations include availability of spoken word accompaniment and the ability to manipulate and print geographic images. A table compares strengths and…

Performance Measures for Teachers and Teacher Education: Corporate Education Reform Opens the Door to New Legal Issues

ERIC Educational Resources Information Center

Pullin, Diana

2015-01-01

Recent efforts to change the teaching profession and teacher preparation include a number of innovations to use portfolio assessment, value added measures (VAM), accountability metrics and other corporate education reform ideas. These approaches may provoke considerable potential legal consequences. Traditional constitutional and civil rights…

AAHPER Research Consortium Symposium Papers: Socio-Psychological Dimensions, Research Design and Safety. Volume II, Book 3.

ERIC Educational Resources Information Center

Cox, Richard H., Ed.

This collection focuses on research topics in physical education and athletics and includes the following papers: Methodological Problems in the Assessment of Personality from the Psychoanalytic, Behavioral and Cognitive Positions; Some Factors Affecting the Performance of Women in Sports and Activity; Multivariate Considerations in Children's…

Tiered analytics for purity assessment of macrocyclic peptides in drug discovery: Analytical consideration and method development.

PubMed

Qian Cutrone, Jingfang Jenny; Huang, Xiaohua Stella; Kozlowski, Edward S; Bao, Ye; Wang, Yingzi; Poronsky, Christopher S; Drexler, Dieter M; Tymiak, Adrienne A

2017-05-10

Synthetic macrocyclic peptides with natural and unnatural amino acids have gained considerable attention from a number of pharmaceutical/biopharmaceutical companies in recent years as a promising approach to drug discovery, particularly for targets involving protein-protein or protein-peptide interactions. Analytical scientists charged with characterizing these leads face multiple challenges including dealing with a class of complex molecules with the potential for multiple isomers and variable charge states and no established standards for acceptable analytical characterization of materials used in drug discovery. In addition, due to the lack of intermediate purification during solid phase peptide synthesis, the final products usually contain a complex profile of impurities. In this paper, practical analytical strategies and methodologies were developed to address these challenges, including a tiered approach to assessing the purity of macrocyclic peptides at different stages of drug discovery. Our results also showed that successful progression and characterization of a new drug discovery modality benefited from active analytical engagement, focusing on fit-for-purpose analyses and leveraging a broad palette of analytical technologies and resources. Copyright © 2017. Published by Elsevier B.V.

40 CFR 194.33 - Consideration of drilling events in performance assessments.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Consideration of drilling events in performance assessments. 194.33 Section 194.33 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... assessments. (a) Performance assessments shall examine deep drilling and shallow drilling that may potentially...

Afterword: Considerations for Future Practice of Assessment and Accountability

ERIC Educational Resources Information Center

Bresciani, Marilee J.

2013-01-01

This afterword offers challenges and considerations as the assessment movement continues to develop. The author offers some simple considerations for readers to ponder as they advance their evidence-based decision making processes, and encourages others to use these methods within the context of recent neuroscientific evidence that learning and…

40 CFR 194.33 - Consideration of drilling events in performance assessments.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 25 2014-07-01 2014-07-01 false Consideration of drilling events in... and Re-certification Containment Requirements § 194.33 Consideration of drilling events in performance... shall be used in assessing the likelihood and consequences of drilling events, and the results of such...

40 CFR 194.33 - Consideration of drilling events in performance assessments.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 26 2012-07-01 2011-07-01 true Consideration of drilling events in... and Re-certification Containment Requirements § 194.33 Consideration of drilling events in performance... shall be used in assessing the likelihood and consequences of drilling events, and the results of such...

40 CFR 194.33 - Consideration of drilling events in performance assessments.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Consideration of drilling events in... and Re-certification Containment Requirements § 194.33 Consideration of drilling events in performance... shall be used in assessing the likelihood and consequences of drilling events, and the results of such...

40 CFR 194.33 - Consideration of drilling events in performance assessments.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 26 2013-07-01 2013-07-01 false Consideration of drilling events in... and Re-certification Containment Requirements § 194.33 Consideration of drilling events in performance... shall be used in assessing the likelihood and consequences of drilling events, and the results of such...

How can teachers assess reading skills of generation z learners in German language class?

NASA Astrophysics Data System (ADS)

Dirga, R. N.; Wijayati, P. H.

2018-01-01

Generation Z is a digital native generation who has unique characteristics on the daily basis includes reading. In order to assess their reading skills correctly, teachers need to take these characteristics into consideration. This paper aims to describe the process in developing an instrument to assess reading skills of Generation Z learners in German language class. This study used developmental method. The developed instrument has not only good quality but also consists of texts that are suitable for German learners of Generation Z. This instrument can be used as an example in assessing German learners’ reading skills in the 21st century.

Justification of CT for Individual Health Assessment of Asymptomatic Persons: A World Health Organization Consultation.

PubMed

Malone, Jim; Del Rosario Perez, Maria; Friberg, Eva Godske; Prokop, Mathias; Jung, Seung Eun; Griebel, Jurgen; Ebdon-Jackson, Steve

2016-12-01

An international expert consultation was convened by the World Health Organization (WHO). The purpose of the meeting was to review the use of CT in examining asymptomatic people. This is often referred to as individual health assessment (IHA). IHA was identified as a global phenomenon unenthusiastically tolerated, and not actively promoted, structured, or regulated in most countries. This paper identifies the state of the art for IHA and some considerations in relation to its justification, in different regions of the world. The outcomes reached include the following: questions around terminology and culture of IHA practice; review of IHA in some countries, regions, and international bodies; dilemmas for participants in IHA; risk communication, education, and training for professions and public; the desirability of guidelines and clinical audit; social, ethical, public health, and resource considerations; and a framework for IHA and regulatory considerations. Three subcategories of examination for asymptomatic individuals were identified: formal screening programs; examinations for which the evidence base or risk profile is incomplete; and opportunistic examinations with little or no evidence or risk profile to suggest they have any merit. The latter challenges the justification principle of radiation protection. In addition, the issue of the costs, direct and indirect, associated with false positives and/or equivocal/incidental findings were highlighted. These and other considerations make it difficult to view some IHA as a bona fide medical activity. To allow it to be viewed as such requires that it be conducted within a robust clinical governance framework that includes regulatory dimensions. Copyright © 2016 The World Health Organization. Published by Elsevier Inc. All rights reserved.

Risk Assessment of Adolescents with Intellectual Disabilities Who Exhibit Sexual Behavior Problems or Sexual Offending Behavior.

PubMed

Blasingame, Gerry D

2018-03-30

Adolescents with intellectual disabilities are known to engage in various sexual behavior problems or sexual offending behaviors. This article provides a review of important aspects of risk assessment within the context of a broader, more comprehensive and holistic assessment of these individuals. Pertinent risk and sexual interest assessment tools are identified along with their strengths and limitations. Issues that are often unattended to are addressed, including consideration of the behavioral implications of the young person's diagnosis and level of cognitive functioning, need for sexual knowledge and sexual interest assessment, and issues related to making a mental health diagnosis. Recommendations for future research are also offered.

Aggregate Exposure and Cumulative Risk Assessment—Integrating Occupational and Non-occupational Risk Factors

PubMed Central

Lentz, T. J.; Dotson, G. S.; Williams, P. R.D.; Maier, A.; Gadagbui, B.; Pandalai, S. P.; Lamba, A.; Hearl, F.; Mumtaz, M.

2015-01-01

Occupational exposure limits have traditionally focused on preventing morbidity and mortality arising from inhalation exposures to individual chemical stressors in the workplace. While central to occupational risk assessment, occupational exposure limits have limited application as a refined disease prevention tool because they do not account for all of the complexities of the work and non-occupational environments and are based on varying health endpoints. To be of greater utility, occupational exposure limits and other risk management tools could integrate broader consideration of risks from multiple exposure pathways and routes (aggregate risk) as well as the combined risk from exposure to both chemical and non-chemical stressors, within and beyond the workplace, including the possibility that such exposures may cause interactions or modify the toxic effects observed (cumulative risk). Although still at a rudimentary stage in many cases, a variety of methods and tools have been developed or are being used in allied risk assessment fields to incorporate such considerations in the risk assessment process. These approaches, which are collectively referred to as cumulative risk assessment, have potential to be adapted or modified for occupational scenarios and provide a tangible path forward for occupational risk assessment. Accounting for complex exposures in the workplace and the broader risks faced by the individual also requires a more complete consideration of the composite effects of occupational and non-occupational risk factors to fully assess and manage worker health problems. Barriers to integrating these different factors remain, but new and ongoing community-based and worker health-related initiatives may provide mechanisms for identifying and integrating risk from aggregate exposures and cumulative risks from all relevant sources, be they occupational or non-occupational. PMID:26583907

Assessment of Climate Suitability of Maize in South Korea

NASA Astrophysics Data System (ADS)

Hyun, S.; Choi, D.; Seo, B.

2017-12-01

Assessing suitable areas for crops would be useful to design alternate cropping systems as an adaptation option to climate change adaptation. Although suitable areas could be identified by using a crop growth model, it would require a number of input parameters including cultivar and soil. Instead, a simple climate suitability model, e.g., EcoCrop model, could be used for an assessment of climate suitability for a major grain crop. The objective of this study was to assess of climate suitability for maize using the EcoCrop model under climate change conditions in Korea. A long term climate data from 2000 - 2100 were compiled from weather data source. The EcoCrop model implemented in R was used to determine climate suitability index at each grid cell. Overall, the EcoCrop model tended to identify suitable areas for maize production near the coastal areas whereas the actual major production areas located in inland areas. It is likely that the discrepancy between assessed and actual crop production areas would result from the socioeconomic aspects of maize production. Because the price of maize is considerably low, maize has been grown in an area where moisture and temperature conditions would be less than optimum. In part, a simple algorithm to predict climate suitability for maize would caused a relatively large error in climate suitability assessment under the present climate conditions. In 2050s, the climate suitability for maize increased in a large areas in southern and western part of Korea. In particular, the plain areas near the coastal region had considerably greater suitability index in the future compared with mountainous areas. The expansion of suitable areas for maize would help crop production policy making such as the allocation of rice production area for other crops due to considerably less demand for the rice in Korea.

Woman's Pre-Conception Evaluation: Genetic and Fetal Risk Considerations for Counselling and Informed Choice.

PubMed

Wilson, R Douglas

2017-10-11

To inform reproductive and other health care providers about genetic and fetal risk information to consider during a woman/couples' pre-conception evaluation, including considerations for genetic risk assessment, genetic screening, or testing to allow for improved counselling and informed choice. This genetic information can be used for patient education, planning, and possible pre-conception and/or prenatal testing. This information may allow improved risk assessment for pre-conception counselling for individual patients and their families. PubMed or Medline and the Cochrane Database were searched in May 2017 using appropriate key words ("pre-conception," "genetic disease," "maternal," "family history," "genetic," "health risk," "genetic health surveillance," "prenatal screening," "prenatal diagnosis," "birth defects," and "teratogen"). Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, and national and international medical specialty societies. The benefits for the patient and her family include an increased understanding of relevant genetic risk pre-conception and in early pregnancy, and better pregnancy outcomes as a result of use of the information. The harm includes potential increased anxiety or psychological stress associated with the possibility of identifying genetic risks. The evidence obtained was peer-reviewed by the Genetics Committee of The Society of Obstetricians and Gynaecologists of Canada. Consideration for Care Statements For this review article, the Consideration for Care Statements use the GRADE strength and quality as it is comparable for the clinician and the patient/public user. [GRADE from the Canadian Task Force on Preventive Health Care (www.canadiantaskforce.ca). For clinicians, Strong = The recommendation would apply to most individuals. Formal discussion aids are not likely to be needed to help individuals make decisions consistent with their values and preferences. For patients/public, Strong = We believe most people in this situation would want the recommended course of actions and only a small number would not. Quality of evidence (High, Moderate, Low) based on the confidence that the true effect lies close to that of the estimate of the effect.] Conclusion Pre-conception planning is presently underutilized by both patients and providers. Pre-conception genetic assessment is only a part of the counselling, education, and health management change that can improve perinatal and maternal morbidity and mortality. A published literature review on pre-conception genetic counselling identified mainly clinical cohort studies, surveys, and expert opinion with no RCTs. There is strong support for pre-conception counselling and moderate quality based on the understanding that most individuals would support and use pre-conception counselling when choice, timing, and ease of access is considered. Copyright © 2017 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

Human epidemiology: A review of fiber type and characteristics in the development of malignant and nonmalignant disease

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

Merchant, J.A.

1990-08-01

Consideration of the human epidemiology of diseases arising from exposure to naturally occurring and man-made mineral fibers encompasses the several forms of asbestos, other naturally occurring silicates, and man-made mineral fibers. The diseases arising from exposures to some of these fibers include pleural thickening, pulmonary fibrosis, lung cancers, mesothelioma of the pleura and peritoneum, and other cancers. Risk factors important in assessing these diseases include assessment of latency, duration of exposure, cumulative exposure, fiber origin and characteristics, other possible confounding occupational or environmental exposures, and smoking. Methodological issues commonly presenting problems in evaluation of these data include assessment of themore » adequacy of environmental exposures, particularly in regard to fiber identification, distribution, and concentration over the duration of exposure, and the adequacy of study design to detect health effects. Research priorities include further assessment and standardization of pleural thickening relative to fiber exposure, uniform mesothelioma surveillance, further epidemiological assessment of certain silicate and man-made mineral fiber cohorts with emphasis given to assessment of tremolite and small diameter glass and ceramic fibers. Further assessment of possible health risks of the general public should await improved definition of relevant fiber exposure in ambient air.« less

Health Monitoring System Technology Assessments: Cost Benefits Analysis

NASA Technical Reports Server (NTRS)

Kent, Renee M.; Murphy, Dennis A.

2000-01-01

The subject of sensor-based structural health monitoring is very diverse and encompasses a wide range of activities including initiatives and innovations involving the development of advanced sensor, signal processing, data analysis, and actuation and control technologies. In addition, it embraces the consideration of the availability of low-cost, high-quality contributing technologies, computational utilities, and hardware and software resources that enable the operational realization of robust health monitoring technologies. This report presents a detailed analysis of the cost benefit and other logistics and operational considerations associated with the implementation and utilization of sensor-based technologies for use in aerospace structure health monitoring. The scope of this volume is to assess the economic impact, from an end-user perspective, implementation health monitoring technologies on three structures. It specifically focuses on evaluating the impact on maintaining and supporting these structures with and without health monitoring capability.

Approving for a community aged care package: experiences and perceptions of six metropolitan aged care assessment service teams.

PubMed

Stephens, Delwyne; Wells, Yvonne; Gardner, Ian

2011-06-01

To establish whether the experiences and perceptions of different metropolitan Aged Care Assessment Service (ACAS) teams when approving people for Community Aged Care Packages (CACPs) were similar. Six semi-structured 30-minute group interviews were completed. ACAS team approval processes for CACPs were similar. The primary criterion for approval was need for case management. Many factors, however, impinged on the approval process. Barriers to making approvals included long waiting times, a lack of confidence in the priority rating system, and consideration of whether a person was better off with Home and Community Care services because of the impact of the Australian Government's Cost Recovery policy. ACAS teams have competing considerations when approving a person for a CACP. In particular, structural barriers, such as cost recovery policies, can have a significant negative impact on approval decisions. © 2010 The Authors. Journal compilation © 2010 ACOTA.

Considerations of informed consent and decision-making competence in older adults with cognitive impairment.

PubMed

Mayo, Ann M; Wallhagen, Margaret I

2009-04-01

Including older adults with cognitive impairment in research studies is necessary to ensure that interventions designed to improve care are effective for all older adults. However, issues related to capacity to consent raise many difficult questions that nurse researchers must address. Protecting vulnerable participants while simultaneously maintaining autonomy and moving important research forward can be challenging. Assessing the decision-making abilities of understanding, appreciation, reasoning, and expressing a choice is an important aspect of determining decision-making capacity. Yet although this is the prominent rational method for judging decision-making competence, it does not take into consideration the importance of culture, values, and emotions. This article focuses on the assessment of decision-making capacity to consent, recommendations for obtaining informed consent in older adults with cognitive impairment, the use of surrogate decision makers, strategies to maximize research participation, and directions for future research. Copyright 2009, SLACK Incorporated.

Psychological and psychosexual aspects of vulvar vestibulitis.

PubMed Central

Nunns, D; Mandal, D

1997-01-01

AIMS: To objectively assess the psychological and psychosexual morbidity of patients with vulvar vestibulitis. METHODS: 30 patients with variable degrees of vulvar vestibulitis were recruited from a vulval clinic. Each patient underwent a detailed history and clinical examination. Friedrich's criteria were used for the diagnosis of vulvar vestibulitis. Standardised questionnaires to assess psychological and psychosexual function were completed by the patient before review. These questionnaires were the STAI and a modified psychosexual questionnaire introduced by Campion. RESULTS: Patients experienced considerable psychological dysfunction compared with controls. All aspects of psychosexual dysfunction were affected. CONCLUSIONS: When managing patients, psychosexual and psychological issues must be considered in addition to other conventional types of therapy. Vulvar vestibulitis may be a risk factor for developing psychosexual complications including vaginismus, low libido, and orgasmic dysfunction. Consideration of these factors must be an integral part of the management of patients with all chronic vulval conditions. PMID:9582478

Decreased pain sensitivity due to trimethylbenzene exposure ...

EPA Pesticide Factsheets

Traditionally, human health risk assessments have relied on qualitative approaches for hazard identification, often using the Hill criteria and weight of evidence determinations to integrate data from multiple studies. Recently, the National Research Council has recommended the development of quantitative approaches for evidence integration, including the application of meta-analyses. The following hazard identification case study applies qualitative as well as meta-analytic approaches to trimethylbenzene (TMB) isomers exposure and the potential neurotoxic effects on pain sensitivity. In the meta-analytic approach, a pooled effect size is calculated, after consideration of multiple confounding factors, in order to determine whether the entire database under consideration indicates that TMBs are likely to be a neurotoxic hazard. The pain sensitivity studies included in the present analyses initially seem discordant in their results: effects on pain sensitivity are seen immediately after termination of exposure, appear to resolve 24 hours after exposure, and then reappear 50 days later following foot-shock. Qualitative consideration of toxicological and toxicokinetic characteristics of the TMB isomers suggests that the observed differences between studies are due to testing time and can be explained through a complete consideration of the underlying biology of the effect and the nervous system as a whole. Meta-analyses and –regressions support this conclus

76 FR 34250 - Notice of Intent To Prepare an Environmental Assessment for the Proposed Gila Lower Box Area of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-13

... management prescriptions should apply? 7. What potential impacts would this proposed action have on neighboring private landowners? 8. What effects would this proposed action have on recreation and tourism in... accordance with policy, and tribal concerns will be given due consideration, including impacts on Indian...

Program Adaptations for Students in Four Selected Sports: Badminton, Golf, Archery, and Tennis.

ERIC Educational Resources Information Center

Cowart, Jim

1982-01-01

The booklet reviews ways in which students with crutches may be helped to successfully participate in four specific sports. General guidelines for modifying programs for this group include the importance of thorough assessment, attention to details of the game play, and consideration of equipment and supply alterations. Each of the four sports is…

Checklist of Library Building Design Considerations. Fourth Edition.

ERIC Educational Resources Information Center

Sannwald, William W.

This checklist serves as a guide during various stages of a library design process to help ensure that all needed spaces and functions are included, to help enable the evaluation of existing library spaces as part of a library's needs assessment process, and to help provide data and support to the library in presentations that might be made to…

Setting the Research and Practice Agenda for Anxiety in Children and Adolescence: A Topic Comes of Age

ERIC Educational Resources Information Center

Kendall, Philip C.; Ollendick, Thomas H.

2004-01-01

Select research and practice issues that merit further attention are described. Specifically, we argue that the pathways for profitable research include studies of normative development, assessment and diagnostic considerations, the role of parents, and the ways to optimize the conduct and evaluation of treatment. At present, the field is too…

Transition to College and Students with High Functioning Autism Spectrum Disorder: Strategy Considerations for School Counselors

ERIC Educational Resources Information Center

Dipeolu, Abiola O.; Storlie, Cassandra; Johnson, Carol

2014-01-01

There are limited school counseling resources that address the unique post high school transition issues faced by students with High-functioning Autism Spectrum Disorder (HASD). While many school counselors have excellent skills in assessment, advising, and career planning, it is worthwhile to expand these to include working with students with…

Approaches to assessment in time-limited Mentalization-Based Therapy for Children (MBT-C)

PubMed Central

Muller, Nicole; Midgley, Nick

2015-01-01

In this article we describe our clinical approach to assessment, formulation and the identification of a therapeutic focus in the context of time-limited Mentalization-Based Treatment for Children (MBT-C) aged between 6 and 12. Rather than seeing the capacity to mentalize as a global construct, we set out an approach to assessing the developmental ‘building blocks’ of the capacity to mentalize the self and others, including the capacity for attention regulation, emotion regulation, and explicit mentalization. Assessing the child’s strengths and vulnerabilities in each of these domains provides a more nuanced picture of the child’s mentalizing capacities and difficulties, and can provide a useful approach to case formulation. The article sets out an approach to assessment that includes a consideration of mentalizing strengths and difficulties in both the child and the parents, and shows how this can be used to help develop a mutually agreed treatment focus. A clinical vignette illustrates the approach taken to assessment and connects it to routine clinical practice. PMID:26283994

Imaging Modalities Relevant to Intracranial Pressure Assessment in Astronauts: A Case-Based Discussion

NASA Technical Reports Server (NTRS)

Sargsyan, Ashot E.; Kramer, Larry A.; Hamilton, Douglas R.; Hamilton, Douglas R.; Fogarty, Jennifer; Polk, J. D.

2010-01-01

Introduction: Intracranial pressure (ICP) elevation has been inferred or documented in a number of space crewmembers. Recent advances in noninvasive imaging technology offer new possibilities for ICP assessment. Most International Space Station (ISS) partner agencies have adopted a battery of occupational health monitoring tests including magnetic resonance imaging (MRI) pre- and postflight, and high-resolution sonography of the orbital structures in all mission phases including during flight. We hypothesize that joint consideration of data from the two techniques has the potential to improve quality and continuity of crewmember monitoring and care. Methods: Specially designed MRI and sonographic protocols were used to image eyes and optic nerves (ON) including the meningeal sheaths. Specific crewmembers multi-modality imaging data were analyzed to identify points of mutual validation as well as unique features of complementary nature. Results and Conclusion: Magnetic resonance imaging (MRI) and high-resolution sonography are both tomographic methods, however images obtained by the two modalities are based on different physical phenomena and use different acquisition principles. Consideration of the images acquired by these two modalities allows cross-validating findings related to the volume and fluid content of the ON subarachnoid space, shape of the globe, and other anatomical features of the orbit. Each of the imaging modalities also has unique advantages, making them complementary techniques.

Environmental health impact assessment: evaluation of a ten-step model.

PubMed

Fehr, R

1999-09-01

"Environmental impact assessment" denotes the attempt to predict and assess the impact of development projects on the environment. A component dealing specifically with human health is often called an "environmental health impact assessment." It is widely held that such impact assessment offers unique opportunities for the protection and promotion of human health. The following components were identified as key elements of an integrated environmental health impact assessment model: project analysis, analysis of status quo (including regional analysis, population analysis, and background situation), prediction of impact (including prognosis of future pollution and prognosis of health impact), assessment of impact, recommendations, communication of results, and evaluation of the overall procedure. The concept was applied to a project of extending a waste disposal facility and to a city bypass highway project. Currently, the coverage of human health aspects in environmental impact assessment still tends to be incomplete, and public health departments often do not participate. Environmental health impact assessment as a tool for health protection and promotion is underutilized. It would be useful to achieve consensus on a comprehensive generic concept. An international initiative to improve the situation seems worth some consideration.

Primary cerebral lymphoma: clinical and aeromedical considerations.

PubMed

Storms, Patrick R

2007-04-01

Cancer, and the complications of cancer therapy, can present significant obstacles to the airman wishing to return to flying status. If found to be free of recurrent lymphoma and to be neurologically intact after completion of therapy, applicants can be considered for a time-limited medical certificate, provided that they are otherwise qualified. Long-term follow up of patients must include not only disease-free survival time, but also serial neuropsychometric evaluation and quality-of-life assessments. This case illustrates the aeromedical considerations and certification issues for a patient presenting with performance issues progressing to discreet neurological findings, culminating in the diagnosis and treatment of primary central nervous system (CNS) lymphoma.

Refusal of Emergency Medical Treatment: Case Studies and Ethical Foundations.

PubMed

Marco, Catherine A; Brenner, Jay M; Kraus, Chadd K; McGrath, Norine A; Derse, Arthur R

2017-11-01

Informed consent is an important component of emergency medical treatment. Most emergency department patients can provide informed consent for treatment upon arrival. Informed consent should also be obtained for emergency medical interventions that may entail significant risk. A related concept to informed consent is informed refusal of treatment. Patients may refuse emergency medical treatment during their evaluation and treatment. This article addresses important considerations for patients who refuse treatment, including case studies and discussion of definitions, epidemiology, assessment of decisional capacity, information delivery, medicolegal considerations, and alternative care plans. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Climate Change, Migration, and Allergic Respiratory Diseases: An Update for the Allergist

PubMed Central

Rottem, Menachem; Dahl, Ronald; Blaiss, Michael; Ridolo, Erminia; Cecchi, Lorenzo; Rosario, Nelson; Motala, Cassim; Ansotegui, Ignacio; Annesi-Maesano, Isabella

2011-01-01

Abstract Local climate changes can impact on a number of factors, including air pollution, that have been shown to influence both the development and attacks of allergic respiratory diseases, and thus, they represent an important consideration for the allergist. Migration involves exposure to a new set of pollutants and allergens as well as changes in housing conditions, diet, and accessibility to medical services, all of which are likely to affect migrants' health. This review provides an update on climate change, migration, and allergy and discusses factors for consideration when making recommendations for local allergy service provision and for assessing an individual patient's environmental exposures. PMID:23268459

The predictive value of chronic kidney disease for assessing cardiovascular events under consideration of pretest probability for coronary artery disease in patients who underwent stress myocardial perfusion imaging.

PubMed

Furuhashi, Tatsuhiko; Moroi, Masao; Joki, Nobuhiko; Hase, Hiroki; Masai, Hirofumi; Kunimasa, Taeko; Fukuda, Hiroshi; Sugi, Kaoru

2013-02-01

Pretest probability of coronary artery disease (CAD) facilitates diagnosis and risk stratification of CAD. Stress myocardial perfusion imaging (MPI) and chronic kidney disease (CKD) are established major predictors of cardiovascular events. However, the role of CKD to assess pretest probability of CAD has been unclear. This study evaluates the role of CKD to assess the predictive value of cardiovascular events under consideration of pretest probability in patients who underwent stress MPI. Patients with no history of CAD underwent stress MPI (n = 310; male = 166; age = 70; CKD = 111; low/intermediate/high pretest probability = 17/194/99) and were followed for 24 months. Cardiovascular events included cardiac death and nonfatal acute coronary syndrome. Cardiovascular events occurred in 15 of the 310 patients (4.8 %), but not in those with low pretest probability which included 2 CKD patients. In patients with intermediate to high pretest probability (n = 293), multivariate Cox regression analysis identified only CKD [hazard ratio (HR) = 4.88; P = 0.022) and summed stress score of stress MPI (HR = 1.50; P < 0.001) as independent and significant predictors of cardiovascular events. Cardiovascular events were not observed in patients with low pretest probability. In patients with intermediate to high pretest probability, CKD and stress MPI are independent predictors of cardiovascular events considering the pretest probability of CAD in patients with no history of CAD. In assessing pretest probability of CAD, CKD might be an important factor for assessing future cardiovascular prognosis.

The failure to fail underperforming trainees in health professions education: A BEME systematic review: BEME Guide No. 42.

PubMed

Yepes-Rios, Monica; Dudek, Nancy; Duboyce, Rita; Curtis, Jerri; Allard, Rhonda J; Varpio, Lara

2016-11-01

Many clinical educators feel unprepared and/or unwilling to report unsatisfactory trainee performance. This systematic review consolidates knowledge from medical, nursing, and dental literature on the experiences and perceptions of evaluators or assessors with this failure to fail phenomenon. We searched the English language literature in CINAHL, EMBASE, and MEDLINE from January 2005 to January 2015. Qualitative and quantitative studies were included. Following our review protocol, registered with BEME, reviewers worked in pairs to identify relevant articles. The investigators participated in thematic analysis of the qualitative data reported in these studies. Through several cycles of analysis, discussion and reflection, the team identified the barriers and enablers to failing a trainee. From 5330 articles, we included 28 publications in the review. The barriers identified were (1) assessor's professional considerations, (2) assessor's personal considerations, (3) trainee related considerations, (4) unsatisfactory evaluator development and evaluation tools, (5) institutional culture and (6) consideration of available remediation for the trainee. The enablers identified were: (1) duty to patients, to society, and to the profession, (2) institutional support such as backing a failing evaluation, support from colleagues, evaluator development, and strong assessment systems, and (3) opportunities for students after failing. The inhibiting and enabling factors to failing an underperforming trainee were common across the professions included in this study, across the 10 years of data, and across the educational continuum. We suggest that these results can inform efforts aimed at addressing the failure to fail problem.

Analogy in causal inference: rethinking Austin Bradford Hill's neglected consideration.

PubMed

Weed, Douglas L

2018-05-01

The purpose of this article was to rethink and resurrect Austin Bradford Hill's "criterion" of analogy as an important consideration in causal inference. In epidemiology today, analogy is either completely ignored (e.g., in many textbooks), or equated with biologic plausibility or coherence, or aligned with the scientist's imagination. None of these examples, however, captures Hill's description of analogy. His words suggest that there may be something gained by contrasting two bodies of evidence, one from an established causal relationship, the other not. Coupled with developments in the methods of systematic assessments of evidence-including but not limited to meta-analysis-analogy can be restructured as a key component in causal inference. This new approach will require that a collection-a library-of known cases of causal inference (i.e., bodies of evidence involving established causal relationships) be developed. This library would likely include causal assessments by organizations such as the International Agency for Research on Cancer, the National Toxicology Program, and the United States Environmental Protection Agency. In addition, a process for describing key features of a causal relationship would need to be developed along with what will be considered paradigm cases of causation. Finally, it will be important to develop ways to objectively compare a "new" body of evidence with the relevant paradigm case of causation. Analogy, along with all other existing methods and causal considerations, may improve our ability to identify causal relationships. Copyright © 2018 Elsevier Inc. All rights reserved.

78 FR 52854 - Use of Differential Income Stream as an Application of the Income Method and as a Consideration...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-27

... Differential Income Stream as an Application of the Income Method and as a Consideration in Assessing the Best Method AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Final regulations and removal of... differential income stream as a consideration in assessing the best method in connection with a cost sharing...

Extending Vulnerability Assessment to Include Life Stages Considerations

PubMed Central

Hodgson, Emma E.; Essington, Timothy E.; Kaplan, Isaac C.

2016-01-01

Species are experiencing a suite of novel stressors from anthropogenic activities that have impacts at multiple scales. Vulnerability assessment is one tool to evaluate the likely impacts that these stressors pose to species so that high-vulnerability cases can be identified and prioritized for monitoring, protection, or mitigation. Commonly used semi-quantitative methods lack a framework to explicitly account for differences in exposure to stressors and organism responses across life stages. Here we propose a modification to commonly used spatial vulnerability assessment methods that includes such an approach, using ocean acidification in the California Current as an illustrative case study. Life stage considerations were included by assessing vulnerability of each life stage to ocean acidification and were used to estimate population vulnerability in two ways. We set population vulnerability equal to: (1) the maximum stage vulnerability and (2) a weighted mean across all stages, with weights calculated using Lefkovitch matrix models. Vulnerability was found to vary across life stages for the six species explored in this case study: two krill–Euphausia pacifica and Thysanoessa spinifera, pteropod–Limacina helicina, pink shrimp–Pandalus jordani, Dungeness crab–Metacarcinus magister and Pacific hake–Merluccius productus. The maximum vulnerability estimates ranged from larval to subadult and adult stages with no consistent stage having maximum vulnerability across species. Similarly, integrated vulnerability metrics varied greatly across species. A comparison showed that some species had vulnerabilities that were similar between the two metrics, while other species’ vulnerabilities varied substantially between the two metrics. These differences primarily resulted from cases where the most vulnerable stage had a low relative weight. We compare these methods and explore circumstances where each method may be appropriate. PMID:27416031

Extending Vulnerability Assessment to Include Life Stages Considerations.

PubMed

Hodgson, Emma E; Essington, Timothy E; Kaplan, Isaac C

2016-01-01

Species are experiencing a suite of novel stressors from anthropogenic activities that have impacts at multiple scales. Vulnerability assessment is one tool to evaluate the likely impacts that these stressors pose to species so that high-vulnerability cases can be identified and prioritized for monitoring, protection, or mitigation. Commonly used semi-quantitative methods lack a framework to explicitly account for differences in exposure to stressors and organism responses across life stages. Here we propose a modification to commonly used spatial vulnerability assessment methods that includes such an approach, using ocean acidification in the California Current as an illustrative case study. Life stage considerations were included by assessing vulnerability of each life stage to ocean acidification and were used to estimate population vulnerability in two ways. We set population vulnerability equal to: (1) the maximum stage vulnerability and (2) a weighted mean across all stages, with weights calculated using Lefkovitch matrix models. Vulnerability was found to vary across life stages for the six species explored in this case study: two krill-Euphausia pacifica and Thysanoessa spinifera, pteropod-Limacina helicina, pink shrimp-Pandalus jordani, Dungeness crab-Metacarcinus magister and Pacific hake-Merluccius productus. The maximum vulnerability estimates ranged from larval to subadult and adult stages with no consistent stage having maximum vulnerability across species. Similarly, integrated vulnerability metrics varied greatly across species. A comparison showed that some species had vulnerabilities that were similar between the two metrics, while other species' vulnerabilities varied substantially between the two metrics. These differences primarily resulted from cases where the most vulnerable stage had a low relative weight. We compare these methods and explore circumstances where each method may be appropriate.

Understanding relevance of health research: considerations in the context of research impact assessment.

PubMed

Dobrow, Mark J; Miller, Fiona A; Frank, Cy; Brown, Adalsteinn D

2017-04-17

With massive investment in health-related research, above and beyond investments in the management and delivery of healthcare and public health services, there has been increasing focus on the impact of health research to explore and explain the consequences of these investments and inform strategic planning. Relevance is reflected by increased attention to the usability and impact of health research, with research funders increasingly engaging in relevance assessment as an input to decision processes. Yet, it is unclear whether relevance is a synonym for or predictor of impact, a necessary condition or stage in achieving it, or a distinct aim of the research enterprise. The main aim of this paper is to improve our understanding of research relevance, with specific objectives to (1) unpack research relevance from both theoretical and practical perspectives, and (2) outline key considerations for its assessment. Our approach involved the scholarly strategy of review and reflection. We prepared a draft paper based on an exploratory review of literature from various fields, and gained from detailed and insightful analysis and critique at a roundtable discussion with a group of key health research stakeholders. We also solicited review and feedback from a small sample of expert reviewers. Research relevance seems increasingly important in justifying research investments and guiding strategic research planning. However, consideration of relevance has been largely tacit in the health research community, often depending on unexplained interpretations of value, fit and potential for impact. While research relevance seems a necessary condition for impact - a process or component of efforts to make rigorous research usable - ultimately, relevance stands apart from research impact. Careful and explicit consideration of research relevance is vital to gauge the overall value and impact of a wide range of individual and collective research efforts and investments. To improve understanding, this paper outlines four key considerations, including how research relevance assessments (1) orientate to, capture and compare research versus non-research sources, (2) consider both instrumental versus non-instrumental uses of research, (3) accommodate dynamic temporal-shifting perspectives on research, and (4) align with an intersubjective understanding of relevance.

Further exploration of dissemination bias in qualitative research required to facilitate assessment within qualitative evidence syntheses.

PubMed

Toews, Ingrid; Booth, Andrew; Berg, Rigmor C; Lewin, Simon; Glenton, Claire; Munthe-Kaas, Heather M; Noyes, Jane; Schroter, Sara; Meerpohl, Joerg J

2017-08-01

To conceptualise and discuss dissemination bias in qualitative research. It is likely that the mechanisms leading to dissemination bias in quantitative research, including time lag, language, gray literature, and truncation bias also contribute to dissemination bias in qualitative research. These conceptual considerations have informed the development of a research agenda. Further exploration of dissemination bias in qualitative research is needed, including the extent of non-dissemination and related dissemination bias, and how to assess dissemination bias within qualitative evidence syntheses. We also need to consider the mechanisms through which dissemination bias in qualitative research could occur to explore approaches for reducing it. Copyright © 2017 Elsevier Inc. All rights reserved.

Regulatory assessment of reproductive toxicology data.

PubMed

Davidson, Elizabeth

2013-01-01

This chapter outlines a regulator's personal approach to the assessment of reproductive toxicology data in the context of the assessment of the overall nonclinical data package for pharmaceutical agents. Using as a framework the International Conference on Harmonisation Common Technical Document headings, guidance is provided on the expectations of regulators for the presentation and discussion of the data by the applicant to facilitate the risk assessment process. Consideration is given to the use of reproductive toxicology data in the assessment process for both clinical trial applications (CTAs) and marketing authorization applications (MAAs). Suggestions for some guiding principles in drafting of the various product information documents (for example the Investigator's Brochure (IB) for CTAs and the Nonclinical Overview and Summary of Product Characteristics for MAAs) are included.

Considerations for the nonclinical safety evaluation of antibody drug conjugates for oncology.

PubMed

Roberts, Stanley A; Andrews, Paul A; Blanset, Diann; Flagella, Kelly M; Gorovits, Boris; Lynch, Carmel M; Martin, Pauline L; Kramer-Stickland, Kimberly; Thibault, Stephane; Warner, Garvin

2013-12-01

Antibody drug conjugates (ADCs) include monoclonal antibodies that are linked to cytotoxic small molecules. A number of these agents are currently being developed as anti-cancer agents designed to improve the therapeutic index of the cytotoxin (i.e., cytotoxic small molecule or cytotoxic agent) by specifically delivering it to tumor cells. This paper presents primary considerations for the nonclinical safety evaluation of ADCs and includes strategies for the evaluation of the entire ADC or the various individual components (i.e., antibody, linker or the cytotoxin). Considerations are presented on how to design a nonclinical safety assessment program to identify the on- and off-target toxicities to enable first-in-human (FIH) studies. Specific discussions are also included that provide details as to the need and how to conduct the studies for evaluating ADCs in genetic toxicology, tissue cross-reactivity, safety pharmacology, carcinogenicity, developmental and reproductive toxicology, biotransformation, toxicokinetic monitoring, bioanalytical assays, immunogenicity testing, test article stability and the selection of the FIH dose. Given the complexity of these molecules and our evolving understanding of their properties, there is no single all-encompassing nonclinical strategy. Instead, each ADC should be evaluated on a case-by-case scientifically-based approach that is consistent with ICH and animal research guidelines. Copyright © 2013 Elsevier Inc. All rights reserved.

Operational Implementation of a Pc Uncertainty Construct for Conjunction Assessment Risk Analysis

NASA Technical Reports Server (NTRS)

Newman, Lauri K.; Hejduk, Matthew D.; Johnson, Lauren C.

2016-01-01

Earlier this year the NASA Conjunction Assessment and Risk Analysis (CARA) project presented the theoretical and algorithmic aspects of a method to include the uncertainties in the calculation inputs when computing the probability of collision (Pc) between two space objects, principally uncertainties in the covariances and the hard-body radius. The output of this calculation approach is to produce rather than a single Pc value an entire probability density function that will represent the range of possible Pc values given the uncertainties in the inputs and bring CA risk analysis methodologies more in line with modern risk management theory. The present study provides results from the exercise of this method against an extended dataset of satellite conjunctions in order to determine the effect of its use on the evaluation of conjunction assessment (CA) event risk posture. The effects are found to be considerable: a good number of events are downgraded from or upgraded to a serious risk designation on the basis of consideration of the Pc uncertainty. The findings counsel the integration of the developed methods into NASA CA operations.

Cost considerations in using simulations for medical training.

PubMed

Fletcher, J D; Wind, Alexander P

2013-10-01

This article reviews simulation used for medical training, techniques for assessing simulation-based training, and cost analyses that can be included in such assessments. Simulation in medical training appears to take four general forms: human actors who are taught to simulate illnesses and ailments in standardized ways; virtual patients who are generally presented via computer-controlled, multimedia displays; full-body manikins that simulate patients using electronic sensors, responders, and controls; and part-task anatomical simulations of various body parts and systems. Techniques for assessing costs include benefit-cost analysis, return on investment, and cost-effectiveness analysis. Techniques for assessing the effectiveness of simulation-based medical training include the use of transfer effectiveness ratios and incremental transfer effectiveness ratios to measure transfer of knowledge and skill provided by simulation to the performance of medical procedures. Assessment of costs and simulation effectiveness can be combined with measures of transfer using techniques such as isoperformance analysis to identify ways of minimizing costs without reducing performance effectiveness or maximizing performance without increasing costs. In sum, economic analysis must be considered in training assessments if training budgets are to compete successfully with other requirements for funding. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

L'Harmonisation des langues Maliennes: Entre l'intregration nationale et regionale (The Harmonization of the Malian Languages: Between National and Regional Integration).

ERIC Educational Resources Information Center

Ouane, Adama

1991-01-01

Assesses efforts to standardize the Malian languages, including the standardization of orthography and the creation of terminology in the Mandingo-Peul Project. Points to conflicts between technical and political considerations, and between local tendencies and balances among languages and the need to respect the ecolinguistics of the country.…

Biological invasion hotspots: a trait-based perspective reveals new sub-continental patterns

Treesearch

Basil V. Iannone III; Kevin M. Potter; Qinfeng Guo; Andrew M. Liebhold; Bryan C. Pijanowski; Christopher M. Oswalt; Songlin Fei

2015-01-01

Invader traits (including plant growth form) may play an important, and perhaps overlooked, role in determining macroscale patterns of biological invasions and therefore warrant greater consideration in future investigations aimed at understanding these patterns. To assess this need, we used empirical data from a national-level survey of forest in the contiguous 48...

Practical Considerations When Using Perturbed Forest Inventory Plot Locations To Develop Spatial Models: A Case Study

Treesearch

John W. Coulston; Gregory A. Reams; Ronald E. McRoberts; William D. Smith

2006-01-01

U.S. Department of Agriculture Forest Service Forest Inventory and Analysis plot information is used in many capacities including timber inventories, forest health assessments, and environmental risk analyses. With few exceptions, actual plot locations cannot be revealed to the general public. The public does, however, have access to perturbed plot coordinates. The...

Assessment of Asphalt Concrete Reinforcement Grid in Flexible Pavements

DTIC Science & Technology

2016-05-01

Guide for the Design of Pavement Structures (1993) remains in use and describes in detail the accepted procedures for both the design and maintenance...of pavement structures. Design considerations include pavement perfor- mance, traffic, subgrade soil, construction materials, environment, drain- age...Association of State Highway and Transportation Officials). 1993. Guide for the Design of Pavement Structures. Washington, DC: American Association of

The Michigan Context and Performance Report Card: Public Elementary and Middle Schools, 2015

ERIC Educational Resources Information Center

Spalding, Audrey; DeGrow, Ben

2016-01-01

This is the Mackinac Center's fourth school report card and covers elementary and middle schools. A similar report card was published in 2013, and this edition includes two years' worth of new data. A unique characteristic of this report card is that takes into consideration the "context" of a school when assessing its performance.…

The Structure of Memory in Infants and Toddlers: An SEM Study with Full-Terms and Preterms

ERIC Educational Resources Information Center

Rose, Susan A.; Feldman, Judith F.; Jankowski, Jeffery J.; Van Rossem, Ronan

2011-01-01

There is considerable dispute about the nature of infant memory. Using SEM models, we examined whether popular characterizations of the structure of adult memory, including the two-process theory of recognition, are applicable in the infant and toddler years. The participants were a cohort of preterms and full-terms assessed longitudinally--at 1,…

Emotional and Behavioural Difficulties among Middle School Students in Oman: An Examination of Prevalence Rate and Gender Differences

ERIC Educational Resources Information Center

Emam, Mahmoud Mohamed; Kazem, Ali Mahdi; Al-Zubaidy, Abdulqawi Salim

2016-01-01

Children with emotional and behavioural difficulties (EBDs) began to receive considerable attention in several countries in the Middle East and North Africa region including Oman. In the Omani context, there is lack of valid assessment instruments which can be used to obtain information on EBDs in schools. The current study used the Arabic…

Family-Based Treatment for Adolescents with Anorexia Nervosa: A Dissemination Study

PubMed Central

Couturier, Jennifer; Isserlin, Leanna; Lock, James

2010-01-01

Objective This open trial of Family-Based Treatment for Anorexia Nervosa was completed in order to assess the dissemination of this treatment, including effectiveness, fidelity, and acceptability. Method Fourteen adolescents with Anorexia Nervosa were recruited with mean age 14.0±1.5 years (range 12–17 years). Therapists were trained using a workshop, manual and weekly supervision. Sessions were videotaped and rated for treatment fidelity. Pre- and post-treatment assessments were compared. Results Weight was significantly increased by an average of 7.8 kg. Dietary restraint showed significant improvement, as did interoceptive deficits and maturity fears. Of the 9 participants who had secondary amenorrhea at baseline, 8 had regained menstrual function. Treatment fidelity was rated as at least considerable 72% of the time in phase I of the treatment. Adolescents and parents found the treatment to be acceptable. Discussion This preliminary investigation of the dissemination of Family-Based Treatment for adolescents with Anorexia Nervosa indicates that this treatment is effective not only for weight restoration, but also in improving some psychological symptoms including dietary restraint, interoceptive deficits, and maturity fears. In addition, this treatment was adopted with considerable fidelity and was acceptable to adolescents and parents. PMID:20419524

It Is Time to Rethink Central Auditory Processing Disorder Protocols for School-Aged Children.

PubMed

DeBonis, David A

2015-06-01

The purpose of this article is to review the literature that pertains to ongoing concerns regarding the central auditory processing construct among school-aged children and to assess whether the degree of uncertainty surrounding central auditory processing disorder (CAPD) warrants a change in current protocols. Methodology on this topic included a review of relevant and recent literature through electronic search tools (e.g., ComDisDome, PsycINFO, Medline, and Cochrane databases); published texts; as well as published articles from the Journal of the American Academy of Audiology; the American Journal of Audiology; the Journal of Speech, Language, and Hearing Research; and Language, Speech, and Hearing Services in Schools. This review revealed strong support for the following: (a) Current testing of CAPD is highly influenced by nonauditory factors, including memory, attention, language, and executive function; (b) the lack of agreement regarding the performance criteria for diagnosis is concerning; (c) the contribution of auditory processing abilities to language, reading, and academic and listening abilities, as assessed by current measures, is not significant; and (d) the effectiveness of auditory interventions for improving communication abilities has not been established. Routine use of CAPD test protocols cannot be supported, and strong consideration should be given to redirecting focus on assessing overall listening abilities. Also, intervention needs to be contextualized and functional. A suggested protocol is provided for consideration. All of these issues warrant ongoing research.

Fault Current Distribution and Pole Earth Potential Rise (EPR) Under Substation Fault

NASA Astrophysics Data System (ADS)

Nnassereddine, M.; Rizk, J.; Hellany, A.; Nagrial, M.

2013-09-01

New high-voltage (HV) substations are fed by transmission lines. The position of these lines necessitates earthing design to ensure safety compliance of the system. Conductive structures such as steel or concrete poles are widely used in HV transmission mains. The earth potential rise (EPR) generated by a fault at the substation could result in an unsafe condition. This article discusses EPR based on substation fault. The pole EPR assessment under substation fault is assessed with and without mutual impedance consideration. Split factor determination with and without the mutual impedance of the line is also discussed. Furthermore, a simplified formula to compute the pole grid current under substation fault is included. Also, it includes the introduction of the n factor which determines the number of poles that required earthing assessments under substation fault. A case study is shown.

Common Operating Picture: UAV Security Study

NASA Technical Reports Server (NTRS)

2004-01-01

This initial communication security study is a top-level assessment of basic security issues related to the operation of Unmanned Aerial Vehicles (UAVs) in the National Airspace System (NAS). Security considerations will include information relating to the use of International Civil Aviation Organization (ICAO) Aeronautical Telecommunications Network (ATN) protocols and applications identifying their maturity, as well as the use of IPV4 and a version of mobile IPV6. The purpose of this assessment is to provide an initial analysis of the security implications of introducing UAVs into the NAS.

Implementing AORN recommended practices for minimally invasive surgery: part I.

PubMed

Morton, Paula J

2012-09-01

This article focuses on the patient safety aspects of the revised AORN "Recommended practices for minimally invasive surgery" (MIS). Key considerations include ensuring proper fluid management practices, assessing patients for risk factors related to MIS, implementing precautions for electrosurgery, planning for risks related to MIS, and assessing patients postoperatively for potential complications related to MIS. Collaboration and collegiality among members of the surgical team are essential for ensuring all pertinent aspects of care are recognized and considered. Copyright © 2012 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Consideration of VT5 etch-based OPC modeling

NASA Astrophysics Data System (ADS)

Lim, ChinTeong; Temchenko, Vlad; Kaiser, Dieter; Meusel, Ingo; Schmidt, Sebastian; Schneider, Jens; Niehoff, Martin

2008-03-01

Including etch-based empirical data during OPC model calibration is a desired yet controversial decision for OPC modeling, especially for process with a large litho to etch biasing. While many OPC software tools are capable of providing this functionality nowadays; yet few were implemented in manufacturing due to various risks considerations such as compromises in resist and optical effects prediction, etch model accuracy or even runtime concern. Conventional method of applying rule-based alongside resist model is popular but requires a lot of lengthy code generation to provide a leaner OPC input. This work discusses risk factors and their considerations, together with introduction of techniques used within Mentor Calibre VT5 etch-based modeling at sub 90nm technology node. Various strategies are discussed with the aim of better handling of large etch bias offset without adding complexity into final OPC package. Finally, results were presented to assess the advantages and limitations of the final method chosen.

Measuring food and nutrition security: tools and considerations for use among people living with HIV.

PubMed

Fielden, Sarah J; Anema, Aranka; Fergusson, Pamela; Muldoon, Katherine; Grede, Nils; de Pee, Saskia

2014-10-01

As an increasing number of countries implement integrated food and nutrition security (FNS) and HIV programs, global stakeholders need clarity on how to best measure FNS at the individual and household level. This paper reviews prominent FNS measurement tools, and describes considerations for interpretation in the context of HIV. There exist a range of FNS measurement tools and many have been adapted for use in HIV-endemic settings. Considerations in selecting appropriate tools include sub-types (food sufficiency, dietary diversity and food safety); scope/level of application; and available resources. Tools need to reflect both the needs of PLHIV and affected households and FNS program objectives. Generalized food sufficiency and dietary diversity tools may provide adequate measures of FNS in PLHIV for programmatic applications. Food consumption measurement tools provide further data for clinical or research applications. Measurement of food safety is an important, but underdeveloped aspect of assessment, especially for PLHIV.

Individualized assessment of driving fitness for older individuals with health, disability, and age-related concerns.

PubMed

Wheatley, Carol J; Di Stefano, Marilyn

2008-08-01

Driver licensing agencies are faced with an increasing population of drivers who are seeking to maintain driving privileges whilst coping with functional changes associated with health, disability, or aging-related issues. Some of these changes impact upon the motor, sensory, and cognitive capacities essential for safe motor vehicle operation. The driver assessment process, as provided by occupational therapists and other professionals trained in the techniques of driver rehabilitation, can provide objective data to identify driver strengths and limitations and options available to increase mobility independence via consideration of adaptive mobility equipment, vehicle choice, driver training, or alternative transportation if necessary. This article provides an overview of the driver rehabilitation specialist's assessment and training process, with an analysis of the key issues related to this form of assessment and the need for further research. The basic driver rehabilitation process is outlined including examples of common deficits, assessment considerations, and intervention approaches. The clinical and on-road assessment procedures are described, with illustrations of the reasoning process that leads to a determination of the person's overall driving competence and rehabilitation recommendations. A review of the literature is provided that examines the currently available documentation that supports this assessment and rehabilitation process. The article concludes with a review of current literature that examines the claim that detailed clinical and on-road assessment, as provided by driver rehabilitation specialists, is currently the best method for assisting drivers with complex health, disability, or aging-related issues to resume or retain driving privileges.

Revisiting the assessment of semen viscosity and its relationship to leucocytospermia.

PubMed

Flint, M; du Plessis, S S; Menkveld, R

2014-10-01

With infertility challenges posing an obstacle to many couples, the extension of variables to assess male fertility is an important line of research. At the Reproductive Biology Unit where the study was undertaken, a considerable proportion of male patient's seeking fertility assessment presented with hyperviscous semen samples and elevated concentrations of leucocytes. Despite viscosity being included as part of a routine spermiogram, it raises a considerable amount of concern as it is assessed semiquantitatively. The study was undertaken to evaluate the quantification of semen viscosity in centipoise (cP) and to investigate whether a correlation exists between hyperviscosity and leucocytospermia. A total of 200 semen samples were assessed from a sample cohort of two population groups: 162 male patients undergoing fertility assessment and 38 volunteer donors. Semen viscosity was determined by measuring the filling time of a capillary-loaded Leja chamber and quantifying the viscosity in cP. Leucocytes were identified histochemically with a leucocyte peroxidase test. The viscosity when quantified in cP was significantly higher in the peroxidase positive sample group (9.01 ± 0.49 vs. 7.39 ± 0.23 cP; P < 0.005). The introduction of a more accurate method of quantifying viscosity may possibly help to identify, diagnose and treat patients suffering from leucocytospermia to ultimately enhance their fertility potential. © 2013 Blackwell Verlag GmbH.

Nursing challenges caring for bone marrow transplantation patients with graft versus host disease.

PubMed

Neumann, Joyce

2017-12-01

Nursing care of blood and marrow transplantation (BMT) patients is complicated. Nursing considerations of BMT patients with GVHD require an additional set of skills and knowledge that include side effects, both expected and less common, assessment skills, treatment administration, both standard and novel, and acute or intensive care. Nursing care of BMT patients with skin GVHD will be determined by the degree of skin alteration with distinct decisions made about hygiene, both topical and systemic treatment, infection prevention, relief of discomfort, functional ability (ADL) and body image alteration. The nurse needs to have knowledge about assessment criteria for acute and chronic (NIH) assessment with special attention to skin (presence of rash, texture, mobility), joint mobility, mouth care, dressings, and skin care products. Nursing consideration of gastrointestinal GVHD includes importance of accurate intake and output, obtaining culture, fluid and electrolyte imbalance, nutrition, treatment, and skin care. Complication of GVHD treatment, namely effects of steroids require experts from many disciplines to provide comprehensive care. Caring and advocating for GVHD patients may include preparing for outcomes that are undesirable and impact the patient's quality of life and mortality. BMT survivorship programs are a major source of patient education about chronic GVHD for patients after treatment. Caring for BMT patients, especially those experiencing GVHD, takes a knowledgeable, committed, and caring team of healthcare providers. Workshops like this are vital in providing information and networking to keep providers around the region and globe engaged in this critical work. Copyright © 2017. Published by Elsevier B.V.

FRAMEWORK FOR ASSESSING RISKS OF ...

EPA Pesticide Factsheets

The Framework for Children's Health Risk Assessment report can serve as a resource on children's health risk assessment and it addresses the need to provide a comprehensive and consistent framework for considering children in risk assessments at EPA. This framework lays out the process, points to existing published sources for more detailed information on life stage-specific considerations, and includes web links to specific online publications and relevant Agency science policy papers, guidelines and guidance. The document emphasizes the need to take into account the potential exposures to environmental agents during preconception and all stages of development and focuses on the relevant adverse health outcomes that may occur as a result of such exposures. This framework is not an Agency guideline, but rather describes the overall structure and the components considered important for children's health risk assessment. The document describes an approach that includes problem formulation, analysis, and risk characterization, and also builds on Agency experience assessing risk to susceptible populations. The problem formulation step focuses on the life stage-specific nature of the analysis to include scoping and screening level questions for hazard characterization, dose response and exposure assessment. The risk characterization step recognizes the need to consider life stage-specific risks and explicitly describes the uncertainties and variability in the d

State experiences implementing youth sports concussion laws: challenges, successes, and lessons for evaluating impact.

PubMed

Lowrey, Kerri McGowan; Morain, Stephanie R

2014-01-01

While provisions of youth sports concussion laws are very similar, little is known as to how they are being implemented, factors that promote or impede implementation, or the level of compliance in each jurisdiction. We aimed to describe state experiences with implementation in order to inform ongoing efforts to reduce the harm of sports-related traumatic brain injury and to guide future evaluations of the laws' impacts and the development of future public health laws. We conducted key-informant interviews in 35 states with recently enacted concussion legislation. States varied considerably in their readiness and capacity for implementation. Factors facilitating implementation included existing partnerships, procedures, and resources; centralized implementation authority; prior related efforts; and involvement in the policymaking process by those now charged with implementation. Inhibitors included ambiguous statutory language, unclear delegation of authority, and compliance difficulties. Ongoing challenges persist, including primary prevention; determining which providers are qualified to make return-to-play assessments and contents of those assessments; compliance difficulties in rural and under-served areas; and unclear responsibility for enforcement. Despite the similarity of youth sports concussion laws, early evidence suggests there is considerable variation in their implementation. These findings are critical for ongoing empirical investigations to accurately evaluate the laws' provisions and to identify successful legal approaches to protecting young athletes. © 2014 American Society of Law, Medicine & Ethics, Inc.

Implementation science in cancer prevention and control: a decade of grant funding by the National Cancer Institute and future directions.

PubMed

Neta, Gila; Sanchez, Michael A; Chambers, David A; Phillips, Siobhan M; Leyva, Bryan; Cynkin, Laurie; Farrell, Margaret M; Heurtin-Roberts, Suzanne; Vinson, Cynthia

2015-01-08

The National Cancer Institute (NCI) has supported implementation science for over a decade. We explore the application of implementation science across the cancer control continuum, including prevention, screening, treatment, and survivorship. We reviewed funding trends of implementation science grants funded by the NCI between 2000 and 2012. We assessed study characteristics including cancer topic, position on the T2-T4 translational continuum, intended use of frameworks, study design, settings, methods, and replication and cost considerations. We identified 67 NCI grant awards having an implementation science focus. R01 was the most common mechanism, and the total number of all awards increased from four in 2003 to 15 in 2012. Prevention grants were most frequent (49.3%) and cancer treatment least common (4.5%). Diffusion of Innovations and Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) were the most widely reported frameworks, but it is unclear how implementation science models informed planned study measures. Most grants (69%) included mixed methods, and half reported replication and cost considerations (49.3%). Implementation science in cancer research is active and diverse but could be enhanced by greater focus on measures development, assessment of how conceptual frameworks and their constructs lead to improved dissemination and implementation outcomes, and harmonization of measures that are valid, reliable, and practical across multiple settings.

The micronucleus test-most widely used in vivo genotoxicity test.

PubMed

Hayashi, Makoto

2016-01-01

Genotoxicity is commonly evaluated during the chemical safety assessment together with other toxicological endpoints. The micronucleus test is always included in many genotoxic test guidelines for long time in many classes of chemicals, e.g., pharmaceutical chemicals, agricultural chemicals, food additives. Although the trend of the safety assessment of chemicals faces to animal welfare and in vitro systems are more welcome than the in vivo systems, the in vivo test systems are paid more attention in the field of genotoxicity because of its weight of evidence. In this review, I will summarize the following points: 1) historical consideration of the test development, 2) characteristics of the test including advantages and limitations, 3) new approaches considering to the animal welfare.

14D. The Epidemic of Diabesity: Functional Medicine Approaches to Treatment, Recovery, and Prevention

PubMed Central

2013-01-01

Focus Areas: Integrative Approaches to Care, Supporting Behavioral Change This brief presentation will offer a view of obesity and diabetes from a functional medicine approach. It will include the use of the Functional Medicine Matrix Model, the GO.TO.IT operating system, and the clinical timeline. Assessing pre-diabetes, diabetes, and obesity must include an evaluation of digestive function and nutritional status, the role of inflammation and insulin resistance, and the consideration of persistent organic pollutants (POPs) as a driver, as well as the relationship to mitochondrial energy production. This presentation will use a case-based format to highlight the unique Functional Medicine approach to assessing the root cause(s) of obesity and diabetes, as well as demonstrating appropriate treatment modalities.

Screening tests: a review with examples

PubMed Central

Niebo, Ron; Utell, Mark J.

2014-01-01

Screening tests are widely used in medicine to assess the likelihood that members of a defined population have a particular disease. This article presents an overview of such tests including the definitions of key technical (sensitivity and specificity) and population characteristics necessary to assess the benefits and limitations of such tests. Several examples are used to illustrate calculations, including the characteristics of low dose computed tomography as a lung cancer screen, choice of an optimal PSA cutoff and selection of the population to undergo mammography. The importance of careful consideration of the consequences of both false positives and negatives is highlighted. Receiver operating characteristic curves are explained as is the need to carefully select the population group to be tested. PMID:25264934

Epidemiologic studies of electric and magnetic fields and cancer: strategies for extending knowledge.

PubMed Central

Savitz, D A

1993-01-01

Epidemiologic research concerning electric and magnetic fields in relation to cancer has focused on the potential etiologic roles of residential exposure on childhood cancer and occupational exposure on adult leukemia and brain cancer. Future residential studies must concentrate on exposure assessment that is enhanced by developing models of historical exposure, assessment of the relation between magnetic fields and wire codes, and consideration of alternate exposure indices. Study design issues deserving attention include possible biases in random digit dialing control selection, consideration of the temporal course of exposure and disease, and acquisition of the necessary information to assess the potential value of ecologic studies. Highest priorities are comprehensive evaluation of exposure patterns and sources and examination of the sociology and geography of residential wire codes. Future occupational studies should also concentrate on improved exposure assessment with increased attention to nonutility worker populations and development of historical exposure indicators that are superior to job titles alone. Potential carcinogens in the workplace that could act as confounders need to be more carefully examined. The temporal relation between exposure and disease and possible effect modification by other workplace agents should be incorporated into future studies. The most pressing need is for measurement of exposure patterns in a variety of worker populations and performance of traditional epidemiologic evaluations of cancer occurrence. The principal source of bias toward the null is nondifferential misclassification of exposure with improvements expected to enhance any true etiologic association that is present. Biases away from the null might include biased control selection in residential studies and chemical carcinogens acting as confounders in occupational studies. PMID:8206046

Uncertainty assessment of PM2.5 contamination mapping using spatiotemporal sequential indicator simulations and multi-temporal monitoring data.

PubMed

Yang, Yong; Christakos, George; Huang, Wei; Lin, Chengda; Fu, Peihong; Mei, Yang

2016-04-12

Because of the rapid economic growth in China, many regions are subjected to severe particulate matter pollution. Thus, improving the methods of determining the spatiotemporal distribution and uncertainty of air pollution can provide considerable benefits when developing risk assessments and environmental policies. The uncertainty assessment methods currently in use include the sequential indicator simulation (SIS) and indicator kriging techniques. However, these methods cannot be employed to assess multi-temporal data. In this work, a spatiotemporal sequential indicator simulation (STSIS) based on a non-separable spatiotemporal semivariogram model was used to assimilate multi-temporal data in the mapping and uncertainty assessment of PM2.5 distributions in a contaminated atmosphere. PM2.5 concentrations recorded throughout 2014 in Shandong Province, China were used as the experimental dataset. Based on the number of STSIS procedures, we assessed various types of mapping uncertainties, including single-location uncertainties over one day and multiple days and multi-location uncertainties over one day and multiple days. A comparison of the STSIS technique with the SIS technique indicate that a better performance was obtained with the STSIS method.

Uncertainty assessment of PM2.5 contamination mapping using spatiotemporal sequential indicator simulations and multi-temporal monitoring data

NASA Astrophysics Data System (ADS)

Yang, Yong; Christakos, George; Huang, Wei; Lin, Chengda; Fu, Peihong; Mei, Yang

2016-04-01

Because of the rapid economic growth in China, many regions are subjected to severe particulate matter pollution. Thus, improving the methods of determining the spatiotemporal distribution and uncertainty of air pollution can provide considerable benefits when developing risk assessments and environmental policies. The uncertainty assessment methods currently in use include the sequential indicator simulation (SIS) and indicator kriging techniques. However, these methods cannot be employed to assess multi-temporal data. In this work, a spatiotemporal sequential indicator simulation (STSIS) based on a non-separable spatiotemporal semivariogram model was used to assimilate multi-temporal data in the mapping and uncertainty assessment of PM2.5 distributions in a contaminated atmosphere. PM2.5 concentrations recorded throughout 2014 in Shandong Province, China were used as the experimental dataset. Based on the number of STSIS procedures, we assessed various types of mapping uncertainties, including single-location uncertainties over one day and multiple days and multi-location uncertainties over one day and multiple days. A comparison of the STSIS technique with the SIS technique indicate that a better performance was obtained with the STSIS method.

Assessment of PWR Steam Generator modelling in RELAP5/MOD2. International Agreement Report

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

Putney, J.M.; Preece, R.J.

1993-06-01

An assessment of Steam Generator (SG) modelling in the PWR thermal-hydraulic code RELAP5/MOD2 is presented. The assessment is based on a review of code assessment calculations performed in the UK and elsewhere, detailed calculations against a series of commissioning tests carried out on the Wolf Creek PWR and analytical investigations of the phenomena involved in normal and abnormal SG operation. A number of modelling deficiencies are identified and their implications for PWR safety analysis are discussed -- including methods for compensating for the deficiencies through changes to the input deck. Consideration is also given as to whether the deficiencies willmore » still be present in the successor code RELAP5/MOD3.« less

A Paradigm for Security Metrics in Counterinsurgency

DTIC Science & Technology

2011-06-10

unhealthy form of micromanagement.25 Both sides can cite examples to support their positions however a balanced position might incorporate considerations of...comprehensive assessments of a country or region. The framework includes a useful presentation of drivers of tipping points but does not use the... lifestyle . Native Algerians referred to these people as the black foot, or pieds noir in French. This group wielded disproportionate political power

Interaction of BDE-47 and its Hydroxylated Metabolite 6-OH-BDE-47 with the Human ABC Efflux Transporters P-gp and BCRP: Considerations for Human Exposure and Risk Assessment

EPA Science Inventory

ATP binding cassette (ABC) transporters, including P-glycoprotein (P-gp; also known as MDR1, ABCB1) and breast cancer resistance protein (BCRP; also known as ABCG2), are membrane-bound proteins that mediate the cellular efflux of xenobiotics as an important defense against chemic...

A 576-year Weber River streamflow reconstruction from tree rings for water resource risk assessment in the Wasatch Front, Utah

Treesearch

Matthew F. Bekker; R. Justin DeRose; Brendan M. Buckley; Roger K. Kjelgren; Nathan S. Gill

2014-01-01

We present a 576-year tree-ring-based reconstruction of streamflow for northern Utah's Weber River that exhibits considerable interannual and decadal-scale variability. While the 20th Century instrumental period includes several extreme individual dry years, it was the century with the fewest such years of the entire reconstruction. Extended droughts were more...

Integrating Exposure into Chemical Alternatives Assessment ...

EPA Pesticide Factsheets

Most alternatives assessments (AA) published to date are largely hazard-based rankings, and as such may not represent a fully informed consideration of the advantages and disadvantages of possible alternatives. With an assessment goal of identifying an alternative chemical that is more sustainable, other attributes beyond hazard are also important, including exposure, risk, life-cycle impacts, performance, cost, and social responsibility. Building on the 2014 recommendations by the U.S. National Academy of Sciences to improve AA decisions by including comparative exposure assessment, the HESISustainable Chemical Alternatives Technical Committee, which consists of scientists from academia, industry, government, and NGOs, has developed a qualitative comparative exposure approach. Conducting such a comparison can screen for alternatives that are expected to have a higher exposure potential, which could trigger a higher-tiered, more quantitative exposure assessment on the alternatives being considered. This talk will demonstrate an approach for including chemical- and product-related exposure information in a qualitative AA comparison. Starting from existing hazard AAs, a series of four chemical-product application scenarios were examined to test the concept, to understand the effort required, and to determine the value of exposure data in AA decision-making. The group has developed a classification approach for ingredient and product parameters to support compariso

Assessment and d/Deaf and Hard of Hearing Multilingual Learners: Considerations and Promising Practices

ERIC Educational Resources Information Center

Pizzo, Lianna; Chilvers, Amanda

2016-01-01

The authors address considerations and promising practices relating to assessment of d/Deaf and Hard of Hearing Multilingual Learners. DMLs' unique culture(s), language(s), and learning needs must be considered when assessments of this population are being planned, conducted, and interpreted. The authors address theory and research on (a) general…

40 CFR 6.405 - Exemptions and considerations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Section 6.405 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL PROCEDURES FOR IMPLEMENTING THE NATIONAL ENVIRONMENTAL POLICY ACT AND ASSESSING THE ENVIRONMENTAL EFFECTS ABROAD OF EPA ACTIONS Assessing the Environmental Effects Abroad of EPA Actions § 6.405 Exemptions and considerations...

An assessment of electric vehicles: technology, infrastructure requirements, greenhouse-gas emissions, petroleum use, material use, lifetime cost, consumer acceptance and policy initiatives.

PubMed

Delucchi, M A; Yang, C; Burke, A F; Ogden, J M; Kurani, K; Kessler, J; Sperling, D

2014-01-13

Concerns about climate change, urban air pollution and dependence on unstable and expensive supplies of foreign oil have led policy-makers and researchers to investigate alternatives to conventional petroleum-fuelled internal-combustion-engine vehicles in transportation. Because vehicles that get some or all of their power from an electric drivetrain can have low or even zero emissions of greenhouse gases (GHGs) and urban air pollutants, and can consume little or no petroleum, there is considerable interest in developing and evaluating advanced electric vehicles (EVs), including pure battery-electric vehicles, plug-in hybrid electric vehicles and hydrogen fuel-cell electric vehicles. To help researchers and policy-makers assess the potential of EVs to mitigate climate change and reduce petroleum use, this paper discusses the technology of EVs, the infrastructure needed for their development, impacts on emissions of GHGs, petroleum use, materials use, lifetime costs, consumer acceptance and policy considerations.

Developmental profile of speech-language and communicative functions in an individual with the Preserved Speech Variant of Rett syndrome

PubMed Central

Marschik, Peter B.; Vollmann, Ralf; Bartl-Pokorny, Katrin D.; Green, Vanessa A.; van der Meer, Larah; Wolin, Thomas; Einspieler, Christa

2018-01-01

Objective We assessed various aspects of speech-language and communicative functions of an individual with the preserved speech variant (PSV) of Rett syndrome (RTT) to describe her developmental profile over a period of 11 years. Methods For this study we incorporated the following data resources and methods to assess speech-language and communicative functions during pre-, peri- and post-regressional development: retrospective video analyses, medical history data, parental checklists and diaries, standardized tests on vocabulary and grammar, spontaneous speech samples, and picture stories to elicit narrative competences. Results Despite achieving speech-language milestones, atypical behaviours were present at all times. We observed a unique developmental speech-language trajectory (including the RTT typical regression) affecting all linguistic and socio-communicative sub-domains in the receptive as well as the expressive modality. Conclusion Future research should take into consideration a potentially considerable discordance between formal and functional language use by interpreting communicative acts on a more cautionary note. PMID:23870013

Developmental profile of speech-language and communicative functions in an individual with the preserved speech variant of Rett syndrome.

PubMed

Marschik, Peter B; Vollmann, Ralf; Bartl-Pokorny, Katrin D; Green, Vanessa A; van der Meer, Larah; Wolin, Thomas; Einspieler, Christa

2014-08-01

We assessed various aspects of speech-language and communicative functions of an individual with the preserved speech variant of Rett syndrome (RTT) to describe her developmental profile over a period of 11 years. For this study, we incorporated the following data resources and methods to assess speech-language and communicative functions during pre-, peri- and post-regressional development: retrospective video analyses, medical history data, parental checklists and diaries, standardized tests on vocabulary and grammar, spontaneous speech samples and picture stories to elicit narrative competences. Despite achieving speech-language milestones, atypical behaviours were present at all times. We observed a unique developmental speech-language trajectory (including the RTT typical regression) affecting all linguistic and socio-communicative sub-domains in the receptive as well as the expressive modality. Future research should take into consideration a potentially considerable discordance between formal and functional language use by interpreting communicative acts on a more cautionary note.

The sequence of disease-modifying therapies in relapsing multiple sclerosis: safety and immunologic considerations.

PubMed

Pardo, Gabriel; Jones, David E

2017-12-01

The treatment landscape for relapsing forms of multiple sclerosis (RMS) has expanded considerably over the last 10 years with the approval of multiple new disease-modifying therapies (DMTs), and others in late-stage clinical development. All DMTs for RMS are believed to reduce central nervous system immune-mediated inflammatory processes, which translate into demonstrable improvement in clinical and radiologic outcomes. However, some DMTs are associated with long-lasting effects on the immune system and/or serious adverse events, both of which may complicate the use of subsequent therapies. When customizing a treatment program, a benefit-risk assessment must consider multiple factors, including the efficacy of the DMT to reduce disease activity, the short- and long-term safety and immunologic profiles of each DMT, the criteria used to define switching treatment, and the risk tolerance of each patient. A comprehensive benefit-risk assessment can only be achieved by evaluating the immunologic, safety, and efficacy data for DMTs in the controlled clinical trial environment and the postmarketing clinical practice setting. This review is intended to help neurologists make informed decisions when treating RMS by summarizing the known data for each DMT and raising awareness of the multiple considerations involved in treating people with RMS throughout the entire course of their disease.

Canyons and gorges as potential geotourism destinations in Serbia: comparative analysis from two perspectives - general geotourists' and pure geotourists'

NASA Astrophysics Data System (ADS)

Božić, Sanja; Tomić, Nemanja

2015-10-01

Serbia represents one of those countries which have not yet differentiated themselves on the world tourism map. However, it has an immense but still unrevealed potential for geotourism development. In this paper we analyzed several remarkable canyons and gorges of great scientific importance and geotourism potential. These sites include the Djerdap Gorge and Lazar River Canyon, located in Eastern Serbia and the Ovcar-Kablar Gorge and Uvac Canyon located in Western Serbia. One of the main goals of this paper was to analyze and compare the current state and tourism potential of these geosites by using the M-GAM model for geosite assessment. However, the principal aim of the paper is to analyze how important is each subindicator in the assessment process for different market segments. In this paper, we also analyzed how giving different importance to subindicators can influence the position of the geosites in the matrix indicating different assessment done by two chosen market segments. The research showed that general geotourists appreciate considerably different values when assessing a geosite in comparison to pure geotourists. The paper can be used as framework for developing the tourism management strategy of geosites taking into consideration the needs and preferences of the target market segments.

GIS-based integrated assessment and decision support system for land use planning in consideration of carbon sequestration benefits

NASA Astrophysics Data System (ADS)

Wang, Jun; Chen, J. M.; Li, Manchun; Ju, Weimin

2007-06-01

As the major eligible land use activities in the Clean Development Mechanism (CDM), afforestation and reforestation offer opportunities and potential economic benefits for developing countries to participate in carbon-trade in the potential international carbon (C) sink markets. However, the design and selection of appropriate afforestation and reforestation locations in CDM are complex processes which need integrated assessment (IA) of C sequestration (CS) potential, environmental effects, and socio-economic impacts. This paper promotes the consideration of CS benefits in local land use planning and presents a GIS-based integrated assessment and spatial decision support system (IA-SDSS) to support decision-making on 'where' and 'how' to afforest. It integrates an Integrated Terrestrial Ecosystem Carbon Model (InTEC) and a GIS platform for modeling regional long-term CS potential and assessment of geo-referenced land use criteria including CS consequence, and produces ranking of plantation schemes with different tree species using the Analytic hierarchy process (AHP) method. Three land use scenarios are investigated: (i) traditional land use planning criteria without C benefits, (ii) land use for CS with low C price, and (iii) land use for CS with high price. Different scenarios and consequences will influence the weights of tree-species selection in the AHP decision process.

Identifying and assessing the substance-exposed infant.

PubMed

Clark, Lisa; Rohan, Annie

2015-01-01

As the rate of opioid prescription grows, so does fetal exposure to opioids during pregnancy. With increasing fetal exposure to both prescription and nonprescription drugs, there has been a concurrent increase in identification of Neonatal Withdrawal Syndrome (NWS) and adaptation difficulties after birth. In addition, extended use of opioids, barbiturates, and benzodiazepines in neonatal intensive care has resulted in iatrogenic withdrawal syndromes. There is a lack of evidence to support the use of any one specific evaluation strategy to identify NWS. Clinicians caring for infants must use a multimethod approach to diagnosis, including interview and toxicology screening. Signs of NWS are widely variable, and reflect dysfunction in autonomic regulation, state control, and sensory and motor functioning. Several assessment tools have been developed for assessing severity of withdrawal in term neonates. These tools assist in determining need and duration of pharmacologic therapy and help in titration of these therapies. Considerable variability exists in the pharmacologic and nonpharmacologic approaches to affected babies across settings. An evidence-based protocol for identification, evaluation, and management of NWS should be in place in every nursery. This article provides an overview of identification and assessment considerations for providers who care for babies at risk for or who are experiencing alterations in state, behavior, and responses after prenatal or iatrogenic exposure to agents associated with the spectrum of withdrawal.

The atmospheric effects of stratospheric aircraft: A fourth program report

NASA Technical Reports Server (NTRS)

Stolarski, Richard S. (Editor); Wesoky, Howard L. (Editor); Wofsy, Steven C.; Ravishankara, A. R.; Rodriguez, Jose M.; Grose, William L.

1995-01-01

This document presents the fourth report from the Atmospheric Effects of Stratospheric Aircraft (AESA) component of NASA's High-Speed Research Program (HSRP). Market and technology considerations continue to provide an impetus for high-speed civil transport research. A recent AESA interim assessment report and a review of that report have shown that considerable uncertainty still exists about the possible impact of aircraft on the atmosphere. The AESA has been designed to develop the body of scientific knowledge necessary for the evaluation of the impact of stratospheric aircraft on the atmosphere. The first Program report presented the basic objectives and plans for AESA. This fourth report comes after the interim assessment and sets forth directions for the 1995 assessment at the end of AESA Phase 1. It also sets forth the goals and directions for AESA Phase 2, as reported at the 1994 Atmospheric Effects of Aviation Project (AEAP) annual meeting held in June. The focus of the Phase 2 effort is to obtain the best possible closure on the outstanding problems identified in the interim assessment and NASA/NRC review. Topics discussed in this report include how high-speed civil transports (HSCT) might affect stratospheric ozone, emissions scenarios and databases to assess potential atmospheric effects from HSCT's, calculated results from 2-D zonal mean models using emissions data, engine trace constituent measurements.

A state-of-practice survey of policy, plan, and program assessment in Canadian provinces

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

Noble, Bram F

2004-04-01

Since the introduction of the 1999 Canadian Cabinet Directive on the environmental assessment of policies, plans, and programs (PPPs), higher-order environmental assessment has been receiving increased attention in Canada. However, while practices and systems are advancing at the federal level, there has been very little attention given to recent developments in PPP assessment at the provincial level. This paper presents the results of a Canada-wide survey of PPP assessment principles and practices in 10 Canadian provincial EA jurisdictions. The findings indicate that there exists considerable variability in the provisions for and practice of PPP assessment amongst Canadian provinces, with onlymore » Saskatchewan, Ontario, and Quebec identifying recent practice experience. Included amongst the main barriers to effective implementation at the provincial level are the lack of legislative requirements for strategic EA, and the limited understanding of the nature and benefits of higher-order impact assessment.« less

National survey of clinical communication assessment in medical education in the United Kingdom (UK)

PubMed Central

2014-01-01

Background All medical schools in the UK are required to be able to provide evidence of competence in clinical communication in their graduates. This is usually provided by summative assessment of clinical communication, but there is considerable variation in how this is carried out. This study aimed to gain insight into the current assessment of clinical communication in UK medical schools. Methods The survey was sent via e-mail to communication leads who then were asked to consult with all staff within their medical school involved in the assessment of communication. Results Results were obtained from 27 out of 33 schools (response rate 82%) and a total of 34 courses. The average number of assessments per year was 2.4 (minimum 0, maximum 10). The Objective Structured Clinical Exam (OSCE) was the most commonly used method of assessment (53%). Other assessments included MCQ and workplace based assessments. Only nine courses used a single method of assessment. Issues raised included, logistics and costs of assessing mainly by OSCE, the robustness and reliability of such exams and integration with other clinical skills. Conclusions It is encouraging that a variety of assessment methods are being used within UK medical schools and that these methods target different components of clinical communication skills acquisition. PMID:24417939

[Risk on bias assessment: (6) A Revised Tool for the Quality Assessment on Diagnostic Accuracy Studies (QUADAS-2)].

PubMed

Qu, Y J; Yang, Z R; Sun, F; Zhan, S Y

2018-04-10

This paper introduced the Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2), including the development and comparison with the original QUADAS, and illustrated the application of QUADAS-2 in a published paper related to the study on diagnostic accuracy which was included in systematic review and Meta-analysis. QUADAS-2 presented considerable improvement over the original tool. Confused items that included in QUADAS had disappeared and the quality assessment of the original study replaced by the rating of risk on bias and applicability. This was implemented through the description on the four main domains with minimal overlapping and answering the signal questions in each domain. The risk of bias and applicability with 'high','low' or 'unclear' was in line with the risk of bias assessment of intervention studies in Cochrane, so to replace the total score of quality assessment in QUADAS. Meanwhile, QUADAS-2 was also applicable to assess the diagnostic accuracy studies in which follow-up without prognosis was involved in golden standard. It was useful to assess the overall methodological quality of the study despite more time consuming than the original QUADAS. However, QUADAS-2 needs to be modified to apply in comparative studies on diagnostic accuracy and we hope the users would follow the updates and give their feedbacks on line.

Wechsler Intelligence Scale for Children-V: Test Review.

PubMed

Na, Sabrina D; Burns, Thomas G

2016-01-01

Changes from the fourth edition of the Wechsler Intelligence Scale for Children (WISC) to the fifth edition are discussed, with particular emphasis on how the electronic administration facilitated assessment. The hierarchical organization and conceptualization of primary indices have been adjusted, based on recent theory and research on the construct of intelligence. Changes also include updates to psychometric properties and consideration of cultural bias. The scoring program allows intelligence scores to be linked statistically to achievement measures to aid in diagnoses of learning disabilities. Electronic assessment was clunky at times but overall delivered on its promise of quicker and more accurate administration and scoring.

Assessment of the five-factor model of personality.

PubMed

Widiger, T A; Trull, T J

1997-04-01

The five-factor model (FFM) of personality is obtaining construct validation, recognition, and practical consideration across a broad domain of fields, including clinical psychology, industrial-organizational psychology, and health psychology. As a result, an array of instruments have been developed and existing instruments are being modified to assess the FFM. In this article, we present an overview and critique of five such instruments (the Goldberg Big Five Markers, the revised NEO Personality Inventory, the Interpersonal Adjective Scales-Big Five, the Personality Psychopathology-Five, and the Hogan Personality Inventory), focusing in particular on their representation of the lexical FFM and their practical application.

Suicide: Across the Life Span.

PubMed

Ramirez, Jeffery

2016-06-01

Suicide remains a major public health issue. There have been more than 40,000 deaths by suicide in 2014. Understanding both the neuroscience and psychological development is key for nursing care so adequate interventions and treatment strategies are developed when working with people thinking about suicide. It is critical to assess and recognize risk and protective factors to ensure patient safety. The older adult, children, and adolescent populations remain vulnerable to suicide. A discussion regarding the psychiatric, psychosocial, and treatment considerations for these populations is included. An overview of communication, suicide assessment, and safety planning is discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

Spiritual Considerations.

PubMed

Puchalski, Christina M; King, Stephen D W; Ferrell, Betty R

2018-06-01

Spiritual issues play a prominent role for patients with cancer. Studies have demonstrated a positive connection between a patient's spirituality and health outcomes, including quality of life, depression and anxiety, hopefulness, and the ability to cope with illness. Spiritual or existential distress is prominent in patients with cancer. Models are described that identify ways for clinicians to identify or diagnose spiritual or existential distress, and to attend to that distress. It is critical that all clinicians assess for spiritual distress as part of a routine distress assessment, identify appropriate treatment strategies, and work closely with trained spiritual care professionals. Copyright © 2018 Elsevier Inc. All rights reserved.

Taking Legal Histories in Psychiatric Assessments.

PubMed

Morris, Nathaniel P

2018-05-25

People with mental illness are often disproportionately affected by the U.S. justice system, yet psychiatrists and other mental health professionals may avoid or feel uncomfortable talking with patients about legal history. This column examines why legal history is relevant to psychiatric assessments and provides guidance for talking with patients about these issues. Key aspects of taking a legal history are reviewed, including suggested questions, the role of collateral information, and considerations for medicolegal documentation. Developing skills in taking patients' legal histories may equip clinicians to better understand their patients' stories and to provide more effective psychiatric care.

Ecosystem-based fisheries management: Perception on definitions, implementations, and aspirations.

PubMed

Trochta, John T; Pons, Maite; Rudd, Merrill B; Krigbaum, Melissa; Tanz, Alexander; Hilborn, Ray

2018-01-01

Ecosystem-based fisheries management (EBFM) was developed to move beyond single species management by incorporating ecosystem considerations for the sustainable utilization of marine resources. Due to the wide range of fishery characteristics, including different goals of fisheries management across regions and species, theoretical best practices for EBFM vary greatly. Here we highlight the lack of consensus in the interpretation of EBFM amongst professionals in marine science and its implementation. Fisheries policy-makers and managers, stock assessment scientists, conservationists, and ecologists had very different opinions on the degree to which certain management strategies would be considered EBFM. We then assess the variability of the implementation of EBFM, where we created a checklist of characteristics typifying EBFM and scored fisheries across different regions, species, ecosystems, and fishery size and capacity. Our assessments show fisheries are unlikely to meet all the criteria on the EBFM checklist. Consequentially, it is unnecessary for management to practice all the traits of EBFM, as some may be disparate from the ecosystem attributes or fishery goals. Instead, incorporating some ecosystem-based considerations to fisheries management that are context-specific is a more realistic and useful way for EBFM to occur in practice.

Ecosystem-based fisheries management: Perception on definitions, implementations, and aspirations

PubMed Central

Hilborn, Ray

2018-01-01

Ecosystem-based fisheries management (EBFM) was developed to move beyond single species management by incorporating ecosystem considerations for the sustainable utilization of marine resources. Due to the wide range of fishery characteristics, including different goals of fisheries management across regions and species, theoretical best practices for EBFM vary greatly. Here we highlight the lack of consensus in the interpretation of EBFM amongst professionals in marine science and its implementation. Fisheries policy-makers and managers, stock assessment scientists, conservationists, and ecologists had very different opinions on the degree to which certain management strategies would be considered EBFM. We then assess the variability of the implementation of EBFM, where we created a checklist of characteristics typifying EBFM and scored fisheries across different regions, species, ecosystems, and fishery size and capacity. Our assessments show fisheries are unlikely to meet all the criteria on the EBFM checklist. Consequentially, it is unnecessary for management to practice all the traits of EBFM, as some may be disparate from the ecosystem attributes or fishery goals. Instead, incorporating some ecosystem-based considerations to fisheries management that are context-specific is a more realistic and useful way for EBFM to occur in practice. PMID:29381700

Anesthetic Considerations in Patients Undergoing Bariatric Surgery: A Review Article

PubMed Central

Soleimanpour, Hassan; Safari, Saeid; Sanaie, Sarvin; Nazari, Mehdi; Alavian, Seyed Moayed

2017-01-01

Context This article discusses the anesthetic considerations in patients undergoing bariatric surgery in the preoperative, intraoperative, and postoperative phases of surgery. Evidence Acquisition This review includes studies involving obese patients undergoing bariatric surgery. Searches have been conducted in PubMed, MEDLINE, EMBASE, Google Scholar, Scopus, and Cochrane Database of Systematic Review using the terms obese, obesity, bariatric, anesthesia, perioperative, preoperative, perioperative, postoperative, and their combinations. Results Obesity is a major worldwide health problem associated with many comorbidities. Bariatric surgery has been proposed as the best alternative treatment for extreme obese patients when all other therapeutic options have failed. Conclusions Anesthetists must completely assess the patients before the surgery to identify anesthesia- related potential risk factors and prepare for management during the surgery. PMID:29430407

Sources of uncertanity as a basis to fill the information gap in a response to flood

NASA Astrophysics Data System (ADS)

Kekez, Toni; Knezic, Snjezana

2016-04-01

Taking into account uncertainties in flood risk management remains a challenge due to difficulties in choosing adequate structural and/or non-structural risk management options. Despite stated measures wrong decisions are often being made when flood occurs. Parameter and structural uncertainties which include model and observation errors as well as lack of knowledge about system characteristics are the main considerations. Real time flood risk assessment methods are predominantly based on measured water level values and vulnerability as well as other relevant characteristics of flood affected area. The goal of this research is to identify sources of uncertainties and to minimize information gap between the point where the water level is measured and the affected area, taking into consideration main uncertainties that can affect risk value at the observed point or section of the river. Sources of uncertainties are identified and determined using system analysis approach and relevant uncertainties are included in the risk assessment model. With such methodological approach it is possible to increase response time with more effective risk assessment which includes uncertainty propagation model. Response phase could be better planned with adequate early warning systems resulting in more time and less costs to help affected areas and save human lives. Reliable and precise information is necessary to raise emergency operability level in order to enhance safety of citizens and reducing possible damage. The results of the EPISECC (EU funded FP7) project are used to validate potential benefits of this research in order to improve flood risk management and response methods. EPISECC aims at developing a concept of a common European Information Space for disaster response which, among other disasters, considers the floods.

Status of hardwood forest resources in the Appalachian region including estimates of growth and removals

Treesearch

Christopher M. Oswalt; Jeffery A. Turner

2009-01-01

The Appalachian Hardwood Region (AHR) is an important wood producing area of the Eastern United States and is near a large portion of the U.S. population that is growing considerably. Combined, these two forces create the need for assessments of the hardwood forest resources in the region. Here we present results from an investigation into the forest resources of the...

Air Force Systems Engineering Assessment Model (AF SEAM) Management Guide, Version 2

DTIC Science & Technology

2010-09-21

gleaned from experienced professionals who assisted with the model’s development. Examples of the references used include the following: • ISO /IEC...Defense Acquisition Guidebook, Chapter 4 • AFI 63-1201, Life Cycle Systems Engineering • IEEE/EIA 12207 , Software Life Cycle Processes • Air...Selection criteria Reference Material: IEEE/EIA 12207 , MIL-HDBK-514 Other Considerations: Modeling, simulation and analysis techniques can be

A Summary of Models and Standards-Based Applications for Grade-to-Grade Growth on Statewide Assessments and Implications for Students with Disabilities. Research Report. ETS RR-10-14

ERIC Educational Resources Information Center

Buzick, Heather M.; Laitusis, Cara Cahalan

2010-01-01

Recently growth-based approaches to accountability have received considerable attention because they have the potential to reward schools and teachers for improving student performance over time by measuring the progress of students at all levels of the performance spectrum (including those who have not yet reached proficiency on state…

Is the Woodcock-Johnson III a Test for All Seasons? Ceiling and Item Gradient Considerations in Its Use with Older Students

ERIC Educational Resources Information Center

Krasa, Nancy

2007-01-01

This study assesses the adequacy of item gradients and ceilings for the subtests of the Woodcock-Johnson III (WJ III) Cognitive and Achievement batteries, including the Diagnostic Supplement, in their use with participants ages 16 to 25 and Grades 10 to 18. Of the 52 subtests, 18 contain adequate item gradients and ceilings for the entire age and…

National Radar Conference, Los Angeles, CA, March 12, 13, 1986, Proceedings

NASA Astrophysics Data System (ADS)

The topics discussed include radar systems, radar subsystems, and radar signal processing. Papers are presented on millimeter wave radar for proximity fuzing of smart munitions, a solid state low pulse power ground surveillance radar, and the Radarsat prototype synthetic-aperture radar signal processor. Consideration is also given to automatic track quality assessment in ADT radar systems instrumentation of RCS measurements of modulation spectra of aircraft blades.

Climate change and forest trees in the Pacific Northwest: a vulnerability assessment and recommended actions for national forests

Treesearch

A. Bower; W. Devine; C. Aubry

2017-01-01

Climate change presents new challenges to land managers. At stake is our ability to make thoughtful, science-based decisions and to add climate change considerations to our project and management plans. We also must prioritize among the opportunities that can be included in adaptation strategies because funding and time are limited, now more than ever. In 2012, we...

Solid state SPS microwave generation and transmission study. Volume 1: Phase 2

NASA Technical Reports Server (NTRS)

Maynard, O. E.

1980-01-01

The solid state sandwich concept for Solar Power Station (SPS) was investigated. The design effort concentrated on the spacetenna, but did include some system analysis for parametric comparison reasons. The study specifically included definition and math modeling of basic solid state microwave devices, an initial conceptual subsystems and system design, sidelobe control and system selection, an assessment of selected system concept and parametric solid state microwave power transmission system data relevant to the SPS concept. Although device efficiency was not a goal, the sensitivities to design of this efficiency were parametrically treated. Sidelobe control consisted of various single step tapers, multistep tapers, and Gaussian tapers. A preliminary assessment of a hybrid concept using tubes and solid state is also included. There is a considerable amount of thermal analysis provided with emphasis on sensitivities to waste heat radiator form factor, emissivity, absorptivity, amplifier efficiency, material and junction temperature.

Enhanced Requirements for Assessment in a Competency-Based, Time-Variable Medical Education System.

PubMed

Gruppen, Larry D; Ten Cate, Olle; Lingard, Lorelei A; Teunissen, Pim W; Kogan, Jennifer R

2018-03-01

Competency-based, time-variable medical education has reshaped the perceptions and practices of teachers, curriculum designers, faculty developers, clinician educators, and program administrators. This increasingly popular approach highlights the fact that learning among different individuals varies in duration, foundation, and goal. Time variability places particular demands on the assessment data that are so necessary for making decisions about learner progress. These decisions may be formative (e.g., feedback for improvement) or summative (e.g., decisions about advancing a student). This article identifies challenges to collecting assessment data and to making assessment decisions in a time-variable system. These challenges include managing assessment data, defining and making valid assessment decisions, innovating in assessment, and modeling the considerable complexity of assessment in real-world settings and richly interconnected social systems. There are hopeful signs of creativity in assessment both from researchers and practitioners, but the transition from a traditional to a competency-based medical education system will likely continue to create much controversy and offer opportunities for originality and innovation in assessment.

Recognition of Teaching Excellence*

PubMed Central

Piascik, Peggy; Medina, Melissa; Pittenger, Amy; Rose, Renee; Creekmore, Freddy; Soltis, Robert; Bouldin, Alicia; Schwarz, Lindsay; Scott, Steven

2010-01-01

The 2008-2009 Task Force for the Recognition of Teaching Excellence was charged by the AACP Council of Faculties Leadership to examine teaching excellence by collecting best practices from colleges and schools of pharmacy, evaluating the literature to identify evidence-based criteria for excellent teaching, and recommending appropriate means to acknowledge and reward teaching excellence. This report defines teaching excellence and discusses a variety of ways to assess it, including student, alumni, peer, and self-assessment. The task force identifies important considerations that colleges and schools must address when establishing teaching recognition programs including the purpose, criteria, number and mix of awards, frequency, type of award, and method of nominating and determining awardees. The report concludes with recommendations for the academy to consider when establishing and revising teaching award programs. PMID:21301598

Host-dependent variables: The missing link to personalized medicine.

PubMed

Demlova, Regina; Zdrazilova-Dubska, Lenka; Sterba, Jaroslav; Stanta, Giorgio; Valik, Dalibor

2018-04-26

Individualized medicine has the potential to tailor anticancer therapy with the best response and highest safety margin to provide better patient care. However, modern targeted therapies are still being tested through clinical trials comparing preselected patient cohorts and assessed upon behaviour of group averages. Clinically manifesting malignant disease requires identification of host- and tumour-dependent variables such as biological characteristics of the tumour and its microenvironment including immune response features, and overall capacity of the host to receive, tolerate and efficiently utilize treatment. Contemporary medical oncology including clinical trial design need to refocus from assessing group averages to individuality taking into consideration time dependent host-associated characteristics and reinventing outliers to be appreciated as naturally occurring variables collectively determining the ultimate outcome of malignant disease. Copyright © 2018. Published by Elsevier Ltd.

International Space Station Modal Correction Analysis

NASA Technical Reports Server (NTRS)

Fotz[atrocl. Lrostom; Grugoer. < ocjae; Laible, Michael; Sugavanam, Sujatha

2012-01-01

This paper summarizes the on-orbit modal test and the related modal analysis, model validation and correlation performed for the ISS Stage ULF4, DTF S4-1A, October 11,2010, GMT 284/06:13:00.00. The objective of this analysis is to validate and correlate analytical models with the intent to verify the ISS critical interface dynamic loads and improve fatigue life prediction. For the ISS configurations under consideration, on-orbit dynamic responses were collected with Russian vehicles attached and without the Orbiter attached to the ISS. ISS instrumentation systems that were used to collect the dynamic responses during the DTF S4-1A included the Internal Wireless Instrumentation System (IWIS), External Wireless Instrumentation System (EWIS), Structural Dynamic Measurement System (SDMS), Space Acceleration Measurement System (SAMS), Inertial Measurement Unit (IMU) and ISS External Cameras. Experimental modal analyses were performed on the measured data to extract modal parameters including frequency, damping and mode shape information. Correlation and comparisons between test and analytical modal parameters were performed to assess the accuracy of models for the ISS configuration under consideration. Based on the frequency comparisons, the accuracy of the mathematical models is assessed and model refinement recommendations are given. Section 2.0 of this report presents the math model used in the analysis. This section also describes the ISS configuration under consideration and summarizes the associated primary modes of interest along with the fundamental appendage modes. Section 3.0 discusses the details of the ISS Stage ULF4 DTF S4-1A test. Section 4.0 discusses the on-orbit instrumentation systems that were used in the collection of the data analyzed in this paper. The modal analysis approach and results used in the analysis of the collected data are summarized in Section 5.0. The model correlation and validation effort is reported in Section 6.0. Conclusions and recommendations drawn from this analysis are included in Section 7.0.

Estimating the Health Effects of Greenhouse Gas Mitigation Strategies: Addressing Parametric, Model, and Valuation Challenges

PubMed Central

Hess, Jeremy J.; Ebi, Kristie L.; Markandya, Anil; Balbus, John M.; Wilkinson, Paul; Haines, Andy; Chalabi, Zaid

2014-01-01

Background: Policy decisions regarding climate change mitigation are increasingly incorporating the beneficial and adverse health impacts of greenhouse gas emission reduction strategies. Studies of such co-benefits and co-harms involve modeling approaches requiring a range of analytic decisions that affect the model output. Objective: Our objective was to assess analytic decisions regarding model framework, structure, choice of parameters, and handling of uncertainty when modeling health co-benefits, and to make recommendations for improvements that could increase policy uptake. Methods: We describe the assumptions and analytic decisions underlying models of mitigation co-benefits, examining their effects on modeling outputs, and consider tools for quantifying uncertainty. Discussion: There is considerable variation in approaches to valuation metrics, discounting methods, uncertainty characterization and propagation, and assessment of low-probability/high-impact events. There is also variable inclusion of adverse impacts of mitigation policies, and limited extension of modeling domains to include implementation considerations. Going forward, co-benefits modeling efforts should be carried out in collaboration with policy makers; these efforts should include the full range of positive and negative impacts and critical uncertainties, as well as a range of discount rates, and should explicitly characterize uncertainty. We make recommendations to improve the rigor and consistency of modeling of health co-benefits. Conclusion: Modeling health co-benefits requires systematic consideration of the suitability of model assumptions, of what should be included and excluded from the model framework, and how uncertainty should be treated. Increased attention to these and other analytic decisions has the potential to increase the policy relevance and application of co-benefits modeling studies, potentially helping policy makers to maximize mitigation potential while simultaneously improving health. Citation: Remais JV, Hess JJ, Ebi KL, Markandya A, Balbus JM, Wilkinson P, Haines A, Chalabi Z. 2014. Estimating the health effects of greenhouse gas mitigation strategies: addressing parametric, model, and valuation challenges. Environ Health Perspect 122:447–455; http://dx.doi.org/10.1289/ehp.1306744 PMID:24583270

21 CFR 25.20 - Actions requiring preparation of an environmental assessment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Actions requiring preparation of an environmental assessment. 25.20 Section 25.20 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ENVIRONMENTAL IMPACT CONSIDERATIONS Agency Actions Requiring Environmental Consideration...

Considerations for Developing a Dosimetry-Based Cumulative Risk Assessment Approach for Mixtures of Environmental Contaminants (Final Report)

EPA Science Inventory

EPA announced the availability of the final report, Considerations for Developing a Dosimetry-Based Cumulative Risk Assessment Approach for Mixtures of Environmental Contaminants. This report describes a process that can be used to determine the potential value of develop...

The measurement of disability in the elderly: a systematic review of self-reported questionnaires.

PubMed

Yang, Ming; Ding, Xiang; Dong, Birong

2014-02-01

To analyze the contents and formats of general self-reported questionnaires on disability that are designed for and/or are widely applied in the elderly population to depict a complete picture of this field and help researchers to choose proper tools more efficiently. A broad systematic literature search was performed in September 2013 and included the following databases: MEDLINE, EMBASE, CINAHL, PsycINFO, and PROQOLID. The publication language was limited to English and Chinese. Two review authors independently performed the study selection and data extraction. All of the included instruments were extracted and classified using the International Classification of Functioning, Disability, and Health framework. Of 5569 articles retrieved from the searches and 156 articles retrieved from the pearling, 22 studies (including 24 questionnaires) fulfilled the inclusion criteria. From these, 42 different domains and 458 items were extracted. The most frequently used questionnaire was the Barthel Index followed by the Lawton and Brody Instrumental Activities of Daily Living Scale and the Katz Index of Activities of Daily Living, respectively. The contents and formats of the questionnaires varied considerably. Activities and participation were the most commonly assessed dimensions. In addition, the Activities of Daily Living, mobility and the Instrumental Activities of Daily Living Scale were the most common domains assessed among the included questionnaires. Among the 24 included questionnaires, the most frequently used questionnaires were the Barthel Index, Lawton and Brody Instrumental Activities of Daily Living Scale, and Katz Index of Activities of Daily Living. The content and format of the questionnaires varied considerably, but none of the questionnaires covered all essential dimensions of the International Classification of Functioning, Disability, and Health framework. Copyright © 2014 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Epidemiologic studies of electric and magnetic fields and cancer: Strategies for extending knowledge

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

Savitz, D.A.

1993-12-01

Epidemiologic research concerning electric and magnetic fields in relation to cancer has focused on the potential etiologic roles of residential exposure on childhood cancer and occupational exposure on adult leukemia and brain cancer. Future residential studies must concentrate on exposure assessment that is enhanced by developing models of historical exposure, assessment of the relation between magnetic fields and wire codes, and consideration of alternate exposure indices. Study design issues deserving attention include possible biases in random digit dialing control selection, consideration of the temporal course of exposure and disease, and acquisition of the necessary information to assess the potential valuemore » of ecologic studies. Highest priorities are comprehensive evaluation of exposure patterns and sources and examination of the sociology and geography of residential wire codes. Future occupational studies should also concentrate on improved exposure assessment with increased attention to nonutility worker populations and development of historical exposure indicators that are superior to job titles alone. Potential carcinogens in the workplace that could act as confounders need to be more carefully examined. The temporal relation between exposure and disease and possible effect modification by other workplace agents should be incorporated into future studies. The most pressing need is for measurement of exposure patterns in a variety of worker populations and performance of traditional epidemiologic evaluations of cancer occurrence. The principal source of bias toward the null is nondifferential misclassification of exposure with improvements expected to enhance any true etiologic association that is present. Biases away from the null might include biased control selection in residential studies and chemical carcinogens acting as confounders in occupational studies. 51 refs., 1 tab.« less

Systematic review of the methodological quality of clinical guideline development for the management of chronic disease in Europe.

PubMed

Knai, Cécile; Brusamento, Serena; Legido-Quigley, Helena; Saliba, Vanessa; Panteli, Dimitra; Turk, Eva; Car, Josip; McKee, Martin; Busse, Reinhard

2012-10-01

The use of evidence-based clinical guidelines is an essential component of chronic disease management. However, there is well-documented concern about variability in the quality of clinical guidelines, with evidence of persisting methodological shortcomings. The most widely accepted approach to assessing the quality of guidelines is the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument. We have conducted a systematic review of the methodological quality (as assessed by AGREE) of clinical guidelines developed in Europe for the management of chronic diseases published since 2000. The systematic review was undertaken in accordance with the Cochrane methodology. The inclusion criteria were that studies should have appraised European clinical guidelines for certain selected chronic disorders using the AGREE instrument. We searched five databases (Cab Abstracts, EMBASE, MEDLINE, Trip and EPPI). Nine studies reported in 10 papers, analysing a total of 28 European guidelines from eight countries as well as pan-European, were included. There was considerable variation in the quality of clinical guidelines across the AGREE domains. The least well addressed domains were 'editorial independence' (with a mean domain score of 41%), 'applicability' (44%), 'stakeholder involvement' (55%), and 'rigour of development' (64%), while 'clarity of presentation' (80%) and 'scope and purpose' (84%) were less problematic. This review indicates that there is considerable scope for improvement in the methods used to develop clinical guidelines for the prevention, management and treatment of chronic diseases in Europe. Given the importance of decision support strategies such as clinical guidelines in chronic disease management, improvement measures should include the explicit and transparent involvement of key stakeholders (especially scientific experts, guideline users and methodological specialists) and consideration of the implications for guideline implementation and applicability early on in the process. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Tree-based flood damage modeling of companies: Damage processes and model performance

NASA Astrophysics Data System (ADS)

Sieg, Tobias; Vogel, Kristin; Merz, Bruno; Kreibich, Heidi

2017-07-01

Reliable flood risk analyses, including the estimation of damage, are an important prerequisite for efficient risk management. However, not much is known about flood damage processes affecting companies. Thus, we conduct a flood damage assessment of companies in Germany with regard to two aspects. First, we identify relevant damage-influencing variables. Second, we assess the prediction performance of the developed damage models with respect to the gain by using an increasing amount of training data and a sector-specific evaluation of the data. Random forests are trained with data from two postevent surveys after flood events occurring in the years 2002 and 2013. For a sector-specific consideration, the data set is split into four subsets corresponding to the manufacturing, commercial, financial, and service sectors. Further, separate models are derived for three different company assets: buildings, equipment, and goods and stock. Calculated variable importance values reveal different variable sets relevant for the damage estimation, indicating significant differences in the damage process for various company sectors and assets. With an increasing number of data used to build the models, prediction errors decrease. Yet the effect is rather small and seems to saturate for a data set size of several hundred observations. In contrast, the prediction improvement achieved by a sector-specific consideration is more distinct, especially for damage to equipment and goods and stock. Consequently, sector-specific data acquisition and a consideration of sector-specific company characteristics in future flood damage assessments is expected to improve the model performance more than a mere increase in data.

Needs assessments in palliative care: an appraisal of definitions and approaches used.

PubMed

Higginson, Irene J; Hart, Sam; Koffman, Jonathan; Selman, Lucy; Harding, Richard

2007-05-01

We report a systematic appraisal of definitions and approaches to needs assessment in palliative care. Electronic databases were searched, and relevant individuals and organizations were contacted to identify needs assessments in palliative care. Over 200 articles were identified giving general information on needs assessment, and 77 articles comprised palliative care-related needs assessment reports. The reports originated from Africa (37), Australia (1), Europe (including former central/eastern European states) (35), USA (1), Latin America (5), and Asia (7). Two underpinning definitions of need were identified, that of Maslow from the field of psychology, and that of Bradshaw from sociology. However, in conducting needs assessments, these definitions were operationalized, and here the National Health Service Executive definition of need as "the ability to benefit from health care" is helpful. We identified three main categories of approach to needs assessment--epidemiological, corporate, and comparative--that can be used in combination. Careful consideration must be paid to any needs assessment data to ensure that the assessment is implemented.

Methodological standards in single-case experimental design: Raising the bar.

PubMed

Ganz, Jennifer B; Ayres, Kevin M

2018-04-12

Single-case experimental designs (SCEDs), or small-n experimental research, are frequently implemented to assess approaches to improving outcomes for people with disabilities, particularly those with low-incidence disabilities, such as some developmental disabilities. SCED has become increasingly accepted as a research design. As this literature base is needed to determine what interventions are evidence-based practices, the acceptance of SCED has resulted in increased critiques with regard to methodological quality. Recent trends include recommendations from a number of expert scholars and institutions. The purpose of this article is to summarize the recent history of methodological quality considerations, synthesize the recommendations found in the SCED literature, and provide recommendations to researchers designing SCEDs with regard to essential and aspirational standards for methodological quality. Conclusions include imploring SCED to increase the quality of their experiments, with particular consideration regarding the applied nature of SCED research to be published in Research in Developmental Disabilities and beyond. Copyright © 2018 Elsevier Ltd. All rights reserved.

Commentary: considerations for using the 'Trials within Cohorts' design in a clinical trial of an investigational medicinal product.

PubMed

Bibby, Anna C; Torgerson, David J; Leach, Samantha; Lewis-White, Helen; Maskell, Nick A

2018-01-08

The 'trials within cohorts' (TwiC) design is a pragmatic approach to randomised trials in which trial participants are randomly selected from an existing cohort. The design has multiple potential benefits, including the option of conducting multiple trials within the same cohort. To date, the TwiC design methodology been used in numerous clinical settings but has never been applied to a clinical trial of an investigational medicinal product (CTIMP). We have recently secured the necessary approvals to undertake the first CTIMP using the TwiC design. In this paper, we describe some of the considerations and modifications required to ensure such a trial is compliant with Good Clinical Practice and international clinical trials regulations. We advocate using a two-stage consent process and using the consent stages to explicitly differentiate between trial participants and cohort participants who are providing control data. This distinction ensured compliance but had consequences with respect to costings, recruitment and the trial assessment schedule. We have demonstrated that it is possible to secure ethical and regulatory approval for a CTIMP TwiC. By including certain considerations at the trial design stage, we believe this pragmatic and efficient methodology could be utilised in other CTIMPs in future.

Assessing patient capacity to consent to treatment: an integrative review of instruments and tools.

PubMed

Lamont, Scott; Jeon, Yun-Hee; Chiarella, Mary

2013-09-01

To provide a narrative synthesis of research findings on instruments or tools designed to aid assessment of patient capacity to consent to treatment. Capacity assessment is of significant priority within health care as a finding of incapacity is a vehicle for the removal of many of an individual's fundamental rights. Despite there being many instruments and tools available to aid health professionals in the assessment of patient capacity, there are no standardised guidelines from professional bodies that inform the assessment of mental capacity. Integrative review. Primary studies of instruments or tools concerning assessment of patient capacity to consent to treatment, published in English in peer-reviewed journals between January 2005-December 2010, were included in the review. Review papers of capacity assessment instruments were included for years including and prior to 2006. Nineteen instruments were found which assess patient capacity to consent. Key themes were identified in terms of capacity domains assessed, psychometric properties, instrument implementation, patient populations studied and instrument versus clinician judgement. Despite a plethora of capacity assessment instruments and tools available, only a small number of instruments were found to have demonstrated both reliability and validity. Further research is required to improve the validity of existing capacity assessment instruments. Increased attention to patient rights and autonomy arguably places a considerable burden on healthcare professionals to facilitate capacity assessments across a continuum of health care. Despite a plethora of capacity assessment instruments and tools being available to healthcare professionals, a comprehensive assessment requires time and is often difficult in the acute care setting. A strictly formulaic approach to the assessment of capacity is unlikely to capture specific individual nuances; therefore, capacity assessment instruments should support, but not replace, experienced clinical judgement. © 2013 John Wiley & Sons Ltd.

Utility of proverb interpretation measures with cardiac transplant candidates.

PubMed

Dugbartey, A T

1998-12-01

To assess metaphorical understanding and proverb interpretation in cardiac transplant candidates, the neuropsychological assessment records of 22 adults with end-stage cardiac disease under consideration for transplantation were analyzed. Neuropsychological tests consisted of the Controlled Oral Word Association Test, Halstead Category Test, Rey-Osterrieth Complex Figure Test (Copy), Trial Making Test, and summed scores for the proverb items of the WAIS-R Comprehension subtest. Analysis showed that the group tended to interpret proverbs literally. Proverb scores were significantly associated with scores on the Similarities and Picture Arrangement subtests of the WAIS-R. There was a moderate negative association between number of reported heart attacks and Proverb scores. The need for brief yet robust assessments including measures of inferential thinking and conceptualization in transplant candidates are highlighted.

Measurement of Circulating Cytokines and Immune-Activation Markers by Multiplex Technology in the Clinical Setting: What Are We Really Measuring?

PubMed

Aziz, Najib

2015-01-01

Measurement of circulating cytokine levels can provide important information in the study of the pathogenesis of disease. John L. Fahey was a pioneer in the measurement of circulating cytokines and immune-activation markers and a leader in the quality assessment/control of assays for measurement of circulating cytokines. Insights into the measurement of circulating cytokines, including consideration of multiplex assays, are presented here.

Pharmacodynamics of nicotine: implications for rational treatment of nicotine addiction.

PubMed

Benowitz, N L

1991-05-01

Rational treatment of the pharmacologic aspects of tobacco addiction includes nicotine substitution therapy. Understanding the pharmacodynamics of nicotine and its role in the addiction process provides a basis for rational therapeutic intervention. Pharmacodynamic considerations are discussed in relation to the elements of smoking cessation therapy: setting objectives, selecting appropriate medication and dosing form, selecting the optimal doses and dosage regimens, assessing therapeutic outcome, and adjusting therapy to optimize benefits and minimize risks.

Advancing scoping study methodology: a web-based survey and consultation of perceptions on terminology, definition and methodological steps.

PubMed

O'Brien, Kelly K; Colquhoun, Heather; Levac, Danielle; Baxter, Larry; Tricco, Andrea C; Straus, Sharon; Wickerson, Lisa; Nayar, Ayesha; Moher, David; O'Malley, Lisa

2016-07-26

Scoping studies (or reviews) are a method used to comprehensively map evidence across a range of study designs in an area, with the aim of informing future research practice, programs and policy. However, no universal agreement exists on terminology, definition or methodological steps. Our aim was to understand the experiences of, and considerations for conducting scoping studies from the perspective of academic and community partners. Primary objectives were to 1) describe experiences conducting scoping studies including strengths and challenges; and 2) describe perspectives on terminology, definition, and methodological steps. We conducted a cross-sectional web-based survey with clinicians, educators, researchers, knowledge users, representatives from community-based organizations, graduate students, and policy stakeholders with experience and/or interest in conducting scoping studies to gain an understanding of experiences and perspectives on the conduct and reporting of scoping studies. We administered an electronic self-reported questionnaire comprised of 22 items related to experiences with scoping studies, strengths and challenges, opinions on terminology, and methodological steps. We analyzed questionnaire data using descriptive statistics and content analytical techniques. Survey results were discussed during a multi-stakeholder consultation to identify key considerations in the conduct and reporting of scoping studies. Of the 83 invitations, 54 individuals (65 %) completed the scoping questionnaire, and 48 (58 %) attended the scoping study meeting from Canada, the United Kingdom and United States. Many scoping study strengths were dually identified as challenges including breadth of scope, and iterative process. No consensus on terminology emerged, however key defining features that comprised a working definition of scoping studies included the exploratory mapping of literature in a field; iterative process, inclusion of grey literature; no quality assessment of included studies, and an optional consultation phase. We offer considerations for the conduct and reporting of scoping studies for researchers, clinicians and knowledge users engaging in this methodology. Lack of consensus on scoping terminology, definition and methodological steps persists. Reasons for this may be attributed to diversity of disciplines adopting this methodology for differing purposes. Further work is needed to establish guidelines on the reporting and methodological quality assessment of scoping studies.

76 FR 80249 - Use of Differential Income Stream as a Consideration in Assessing the Best Method

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-23

... Differential Income Stream as a Consideration in Assessing the Best Method AGENCY: Internal Revenue Service... method in connection with a cost sharing arrangement. The text of these temporary regulations also serves... unreasonable positions in applying the income method by using relatively low licensing discount rates, and...

Further Commentary on Mitochondrial Dysfunction in Autism Spectrum Disorder: Assessment and Treatment Considerations

ERIC Educational Resources Information Center

Dager, Stephen R.; Corrigan, Neva M.; Estes, Annette; Shaw, Dennis W. W.

2012-01-01

The authors respond to a recent letter (Rossignol and Frye 2011) critical of their paper, "Proton magnetic resonance spectroscopy and MRI reveal no evidence for brain mitochondrial dysfunction in children with autism spectrum disorder" (Corrigan et al. 2011). Further considerations regarding the assessment of mitochondrial dysfunction in autism…

47 CFR 1.1308 - Consideration of environmental assessments (EAs); findings of no significant impact.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 1969 § 1.1308 Consideration of environmental assessments (EAs); findings of no significant impact. (a) Applicants shall prepare EAs for actions that may have a significant environmental impact (see § 1.1307). An...), that the proposal will have a significant environmental impact upon the quality of the human...

Primary and secondary management of pediatric soft tissue injuries.

PubMed

Hogg, Nicholas J V

2012-08-01

Injury is the most common cause of death in pediatric patients, with a large proportion related to head injury. The craniofacial region in children develops rapidly and at an early age, making the area more prominent compared with the remainder of the body, increasing the likelihood of injury. This article reviews the primary management of pediatric soft tissue injuries, including assessment, cleansing, surgical technique, anesthesia, and considerations for special wounds. The secondary management of pediatric facial injury is also discussed, including scar revision, management of scar hypertrophy/keloids, and staged surgical correction. Copyright © 2012 Elsevier Inc. All rights reserved.

Robotic space construction

NASA Technical Reports Server (NTRS)

Mixon, Randolph W.; Hankins, Walter W., III; Wise, Marion A.

1988-01-01

Research at Langley AFB concerning automated space assembly is reviewed, including a Space Shuttle experiment to test astronaut ability to assemble a repetitive truss structure, testing the use of teleoperated manipulators to construct the Assembly Concept for Construction of Erectable Space Structures I truss, and assessment of the basic characteristics of manipulator assembly operations. Other research topics include the simultaneous coordinated control of dual-arm manipulators and the automated assembly of candidate Space Station trusses. Consideration is given to the construction of an Automated Space Assembly Laboratory to study and develop the algorithms, procedures, special purpose hardware, and processes needed for automated truss assembly.

Machine Learning Assessments of Soil Drying

NASA Astrophysics Data System (ADS)

Coopersmith, E. J.; Minsker, B. S.; Wenzel, C.; Gilmore, B. J.

2011-12-01

Agricultural activities require the use of heavy equipment and vehicles on unpaved farmlands. When soil conditions are wet, equipment can cause substantial damage, leaving deep ruts. In extreme cases, implements can sink and become mired, causing considerable delays and expense to extricate the equipment. Farm managers, who are often located remotely, cannot assess sites before allocating equipment, causing considerable difficulty in reliably assessing conditions of countless sites with any reliability and frequency. For example, farmers often trace serpentine paths of over one hundred miles each day to assess the overall status of various tracts of land spanning thirty, forty, or fifty miles in each direction. One means of assessing the moisture content of a field lies in the strategic positioning of remotely-monitored in situ sensors. Unfortunately, land owners are often reluctant to place sensors across their properties due to the significant monetary cost and complexity. This work aspires to overcome these limitations by modeling the process of wetting and drying statistically - remotely assessing field readiness using only information that is publically accessible. Such data includes Nexrad radar and state climate network sensors, as well as Twitter-based reports of field conditions for validation. Three algorithms, classification trees, k-nearest-neighbors, and boosted perceptrons are deployed to deliver statistical field readiness assessments of an agricultural site located in Urbana, IL. Two of the three algorithms performed with 92-94% accuracy, with the majority of misclassifications falling within the calculated margins of error. This demonstrates the feasibility of using a machine learning framework with only public data, knowledge of system memory from previous conditions, and statistical tools to assess "readiness" without the need for real-time, on-site physical observation. Future efforts will produce a workflow assimilating Nexrad, climate network, and Twitter data to generate a real-time web-map of estimated readiness conditions.

US DOE-EM On-Site Disposal Cell Working Group - Fostering Communication On Performance Assessment Challenges

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

Seitz, Roger R.; Suttora, Linda C.; Phifer, Mark

On-site disposal cells are in use and being considered at several U.S. Department of Energy (USDOE) sites as the final disposition for large amounts of waste associated with cleanup of contaminated areas and facilities. These facilities are typically developed with regulatory oversight from States and/or the US Environmental Protection Agency (USEPA) in addition to USDOE. The facilities are developed to meet design standards for disposal of hazardous waste as well as the USDOE performance based standards for disposal of radioactive waste. The involvement of multiple and different regulators for facilities across separate sites has resulted in some differences in expectationsmore » for performance assessments and risk assessments (PA/RA) that are developed for the disposal facilities. The USDOE-EM Office of Site Restoration formed a working group to foster improved communication and sharing of information for personnel associated with these Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) disposal cells and work towards more consistent assumptions, as appropriate, for technical and policy considerations related to performance and risk assessments in support of a Record of Decision and Disposal Authorization Statement. The working group holds teleconferences, as needed, focusing on specific topics of interest. The topics addressed to date include an assessment of the assumptions used for performance assessments and risk assessments (PA/RAs) for on-site disposal cells, requirements and assumptions related to assessment of inadvertent intrusion, DOE Manual 435.1-1 requirements, and approaches for consideration of the long-term performance of liners and covers in the context of PAs. The working group has improved communication among the staff and oversight personnel responsible for onsite disposal cells and has provided a forum to identify and resolve common concerns.« less

Measuring conditions and trends in ecosystem services at multiple scales: the Southern African Millennium Ecosystem Assessment (SAfMA) experience

PubMed Central

van Jaarsveld, A.S; Biggs, R; Scholes, R.J; Bohensky, E; Reyers, B; Lynam, T; Musvoto, C; Fabricius, C

2005-01-01

The Southern African Millennium Ecosystem Assessment (SAfMA) evaluated the relationships between ecosystem services and human well-being at multiple scales, ranging from local through to sub-continental. Trends in ecosystem services (fresh water, food, fuel-wood, cultural and biodiversity) over the period 1990–2000 were mixed across scales. Freshwater resources appear strained across the continent with large numbers of people not securing adequate supplies, especially of good quality water. This translates to high infant mortality patterns across the region. In some areas, the use of water resources for irrigated agriculture and urban–industrial expansion is taking place at considerable cost to the quality and quantity of freshwater available to ecosystems and for domestic use. Staple cereal production across the region has increased but was outstripped by population growth while protein malnutrition is on the rise. The much-anticipated wood-fuel crisis on the subcontinent has not materialized but some areas are experiencing shortages while numerous others remain vulnerable. Cultural benefits of biodiversity are considerable, though hard to quantify or track over time. Biodiversity resources remain at reasonable levels, but are declining faster than reflected in species extinction rates and appear highly sensitive to land-use decisions. The SAfMA sub-global assessment provided an opportunity to experiment with innovative ways to assess ecosystem services including the use of supply–demand surfaces, service sources and sink areas, priority areas for service provision, service ‘hotspots’ and trade-off assessments. PMID:15814355

Issues and considerations in the use of serologic biomarkers for classifying vaccination history in household surveys.

PubMed

MacNeil, Adam; Lee, Chung-Won; Dietz, Vance

2014-09-03

Accurate estimates of vaccination coverage are crucial for assessing routine immunization program performance. Community based household surveys are frequently used to assess coverage within a country. In household surveys to assess routine immunization coverage, a child's vaccination history is classified on the basis of observation of the immunization card, parental recall of receipt of vaccination, or both; each of these methods has been shown to commonly be inaccurate. The use of serologic data as a biomarker of vaccination history is a potential additional approach to improve accuracy in classifying vaccination history. However, potential challenges, including the accuracy of serologic methods in classifying vaccination history, varying vaccine types and dosing schedules, and logistical and financial implications must be considered. We provide historic and scientific context for the potential use of serologic data to assess vaccination history and discuss in detail key areas of importance for consideration in the context of using serologic data for classifying vaccination history in household surveys. Further studies are needed to directly evaluate the performance of serologic data compared with use of immunization cards or parental recall for classification of vaccination history in household surveys, as well assess the impact of age at the time of sample collection on serologic titers, the predictive value of serology to identify a fully vaccinated child for multi-dose vaccines, and the cost impact and logistical issues on outcomes associated with different types of biological samples for serologic testing. Published by Elsevier Ltd.

Measuring conditions and trends in ecosystem services at multiple scales: the Southern African Millennium Ecosystem Assessment (SAfMA) experience.

PubMed

van Jaarsveld, A S; Biggs, R; Scholes, R J; Bohensky, E; Reyers, B; Lynam, T; Musvoto, C; Fabricius, C

2005-02-28

The Southern African Millennium Ecosystem Assessment (SAfMA) evaluated the relationships between ecosystem services and human well-being at multiple scales, ranging from local through to sub-continental. Trends in ecosystem services (fresh water, food, fuel-wood, cultural and biodiversity) over the period 1990-2000 were mixed across scales. Freshwater resources appear strained across the continent with large numbers of people not securing adequate supplies, especially of good quality water. This translates to high infant mortality patterns across the region. In some areas, the use of water resources for irrigated agriculture and urban-industrial expansion is taking place at considerable cost to the quality and quantity of freshwater available to ecosystems and for domestic use. Staple cereal production across the region has increased but was outstripped by population growth while protein malnutrition is on the rise. The much-anticipated wood-fuel crisis on the subcontinent has not materialized but some areas are experiencing shortages while numerous others remain vulnerable. Cultural benefits of biodiversity are considerable, though hard to quantify or track over time. Biodiversity resources remain at reasonable levels, but are declining faster than reflected in species extinction rates and appear highly sensitive to land-use decisions. The SAfMA sub-global assessment provided an opportunity to experiment with innovative ways to assess ecosystem services including the use of supply-demand surfaces, service sources and sink areas, priority areas for service provision, service 'hotspots' and trade-off assessments.

A tutorial on aphasia test development in any language: Key substantive and psychometric considerations

PubMed Central

Ivanova, Maria V.; Hallowell, Brooke

2013-01-01

Background There are a limited number of aphasia language tests in the majority of the world's commonly spoken languages. Furthermore, few aphasia tests in languages other than English have been standardized and normed, and few have supportive psychometric data pertaining to reliability and validity. The lack of standardized assessment tools across many of the world's languages poses serious challenges to clinical practice and research in aphasia. Aims The current review addresses this lack of assessment tools by providing conceptual and statistical guidance for the development of aphasia assessment tools and establishment of their psychometric properties. Main Contribution A list of aphasia tests in the 20 most widely spoken languages is included. The pitfalls of translating an existing test into a new language versus creating a new test are outlined. Factors to consider in determining test content are discussed. Further, a description of test items corresponding to different language functions is provided, with special emphasis on implementing important controls in test design. Next, a broad review of principal psychometric properties relevant to aphasia tests is presented, with specific statistical guidance for establishing psychometric properties of standardized assessment tools. Conclusions This article may be used to help guide future work on developing, standardizing and validating aphasia language tests. The considerations discussed are also applicable to the development of standardized tests of other cognitive functions. PMID:23976813

Aeroelastic Tailoring for Stability Augmentation and Performance Enhancements of Tiltrotor Aircraft

NASA Technical Reports Server (NTRS)

Nixon, Mark W.; Piatak, David J.; Corso, Lawrence M.; Popelka, David A.

1999-01-01

The requirements for increased speed and productivity for tiltrotors has spawned several investigations associated with proprotor aeroelastic stability augmentation and aerodynamic performance enhancements. Included among these investigations is a focus on passive aeroelastic tailoring concepts which exploit the anisotropic capabilities of fiber composite materials. Researchers at Langley Research Center and Bell Helicopter have devoted considerable effort to assess the potential for using these materials to obtain aeroelastic responses which are beneficial to the important stability and performance considerations of tiltrotors. Both experimental and analytical studies have been completed to examine aeroelastic tailoring concepts for the tiltrotor, applied either to the wing or to the rotor blades. This paper reviews some of the results obtained in these aeroelastic tailoring investigations and discusses the relative merits associated with these approaches.

Oral health assessment and mouth care for children and young people receiving palliative care. Part one.

PubMed

Sargeant, Stephanie; Chamley, Carol

2013-03-01

This is the first part of two articles exploring oral health problems and treatments for children receiving palliative care, successful management of which can improve considerably the quality of life for this group of children and young people. Part one includes an adapted oral health assessment tool for use in children and young people with complex and palliative healthcare needs that has the potential to help nurses identify and monitor oral health problems and prevent or minimise oral problems from developing. Part two--to be published next month--focuses on basic oral hygiene and the management of specific oral health problems.

Mission Concepts and Operations for Asteroid Mitigation Involving Multiple Gravity Tractors

NASA Technical Reports Server (NTRS)

Foster, Cyrus; Bellerose, Julie; Jaroux, Belgacem; Mauro, David

2012-01-01

The gravity tractor concept is a proposed method to deflect an imminent asteroid impact through gravitational tugging over a time scale of years. In this study, we present mission scenarios and operational considerations for asteroid mitigation efforts involving multiple gravity tractors. We quantify the deflection performance improvement provided by a multiple gravity tractor campaign and assess its sensitivity to staggered launches. We next explore several proximity operation strategies to accommodate multiple gravity tractors at a single asteroid including formation-flying and mechanically-docked configurations. Finally, we utilize 99942 Apophis as an illustrative example to assess the performance of a multiple gravity tractor campaign.

Pick and Eat Crop Testing: Dwarf Tomato and Pepper as Candidate Space Crops

NASA Technical Reports Server (NTRS)

Wheeler, R. M.; Massa, G. D.; Stutte, G. W.; Spencer, L. E.; Hummerick, M. E.; Sirmons, T.; Douglas, G. L.

2016-01-01

Dwarf tomato and pepper plants were grown in controlled environment chambers to assess their potential as space crops for supplementing the crew's diet. Six cultivars of each species were compared in initial tests and then down-selected to three cultivars of each. Initial selection criteria included fruit yield, growth height, and nutritional value. Following completion of a second production test with the three best performing cultivars, sample fruits of both tomato and peppers were then assessed for acceptance using tasting panels. Based on the criteria considered in these studies, Red Robin tomato and Pompeii pepper were recommended for consideration for use in space.

The impact of land use on estimates of pesticide leaching potential: Assessments and uncertainties

NASA Astrophysics Data System (ADS)

Loague, Keith

1991-11-01

This paper illustrates the magnitude of uncertainty which can exist for pesticide leaching assessments, due to data uncertainties, both between soil orders and within a single soil order. The current work differs from previous efforts because the impact of uncertainty in recharge estimates is considered. The examples are for diuron leaching in the Pearl Harbor Basin. The results clearly indicate that land use has a significant impact on both estimates of pesticide leaching potential and the uncertainties associated with those estimates. It appears that the regulation of agricultural chemicals in the future should include consideration for changing land use.

Benefit-cost assessment programs: Costa Rica case study

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

Clark, A.L.; Trocki, L.K.

An assessment of mineral potential, in terms of types and numbers of deposits, approximate location and associated tonnage and grades, is a valuable input to a nation's economic planning and mineral policy development. This study provides a methodology for applying benefit-cost analysis to mineral resource assessment programs, both to determine the cost effectiveness of resource assessments and to ascertain future benefits to the nation. In a case study of Costa Rica, the benefit-cost ratio of a resource assessment program was computed to be a minimum of 4:1 ($10.6 million to $2.5 million), not including the economic benefits accuring from themore » creation of 800 mining sector and 1,200 support services jobs. The benefit-cost ratio would be considerably higher if presently proposed revisions of mineral policy were implemented and benefits could be defined for Costa Rica.« less

Methodological optimization of tinnitus assessment using prepulse inhibition of the acoustic startle reflex.

PubMed

Longenecker, R J; Galazyuk, A V

2012-11-16

Recently prepulse inhibition of the acoustic startle reflex (ASR) became a popular technique for tinnitus assessment in laboratory animals. This method confers a significant advantage over the previously used time-consuming behavioral approaches utilizing basic mechanisms of conditioning. Although this technique has been successfully used to assess tinnitus in different laboratory animals, many of the finer details of this methodology have not been described enough to be replicated, but are critical for tinnitus assessment. Here we provide detail description of key procedures and methodological issues that provide guidance for newcomers with the process of learning to correctly apply gap detection techniques for tinnitus assessment in laboratory animals. The major categories of these issues include: refinement of hardware for best performance, optimization of stimulus parameters, behavioral considerations, and identification of optimal strategies for data analysis. This article is part of a Special Issue entitled: Tinnitus Neuroscience. Copyright © 2012. Published by Elsevier B.V.

Using the Program Sustainability Assessment Tool to Assess and Plan for Sustainability

PubMed Central

Mainor, Avia; Moreland-Russell, Sarah; Maier, Ryan C.; Brossart, Laura; Luke, Douglas A.

2014-01-01

Implementing and growing a public health program that benefits society takes considerable time and effort. To ensure that positive outcomes are maintained over time, program managers and stakeholders should plan and implement activities to build sustainability capacity within their programs. We describe a 3-part sustainability planning process that programs can follow to build their sustainability capacity. First, program staff and stakeholders take the Program Sustainability Assessment Tool to measure their program’s sustainability across 8 domains. Next, managers and stakeholders use results from the assessment to inform and prioritize sustainability action planning. Lastly, staff members implement the plan and keep track of progress toward their sustainability goals. Through this process, staff can more holistically address the internal and external challenges and pressures associated with sustaining a program. We include a case example of a chronic disease program that completed the Program Sustainability Assessment Tool and engaged in program sustainability planning. PMID:24456644

Respiratory assessment.

PubMed

Simpson, Heidi

The ability to carry out and document a full respiratory assessment is an essential skill for all nurses. The elements included are: an initial assessment, history taking, inspection, palpation, percussion, auscultation and further investigations. A prompt initial assessment allows immediate evaluation of severity of illness and appropriate treatment measures may warrant instigation at this point. Following this, a comprehensive patient history will be elicited. Clinical examination of the patient follows and involves inspection, palpation, percussion and auscultation. At this point, consideration must be given to preparation of a light, warm, quiet, private environment for examination and suitable patient positioning. Inspection is a comprehensive visual assessment, while palpation involves using touch to gather information. The next stages are percussion and auscultation. While percussion is striking the chest to determine the state of underlying tissues, auscultation entails listening to and interpreting sound transmission through the chest wall via a stethoscope. Finally, further investigations may be necessary to confirm or negate suspected diagnoses.

Ferrets as Models for Influenza Virus Transmission Studies and Pandemic Risk Assessments

PubMed Central

Barclay, Wendy; Barr, Ian; Fouchier, Ron A.M.; Matsuyama, Ryota; Nishiura, Hiroshi; Peiris, Malik; Russell, Charles J.; Subbarao, Kanta; Zhu, Huachen

2018-01-01

The ferret transmission model is extensively used to assess the pandemic potential of emerging influenza viruses, yet experimental conditions and reported results vary among laboratories. Such variation can be a critical consideration when contextualizing results from independent risk-assessment studies of novel and emerging influenza viruses. To streamline interpretation of data generated in different laboratories, we provide a consensus on experimental parameters that define risk-assessment experiments of influenza virus transmissibility, including disclosure of variables known or suspected to contribute to experimental variability in this model, and advocate adoption of more standardized practices. We also discuss current limitations of the ferret transmission model and highlight continued refinements and advances to this model ongoing in laboratories. Understanding, disclosing, and standardizing the critical parameters of ferret transmission studies will improve the comparability and reproducibility of pandemic influenza risk assessment and increase the statistical power and, perhaps, accuracy of this model. PMID:29774862

The Next Generation of Risk Assessment Multi-Year Study-Highlights of Findings, Applications to Risk Assessment, and Future Directions.

PubMed

Cote, Ila; Andersen, Melvin E; Ankley, Gerald T; Barone, Stanley; Birnbaum, Linda S; Boekelheide, Kim; Bois, Frederic Y; Burgoon, Lyle D; Chiu, Weihsueh A; Crawford-Brown, Douglas; Crofton, Kevin M; DeVito, Michael; Devlin, Robert B; Edwards, Stephen W; Guyton, Kathryn Z; Hattis, Dale; Judson, Richard S; Knight, Derek; Krewski, Daniel; Lambert, Jason; Maull, Elizabeth Anne; Mendrick, Donna; Paoli, Gregory M; Patel, Chirag Jagdish; Perkins, Edward J; Poje, Gerald; Portier, Christopher J; Rusyn, Ivan; Schulte, Paul A; Simeonov, Anton; Smith, Martyn T; Thayer, Kristina A; Thomas, Russell S; Thomas, Reuben; Tice, Raymond R; Vandenberg, John J; Villeneuve, Daniel L; Wesselkamper, Scott; Whelan, Maurice; Whittaker, Christine; White, Ronald; Xia, Menghang; Yauk, Carole; Zeise, Lauren; Zhao, Jay; DeWoskin, Robert S

2016-11-01

The Next Generation (NexGen) of Risk Assessment effort is a multi-year collaboration among several organizations evaluating new, potentially more efficient molecular, computational, and systems biology approaches to risk assessment. This article summarizes our findings, suggests applications to risk assessment, and identifies strategic research directions. Our specific objectives were to test whether advanced biological data and methods could better inform our understanding of public health risks posed by environmental exposures. New data and methods were applied and evaluated for use in hazard identification and dose-response assessment. Biomarkers of exposure and effect, and risk characterization were also examined. Consideration was given to various decision contexts with increasing regulatory and public health impacts. Data types included transcriptomics, genomics, and proteomics. Methods included molecular epidemiology and clinical studies, bioinformatic knowledge mining, pathway and network analyses, short-duration in vivo and in vitro bioassays, and quantitative structure activity relationship modeling. NexGen has advanced our ability to apply new science by more rapidly identifying chemicals and exposures of potential concern, helping characterize mechanisms of action that influence conclusions about causality, exposure-response relationships, susceptibility and cumulative risk, and by elucidating new biomarkers of exposure and effects. Additionally, NexGen has fostered extensive discussion among risk scientists and managers and improved confidence in interpreting and applying new data streams. While considerable uncertainties remain, thoughtful application of new knowledge to risk assessment appears reasonable for augmenting major scope assessments, forming the basis for or augmenting limited scope assessments, and for prioritization and screening of very data limited chemicals. Citation: Cote I, Andersen ME, Ankley GT, Barone S, Birnbaum LS, Boekelheide K, Bois FY, Burgoon LD, Chiu WA, Crawford-Brown D, Crofton KM, DeVito M, Devlin RB, Edwards SW, Guyton KZ, Hattis D, Judson RS, Knight D, Krewski D, Lambert J, Maull EA, Mendrick D, Paoli GM, Patel CJ, Perkins EJ, Poje G, Portier CJ, Rusyn I, Schulte PA, Simeonov A, Smith MT, Thayer KA, Thomas RS, Thomas R, Tice RR, Vandenberg JJ, Villeneuve DL, Wesselkamper S, Whelan M, Whittaker C, White R, Xia M, Yauk C, Zeise L, Zhao J, DeWoskin RS. 2016. The Next Generation of Risk Assessment multiyear study-highlights of findings, applications to risk assessment, and future directions. Environ Health Perspect 124:1671-1682; http://dx.doi.org/10.1289/EHP233.

Evaluation of interventions on road traffic injuries in Peru: a qualitative approach

PubMed Central

2012-01-01

Background Evaluation of interventions on road traffic injuries (RTI) going beyond the assessment of impact to include factors underlying success or failure is an important complement to standard impact evaluations. We report here how we used a qualitative approach to assess current interventions implemented to reduce RTIs in Peru. Methods We performed in-depth interviews with policymakers and technical officers involved in the implementation of RTI interventions to get their insight on design, implementation and evaluation aspects. We then conducted a workshop with key stakeholders to analyze the results of in-depth interviews, and to further discuss and identify key programmatic considerations when designing and implementing RTI interventions. We finally performed brainstorming sessions to assess potential system-wide effects of a selected intervention (Zero Tolerance), and to identify adaptation and redesign needs for this intervention. Results Key programmatic components were consistently identified that should be considered when designing and implementing RTI interventions. They include effective and sustained political commitment and planning; sufficient and sustained budget allocation; training, supervision, monitoring and evaluation of implemented policies; multisectoral participation; and strong governance and accountability. Brainstorming sessions revealed major negative effects of the selected intervention on various system building blocks. Conclusions Our approach revealed substantial caveats in current RTI interventions in Peru, and fundamental negative effects on several components of the sectors and systems involved. It also highlighted programmatic issues that should be applied to guarantee an effective implementation and evaluation of these policies. The findings from this study were discussed with key stakeholders for consideration in further designing and planning RTI control interventions in Peru. PMID:22269578

Evaluation of interventions on road traffic injuries in Peru: a qualitative approach.

PubMed

Huicho, Luis; Adam, Taghreed; Rosales, Edmundo; Paca-Palao, Ada; López, Luis; Luna, Diego; Miranda, J Jaime

2012-01-23

Evaluation of interventions on road traffic injuries (RTI) going beyond the assessment of impact to include factors underlying success or failure is an important complement to standard impact evaluations. We report here how we used a qualitative approach to assess current interventions implemented to reduce RTIs in Peru. We performed in-depth interviews with policymakers and technical officers involved in the implementation of RTI interventions to get their insight on design, implementation and evaluation aspects. We then conducted a workshop with key stakeholders to analyze the results of in-depth interviews, and to further discuss and identify key programmatic considerations when designing and implementing RTI interventions. We finally performed brainstorming sessions to assess potential system-wide effects of a selected intervention (Zero Tolerance), and to identify adaptation and redesign needs for this intervention. Key programmatic components were consistently identified that should be considered when designing and implementing RTI interventions. They include effective and sustained political commitment and planning; sufficient and sustained budget allocation; training, supervision, monitoring and evaluation of implemented policies; multisectoral participation; and strong governance and accountability. Brainstorming sessions revealed major negative effects of the selected intervention on various system building blocks. Our approach revealed substantial caveats in current RTI interventions in Peru, and fundamental negative effects on several components of the sectors and systems involved. It also highlighted programmatic issues that should be applied to guarantee an effective implementation and evaluation of these policies. The findings from this study were discussed with key stakeholders for consideration in further designing and planning RTI control interventions in Peru.

Portable recording in the assessment of obstructive sleep apnea. ASDA standards of practice.

PubMed

Ferber, R; Millman, R; Coppola, M; Fleetham, J; Murray, C F; Iber, C; McCall, V; Nino-Murcia, G; Pressman, M; Sanders, M

1994-06-01

The objective assessment of patients with a presumptive diagnosis of obstructive sleep apnea (OSA) has primarily used attended polysomnographic study. Recent technologic advances and issues of availability, convenience and cost have led to a rapid increase in the use of portable recording devices. However, limited scientific information has been published regarding the evaluation of the efficacy, accuracy, validity, utility, cost effectiveness and limitations of this portable equipment. Attaining a clear assessment of the role of portable devices is complicated by the multiplicity of recording systems and the variability of clinical settings in which they have been analyzed. This paper reviews the current knowledge base regarding portable recording in the assessment of OSA, including technical considerations, validation studies, potential advantages and disadvantages, issues of safety, current clinical usage and areas most in need of further study.

'Seeking authorization': a grounded theory exploration of mentors' experiences of assessing nursing students on the borderline of achievement of competence in clinical practice.

PubMed

Cassidy, Simon; Coffey, Michael; Murphy, Fiona

2017-09-01

To develop a substantive theoretical explanation of how mentors make sense of their experiences where nursing students are on the borderline of achievement of competence in clinical practice. The reluctance of Registered Nurse mentors to fail nursing students in clinical practice despite concerns about competence remains a contemporary issue in international healthcare education. Mentors' assessment decisions have considerable impact for a variety of key stakeholders, not least for students in these circumstances. Grounded theory qualitative study. Phase one involved 20 individual semi-structured interviews with nurse mentors in one United Kingdom National Health Service Health Board (July-October 2009). Phase two included eight individual semi-structured interviews and seven focus groups with mentors and practice educators (n = 38) in four further Health Boards (June 2011-February 2012). Data were analysed using open, axial and selective coding consistent with grounded theory method. Three categories 'the conundrum of practice competence,' 'the intensity of nurturing hopefulness,' and 'managing assessment impasse,' led to the study's substantive theoretical explanation - 'Seeking authorization: Establishing collective accountability for mentorship.' This demonstrates how mentors are dependent on key sources of support and feedback to validate their assessment decision-making, notwithstanding substantial personal, professional and organizational pressures. We conclude that management of borderline assessment situations is considerably developed by recognition of the authorizing effects of a wider community of assessors. Consequently, we identify the personal, professional and organizational implications involved in the preparation, support and regulation of mentors specifically during borderline assessment circumstances. © 2017 John Wiley & Sons Ltd.

Hazard identification by methods of animal-based toxicology.

PubMed

Barlow, S M; Greig, J B; Bridges, J W; Carere, A; Carpy, A J M; Galli, C L; Kleiner, J; Knudsen, I; Koëter, H B W M; Levy, L S; Madsen, C; Mayer, S; Narbonne, J-F; Pfannkuch, F; Prodanchuk, M G; Smith, M R; Steinberg, P

2002-01-01

This paper is one of several prepared under the project "Food Safety In Europe: Risk Assessment of Chemicals in Food and Diet" (FOSIE), a European Commission Concerted Action Programme, organised by the International Life Sciences Institute, Europe (ILSI). The aim of the FOSIE project is to review the current state of the science of risk assessment of chemicals in food and diet, by consideration of the four stages of risk assessment, that is, hazard identification, hazard characterisation, exposure assessment and risk characterisation. The contribution of animal-based methods in toxicology to hazard identification of chemicals in food and diet is discussed. The importance of first applying existing technical and chemical knowledge to the design of safety testing programs for food chemicals is emphasised. There is consideration of the presently available and commonly used toxicity testing approaches and methodologies, including acute and repeated dose toxicity, reproductive and developmental toxicity, neurotoxicity, genotoxicity, carcinogenicity, immunotoxicity and food allergy. They are considered from the perspective of whether they are appropriate for assessing food chemicals and whether they are adequate to detect currently known or anticipated hazards from food. Gaps in knowledge and future research needs are identified; research on these could lead to improvements in the methods of hazard identification for food chemicals. The potential impact of some emerging techniques and toxicological issues on hazard identification for food chemicals, such as new measurement techniques, the use of transgenic animals, assessment of hormone balance and the possibilities for conducting studies in which common human diseases have been modelled, is also considered.

The impact of health technology assessment reports on decision making in Austria.

PubMed

Zechmeister, Ingrid; Schumacher, Ines

2012-01-01

Health technology assessment (HTA) was established in Austria in the 1990s and, since then, it has gained considerable importance. In this study, we aim to analyze whether the HTA reports that have been produced at the Institute for Technology Assessment (ITA) and at the Ludwig Boltzmann Institute for HTA (LBI-HTA) have had an impact on decision making within the Austrian health care system. We selected all reports that were intended for supporting (i) reimbursement/investment or (ii) disinvestment decisions. Eleven full HTA reports and fifty-eight rapid assessments fulfilled the inclusion criteria. We used interview data and administrative data on volumes, tariffs and expenditure of products/services to analyze whether and how reports were in reality used in decision making and what the consequences for health care expenditure and resource distribution have been. Five full HTA reports and fifty-six rapid technology assessments were used for reimbursement decisions. Four full HTA reports and two rapid assessments were used for disinvestment decisions and resulted in reduced volumes and expenditure. Two full HTA reports showed no impact on decision making. Impact was most evident for hospital technologies. HTA has played some role in reducing volumes of over-supplied hospital technologies, resulting in reduced expenditure for several hospital providers. Additionally, it has been increasingly included in prospective planning and reimbursement decisions of late, indicating re-distribution of resources toward evidence-based technologies. However, further factors may have influenced the decisions, and the impact could be considerably increased by systematically incorporating HTA into the decision-making process in Austria.

Raw materials in the manufacture of biotechnology products: regulatory considerations.

PubMed

Cordoba-Rodriguez, Ruth

2010-01-01

The Food and Drug Administration's Pharmaceutical cGMPs for the 21st Century initiative emphasizes science and risk-based approaches in the manufacture of drugs. These approaches are reflected in the International Conference on Harmonization (ICH) guidances ICH Q8, Q9, and Q10 and encourage a comprehensive assessment of the manufacture of a biologic, including all aspects of manufacture that have the potential to affect the finished drug product. Appropriate assessment and management of raw materials are an important part of this initiative. Ideally, a raw materials program should strive to assess and minimize the risk to product quality. With this in mind, risk-assessment concepts and control strategies will be discussed and illustrated by examples, with an emphasis on the impact of raw materials on cell substrates. Finally, the life cycle of the raw material will be considered, including its potential to affect the drug product life cycle. In this framework, the supply chain and the vendor-manufacturer relationship will be explored as important parts of an adequate raw materials control strategy.

Promotion of Physical Activity Among Mexican-Origin Women in Texas and South Carolina: An Examination of Social, Cultural, Economic, and Environmental Factors

PubMed Central

Parra-Medina, Deborah; Hilfinger Messias, DeAnne K.

2011-01-01

Interventions to improve physical activity levels among Latinos must take into consideration the social, cultural, economic, and environmental contexts of Latino communities. We report findings of formative assessments related to Mexican-origin women’s levels of readiness, willingness, and ability to participate in regular leisure time physical activity in two diverse locations, the Texas Lower Rio Grande Valley and the South Carolina Midlands. The ENLACE project employed a Community-Based Participatory Research approach. Formative assessment activities focused on identification of community assets and resources and exploration of community members’ experiences, opinions, values, preferences, and perceived needs related to physical activity. Data sources included windshield tours, walkability assessments of local neighborhoods; community inventory exercises, focus groups, and individual interviews. Barriers to regular physical activity included the dominance of work and family responsibilities, social norms, lack of social support, social isolation, environmental constraints, economics, and low levels of personal knowledge and motivation. PMID:21731409

Assessing the Queuing Process Using Data Envelopment Analysis: an Application in Health Centres.

PubMed

Safdar, Komal A; Emrouznejad, Ali; Dey, Prasanta K

2016-01-01

Queuing is one of the very important criteria for assessing the performance and efficiency of any service industry, including healthcare. Data Envelopment Analysis (DEA) is one of the most widely-used techniques for performance measurement in healthcare. However, no queue management application has been reported in the health-related DEA literature. Most of the studies regarding patient flow systems had the objective of improving an already existing Appointment System. The current study presents a novel application of DEA for assessing the queuing process at an Outpatients' department of a large public hospital in a developing country where appointment systems do not exist. The main aim of the current study is to demonstrate the usefulness of DEA modelling in the evaluation of a queue system. The patient flow pathway considered for this study consists of two stages; consultation with a doctor and pharmacy. The DEA results indicated that waiting times and other related queuing variables included need considerable minimisation at both stages.

Cross-cultural Measurement Equivalence of the KINDL Questionnaire for Quality of Life Assessment in Children and Adolescents.

PubMed

Jafari, Peyman; Stevanovic, Dejan; Bagheri, Zahra

2016-04-01

This cross-cultural study aimed to assess whether Iranian and Serbian children, and also their parents, perceived the meaning of the items in the KINDL quality of life questionnaire consistently. The sample included 1086 Iranian and 756 Serbian children and adolescents, alongside 1061 and 618 of their parents, respectively. The ordinal logistic regression was used to assess differential item functioning (DIF) of the self and proxy-reports of the two versions of the KINDL, including Kid-KINDL and Kiddo-KINDL, across Iranian and Serbian samples. Statistically significant DIF was flagged for 14 out of 24 (58%) and 20 out of 24 (83%) items in the self-report of the Kid-KINDL and Kiddo-KINDL, respectively. Moreover, 20 out of 24 (83%) in the proxy reports of the both Kid-KINDL and Kiddo-KINDL, showed DIF across two samples. Accordingly, considerable caution is warranted when using the KINDL for cross-cultural comparisons.

Effects and risk assessment of linear alkylbenzene sulfonates in agricultural soil. 5. Probabilistic risk assessment of linear alkylbenzene sulfonates in sludge-amended soils.

PubMed

Jensen, J; Løkke, H; Holmstrup, M; Krogh, P H; Elsgaard, L

2001-08-01

Linear alkylbenzene sulfonates (LAS) can be found in high concentrations in sewage sludge and, hence, may enter the soil compartment as a result of sludge application. Here, LAS may pose a risk for soil-dwelling organisms. In the present probabilistic risk assessment, statistical extrapolation has been used to assess the risk of LAS to soil ecosystems. By use of a log-normal distribution model, the predicted no-effect concentration (PNEC) was estimated for soil fauna, plants, and a combination of these. Due to the heterogeneous endpoints for microorganisms, including functional as well as structural parameters, the use of sensitivity distributions is not considered to be applicable to this group of organisms, and a direct, expert evaluation of toxicity data was used instead. The soil concentration after sludge application was predicted for a number of scenarios and used as the predicted environmental concentration (PEC) in the risk characterization and calculation of risk quotients (RQ = PEC/PNEC). A LAS concentration of 4.6 mg/kg was used as the current best estimate of PNEC in all RQ calculations. Three levels of LAS contamination (530, 2,600, and 16,100 mg/kg), three half-lives (10, 25, and 40 d), and five different sludge loads (2, 4, 6, 8, and 10 t/ha) were included in the risk scenarios. In Denmark, the initial risk ratio would reach 1.5 in a realistic worst-case consideration. For countries not having similar sludge regulations, the estimated risk ratio may initially be considerably higher. However, even in the most extreme scenarios, the level of LAS is expected to be well beyond the estimated PNEC one year after application. The present risk assessment, therefore, concludes that LAS does not pose a significant risk to fauna, plants, and essential functions of agricultural soils as a result of normal sewage sludge amendment. However, risks have been identified in worst-case scenarios.

Use of System Safety Risk Assessments for the Space Shuttle Reusable Solid Rocket Motor (RSRM)

NASA Technical Reports Server (NTRS)

Greenhalgh, Phillip O.; McCool, Alex (Technical Monitor)

2001-01-01

This paper discusses the System Safety approach used to assess risk for the Space Shuttle Reusable Solid Rocket Motor (RSRM). Previous to the first RSRM flight in the fall of 1988, all systems were analyzed extensively to assure that hazards were identified, assessed and that the baseline risk was understood and appropriately communicated. Since the original RSRM baseline was established, Thiokol and NASA have implemented a number of initiatives that have further improved the RSRM. The robust design, completion of rigorous testing and flight success of the RSRM has resulted in a wise reluctance to make changes. One of the primary assessments required to accompany the documentation of each proposed change and aid in the decision making process is a risk assessment. Documentation supporting proposed changes, including the risk assessments from System Safety, are reviewed and assessed by Thiokol and NASA technical management. After thorough consideration, approved changes are implemented adding improvements to and reducing risk of the Space Shuttle RSRM.

40 CFR 194.51 - Consideration of protected individual.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Consideration of protected individual... Individual and Ground-Water Protection Requirements § 194.51 Consideration of protected individual. Compliance assessments that analyze compliance with § 191.15 of this chapter shall assume that an individual...

40 CFR 194.52 - Consideration of exposure pathways.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 25 2014-07-01 2014-07-01 false Consideration of exposure pathways... Individual and Ground-Water Protection Requirements § 194.52 Consideration of exposure pathways. In compliance assessments that analyze compliance with § 191.15 of this chapter, all potential exposure pathways...

40 CFR 194.52 - Consideration of exposure pathways.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Consideration of exposure pathways... Individual and Ground-Water Protection Requirements § 194.52 Consideration of exposure pathways. In compliance assessments that analyze compliance with § 191.15 of this chapter, all potential exposure pathways...

40 CFR 194.52 - Consideration of exposure pathways.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Consideration of exposure pathways... Individual and Ground-Water Protection Requirements § 194.52 Consideration of exposure pathways. In compliance assessments that analyze compliance with § 191.15 of this chapter, all potential exposure pathways...

40 CFR 194.52 - Consideration of exposure pathways.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 26 2012-07-01 2011-07-01 true Consideration of exposure pathways. 194... Individual and Ground-Water Protection Requirements § 194.52 Consideration of exposure pathways. In compliance assessments that analyze compliance with § 191.15 of this chapter, all potential exposure pathways...

40 CFR 194.52 - Consideration of exposure pathways.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 26 2013-07-01 2013-07-01 false Consideration of exposure pathways... Individual and Ground-Water Protection Requirements § 194.52 Consideration of exposure pathways. In compliance assessments that analyze compliance with § 191.15 of this chapter, all potential exposure pathways...

Core principles of assessment in competency-based medical education.

PubMed

Lockyer, Jocelyn; Carraccio, Carol; Chan, Ming-Ka; Hart, Danielle; Smee, Sydney; Touchie, Claire; Holmboe, Eric S; Frank, Jason R

2017-06-01

The meaningful assessment of competence is critical for the implementation of effective competency-based medical education (CBME). Timely ongoing assessments are needed along with comprehensive periodic reviews to ensure that trainees continue to progress. New approaches are needed to optimize the use of multiple assessors and assessments; to synthesize the data collected from multiple assessors and multiple types of assessments; to develop faculty competence in assessment; and to ensure that relationships between the givers and receivers of feedback are appropriate. This paper describes the core principles of assessment for learning and assessment of learning. It addresses several ways to ensure the effectiveness of assessment programs, including using the right combination of assessment methods and conducting careful assessor selection and training. It provides a reconceptualization of the role of psychometrics and articulates the importance of a group process in determining trainees' progress. In addition, it notes that, to reach its potential as a driver in trainee development, quality care, and patient safety, CBME requires effective information management and documentation as well as ongoing consideration of ways to improve the assessment system.

Lessons Learned from Dependency Usage in HERA: Implications for THERP-Related HRA Methods

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

April M. Whaley; Ronald L. Boring; Harold S. Blackman

Dependency occurs when the probability of success or failure on one action changes the probability of success or failure on a subsequent action. Dependency may serve as a modifier on the human error probabilities (HEPs) for successive actions in human reliability analysis (HRA) models. Discretion should be employed when determining whether or not a dependency calculation is warranted: dependency should not be assigned without strongly grounded reasons. Human reliability analysts may sometimes assign dependency in cases where it is unwarranted. This inappropriate assignment is attributed to a lack of clear guidance to encompass the range of scenarios human reliability analystsmore » are addressing. Inappropriate assignment of dependency produces inappropriately elevated HEP values. Lessons learned about dependency usage in the Human Event Repository and Analysis (HERA) system may provide clarification and guidance for analysts using first-generation HRA methods. This paper presents the HERA approach to dependency assessment and discusses considerations for dependency usage in HRA, including the cognitive basis for dependency, direction for determining when dependency should be assessed, considerations for determining the dependency level, temporal issues to consider when assessing dependency, (e.g., considering task sequence versus overall event sequence, and dependency over long periods of time), and diagnosis and action influences on dependency.« less

Utilizing a Health Impact Assessment (HIA) to Connect Natural ...

EPA Pesticide Factsheets

Marrying scientific and health research with natural resource management should be a straightforward process. However, differences in purpose, goals, language, levels of detail and implementation authority between the scientists who conduct research and resource managers who plan and implement projects make it difficult for resource managers to include information not specific to the problem at hand. One method to overcome this barrier is a Health Impact Assessment (HIA) or process that uses scientific data, health expertise and public input to factor public health considerations into the decision-making process. An HIA informs decision makers and stakeholders of the potential health effects of a proposed program, policy, project or plan through a systematic investigation of impacts to health and health determinants and deliberative engagement of community members and other stakeholders throughout the HIA process. USEPA will be conducting an HIA on the Minnesota Department of Natural Resources’ sediment remediation and habitat restoration project at Kingsbury Bay and Grassy Point. This poster outlines the HIA process, illustrates how technical and stakeholder committees inform the process, and presents the determinants of health that will be explored in the HIA. This poster will illustrate how a Health Impact Assessment, a process that uses scientific data, health expertise and public input to factor public health considerations into the decision-making proces

Laser Scanning Systems and Techniques in Rockfall Source Identification and Risk Assessment: A Critical Review

NASA Astrophysics Data System (ADS)

Fanos, Ali Mutar; Pradhan, Biswajeet

2018-04-01

Rockfall poses risk to people, their properties and to transportation ways in mountainous and hilly regions. This catastrophe shows various characteristics such as vast distribution, sudden occurrence, variable magnitude, strong fatalness and randomicity. Therefore, prediction of rockfall phenomenon both spatially and temporally is a challenging task. Digital Terrain model (DTM) is one of the most significant elements in rockfall source identification and risk assessment. Light detection and ranging (LiDAR) is the most advanced effective technique to derive high-resolution and accurate DTM. This paper presents a critical overview of rockfall phenomenon (definition, triggering factors, motion modes and modeling) and LiDAR technique in terms of data pre-processing, DTM generation and the factors that can be obtained from this technique for rockfall source identification and risk assessment. It also reviews the existing methods that are utilized for the evaluation of the rockfall trajectories and their characteristics (frequency, velocity, bouncing height and kinetic energy), probability, susceptibility, hazard and risk. Detail consideration is given on quantitative methodologies in addition to the qualitative ones. Various methods are demonstrated with respect to their application scales (local and regional). Additionally, attention is given to the latest improvement, particularly including the consideration of the intensity of the phenomena and the magnitude of the events at chosen sites.

An Ethical Justification for Expanding the Notion of Effectiveness in Vaccine Post-Market Monitoring: Insights from the HPV Vaccine in Canada.

PubMed

Komparic, Ana; Smith, Maxwell J; Thompson, Alison

2016-04-01

Health regulators must carefully monitor the real-world safety and effectiveness of marketed vaccines through post-market monitoring in order to protect the public's health and promote those vaccines that best achieve public health goals. Yet, despite the fact that vaccines used in collective immunization programmes should be assessed in the context of a public health response, post-market effectiveness monitoring is often limited to assessing immunogenicity or limited programmatic features, rather than assessing effectiveness across populations. We argue that post-market monitoring ought to be expanded in two ways to reflect a 'public health notion of post-market effectiveness', which incorporates normative public health considerations: (i) effectiveness monitoring should yield higher quality data and grant special attention to underrepresented and vulnerable populations; and (ii) the scope of effectiveness should be expanded to include a consideration of the various social factors that maximize (and minimize) a vaccine's effectiveness at the population level, paying particular attention to how immunization programmes impact related health gradients. We use the case of the human papillomavirus vaccine in Canada to elucidate how expanding post-market effectiveness monitoring is necessary to close the gap between clinical practice and public health, and to ensure that vaccines are effective in a morally relevant sense.

International Space Station Model Correlation Analysis

NASA Technical Reports Server (NTRS)

Laible, Michael R.; Fitzpatrick, Kristin; Hodge, Jennifer; Grygier, Michael

2018-01-01

This paper summarizes the on-orbit structural dynamic data and the related modal analysis, model validation and correlation performed for the International Space Station (ISS) configuration ISS Stage ULF7, 2015 Dedicated Thruster Firing (DTF). The objective of this analysis is to validate and correlate the analytical models used to calculate the ISS internal dynamic loads and compare the 2015 DTF with previous tests. During the ISS configurations under consideration, on-orbit dynamic measurements were collected using the three main ISS instrumentation systems; Internal Wireless Instrumentation System (IWIS), External Wireless Instrumentation System (EWIS) and the Structural Dynamic Measurement System (SDMS). The measurements were recorded during several nominal on-orbit DTF tests on August 18, 2015. Experimental modal analyses were performed on the measured data to extract modal parameters including frequency, damping, and mode shape information. Correlation and comparisons between test and analytical frequencies and mode shapes were performed to assess the accuracy of the analytical models for the configurations under consideration. These mode shapes were also compared to earlier tests. Based on the frequency comparisons, the accuracy of the mathematical models is assessed and model refinement recommendations are given. In particular, results of the first fundamental mode will be discussed, nonlinear results will be shown, and accelerometer placement will be assessed.

Considerations for Pediatric Cochlear Implant Recipients With Unilateral or Asymmetric Hearing Loss: Assessment, Device Fitting, and Habilitation.

PubMed

Greaver, Laura; Eskridge, Hannah; Teagle, Holly F B

2017-06-13

The purpose of this clinical report is to present case studies of children who are nontraditional candidates for cochlear implantation because they have significant residual hearing in 1 ear and to describe outcomes and considerations for their audiological management and habilitation. Case information is presented for 5 children with profound hearing loss in 1 ear and normal or mild-to-moderate hearing loss in the opposite ear and who have undergone unilateral cochlear implantation. Pre- and postoperative assessments were performed per typical clinic routines with modifications described. Postimplant habilitation was customized for each recipient using a combination of traditional methods, newer technologies, and commercial materials. The 5 children included in this report are consistent users of their cochlear implants and demonstrate speech recognition in the implanted ear when isolated from the better hearing ear. Candidacy criteria for cochlear implantation are evolving. Children with single-sided deafness or asymmetric hearing loss who have traditionally not been considered candidates for cochlear implantation should be evaluated on a case-by-case basis. Audiological management of these recipients is not vastly different compared with children who are traditional cochlear implant recipients. Assessment and habilitation techniques must be modified to isolate the implanted ear to obtain accurate results and to provide meaningful therapeutic intervention.

Generation Changes over the Period of 1986-2006 in the Physical Fitness of Boys Aged 7-19 from Eastern Poland at Particular Stages of Education

ERIC Educational Resources Information Center

Saczuk, Jerzy; Wasiluk, Agnieszka; Zalech, Miroslaw

2012-01-01

Study aim: To assess the size of secular trends in the physical fitness of boys from eastern Poland taking into consideration stages of education. Material and methods: The physical fitness results of boys aged 7-19 years living in eastern regions of Poland were analyzed: 3188 students were examined in 1986 while in 2006 the research included 10…

Biomedical research and the commercialization agenda: a review of main considerations for neuroscience.

PubMed

Caulfield, Timothy; Ogbogu, Ubaka

2008-01-01

This article reviews a range of issues associated with the commercialization of biomedical research and speculates on how these issues might apply to the neuroscience context. Drawing on existing studies of the impact of research commercialization activities on various areas of biotechnology research, the authors explore normative benchmarks for assessing and resolving issues likely to arise from the commercialization of neuroscientific research, including such topics as patenting, marketing pressures, and representations of research prospects.

Final Environmental Assessment: Proposed Fire Crash Rescue Station, Hill Air Force Base, Utah

DTIC Science & Technology

2008-10-02

storage shed (Building 16) would be demolished and converted to parking ( see Figure 1 for the approximate locations). 1.3 Need for the Action The...existing facilities ( see Section 2.3.3.1), and other potential locations for siting the proposed fire crash rescue station ( see Section 2.3.3.2). 2.3...during scoping meetings, but eliminated from detailed consideration ( see Section 1.7.3) include: • geology and surface soils (seismicity, topography

Energy efficient engine: Propulsion system-aircraft integration evaluation

NASA Technical Reports Server (NTRS)

Owens, R. E.

1979-01-01

Flight performance and operating economics of future commercial transports utilizing the energy efficient engine were assessed as well as the probability of meeting NASA's goals for TSFC, DOC, noise, and emissions. Results of the initial propulsion systems aircraft integration evaluation presented include estimates of engine performance, predictions of fuel burns, operating costs of the flight propulsion system installed in seven selected advanced study commercial transports, estimates of noise and emissions, considerations of thrust growth, and the achievement-probability analysis.

Assessment of U.S. Government and Coalition Efforts to Develop the Logistics Sustainment Capability of the Afghan National Army

DTIC Science & Technology

2014-12-19

enabled them to return home to work in the private sector at higher pay. The result was a considerable shortfall of trained mechanics at logistics...of reasons for the attrition of trained mechanics from the ANA, including higher pay and better benefits in the private sector , without the...removal and replacement of designated items (e.g. starters , radiators, etc.), and limited repairs to certain items. • General maintenance

Passive sampling methods for contaminated sediments: Practical guidance for selection, calibration, and implementation

PubMed Central

Ghosh, Upal; Driscoll, Susan Kane; Burgess, Robert M; Jonker, Michiel To; Reible, Danny; Gobas, Frank; Choi, Yongju; Apitz, Sabine E; Maruya, Keith A; Gala, William R; Mortimer, Munro; Beegan, Chris

2014-01-01

This article provides practical guidance on the use of passive sampling methods (PSMs) that target the freely dissolved concentration (Cfree) for improved exposure assessment of hydrophobic organic chemicals in sediments. Primary considerations for selecting a PSM for a specific application include clear delineation of measurement goals for Cfree, whether laboratory-based “ex situ” and/or field-based “in situ” application is desired, and ultimately which PSM is best-suited to fulfill the measurement objectives. Guidelines for proper calibration and validation of PSMs, including use of provisional values for polymer–water partition coefficients, determination of equilibrium status, and confirmation of nondepletive measurement conditions are defined. A hypothetical example is described to illustrate how the measurement of Cfree afforded by PSMs reduces uncertainty in assessing narcotic toxicity for sediments contaminated with polycyclic aromatic hydrocarbons. The article concludes with a discussion of future research that will improve the quality and robustness of Cfree measurements using PSMs, providing a sound scientific basis to support risk assessment and contaminated sediment management decisions. Integr Environ Assess Manag 2014;10:210–223. © 2014 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of SETAC. PMID:24288273

Behavioral Economic Laboratory Research in Tobacco Regulatory Science.

PubMed

Tidey, Jennifer W; Cassidy, Rachel N; Miller, Mollie E; Smith, Tracy T

2016-10-01

Research that can provide a scientific foundation for the United States Food and Drug Administration (FDA) tobacco policy decisions is needed to inform tobacco regulatory policy. One factor that affects the impact of a tobacco product on public health is its intensity of use, which is determined, in part, by its abuse liability or reinforcing efficacy. Behavioral economic tasks have considerable utility for assessing the reinforcing efficacy of current and emerging tobacco products. This paper provides a narrative review of several behavioral economic laboratory tasks and identifies important applications to tobacco regulatory science. Behavioral economic laboratory assessments, including operant self-administration, choice tasks and purchase tasks, can be used generate behavioral economic data on the effect of price and other constraints on tobacco product consumption. These tasks could provide an expedited simulation of the effects of various tobacco control policies across populations of interest to the FDA. Tobacco regulatory research questions that can be addressed with behavioral economic tasks include assessments of the impact of product characteristics on product demand, assessments of the abuse liability of novel and potential modified risk tobacco products (MRTPs), and assessments of the impact of conventional and novel products in vulnerable populations.

The development and regulation of occupational exposure limits in Taiwan.

PubMed

Shih, Tung-Sheng; Wu, Kuen-Yuh; Chen, Hong-I; Chang, Cheng-Ping; Chang, Ho-Yuan; Huang, Yi-Shiao; Liou, Saou-Hsing

2006-11-01

The occupational exposure limits (OELs) in Taiwan was promulgated in 1974 and has been revised five times since then. Many of the OELs were adopted from the most recent ACGIH TLVs and US OSHA PELs. A total of 483 chemicals were listed in the current Taiwan OELs Standard. The procedures of OELs development in Taiwan include the IOSH organized a recommended exposure limits (RELs) Committee to select the target chemicals and to recommend the RELs through literature review based on the health effects in the first stage, then, the CLA put policy needs, economical and technical feasibility into consideration and set up the final OELs at the second stage. A standard operation manual of RELs Committee has been developed. Based on our experience, several issues including the participation of representatives from a comprehensive spectrum, communication/education and training/enforcement, continuous collection of the local exposure data and health hazard information, use of health risk assessment, consideration of economic, and technical feasibility, as well as the globalization and information and experience sharing are critical in developing the appropriate OELs. Three examples including benzene, crystalline silica, and 2-methoxy ethanol are given to demonstrate the operation of system.

Influence of climate on landscape characteristics in safety assessments of repositories for radioactive wastes.

PubMed

Becker, J K; Lindborg, T; Thorne, M C

2014-12-01

In safety assessments of repositories for radioactive wastes, large spatial and temporal scales have to be considered when developing an approach to risk calculations. A wide range of different types of information may be required. Local to the site of interest, temperature and precipitation data may be used to determine the erosional regime (which may also be conditioned by the vegetation characteristics adopted, based both on climatic and other considerations). However, geomorphological changes may be governed by regional rather than local considerations, e.g. alteration of river base levels, river capture and drainage network reorganisation, or the progression of an ice sheet or valley glacier across the site. The regional climate is in turn governed by the global climate. In this work, a commentary is presented on the types of climate models that can be used to develop projections of climate change for use in post-closure radiological impact assessments of geological repositories for radioactive wastes. These models include both Atmosphere-Ocean General Circulation Models and Earth Models of Intermediate Complexity. The relevant outputs available from these models are identified and consideration is given to how these outputs may be used to inform projections of landscape development. Issues of spatial and temporal downscaling of climate model outputs to meet the requirements of local-scale landscape development modelling are also addressed. An example is given of how climate change and landscape development influence the radiological impact of radionuclides potentially released from the deep geological disposal facility for spent nuclear fuel that SKB (the Swedish Nuclear Fuel and Waste Management Company) proposes to construct at Forsmark, Sweden. Copyright © 2014 Elsevier Ltd. All rights reserved.

An economic evaluation and assessment of environmental impact of the municipal solid waste management system for Taichung City in Taiwan.

PubMed

Chang, Yao-Jen; Chu, Chien-Wei; Lin, Min-Der

2012-05-01

Municipal solid waste management (MSWM) is an important environmental challenge and subject in urban planning. For sustainable MSWM strategies, the critical management factors to be considered include not only economic efficiency of MSW treatment but also life-cycle assessment of the environmental impact. This paper employed linear programming technique to establish optimal MSWM strategies considering economic efficiency and the air pollutant emissions during the life cycle of a MSWM system, and investigated the correlations between the economical optimization and pollutant emissions. A case study based on real-world MSW operating parameters in Taichung City is also presented. The results showed that the costs, benefits, streams of MSW, and throughputs of incinerators and landfills will be affected if pollution emission reductions are implemented in the MSWM strategies. In addition, the quantity of particulate matter is the best pollutant indicator for the MSWM system performance of emission reduction. In particular this model will assist the decision maker in drawing up a friendly MSWM strategy for Taichung City in Taiwan. Recently, life-cycle assessments of municipal solid waste management (MSWM) strategies have been given more considerations. However, what seems to be lacking is the consideration of economic factors and environmental impacts simultaneously. This work analyzed real-world data to establish optimal MSWM strategies considering economic efficiency and the air pollutant emissions during the life cycle of the MSWM system. The results indicated that the consideration of environmental impacts will affect the costs, benefits, streams of MSW, and throughputs of incinerators and landfills. This work is relevant to public discussion and may establish useful guidelines for the MSWM policies.

Climate Curriculum Modules on Volcanic Eruptions, Geoengineering, and Nuclear Winter

NASA Astrophysics Data System (ADS)

Robock, A.

2014-12-01

To support a climate dynamics multidisciplinary curriculum for graduate and senior university students, I will describe on-line modules on volcanic eruptions and climate, geoengineering, and nuclear winter. Each of these topics involves aerosols in the stratosphere and the response of the climate system, but each is distinct, and each is evolving as more research becomes available. As reported for the first time in the Fifth Assessment Report of the Intergovernmental Panel on Climate Change, volcanic eruptions are a natural analog for the climate impacts of potential anthropogenic aerosol injections into the stratosphere, either sulfates from potential attempts to cool the climate to counteract global warming, or smoke that would be produced from fires in cities and industrial targets in a nuclear war. The volcanic eruptions module would stand alone, and would also serve as a prerequisite for each of the other two modules, which could be taught independently of each other. Each module includes consideration of the physical climate system as well as impacts of the resulting climate change. Geoengineering includes both solar radiation management and carbon dioxide reduction. The geoengineering and nuclear winter modules also include consideration of policy and governance issues. Each module includes a slide set for use in lecturing, links to related resources, and student exercises. The modules will be regularly updated.

The association between patient attitudes and values and the strength of consideration for contralateral prophylactic mastectomy in a population-based sample of breast cancer patients.

PubMed

Hawley, Sarah T; Griffith, Kent A; Hamilton, Ann S; Ward, Kevin C; Morrow, Monica; Janz, Nancy K; Katz, Steven J; Jagsi, Reshma

2017-12-01

Little is known about how the individual decision styles and values of breast cancer patients at the time of treatment decision making are associated with the consideration of different treatment options and specifically with the consideration of contralateral prophylactic mastectomy (CPM). Newly diagnosed patients with early-stage breast cancer who were treated in 2013-2014 were identified through the Surveillance, Epidemiology, and End Results registries of Los Angeles and Georgia and were surveyed approximately 7 months after surgery (n = 2578; response rate, 71%). The primary outcome was the consideration of CPM (strong vs less strong). The association between patients' values and decision styles and strong consideration was assessed with multivariate logistic regression. Approximately one-quarter of women (25%) reported strong/very strong consideration of CPM, and another 29% considered it moderately/weakly. Decision styles, including a rational-intuitive approach to decision making, varied. The factors most valued by women at the time of treatment decision making were as follows: avoiding worry about recurrence (82%) and reducing the need for more surgery (73%). In a multivariate analysis, patients who preferred to make their own decisions, those who valued avoiding worry about recurrence, and those who valued avoiding radiation significantly more often strongly considered CPM (P < .05), whereas those who reported being more logical and those who valued keeping their breast did so less often. Many patients considered CPM, and the consideration was associated with both decision styles and values. The variability in decision styles and values observed in this study suggests that formally evaluating these characteristics at or before the initial treatment encounter could provide an opportunity for improving patient clinician discussions. Cancer 2017;123:4547-4555. © 2017 American Cancer Society. © 2017 American Cancer Society.

A geographical assessment of vegetation carbon stocks and greenhouse gas emissions on potential microalgae-based biofuel facilities in the United States.

PubMed

Quiroz Arita, Carlos; Yilmaz, Özge; Barlak, Semin; Catton, Kimberly B; Quinn, Jason C; Bradley, Thomas H

2016-12-01

The microalgae biofuels life cycle assessments (LCA) present in the literature have excluded the effects of direct land use change (DLUC) from facility construction under the assumption that DLUC effects are negligible. This study seeks to model the greenhouse gas (GHG) emissions of microalgae biofuels including DLUC by quantifying the CO 2 equivalence of carbon released to the atmosphere through the construction of microalgae facilities. The locations and types of biomass and Soil Organic Carbon that are disturbed through microalgae cultivation facility construction are quantified using geographical models of microalgae productivity potential including consideration of land availability. The results of this study demonstrate that previous LCA of microalgae to biofuel processes have overestimated GHG benefits of microalgae-based biofuels production by failing to include the effect of DLUC. Previous estimations of microalgae biofuel production potential have correspondingly overestimated the volume of biofuels that can be produced in compliance with U.S. environmental goals. Copyright © 2016 Elsevier Ltd. All rights reserved.

Addressing overuse of health services in health systems: a critical interpretive synthesis.

PubMed

Ellen, Moriah E; Wilson, Michael G; Vélez, Marcela; Shach, Ruth; Lavis, John N; Grimshaw, Jeremy M; Moat, Kaelan A

2018-06-15

Health systems are increasingly focusing on the issue of 'overuse' of health services and how to address it. We developed a framework focused on (1) the rationale and context for health systems prioritising addressing overuse, (2) elements of a comprehensive process and approach to reduce overuse and (3) implementation considerations for addressing overuse. We conducted a critical interpretive synthesis informed by a stakeholder-engagement process. The synthesis identified relevant empirical and non-empirical articles about system-level overuse. Two reviewers independently screened records, assessed for inclusion and conceptually mapped included articles. From these, we selected a purposive sample, created structured summaries of key findings and thematically synthesised the results. Our search identified 3545 references, from which we included 251. Most articles (76%; n = 192) were published within 5 years of conducting the review and addressed processes for addressing overuse (63%; n = 158) or political and health system context (60%; n = 151). Besides negative outcomes at the patient, system and global level, there were various contextual factors to addressing service overuse that seem to be key issue drivers. Processes for addressing overuse can be grouped into three elements comprising a comprehensive approach, including (1) approaches to identify overused health services, (2) stakeholder- or patient-led approaches and (3) government-led initiatives. Key implementation considerations include the need to develop 'buy in' from stakeholders and citizens. Health systems want to ensure the use of high-value services to keep citizens healthy and avoid harm. Our synthesis can be used by policy-makers, stakeholders and researchers to understand how the issue has been prioritised, what approaches have been used to address it and implementation considerations. PROSPERO CRD42014013204 .

Applying ILAMB to data from several generations of the Community Land Model to assess the relative contribution of model improvements and forcing uncertainty to model-data agreement

NASA Astrophysics Data System (ADS)

Lawrence, D. M.; Fisher, R.; Koven, C.; Oleson, K. W.; Swenson, S. C.; Hoffman, F. M.; Randerson, J. T.; Collier, N.; Mu, M.

2017-12-01

The International Land Model Benchmarking (ILAMB) project is a model-data intercomparison and integration project designed to assess and help improve land models. The current package includes assessment of more than 25 land variables across more than 60 global, regional, and site-level (e.g., FLUXNET) datasets. ILAMB employs a broad range of metrics including RMSE, mean error, spatial distributions, interannual variability, and functional relationships. Here, we apply ILAMB for the purpose of assessment of several generations of the Community Land Model (CLM4, CLM4.5, and CLM5). Encouragingly, CLM5, which is the result of model development over the last several years by more than 50 researchers from 15 different institutions, shows broad improvements across many ILAMB metrics including LAI, GPP, vegetation carbon stocks, and the historical net ecosystem carbon balance among others. We will also show that considerable uncertainty arises from the historical climate forcing data used (GSWP3v1 and CRUNCEPv7). ILAMB score variations due to forcing data can be as large for many variables as that due to model structural differences. Strengths and weaknesses and persistent biases across model generations will also be presented.

Content validation using an expert panel: assessment process for assistive technology adopted by farmers with disabilities.

PubMed

Mathew, S N; Field, W E; French, B F

2011-07-01

This article reports the use of an expert panel to perform content validation of an experimental assessment process for the safety of assistive technology (AT) adopted by farmers with disabilities. The validation process was conducted by a panel of six experts experienced in the subject matter, i.e., design, use, and assessment of AT for farmers with disabilities. The exercise included an evaluation session and two focus group sessions. The evaluation session consisted of using the assessment process under consideration by the panel to evaluate a set of nine ATs fabricated by a farmer on his farm site. The expert panel also participated in the focus group sessions conducted immediately before and after the evaluation session. The resulting data were analyzed using discursive analysis, and the results were incorporated into the final assessment process. The method and the results are presented with recommendations for the use of expert panels in research projects and validation of assessment tools.

Uncertainty characterization approaches for risk assessment of DBPs in drinking water: a review.

PubMed

Chowdhury, Shakhawat; Champagne, Pascale; McLellan, P James

2009-04-01

The management of risk from disinfection by-products (DBPs) in drinking water has become a critical issue over the last three decades. The areas of concern for risk management studies include (i) human health risk from DBPs, (ii) disinfection performance, (iii) technical feasibility (maintenance, management and operation) of treatment and disinfection approaches, and (iv) cost. Human health risk assessment is typically considered to be the most important phase of the risk-based decision-making or risk management studies. The factors associated with health risk assessment and other attributes are generally prone to considerable uncertainty. Probabilistic and non-probabilistic approaches have both been employed to characterize uncertainties associated with risk assessment. The probabilistic approaches include sampling-based methods (typically Monte Carlo simulation and stratified sampling) and asymptotic (approximate) reliability analysis (first- and second-order reliability methods). Non-probabilistic approaches include interval analysis, fuzzy set theory and possibility theory. However, it is generally accepted that no single method is suitable for the entire spectrum of problems encountered in uncertainty analyses for risk assessment. Each method has its own set of advantages and limitations. In this paper, the feasibility and limitations of different uncertainty analysis approaches are outlined for risk management studies of drinking water supply systems. The findings assist in the selection of suitable approaches for uncertainty analysis in risk management studies associated with DBPs and human health risk.

Assessment of anorexia nervosa: an overview of universal issues and contextual challenges

PubMed Central

2013-01-01

Aim Anorexia Nervosa (AN) is a complex and clinically challenging syndrome. Intended for specialist audiences, this narrative review aims to summarise the available literature related to assessment in the adult patient context, synthesising both research evidence and clinical consensus guidelines. Method We provide a review of the available literature on specialist assessment of AN focusing on common trajectories into assessment, obstacles accessing assessment, common presenting issues and barriers to the assessment process, the necessary scope of assessment, and tools and techniques. It describes the further step of synthesising assessment information in ways that can inform resultant care plans. Results In addition to assessment of core behaviours and diagnostic skills, considerations for the expert assessor include the functions of primary care, systemic and personal barriers, knowledge of current assessment tools and research pertaining to comorbid pathology in AN, assessing severity of illness, role of family at assessment, as well as medical, nutritional and compulsory elements of assessment. Conclusion Comprehensive assessment of AN in the current healthcare context still remains largely the remit of the specialist ED clinician. Assessment should remain an on-going process, paying particular attention to available empirical evidence, thereby reducing the gap between research and practice. PMID:24999408

Assessment of Adolescent Neurotoxicity: Rationale and Methodological Considerations

PubMed Central

Spear, Linda Patia

2007-01-01

This introduction to the special issue of Neurotoxicology and Teratology on “Risk of neurobehavioral toxicity in adolescence” begins by broadly considering the ontogeny and phylogeny of adolescence, and the potential value of animal models of adolescence. Major findings from the emerging neuroscience of adolescence are then highlighted to establish the importance of studies of adolescent neurotoxicity. A variety of methodological issues that are of particular relevance to adolescent exposures are then discussed. These include consideration of pharmacokinetic factors, inclusion of other-aged comparison group(s), and issues involving timing, route of administration, and exposure-induced alterations in growth rate. Despite such methodological challenges, research to determine whether adolescence is a time of increased vulnerability (or greater resiliency) to specific drugs and environmental toxicants is progressing rapidly, as exemplified by the work presented in the articles of this special issue. PMID:17222532

Scientific, statistical, practical, and regulatory considerations in design space development.

PubMed

Debevec, Veronika; Srčič, Stanko; Horvat, Matej

2018-03-01

The quality by design (QbD) paradigm guides the pharmaceutical industry towards improved understanding of products and processes, and at the same time facilitates a high degree of manufacturing and regulatory flexibility throughout the establishment of the design space. This review article presents scientific, statistical and regulatory considerations in design space development. All key development milestones, starting with planning, selection of factors, experimental execution, data analysis, model development and assessment, verification, and validation, and ending with design space submission, are presented and discussed. The focus is especially on frequently ignored topics, like management of factors and CQAs that will not be included in experimental design, evaluation of risk of failure on design space edges, or modeling scale-up strategy. Moreover, development of a design space that is independent of manufacturing scale is proposed as the preferred approach.

Methodological considerations in observational comparative effectiveness research for implantable medical devices: an epidemiologic perspective.

PubMed

Jalbert, Jessica J; Ritchey, Mary Elizabeth; Mi, Xiaojuan; Chen, Chih-Ying; Hammill, Bradley G; Curtis, Lesley H; Setoguchi, Soko

2014-11-01

Medical devices play a vital role in diagnosing, treating, and preventing diseases and are an integral part of the health-care system. Many devices, including implantable medical devices, enter the market through a regulatory pathway that was not designed to assure safety and effectiveness. Several recent studies and high-profile device recalls have demonstrated the need for well-designed, valid postmarketing studies of medical devices. Medical device epidemiology is a relatively new field compared with pharmacoepidemiology, which for decades has been developed to assess the safety and effectiveness of medications. Many methodological considerations in pharmacoepidemiology apply to medical device epidemiology. Fundamental differences in mechanisms of action and use and in how exposure data are captured mean that comparative effectiveness studies of medical devices often necessitate additional and different considerations. In this paper, we discuss some of the most salient issues encountered in conducting comparative effectiveness research on implantable devices. We discuss special methodological considerations regarding the use of data sources, exposure and outcome definitions, timing of exposure, and sources of bias. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Safety assessment methodology in management of spent sealed sources.

PubMed

Mahmoud, Narmine Salah

2005-02-14

Environmental hazards can be caused from radioactive waste after their disposal. It was therefore important that safety assessment methodologies be developed and established to study and estimate the possible hazards, and institute certain safety methodologies that lead and prevent the evolution of these hazards. Spent sealed sources are specific type of radioactive waste. According to IAEA definition, spent sealed sources are unused sources because of activity decay, damage, misuse, loss, or theft. Accidental exposure of humans from spent sealed sources can occur at the moment they become spent and before their disposal. Because of that reason, safety assessment methodologies were tailored to suit the management of spent sealed sources. To provide understanding and confidence of this study, validation analysis was undertaken by considering the scenario of an accident that occurred in Egypt, June 2000 (the Meet-Halfa accident from an iridium-192 source). The text of this work includes consideration related to the safety assessment approaches of spent sealed sources which constitutes assessment context, processes leading an active source to be spent, accident scenarios, mathematical models for dose calculations, and radiological consequences and regulatory criteria. The text also includes a validation study, which was carried out by evaluating a theoretical scenario compared to the real scenario of Meet-Halfa accident depending on the clinical assessment of affected individuals.

Preparing for International Travel and Global Medical Care.

PubMed

Mahadevan, Swaminatha V; Strehlow, Matthew C

2017-05-01

Thorough pretravel preparation and medical consultation can mitigate avoidable health and safety risks. A comprehensive pretravel medical consultation should include an individualized risk assessment, immunization review, and discussion of arthropod protective measures, malaria prophylaxis, traveler's diarrhea, and injury prevention. Travel with children and jet lag reduction require additional planning and prevention strategies; travel and evacuation insurance may prove essential when traveling to less resourced countries. Consideration should also be given to other high-risk travel scenarios, including the provision of health care overseas, adventure and extreme sports, water environments and diving, high altitude, and terrorism/unstable political situations. Copyright © 2017 Elsevier Inc. All rights reserved.

76 FR 24024 - Request for Information Relating to Studies Regarding the Resolution of Financial Companies Under...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-29

... such adverse impacts without creating such moral hazard; (D) The key factors and considerations that... financial companies; (A) The key factors and considerations that should be taken into account in assessing... of systemic financial companies; (B) The key factors and considerations that should be taken into...

Assessment of Alternative RF Linac Structures for APT

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

None

The APT program has been examining both normal and superconducting variants of the APT linac for the past two years. A decision on which of the two will be the selected technology will depend upon several considerations including the results of ongoing feasibility experiments, the performance and overall attractiveness of each of the design concepts, and an assessment of the system-level features of both alternatives. The primary objective of the Assessment of Alternative RF Linac Structures for APT study reported herein was to assess and compare, at the system-level, the performance, capital and life cycle costs, reliability/availability/maintainability (RAM) and manufacturingmore » schedules of APT RF linear accelerators based upon both superconducting and normal conducting technologies. A secondary objective was to perform trade studies to explore opportunities for system optimization, technology substitution and alternative growth pathways and to identify sensitivities to design uncertainties.« less

Assessment of existing and potential landslide hazards resulting from the April 25, 2015 Gorkha, Nepal earthquake sequence

USGS Publications Warehouse

Collins, Brian D.; Jibson, Randall W.

2015-07-28

This report provides a detailed account of assessments performed in May and June 2015 and focuses on valley-blocking landslides because they have the potential to pose considerable hazard to many villages in Nepal. First, we provide a seismological background of Nepal and then detail the methods used for both external and in-country data collection and interpretation. Our results consist of an overview of landsliding extent, a characterization of all valley-blocking landslides identified during our work, and a description of video resources that provide high resolution coverage of approximately 1,000 kilometers (km) of river valleys and surrounding terrain affected by the Gorkha earthquake sequence. This is followed by a description of site-specific landslide-hazard assessments conducted while in Nepal and includes detailed descriptions of five noteworthy case studies. Finally, we assess the expectation for additional landslide hazards during the 2015 summer monsoon season.

24 CFR 1.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., and the term State means any one of the foregoing. (e) The term Federal financial assistance includes... without consideration or at a nominal consideration, or at a consideration which is reduced for the... of its purposes the provision of assistance. The term Federal financial assistance does not include a...

Obesity in America: implications for clinical and health psychologists.

PubMed

Bean, Melanie K; Stewart, Karen; Olbrisch, Mary Ellen

2008-09-01

The number of individuals classified as overweight and obese is increasing at alarming rates and these conditions are associated with numerous psychological and physiological health problems. Within this epidemic, there is an increasing need and demand for psychologists and other mental health professionals to participate in the care of patients with obesity, both in assessment and treatment domains. The current paper provides a review of the status of the obesity epidemic, including psychological comorbidities and treatment approaches. Throughout this review, we highlight and discuss the important roles and impact psychologists can have. These roles include serving as members of multidisciplinary obesity treatment programs, conducting assessments for bariatric surgery, and treating related psychiatric disorders, such as depression and disordered eating. Other considerations, such as weight gain associated with psychiatric medications, and directions for future involvement of psychologists in addressing the obesity epidemic are also discussed.

Shifts in fisheries management: adapting to regime shifts

PubMed Central

King, Jacquelynne R.; McFarlane, Gordon A.; Punt, André E.

2015-01-01

For many years, fisheries management was based on optimizing yield and maintaining a target biomass, with little regard given to low-frequency environmental forcing. However, this policy was often unsuccessful. In the last two to three decades, fisheries science and management have undergone a shift towards balancing sustainable yield with conservation, with the goal of including ecosystem considerations in decision-making frameworks. Scientific understanding of low-frequency climate–ocean variability, which is manifested as ecosystem regime shifts and states, has led to attempts to incorporate these shifts and states into fisheries assessment and management. To date, operationalizing these attempts to provide tactical advice has met with limited success. We review efforts to incorporate regime shifts and states into the assessment and management of fisheries resources, propose directions for future investigation and outline a potential framework to include regime shifts and changes in ecosystem states into fisheries management.

From Earth to Orbit: An assessment of transportation options

NASA Technical Reports Server (NTRS)

Gavin, Joseph G., Jr.; Blond, Edmund; Brill, Yvonne C.; Budiansky, Bernard; Cooper, Robert S.; Demisch, Wolfgang H.; Hawk, Clark W.; Kerrebrock, Jack L.; Lichtenberg, Byron K.; Mager, Artur

1992-01-01

The report assesses the requirements, benefits, technological feasibility, and roles of Earth-to-Orbit transportation systems and options that could be developed in support of future national space programs. Transportation requirements, including those for Mission-to-Planet Earth, Space Station Freedom assembly and operation, human exploration of space, space science missions, and other major civil space missions are examined. These requirements are compared with existing, planned, and potential launch capabilities, including expendable launch vehicles (ELV's), the Space Shuttle, the National Launch System (NLS), and new launch options. In addition, the report examines propulsion systems in the context of various launch vehicles. These include the Advanced Solid Rocket Motor (ASRM), the Redesigned Solid Rocket Motor (RSRM), the Solid Rocket Motor Upgrade (SRMU), the Space Shuttle Main Engine (SSME), the Space Transportation Main Engine (STME), existing expendable launch vehicle engines, and liquid-oxygen/hydrocarbon engines. Consideration is given to systems that have been proposed to accomplish the national interests in relatively cost effective ways, with the recognition that safety and reliability contribute to cost-effectiveness. Related resources, including technology, propulsion test facilities, and manufacturing capabilities are also discussed.

Diabetes Prevention for Latino Youth: Unraveling the Intervention "Black Box".

PubMed

Shaibi, Gabriel Q; Konopken, Yolanda P; Nagle-Williams, Allison; McClain, Darya D; Castro, Felipe Gonzalez; Keller, Colleen S

2015-11-01

The translation of research findings into sustainable health promotion and disease prevention programs in community settings remains a challenge. This report describes the process of substantiating a community-developed diabetes prevention program for Latino youth through research. Included are design considerations, measurement strategies, and the context through which the project is culturally grounded for relevance and fit within a local community. The process included (1) refining the program to include salient, stakeholder-identified behavioral components; (2) refining the collaborative effort to embrace the capacity for facilitating relevant behavior change on targeted health-related outcomes to enhance intervention effectiveness; and (3) including the accurate assessment of intervention efficacy via precise assessment of diabetes-related health outcomes. We explain the process of collaborating with community partners to enhance the cultural relevance and sustainability of intervention effects on both individuals and communities. We discuss the rationale for empirical support for academic-community collaborations that function in both a "top-down" and a "bottom-up" manner to advance the science and practice of sustainable and efficacious community health promotion. © 2015 Society for Public Health Education.

Features and selection of vascular access devices.

PubMed

Sansivero, Gail Egan

2010-05-01

To review venous anatomy and physiology, discuss assessment parameters before vascular access device (VAD) placement, and review VAD options. Journal articles, personal experience. A number of VAD options are available in clinical practice. Access planning should include comprehensive assessment, with attention to patient participation in the planning and selection process. Careful consideration should be given to long-term access needs and preservation of access sites. Oncology nurses are uniquely suited to perform a key role in VAD planning and placement. With knowledge of infusion therapy, anatomy and physiology, device options, and community resources, nurses can be key leaders in preserving vascular access and improving the safety and comfort of infusion therapy. Copyright 2010 Elsevier Inc. All rights reserved.

Lone-actor Terrorism and Impulsivity.

PubMed

Meloy, J Reid; Pollard, Jeffrey W

2017-11-01

In some recent cases of lone-actor terrorism, there is evidence the subject acted impulsively, often in response to a triggering event which contained a loss and humiliation. Evidence suggests the subjects acted precipitously, despite planning and preparation carried out in the preceding weeks or months, and their attacks failed to include the often considerable preparation that had been done. The pathway became a runway. The authors recommend the traditional assessment of impulsivity in persons of concern for lone acts of terrorism, as well as other proximal warning behaviors for targeted violence. Both indirect and direct assessment guidelines are proposed, with an emphasis upon self-report, psychological testing, collateral data gathering, and historical records. © 2017 American Academy of Forensic Sciences.

Nuclear cardiology. I - Radionuclide angiographic assessment of left ventricular contraction: uses, limitations and future directions. II - The role of myocardial perfusion imaging using thallium-201 in diagnosis of coronary heart disease

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

Bodenheimer, M.M.; Banka, V.S.; Helfant, R.H.

1980-01-01

The current status of radionuclide angiography is reviewed. First pass and gated equilibrium methods for determining left ventricular contraction are compared. Some clinical applications of radionuclide angiography are then examined, including the detection of discrete versus diffuse asynergy and the assessment of myocardial infarction. The second part of this work reviews the uses and limitations of thallium-201 perfusion imaging in the diagnosis of the acute and chronic manifestations of coronary heart disease. Theoretical and technical considerations of thallium-201 imaging are reviewed along with the clinical implications of the technique.

Substance Abuse Prevention, Assessment, and Treatment for Lesbian, Gay, Bisexual, and Transgender Youth.

PubMed

Aromin, Romulo Alcalde

2016-12-01

Knowing how to manage substance abuse in all youth is an important aspect of pediatric care, including providing clinically appropriate anticipatory guidance, monitoring, assessment, and treatment. Although most lesbian, gay, bisexual, and transgender (LGBT) youth do not abuse substances, as a group they experience unique challenges in self-identity development that put them at an increased risk for substance abuse. This article addresses prevention and management of substance use in LGBT youth relevant to pediatrics and allied professions as an aspect of their overall health care. It reviews basic information about substance abuse in youth and special considerations for LGBT youth. Copyright © 2016 Elsevier Inc. All rights reserved.

Performance considerations in long-term spaceflight

NASA Technical Reports Server (NTRS)

Akins, F. R.

1979-01-01

Maintenance of skilled performance during extended space flight is of critical importance to both the health and safety of crew members and to the overall success of mission goals. An examination of long term effects and performance requirements is therefore a factor of immense importance to the planning of future missions. Factors that were investigated include: definition of performance categories to be investigated; methods for assessing and predicting performance levels; in-flight factors which can affect performance; and factors pertinent to the maintenance of skilled performance.

A normative price for energy from an electricity generation system: An Owner-dependent Methodology for Energy Generation (system) Assessment (OMEGA). Volume 2: Derivation of system energy price equations

NASA Technical Reports Server (NTRS)

Chamberlain, R. G.; Mcmaster, K. M.

1981-01-01

The methodology presented is a derivation of the utility owned solar electric systems model. The net present value of the system is determined by consideration of all financial benefits and costs including a specified return on investment. Life cycle costs, life cycle revenues, and residual system values are obtained. Break-even values of system parameters are estimated by setting the net present value to zero.

ECONOMIC ANALYSIS FOR THE GROUND WATER RULE ...

EPA Pesticide Factsheets

The Ground Water Rule Economic Analysis provides a description of the need for the rule, consideration of regulatory alternatives, baseline analysis including national ground water system profile and an estimate of pathogen and indicator occurrence (Chapter 4), a risk assessment and benefits analysis (Chapter 5), and a cost analysis ( Chapter 6). Chapters 4, 5 and 6, selected appendices and sections of other chapters will be peer reviewed. The objective of the Economic Analysis Document is to support the final Ground Water Rule.

Managing and Rehabilitating the ‘Stroke’ Patient

PubMed Central

Sky, Ruth

1972-01-01

Strokes account for five out of every 1,000 general hospital admissions. Postoperative care can be frustrating, but with judicious use of allied health workers, and careful assessment of the patient's condition, most patients who survive can be rehabilitated to a considerable degree of self-care. The patient's family must be included in the team, and his preferences in activities must be considered. This article describes the results of a study done on 244 patient charts at a convalescent hospital in Toronto. PMID:20468858

Consideration of environmental noise effects in transportation planning by governmental entities

NASA Technical Reports Server (NTRS)

Mayo, L. H.

1975-01-01

Environmental concerns are reviewed with respect to major transportation systems: the interstate highway system and commercial air transportation. The type of planning that was done for interstate highway systems is described, and the shift in social value emphasis that has become apparent since the interstate system was authorized is considered. Other topics discussed include the constitutional framework for the allocation of governmental power with respect to transportation systems planning, governmental assessment of the aircraft noise problem, and evaluating the social benefit of noise abatement.

Federal Land Managers Notification and Visibility Assessment Requirements for PSD Permitting

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Summary of the Active Microwave Workshop, chapter 1. [utilization in applications and aerospace programs

NASA Technical Reports Server (NTRS)

1975-01-01

An overview is given of the utility, feasibility, and advantages of active microwave sensors for a broad range of applications, including aerospace. In many instances, the material provides an in-depth examination of the applicability and/or the technology of microwave remote sensing, and considerable documentation is presented in support of these techniques. An assessment of the relative strengths and weaknesses of active microwave sensor data indicates that satisfactory data are obtainable for several significant applications.

Validity evidence as a key marker of quality of technical skill assessment in OTL-HNS.

PubMed

Labbé, Mathilde; Young, Meredith; Nguyen, Lily H P

2018-01-13

Quality monitoring of assessment practices should be a priority in all residency programs. Validity evidence is one of the main hallmarks of assessment quality and should be collected to support the interpretation and use of assessment data. Our objective was to identify, synthesize, and present the validity evidence reported supporting different technical skill assessment tools in otolaryngology-head and neck surgery (OTL-HNS). We performed a secondary analysis of data generated through a systematic review of all published tools for assessing technical skills in OTL-HNS (n = 16). For each tool, we coded validity evidence according to the five types of evidence described by the American Educational Research Association's interpretation of Messick's validity framework. Descriptive statistical analyses were conducted. All 16 tools included in our analysis were supported by internal structure and relationship to variables validity evidence. Eleven articles presented evidence supporting content. Response process was discussed only in one article, and no study reported on evidence exploring consequences. We present the validity evidence reported for 16 rater-based tools that could be used for work-based assessment of OTL-HNS residents in the operating room. The articles included in our review were consistently deficient in evidence for response process and consequences. Rater-based assessment tools that support high-stakes decisions that impact the learner and programs should include several sources of validity evidence. Thus, use of any assessment should be done with careful consideration of the context-specific validity evidence supporting score interpretation, and we encourage deliberate continual assessment quality-monitoring. NA. Laryngoscope, 2018. © 2018 The American Laryngological, Rhinological and Otological Society, Inc.

Creating a learning organization to help meet the needs of multihospital health systems.

PubMed

Ward, Angela; Berensen, Nannette; Daniels, Rowell

2018-04-01

The considerations that leaders of multihospital health systems must take into account in developing and implementing initiatives to build and maintain an exceptional pharmacy workforce are described. Significant changes that require constant individual and organizational learning are occurring throughout healthcare and within the profession of pharmacy. These considerations include understanding why it is important to have a succession plan and determining what types of education and training are important to support that plan. Other considerations include strategies for leveraging learners, dealing with a large geographic footprint, adjusting training opportunities to accommodate the ever-evolving demands on pharmacy staffs in terms of skill mix, and determining ways to either budget for or internally develop content for staff development. All of these methods are critically important to ensuring an optimized workforce. Especially for large health systems operating multiple sites across large distances, the use of technology-enabled solutions to provide effective delivery of programming to multiple sites is critical. Commonly used tools include live webinars, live "telepresence" programs, prerecorded programming that is available through an on-demand repository, and computer-based training modules. A learning management system is helpful to assign and document completion of educational requirements, especially those related to regulatory requirements (e.g., controlled substances management, sterile and nonsterile compounding, competency assessment). Creating and sustaining an environment where all pharmacy caregivers feel invested in and connected to ongoing learning is a powerful motivator for performance, engagement, and retention. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Medical Students' Understanding of Directed Questioning by Their Clinical Preceptors.

PubMed

Lo, Lawrence; Regehr, Glenn

2017-01-01

Phenomenon: Throughout clerkship, preceptors ask medical students questions for both assessment and teaching purposes. However, the cognitive and strategic aspects of students' approaches to managing this situation have not been explored. Without an understanding of how students approach the question and answer activity, medical educators are unable to appreciate how effectively this activity fulfills their purposes of assessment or determine the activity's associated educational effects. A convenience sample of nine 4th-year medical students participated in semistructured one-on-one interviews exploring their approaches to managing situations in which they have been challenged with questions from preceptors to which they do not know the answer. Through an iterative and recursive analytic reading of the interview transcripts, data were coded and organized to identify themes relevant to the students' considerations in answering such questions. Students articulated deliberate strategies for managing the directed questioning activity, which at times focused on the optimization of their learning but always included considerations of image management. Managing image involved projecting not only being knowledgeable but also being teachable. The students indicated that their considerations in selecting an appropriate strategy in a given situation involved their perceptions of their preceptors' intentions and preferences as well as several contextual factors. Insights: The medical students we interviewed were quite sophisticated in their understanding of the social nuances of the directed questioning process and described a variety of contextually invoked strategies to manage the situation and maintain a positive image.

Design and analysis issues for economic analysis alongside clinical trials.

PubMed

Marshall, Deborah A; Hux, Margaret

2009-07-01

Clinical trials can offer a valuable and efficient opportunity to collect the health resource use and outcomes data for economic evaluation. However, economic and clinical studies differ fundamentally in the question they seek to answer. The design and analysis of trial-based cost-effectiveness studies require special consideration, which are reviewed in this article. Traditional randomized controlled trials, using an experimental design with a controlled protocol, are designed to measure safety and efficacy for product registration. Cost-effectiveness analysis seeks to measure effectiveness in the context of routine clinical practice, and requires collection of health care resources to allow estimation of cost over an equal timeframe for each treatment alternative. In assessing suitability of a trial for economic data collection, the comparator treatment and other protocol factors need to reflect current clinical practice and the trial follow-up must be sufficiently long to capture important costs and effects. The broadest available population and a measure of effectiveness reflecting important benefits for patients are preferred for economic analyses. Special analytical issues include dealing with missing and censored cost data, assessing uncertainty of the incremental cost-effectiveness ratio, and accounting for the underlying heterogeneity in patient subgroups. Careful consideration also needs to be given to data from multinational studies since practice patterns can differ across countries. Although clinical trials can be an efficient opportunity to collect data for economic evaluation, careful consideration of the suitability of the study design, and appropriate analytical methods must be applied to obtain rigorous results.

Cumulative environmental impacts and integrated coastal management: the case of Xiamen, China.

PubMed

Xue, Xiongzhi; Hong, Huasheng; Charles, Anthony T

2004-07-01

This paper examines the assessment of cumulative environmental impacts and the implementation of integrated coastal management within the harbour of Xiamen, China, an urban region in which the coastal zone is under increasing pressure as a result of very rapid economic growth. The first stage of analysis incorporates components of a cumulative effects assessment, including (a) identification of sources of environmental impacts, notably industrial expansion, port development, shipping, waste disposal, aquaculture and coastal construction, (b) selection of a set of valued ecosystem components, focusing on circulation and siltation, water quality, sediment, the benthic community, and mangrove forests, and (c) use of a set of key indicators to examine cumulative impacts arising from the aggregate of human activities. In the second stage of analysis, the paper describes and assesses the development of an institutional framework for integrated coastal management in Xiamen, one that combines policy and planning (including legislative and enforcement mechanisms) with scientific and monitoring mechanisms (including an innovative 'marine functional zoning' system). The paper concludes that the integrated coastal management framework in Xiamen has met all relevant requirements for 'integration' as laid out in the literature, and has explicitly incorporated consideration of cumulative impacts within its management and monitoring processes.

Numerical Modeling of the Lake Mary Road Bridge for Foundation Reuse Assessment

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

Sitek, M. A.; Bojanowski, C.; Lottes, S. A.

This project uses numerical techniques to assess the structural integrity and capacity of the bridge foundations and, as a result, reduces the risk associated with reusing the same foundation for a new superstructure. Nondestructive test methods of different types were used in combination with the numerical modeling and analysis. The onsite tests included visual inspection, tomography, ground penetrating radar, drilling boreholes and coreholes, and the laboratory tests on recovered samples. The results were utilized to identify the current geometry of the structure with foundation, including the hidden geometry of the abutments and piers, and soil and foundation material properties. Thismore » data was used to build the numerical models and run computational analyses on a high performance computer cluster to assess the structural integrity of the bridge and foundations including the suitability of the foundation for reuse with a new superstructure and traffic that will increase the load on the foundations. Computational analysis is more cost-effective and gives an advantage of getting more detailed knowledge about the structural response. It also enables to go beyond non-destructive testing and find the failure conditions without destroying the structure under consideration.« less

Accounting for multiple sources of uncertainty in impact assessments: The example of the BRACE study

NASA Astrophysics Data System (ADS)

O'Neill, B. C.

2015-12-01

Assessing climate change impacts often requires the use of multiple scenarios, types of models, and data sources, leading to a large number of potential sources of uncertainty. For example, a single study might require a choice of a forcing scenario, climate model, bias correction and/or downscaling method, societal development scenario, model (typically several) for quantifying elements of societal development such as economic and population growth, biophysical model (such as for crop yields or hydrology), and societal impact model (e.g. economic or health model). Some sources of uncertainty are reduced or eliminated by the framing of the question. For example, it may be useful to ask what an impact outcome would be conditional on a given societal development pathway, forcing scenario, or policy. However many sources of uncertainty remain, and it is rare for all or even most of these sources to be accounted for. I use the example of a recent integrated project on the Benefits of Reduced Anthropogenic Climate changE (BRACE) to explore useful approaches to uncertainty across multiple components of an impact assessment. BRACE comprises 23 papers that assess the differences in impacts between two alternative climate futures: those associated with Representative Concentration Pathways (RCPs) 4.5 and 8.5. It quantifies difference in impacts in terms of extreme events, health, agriculture, tropical cyclones, and sea level rise. Methodologically, it includes climate modeling, statistical analysis, integrated assessment modeling, and sector-specific impact modeling. It employs alternative scenarios of both radiative forcing and societal development, but generally uses a single climate model (CESM), partially accounting for climate uncertainty by drawing heavily on large initial condition ensembles. Strengths and weaknesses of the approach to uncertainty in BRACE are assessed. Options under consideration for improving the approach include the use of perturbed physics ensembles of CESM, employing results from multiple climate models, and combining the results from single impact models with statistical representations of uncertainty across multiple models. A key consideration is the relationship between the question being addressed and the uncertainty approach.

Strengthening health professions regulation in Cambodia: a rapid assessment.

PubMed

Clarke, David; Duke, Jan; Wuliji, Tana; Smith, Alyson; Phuong, Keat; San, Un

2016-03-10

This paper describes a rapid assessment of Cambodia's current system for regulating its health professions. The assessment forms part of a co-design process to set strategic priorities for strengthening health profession regulation to improve the quality and safety of health services. A health system approach for strengthening health professions' regulation is underway and aims to support the Government of Cambodia's plans for scaling up its health workforce, improving health services' safety and quality, and meeting its Association of South East Asian Nations (ASEAN) obligations to facilitate trade in health care services. The assessment used a mixed methods approach including: A desktop review of key laws, plans, reports and other documents relating to the regulation of the health professions in Cambodia (medicine, dentistry, midwifery, nursing and pharmacy); Key informant interviews with stakeholders in Cambodia (The term "stakeholders" refers to government officials, people working on health professional regulation, people working for the various health worker training institutions and health workers at the national and provincial level); Surveys and questionnaires to assess Cambodian stakeholder knowledge of regulation; Self-assessments by members of the five Cambodian regulatory councils regarding key capacities and activities of high-performing regulatory bodies; and A rapid literature review to identify: The key functions of health professional regulation; The key issues affecting the Cambodian health sector (including relevant developments in the wider ASEAN region); and "Smart" health profession regulation practices of possible relevance to Cambodia. We found that the current regulatory system only partially meets Cambodia's needs. A number of key regulatory functions are being performed, but overall, the current system was not designed with Cambodia's specific needs in mind. The existing system is also overly complex, with considerable duplication and overlap between governance and regulatory arrangements for the five regulated professions. There is considerable scope for reform to the current regulatory system to better align the system to Cambodia's: Current needs and circumstances; Health system strategic priorities; and International obligations. Cambodia is also well placed to base its reformed regulatory system on recent developments of "smart regulatory practices" for health professionals.

Perspective: Randomized Controlled Trials Are Not a Panacea for Diet-Related Research12

PubMed Central

Hébert, James R; Frongillo, Edward A; Adams, Swann A; Turner-McGrievy, Gabrielle M; Hurley, Thomas G; Miller, Donald R; Ockene, Ira S

2016-01-01

Research into the role of diet in health faces a number of methodologic challenges in the choice of study design, measurement methods, and analytic options. Heavier reliance on randomized controlled trial (RCT) designs is suggested as a way to solve these challenges. We present and discuss 7 inherent and practical considerations with special relevance to RCTs designed to study diet: 1) the need for narrow focus; 2) the choice of subjects and exposures; 3) blinding of the intervention; 4) perceived asymmetry of treatment in relation to need; 5) temporal relations between dietary exposures and putative outcomes; 6) strict adherence to the intervention protocol, despite potential clinical counter-indications; and 7) the need to maintain methodologic rigor, including measuring diet carefully and frequently. Alternatives, including observational studies and adaptive intervention designs, are presented and discussed. Given high noise-to-signal ratios interjected by using inaccurate assessment methods in studies with weak or inappropriate study designs (including RCTs), it is conceivable and indeed likely that effects of diet are underestimated. No matter which designs are used, studies will require continued improvement in the assessment of dietary intake. As technology continues to improve, there is potential for enhanced accuracy and reduced user burden of dietary assessments that are applicable to a wide variety of study designs, including RCTs. PMID:27184269

Risk-adjusted Outcomes of Clinically Relevant Pancreatic Fistula Following Pancreatoduodenectomy: A Model for Performance Evaluation.

PubMed

McMillan, Matthew T; Soi, Sameer; Asbun, Horacio J; Ball, Chad G; Bassi, Claudio; Beane, Joal D; Behrman, Stephen W; Berger, Adam C; Bloomston, Mark; Callery, Mark P; Christein, John D; Dixon, Elijah; Drebin, Jeffrey A; Castillo, Carlos Fernandez-Del; Fisher, William E; Fong, Zhi Ven; House, Michael G; Hughes, Steven J; Kent, Tara S; Kunstman, John W; Malleo, Giuseppe; Miller, Benjamin C; Salem, Ronald R; Soares, Kevin; Valero, Vicente; Wolfgang, Christopher L; Vollmer, Charles M

2016-08-01

To evaluate surgical performance in pancreatoduodenectomy using clinically relevant postoperative pancreatic fistula (CR-POPF) occurrence as a quality indicator. Accurate assessment of surgeon and institutional performance requires (1) standardized definitions for the outcome of interest and (2) a comprehensive risk-adjustment process to control for differences in patient risk. This multinational, retrospective study of 4301 pancreatoduodenectomies involved 55 surgeons at 15 institutions. Risk for CR-POPF was assessed using the previously validated Fistula Risk Score, and pancreatic fistulas were stratified by International Study Group criteria. CR-POPF variability was evaluated and hierarchical regression analysis assessed individual surgeon and institutional performance. There was considerable variability in both CR-POPF risk and occurrence. Factors increasing the risk for CR-POPF development included increasing Fistula Risk Score (odds ratio 1.49 per point, P < 0.00001) and octreotide (odds ratio 3.30, P < 0.00001). When adjusting for risk, performance outliers were identified at the surgeon and institutional levels. Of the top 10 surgeons (≥15 cases) for nonrisk-adjusted performance, only 6 remained in this high-performing category following risk adjustment. This analysis of pancreatic fistulas following pancreatoduodenectomy demonstrates considerable variability in both the risk and occurrence of CR-POPF among surgeons and institutions. Disparities in patient risk between providers reinforce the need for comprehensive, risk-adjusted modeling when assessing performance based on procedure-specific complications. Furthermore, beyond inherent patient risk factors, surgical decision-making influences fistula outcomes.

Characterizing chronic and acute health risks of residues of veterinary drugs in food: latest methodological developments by the joint FAO/WHO expert committee on food additives.

PubMed

Boobis, Alan; Cerniglia, Carl; Chicoine, Alan; Fattori, Vittorio; Lipp, Markus; Reuss, Rainer; Verger, Philippe; Tritscher, Angelika

2017-11-01

The risk assessment of residues of veterinary drugs in food is a field that continues to evolve. The toxicological end-points to be considered are becoming more nuanced and in light of growing concern about the development of antimicrobial resistance, detailed analysis of the antimicrobial activity of the residues of veterinary drugs in food is increasingly incorporated in the assessment. In recent years, the Joint FAO/WHO Expert Committee on Food Additives (JECFA) has refined its approaches to provide a more comprehensive and fit-for-purpose risk assessment. This publication describes in detail the consideration of acute and chronic effects, the estimation of acute and chronic dietary exposure, current approaches for including microbiological endpoints in the risk assessment, and JECFA's considerations for the potential effects of food processing on residues from veterinary drugs. JECFA now applies these approaches in the development of health-based guidance values (i.e. safe exposure levels) for residues of veterinary drugs. JECFA, thus, comprehensively addresses acute and chronic risks by using corresponding estimates for acute and chronic exposure and suitable correction for the limited bioavailability of bound residues by the Gallo-Torres model. On a case-by-case basis, JECFA also considers degradation products that occur from normal food processing of food containing veterinary drug residues. These approaches will continue to be refined to ensure the most scientifically sound basis for the establishment of health-based guidance values for veterinary drug residues.

Ab initio chemical safety assessment: A workflow based on exposure considerations and non-animal methods.

PubMed

Berggren, Elisabet; White, Andrew; Ouedraogo, Gladys; Paini, Alicia; Richarz, Andrea-Nicole; Bois, Frederic Y; Exner, Thomas; Leite, Sofia; Grunsven, Leo A van; Worth, Andrew; Mahony, Catherine

2017-11-01

We describe and illustrate a workflow for chemical safety assessment that completely avoids animal testing. The workflow, which was developed within the SEURAT-1 initiative, is designed to be applicable to cosmetic ingredients as well as to other types of chemicals, e.g. active ingredients in plant protection products, biocides or pharmaceuticals. The aim of this work was to develop a workflow to assess chemical safety without relying on any animal testing, but instead constructing a hypothesis based on existing data, in silico modelling, biokinetic considerations and then by targeted non-animal testing. For illustrative purposes, we consider a hypothetical new ingredient x as a new component in a body lotion formulation. The workflow is divided into tiers in which points of departure are established through in vitro testing and in silico prediction, as the basis for estimating a safe external dose in a repeated use scenario. The workflow includes a series of possible exit (decision) points, with increasing levels of confidence, based on the sequential application of the Threshold of Toxicological (TTC) approach, read-across, followed by an "ab initio" assessment, in which chemical safety is determined entirely by new in vitro testing and in vitro to in vivo extrapolation by means of mathematical modelling. We believe that this workflow could be applied as a tool to inform targeted and toxicologically relevant in vitro testing, where necessary, and to gain confidence in safety decision making without the need for animal testing.

The socio-economic dimension of flood risk assessment: insights of KULTURisk framework

NASA Astrophysics Data System (ADS)

Giupponi, Carlo; Gain, Animesh; Mojtahed, Vahid; Balbi, Stefano

2013-04-01

The approaches for vulnerability and risk assessment have found different and often contrasting solutions by various schools of thought. The two most prominent communities in this field are: climate change adaptation (CCA), and disaster risk reduction (DRR). Although those communities have usually in common the aim of reducing socio-economic vulnerability and risk to natural hazards, they have usually referred to different definitions and conceptualizations. For example, the DRR community has always driven more emphasis on the concept of risk and vulnerability is considered as a physical/environmental input for the quantification of risk, while the CCA research stream, mainly under the auspices of the Intergovernmental Panel on Climate Change (IPCC), considered vulnerability as an output deriving from social conditions and processes such as adaptation or maladaptation. Recently, with the publication of the IPCC Special Report on extreme events and disasters (IPCC-SREX), the notions of vulnerability and risk are somehow integrated in order to jointly consider both climate change adaptation and disaster risk management. The IPCC-SREX indeed is expected to significantly contribute to find common language and methodological approaches across disciplines and, therefore, the opportunity emerges for proposing new operational solutions, consistent with the most recent evolution of concepts and terminology. Based on the development of the IPCC Report, the KULTURisk project developed an operational framework to support integrated assessment and decision support through the combination of contributions from diverse disciplinary knowledge, with emphasis on the social and economic dimensions. KIRAF (KULTURisk Integrated Risk Assessment Framework) is specifically aimed at comprehensively evaluate the benefits of risk mitigation measures with consideration of the dynamic context deriving from the consideration of climatic changes and their effects on natural disasters, within the policy framework of climate change adaptation (CCA). Three main innovations are proposed with respect to the current state of the art: (1) to include the social capacities of reducing risk, (2) to go beyond the estimation direct tangible costs, and (3) to provide an operational solution for decision support to assess risks, impacts and the benefits of plausible risk reduction measures, compatible with both the DRR and the CCA literatures. As stated above, the proposed framework is the inclusion of social capacities (adaptive and coping capacities) in the process of translating risk into a comprehensive cost matrix considering not only direct tangible costs (damages), but also the three other components deriving from the combination of tangible/intangible and direct/indirect costs. The proposed KIRAF approach is thus expected to provide: 1) an operational basis for multidisciplinary integration; 2) a flexible reference to deal with heterogeneous case studies and potentially various types of hazards; and 3) a means to support the assessment of alternative risk prevention measures including consideration of social and cultural dimensions.

[Internet Addiction, Suicidality and Non-Suicidal Self-Harming Behavior - A Systematic Review].

PubMed

Steinbüchel, Toni Andreas; Herpertz, Stephan; Külpmann, Ina; Kehyayan, Aram; Dieris-Hirche, Jan; Te Wildt, Bert Theodor

2017-11-23

Background Internet addiction (IA) is associated with a high rate of co-morbid mental disorders, especially depression, anxiety disorders, ADHD and personality disorders and a considerable level of psychological strain. In terms of risk assessment, the present work investigates the current research literature on suicidal behavior and non-suicidal self-injurious behavior (NSSI). Methods We performed a systematic literature search in 14 databases on title and abstract level for the most common keywords for IA, NSSI and suicidality. After deduction of multiple items, 2334 articles remained. They were filtered per inclusion and exclusion criteria. We identified studies that examined the relationship between IA, NSSI and suicidality, which were assessed by validated psychometric instruments. This allowed a total of 15 studies to be included. Results The relationship between IA and suicidality was examined in 10 studies, four studies examined the relationship of IA, suicidality, and NSSI, and one study exclusively focused on IA and NSSHB. All studies showed higher prevalence for NSSI and respectively suicidality of the subjects with an IA compared to subjects without IA, with point prevalence varying considerably between 1.6-18.7%. Discussion The results of the included publications suggest that Internet dependency is associated with an increased rate of non-suicidal self-harming behavior and increased suicidality, with suicidal ideation being more closely related to IA than suicidal actions. In order to develop a better understanding of causal relationships between IA, NSSI and suicidality, further longitudinal studies are required. Conclusion  Against the background of the presented studies NSSHB and suicidality need to be explicitly addressed within the assessment and treatment of IA patients. © Georg Thieme Verlag KG Stuttgart · New York.

The GRADE Evidence to Decision (EtD) framework for health system and public health decisions.

PubMed

Moberg, Jenny; Oxman, Andrew D; Rosenbaum, Sarah; Schünemann, Holger J; Guyatt, Gordon; Flottorp, Signe; Glenton, Claire; Lewin, Simon; Morelli, Angela; Rada, Gabriel; Alonso-Coello, Pablo

2018-05-29

To describe a framework for people making and using evidence-informed health system and public health recommendations and decisions. We developed the GRADE Evidence to Decision (EtD) framework for health system and public health decisions as part of the DECIDE project, in which we simultaneously developed frameworks for these and other types of healthcare decisions, including clinical recommendations, coverage decisions and decisions about diagnostic tests. Building on GRADE EtD tables, we used an iterative approach, including brainstorming, consultation of the literature and with stakeholders, and an international survey of policy-makers. We applied the framework to diverse examples, conducted workshops and user testing with health system and public health guideline developers and policy-makers, and observed and tested its use in real-life guideline panels. All the GRADE EtD frameworks share the same basic structure, including sections for formulating the question, making an assessment and drawing conclusions. Criteria listed in the assessment section of the health system and public health framework cover the important factors for making these types of decisions; in addition to the effects and economic impact of an option, the priority of the problem, the impact of the option on equity, and its acceptability and feasibility are important considerations that can inform both whether and how to implement an option. Because health system and public health interventions are often complex, detailed implementation considerations should be made when making a decision. The certainty of the evidence is often low or very low, but decision-makers must still act. Monitoring and evaluation are therefore often important considerations for these types of decisions. We illustrate the different components of the EtD framework for health system and public health decisions by presenting their application in a framework adapted from a real-life guideline. This framework provides a structured and transparent approach to support policy-making informed by the best available research evidence, while making the basis for decisions accessible to those whom they will affect. The health system and public health EtD framework can also be used to facilitate dissemination of recommendations and enable decision-makers to adopt, and adapt, recommendations or decisions.

Municipal officials' perceived barriers to consideration of physical activity in community design decision making.

PubMed

Goins, Karin Valentine; Schneider, Kristin L; Brownson, Ross; Carnoske, Cheryl; Evenson, Kelly R; Eyler, Amy; Heinrich, Katie; Litt, Jill; Lyn, Rodney; Maddock, Jay; Reed, Hannah; Tompkins, Nancy Oʼhara; Lemon, Stephenie C

2013-01-01

Built environment-focused interventions and policies are recommended as sustainable approaches for promoting physical activity. Physical activity has not traditionally been considered in land use and transportation decision making. Effective collaboration with non-public health partners requires knowledge of their perceived barriers to such consideration. This analysis sought to (a) establish prevalence estimates of selected barriers to the consideration of physical activity in community design and layout decisions and (b) describe how barrier reporting by public health officials differs from other municipal officials among a wide range of job functions and departments in a geographically diverse sample. A Web-based survey was conducted among municipal officials in 94 cities and towns with populations of at least 50 000 residents in 8 states. A total of 453 municipal officials from public health, planning, transportation/public works, community and economic development, parks and recreation, city management, and municipal legislatures in 83 cities and towns responded to the survey. Five barriers to consideration of physical activity in community design and layout were assessed. The most common barriers included lack of political will (23.5%), limited staff (20.4%), and lack of collaboration across municipal departments (16.2%). Fewer participants reported opposition from the business community or residents as barriers. Public health department personnel were more likely to report the barriers of limited staff and lack of collaboration across municipal departments than other professionals. They were also more likely to report lack of political will than city managers or mayors and municipal legislators. Barriers to increasing consideration of physical activity in decision making about community design and layout are encouragingly low. Implications for public health practice include the need to strategically increase political will despite public health staffing constraints and perceived lack of collaboration with relevant departments such as planning and public works/transportation.

76 FR 80309 - Use of Differential Income Stream as an Application of the Income Method and as a Consideration...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-23

... Use of Differential Income Stream as an Application of the Income Method and as a Consideration in Assessing the Best Method AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of proposed... guidance on how an analysis of the differential income stream may provide a best method consideration for...

Genetically modified plants and food hypersensitivity diseases: usage and implications of experimental models for risk assessment.

PubMed

Prescott, Vanessa E; Hogan, Simon P

2006-08-01

The recent advances in biotechnology in the plant industry have led to increasing crop production and yield that in turn has increased the usage of genetically modified (GM) food in the human food chain. The usage of GM foods for human consumption has raised a number of fundamental questions including the ability of GM foods to elicit potentially harmful immunological responses, including allergic hypersensitivity. To assess the safety of foods derived from GM plants including allergenic potential, the US FDA, Food and Agriculture Organization of the United Nations (FAO)/World Health Organization (WHO), and the EU have developed approaches for evaluation assessment. One assessment approach that has been a very active area of research and debate is the development and usage of animal models to assess the potential allergenicity of GM foods. A number of specific animal models employing rodents, pigs, and dogs have been developed for allergenicity assessment. However, validation of these models is needed and consideration of the criteria for an appropriate animal model for the assessment of allergenicity in GM plants is required. We have recently employed a BALB/c mouse model to assess the potential allergenicity of GM plants. We have been able to demonstrate that this model is able to detect differences in antigenicity and identify aspects of protein post-translational modifications that can alter antigenicity. Furthermore, this model has also enabled us to examine the usage of GM plants as a therapeutic approach for the treatment of allergic diseases. This review discusses the current approaches to assess the allergenic potential of GM food and particularly focusing on the usage of animal models to determine the potential allergenicity of GM foods and gives an overview of our recent findings and implications of these studies.

Medical devices early assessment methods: systematic literature review.

PubMed

Markiewicz, Katarzyna; van Til, Janine A; IJzerman, Maarten J

2014-04-01

The aim of this study was to get an overview of current theory and practice in early assessments of medical devices, and to identify aims and uses of early assessment methods used in practice. A systematic literature review was conducted in September 2013, using computerized databases (PubMed, Science Direct, and Scopus), and references list search. Selected articles were categorized based on their type, objective, and main target audience. The methods used in the application studies were extracted and mapped throughout the early stages of development and for their particular aims. Of 1,961 articles identified, eighty-three studies passed the inclusion criteria, and thirty were included by searching reference lists. There were thirty-one theoretical papers, and eighty-two application papers included. Most studies investigated potential applications/possible improvement of medical devices, developed early assessment framework or included stakeholder perspective in early development stages. Among multiple qualitative and quantitative methods identified, only few were used more than once. The methods aim to inform strategic considerations (e.g., literature review), economic evaluation (e.g., cost-effectiveness analysis), and clinical effectiveness (e.g., clinical trials). Medical devices were often in the prototype product development stage, and the results were usually aimed at informing manufacturers. This study showed converging aims yet widely diverging methods for early assessment during medical device development. For early assessment to become an integral part of activities in the development of medical devices, methods need to be clarified and standardized, and the aims and value of assessment itself must be demonstrated to the main stakeholders for assuring effective and efficient medical device development.

Development and validation of a computer-based situational judgement test to assess medical students' communication skills in the field of shared decision making.

PubMed

Kiessling, Claudia; Bauer, Johannes; Gartmeier, Martin; Iblher, Peter; Karsten, Gudrun; Kiesewetter, Jan; Moeller, Grit E; Wiesbeck, Anne; Zupanic, Michaela; Fischer, Martin R

2016-11-01

To develop a computer-based test (CBT) measuring medical students' communication skills in the field of shared decision making (SDM) and to evaluate its construct validity. The CBT was developed in the context of an experimental study comparing three different trainings for SDM (including e-learning and/or role-play) and a control group. Assessment included a CBT (Part A: seven context-poor questions, Part B: 15 context-rich questions) and interviews with two simulated patients (SP-assessment). Cronbach's α was used to test the internal consistency. Correlations between CBT and SP-assessment were used to further evaluate construct validity of the CBT. Seventy-two students took part in the study. Mean value for the CBT score was 72% of the total score. Cronbach's α was 0.582. After eliminating three items, Cronbach's α increased to 0.625. Correlations between the CBT and SP-assessment were low to moderate. The control group scored significantly lower than the training settings (p<0.001). The CBT was reliable enough to test for group differences. For summative assessment purposes, considerably more questions would be needed. We encourage teachers who particularly work with large student numbers to consider CBT as a feasible assessment method for cognitive aspects of communication skills. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Setting Up CD-ROM Work Areas. Part I: Ergonomic Considerations, User Furniture, Location.

ERIC Educational Resources Information Center

Vasi, John; LaGuardia, Cheryl

1992-01-01

The first of a two-part series on design of CD-ROM work areas in libraries discusses (1) space and location considerations; (2) ergonomics, including work surface, chairs, lighting, printers, other accessories, and security; and (3) other considerations, including staff assistance, reference tools, literature racks, and promotional materials. (MES)

Final Report of the AMC Committee-Armament. Armament Development Center Concept Plan. Volume 2

DTIC Science & Technology

1974-12-01

Considerations 111-22 Section C Operational Considerations 111-26 Section D Community Economic Impact 111-35 Statements Section E Delphi Benefit Analysis 111-37...Cost Analysis 111-3 B Personnel Considerations III-22 C Operational Considerations 111-26 D Community Economic Impact Statements 111-35 E Delphi ...sidered to be minimal. 111-36 S SECTION E. Delphi Benefit Analysis 1. Introduction. The assessment and comparison of the relative benefits of the various

Alternative approaches for vertebrate ecotoxicity tests in the ...

EPA Pesticide Factsheets

The need for alternative approaches to the use of vertebrate animals for hazard assessing chemicals and pollutants has become of increasing importance. It is now the first consideration when initiating a vertebrate ecotoxicity test, to ensure that unnecessary use of vertebrate organisms is minimised wherever possible. For some regulatory purposes, the use of vertebrate organisms for environmental risk assessments (ERA) has even been banned, and in other situations the numbers of organisms tested has been dramatically reduced, or the severity of the procedure refined. However, there is still a long way to go to achieve replacement of vertebrate organisms to generate environmental hazard data. The development of animal alternatives is not just based on ethical considerations but also to reduce the cost of performing vertebrate ecotoxicity tests and in some cases to provide better information aimed at improving ERAs. The present focus paper provides an overview of the considerable advances that have been made towards alternative approaches for ecotoxicity assessments over the last few decades. The need for alternative approaches to the use of vertebrate animals for hazard assessing chemicals and pollutants has become of increasing importance. It is now the first consideration when initiating a vertebrate ecotoxicity test, to ensure that unnecessary use of vertebrate organisms is minimised wherever possible. For some regulatory purposes, the use of vertebrate organi

The Next Generation of Risk Assessment Multi-Year Study—Highlights of Findings, Applications to Risk Assessment, and Future Directions

PubMed Central

Cote, Ila; Andersen, Melvin E.; Ankley, Gerald T.; Barone, Stanley; Birnbaum, Linda S.; Boekelheide, Kim; Bois, Frederic Y.; Burgoon, Lyle D.; Chiu, Weihsueh A.; Crawford-Brown, Douglas; Crofton, Kevin M.; DeVito, Michael; Devlin, Robert B.; Edwards, Stephen W.; Guyton, Kathryn Z.; Hattis, Dale; Judson, Richard S.; Knight, Derek; Krewski, Daniel; Lambert, Jason; Maull, Elizabeth Anne; Mendrick, Donna; Paoli, Gregory M.; Patel, Chirag Jagdish; Perkins, Edward J.; Poje, Gerald; Portier, Christopher J.; Rusyn, Ivan; Schulte, Paul A.; Simeonov, Anton; Smith, Martyn T.; Thayer, Kristina A.; Thomas, Russell S.; Thomas, Reuben; Tice, Raymond R.; Vandenberg, John J.; Villeneuve, Daniel L.; Wesselkamper, Scott; Whelan, Maurice; Whittaker, Christine; White, Ronald; Xia, Menghang; Yauk, Carole; Zeise, Lauren; Zhao, Jay; DeWoskin, Robert S.

2016-01-01

Background: The Next Generation (NexGen) of Risk Assessment effort is a multi-year collaboration among several organizations evaluating new, potentially more efficient molecular, computational, and systems biology approaches to risk assessment. This article summarizes our findings, suggests applications to risk assessment, and identifies strategic research directions. Objective: Our specific objectives were to test whether advanced biological data and methods could better inform our understanding of public health risks posed by environmental exposures. Methods: New data and methods were applied and evaluated for use in hazard identification and dose–response assessment. Biomarkers of exposure and effect, and risk characterization were also examined. Consideration was given to various decision contexts with increasing regulatory and public health impacts. Data types included transcriptomics, genomics, and proteomics. Methods included molecular epidemiology and clinical studies, bioinformatic knowledge mining, pathway and network analyses, short-duration in vivo and in vitro bioassays, and quantitative structure activity relationship modeling. Discussion: NexGen has advanced our ability to apply new science by more rapidly identifying chemicals and exposures of potential concern, helping characterize mechanisms of action that influence conclusions about causality, exposure–response relationships, susceptibility and cumulative risk, and by elucidating new biomarkers of exposure and effects. Additionally, NexGen has fostered extensive discussion among risk scientists and managers and improved confidence in interpreting and applying new data streams. Conclusions: While considerable uncertainties remain, thoughtful application of new knowledge to risk assessment appears reasonable for augmenting major scope assessments, forming the basis for or augmenting limited scope assessments, and for prioritization and screening of very data limited chemicals. Citation: Cote I, Andersen ME, Ankley GT, Barone S, Birnbaum LS, Boekelheide K, Bois FY, Burgoon LD, Chiu WA, Crawford-Brown D, Crofton KM, DeVito M, Devlin RB, Edwards SW, Guyton KZ, Hattis D, Judson RS, Knight D, Krewski D, Lambert J, Maull EA, Mendrick D, Paoli GM, Patel CJ, Perkins EJ, Poje G, Portier CJ, Rusyn I, Schulte PA, Simeonov A, Smith MT, Thayer KA, Thomas RS, Thomas R, Tice RR, Vandenberg JJ, Villeneuve DL, Wesselkamper S, Whelan M, Whittaker C, White R, Xia M, Yauk C, Zeise L, Zhao J, DeWoskin RS. 2016. The Next Generation of Risk Assessment multiyear study—highlights of findings, applications to risk assessment, and future directions. Environ Health Perspect 124:1671–1682; http://dx.doi.org/10.1289/EHP233 PMID:27091369

Assessment of therapeutic response and treatment planning for brain tumors using metabolic and physiological MRI.

PubMed

Nelson, Sarah J

2011-07-01

MRI is routinely used for diagnosis, treatment planning and assessment of response to therapy for patients with glioma. Gliomas are spatially heterogeneous and infiltrative lesions that are quite variable in terms of their response to therapy. Patients classified as having low-grade histology have a median overall survival of 7 years or more, but need to be monitored carefully to make sure that their tumor does not upgrade to a more malignant phenotype. Patients with the most aggressive grade IV histology have a median overall survival of 12-15 months and often undergo multiple surgeries and adjuvant therapies in an attempt to control their disease. Despite improvements in the spatial resolution and sensitivity of anatomic images, there remain considerable ambiguities in the interpretation of changes in the size of the gadolinium-enhancing lesion on T(1) -weighted images as a measure of treatment response, and in differentiating between treatment effects and infiltrating tumor within the larger T(2) lesion. The planning of focal therapies, such as surgery, radiation and targeted drug delivery, as well as a more reliable assessment of the response to therapy, would benefit considerably from the integration of metabolic and physiological imaging techniques into routine clinical MR examinations. Advanced methods that have been shown to provide valuable data for patients with glioma are diffusion, perfusion and spectroscopic imaging. Multiparametric examinations that include the acquisition of such data are able to assess tumor cellularity, hypoxia, disruption of normal tissue architecture, changes in vascular density and vessel permeability, in addition to the standard measures of changes in the volume of enhancing and nonenhancing anatomic lesions. This is particularly critical for the interpretation of the results of Phase I and Phase II clinical trials of novel therapies, which are increasingly including agents that are designed to have anti-angiogenic and anti-proliferative properties as opposed to having a direct effect on tumor cell viability. Copyright © 2011 John Wiley & Sons, Ltd.

Considerations and measurements of latent-heat-storage salts for secondary thermal battery applications

NASA Astrophysics Data System (ADS)

Koenig, A. A.; Braithwaite, J. W.; Armijo, J. R.

1988-05-01

Given its potential benefits, the practicality of using a latent heat-storage material as the basis for a passive thermal management system is being assessed by Chloride Silent Power Ltd. (CSPL) with technical assistance from Beta Power, Inc. and Sandia National Laboratories (SNL). Based on the experience gained in large-scale solar energy storage programs, fused salts were selected as the primary candidates for the heat-storage material. The initial phase of this assessment was directed to an EV battery being designed at CSPL for the ETX-II program. Specific tasks included the identification and characterization of potential fused salts, a determination of placement options for the salts within the battery, and an assessment of the ultimate benefit to the battery system. The results obtained to date for each of these tasks are presented in this paper.

Debris and shrapnel assessments for National Ignition Facility targets and diagnostics

NASA Astrophysics Data System (ADS)

Masters, N. D.; Fisher, A.; Kalantar, D.; Stölken, J.; Smith, C.; Vignes, R.; Burns, S.; Doeppner, T.; Kritcher, A.; Park, H.-S.

2016-05-01

High-energy laser experiments at the National Ignition Facility (NIF) can create debris and shrapnel capable of damaging laser optics and diagnostic instruments. The size, composition and location of target components and sacrificial shielding (e.g., disposable debris shields, or diagnostic filters) and the protection they provide is constrained by many factors, including: chamber and diagnostic geometries, experimental goals and material considerations. An assessment of the generation, nature and velocity of shrapnel and debris and their potential threats is necessary prior to fielding targets or diagnostics. These assessments may influence target and shielding design, filter configurations and diagnostic selection. This paper will outline the approach used to manage the debris and shrapnel risk associated with NIF targets and diagnostics and present some aspects of two such cases: the Material Strength Rayleigh- Taylor campaign and the Mono Angle Crystal Spectrometer (MACS).

The planning cycle.

PubMed

Johnson, William

2005-01-01

Information technology planning can be described as a continuous cyclical process composed of three phases whose primary purpose is optimum allocation of scarce resources. In the assessment phase, planners assess user needs, environmental factors, business objectives, and IT infrastructure needs to develop IT projects that address needs in each of these areas. A major goal of this phase is to develop a broad IT inventory. The prioritization phase seeks to ensure optimum allocation of scarce resources by prioritizing ITprojects based on: Costs--total life cycle costs. Benefits--both quantitative and non-quantitative, including support for the organization's strategic business objectives. Risks--subjective assessments of technological and non-technological risks. Implementation requirements--time and personnel requirements to implement the system. The scheduling phase incorporates sequencing considerations, personnel availability, and budgetary constraints to produce an IT plan in which project priorities are adjusted to meet organizational realities.

Summary of Building Protection Factor Studies for External Exposure to Ionizing Radiation

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

Dillon, Michael B.; Kane, Jave; Nasstrom, John

Radiation dose assessments are used to help inform decisions to minimize health risks in the event of an atmospheric release of radioactivity including, for example, from a Radiological Dispersal Device, an Improvised Nuclear Device detonation, or a Nuclear Power Plant accident. During these incidents, radiation dose assessments for both indoor and outdoor populations are needed to make informed decisions. These dose assessments inform emergency plans and decisions including, for example, identifying areas in which people should be sheltered and determining when controlled population evacuations should be made. US dose assessment methodologies allow consideration of the protection, and therefore dose reduction,more » that buildings provide their occupants. However, these methodologies require an understanding of the protection provided by various building types that is currently lacking. To help address this need, Lawrence Livermore National Laboratory, in cooperation with Sandia National Laboratories and the Nuclear Regulatory Commission, was tasked with (a) identifying prior building protection studies, (b) extracting results relevant to US building construction, and (c) summarizing building protection by building type. This report focuses primarily on the protection against radiation from outdoor fallout particles (external gamma radiation).« less

Influences of aquatic plants on the fate of the pyrethroid insecticide lambda-cyhalothrin in aquatic environments.

PubMed

Hand, L H; Kuet, S F; Lane, M C; Maund, S J; Warinton, J S; Hill, I R

2001-08-01

Aquatic exposure assessments for pesticides are generally based on laboratory studies performed in water alone or water sediment systems. Although aquatic macrophytes, which include a variety of bryophytes, macroalgae, and angiosperms, can be a significant component of many aquatic ecosystems, their impact on pesticide fate is generally not included in exposure assessments. To investigate the influence of aquatic plants on the fate and behavior of the pyrethroid insecticide lambda (lambda)-cyhalothrin, two laboratory experiments (to assess adsorption and degradation) and an indoor microcosm study (to assess fate under semirealistic conditions) were conducted. In the laboratory studies, adsorption to macrophytes was extensive and essentially irreversible, and degradation occurred rapidly by cleavage of the ester bond. In the indoor microcosm, which contained water, sediment, and macrophytes from a pond, degradation was also rapid, with DT50 and DT90 values of less than 3 and 19 h, respectively, for dissipation from the water column and of less than 3 and 56 h, respectively, for the whole system. For adsorptive and readily degraded pesticides like lambda-cyhalothrin, we conclude that macrophytes have considerable influence on fate and behavior in surface waters.

In-vessel coolability and retention of a core melt. Volume 1

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

Theofanous, T.G.; Liu, C.; Additon, S.

1996-10-01

The efficacy of external flooding of a reactor vessel as a severe accident management strategy is assessed for an AP600-like reactor design. The overall approach is based on the Risk Oriented Accident Analysis Methodology (ROAAM), and the assessment includes consideration of bounding scenarios and sensitivity studies, as well as arbitrary parametric evaluations that allow the delineation of the failure boundaries. Quantification of the input parameters is carried out for an AP600-like design, and the results of the assessment demonstrate that lower head failure is physically unreasonable. Use of this conclusion for any specific application is subject to verifying the requiredmore » reliability of the depressurization and cavity-flooding systems, and to showing the appropriateness (in relation to the database presented here, or by further testing as necessary) of the thermal insulation design and of the external surface properties of the lower head, including any applicable coatings. The AP600 is particularly favorable to in-vessel retention. Some ideas to enhance the assessment basis as well as performance in this respect, for applications to larger and/or higher power density reactors are also provided.« less

In-vessel coolability and retention of a core melt. Volume 2

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

Theofanous, T.G.; Liu, C.; Additon, S.

1996-10-01

The efficacy of external flooding of a reactor vessel as a severe accident management strategy is assessed for an AP600-like reactor design. The overall approach is based on the Risk Oriented Accident Analysis Methodology (ROAAM), and the assessment includes consideration of bounding scenarios and sensitivity studies, as well as arbitrary parametric evaluations that allow the delineation of the failure boundaries. Quantification of the input parameters is carried out for an AP600-like design, and the results of the assessment demonstrate that lower head failure is physically unreasonable. Use of this conclusion for any specific application is subject to verifying the requiredmore » reliability of the depressurization and cavity-flooding systems, and to showing the appropriateness (in relation to the database presented here, or by further testing as necessary) of the thermal insulation design and of the external surface properties of the lower head, including any applicable coatings. The AP600 is particularly favorable to in-vessel retention. Some ideas to enhance the assessment basis as well as performance in this respect, for applications to larger and/or higher power density reactors are also provided.« less

Rapid Response Risk Assessment in New Project Development

NASA Technical Reports Server (NTRS)

Graber, Robert R.

2010-01-01

A capability for rapidly performing quantitative risk assessments has been developed by JSC Safety and Mission Assurance for use on project design trade studies early in the project life cycle, i.e., concept development through preliminary design phases. A risk assessment tool set has been developed consisting of interactive and integrated software modules that allow a user/project designer to assess the impact of alternative design or programmatic options on the probability of mission success or other risk metrics. The risk and design trade space includes interactive options for selecting parameters and/or metrics for numerous design characteristics including component reliability characteristics, functional redundancy levels, item or system technology readiness levels, and mission event characteristics. This capability is intended for use on any project or system development with a defined mission, and an example project will used for demonstration and descriptive purposes, e.g., landing a robot on the moon. The effects of various alternative design considerations and their impact of these decisions on mission success (or failure) can be measured in real time on a personal computer. This capability provides a high degree of efficiency for quickly providing information in NASA s evolving risk-based decision environment

The pedagogical potential of drawing and writing in a primary science multimodal unit

NASA Astrophysics Data System (ADS)

Wilson, Rachel E.; Bradbury, Leslie U.

2016-11-01

In consideration of the potential of drawing and writing as assessment and learning tools, we explored how early primary students used these modes to communicate their science understandings. The context for this study was a curricular unit that incorporated multiple modes of representation in both the presentation of information and production of student understanding with a focus on the structure and function of carnivorous plants (CPs). Two science teacher educators and two first-grade teachers in the United States co-planned and co-taught a multimodal science unit on CP structure and function that included multiple representations of Venus flytraps (VFTs): physical specimens, photographs, videos, text, and discussions. Pre- and post-assessment student drawings and writings were statistically compared to note significant changes, and pre- and post-assessment writings were qualitatively analysed to note themes in student ideas. Results indicate that students increased their knowledge of VFT structure and function and synthesised information from multiple modes. While students included more structures of the VFT in their drawings, they were better able to describe the functions of structures in their writings. These results suggest the benefits for student learning and assessment of having early primary students represent their science understandings in multiple modes.

Georgetown University Integrated Community Energy System (GU-ICES). Phase III, Stage I. Feasibility analysis. Final report. Volume 1

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

None

This Feasibility Analysis covers a wide range of studies and evaluations. The Report is divided into five parts. Section 1 contains all material relating to the Institutional Assessment including consideration of the requirements and position of the Potomac Electric Co. as they relate to cogeneration at Georgetown in parallel with the utility (Task 1). Sections 2 through 7 contain all technical information relating to the Alternative Subsystems Analysis (Task 4). This includes the energy demand profiles upon which the evaluations were based (Task 3). It further includes the results of the Life-Cycle-Cost Analyses (Task 5) which are developed in detailmore » in the Appendix for evaluation in the Technical Report. Also included is the material relating to Incremental Savings and Optimization (Task 6) and the Conceptual Design for candidate alternate subsystems (Task 7). Section 8 contains all material relating to the Environmental Impact Assessment (Task 2). The Appendix contains supplementary material including the budget cost estimates used in the life-cycle-cost analyses, the basic assumptions upon which the life-cycle analyses were developed, and the detailed life-cycle-cost anlysis for each subsystem considered in detail.« less

Methodological Challenges in Studies Examining the Effects of Breakfast on Cognitive Performance and Appetite in Children and Adolescents.

PubMed

Adolphus, Katie; Bellissimo, Nick; Lawton, Clare L; Ford, Nikki A; Rains, Tia M; Totosy de Zepetnek, Julia; Dye, Louise

2017-01-01

Breakfast is purported to confer a number of benefits on diet quality, health, appetite regulation, and cognitive performance. However, new evidence has challenged the long-held belief that breakfast is the most important meal of the day. This review aims to provide a comprehensive discussion of the key methodological challenges and considerations in studies assessing the effect of breakfast on cognitive performance and appetite control, along with recommendations for future research. This review focuses on the myriad challenges involved in studying children and adolescents specifically. Key methodological challenges and considerations include study design and location, sampling and sample section, choice of objective cognitive tests, choice of objective and subjective appetite measures, merits of providing a fixed breakfast compared with ad libitum, assessment and definition of habitual breakfast consumption, transparency of treatment condition, difficulty of isolating the direct effects of breakfast consumption, untangling acute and chronic effects, and influence of confounding variables. These methodological challenges have hampered a clear substantiation of the potential positive effects of breakfast on cognition and appetite control and contributed to the debate questioning the notion that breakfast is the most important meal of the day. © 2017 American Society for Nutrition.

Methodological Challenges in Studies Examining the Effects of Breakfast on Cognitive Performance and Appetite in Children and Adolescents123

PubMed Central

Bellissimo, Nick; Ford, Nikki A; Rains, Tia M

2017-01-01

Breakfast is purported to confer a number of benefits on diet quality, health, appetite regulation, and cognitive performance. However, new evidence has challenged the long-held belief that breakfast is the most important meal of the day. This review aims to provide a comprehensive discussion of the key methodological challenges and considerations in studies assessing the effect of breakfast on cognitive performance and appetite control, along with recommendations for future research. This review focuses on the myriad challenges involved in studying children and adolescents specifically. Key methodological challenges and considerations include study design and location, sampling and sample section, choice of objective cognitive tests, choice of objective and subjective appetite measures, merits of providing a fixed breakfast compared with ad libitum, assessment and definition of habitual breakfast consumption, transparency of treatment condition, difficulty of isolating the direct effects of breakfast consumption, untangling acute and chronic effects, and influence of confounding variables. These methodological challenges have hampered a clear substantiation of the potential positive effects of breakfast on cognition and appetite control and contributed to the debate questioning the notion that breakfast is the most important meal of the day. PMID:28096143

Progress in Public Health Emergency Preparedness—United States, 2001–2016

PubMed Central

Molinari, Noelle-Angelique M.; LeBlanc, Tanya T.; Vagi, Sara J.; Avchen, Rachel N.

2017-01-01

Objectives. To evaluate the Public Health Emergency Preparedness (PHEP) program’s progress toward meeting public health preparedness capability standards in state, local, and territorial health departments. Methods. All 62 PHEP awardees completed the Centers for Disease Control and Prevention’s self-administered PHEP Impact Assessment as part of program review measuring public health preparedness capability before September 11, 2001 (9/11), and in 2014. We collected additional self-reported capability self-assessments from 2016. We analyzed trends in congressional funding for public health preparedness from 2001 to 2016. Results. Before 9/11, most PHEP awardees reported limited preparedness capabilities, but considerable progress was reported by 2016. The number of jurisdictions reporting established capability functions within the countermeasures and mitigation domain had the largest increase, almost 200%, by 2014. However, more than 20% of jurisdictions still reported underdeveloped coordination between the health system and public health agencies in 2016. Challenges and barriers to building PHEP capabilities included lack of trained personnel, plans, and sustained resources. Conclusions. Considerable progress in public health preparedness capability was observed from before 9/11 to 2016. Support, sustainment, and advancement of public health preparedness capability is critical to ensure a strong public health infrastructure. PMID:28892440

Accumulating Data to Optimally Predict Obesity Treatment (ADOPT) Core Measures: Behavioral Domain.

PubMed

Lytle, Leslie A; Nicastro, Holly L; Roberts, Susan B; Evans, Mary; Jakicic, John M; Laposky, Aaron D; Loria, Catherine M

2018-04-01

The ability to identify and measure behaviors that are related to weight loss and the prevention of weight regain is crucial to understanding the variability in response to obesity treatment and the development of tailored treatments. The overarching goal of the Accumulating Data to Optimally Predict obesity Treatment (ADOPT) Core Measures Project is to provide obesity researchers with guidance on a set of constructs and measures that are related to weight control and that span and integrate obesity-related behavioral, biological, environmental, and psychosocial domains. This article describes how the behavioral domain subgroup identified the initial list of high-priority constructs and measures to be included, and it describes practical considerations for assessing the following four behavioral areas: eating, activity, sleep, and self-monitoring of weight. Challenges and considerations for advancing the science related to weight loss and maintenance behaviors are also discussed. Assessing a set of core behavioral measures in combination with those from other ADOPT domains is critical to improve our understanding of individual variability in response to adult obesity treatment. The selection of behavioral measures is based on the current science, although there continues to be much work needed in this field. © 2018 The Obesity Society.

Behavioral assays with mouse models of Alzheimer’s disease: practical considerations and guidelines

PubMed Central

Puzzo, Daniela; Lee, Linda; Palmeri, Agostino; Calabrese, Giorgio; Arancio, Ottavio

2014-01-01

In Alzheimer’s disease (AD) basic research and drug discovery, mouse models are essential resources for uncovering biological mechanisms, validating molecular targets and screening potential compounds. Both transgenic and non-genetically modified mouse models enable access to different types of AD-like pathology in vivo. Although there is a wealth of genetic and biochemical studies on proposed AD pathogenic pathways, as a disease that centrally features cognitive failure, the ultimate readout for any interventions should be measures of learning and memory. This is particularly important given the lack of knowledge on disease etiology – assessment by cognitive assays offers the advantage of targeting relevant memory systems without requiring assumptions about pathogenesis. A multitude of behavioral assays are available for assessing cognitive functioning in mouse models, including ones specific for hippocampal-dependent learning and memory. Here we review the basics of available transgenic and non-transgenic AD mouse models and detail three well-established behavioral tasks commonly used for testing hippocampal-dependent cognition in mice – contextual fear conditioning, radial arm water maze and Morris water maze. In particular, we discuss the practical considerations, requirements and caveats of these behavioral testing paradigms. PMID:24462904

Progress in Public Health Emergency Preparedness-United States, 2001-2016.

PubMed

Murthy, Bhavini Patel; Molinari, Noelle-Angelique M; LeBlanc, Tanya T; Vagi, Sara J; Avchen, Rachel N

2017-09-01

To evaluate the Public Health Emergency Preparedness (PHEP) program's progress toward meeting public health preparedness capability standards in state, local, and territorial health departments. All 62 PHEP awardees completed the Centers for Disease Control and Prevention's self-administered PHEP Impact Assessment as part of program review measuring public health preparedness capability before September 11, 2001 (9/11), and in 2014. We collected additional self-reported capability self-assessments from 2016. We analyzed trends in congressional funding for public health preparedness from 2001 to 2016. Before 9/11, most PHEP awardees reported limited preparedness capabilities, but considerable progress was reported by 2016. The number of jurisdictions reporting established capability functions within the countermeasures and mitigation domain had the largest increase, almost 200%, by 2014. However, more than 20% of jurisdictions still reported underdeveloped coordination between the health system and public health agencies in 2016. Challenges and barriers to building PHEP capabilities included lack of trained personnel, plans, and sustained resources. Considerable progress in public health preparedness capability was observed from before 9/11 to 2016. Support, sustainment, and advancement of public health preparedness capability is critical to ensure a strong public health infrastructure.

GRADE equity guidelines 4: considering health equity in GRADE guideline development: evidence to decision process.

PubMed

Pottie, Kevin; Welch, Vivian; Morton, Rachael; Akl, Elie A; Eslava-Schmalbach, Javier H; Katikireddi, Vittal; Singh, Jasvinder; Moja, Lorenzo; Lang, Eddy; Magrini, Nicola; Thabane, Lehana; Stanev, Roger; Matovinovic, Elizabeth; Snellman, Alexandra; Briel, Matthias; Shea, Beverly; Tugwell, Peter; Schunemann, Holger; Guyatt, Gordon; Alonso-Coello, Pablo

2017-10-01

The aim of this paper is to provide detailed guidance on how to incorporate health equity within the GRADE (Grading Recommendations Assessment and Development Evidence) evidence to decision process. We developed this guidance based on the GRADE evidence to decision framework, iteratively reviewing and modifying draft documents, in person discussion of project group members and input from other GRADE members. Considering the impact on health equity may be required, both in general guidelines and guidelines that focus on disadvantaged populations. We suggest two approaches to incorporate equity considerations: (1) assessing the potential impact of interventions on equity and (2) incorporating equity considerations when judging or weighing each of the evidence to decision criteria. We provide guidance and include illustrative examples. Guideline panels should consider the impact of recommendations on health equity with attention to remote and underserviced settings and disadvantaged populations. Guideline panels may wish to incorporate equity judgments across the evidence to decision framework. This is the fourth and final paper in a series about considering equity in the GRADE guideline development process. This series is coming from the GRADE equity subgroup. Copyright © 2017 Elsevier Inc. All rights reserved.

Desire for autonomy in health care decisions: a general population survey.

PubMed

Cullati, Stéphane; Courvoisier, Delphine S; Charvet-Bérard, Agathe I; Perneger, Thomas V

2011-04-01

To examine factors associated with desire for autonomy in health care decisions in the general population. Mailed survey of 2348 residents of Geneva, Switzerland. Participants answered questions on a scale measuring their desire for autonomy in health care decisions. The scale was scored between 0 (lowest desire for autonomy) and 100 (highest desire for autonomy). On average the respondents favoured shared or active involvement in medical decisions (mean score 62.0, SD 20.9), but attitudes varied considerably. In the multivariate model, factors associated with a higher desire for autonomy included female gender, younger age, higher education, living alone, reporting an excellent global health and - a new observation compared to previous studies - having made several medical decisions in the past 6 months. The attitudes of the general public appear to be consistent with the model of shared decision making. However, people vary considerably in their desire for autonomy. An explicit assessment of each individual's desire for autonomy may improve the decision-making process. Such an assessment should be repeated regularly, as familiarity with medical decisions may increase the desire for autonomy. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Occupational exposure limit for silver nanoparticles: considerations on the derivation of a general health-based value.

PubMed

Weldon, Brittany A; M Faustman, Elaine; Oberdörster, Günter; Workman, Tomomi; Griffith, William C; Kneuer, Carsten; Yu, Il Je

2016-09-01

With the increased production and widespread commercial use of silver nanoparticles (AgNPs), human and environmental exposures to silver nanoparticles are inevitably increasing. In particular, persons manufacturing and handling silver nanoparticles and silver nanoparticle containing products are at risk of exposure, potentially resulting in health hazards. While silver dusts, consisting of micro-sized particles and soluble compounds have established occupational exposure limits (OELs), silver nanoparticles exhibit different physicochemical properties from bulk materials. Therefore, we assessed silver nanoparticle exposure and related health hazards in order to determine whether an additional OEL may be needed. Dosimetric evaluations in our study identified the liver as the most sensitive target organ following inhalation exposure, and as such serves as the critical target organ for setting an occupational exposure standard for airborne silver nanoparticles. This study proposes an OEL of 0.19 μg/m(3) for silver nanoparticles derived from benchmark concentrations (BMCs) from subchronic rat inhalation toxicity assessments and the human equivalent concentration (HEC) with kinetic considerations and additional uncertainty factors. It is anticipated that this level will protect workers from potential health hazards, including lung, liver, and skin damage.

Quality control and the substantive influence of environmental impact assessment in Finland

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

Poeloenen, Ismo

2006-07-15

This paper focuses on the challenges concerning the quality assurance of environmental impact statements (EIS) in Finland and the European Union. Moreover, the linkage between environmental impact assessment and decision-making is examined from a legal point of view. In addition, the paper includes some comparative remarks concerning the content requirements of examination of alternatives. The study reveals that a significant problem of the Finnish EIA system is the lack of efficient access to a judicial procedure to challenge the quality and completeness of an EIS. Another pitfall is the fact that in certain permit procedures, environmental consideration is so limitedmore » that only a minor part of the EIA can be taken into account. In its current state, EIA legislation in the EU and in Finland does not guarantee that the assessment results filter into decision-making. From the national point of view, the shortcomings can be addressed by amending current legislation concerning licensing procedures so that authorities have the competence and the duty to take environmental matters widely into account in the permit consideration. At the European level, a legislative alternative could be to strengthen the substantive element of the EIA Directive (85/337/EEC). This would increase the weight of EIA related arguments in the national appellate procedures and contribute, in some cases significantly, to the substantive influence of EIA in decision-making.« less

Streamflow characteristics and trends along Soldier Creek, Northeast Kansas

USGS Publications Warehouse

Juracek, Kyle E.

2017-08-16

Historical data for six selected U.S. Geological Survey streamgages along Soldier Creek in northeast Kansas were used in an assessment of streamflow characteristics and trends. This information is required by the Prairie Band Potawatomi Nation for the effective management of tribal water resources, including drought contingency planning. Streamflow data for the period of record at each streamgage were used to assess annual mean streamflow, annual mean base flow, mean monthly flow, annual peak flow, and annual minimum flow.Annual mean streamflows along Soldier Creek were characterized by substantial year-to-year variability with no pronounced long-term trends. On average, annual mean base flow accounted for about 20 percent of annual mean streamflow. Mean monthly flows followed a general seasonal pattern that included peak values in spring and low values in winter. Annual peak flows, which were characterized by considerable year-to-year variability, were most likely to occur in May and June and least likely to occur during November through February. With the exception of a weak yet statistically significant increasing trend at the Soldier Creek near Topeka, Kansas, streamgage, there were no pronounced long-term trends in annual peak flows. Annual 1-day, 30-day, and 90-day mean minimum flows were characterized by considerable year-to-year variability with no pronounced long-term trend. During an extreme drought, as was the case in the mid-1950s, there may be zero flow in Soldier Creek continuously for a period of one to several months.

Skill Assessment in Ocean Biological Data Assimilation

NASA Technical Reports Server (NTRS)

Gregg, Watson W.; Friedrichs, Marjorie A. M.; Robinson, Allan R.; Rose, Kenneth A.; Schlitzer, Reiner; Thompson, Keith R.; Doney, Scott C.

2008-01-01

There is growing recognition that rigorous skill assessment is required to understand the ability of ocean biological models to represent ocean processes and distributions. Statistical analysis of model results with observations represents the most quantitative form of skill assessment, and this principle serves as well for data assimilation models. However, skill assessment for data assimilation requires special consideration. This is because there are three sets of information in the free-run model, data, and the assimilation model, which uses Data assimilation information from both the flee-run model and the data. Intercom parison of results among the three sets of information is important and useful for assessment, but is not conclusive since the three information sets are intertwined. An independent data set is necessary for an objective determination. Other useful measures of ocean biological data assimilation assessment include responses of unassimilated variables to the data assimilation, performance outside the prescribed region/time of interest, forecasting, and trend analysis. Examples of each approach from the literature are provided. A comprehensive list of ocean biological data assimilation and their applications of skill assessment, in both ecosystem/biogeochemical and fisheries efforts, is summarized.

Revised analyses of decommissioning for the reference pressurized Water Reactor Power Station. Volume 2, Effects of current regulatory and other considerations on the financial assurance requirements of the decommissioning rule and on estimates of occupational radiation exposure: Appendices, Final report

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

Konzek, G.J.; Smith, R.I.; Bierschbach, M.C.

1995-11-01

With the issuance of the final Decommissioning Rule (July 27, 1998), owners and operators of licensed nuclear power plants are required to prepare, and submit to the US Nuclear Regulatory Commission (NRC) for review, decommissioning plans and cost estimates. The NRC staff is in need of bases documentation that will assist them in assessing the adequacy of the licensee submittals, from the viewpoint of both the planned actions, including occupational radiation exposure, and the probable costs. The purpose of this reevaluation study is to provide some of the needed bases documentation. This report contains the results of a review andmore » reevaluation of the 1978 PNL decommissioning study of the Trojan nuclear power plant (NUREG/CR-0130), including all identifiable factors and cost assumptions which contribute significantly to the total cost of decommissioning the nuclear power plant for the DECON, SAFSTOR, and ENTOMB decommissioning alternatives. These alternatives now include an initial 5--7 year period during which time the spent fuel is stored in the spent fuel pool, prior to beginning major disassembly or extended safe storage of the plant. Included for information (but not presently part of the license termination cost) is an estimate of the cost to demolish the decontaminated and clean structures on the site and to restore the site to a ``green field`` condition. This report also includes consideration of the NRC requirement that decontamination and decommissioning activities leading to termination of the nuclear license be completed within 60 years of final reactor shutdown, consideration of packaging and disposal requirements for materials whose radionuclide concentrations exceed the limits for Class C low-level waste (i.e., Greater-Than-Class C), and reflects 1993 costs for labor, materials, transport, and disposal activities.« less

Revised analyses of decommissioning for the reference pressurized Water Reactor Power Station. Effects of current regulatory and other considerations on the financial assurance requirements of the decommissioning rule and on estimates of occupational radiation exposure, Volume 1, Final report

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

Konzek, G.J.; Smith, R.I.; Bierschbach, M.C.

1995-11-01

With the issuance of the final Decommissioning Rule (July 27, 1988), owners and operators of licensed nuclear power plants are required to prepare, and submit to the US Nuclear Regulatory Commission (NRC) for review, decommissioning plans and cost estimates. The NRC staff is in need of bases documentation that will assist them in assessing the adequacy of the licensee submittals, from the viewpoint of both the planned actions, including occupational radiation exposure, and the probable costs. The purpose of this reevaluation study is to provide some of the needed bases documentation. This report contains the results of a review andmore » reevaluation of the {prime}978 PNL decommissioning study of the Trojan nuclear power plant (NUREG/CR-0130), including all identifiable factors and cost assumptions which contribute significantly to the total cost of decommissioning the nuclear power plant for the DECON, SAFSTOR, and ENTOMB decommissioning alternatives. These alternatives now include an initial 5--7 year period during which time the spent fuel is stored in the spent fuel pool, prior to beginning major disassembly or extended safe storage of the plant. Included for information (but not presently part of the license termination cost) is an estimate of the cost to demolish the decontaminated and clean structures on the site and to restore the site to a ``green field`` condition. This report also includes consideration of the NRC requirement that decontamination and decommissioning activities leading to termination of the nuclear license be completed within 60 years of final reactor shutdown, consideration of packaging and disposal requirements for materials whose radionuclide concentrations exceed the limits for Class C low-level waste (i.e., Greater-Than-Class C), and reflects 1993 costs for labor, materials, transport, and disposal activities.« less

Assessing health impact assessment: multidisciplinary and international perspectives

PubMed Central

Krieger, N; Northridge, M; Gruskin, S; Quinn, M; Kriebel, D; Davey, S; Bassett, M; Rehkopf, D; Miller, C

2003-01-01

Health impact assessment (HIA) seeks to expand evaluation of policy and programmes in all sectors, both private and public, to include their impact on population health. While the idea that the public's health is affected by a broad array of social and economic policies is not new and dates back well over two centuries, what is new is the notion—increasingly adopted by major health institutions, such as the World Health Organisation (WHO) and the United Kingdom National Health Services (NHS)—that health should be an explicit consideration when evaluating all public policies. In this article, it is argued that while HIA has the potential to enhance recognition of societal determinants of health and of intersectoral responsibility for health, its pitfalls warrant critical attention. Greater clarity is required regarding criteria for initiating, conducting, and completing HIA, including rules pertaining to decision making, enforcement, compliance, plus paying for their conduct. Critical debate over the promise, process, and pitfalls of HIA needs to be informed by multiple disciplines and perspectives from diverse people and regions of the world. PMID:12933768

Current Challenges in Neurotoxicity Risk Assessment ...

EPA Pesticide Factsheets

Neurotoxicity risk assessment must continue to evolve in parallel with advances in basic research. Along with this evolution is an expansion in the scope of neurotoxicity assessments of environmental health risks. Examples of this expansion include an increasing emphasis on complex animal models that better replicate human behavior and a wider array of molecular and mechanistic data relevant to interpreting the underlying cause(s) of toxicity. However, modern neurotoxicology studies are often more nuanced and complicated than traditional studies, and they often vary considerably in evaluation methods from one study to the next, impeding comparisons. This can pose particular difficulties for risk assessors, especially given the recent demand for chemical risk assessments to be more systematic and transparent. This presentation will introduce and provide some examples of specific challenges in neurotoxicity assessments of environmental chemicals. Some of these challenges are relatively new to the field, such as the incorporation of data on neuron-supportive glial cells into hazard characterization, while other challenges have persisted for several decades, but only recently are studies being designed to evaluate them, including analyses of latent neurotoxicity. The examples provided illustrate some future research areas of interest for scientists and risk assessors examining human neurotoxicity risk. This abstract will be presented to internal U.S. Food and Drug A

Back to "the Future": Evidence of a Bifactor Solution for Scores on the Consideration of Future Consequences Scale.

PubMed

McKay, Michael T; Morgan, Grant B; van Exel, N Job; Worrell, Frank C

2015-01-01

Despite its widespread use, disagreement remains regarding the structure of the Consideration of Future Consequences Scale (CFCS). In particular there is disagreement regarding whether the scale assesses future orientation as a unidimensional or multidimensional (immediate and future) construct. Using 2 samples of high school students in the United Kingdom, 4 models were tested. The totality of results including item loadings, goodness-of-fit indexes, and reliability estimates all supported the bifactor model, suggesting that the 2 hypothesized factors are better understood as grouping or method factors rather than as representative of latent constructs. Accordingly this study supports the unidimensionality of the CFCS and the scoring of all 12 items to produce a global future orientation score. Researchers intending to use the CFCS, and those with existing data, are encouraged to examine a bifactor solution for the scale.

Human subjects concerns in ground based ECLSS testing - Managing uncertainty in closely recycled systems

NASA Technical Reports Server (NTRS)

Crump, William J.; Janik, Daniel S.; Thomas, L. Dale

1990-01-01

U.S. space missions have to this point used water either made on board or carried from earth and discarded after use. For Space Station Freedom, long duration life support will include air and water recycling using a series of physical-chemical subsystems. The Environmental Control and Life Support System (ECLSS) designed for this application must be tested extensively at all stages of hardware maturity. Human test subjects are required to conduct some of these tests, and the risks associated with the use of development hardware must be addressed. Federal guidelines for protection of human subjects require careful consideration of risks and potential benefits by an Institutional Review Board (IRB) before and during testing. This paper reviews the ethical principles guiding this consideration, details the problems and uncertainties inherent in current hardware testing, and presents an incremental approach to risk assessment for ECLSS testing.

Testosterone replacement therapy: role of pituitary and thyroid in diagnosis and treatment

PubMed Central

Crawford, Megan

2016-01-01

Crosstalk among hormones characterizes endocrine function, and assessment of the hypogonadal man should take that into consideration. In men for whom testosterone deficiency is a concern, initial evaluation should include a thorough history and physical exam in which other endocrinopathies are being considered. Hypogonadism can be associated with both pituitary and thyroid dysfunction, for which appropriate biochemical evaluation should be undertaken in certain clinical scenarios. If low serum testosterone is confirmed measurement of luteinizing and follicle stimulating hormones (LH and FSH respectively) is essential to establish whether the hypogonadism is primary or secondary. In secondary hypogonadism measurement of prolactin is always necessary, and measurement of other pituitary hormones, along with pituitary imaging, may be indicated. Checking thyroid function may also be enlightening, and can raise additional therapeutic considerations. Correction of other pituitary axes may attenuate the need for testosterone replacement therapy in some cases. PMID:28078216

Computer-based objective quantitative assessment of pulmonary parenchyma via x-ray CT

NASA Astrophysics Data System (ADS)

Uppaluri, Renuka; McLennan, Geoffrey; Sonka, Milan; Hoffman, Eric A.

1998-07-01

This paper is a review of our recent studies using a texture- based tissue characterization method called the Adaptive Multiple Feature Method. This computerized method is automated and performs tissue classification based upon the training acquired on a set of representative examples. The AMFM has been applied to several different discrimination tasks including normal subjects, subjects with interstitial lung disease, smokers, asbestos-exposed subjects, and subjects with cystic fibrosis. The AMFM has also been applied to data acquired using different scanners and scanning protocols. The AMFM has shown to be successful and better than other existing techniques in discriminating the tissues under consideration. We demonstrate that the AMFM is considerably more sensitive and specific in characterizing the lung, especially in the presence of mixed pathology, as compared to more commonly used methods. Evidence is presented suggesting that the AMFM is highly sensitive to some of the earliest disease processes.

Study of ceramic products and processing techniques in space. [using computerized simulation

NASA Technical Reports Server (NTRS)

Markworth, A. J.; Oldfield, W.

1974-01-01

An analysis of the solidification kinetics of beta alumina in a zero-gravity environment was carried out, using computer-simulation techniques, in order to assess the feasibility of producing high-quality single crystals of this material in space. The two coupled transport processes included were movement of the solid-liquid interface and diffusion of sodium atoms in the melt. Results of the simulation indicate that appreciable crystal-growth rates can be attained in space. Considerations were also made of the advantages offered by high-quality single crystals of beta alumina for use as a solid electrolyte; these clearly indicate that space-grown materials are superior in many respects to analogous terrestrially-grown crystals. Likewise, economic considerations, based on the rapidly expanding technological applications for beta alumina and related fast ionic conductors, reveal that the many superior qualities of space-grown material justify the added expense and experimental detail associated with space processing.

Assessment of Patient Empowerment - A Systematic Review of Measures

PubMed Central

Barr, Paul J.; Scholl, Isabelle; Bravo, Paulina; Faber, Marjan J.; Elwyn, Glyn; McAllister, Marion

2015-01-01

Background Patient empowerment has gained considerable importance but uncertainty remains about the best way to define and measure it. The validity of empirical findings depends on the quality of measures used. This systematic review aims to provide an overview of studies assessing psychometric properties of questionnaires purporting to capture patient empowerment, evaluate the methodological quality of these studies and assess the psychometric properties of measures identified. Methods Electronic searches in five databases were combined with reference tracking of included articles. Peer-reviewed articles reporting psychometric testing of empowerment measures for adult patients in French, German, English, Portuguese and Spanish were included. Study characteristics, constructs operationalised and psychometric properties were extracted. The quality of study design, methods and reporting was assessed using the COSMIN checklist. The quality of psychometric properties was assessed using Terwee’s 2007 criteria. Findings 30 studies on 19 measures were included. Six measures are generic, while 13 were developed for a specific condition (N=4) or specialty (N=9). Most studies tested measures in English (N=17) or Swedish (N=6). Sample sizes of included studies varied from N=35 to N=8261. A range of patient empowerment constructs was operationalised in included measures. These were classified into four domains: patient states, experiences and capacities; patient actions and behaviours; patient self-determination within the healthcare relationship and patient skills development. Quality assessment revealed several flaws in methodological study quality with COSMIN scores mainly fair or poor. The overall quality of psychometric properties of included measures was intermediate to positive. Certain psychometric properties were not tested for most measures. Discussion Findings provide a basis from which to develop consensus on a core set of patient empowerment constructs and for further work to develop a (set of) appropriately validated measure(s) to capture this. The methodological quality of psychometric studies could be improved by adhering to published quality criteria. PMID:25970618

Assessment, Planning, and Execution Considerations for Conjunction Risk Assessment and Mitigation Operations

NASA Technical Reports Server (NTRS)

Frigm, Ryan C.; Levi, Joshua A.; Mantziaras, Dimitrios C.

2010-01-01

An operational Conjunction Assessment Risk Analysis (CARA) concept is the real-time process of assessing risk posed by close approaches and reacting to those risks if necessary. The most effective way to completely mitigate conjunction risk is to perform an avoidance maneuver. The NASA Goddard Space Flight Center has implemented a routine CARA process since 2005. Over this period, considerable experience has been gained and many lessons have been learned. This paper identifies and presents these experiences as general concepts in the description of the Conjunction Assessment, Flight Dynamics, and Flight Operations methodologies and processes. These general concepts will be tied together and will be exemplified through a case study of an actual high risk conjunction event for the Aura mission.

Fossil Energy Planning for Navajo Nation

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

Acedo, Margarita

This project includes fossil energy transition planning to find optimal solutions that benefit the Navajo Nation and stakeholders. The majority of the tribe’s budget currently comes from fossil energy-revenue. The purpose of this work is to assess potential alternative energy resources including solar photovoltaics and biomass (microalgae for either biofuel or food consumption). This includes evaluating carbon-based reserves related to the tribe’s resources including CO 2 emissions for the Four Corners generating station. The methodology for this analysis will consist of data collection from publicly available data, utilizing expertise from national laboratories and academics, and evaluating economic, health, and environmentalmore » impacts. Finally, this report will highlight areas of opportunities to implement renewable energy in the Navajo Nation by presenting the technology requirements, cost, and considerations to energy, water, and environment in an educational structure.« less

Design Considerations | Efficient Windows Collaborative

Science.gov Websites

Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

Instream flow assessment and economic valuation: a survey of nonmarket benefits research

USGS Publications Warehouse

Douglas, Aaron J.; Johnson, Richard L.

1993-01-01

Instream flow benefits for United States streams and rivers have recently been investigated by a number of resource economists. These valuation efforts differ in scope, method, and quantitative results. An assessment and review of these valuation efforts is presented. The various sources of differences in non‐market values produced by these studies are explored in some detail. The considerable difficulty of producing estimates of instream flow benefits values that consider all of the pertinent policy and technical issues is delineated in various policy contexts. Evidence is presented that indicates that the considerable policy impact of recent research on this topic is justified despite considerable variation in the magnitude of the estimates.

Instruments to assess self-care among healthy children: A systematic review of measurement properties.

PubMed

Urpí-Fernández, Ana-María; Zabaleta-Del-Olmo, Edurne; Montes-Hidalgo, Javier; Tomás-Sábado, Joaquín; Roldán-Merino, Juan-Francisco; Lluch-Canut, María-Teresa

2017-12-01

To identify, critically appraise and summarize the measurement properties of instruments to assess self-care in healthy children. Assessing self-care is a proper consideration for nursing practice and nursing research. No systematic review summarizes instruments of measurement validated in healthy children. Psychometric review in accordance with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) panel. MEDLINE, CINAHL, PsycINFO, Web of Science and Open Grey were searched from their inception to December 2016. Validation studies with a healthy child population were included. Search was not restricted by language. Two reviewers independently assessed the methodological quality of included studies using the COSMIN checklist. Eleven studies were included in the review assessing the measurement properties of ten instruments. There was a maximum of two studies per instrument. None of the studies evaluated the properties of test-retest reliability, measurement error, criterion validity and responsiveness. Internal consistency and structural validity were rated as "excellent" or "good" in four studies. Four studies were rated as "excellent" in content validity. Cross-cultural validity was rated as "poor" in the two studies (three instruments) which cultural adaptation was carried out. The evidence available does not allow firm conclusions about the instruments identified in terms of reliability and validity. Future research should focus on generate evidence about a wider range of measurement properties of these instruments using a rigorous methodology, as well as instrument testing on different countries and child population. © 2017 John Wiley & Sons Ltd.

A weight-of-evidence approach to assess chemicals: case study on the assessment of persistence of 4,6-substituted phenolic benzotriazoles in the environment.

PubMed

Brandt, Marc; Becker, Eva; Jöhncke, Ulrich; Sättler, Daniel; Schulte, Christoph

2016-01-01

One important purpose of the European REACH Regulation (EC No. 1907/2006) is to promote the use of alternative methods for assessment of hazards of substances in order to avoid animal testing. Experience with environmental hazard assessment under REACH shows that efficient alternative methods are needed in order to assess chemicals when standard test data are missing. One such assessment method is the weight-of-evidence (WoE) approach. In this study, the WoE approach was used to assess the persistence of certain phenolic benzotriazoles, a group of substances including also such of very high concern (SVHC). For phenolic benzotriazoles, assessment of the environmental persistence is challenging as standard information, i.e. simulation tests on biodegradation are not available. Thus, the WoE approach was used: overall information resulting from many sources was considered, and individual uncertainties of each source analysed separately. In a second step, all information was aggregated giving an overall picture of persistence to assess the degradability of the phenolic benzotriazoles under consideration although the reliability of individual sources was incomplete. Overall, the evidence suggesting that phenolic benzotriazoles are very persistent in the environment is unambiguous. This was demonstrated by a WoE approach considering the prerequisites of REACH by combining several limited information sources. The combination enabled a clear overall assessment which can be reliably used for SVHC identification. Finally, it is recommended to include WoE approaches as an important tool in future environmental risk assessments.

Laser Hot Wire Process: A Novel Process for Near-Net Shape Fabrication for High-Throughput Applications

NASA Astrophysics Data System (ADS)

Kottman, Michael; Zhang, Shenjia; McGuffin-Cawley, James; Denney, Paul; Narayanan, Badri K.

2015-03-01

The laser hot wire process has gained considerable interest for additive manufacturing applications, leveraging its high deposition rate, low dilution, thermal stability, and general metallurgical control including the ability to introduce and preserve desired meta-stable phases. Recent advancements in closed-loop process control and laser technology have increased productivity, process stability, and control of deposit metallurgy. The laser hot wire process has shown success in several applications: repairing and rejuvenating casting dies, depositing a variety of alloys including abrasion wear-resistant overlays with solid and tubular wires, and producing low-dilution (<5%) nickel alloy overlays for corrosion applications. The feasibility of fabricating titanium buildups is being assessed for aerospace applications.

An economic assessment of STOL aircraft potential including terminal area environmental considerations, volume 1

NASA Technical Reports Server (NTRS)

Solomon, H. L.; Sokolsky, S.

1974-01-01

The results of an economic and environmental study of short haul airline systems using short takeoff and landing (STOL) aircraft are presented. The STOL system characteristics were optimized for maximum patronage at a specified return on investment, while maintaining noise impact compatibility with the terminal area. Supporting studies of aircraft air pollution and hub airport congestion relief were also performed. The STOL concept specified for this study was an Augmentor Wing turbofan aircraft having a field length capability of 2,000 ft. and an effective perceived noise level of 95 EPNdB at 500 ft. sideline distance. An economic and environmental assessment of the defined STOL system and a summary of the methodology, STOL system characteristics and arena characteristics are provided.

Cardiac mechanics: Physiological, clinical, and mathematical considerations

NASA Technical Reports Server (NTRS)

Mirsky, I. (Editor); Ghista, D. N.; Sandler, H.

1974-01-01

Recent studies concerning the basic physiological and biochemical principles underlying cardiac muscle contraction, methods for the assessment of cardiac function in the clinical situation, and mathematical approaches to cardiac mechanics are presented. Some of the topics covered include: cardiac ultrastructure and function in the normal and failing heart, myocardial energetics, clinical applications of angiocardiography, use of echocardiography for evaluating cardiac performance, systolic time intervals in the noninvasive assessment of left ventricular performance in man, evaluation of passive elastic stiffness for the left ventricle and isolated heart muscle, a conceptual model of myocardial infarction and cardiogenic shock, application of Huxley's sliding-filament theory to the mechanics of normal and hypertrophied cardiac muscle, and a rheological modeling of the intact left ventricle. Individual items are announced in this issue.

A normative price for energy from an electricity generation system: An Owner-dependent Methodology for Energy Generation (system) Assessment (OMEGA). Volume 1: Summary

NASA Technical Reports Server (NTRS)

Chamberlain, R. G.; Mcmaster, K. M.

1981-01-01

The utility owned solar electric system methodology is generalized and updated. The net present value of the system is determined by consideration of all financial benefits and costs (including a specified return on investment). Life cycle costs, life cycle revenues, and residual system values are obtained. Break even values of system parameters are estimated by setting the net present value to zero. While the model was designed for photovoltaic generators with a possible thermal energy byproduct, it applicability is not limited to such systems. The resulting owner-dependent methodology for energy generation system assessment consists of a few equations that can be evaluated without the aid of a high-speed computer.

Sensor Systems for Prognostics and Health Management

PubMed Central

Cheng, Shunfeng; Azarian, Michael H.; Pecht, Michael G.

2010-01-01

Prognostics and health management (PHM) is an enabling discipline consisting of technologies and methods to assess the reliability of a product in its actual life cycle conditions to determine the advent of failure and mitigate system risk. Sensor systems are needed for PHM to monitor environmental, operational, and performance-related characteristics. The gathered data can be analyzed to assess product health and predict remaining life. In this paper, the considerations for sensor system selection for PHM applications, including the parameters to be measured, the performance needs, the electrical and physical attributes, reliability, and cost of the sensor system, are discussed. The state-of-the-art sensor systems for PHM and the emerging trends in technologies of sensor systems for PHM are presented. PMID:22219686

Perceived Characteristics of Intervention Scale: Development and Psychometric Properties.

PubMed

Cook, Joan M; Thompson, Richard; Schnurr, Paula P

2015-12-01

The Perceived Characteristics of Intervention Scale (PCIS), a 20-item assessment measure, was developed to assess health care providers' views of interventions. Two hundred and fifteen Department of Veterans Affairs' residential treatment providers from 38 programs across the United States completed an online survey that included the PCIS as well as self-reported use of two evidence-based treatments. The PCIS was anchored to ask about two evidence-based psychotherapies for posttraumatic stress disorder, prolonged exposure, and cognitive processing therapy. The PCIS is a reliable measure of perceived characteristics of interventions, with some preliminary support for its validity. Consideration of providers' perceptions of particular evidence-based treatments may serve as an aid to improve their dissemination, implementation, and sustained use. © The Author(s) 2014.

Sensor systems for prognostics and health management.

PubMed

Cheng, Shunfeng; Azarian, Michael H; Pecht, Michael G

2010-01-01

Prognostics and health management (PHM) is an enabling discipline consisting of technologies and methods to assess the reliability of a product in its actual life cycle conditions to determine the advent of failure and mitigate system risk. Sensor systems are needed for PHM to monitor environmental, operational, and performance-related characteristics. The gathered data can be analyzed to assess product health and predict remaining life. In this paper, the considerations for sensor system selection for PHM applications, including the parameters to be measured, the performance needs, the electrical and physical attributes, reliability, and cost of the sensor system, are discussed. The state-of-the-art sensor systems for PHM and the emerging trends in technologies of sensor systems for PHM are presented.

Contemporary research on parenting: conceptual, methodological, and translational issues.

PubMed

Power, Thomas G; Sleddens, Ester F C; Berge, Jerica; Connell, Lauren; Govig, Bert; Hennessy, Erin; Liggett, Leanne; Mallan, Kimberley; Santa Maria, Diane; Odoms-Young, Angela; St George, Sara M

2013-08-01

Researchers over the last decade have documented the association between general parenting style and numerous factors related to childhood obesity (e.g., children's eating behaviors, physical activity, and weight status). Many recent childhood obesity prevention programs are family focused and designed to modify parenting behaviors thought to contribute to childhood obesity risk. This article presents a brief consideration of conceptual, methodological, and translational issues that can inform future research on the role of parenting in childhood obesity. They include: (1) General versus domain specific parenting styles and practices; (2) the role of ethnicity and culture; (3) assessing bidirectional influences; (4) broadening assessments beyond the immediate family; (5) novel approaches to parenting measurement; and (6) designing effective interventions. Numerous directions for future research are offered.

Workplace Violence: Practical Considerations for Mental Health Professionals in Consultation, Assessment, and Management of Risk.

PubMed

Saragoza, Philip; White, Stephen G

2016-12-01

Workplace predatory violence has been the focus of increased study over the past 30 years, leading to a more sophisticated understanding of the factors that contribute to it, and important considerations for its assessment and management. Risk assessment professionals involved in workplace violence consultations should be mindful of issues specific to the workplace context and the principles of threat assessment to provide a more precise opinion of risk, to inform and enhance critical decisions regarding the employment status of the individual of concern, security measures, possible treatment options, and other management responses, while being mindful of the employee's certain rights. Copyright © 2016 Elsevier Inc. All rights reserved.

Advancing practice relating to SEA alternatives

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

González, Ainhoa, E-mail: agonzal@tcd.ie; Thérivel, Riki, E-mail: levett-therivel@phonecoop.coop; Fry, John, E-mail: john.fry@ucd.ie

Developing and assessing alternatives is a key and central stage to Strategic Environmental Assessment (SEA). However, research has repeatedly reported this stage as one of the most poorly undertaken aspects of the SEA process. Current practice limitations include belated consideration of reasonable alternatives, narrow scope of alternatives that often include unrealistic or retrofitted options, limited stakeholder and public involvement in their identification, assessment and selection, lack of systematic approaches to their assessment and comparison, and inadequate reporting of the ‘storyline’ on how they were identified, what the potential impacts are and why the preferred alternative was selected. These issues havemore » resulted in objections and judicial reviews. On the positive side, a number of good practice case studies enable extraction of key lessons and formulation of a set of general recommendations to advance practice in SEA alternatives. In this paper, practical guidance on the identification and development of alternatives, their assessment and comparison, selection of the preferred option, and documentation of the process and the reasons for selection is provided and discussed to frame good practice approaches. - Highlights: • Alternatives are one of the most poorly completed aspects of Strategic Environmental Assessment. • Current practice limitations need to be addressed to enhance SEA effectiveness. • A set of recommendations are extracted from good practice case studies. • These recommendations can be applied across jurisdictions and sectors and tailored as necessary.« less

The role of impacts in the history of the early earth

NASA Technical Reports Server (NTRS)

French, Bevan M.

1991-01-01

The significant conclusions of a conference called 'Meteorite Impact and the Early Earth' are reported including data which support the notion that extraterrestrial impacts greatly influenced the development of the earth. The cratering of other planetary surfaces is discussed, and the energy added by meteorite impacts is characterized. The primary effects of large impacts are set forth in terms of atmospheric, oceanic, and biological considerations which suggest that the ramifications would have been significant. Contentious issues include the variation of impact rate with time in the early universe, the interpretation of the record of intense bombardment in the lunar highlands, and the effects related to alternative scenarios. Directions of future study are mentioned including the identification of terrestrial impact structures, conducting searches in the Archean, and assessing ancient impact rates.

Improvement in Context: Exploring Aims, Improvement Priorities, and Environmental Considerations in a National Sample of Programs Using "Small Data".

PubMed

Philibert, Ingrid; Beernink, John H; Bush, Barbara H; Caniano, Donna A; Chow, Andrea; Coyle, John J; Gilhooly, Joseph; Kraybill, Donald E; Larson, David; Moran, Sarah; Nace, Mary Catherine; Robertson, William W; Rubin, Judith D; Sanford, Theodore

2017-12-01

In 2013, the Accreditation Council for Graduate Medical Education (ACGME) transitioned into a new accreditation system to reduce burden, focus on outcomes, and promote innovation and improvement. One component is a self-study that includes aims, an environmental assessment, and setting improvement priorities. The ACGME initiated voluntary site visits following the self-study. We explored common themes in program aims and assessment of their environment. Using grounded theory, inductive and deductive qualitative methods, and truth grounding, we analyzed data from voluntary site visits of 396 core and subspecialty programs between June 2015 and September 2017, with a focus on common themes. We report common themes for aims and the dimensions of the environmental assessment. Themes for strengths include a collegial, supportive learning environment; responsive leaders; and experiences that prepare residents for unsupervised practice. Improvement priorities encompass low learner engagement and "content mismatch" in didactic education, balancing education and service at a time of growing clinical volumes, and improving the utility of assessment systems. Common opportunities encompass collaborations that improve education, involving alumni and harnessing technology to enrich education, while threats include an unsustainable effort for many program leaders, clinical pressures on faculty, and loss of external sites important for education. Linked dimensions of the environmental assessment suggest benefit in a growing focus on learners, and approaches to ensure a humanistic learning environment that allows for growth, self-determination, and inclusion. The findings highlight actionable themes for the environmental assessment. We discuss implications for programs, institutions, and the ACGME.

Cloud Ice: A Climate Model Challenge With Signs and Expectations of Progress

NASA Astrophysics Data System (ADS)

Li, F.; Waliser, D.; Bacmeister, J.; Chern, J.; Del Genio, T.; Jiang, J.; Kharitondov, M.; Liou, K.; Meng, H.; Minnis, P.; Rossow, B.; Stephens, G.; Sun-Mack, S.; Tao, W.; Vane, D.; Woods, C.; Tompkins, A.; Wu, D.

2007-12-01

Global climate models (GCMs), including those assessed in the IPCC AR4, exhibit considerable disagreement in the amount of cloud ice - both in terms of the annual global mean as well as their spatial variability. Global measurements of cloud ice have been difficult due to the challenges involved in remotely sensing ice water content (IWC) and its vertical profile - including complications associated with multi-level clouds, mixed-phases and multiple hydrometer types, the uncertainty in classifying ice particle size and shape for remote retrievals, and the relatively small time and space scales associated with deep convection. Together, these measurement difficulties make it a challenge to characterize and understand the mechanisms of ice cloud formation and dissipation. Fortunately, there are new observational resources recently established that can be expected to lead to considerable reduction in the observational uncertainties of cloud ice, and in turn improve the fidelity of model representations. Specifically, these include the Microwave Limb Sounder (MLS) on the Earth Observing System (EOS) Aura satellite, and the CloudSat and Calipso satellite missions, all of which fly in formation in what is referred to as the A-Train. Based on radar and limb-sounding techniques, these new satellite measurements provide a considerable leap forward in terms of the information gathered regarding upper-tropospheric cloud IWC as well as other macrophysical and microphysical properties. In this presentation, we describe the current state of GCM representations of cloud ice and their associated uncertainties, the nature of the new observational resources for constraining cloud ice values in GCMs, the challenges in making model-data comparisons with these data resources, and prospects for near-term improvements in model representations.

50 CFR 679.20 - General limitations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... prohibitions designed to prevent overfishing of that species or species group. (ii) Limitations and...; updated estimates of the MSY of the groundfish complex and its component species groups; assessments of... component species group. (ii) Socioeconomic considerations. Socioeconomic considerations that are consistent...

Sustainable nanotechnology decision support system: bridging risk management, sustainable innovation and risk governance

NASA Astrophysics Data System (ADS)

Subramanian, Vrishali; Semenzin, Elena; Hristozov, Danail; Zabeo, Alex; Malsch, Ineke; McAlea, Eamonn; Murphy, Finbarr; Mullins, Martin; van Harmelen, Toon; Ligthart, Tom; Linkov, Igor; Marcomini, Antonio

2016-04-01

The significant uncertainties associated with the (eco)toxicological risks of engineered nanomaterials pose challenges to the development of nano-enabled products toward greatest possible societal benefit. This paper argues for the use of risk governance approaches to manage nanotechnology risks and sustainability, and considers the links between these concepts. Further, seven risk assessment and management criteria relevant to risk governance are defined: (a) life cycle thinking, (b) triple bottom line, (c) inclusion of stakeholders, (d) risk management, (e) benefit-risk assessment, (f) consideration of uncertainty, and (g) adaptive response. These criteria are used to compare five well-developed nanotechnology frameworks: International Risk Governance Council framework, Comprehensive Environmental Assessment, Streaming Life Cycle Risk Assessment, Certifiable Nanospecific Risk Management and Monitoring System and LICARA NanoSCAN. A Sustainable Nanotechnology Decision Support System (SUNDS) is proposed to better address current nanotechnology risk assessment and management needs, and makes. Stakeholder needs were solicited for further SUNDS enhancement through a stakeholder workshop that included representatives from regulatory, industry and insurance sectors. Workshop participants expressed the need for the wider adoption of sustainability assessment methods and tools for designing greener nanomaterials.

Non-animal approaches for consumer safety risk assessments: Unilever's scientific research programme.

PubMed

Carmichael, Paul; Davies, Michael; Dent, Matt; Fentem, Julia; Fletcher, Samantha; Gilmour, Nicola; MacKay, Cameron; Maxwell, Gavin; Merolla, Leona; Pease, Camilla; Reynolds, Fiona; Westmoreland, Carl

2009-12-01

Non-animal based approaches to risk assessment are now routinely used for assuring consumer safety for some endpoints (such as skin irritation) following considerable investment in developing and applying new methods over the past 20 years. Unilever's research programme into non-animal approaches for safety assessment is currently focused on the application of new technologies to risk assessments in the areas of skin allergy, cancer and general toxicity (including inhalation toxicity). In all of these areas, a long-term investment is essential to increase the scientific understanding of the underlying biological and chemical processes that we believe will ultimately form a sound basis for novel risk assessment approaches. Our research programme in these priority areas consists of in-house research as well as Unilever-sponsored academic research, involvement with EU-funded projects (e.g. Sens-it-iv, carcinoGENOMICS), participation in cross-industry collaborative research (e.g. COLIPA, EPAA) and ongoing involvement with other scientific initiatives on non-animal approaches to risk assessment (e.g. UK NC3Rs, US 'Human Toxicology Project' consortium). 2009 FRAME.

Cancer in Transgender People: Evidence and Methodological Considerations

PubMed Central

Braun, Hayley; Nash, Rebecca; Tangpricha, Vin; Brockman, Janice; Ward, Kevin; Goodman, Michael

2017-01-01

Abstract Transgender people comprise a diverse group of individuals whose gender identity or expression differs from that originally assigned to them at birth. Some, but not all, transgender people elect to undergo medical gender affirmation, which may include therapy with cross-sex hormones and/or surgical change of the genitalia and other sex characteristics. As cross-sex hormones administered for the purposes of gender affirmation may be delivered at high doses and over a period of decades, the carcinogenicity of hormonal therapy in transgender people is an area of considerable concern. In addition, concerns about cancer risk in transgender patients have been linked to sexually transmitted infections, increased exposure to well-known risk factors such as smoking and alcohol use, and the lack of adequate access to screening. Several publications have identified cancer as an important priority in transgender health research and called for large-scale studies. The goals of this article are to summarize the evidence on factors that may differentially affect cancer risk in transgender people, assess the relevant cancer surveillance and epidemiologic data available to date, and offer an overview of possible methodological considerations for future studies investigating cancer incidence and mortality in this population. PMID:28486701

SCIENTIFIC AND SOCIAL VALUE JUDGMENTS FOR ORPHAN DRUGS IN HEALTH TECHNOLOGY ASSESSMENT.

PubMed

Nicod, Elena; Kanavos, Panos

2016-01-01

We explore how broader aspects of a treatment's value and the impact of the condition on patients not captured by routine health technology assessment (HTA) methods using clinical and economic evidence, defined as "other considerations," may influence HTA processes in different settings. Countries included were England, Scotland, Sweden, and France. Data sources were the publicly available reports on HTA recommendations. Ten drugs with European Medicines Agency orphan designation and appraised in England were selected. Qualitative thematic analysis was used to systematically identify and code all "other considerations" based on a previously developed methodological framework, which also coded whether it was provided by stakeholders, and how it influenced the decision. A classification framework of scientific and social value judgments was developed and used throughout the study. A total of 125 "other considerations" were identified and grouped into ten subcategories based on the information provided. Eighteen to 100 percent of these, depending on the agency, were put forward as one of the main reasons for the final decision potentially contributing to accepting a higher incremental cost-effectiveness ratio or uncertain evidence. Some of these were nonquantified or nonelicited and pertained to the assessor's judgment. A taxonomy of these value judgments was created to be used in future cases. Results also contributed to better defining the determinants of social value and improving accountability for reasonableness. The systematic identification of the scientific and social value judgments enables to better understanding the dimensions of value, which can be used to improve their transparency and consistent use across decisions and settings.

Assessing the potential effects and cost-effectiveness of programmatic herpes zoster vaccination of elderly in the Netherlands

PubMed Central

2010-01-01

Background Herpes zoster (HZ) is a painful disease affecting a considerable part of the elderly. Programmatic HZ vaccination of elderly people may considerably reduce HZ morbidity and its related costs, but the extent of these effects is unknown. In this article, the potential effects and cost-effectiveness of programmatic HZ vaccination of elderly in the Netherlands have been assessed according to a framework that was developed to support evidence-based decision making regarding inclusion of new vaccines in the Dutch National Immunization Program. Methods An analytical framework was used combining a checklist, which structured relevant data on the vaccine, pathogen and disease, and a cost-effectiveness analysis. The cost-effectiveness analysis was performed from a societal perspective, using a Markov-cohort-model. Simultaneous vaccination with influenza was assumed. Results Due to the combination of waning immunity after vaccination and a reduced efficacy of vaccination at high ages, the most optimal cost-effectiveness ratio (€21716 per QALY) for HZ vaccination in the Netherlands was found for 70-year olds. This estimated ratio is just above the socially accepted threshold in the Netherlands of €20000 per QALY. If additional reduction of postherpetic neuralgia was included, the cost-effectiveness ratio improved (~€10000 per QALY) but uncertainty for this scenario is high. Conclusions Vaccination against HZ at the age of 70 years seems marginally cost-effective in the Netherlands. Due to limited vaccine efficacy a considerable part of the disease burden caused by HZ will remain, even with optimal acceptance of programmatic vaccination. PMID:20707884

Assessing the potential effects and cost-effectiveness of programmatic herpes zoster vaccination of elderly in the Netherlands.

PubMed

van Lier, Alies; van Hoek, Albert Jan; Opstelten, Wim; Boot, Hein J; de Melker, Hester E

2010-08-13

Herpes zoster (HZ) is a painful disease affecting a considerable part of the elderly. Programmatic HZ vaccination of elderly people may considerably reduce HZ morbidity and its related costs, but the extent of these effects is unknown. In this article, the potential effects and cost-effectiveness of programmatic HZ vaccination of elderly in the Netherlands have been assessed according to a framework that was developed to support evidence-based decision making regarding inclusion of new vaccines in the Dutch National Immunization Program. An analytical framework was used combining a checklist, which structured relevant data on the vaccine, pathogen and disease, and a cost-effectiveness analysis. The cost-effectiveness analysis was performed from a societal perspective, using a Markov-cohort-model. Simultaneous vaccination with influenza was assumed. Due to the combination of waning immunity after vaccination and a reduced efficacy of vaccination at high ages, the most optimal cost-effectiveness ratio (21716 euro per QALY) for HZ vaccination in the Netherlands was found for 70-year olds. This estimated ratio is just above the socially accepted threshold in the Netherlands of 20000 euro per QALY. If additional reduction of postherpetic neuralgia was included, the cost-effectiveness ratio improved (approximately 10000 euro per QALY) but uncertainty for this scenario is high. Vaccination against HZ at the age of 70 years seems marginally cost-effective in the Netherlands. Due to limited vaccine efficacy a considerable part of the disease burden caused by HZ will remain, even with optimal acceptance of programmatic vaccination.

Assessing the number of fire fatalities in a defined population.

PubMed

Jonsson, Anders; Bergqvist, Anders; Andersson, Ragnar

2015-12-01

Fire-related fatalities and injuries have become a growing governmental concern in Sweden, and a national vision zero strategy has been adopted stating that nobody should get killed or seriously injured from fires. There is considerable uncertainty, however, regarding the numbers of both deaths and injuries due to fires. Different national sources present different numbers, even on deaths, which obstructs reliable surveillance of the problem over time. We assume the situation is similar in other countries. This study seeks to assess the true number of fire-related deaths in Sweden by combining sources, and to verify the coverage of each individual source. By doing so, we also wish to demonstrate the possibilities of improved surveillance practices. Data from three national sources were collected and matched; a special database on fatal fires held by The Swedish Contingencies Agency (nationally responsible for fire prevention), a database on forensic medical examinations held by the National Board of Forensic Medicine, and the cause of death register held by the Swedish National Board of Health and Welfare. The results disclose considerable underreporting in the single sources. The national database on fatal fires, serving as the principal source for policy making on fire prevention matters, underestimates the true situation by 20%. Its coverage of residential fires appears to be better than other fires. Systematic safety work and informed policy-making presuppose access to correct and reliable numbers. By combining several different sources, as suggested in this study, the national database on fatal fires is now considerably improved and includes regular matching with complementary sources.

At the nexus of fire, water and society

USGS Publications Warehouse

Martin, Deborah

2016-01-01

The societal risks of water scarcity and water-quality impairment have received considerable attention, evidenced by recent analyses of these topics by the 2030 Water Resources Group, the United Nations and the World Economic Forum. What are the effects of fire on the predicted water scarcity and declines in water quality? Drinking water supplies for humans, the emphasis of this exploration, are derived from several land cover types, including forests, grasslands and peatlands, which are vulnerable to fire. In the last two decades, fires have affected the water supply catchments of Denver (CO) and other southwestern US cities, and four major Australian cities including Sydney, Canberra, Adelaide and Melbourne. In the same time period, several, though not all, national, regional and global water assessments have included fire in evaluations of the risks that affect water supplies. The objective of this discussion is to explore the nexus of fire, water and society with the hope that a more explicit understanding of fire effects on water supplies will encourage the incorporation of fire into future assessments of water supplies, into the pyrogeography conceptual framework and into planning efforts directed at water resiliency.

Prevalence, incidence, and natural course of anorexia and bulimia nervosa among adolescents and young adults.

PubMed

Nagl, Michaela; Jacobi, Corinna; Paul, Martin; Beesdo-Baum, Katja; Höfler, Michael; Lieb, Roselind; Wittchen, Hans-Ulrich

2016-08-01

We aimed to assess the prevalence, incidence, age-of-onset and diagnostic stability of threshold and subthreshold anorexia nervosa (AN) and bulimia nervosa (BN) in the community. Data come from a prospective-longitudinal community study of 3021 subjects aged 14-24 at baseline, who were followed up at three assessment waves over 10 years. Eating disorder (ED) symptomatology was assessed with the DSM-IV/M-CIDI at each wave. Diagnostic stability was defined as the proportion of individuals still affected with at least symptomatic eating disorders (EDs) at follow-ups. Baseline lifetime prevalence for any threshold ED were 2.9 % among females and 0.1 % among males. For any subthreshold ED lifetime prevalence were 2.2 % for females and 0.7 % for males. Symptomatic expressions of EDs (including core symptoms of the respective disorder) were most common with a lifetime prevalence of 11.5 % among females and 1.8 % among males. Symptomatic AN showed the earliest onset with a considerable proportion of cases emerging in childhood. 47 % of initial threshold AN cases and 42 % of initial threshold BN cases showed at least symptomatic expressions of any ED at any follow-up assessment. Stability for subthreshold EDs and symptomatic expressions was 14-36 %. While threshold EDs are rare, ED symptomatology is common particularly in female adolescents and young women. Especially threshold EDs are associated with a substantial risk for stability. A considerable degree of symptom fluctuation is characteristic especially for subthreshold EDs.

Variation in Health Technology Assessment and Reimbursement Processes in Europe.

PubMed

Akehurst, Ronald L; Abadie, Eric; Renaudin, Noël; Sarkozy, François

2017-01-01

It has been suggested that differences in health technology assessment (HTA) processes among countries, particularly within Europe, have led to inequity in patient access to new medicines. To provide an up-to-date snapshot analysis of the present status of HTA and reimbursement systems in select European countries, and to investigate the implications of these processes, especially with regard to delays in market and patient access. HTA and reimbursement processes were assessed through a review of published and gray literature, and through a series of interviews with HTA experts. To quantify the impact of differences among countries, we conducted case studies of 12 products introduced since 2009, including 10 cancer drugs. In addition to the differences in HTA and reimbursement processes among countries, the influence of particular sources of information differs among HTA bodies. The variation in the time from the authorization by the European Medicines Agency to the publication of HTA decisions was considerable, both within and among countries, with a general lack of transparency as to why some assessments take longer than others. In most countries, market access for oncology products can occur outside the HTA process, with sales often preceding HTA decisions. It is challenging even for those with considerable personal experience in European HTA processes to establish what is really happening in market access for new drugs. We recommend that efforts should be directed toward improving transparency in HTA, which should, in turn, lead to more effective processes. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Reasons for current E-cigarette use among U.S. adults

PubMed Central

Patel, Deesha; Davis, Kevin C.; Cox, Shanna; Bradfield, Brian; King, Brian A.; Shafer, Paul; Caraballo, Ralph; Bunnell, Rebecca

2017-01-01

E-cigarette use has increased rapidly among U.S. adults. However, reasons for use among adults are unclear. We assessed reasons for e-cigarette use among a national sample of U.S. adults. Data were collected via online surveys among U.S. adults aged 18 or older from April through June 2014. Descriptive and multivariate regression analyses were conducted to assess reasons for e-cigarette use among 2448 current e-cigarette users, by sociodemographic characteristics and product type. Assessed reasons included cessation/health, consideration of others, convenience, cost, curiosity, flavoring, and simulation of conventional cigarettes. Among current e-cigarette users, 93% were also current cigarette smokers. The most common reasons for e-cigarette use were cessation/health (84.5%), consideration of others (71.5%), and convenience (56.7%). The prevalence of citing convenience (adjusted prevalence ratio [aPR] = 1.49) and curiosity (aPR = 1.54) as reasons for e-cigarette use were greater among current cigarette smokers than nonsmokers (P < 0.05). The prevalence of citing flavoring as a reason for use was greater among adults aged 18 to 24 (aPR = 2.02) than 55 or older (P < 0.05). Tank use was associated with greater prevalence of citing every assessed reason except convenience and curiosity. Cessation- and health-related factors are primary reasons cited for e-cigarette use among adults, and flavorings are more commonly cited by younger adults. Efforts are warranted to provide consumers with accurate information on the health effects of e-cigarettes and to ensure that flavoring and other unregulated features do not promote nicotine addiction, particularly among young adults. PMID:27612572

The Business of Bronchoscopy: How to Set up an Interventional Pulmonology Program.

PubMed

Kessler, Edward; Wahidi, Momen M

2018-03-01

Interventional pulmonology has advanced rapidly over the last decade and continues to evolve with new medical advances and changes in the health care landscape. Establishing and developing a new interventional pulmonology program entails careful planning, including a needs assessment, a business plan with financial and marketing considerations, and outcomes monitoring. Addressing these aspects will provide a framework to ensure the success of a new interventional pulmonology program that can provide valuable services to the local practice and community. Copyright © 2017 Elsevier Inc. All rights reserved.

Regulatory considerations for pluripotent stem cell therapies.

PubMed

Carpenter, Melissa K

2017-01-01

The development of pluripotent stem cell (PSC) therapies is rapidly advancing, and a number of PSC-derived cell products are currently being tested in clinical trials. The biological complexity of these therapies results in specific challenges in complying with regulatory guidelines. This includes the choice of starting material, reproducible and consistent manufacturing, and preclinical safety and efficacy assessment of the PSC-derived product. This review discusses current US cell therapy regulations and strategies for compliance with these regulations when developing PSC-derived products. © 2017 Elsevier B.V. All rights reserved.

Assessing the TMDL Approach to Water Quality Management

NASA Astrophysics Data System (ADS)

Aswathanarayana, U.

Every human being on Earth is a stakeholder in water quality management. And so, for that matter, is every animal, domesticated or wild, though they have no constituency Water quality includes not only considerations of water composition for multiple human uses such as drinking and irrigation, but also in terms of its capacity to support systems of aquatic biota in general. This is so because we now realize that our well-being is inseparable from the well-being of, say the aquatic biota. If frogs were dying, we would be next in line!

Assessing the Role of Anhydrite in the KT Mass Extinction: Hints from Shock-loading Experiments

NASA Technical Reports Server (NTRS)

Skala, R.; Lnagenhorst, F.; Hoerz, F.

2004-01-01

Various killing mechanisms have been suggested to contribute to the mass extinctions at the KT boundary, including severe, global deterioration of the atmosphere and hydrosphere due to SO(x) released from heavily shocked, sulfate-bearing target rocks. The devolatilization of anhydrite is predominantly inferred from thermodynamic considerations and lacks experimental confirmation. To date, the experimentally determined shock behavior of anhydrite is limited to solid-state effects employing X-ray diffraction methods. The present report employs additional methods to characterize experimentally shocked anhydrite.

Multiple-modality program for standoff detection of roadside hazards

NASA Astrophysics Data System (ADS)

Williams, Kathryn; Middleton, Seth; Close, Ryan; Luke, Robert H.; Suri, Rajiv

2016-05-01

The U.S. Army RDECOM CERDEC Night Vision and Electronic Sensors Directorate (NVESD) is executing a program to assess the performance of a variety of sensor modalities for standoff detection of roadside explosive hazards. The program objective is to identify an optimal sensor or combination of fused sensors to incorporate with autonomous detection algorithms into a system of systems for use in future route clearance operations. This paper provides an overview of the program, including a description of the sensors under consideration, sensor test events, and ongoing data analysis.

Thirteenth annual U.S. DOE low-level radioactive waste management conference: Proceedings

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

NONE

1991-12-31

The 40 papers in this document comprise the proceedings of the Department of Energy`s Thirteenth Annual Low-Level Radioactive Waste Management Conference that was held in Atlanta, Georgia, on November 19--21, 1991. General subjects addressed during the conference included: disposal facility design; greater-than-class C low-level waste; public acceptance considerations; waste certification; site characterization; performance assessment; licensing and documentation; emerging low-level waste technologies; waste minimization; mixed waste; tracking and transportation; storage; and regulatory changes. Papers have been processed separately for inclusion on the data base.

A probabilistic analysis of electrical equipment vulnerability to carbon fibers

NASA Technical Reports Server (NTRS)

Elber, W.

1980-01-01

The statistical problems of airborne carbon fibers falling onto electrical circuits were idealized and analyzed. The probability of making contact between randomly oriented finite length fibers and sets of parallel conductors with various spacings and lengths was developed theoretically. The probability of multiple fibers joining to bridge a single gap between conductors, or forming continuous networks is included. From these theoretical considerations, practical statistical analyses to assess the likelihood of causing electrical malfunctions was produced. The statistics obtained were confirmed by comparison with results of controlled experiments.

[Clinical assessment of drug safety].

PubMed

Imbs, J-L; Welsch, M

2007-09-01

The environment of drug safety is changing. In addition to the current system of pharmacovigilance based on spontaneous report of adverse events, clinical data observed in a given patient with a given symptom is taken into consideration and compared with information coming from pharmacovigilance data bases, which is then analyzed for causality by the experts of both the promotor and the public network. Such information is integrated into a risk management strategy, defined together by the French drug agency (Afssaps) and the marketing authorization holder. This strategy includes a pharmacovigilance plan and, if possible, a risk minimisation plan.

Regulatory and quality considerations for continuous manufacturing. May 20-21, 2014 Continuous Manufacturing Symposium.

PubMed

Allison, Gretchen; Cain, Yanxi Tan; Cooney, Charles; Garcia, Tom; Bizjak, Tara Gooen; Holte, Oyvind; Jagota, Nirdosh; Komas, Bekki; Korakianiti, Evdokia; Kourti, Dora; Madurawe, Rapti; Morefield, Elaine; Montgomery, Frank; Nasr, Moheb; Randolph, William; Robert, Jean-Louis; Rudd, Dave; Zezza, Diane

2015-03-01

This paper assesses the current regulatory environment, relevant regulations and guidelines, and their impact on continuous manufacturing. It summarizes current regulatory experience and learning from both review and inspection perspectives. It outlines key regulatory aspects, including continuous manufacturing process description and control strategy in regulatory files, process validation, and key Good Manufacturing Practice (GMP) requirements. In addition, the paper identifies regulatory gaps and challenges and proposes a way forward to facilitate implementation. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association.

[Clinicopathological confrontation. Was the skin cancer eradicated?].

PubMed

Arrese, J E; Piérard, G E; Ruiz Ballon, M; Quatresooz, P

2007-09-01

Distinguishing complete removal of a skin cancer and its partial destruction is frequently requested by the clinicians and their patients. The information is awaited from the laboratory, but it is not always correctly interpreted by the information-seekers. The factors influencing this assessment include the combination of the nature of the antineoplastic therapy, the sampling modality of the area to be examined, and the quality of the dermatopathology procedure. In addition, the possibility of neoplastic regression linked to scarring or, conversely, the existence of a possible field cancerisation should be taken into consideration.

Clinical exam of the shoulder.

PubMed

Clarnette, R G; Miniaci, A

1998-04-01

This paper outlines the important features of the clinical assessment of the shoulder in a systematic and thorough manner. We highlight the key symptoms, particularly pain and instability, and describe how they may be associated with the various different pathologies. The physical examination is detailed in order of inspection, palpation, and motion, and then considerable emphasis is given to specific shoulder tests looking for evidence of rotator cuff weakness, impingement, biceps pathology, and instability. A number of specific tests of instability are outlined including an examination technique for posterior instability that has not previously been described.

Contributions from personality- and psychodynamically oriented assessment to the development of the DSM-5 personality disorders.

PubMed

Huprich, Steven K

2011-07-01

Advances in personality assessment over the past 20 years have notably influenced the proposed assessment and classification of personality disorders in the Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM-5]). However, a considerable body of personality assessment and psychodynamically oriented assessment research has significant relevance to the way in which personality disorders are evaluated that appears to have gone unrecognized in the current proposals for DSM-5. In this article, I discuss the ways in which some of these 2 bodies of literature can and should inform the DSM-5 so that the diagnostic nomenclature can be more scientifically and comprehensively informed and consequently improve the clinical utility of a diagnostic system in need of considerable revision.

Alternative approaches to vertebrate ecotoxicity tests in the 21st century: A review of developments over the last 2 decades and current status

USGS Publications Warehouse

Lillicrap, Adam; Belanger, Scott; Burden, Natalie; Du Pasquier, David; Embry, Michelle; Halder, Marlies; Lampi, Mark; Lee, Lucy; Norberg-King, Teresa J.; Rattner, Barnett A.; Schirmer, Kristin; Thomas, Paul

2016-01-01

The need for alternative approaches to the use of vertebrate animals for hazard assessment of chemicals and pollutants has become of increasing importance. It is now the first consideration when initiating a vertebrate ecotoxicity test, to ensure that unnecessary use of vertebrate organisms is minimized wherever possible. For some regulatory purposes, the use of vertebrate organisms for environmental risk assessments has been banned; in other situations, the number of organisms tested has been dramatically reduced or the severity of the procedure refined. However, there is still a long way to go to achieve a complete replacement of vertebrate organisms to generate environmental hazard data. The development of animal alternatives is based not just on ethical considerations but also on reducing the cost of performing vertebrate ecotoxicity tests and in some cases on providing better information aimed at improving environmental risk assessments. The present Focus article provides an overview of the considerable advances that have been made toward alternative approaches for ecotoxicity assessments over the last few decades.

40 CFR 1505.2 - Record of decision in cases requiring environmental impact statements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... alternatives based on relevant factors including economic and technical considerations and agency statutory missions. An agency shall identify and discuss all such factors including any essential considerations of...

Using a Geographic Information System to Assess Site Suitability for Managed Aquifer Recharge using Stormwater Capture

NASA Astrophysics Data System (ADS)

Teo, E. K.; Harmon, R. E.; Beganskas, S.; Young, K. S.; Fisher, A. T.; Weir, W. B.; Lozano, S.

2015-12-01

We are completing a regional analysis of Santa Cruz and northern Monterey Counties, CA, to assess the conditions amenable to managed aquifer recharge using stormwater runoff. Communities and water supply agencies across CA are struggling to mitigate the ongoing drought and to develop secure and sustainable water supplies to support long-term municipal, agricultural, environmental and other needs. Enhanced storage of groundwater is an important part of this effort in many basins. This work is especially timely because of the recently enacted "Sustainable Groundwater Management Act" (SGMA), which requires the development of groundwater sustainability agencies and implementation of basin management plans in coming decades. Our analysis focuses specifically on the distributed collection of stormwater runoff, a water source that has typically been treated as a nuisance or waste, from drainages having an area on the order of 40-160 hectares. The first part of this project is a geographic information system (GIS) analysis using surface and subsurface data sets. Developing complete and accurate datasets across the study region required considerable effort to locate, assemble, co-register, patch, and reconcile information from many sources and scales. We have complete spatial coverage for surface data, but subsurface data is more limited in lateral extent. Sites that are most suitable for distributed stormwater capture supporting MAR have high soil infiltration capacity, are well-connected to an underlying aquifer with good transmissive and storage properties, and have space to receive MAR. Additional considerations include method of infiltration, slope, and land use and access. Based on initial consideration of surface data and slope, 7% of the complete study region appears to be "suitable or highly suitable" for MAR (in the top third of the rating system), but there is considerable spatial heterogeneity based on the distribution of shallow soils and bedrock geology.

Considerations and measurements of latent-heat-storage salts for secondary thermal battery applications

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

Koenig, A.A.; Braithwaite, J.W.; Armijo, J.R.

Given its potential benefits, the practicality of using a latent heat-storage material as the basis for a passive thermal management system is being assessed by Chloride Silent Power Ltd. (CSPL) with technical assistance from Beta Power, Inc. and Sandia National Laboratories (SNL). Based on the experience gained in large-scale solar energy storage programs, fused salts were selected as the primary candidates for the heat-storage material. The initial phase of this assessment was directed to an EV battery being designed at CSPL for the ETX-II program. Specific tasks included the identification and characterization of potential fused salts, a determination of placementmore » options for the salts within the battery, and an assessment of the ultimate benefit to the battery system. The results obtained to date for each of these tasks are presented in this paper.« less

Religious and spiritual aspects of family assessment.

PubMed

Moncher, Frank J; Josephson, Allan M

2004-01-01

Childhood emotional and behavioral problems have increased over the past several decades, and the consequences of these behaviors have an impact on the entire family. The role of the family in these problems is clearly an important consideration for the child psychiatrist. A specific understanding of how the family's spiritual worldview or religious convictions impact clinical problems has been underappreciated. The religious orientation or spirituality of parents influences various aspects of family life, from ideals about marriage and family to specifics regarding child rearing. This article reviews the goals of assessment of family religious or spiritual worldview, which include empathically engaging the family of a child in treatment, developing a formulation of how these spiritual factors impact general family functioning, and determining whether the family's religion and spirituality are a resource for treatment or a contributor to disorder. The spiritual and religious assessment of the family facilitates the development of a treatment plan.

The international space station as a free flyer servicing node

NASA Astrophysics Data System (ADS)

Antol, Jeffrey; Headley, David E.

1999-01-01

The International Space Station will provide a multitude of opportunities for an expanding customer base to make use of this international resource. One such opportunity is servicing of various visiting vehicles that are in a similar orbit to the station. Servicing may include change-out of payloads, replenishment of consumables, repair, and refurbishment operations. Previous studies have been conducted in which ``paper'' free flyers have been assessed against the station's ability to accommodate them. Over the last several months though, an already flown free flyer, EURECA, was assessed as a real-life visiting free flyer design reference mission. Issues such as capture/berthing, servicing, logistics support, and stowage were assessed for station design and operational approaches. This paper will highlight critical visiting vehicle design considerations, identify station issues, and provide recommendations for accommodation of a wide range of visiting vehicle requirements of the future.

The International Space Station As a Free Flyer Servicing Node

NASA Technical Reports Server (NTRS)

Antol, Jeffrey; Headley, David E.

1999-01-01

The International Space Station will provide a multitude of opportunities for an expanding customer base to make use of this international resource. One such opportunity is servicing of various visiting vehicles that are in a similar orbit to the station. Servicing may include change-out of payloads, replenishment of consumables, repair, and refurbishment operations. Previous studies have been conducted in which "paper" free flyers have been assessed against the station s ability to accommodate them. Over the last several months though, an already flown free flyer, EURECA, was assessed as a real-life visiting free flyer design reference mission. Issues such as capture/berthing, servicing, logistics support, and stowage were assessed for station design and operational approaches. This paper will highlight critical visiting vehicle design considerations, identify station issues, and provide recommendations for accommodation of a wide range of visiting vehicle requirements of the future.

Covert video monitoring in the assessment of medically unexplained symptoms in children.

PubMed

Wallace, Dustin P; Sim, Leslie A; Harrison, Tracy E; Bruce, Barbara K; Harbeck-Weber, Cynthia

2012-04-01

Diagnosis of medically unexplained symptoms (MUS) occurs after thorough evaluations have failed to identify a physiological cause for symptoms. However, families and providers may wonder if something has been missed, leading to reduced confidence in behavioral treatment. Confidence may be improved through the use of technology such as covert video monitoring to better assess functioning across settings. A 12-year-old male presented with progressive neurological decline, precipitated by chronic pain. After thorough evaluation and the failure of standard treatments (medical, rehabilitative, and psychological) covert video monitoring revealed that the patient demonstrated greater abilities when alone in his room. Negative reinforcement was used to initiate recovery, accompanied by positive reinforcement and a rehabilitative approach. Covert video monitoring assisted in three subsequent cases over the following 3 years. In certain complex cases, video monitoring can inform the assessment and treatment of MUS. Discussion includes ethical and practical considerations.

Expected net present value of sample information: from burden to investment.

PubMed

Hall, Peter S; Edlin, Richard; Kharroubi, Samer; Gregory, Walter; McCabe, Christopher

2012-01-01

The Expected Value of Information Framework has been proposed as a method for identifying when health care technologies should be immediately reimbursed and when any reimbursement should be withheld while awaiting more evidence. This framework assesses the value of obtaining additional evidence to inform a current reimbursement decision. This represents the burden of not having the additional evidence at the time of the decision. However, when deciding whether to reimburse now or await more evidence, decision makers need to know the value of investing in more research to inform a future decision. Assessing this value requires consideration of research costs, research time, and what happens to patients while the research is undertaken and after completion. The investigators describe a development of the calculation of the expected value of sample information that assesses the value of investing in further research, including an only-in-research strategy and an only-with-research strategy.

How reliable is computerized assessment of readability?

PubMed

Mailloux, S L; Johnson, M E; Fisher, D G; Pettibone, T J

1995-01-01

To assess the consistency and comparability of readability software programs, four software programs (Corporate Voice, Grammatix IV, Microsoft Word for Windows, and RightWriter) were compared. Standard materials included 28 pieces of printed educational materials on human immunodeficiency virus/acquired immunodeficiency syndrome distributed nationally and the Gettysburg Address. Statistical analyses for the educational materials revealed that each of the three formulas assessed (Flesch-Kincaid, Flesch Reading Ease, and Gunning Fog Index) provided significantly different grade equivalent scores and that the Microsoft Word program provided significantly lower grade levels and was more inconsistent in the scores provided. For the Gettysburg Address, considerable variation was revealed among formulas, with the discrepancy being up to two grade levels. When averaging across formulas, there was a variation of 1.3 grade levels between the four software programs. Given the variation between formulas and programs, implications for decisions based on results of these software programs are provided.

Final Technical Report: Renewable Energy Feasibility Study and Resources Assessment

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

Rivero, Mariah

In March 2011, the U.S. Department of Energy (DOE) awarded White Pine County, Nevada, a grant to assess the feasibility of renewable resource-related economic development activities in the area. The grant project included a public outreach and training component and was to include a demonstration project; however, the demonstration project was not completed due to lack of identification of an entity willing to locate a project in White Pine County. White Pine County completed the assessment of renewable resources and a feasibility study on the potential for a renewable energy-focused economic sector within the County. The feasibility study concluded "allmore » resources studied were present and in sufficient quantity and quality to warrant consideration for development" and there were varying degrees of potential economic impact based on the resource type and project size. The feasibility study and its components were to be used as tools to attract potential developers and other business ventures to the local market. White Pine County also marketed the County’s resources to the renewable energy business community in an effort to develop contracts for demonstration projects. The County also worked to develop partnerships with local educational institutions, including the White Pine County School District, conducted outreach and training for the local community.« less

A rapid needs assessment of the Rockaway Peninsula in New York City after Hurricane Sandy and the relationship of socioeconomic status to recovery.

PubMed

Subaiya, Saleena; Moussavi, Cyrus; Velasquez, Anthony; Stillman, Joshua

2014-04-01

We conducted a rapid needs assessment in the Rockaway Peninsula-one of the areas of New York City most severely affected by Hurricane Sandy on October 29, 2012-to assess basic needs and evaluate for an association between socioeconomic status (SES) and storm recovery. We conducted a cross-sectional survey within the Rockaways 3 weeks after the hurricane made landfall to elicit information regarding basic utilities, food access, health, relief-effort opinions, and SES. We used a modified cluster sampling method to select households with a goal of 7 to 10 surveys per cluster. Thirty to fifty percent of households were without basic utilities including electricity, heat, and telephone services. Lower-income households were more likely to worry about food than higher-income households (odds ratio = 4.5; 95% confidence interval = 1.43, 15.23; P = .01). A post-storm trend also existed among the lower-income group towards psychological disturbances. Storm preparation should include disseminating information regarding carbon monoxide and proper generator use, considerations for prescription refills, neighborhood security, and location of food distribution centers. Lower-income individuals may have greater difficulty meeting their needs following a natural disaster, and recovery efforts may include prioritization of these households.

A Systematic Narrative Review of Effects of Community-Based Intervention on Rates of Organ Donor Registration.

PubMed

Golding, Sarah Elizabeth; Cropley, Mark

2017-09-01

The demand for organ donation is increasing worldwide. One possible way of increasing the pool of potential posthumous donors is to encourage more members of the general public to join an organ donor registry. A systematic review was conducted to investigate the effectiveness of psychological interventions designed to increase the number of individuals in the community who register as organ donors. PsycINFO and PubMed databases were searched. No date limits were set. Randomized and nonrandomized controlled trials exploring the effects of community-based interventions on organ donor registration rates were included. Methodological quality was assessed using the "Quality Assessment Tool for Quantitative Studies." Twenty-four studies met the inclusion criteria; 19 studies found a positive intervention effect on registration. Only 8 studies were assessed as having reasonable methodological robustness. A narrative synthesis was conducted. Factors influencing registration rates include providing an immediate registration opportunity and using brief interventions to challenge misconceptions and concerns about organ donation. Community-based interventions can be effective at increasing organ donor registrations among the general public. Factors that may increase effectiveness include brief interventions to address concerns and providing an immediate registration opportunity. Particular consideration should be paid to the fidelity of intervention delivery. Protocol registration number: CRD42014012975.

An Overview of Meta-Analyses of Danhong Injection for Unstable Angina.

PubMed

Zhang, Xiaoxia; Wang, Hui; Chang, Yanxu; Wang, Yuefei; Lei, Xiang; Fu, Shufei; Zhang, Junhua

2015-01-01

Objective. To systematically collect evidence and evaluate the effects of Danhong injection (DHI) for unstable angina (UA). Methods. A comprehensive search was conducted in seven electronic databases up to January 2015. The methodological and reporting quality of included studies was assessed by using AMSTAR and PRISMA. Result. Five articles were included. The conclusions suggest that DHI plus conventional medicine treatment was effective for UA pectoris treatment, could alleviate symptoms of angina and ameliorate electrocardiograms. Flaws of the original studies and systematic reviews weaken the strength of evidence. Limitations of the methodology quality include performing an incomprehensive literature search, lacking detailed characteristics, ignoring clinical heterogeneity, and not assessing publication bias and other forms of bias. The flaws of reporting systematic reviews included the following: not providing a structured summary, no standardized search strategy. For the pooled findings, researchers took statistical heterogeneity into consideration, but clinical and methodology heterogeneity were ignored. Conclusion. DHI plus conventional medicine treatment generally appears to be effective for UA treatment. However, the evidence is not hard enough due to methodological flaws in original clinical trials and systematic reviews. Furthermore, rigorous designed randomized controlled trials are also needed. The methodology and reporting quality of systematic reviews should be improved.

An Overview of Meta-Analyses of Danhong Injection for Unstable Angina

PubMed Central

Zhang, Xiaoxia; Chang, Yanxu; Wang, Yuefei; Lei, Xiang; Fu, Shufei; Zhang, Junhua

2015-01-01

Objective. To systematically collect evidence and evaluate the effects of Danhong injection (DHI) for unstable angina (UA). Methods. A comprehensive search was conducted in seven electronic databases up to January 2015. The methodological and reporting quality of included studies was assessed by using AMSTAR and PRISMA. Result. Five articles were included. The conclusions suggest that DHI plus conventional medicine treatment was effective for UA pectoris treatment, could alleviate symptoms of angina and ameliorate electrocardiograms. Flaws of the original studies and systematic reviews weaken the strength of evidence. Limitations of the methodology quality include performing an incomprehensive literature search, lacking detailed characteristics, ignoring clinical heterogeneity, and not assessing publication bias and other forms of bias. The flaws of reporting systematic reviews included the following: not providing a structured summary, no standardized search strategy. For the pooled findings, researchers took statistical heterogeneity into consideration, but clinical and methodology heterogeneity were ignored. Conclusion. DHI plus conventional medicine treatment generally appears to be effective for UA treatment. However, the evidence is not hard enough due to methodological flaws in original clinical trials and systematic reviews. Furthermore, rigorous designed randomized controlled trials are also needed. The methodology and reporting quality of systematic reviews should be improved. PMID:26539221

77 FR 28894 - Maritime Vulnerability Self-Assessment Tool

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-16

... DEPARTMENT OF HOMELAND SECURITY Transportation Security Administration Maritime Vulnerability Self... maritime vulnerability self- assessment tool. SUMMARY: The Transportation Security Administration (TSA... conducting vulnerability assessments became available and usage of the TMSARM has dropped off considerably...

Approaches for the Application of Physiologically Based ...

EPA Pesticide Factsheets

This draft report of Approaches for the Application of Physiologically Based Pharmacokinetic (PBPK) Models and Supporting Data in Risk Assessment addresses the application and evaluation of PBPK models for risk assessment purposes. These models represent an important class of dosimetry models that are useful for predicting internal dose at target organs for risk assessment applications. Topics covered include:the types of data required use of PBPK models in risk assessment,evaluation of PBPK models for use in risk assessment, andthe application of these models to address uncertainties resulting from extrapolations (e.g. interspecies extrapolation) often used in risk assessment.In addition, appendices are provided that includea compilation of chemical partition coefficients and rate constants,algorithms for estimating chemical-specific parameters, anda list of publications relating to PBPK modeling. This report is primarily meant to serve as a learning tool for EPA scientists and risk assessors who may be less familiar with the field. In addition, this report can be informative to PBPK modelers within and outside the Agency, as it provides an assessment of the types of data and models that the EPA requires for consideration of a model for use in risk assessment.

42 CFR 137.329 - What environmental considerations must be included in the construction project agreement?

Code of Federal Regulations, 2010 CFR

2010-10-01

... must be included in the construction project agreement? The construction project agreement must include..., and (d) An assurance that no action will be taken on the construction phase of the project that would... 42 Public Health 1 2010-10-01 2010-10-01 false What environmental considerations must be included...

Classroom Research in Accounting: Assessing for Learning.

ERIC Educational Resources Information Center

Cottell, Philip G., Jr.

1991-01-01

The use of several college classroom assessment techniques to evaluate the processes and products of accounting instruction through cooperative learning is described. The discussion looks at considerations in planning classroom assessment, choosing initial assessment techniques and adapting them, and blending cooperative learning structures with…

REGIONAL ASSESSMENT OF WETLAND ECOLOGICAL CONDITION -- ISSUES AND CHALLENGES

EPA Science Inventory

Most work on wetland assessment has focused on the development of methods, however, effective assessment involves more than having a method. In a 2004 review of rapid assessment methods, Fennessey et al. recommended key considerations when adopting existing methods or developing...

Safety Assessment of Food and Feed from GM Crops in Europe: Evaluating EFSA's Alternative Framework for the Rat 90-day Feeding Study.

PubMed

Hong, Bonnie; Du, Yingzhou; Mukerji, Pushkor; Roper, Jason M; Appenzeller, Laura M

2017-07-12

Regulatory-compliant rodent subchronic feeding studies are compulsory regardless of a hypothesis to test, according to recent EU legislation for the safety assessment of whole food/feed produced from genetically modified (GM) crops containing a single genetic transformation event (European Union Commission Implementing Regulation No. 503/2013). The Implementing Regulation refers to guidelines set forth by the European Food Safety Authority (EFSA) for the design, conduct, and analysis of rodent subchronic feeding studies. The set of EFSA recommendations was rigorously applied to a 90-day feeding study in Sprague-Dawley rats. After study completion, the appropriateness and applicability of these recommendations were assessed using a battery of statistical analysis approaches including both retrospective and prospective statistical power analyses as well as variance-covariance decomposition. In the interest of animal welfare considerations, alternative experimental designs were investigated and evaluated in the context of informing the health risk assessment of food/feed from GM crops.

Uncertainty in BMP evaluation and optimization for watershed management

NASA Astrophysics Data System (ADS)

Chaubey, I.; Cibin, R.; Sudheer, K.; Her, Y.

2012-12-01

Use of computer simulation models have increased substantially to make watershed management decisions and to develop strategies for water quality improvements. These models are often used to evaluate potential benefits of various best management practices (BMPs) for reducing losses of pollutants from sources areas into receiving waterbodies. Similarly, use of simulation models in optimizing selection and placement of best management practices under single (maximization of crop production or minimization of pollutant transport) and multiple objective functions has increased recently. One of the limitations of the currently available assessment and optimization approaches is that the BMP strategies are considered deterministic. Uncertainties in input data (e.g. precipitation, streamflow, sediment, nutrient and pesticide losses measured, land use) and model parameters may result in considerable uncertainty in watershed response under various BMP options. We have developed and evaluated options to include uncertainty in BMP evaluation and optimization for watershed management. We have also applied these methods to evaluate uncertainty in ecosystem services from mixed land use watersheds. In this presentation, we will discuss methods to to quantify uncertainties in BMP assessment and optimization solutions due to uncertainties in model inputs and parameters. We have used a watershed model (Soil and Water Assessment Tool or SWAT) to simulate the hydrology and water quality in mixed land use watershed located in Midwest USA. The SWAT model was also used to represent various BMPs in the watershed needed to improve water quality. SWAT model parameters, land use change parameters, and climate change parameters were considered uncertain. It was observed that model parameters, land use and climate changes resulted in considerable uncertainties in BMP performance in reducing P, N, and sediment loads. In addition, climate change scenarios also affected uncertainties in SWAT simulated crop yields. Considerable uncertainties in the net cost and the water quality improvements resulted due to uncertainties in land use, climate change, and model parameter values.

Assessing Flood Risk at Nuclear Power Plants with an Uncertain Climate

NASA Astrophysics Data System (ADS)

Wigmosta, M. S.; Vail, L. W.

2011-12-01

In 2010 a tsunami severely damaged the Fukushima Dai-ichi Nuclear Power Plant in Japan. As a result, the U.S. Nuclear Regulatory Commission directed that a systematic and methodical review of Commission processes and regulations be performed to determine whether the agency should make additional improvements to its regulatory system and to make recommendations to the Commission. Two of the recommendations of the Task Force created to inform the Commission were: establish a logical, systematic, and coherent regulatory framework for adequate protection that appropriately balances defense-in-depth and risk considerations and that the NRC require licensees to reevaluate and upgrade as necessary the design-basis flooding protection of structures, systems, and components for each operating reactor. These recommendations came at the same time as technical discussions about updating approaches to evaluate flood hazard were underway. These discussions included: consideration of climate nonstationarity in flood assessments; transitioning from PMP/PMF assessments to probabilistic flood analyses to better align with risk-informed decision making; and systematic consideration of combined events in flood risk analysis. There is no scientific basis to assume that shifts in long-term mean precipitation and temperature (such as is commonly derived from climate models) relate to flood probability. Flood mechanisms are often more complex and reflect climate pattern anomalies more than mean annual shifts. Instead of discounting historical data due to climatic nonstationarity, it is important to better understand the climate patterns that have triggered floods in the past and to look to climate forecasts to understand the likely changes in the frequency of those historical climate patterns with climate change. It is equally important to have a better understanding of whether climate change will result in flood-generating climate systems heretofore unknown in the particular locale. This presentation will provide a roadmap to ensuring that the flood hazards of existing and future nuclear power plants are well defined.

Key elements of high-quality practice organisation in primary health care: a systematic review.

PubMed

Crossland, Lisa; Janamian, Tina; Jackson, Claire L

2014-08-04

To identify elements that are integral to high-quality practice and determine considerations relating to high-quality practice organisation in primary care. A narrative systematic review of published and grey literature. Electronic databases (PubMed, CINAHL, the Cochrane Library, Embase, Emerald Insight, PsycInfo, the Primary Health Care Research and Information Service website, Google Scholar) were searched in November 2013 and used to identify articles published in English from 2002 to 2013. Reference lists of included articles were searched for relevant unpublished articles and reports. Data were configured at the study level to allow for the inclusion of findings from a broad range of study types. Ten elements were most often included in the existing organisational assessment tools. A further three elements were identified from an inductive thematic analysis of descriptive articles, and were noted as important considerations in effective quality improvement in primary care settings. Although there are some validated tools available to primary care that identify and build quality, most are single-strategy approaches developed outside health care settings. There are currently no validated organisational improvement tools, designed specifically for primary health care, which combine all elements of practice improvement and whose use does not require extensive external facilitation.

Changing perspectives of stress gastritis prophylaxis.

PubMed

Smythe, M A; Zarowitz, B J

1994-09-01

To present recent advances in stress gastritis prophylaxis in the critically ill and review considerations in selection of a prophylactic agent. Information was obtained from MEDLINE search, reference lists from articles identified in search, and from review articles. Emphasis was placed on controlled trials conducted within the last 5 years. All literature was assessed for methodology, results, and conclusions. Results of prospective, randomized trials, and meta-analyses are summarized. Histamine2-receptor antagonists, antacids, and sucralfate appear equally effective in preventing stress gastritis in the critically ill. A definitive cause-effect relationship between histamine2-receptor antagonists and increased incidence of nosocomial pneumonia has not yet been established. The indications for using a prophylactic agent and consideration in selecting an agent should include an evaluation of the following: risk factors for gastritis including the type of intensive care patient, comparative efficacy, adverse effects, drug interactions, cost, and ease of administration. The least expensive, safest agent requiring minimal monitoring is sucralfate. Prevention of stress gastritis has never been shown to reduce morbidity or mortality significantly. Controversies still exist regarding the need to provide prophylaxis, the choice of an agent, and the relative importance of previously identified risk factors. Further well-designed studies are needed before consensus can be reached.

The development, past achievements, and future directions of brain PET

PubMed Central

Jones, Terry; Rabiner, Eugenii A

2012-01-01

The early developments of brain positron emission tomography (PET), including the methodological advances that have driven progress, are outlined. The considerable past achievements of brain PET have been summarized in collaboration with contributing experts in specific clinical applications including cerebrovascular disease, movement disorders, dementia, epilepsy, schizophrenia, addiction, depression and anxiety, brain tumors, drug development, and the normal healthy brain. Despite a history of improving methodology and considerable achievements, brain PET research activity is not growing and appears to have diminished. Assessments of the reasons for decline are presented and strategies proposed for reinvigorating brain PET research. Central to this is widening the access to advanced PET procedures through the introduction of lower cost cyclotron and radiochemistry technologies. The support and expertize of the existing major PET centers, and the recruitment of new biologists, bio-mathematicians and chemists to the field would be important for such a revival. New future applications need to be identified, the scope of targets imaged broadened, and the developed expertize exploited in other areas of medical research. Such reinvigoration of the field would enable PET to continue making significant contributions to advance the understanding of the normal and diseased brain and support the development of advanced treatments. PMID:22434067

Treatment considerations in hutchinson-gilford progeria syndrome: a case report.

PubMed

Hazan-Molina, H; Aizenbud, D; Dror, Aizenbud D

2015-01-01

Hutchinson-Guilford progeria syndrome is an extremely rare condition classified as one of the premature ageing syndromes. This case presents a 16-year-old Israeli female patient, suffering from a variant of Hutchinson-Guilford progeria with a history of treatment with oral biphosphnates. The patient presented with typical cranial and facial features of the syndrome including delayed teeth eruption and root development probably due to insufficient jaw growth and severs retrognatic position of the maxilla and mandible. Orthodontic treatment considerations are described along with those required in light of the previous treatment by oral biphosphonates.All primary teeth were extracted in three appointments while creating as minimal trauma as possible to the surrounding tissue and alveolar bone. For now, the patient refuses to begin the orthodontic treatment course. There are no limitations to conduct any dental procedures in progeria patients, however, extreme caution must be exercised during oral surgery due to the inelasticity of tissues and dermal atrophy. Orthodontic procedure commencement should be early enough to manage the delayed development and eruption of teeth. Patients taking oral biphosphonates should be advised of this potential complication. If orthodontic treatment is considered appropriate, plans should be assessed and modified to include compromises.

Authentic Assessment: A Handbook for Educators. Assessment Bookshelf Series.

ERIC Educational Resources Information Center

Hart, Diane

This book reviews the assessment movement, from the history of testing to the practical considerations of enhancing classroom experiences for teachers and students. It explores making time for assessment, tailoring assessment to desired outcomes, and scoring and evaluating student performance. The chapters are: (1) "Where We've Been: Standardized…

National Assessment's Consumer Skills Assessments.

ERIC Educational Resources Information Center

Education Commission of the States, Denver, CO. National Assessment of Educational Progress.

The National Assessment of Educational Progress (NAEP) encountered problems when developing a comprehensive assessment of consumer skills of 17-year-olds in 1978. When NAEP conducted a nationwide assessment of basic life skills of 17-year-olds in 1977, there was considerable interest in the consumer skills portion. Therefore, it was decided to…

Adequacy assessment of composite generation and transmission systems incorporating wind energy conversion systems

NASA Astrophysics Data System (ADS)

Gao, Yi

The development and utilization of wind energy for satisfying electrical demand has received considerable attention in recent years due to its tremendous environmental, social and economic benefits, together with public support and government incentives. Electric power generation from wind energy behaves quite differently from that of conventional sources. The fundamentally different operating characteristics of wind energy facilities therefore affect power system reliability in a different manner than those of conventional systems. The reliability impact of such a highly variable energy source is an important aspect that must be assessed when the wind power penetration is significant. The focus of the research described in this thesis is on the utilization of state sampling Monte Carlo simulation in wind integrated bulk electric system reliability analysis and the application of these concepts in system planning and decision making. Load forecast uncertainty is an important factor in long range planning and system development. This thesis describes two approximate approaches developed to reduce the number of steps in a load duration curve which includes load forecast uncertainty, and to provide reasonably accurate generating and bulk system reliability index predictions. The developed approaches are illustrated by application to two composite test systems. A method of generating correlated random numbers with uniform distributions and a specified correlation coefficient in the state sampling method is proposed and used to conduct adequacy assessment in generating systems and in bulk electric systems containing correlated wind farms in this thesis. The studies described show that it is possible to use the state sampling Monte Carlo simulation technique to quantitatively assess the reliability implications associated with adding wind power to a composite generation and transmission system including the effects of multiple correlated wind sites. This is an important development as it permits correlated wind farms to be incorporated in large practical system studies without requiring excessive increases in computer solution time. The procedures described in this thesis for creating monthly and seasonal wind farm models should prove useful in situations where time period models are required to incorporate scheduled maintenance of generation and transmission facilities. There is growing interest in combining deterministic considerations with probabilistic assessment in order to evaluate the quantitative system risk and conduct bulk power system planning. A relatively new approach that incorporates deterministic and probabilistic considerations in a single risk assessment framework has been designated as the joint deterministic-probabilistic approach. The research work described in this thesis illustrates that the joint deterministic-probabilistic approach can be effectively used to integrate wind power in bulk electric system planning. The studies described in this thesis show that the application of the joint deterministic-probabilistic method provides more stringent results for a system with wind power than the traditional deterministic N-1 method because the joint deterministic-probabilistic technique is driven by the deterministic N-1 criterion with an added probabilistic perspective which recognizes the power output characteristics of a wind turbine generator.