Sediment control in bridge waterways.

DOT National Transportation Integrated Search

1990-02-01

The objective of this study was to develop guidelines for use of the Iowa Vanes : technique for sediment control in bridge waterways. Iowa Vanes are small flow-training : structures (foils) designed to modify the near-bed flow pattern and redistribut...

Parametric robust control and system identification: Unified approach

NASA Technical Reports Server (NTRS)

Keel, Leehyun

1994-01-01

Despite significant advancement in the area of robust parametric control, the problem of synthesizing such a controller is still a wide open problem. Thus, we attempt to give a solution to this important problem. Our approach captures the parametric uncertainty as an H(sub infinity) unstructured uncertainty so that H(sub infinity) synthesis techniques are applicable. Although the techniques cannot cope with the exact parametric uncertainty, they give a reasonable guideline to model the unstructured uncertainty that contains the parametric uncertainty. An additional loop shaping technique is also introduced to relax its conservatism.

40 CFR 798.5500 - Differential growth inhibition of repair proficient and repair deficient bacteria: “Bacterial DNA...

Code of Federal Regulations, 2012 CFR

2012-07-01

..., tissues or techniques may also be appropriate. (6) Control groups—(i) Concurrent controls. Concurrent positive, negative, and vehicle controls should be included in each assay. (ii) Negative controls. The... CONTROL ACT (CONTINUED) HEALTH EFFECTS TESTING GUIDELINES Genetic Toxicity § 798.5500 Differential growth...

40 CFR 798.5500 - Differential growth inhibition of repair proficient and repair deficient bacteria: “Bacterial DNA...

Code of Federal Regulations, 2013 CFR

2013-07-01

..., tissues or techniques may also be appropriate. (6) Control groups—(i) Concurrent controls. Concurrent positive, negative, and vehicle controls should be included in each assay. (ii) Negative controls. The... CONTROL ACT (CONTINUED) HEALTH EFFECTS TESTING GUIDELINES Genetic Toxicity § 798.5500 Differential growth...

40 CFR 798.5500 - Differential growth inhibition of repair proficient and repair deficient bacteria: “Bacterial DNA...

Code of Federal Regulations, 2011 CFR

2011-07-01

..., tissues or techniques may also be appropriate. (6) Control groups—(i) Concurrent controls. Concurrent positive, negative, and vehicle controls should be included in each assay. (ii) Negative controls. The... CONTROL ACT (CONTINUED) HEALTH EFFECTS TESTING GUIDELINES Genetic Toxicity § 798.5500 Differential growth...

40 CFR 798.5500 - Differential growth inhibition of repair proficient and repair deficient bacteria: “Bacterial DNA...

Code of Federal Regulations, 2014 CFR

2014-07-01

..., tissues or techniques may also be appropriate. (6) Control groups—(i) Concurrent controls. Concurrent positive, negative, and vehicle controls should be included in each assay. (ii) Negative controls. The... CONTROL ACT (CONTINUED) HEALTH EFFECTS TESTING GUIDELINES Genetic Toxicity § 798.5500 Differential growth...

76 FR 72885 - Approval and Promulgation of Air Quality Implementation Plans: South Carolina; Negative...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-28

... Carolina; Negative Declarations for Groups I, II, III and IV Control Techniques Guidelines; and Reasonably Available Control Technology AGENCY: Environmental Protection Agency (EPA). ACTION: Proposed rule. SUMMARY... Carolina Department of Health and Environmental Control (SC DHEC). These revisions establish reasonably...

76 FR 74014 - Approval and Promulgation of Implementation Plans; Illinois; Volatile Organic Compound Emission...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-30

... Promulgation of Implementation Plans; Illinois; Volatile Organic Compound Emission Control Measures for Chicago... Act's (the Act) requirement that States revise their SIPs to include reasonably available control... rules are approvable because they are consistent with the Control Technique Guideline (CTG) documents...

Guideline series: Control of volatile organic compound emissions from wood furniture manufacturing operations, April 1996. Final report

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

NONE

1996-04-01

This Control Techniques Guideline (CTG) provides the necessary guidance for development of regulations to limit emissions of volatile organic compounds (VOC) from wood furniture finishing and cleaning operations. This guidance includes emission limits for specific wood furniture finishing steps and work practices to reduce waste and evaporation through pollution prevention methods; these represent available control technology for wood furniture finishing and cleaning operations. This document is intended to provide State and local air pollution authorities with an information base for proceeding with their own analyses of RACT to meet statutory requirements.

Guideline series: Control of volatile organic compound emissions from wood furniture manufacturing operations. Draft report

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

NONE

1995-08-01

This draft Control Techniques Guidelines (CTG) provides necessary guidance for development of regulations to limit emissions of volatile organic compounds (VOC`s) from wood furniture finishing and cleaning operations. This guidance includes emission limits for specific wood furniture finishing steps and work pratices to reduce waste and evaporation through pollution prevention methods; these represent reasonably available control technology for wood furniture finishing and cleaning operations. This document is intended to provide State and local air pollution authorities with an information base for proceeding with their own analyses of RACT to meet statutory requirements.

78 FR 28773 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption of Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-16

... Miscellaneous Metal and Plastic Parts Which Includes Pleasure Craft Coating Operations AGENCY: Environmental... recommended by EPA's control technique guidelines (CTG) for Miscellaneous Metal Parts and Plastic Coating... air pollution control authorities information that should assist them in determining RACT for VOC from...

40 CFR 52.1168 - Certification of no sources.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Massachusetts § 52.1168... sources are located in the Commonwealth which are covered by the following Control Techniques Guidelines...

40 CFR 52.1168 - Certification of no sources.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Massachusetts § 52.1168... sources are located in the Commonwealth which are covered by the following Control Techniques Guidelines...

40 CFR 52.1168 - Certification of no sources.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Massachusetts § 52.1168... sources are located in the Commonwealth which are covered by the following Control Techniques Guidelines...

40 CFR 52.1168 - Certification of no sources.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Massachusetts § 52.1168... sources are located in the Commonwealth which are covered by the following Control Techniques Guidelines...

Guidelines for handling radioactively contaminated decedents.

PubMed

Wood, Charles M; DePaolo, Frank; Whitaker, Doggett

2008-05-01

The Centers for Disease Control and Prevention recently issued guidelines for medical examiners, coroners, and morticians in dealing with decedents after detonation of an improvised nuclear device (IND) or radiological dispersal device (RDD) (). Partners in this effort included the New York City Office of Chief Medical Examiner and the National Funeral Directors' Association. This paper describes the handling techniques required for loose surface contamination, radioactive shrapnel, and internal contamination caused by inhaling or ingesting radioactive materials from an IND or RDD, and provides suggested guidelines for medical examiners, coroners, and morticians to deal with these situations.

78 FR 9648 - Approval and Promulgation of Air Quality Implementation Plans; District of Columbia; Volatile...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-11

... Regulations (DCMR) for the Control of Volatile Organic Compounds (VOC) to meet the requirement to adopt reasonably available control technology (RACT) for sources as recommended by the Ozone Transport Commission (OTC) model rules and EPA's Control Techniques Guidelines (CTG) standards. On January 26, 2010 and...

Advanced lighting guidelines: 1993. Final report

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

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

1993-12-31

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

76 FR 64237 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adhesives and Sealants Rule

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-18

... chemical production and polytetrafluoroethylene operations; from paint, resin, and adhesive manufacturing... miscellaneous industrial adhesives control techniques guideline (CTG) category in accordance with the... to COMAR 26.11.19.30 ``Control of VOC from Chemical Production and Polytetrafluoroethylene Operations...

A Guideline to Local Anesthetic Allergy Testing

PubMed Central

Canfield, David W.; Gage, Tommy W.

1987-01-01

Patients with a history of adverse reactions to a local anesthetic may often be incorrectly labeled as “allergic.” Determining if a patient is allergic to a local anesthetic is essential in the selection of appropriate pain control techniques. Local anesthetic allergy testing may be performed safely and with reasonable accuracy by a knowledgeable practitioner. This paper presents guidelines for an allergy testing method. ImagesFigure 1 PMID:3318567

76 FR 31856 - Approval and Promulgation of Air Quality Implementation Plans; Pennsylvania; Adoption of Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-02

... Flat Wood Paneling Surface Coating Processes AGENCY: Environmental Protection Agency (EPA). ACTION... by EPA's Control Techniques Guidelines (CTG) standards for flat wood paneling surface coating processes. EPA is approving this revision concerning the adoption of the EPA CTG requirements for flat wood...

76 FR 4578 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption of Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-26

... Wood Paneling Coatings AGENCY: Environmental Protection Agency (EPA). ACTION: Proposed rule. SUMMARY... (RACT) for sources covered by EPA's Control Techniques Guidelines (CTG) for flat wood paneling coatings. These amendments will reduce emissions of volatile organic compound (VOC) from flat wood coating...

76 FR 13567 - Approval and Promulgation of Air Quality Implementation Plans; Pennsylvania; Adoption of Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-14

... Flat Wood Paneling Surface Coating Processes AGENCY: Environmental Protection Agency (EPA). ACTION... sources covered by EPA's Control Techniques Guidelines (CTG) standards for flat wood paneling surface... Protection (PADEP) submitted to EPA a SIP revision concerning the adoption of the CTG for flat wood paneling...

Harmonic analysis and FPGA implementation of SHE controlled three phase CHB 11-level inverter in MV drives using deterministic and stochastic optimization techniques.

PubMed

Vesapogu, Joshi Manohar; Peddakotla, Sujatha; Kuppa, Seetha Rama Anjaneyulu

2013-01-01

With the advancements in semiconductor technology, high power medium voltage (MV) Drives are extensively used in numerous industrial applications. Challenging technical requirements of MV Drives is to control multilevel inverter (MLI) with less Total harmonic distortion (%THD) which satisfies IEEE standard 519-1992 harmonic guidelines and less switching losses. Among all modulation control strategies for MLI, Selective harmonic elimination (SHE) technique is one of the traditionally preferred modulation control technique at fundamental switching frequency with better harmonic profile. On the other hand, the equations which are formed by SHE technique are highly non-linear in nature, may exist multiple, single or even no solution at particular modulation index (MI). However, in some MV Drive applications, it is required to operate over a range of MI. Providing analytical solutions for SHE equations during the whole range of MI from 0 to 1, has been a challenging task for researchers. In this paper, an attempt is made to solve SHE equations by using deterministic and stochastic optimization methods and comparative harmonic analysis has been carried out. An effective algorithm which minimizes %THD with less computational effort among all optimization algorithms has been presented. To validate the effectiveness of proposed MPSO technique, an experiment is carried out on a low power proto type of three phase CHB 11- level Inverter using FPGA based Xilinx's Spartan -3A DSP Controller. The experimental results proved that MPSO technique has successfully solved SHE equations over all range of MI from 0 to 1, the %THD obtained over major range of MI also satisfies IEEE 519-1992 harmonic guidelines too.

SU-E-I-97: Smart Auto-Planning Framework in An EMR Environment (SAFEE)

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

Zhang, B; Chen, S; Mutaf, Y

2014-06-01

Purpose: Our Radiation Oncology Department uses clinical practice guidelines for patient treatment, including normal tissue sparing and other dosimetric constraints. These practice guidelines were adapted from national guidelines, clinical trials, literature reviews, and practitioner's own experience. Modern treatment planning systems (TPS) have the capability of incorporating these practice guidelines to automatically create radiation therapy treatment plans with little human intervention. We are developing a software infrastructure to integrate clinical practice guidelines and radiation oncology electronic medical record (EMR) system into radiation therapy treatment planning system (TPS) for auto planning. Methods: Our Smart Auto-Planning Framework in an EMR environment (SAFEE) usesmore » a software pipeline framework to integrate practice guidelines,EMR, and TPS together. The SAFEE system starts with retrieving diagnosis information and physician's prescription from the EMR system. After approval of contouring, SAFEE will automatically create plans according to our guidelines. Based on clinical objectives, SAFEE will automatically select treatment delivery techniques (such as, 3DRT/IMRT/VMAT) and optimize plans. When necessary, SAFEE will create multiple treatment plans with different combinations of parameters. SAFEE's pipeline structure makes it very flexible to integrate various techniques, such as, Model-Base Segmentation (MBS) and plan optimization algorithms, e.g., Multi-Criteria Optimization (MCO). In addition, SAFEE uses machine learning, data mining techniques, and an integrated database to create clinical knowledgebase and then answer clinical questions, such as, how to score plan quality or how volume overlap affects physicians' decision in beam and treatment technique selection. Results: In our institution, we use Varian Aria EMR system and RayStation TPS from RaySearch, whose ScriptService API allows control by external programs. These applications are the building blocks of our SAFEE system. Conclusion: SAFEE is a feasible method of integrating clinical information to develop an auto-planning paradigm to improve clinical workflow in cancer patient care.« less

Caring for Your Videodiscs, CD-ROM Discs, and Players.

ERIC Educational Resources Information Center

Ekhaml, Leticia; Saygan, Bobby

1993-01-01

Presents guidelines for the proper care and handling of videodisc and CD-ROM hardware and software. Topics discussed include handling the equipment, moving, cleaning techniques, storage considerations, ventilation requirements, and climate control. (LRW)

Implementation plans included in World Health Organisation guidelines.

PubMed

Wang, Zhicheng; Norris, Susan L; Bero, Lisa

2016-05-20

The implementation of high-quality guidelines is essential to improve clinical practice and public health. The World Health Organisation (WHO) develops evidence-based public health and other guidelines that are used or adapted by countries around the world. Detailed implementation plans are often necessary for local policymakers to properly use the guidelines developed by WHO. This paper describes the plans for guideline implementation reported in WHO guidelines and indicates which of these plans are evidence-based. We conducted a content analysis of the implementation sections of WHO guidelines approved by the WHO guideline review committee between December 2007 and May 2015. The implementation techniques reported in each guideline were coded according to the Cochrane Collaboration's Effective Practice and Organisation of Care (EPOC) taxonomy and classified as passive, active or policy strategies. The frequencies of implementation techniques are reported. The WHO guidelines (n = 123) analysed mentioned implementation techniques 800 times, although most mentioned implementation techniques very briefly, if at all. Passive strategies (21 %, 167/800) and general policy strategies (62 %, 496/800) occurred most often. Evidence-based active implementation methods were generally neglected with no guideline mentioning reminders (computerised or paper) and only one mentioning a multifaceted approach. Many guidelines contained implementation sections that were identical to those used in older guidelines produced by the same WHO technical unit. The prevalence of passive and policy-based implementation techniques as opposed to evidence-based active techniques suggests that WHO guidelines should contain stronger guidance for implementation. This could include structured and increased detail on implementation considerations, accompanying or linked documents that provide information on what is needed to contextualise or adapt a guideline and specific options from among evidence-based implementation strategies.

Developing prescribing guidelines for microprocessor-controlled prosthetic knees in the South East England.

PubMed

Sedki, Imad; Fisher, Keren

2015-06-01

Microprocessor-controlled prosthetic knees have gained increasing popularity over the last decade. Research supports their provision to address specific problems or to achieve certain rehabilitation goals. However, there are yet no agreed protocols or prescribing criteria to assist clinicians in the identification and appropriate selection of suitable users. The aim is to reach professionals' agreement on specific prescribing guidelines for microprocessor-controlled prosthetic knees. The study involved multidisciplinary teams from the Inter Regional Prosthetic Audit Group, representing nine Prosthetic Rehabilitation Centres in the South East England region. We used the Delphi technique with a total of three rounds to reach professionals' agreement. The prescribing guidelines were agreed and will be reviewed and updated depending on new research evidence and technical advances. This project is highly useful for professionals in a clinic setting to aid in appropriate patient selection and to justify the cost of prescribing microprocessor-controlled prosthetic knees. © The International Society for Prosthetics and Orthotics 2014.

A sustainable approach to controlling oil spills.

PubMed

Al-Majed, Abdul Aziz; Adebayo, Abdulrauf Rasheed; Hossain, M Enamul

2012-12-30

As a result of the huge economic and environmental destruction from oil spills, studies have been directed at improving and deploying natural sorbents which are not only the least expensive but also the safest means of spill control. This research reviews the limitations and environmental impact of existing cleanup methods. It also justifies the need for concerted research effort on oil spill control using natural and sustainable technology concepts. The article proposes future guidelines for the development of a sustainable cleanup technology. Finally, guidelines for the development of a new technology for the Middle East are proposed, which is the use of an abundant resource--date palm fibers--for such techniques. Copyright © 2012 Elsevier Ltd. All rights reserved.

Enhancing implementation of tobacco use prevention and cessation counselling guideline among dental providers: a cluster randomised controlled trial.

PubMed

Amemori, Masamitsu; Korhonen, Tellervo; Kinnunen, Taru; Michie, Susan; Murtomaa, Heikki

2011-02-14

Tobacco use adversely affects oral health. Tobacco use prevention and cessation (TUPAC) counselling guidelines recommend that healthcare providers ask about each patient's tobacco use, assess the patient's readiness and willingness to stop, document tobacco use habits, advise the patient to stop, assist and help in quitting, and arrange monitoring of progress at follow-up appointments. Adherence to such guidelines, especially among dental providers, is poor. To improve guideline implementation, it is essential to understand factors influencing it and find effective ways to influence those factors. The aim of the present study protocol is to introduce a theory-based approach to diagnose implementation difficulties of TUPAC counselling guidelines among dental providers. Theories of behaviour change have been used to identify key theoretical domains relevant to the behaviours of healthcare providers involved in implementing clinical guidelines. These theoretical domains will inform the development of a questionnaire aimed at assessing the implementation of the TUPAC counselling guidelines among Finnish municipal dental providers. Specific items will be drawn from the guidelines and the literature on TUPAC studies. After identifying potential implementation difficulties, we will design two interventions using theories of behaviour change to link them with relevant behaviour change techniques aiming to improve guideline adherence. For assessing the implementation of TUPAC guidelines, the electronic dental record audit and self-reported questionnaires will be used. To improve guideline adherence, the theoretical-domains approach could provide a comprehensive basis for assessing implementation difficulties, as well as designing and evaluating interventions. After having identified implementation difficulties, we will design and test two interventions to enhance TUPAC guideline adherence. Using the cluster randomised controlled design, we aim to provide further evidence on intervention effects, as well as on the validity and feasibility of the theoretical-domain approach. The empirical data collected within this trial will be useful in testing whether this theoretical-domain approach can improve our understanding of the implementation of TUPAC guidelines among dental providers. Current Controlled Trials ISRCTN15427433.

78 FR 27065 - Approval and Promulgation of Implementation Plans; North Carolina; Control Techniques Guidelines...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-09

... requirements. See section 307(b)(2). List of Subjects in 40 CFR Part 52 Environmental protection, Air pollution... Explanation Subchapter 2D Air Pollution Control Requirements * * * * * * * Section .0900 Volatile Organic... Miscellaneous Metal 9/1/2010 5/9/2013 [Insert citation of and Plastic Parts publication]. Coatings. Sect .0968...

Contributions of CCLM to advances in quality control.

PubMed

Kazmierczak, Steven C

2013-01-01

Abstract The discipline of laboratory medicine is relatively young when considered in the context of the history of medicine itself. The history of quality control, within the context of laboratory medicine, also enjoys a relatively brief, but rich history. Laboratory quality control continues to evolve along with advances in automation, measurement techniques and information technology. Clinical Chemistry and Laboratory Medicine (CCLM) has played a key role in helping disseminate information about the proper use and utility of quality control. Publication of important advances in quality control techniques and dissemination of guidelines concerned with laboratory quality control has undoubtedly helped readers of this journal keep up to date on the most recent developments in this field.

Central nervous system cancers, version 2.2014. Featured updates to the NCCN Guidelines.

PubMed

Nabors, Louis Burt; Portnow, Jana; Ammirati, Mario; Brem, Henry; Brown, Paul; Butowski, Nicholas; Chamberlain, Marc C; DeAngelis, Lisa M; Fenstermaker, Robert A; Friedman, Allan; Gilbert, Mark R; Hattangadi-Gluth, Jona; Hesser, Deneen; Holdhoff, Matthias; Junck, Larry; Lawson, Ronald; Loeffler, Jay S; Moots, Paul L; Mrugala, Maciej M; Newton, Herbert B; Raizer, Jeffrey J; Recht, Lawrence; Shonka, Nicole; Shrieve, Dennis C; Sills, Allen K; Swinnen, Lode J; Tran, David; Tran, Nam; Vrionis, Frank D; Wen, Patrick Yung; McMillian, Nicole R; Ho, Maria

2014-11-01

The NCCN Guidelines for Central Nervous System Cancers provide multidisciplinary recommendations for the clinical management of patients with cancers of the central nervous system. These NCCN Guidelines Insights highlight recent updates regarding the management of metastatic brain tumors using radiation therapy. Use of stereotactic radiosurgery (SRS) is no longer limited to patients with 3 or fewer lesions, because data suggest that total disease burden, rather than number of lesions, is predictive of survival benefits associated with the technique. SRS is increasingly becoming an integral part of management of patients with controlled, low-volume brain metastases. Copyright © 2014 by the National Comprehensive Cancer Network.

76 FR 72844 - Approval and Promulgation of Air Quality Implementation Plans: South Carolina; Negative...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-28

... has various NO X sources. The 4110 Paper Mill-Coating unit requires Best Available Control Technology... Carolina; Negative Declarations for Groups I, II, III and IV Control Techniques Guidelines; and Reasonably... for Groups I and I CTG. ``EPA-R04-OAR-2010-0018'' for comments regarding the negative declarations for...

Wetlands and Malaria in the Amazon: Guidelines for the Use of Synthetic Aperture Radar Remote-Sensing

PubMed Central

Catry, Thibault; Li, Zhichao; Roux, Emmanuel; Herbreteau, Vincent; Dessay, Nadine

2018-01-01

The prevention and control of mosquito-borne diseases, such as malaria, are important health issues in tropical areas. Malaria transmission is a multi-scale process strongly controlled by environmental factors, and the use of remote-sensing data is suitable for the characterization of its spatial and temporal dynamics. Synthetic aperture radar (SAR) is well-adapted to tropical areas, since it is capable of imaging independent of light and weather conditions. In this study, we highlight the contribution of SAR sensors in the assessment of the relationship between vectors, malaria and the environment in the Amazon region. More specifically, we focus on the SAR-based characterization of potential breeding sites of mosquito larvae, such as man-made water collections and natural wetlands, providing guidelines for the use of SAR capabilities and techniques in order to optimize vector control and malaria surveillance. In light of these guidelines, we propose a framework for the production of spatialized indicators and malaria risk maps based on the combination of SAR, entomological and epidemiological data to support malaria risk prevention and control actions in the field. PMID:29518988

Wetlands and Malaria in the Amazon: Guidelines for the Use of Synthetic Aperture Radar Remote-Sensing.

PubMed

Catry, Thibault; Li, Zhichao; Roux, Emmanuel; Herbreteau, Vincent; Gurgel, Helen; Mangeas, Morgan; Seyler, Frédérique; Dessay, Nadine

2018-03-07

The prevention and control of mosquito-borne diseases, such as malaria, are important health issues in tropical areas. Malaria transmission is a multi-scale process strongly controlled by environmental factors, and the use of remote-sensing data is suitable for the characterization of its spatial and temporal dynamics. Synthetic aperture radar (SAR) is well-adapted to tropical areas, since it is capable of imaging independent of light and weather conditions. In this study, we highlight the contribution of SAR sensors in the assessment of the relationship between vectors, malaria and the environment in the Amazon region. More specifically, we focus on the SAR-based characterization of potential breeding sites of mosquito larvae, such as man-made water collections and natural wetlands, providing guidelines for the use of SAR capabilities and techniques in order to optimize vector control and malaria surveillance. In light of these guidelines, we propose a framework for the production of spatialized indicators and malaria risk maps based on the combination of SAR, entomological and epidemiological data to support malaria risk prevention and control actions in the field.

Planning: supporting and optimizing clinical guidelines execution.

PubMed

Anselma, Luca; Montani, Stefania

2008-01-01

A crucial feature of computerized clinical guidelines (CGs) lies in the fact that they may be used not only as conventional documents (as if they were just free text) describing general procedures that users have to follow. In fact, thanks to a description of their actions and control flow in some semiformal representation language, CGs can also take advantage of Computer Science methods and Information Technology infrastructures and techniques, to become executable documents, in the sense that they may support clinical decision making and clinical procedures execution. In order to reach this goal, some advanced planning techniques, originally developed within the Artificial Intelligence (AI) community, may be (at least partially) resorted too, after a proper adaptation to the specific CG needs has been carried out.

Enhancing implementation of tobacco use prevention and cessation counselling guideline among dental providers: a cluster randomised controlled trial

PubMed Central

2011-01-01

Background Tobacco use adversely affects oral health. Tobacco use prevention and cessation (TUPAC) counselling guidelines recommend that healthcare providers ask about each patient's tobacco use, assess the patient's readiness and willingness to stop, document tobacco use habits, advise the patient to stop, assist and help in quitting, and arrange monitoring of progress at follow-up appointments. Adherence to such guidelines, especially among dental providers, is poor. To improve guideline implementation, it is essential to understand factors influencing it and find effective ways to influence those factors. The aim of the present study protocol is to introduce a theory-based approach to diagnose implementation difficulties of TUPAC counselling guidelines among dental providers. Methods Theories of behaviour change have been used to identify key theoretical domains relevant to the behaviours of healthcare providers involved in implementing clinical guidelines. These theoretical domains will inform the development of a questionnaire aimed at assessing the implementation of the TUPAC counselling guidelines among Finnish municipal dental providers. Specific items will be drawn from the guidelines and the literature on TUPAC studies. After identifying potential implementation difficulties, we will design two interventions using theories of behaviour change to link them with relevant behaviour change techniques aiming to improve guideline adherence. For assessing the implementation of TUPAC guidelines, the electronic dental record audit and self-reported questionnaires will be used. Discussion To improve guideline adherence, the theoretical-domains approach could provide a comprehensive basis for assessing implementation difficulties, as well as designing and evaluating interventions. After having identified implementation difficulties, we will design and test two interventions to enhance TUPAC guideline adherence. Using the cluster randomised controlled design, we aim to provide further evidence on intervention effects, as well as on the validity and feasibility of the theoretical-domain approach. The empirical data collected within this trial will be useful in testing whether this theoretical-domain approach can improve our understanding of the implementation of TUPAC guidelines among dental providers. Trial registration Current Controlled Trials ISRCTN15427433 PMID:21320312

77 FR 59554 - Approval and Promulgation of Implementation Plans; Georgia; Control Techniques Guidelines and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-28

...-.02(2)(ddd),'' ``391-3-1-.02(2)(eee),'' ``391-3-1-.02(2)(hhh),'' ``391-3-1-.02(2)(kkk),'' and ``391-3... expanded Polystyrene publication]. Products Manufacturing. * * * * * * * 391-3-1-.02(2)(hhh) Wood Furniture...

Modern Radiation Therapy for Nodal Non-Hodgkin Lymphoma—Target Definition and Dose Guidelines From the International Lymphoma Radiation Oncology Group

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

Illidge, Tim, E-mail: Tim.Illidge@ics.manchester.ac.uk; Specht, Lena; Yahalom, Joachim

2014-05-01

Radiation therapy (RT) is the most effective single modality for local control of non-Hodgkin lymphoma (NHL) and is an important component of therapy for many patients. Many of the historic concepts of dose and volume have recently been challenged by the advent of modern imaging and RT planning tools. The International Lymphoma Radiation Oncology Group (ILROG) has developed these guidelines after multinational meetings and analysis of available evidence. The guidelines represent an agreed consensus view of the ILROG steering committee on the use of RT in NHL in the modern era. The roles of reduced volume and reduced doses aremore » addressed, integrating modern imaging with 3-dimensional planning and advanced techniques of RT delivery. In the modern era, in which combined-modality treatment with systemic therapy is appropriate, the previously applied extended-field and involved-field RT techniques that targeted nodal regions have now been replaced by limiting the RT to smaller volumes based solely on detectable nodal involvement at presentation. A new concept, involved-site RT, defines the clinical target volume. For indolent NHL, often treated with RT alone, larger fields should be considered. Newer treatment techniques, including intensity modulated RT, breath holding, image guided RT, and 4-dimensional imaging, should be implemented, and their use is expected to decrease significantly the risk for normal tissue damage while still achieving the primary goal of local tumor control.« less

Comprehensive review of neurophysiologic basis and diagnostic interventions in managing chronic spinal pain.

PubMed

Manchikanti, Laxmaiah; Boswell, Mark V; Singh, Vijay; Derby, Richard; Fellows, Bert; Falco, Frank J E; Datta, Sukdeb; Smith, Howard S; Hirsch, Joshua A

2009-01-01

Understanding the neurophysiological basis of chronic spinal pain and diagnostic interventional techniques is crucial in the proper diagnosis and management of chronic spinal pain. Central to the understanding of the structural basis of chronic spinal pain is the provision of physical diagnosis and validation of patient symptomatology. It has been shown that history, physical examination, imaging, and nerve conduction studies in non-radicular or discogenic pain are unable to diagnose the precise cause in 85% of the patients. In contrast, controlled diagnostic blocks have been shown to determine the cause of pain in as many as 85% of the patients. To provide evidence-based clinical practice guidelines for diagnostic interventional techniques. Best evidence synthesis. Strength of evidence was assessed by the U.S. Preventive Services Task Force (USPSTF) criteria utilizing 5 levels of evidence ranging from Level I to III with 3 subcategories in Level II. Diagnostic criteria established by systematic reviews were utilized with controlled diagnostic blocks. Diagnostic criteria included at least 80% pain relief with controlled local anesthetic blocks with the ability to perform multiple maneuvers which were painful prior to the diagnostic blocks for facet joint and sacroiliac joint blocks, whereas for provocation discography, the criteria included concordant pain upon stimulation of the target disc with 2 adjacent discs producing no pain at all. The indicated level of evidence for diagnostic lumbar, cervical, and thoracic facet joint nerve blocks is Level I or II-1. The indicated evidence is Level II-2 for lumbar and cervical discography, whereas it is Level II-3 for thoracic provocation discography. The evidence for diagnostic sacroiliac joint nerve blocks is Level II-2. Level of evidence for selective nerve root blocks for diagnostic purposes is Level II-3. Limitations of this guideline preparation include a continued paucity of literature and conflicts in preparation of systematic reviews and guidelines. These guidelines include the evaluation of evidence for diagnostic interventional procedures in managing chronic spinal pain and recommendations. However, these guidelines do not constitute inflexible treatment recommendations. These guidelines also do not represent a "standard of care."

Fertility preservation for medical reasons in girls and women: British fertility society policy and practice guideline.

PubMed

Yasmin, Ephia; Balachandren, Neerujah; Davies, Melanie C; Jones, Georgina L; Lane, Sheila; Mathur, Raj; Webber, Lisa; Anderson, Richard A

2018-04-01

Fertility preservation in the female poses several challenges due to the invasive nature of the techniques available to achieve it. The guideline aims to bring together the evidence available for the measures for fertility preservation and their outcome. The guideline addresses fertility preservation for medical reasons and includes both oncological and non-oncological causes. The techniques that the guideline considers are: (i) embryo and oocyte cryopreservation; (ii) ovarian tissue cryopreservation; (iii) GnRH agonist suppression and (iv) ovarian transposition. Although ovarian tissue cryopreservation is still considered experimental, the availability of this technique is gaining momentum as more live births from auto-transplanted tissue are reported. The guideline also highlights use of current treatment modalities for benign and malignant conditions that have a better fertility sparing profile. The guideline recommends a multidisciplinary approach in counselling women and girls about the risk to their fertility and available techniques. The role of psychological support in assisting women and girls with decision-making is highlighted. The guideline also highlights the risks associated with these techniques. Women need to be medically fit to undergo invasive procedures. Fertility preservation techniques are appropriate when treatment has curative intent. Fertility preservation is a subject of on-going research on outcomes of different techniques and at the time of publication, studies are still likely to emerge adding to the available literature.

Human Factors Considerations in System Design

NASA Technical Reports Server (NTRS)

Mitchell, C. M. (Editor); Vanbalen, P. M. (Editor); Moe, K. L. (Editor)

1983-01-01

Human factors considerations in systems design was examined. Human factors in automated command and control, in the efficiency of the human computer interface and system effectiveness are outlined. The following topics are discussed: human factors aspects of control room design; design of interactive systems; human computer dialogue, interaction tasks and techniques; guidelines on ergonomic aspects of control rooms and highly automated environments; system engineering for control by humans; conceptual models of information processing; information display and interaction in real time environments.

Methodology for Determination of Grade Crossing Resource-Allocation Guidelines

DOT National Transportation Integrated Search

1975-04-01

The primary objective of this study was to determine the most effective method of reducing emissions of oxides of nitrogen from a two-cylinder version of an EMD series 567C locomotive engine. The NOx control techniques selected for use in this study ...

Clinician Agreement, Self-Efficacy, and Adherence with the Guidelines for the Diagnosis and Management of Asthma.

PubMed

Cloutier, Michelle M; Salo, Paivi M; Akinbami, Lara J; Cohn, Richard D; Wilkerson, Jesse C; Diette, Gregory B; Williams, Sonja; Elward, Kurtis S; Mazurek, Jacek M; Spinner, Jovonni R; Mitchell, Tracey A; Zeldin, Darryl C

The 2007 Guidelines for the Diagnosis and Management of Asthma provide evidence-based recommendations to improve asthma care. Limited national-level data are available about clinician agreement and adherence to these guidelines. To assess clinician-reported adherence with specific guideline recommendations, as well as agreement with and self-efficacy to implement guidelines. We analyzed 2012 National Asthma Survey of Physicians data for 1412 primary care clinicians and 233 asthma specialists about 4 cornerstone guideline domains: asthma control, patient education, environmental control, and pharmacologic treatment. Agreement and self-efficacy were measured using Likert scales; 2 overall indices of agreement and self-efficacy were compiled. Adherence was compared between primary care clinicians and asthma specialists. Logistic regression models assessed the association of agreement and self-efficacy indices with adherence. Asthma specialists expressed stronger agreement, higher self-efficacy, and greater adherence with guideline recommendations than did primary care clinicians. Adherence was low among both groups for specific core recommendations, including written asthma action plan (30.6% and 16.4%, respectively; P < .001); home peak flow monitoring, (12.8% and 11.2%; P = .34); spirometry testing (44.7% and 10.8%; P < .001); and repeated assessment of inhaler technique (39.7% and 16.8%; P < .001). Among primary care clinicians, greater self-efficacy was associated with greater adherence. For specialists, self-efficacy was associated only with increased odds of spirometry testing. Guideline agreement was generally not associated with adherence. Agreement with and adherence to asthma guidelines was higher for specialists than for primary care clinicians, but was low in both groups for several key recommendations. Self-efficacy was a good predictor of guideline adherence among primary care clinicians but not among specialists. Published by Elsevier Inc.

Instrument Quality Control.

PubMed

Jayakody, Chatura; Hull-Ryde, Emily A

2016-01-01

Well-defined quality control (QC) processes are used to determine whether a certain procedure or action conforms to a widely accepted standard and/or set of guidelines, and are important components of any laboratory quality assurance program (Popa-Burke et al., J Biomol Screen 14: 1017-1030, 2009). In this chapter, we describe QC procedures useful for monitoring the accuracy and precision of laboratory instrumentation, most notably automated liquid dispensers. Two techniques, gravimetric QC and photometric QC, are highlighted in this chapter. When used together, these simple techniques provide a robust process for evaluating liquid handler accuracy and precision, and critically underpin high-quality research programs.

77 FR 28336 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Offset Lithographic...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-14

... Technology Transfer and Advancement Act of 1995 (15 U.S.C. 272 note) because application of those... Technology (RACT) for sources covered by EPA's Control Techniques Guidelines (CTG) for offset lithographic..., unless the comment includes information claimed to be Confidential Business Information (CBI) or other...

40 CFR 52.1520 - Identification of plan.

Code of Federal Regulations, 2012 CFR

2012-07-01

... plan. (a) Purpose and scope. This section sets forth the applicable State Implementation Plan for New... provisions for retention and availability of air quality data Statewide 3/23/1972 7/27/1972, 37 FR 15080 See..., 1998 stating a negative declaration for the aerospace coating operations Control Techniques Guideline...

40 CFR 52.1520 - Identification of plan.

Code of Federal Regulations, 2011 CFR

2011-07-01

... plan. (a) Purpose and scope. This section sets forth the applicable State Implementation Plan for New... provisions for retention and availability of air quality data Statewide 3/23/1972 7/27/1972, 37 FR 15080 See..., 1998 stating a negative declaration for the aerospace coating operations Control Techniques Guideline...

Guidelines for Managing Vegetation on Earth-Covered Magazines Within the U.S. Army Materiel Command

DTIC Science & Technology

1994-05-01

Plant Basil Kirby, Pest Controller, Letterkenny Army Depot Ken Davis, Safety Office, Depot Systt., Command Robert Klein, Army Materiel Command Field...refertilization, herbicides, tion techniques; this should be done by visiting the plant growth regulators, pesticides , mowing or site, talking to the

76 FR 64020 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption of Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-17

... Plastic Parts and Business Machines Coatings AGENCY: Environmental Protection Agency (EPA). ACTION: Final....19.07-2, Plastic Parts and Business Machines Coating. Maryland's SIP revision meets the requirement... Techniques Guidelines (CTG) standards for plastic parts and business machines coatings and will help Maryland...

77 FR 43000 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Offset Lithographic...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-23

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R03-OAR-2012-0042; FRL-9702-2] Approval and... Printing Regulations AGENCY: Environmental Protection Agency (EPA). ACTION: Final rule. SUMMARY: EPA is... Technology (RACT) for sources covered by EPA's Control Techniques Guidelines (CTG) for offset lithographic...

Development of guidelines for operationally effective raised medians and the use of alternative movements on urban roadways.

DOT National Transportation Integrated Search

2012-10-01

The development of raised medians is an important access management technique commonly used in urban settings. It : can be used to control or restrict mid-block left turns, U-turns or crossing maneuvers for implementing of alternative : left-turn/U-t...

Comparison of acrylamide intake from Western and guideline based diets using probabilistic techniques and linear programming.

PubMed

Katz, Josh M; Winter, Carl K; Buttrey, Samuel E; Fadel, James G

2012-03-01

Western and guideline based diets were compared to determine if dietary improvements resulting from following dietary guidelines reduce acrylamide intake. Acrylamide forms in heat treated foods and is a human neurotoxin and animal carcinogen. Acrylamide intake from the Western diet was estimated with probabilistic techniques using teenage (13-19 years) National Health and Nutrition Examination Survey (NHANES) food consumption estimates combined with FDA data on the levels of acrylamide in a large number of foods. Guideline based diets were derived from NHANES data using linear programming techniques to comport to recommendations from the Dietary Guidelines for Americans, 2005. Whereas the guideline based diets were more properly balanced and rich in consumption of fruits, vegetables, and other dietary components than the Western diets, acrylamide intake (mean±SE) was significantly greater (P<0.001) from consumption of the guideline based diets (0.508±0.003 μg/kg/day) than from consumption of the Western diets (0.441±0.003 μg/kg/day). Guideline based diets contained less acrylamide contributed by French fries and potato chips than Western diets. Overall acrylamide intake, however, was higher in guideline based diets as a result of more frequent breakfast cereal intake. This is believed to be the first example of a risk assessment that combines probabilistic techniques with linear programming and results demonstrate that linear programming techniques can be used to model specific diets for the assessment of toxicological and nutritional dietary components. Copyright © 2011 Elsevier Ltd. All rights reserved.

Longitudinal-control design approach for high-angle-of-attack aircraft

NASA Technical Reports Server (NTRS)

Ostroff, Aaron J.; Proffitt, Melissa S.

1993-01-01

This paper describes a control synthesis methodology that emphasizes a variable-gain output feedback technique that is applied to the longitudinal channel of a high-angle-of-attack aircraft. The aircraft is a modified F/A-18 aircraft with thrust-vectored controls. The flight regime covers a range up to a Mach number of 0.7; an altitude range from 15,000 to 35,000 ft; and an angle-of-attack (alpha) range up to 70 deg, which is deep into the poststall region. A brief overview is given of the variable-gain mathematical formulation as well as a description of the discrete control structure used for the feedback controller. This paper also presents an approximate design procedure with relationships for the optimal weights for the selected feedback control structure. These weights are selected to meet control design guidelines for high-alpha flight controls. Those guidelines that apply to the longitudinal-control design are also summarized. A unique approach is presented for the feed-forward command generator to obtain smooth transitions between load factor and alpha commands. Finally, representative linear analysis results and nonlinear batch simulation results are provided.

Guidelines for selecting matching techniques for ride sharing.

DOT National Transportation Integrated Search

1982-01-01

Several matching techniques for ride sharing are available to serve a wide range of operating conditions. There is a need for guidelines to aid ride-sharing agencies in Virginia in selecting the most appropriate matching technique. The objective of t...

The confusion in complying with good manufacturing practice requirements in Malaysia

NASA Astrophysics Data System (ADS)

Jali, Mohd Bakri; Ghani, Maaruf Abdul; Nor, Norazmir Md

2016-11-01

Food manufacturing operations need to fulfil regulatory requirements related to hygiene and good manufacturing practices (GMP) to successfully market their products as safe and quality products. GMP based on its ten elements used as guidelines to ensure control over biological, chemical and physical hazards. This study aims to investigate the confusion for design and facilities elements among food industries. Both qualitative and quantitative techniques are used as systematic tools. Design and facilities elements lay a firm foundation for good manufacturing practice to ensure food hygiene and should be used in conjunction with each specific code of hygiene practice and guidelines.

Central Nervous System Cancers, Version 2.2014

PubMed Central

Nabors, Louis Burt; Portnow, Jana; Ammirati, Mario; Brem, Henry; Brown, Paul; Butowski, Nicholas; Chamberlain, Marc C.; DeAngelis, Lisa M.; Fenstermaker, Robert A.; Friedman, Allan; Gilbert, Mark R.; Hattangadi-Gluth, Jona; Hesser, Deneen; Holdhoff, Matthias; Junck, Larry; Lawson, Ronald; Loeffler, Jay S.; Moots, Paul L.; Mrugala, Maciej M.; Newton, Herbert B.; Raizer, Jeffrey J.; Recht, Lawrence; Shonka, Nicole; Shrieve, Dennis C.; Sills, Allen K.; Swinnen, Lode J.; Tran, David; Tran, Nam; Vrionis, Frank D.; Wen, Patrick Yung; McMillian, Nicole R.; Ho, Maria

2015-01-01

The NCCN Guidelines for Central Nervous System Cancers provide multidisciplinary recommendations for the clinical management of patients with cancers of the central nervous system. These NCCN Guidelines Insights highlight recent updates regarding the management of metastatic brain tumors using radiation therapy. Use of stereotactic radiosurgery (SRS) is no longer limited to patients with 3 or fewer lesions, because data suggest that total disease burden, rather than number of lesions, is predictive of survival benefits associated with the technique. SRS is increasingly becoming an integral part of management of patients with controlled, low-volume brain metastases. PMID:25361798

European Guidelines for AP/PA chest X-rays: routinely satisfiable in a paediatric radiology division?

PubMed

Tschauner, Sebastian; Marterer, Robert; Gübitz, Michael; Kalmar, Peter I; Talakic, Emina; Weissensteiner, Sabine; Sorantin, Erich

2016-02-01

Accurate collimation helps to reduce unnecessary irradiation and improves radiographic image quality, which is especially important in the radiosensitive paediatric population. For AP/PA chest radiographs in children, a minimal field size (MinFS) from "just above the lung apices" to "T12/L1" with age-dependent tolerance is suggested by the 1996 European Commission (EC) guidelines, which were examined qualitatively and quantitatively at a paediatric radiology division. Five hundred ninety-eight unprocessed chest X-rays (45% boys, 55% girls; mean age 3.9 years, range 0-18 years) were analysed with a self-developed tool. Qualitative standards were assessed based on the EC guidelines, as well as the overexposed field size and needlessly irradiated tissue compared to the MinFS. While qualitative guideline recommendations were satisfied, mean overexposure of +45.1 ± 18.9% (range +10.2% to +107.9%) and tissue overexposure of +33.3 ± 13.3% were found. Only 4% (26/598) of the examined X-rays completely fulfilled the EC guidelines. This study presents a new chest radiography quality control tool which allows assessment of field sizes, distances, overexposures and quality parameters based on the EC guidelines. Utilising this tool, we detected inadequate field sizes, inspiration depths, and patient positioning. Furthermore, some debatable EC guideline aspects were revealed. • European Guidelines on X-ray quality recommend exposed field sizes for common examinations. • The major failing in paediatric radiographic imaging techniques is inappropriate field size. • Optimal handling of radiographic units can reduce radiation exposure to paediatric patients. • Constant quality control helps ensure optimal chest radiographic image acquisition in children.

40 CFR Appendix W to Part 51 - Guideline on Air Quality Models

Code of Federal Regulations, 2011 CFR

2011-07-01

... sufficient spatial and temporal coverage are available. c. It would be advantageous to categorize the various... control strategies. These are referred to as refined models. c. The use of screening techniques followed... location of the source in question and its expected impacts. c. In all regulatory analyses, especially if...

Study on Integrated Pest Management for Libraries and Archives.

ERIC Educational Resources Information Center

Parker, Thomas A.

This study addresses the problems caused by the major insect and rodent pests and molds and mildews in libraries and archives; the damage they do to collections; and techniques for their prevention and control. Guidelines are also provided for the development and initiation of an Integrated Pest Management program for facilities housing library…

A review of behaviour change theories and techniques used in group based self-management programmes for chronic low back pain and arthritis.

PubMed

Keogh, Alison; Tully, Mark A; Matthews, James; Hurley, Deirdre A

2015-12-01

Medical Research Council (MRC) guidelines recommend applying theory within complex interventions to explain how behaviour change occurs. Guidelines endorse self-management of chronic low back pain (CLBP) and osteoarthritis (OA), but evidence for its effectiveness is weak. This literature review aimed to determine the use of behaviour change theory and techniques within randomised controlled trials of group-based self-management programmes for chronic musculoskeletal pain, specifically CLBP and OA. A two-phase search strategy of electronic databases was used to identify systematic reviews and studies relevant to this area. Articles were coded for their use of behaviour change theory, and the number of behaviour change techniques (BCTs) was identified using a 93-item taxonomy, Taxonomy (v1). 25 articles of 22 studies met the inclusion criteria, of which only three reported having based their intervention on theory, and all used Social Cognitive Theory. A total of 33 BCTs were coded across all articles with the most commonly identified techniques being 'instruction on how to perform the behaviour', 'demonstration of the behaviour', 'behavioural practice', 'credible source', 'graded tasks' and 'body changes'. Results demonstrate that theoretically driven research within group based self-management programmes for chronic musculoskeletal pain is lacking, or is poorly reported. Future research that follows recommended guidelines regarding the use of theory in study design and reporting is warranted. Copyright © 2015 Elsevier Ltd. All rights reserved.

2016 Guidelines of the Taiwan Heart Rhythm Society and the Taiwan Society of Cardiology for the management of atrial fibrillation.

PubMed

Chiang, Chern-En; Wu, Tsu-Juey; Ueng, Kwo-Chang; Chao, Tze-Fan; Chang, Kuan-Cheng; Wang, Chun-Chieh; Lin, Yenn-Jiang; Yin, Wei-Hsian; Kuo, Jen-Yuan; Lin, Wei-Shiang; Tsai, Chia-Ti; Liu, Yen-Bin; Lee, Kun-Tai; Lin, Li-Jen; Lin, Lian-Yu; Wang, Kang-Ling; Chen, Yi-Jen; Chen, Mien-Cheng; Cheng, Chen-Chuan; Wen, Ming-Shien; Chen, Wen-Jone; Chen, Jyh-Hong; Lai, Wen-Ter; Chiou, Chuen-Wang; Lin, Jiunn-Lee; Yeh, San-Jou; Chen, Shih-Ann

2016-11-01

Atrial fibrillation (AF) is the most common sustained arrhythmia. Both the incidence and prevalence of AF are increasing, and the burden of AF is becoming huge. Many innovative advances have emerged in the past decade for the diagnosis and management of AF, including a new scoring system for the prediction of stroke and bleeding events, the introduction of non-vitamin K antagonist oral anticoagulants and their special benefits in Asians, new rhythm- and rate-control concepts, optimal endpoints of rate control, upstream therapy, life-style modification to prevent AF recurrence, and new ablation techniques. The Taiwan Heart Rhythm Society and the Taiwan Society of Cardiology aimed to update the information and have appointed a jointed writing committee for new AF guidelines. The writing committee members comprehensively reviewed and summarized the literature, and completed the 2016 Guidelines of the Taiwan Heart Rhythm Society and the Taiwan Society of Cardiology for the Management of Atrial Fibrillation. This guideline presents the details of the updated recommendations, along with their background and rationale, focusing on data unique for Asians. The guidelines are not mandatory, and members of the writing committee fully realize that treatment of AF should be individualized. The physician's decision remains most important in AF management. Copyright © 2016. Published by Elsevier B.V.

High angle of attack control law development for a free-flight wind tunnel model using direct eigenstructure assignment

NASA Technical Reports Server (NTRS)

Wendel, Thomas R.; Boland, Joseph R.; Hahne, David E.

1991-01-01

Flight-control laws are developed for a wind-tunnel aircraft model flying at a high angle of attack by using a synthesis technique called direct eigenstructure assignment. The method employs flight guidelines and control-power constraints to develop the control laws, and gain schedules and nonlinear feedback compensation provide a framework for considering the nonlinear nature of the attack angle. Linear and nonlinear evaluations show that the control laws are effective, a conclusion that is further confirmed by a scale model used for free-flight testing.

Update of guidelines for surgical endodontics - the position after ten years.

PubMed

Evans, G E; Bishop, K; Renton, T

2012-05-25

This is the first of a series of articles, which will summarise new or updated clinical guidelines produced by the Clinical Standards Committee of the Faculty of Dental Surgery, Royal College of Surgeons of England (FDSRCS). Important developments for the dental profession from a number of clinical guidelines will be presented, commencing with the Guidelines for surgical endodontics. The impact of recent evidence relating to the outcome of surgical endodontics and techniques such as cone beam computed tomography and microsurgical techniques are considered.

Manual herbicide application methods for managing vegetation in Appalachian hardwood forests

Treesearch

Jeffrey D. Kochenderfer; James N. Kochenderfer; Gary W. Miller

2012-01-01

Four manual herbicide application methods are described for use in Appalachian hardwood forests. Stem injection, basal spray, cut-stump, and foliar spray techniques can be used to control interfering vegetation and promote the development of desirable reproduction and valuable crop trees in hardwood forests. Guidelines are presented to help the user select the...

78 FR 44890 - Approval and Promulgation of Implementation Plans; North Carolina; Control Techniques Guidelines...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-25

... for the 1997 8- hour ozone NAAQS includes six full counties and one partial county in North Carolina; and one partial county in South Carolina. The North Carolina portion of the bi-state Charlotte Area... one full county and six partial counties in the bi-state Charlotte area as a marginal nonattainment...

Advances in clinical studies of cardiopulmonary resuscitation

PubMed Central

Chen, Shou-quan

2015-01-01

BACKGROUND: The survival rate of patients after cardiac arrest (CA) remains lower since 2010 International Consensus on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) was published. In clinical trials, the methods and techniques for CPR have been overly described. This article gives an overview of the progress in methods and techniques for CPR in the past years. DATA SOURCES: Original articles about cardiac arrest and CPR from MEDLINE (PubMed) and relevant journals were searched, and most of them were clinical randomized controlled trials (RCTs). RESULTS: Forty-two articles on methods and techniques of CPR were reviewed, including chest compression and conventional CPR, chest compression depth and speed, defibrillation strategies and priority, mechanical and manual chest compression, advanced airway management, impedance threshold device (ITD) and active compression-decompression (ACD) CPR, epinephrine use, and therapeutic hypothermia. The results of studies and related issues described in the international guidelines had been testified. CONCLUSIONS: Although large multicenter studies on CPR are still difficult to carry out, progress has been made in the past 4 years in the methods and techniques of CPR. The results of this review provide evidences for updating the 2015 international guidelines. PMID:26056537

Integrating geographical information and augmented reality techniques for mobile escape guidelines on nuclear accident sites.

PubMed

Tsai, Ming-Kuan; Lee, Yung-Ching; Lu, Chung-Hsin; Chen, Mei-Hsin; Chou, Tien-Yin; Yau, Nie-Jia

2012-07-01

During nuclear accidents, when radioactive materials spread into the environment, the people in the affected areas should evacuate immediately. However, few information systems are available regarding escape guidelines for nuclear accidents. Therefore, this study constructs escape guidelines on mobile phones. This application is called Mobile Escape Guidelines (MEG) and adopts two techniques. One technique is the geographical information that offers multiple representations; the other is the augmented reality that provides semi-realistic information services. When this study tested the mobile escape guidelines, the results showed that this application was capable of identifying the correct locations of users, showing the escape routes, filtering geographical layers, and rapidly generating the relief reports. Users could evacuate from nuclear accident sites easily, even without relief personnel, since using slim devices to access the mobile escape guidelines is convenient. Overall, this study is a useful reference for a nuclear accident emergency response. Copyright © 2012 Elsevier Ltd. All rights reserved.

Multi-community command and control systems in law enforcement: An introductory planning guide

NASA Technical Reports Server (NTRS)

Sohn, R. L.; Garcia, E. A.; Kennedy, R. D.

1976-01-01

A set of planning guidelines for multi-community command and control systems in law enforcement is presented. Essential characteristics and applications of these systems are outlined. Requirements analysis, system concept design, implementation planning, and performance and cost modeling are described and demonstrated with numerous examples. Program management techniques and joint powers agreements for multicommunity programs are discussed in detail. A description of a typical multi-community computer-aided dispatch system is appended.

Guidelines for reporting quantitative mass spectrometry based experiments in proteomics.

PubMed

Martínez-Bartolomé, Salvador; Deutsch, Eric W; Binz, Pierre-Alain; Jones, Andrew R; Eisenacher, Martin; Mayer, Gerhard; Campos, Alex; Canals, Francesc; Bech-Serra, Joan-Josep; Carrascal, Montserrat; Gay, Marina; Paradela, Alberto; Navajas, Rosana; Marcilla, Miguel; Hernáez, María Luisa; Gutiérrez-Blázquez, María Dolores; Velarde, Luis Felipe Clemente; Aloria, Kerman; Beaskoetxea, Jabier; Medina-Aunon, J Alberto; Albar, Juan P

2013-12-16

Mass spectrometry is already a well-established protein identification tool and recent methodological and technological developments have also made possible the extraction of quantitative data of protein abundance in large-scale studies. Several strategies for absolute and relative quantitative proteomics and the statistical assessment of quantifications are possible, each having specific measurements and therefore, different data analysis workflows. The guidelines for Mass Spectrometry Quantification allow the description of a wide range of quantitative approaches, including labeled and label-free techniques and also targeted approaches such as Selected Reaction Monitoring (SRM). The HUPO Proteomics Standards Initiative (HUPO-PSI) has invested considerable efforts to improve the standardization of proteomics data handling, representation and sharing through the development of data standards, reporting guidelines, controlled vocabularies and tooling. In this manuscript, we describe a key output from the HUPO-PSI-namely the MIAPE Quant guidelines, which have developed in parallel with the corresponding data exchange format mzQuantML [1]. The MIAPE Quant guidelines describe the HUPO-PSI proposal concerning the minimum information to be reported when a quantitative data set, derived from mass spectrometry (MS), is submitted to a database or as supplementary information to a journal. The guidelines have been developed with input from a broad spectrum of stakeholders in the proteomics field to represent a true consensus view of the most important data types and metadata, required for a quantitative experiment to be analyzed critically or a data analysis pipeline to be reproduced. It is anticipated that they will influence or be directly adopted as part of journal guidelines for publication and by public proteomics databases and thus may have an impact on proteomics laboratories across the world. This article is part of a Special Issue entitled: Standardization and Quality Control. Copyright © 2013 Elsevier B.V. All rights reserved.

Modern Radiation Therapy for Hodgkin Lymphoma: Field and Dose Guidelines From the International Lymphoma Radiation Oncology Group (ILROG)

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

Specht, Lena, E-mail: lena.specht@regionh.dk; Yahalom, Joachim; Illidge, Tim

2014-07-15

Radiation therapy (RT) is the most effective single modality for local control of Hodgkin lymphoma (HL) and an important component of therapy for many patients. These guidelines have been developed to address the use of RT in HL in the modern era of combined modality treatment. The role of reduced volumes and doses is addressed, integrating modern imaging with 3-dimensional (3D) planning and advanced techniques of treatment delivery. The previously applied extended field (EF) and original involved field (IF) techniques, which treated larger volumes based on nodal stations, have now been replaced by the use of limited volumes, based solelymore » on detectable nodal (and extranodal extension) involvement at presentation, using contrast-enhanced computed tomography, positron emission tomography/computed tomography, magnetic resonance imaging, or a combination of these techniques. The International Commission on Radiation Units and Measurements concepts of gross tumor volume, clinical target volume, internal target volume, and planning target volume are used for defining the targeted volumes. Newer treatment techniques, including intensity modulated radiation therapy, breath-hold, image guided radiation therapy, and 4-dimensional imaging, should be implemented when their use is expected to decrease significantly the risk for normal tissue damage while still achieving the primary goal of local tumor control. The highly conformal involved node radiation therapy (INRT), recently introduced for patients for whom optimal imaging is available, is explained. A new concept, involved site radiation therapy (ISRT), is introduced as the standard conformal therapy for the scenario, commonly encountered, wherein optimal imaging is not available. There is increasing evidence that RT doses used in the past are higher than necessary for disease control in this era of combined modality therapy. The use of INRT and of lower doses in early-stage HL is supported by available data. Although the use of ISRT has not yet been validated in a formal study, it is more conservative than INRT, accounting for suboptimal information and appropriately designed for safe local disease control. The goal of modern smaller field radiation therapy is to reduce both treatment volume and treatment dose while maintaining efficacy and minimizing acute and late sequelae. This review is a consensus of the International Lymphoma Radiation Oncology Group (ILROG) Steering Committee regarding the modern approach to RT in the treatment of HL, outlining a new concept of ISRT in which reduced treatment volumes are planned for the effective control of involved sites of HL. Nodal and extranodal non-Hodgkin lymphomas (NHL) are covered separately by ILROG guidelines.« less

Modern radiation therapy for Hodgkin lymphoma: field and dose guidelines from the international lymphoma radiation oncology group (ILROG).

PubMed

Specht, Lena; Yahalom, Joachim; Illidge, Tim; Berthelsen, Anne Kiil; Constine, Louis S; Eich, Hans Theodor; Girinsky, Theodore; Hoppe, Richard T; Mauch, Peter; Mikhaeel, N George; Ng, Andrea

2014-07-15

Radiation therapy (RT) is the most effective single modality for local control of Hodgkin lymphoma (HL) and an important component of therapy for many patients. These guidelines have been developed to address the use of RT in HL in the modern era of combined modality treatment. The role of reduced volumes and doses is addressed, integrating modern imaging with 3-dimensional (3D) planning and advanced techniques of treatment delivery. The previously applied extended field (EF) and original involved field (IF) techniques, which treated larger volumes based on nodal stations, have now been replaced by the use of limited volumes, based solely on detectable nodal (and extranodal extension) involvement at presentation, using contrast-enhanced computed tomography, positron emission tomography/computed tomography, magnetic resonance imaging, or a combination of these techniques. The International Commission on Radiation Units and Measurements concepts of gross tumor volume, clinical target volume, internal target volume, and planning target volume are used for defining the targeted volumes. Newer treatment techniques, including intensity modulated radiation therapy, breath-hold, image guided radiation therapy, and 4-dimensional imaging, should be implemented when their use is expected to decrease significantly the risk for normal tissue damage while still achieving the primary goal of local tumor control. The highly conformal involved node radiation therapy (INRT), recently introduced for patients for whom optimal imaging is available, is explained. A new concept, involved site radiation therapy (ISRT), is introduced as the standard conformal therapy for the scenario, commonly encountered, wherein optimal imaging is not available. There is increasing evidence that RT doses used in the past are higher than necessary for disease control in this era of combined modality therapy. The use of INRT and of lower doses in early-stage HL is supported by available data. Although the use of ISRT has not yet been validated in a formal study, it is more conservative than INRT, accounting for suboptimal information and appropriately designed for safe local disease control. The goal of modern smaller field radiation therapy is to reduce both treatment volume and treatment dose while maintaining efficacy and minimizing acute and late sequelae. This review is a consensus of the International Lymphoma Radiation Oncology Group (ILROG) Steering Committee regarding the modern approach to RT in the treatment of HL, outlining a new concept of ISRT in which reduced treatment volumes are planned for the effective control of involved sites of HL. Nodal and extranodal non-Hodgkin lymphomas (NHL) are covered separately by ILROG guidelines. Copyright © 2014 Elsevier Inc. All rights reserved.

Lack of latex allergen contamination of solutions withdrawn from vials with natural rubber stoppers.

PubMed

Thomsen, D J; Burke, T G

2000-01-01

The effect on latex allergen contamination and microbial growth of a latex-allergy precaution technique for preparing injectable products was studied. The study consisted of three parts: (1) preparation of 20 samples from vials with latex-containing stoppers in accordance with conventional guidelines, (2) preparation of 20 samples in accordance with latex-allergy precaution guidelines, and (3) preparation of 5 latex-free samples and 1 latex-contaminated sample as negative and positive controls, respectively. The conventional method involved swabbing a vial top with an alcohol prep pad, puncturing the dry natural rubber stopper with an 18-gauge needle attached to a latex-free syringe, and withdrawing the contents of the vial into the syringe. The latex-allergy precaution preparation technique was similar, except that the stopper was removed before the vial contents were withdrawn. There was essentially no difference in latex allergen concentrations between the two drug preparation methods. None of the samples prepared with the standard method supported any microbial growth. One sample prepared with the latex-allergy precaution method grew bacteria. Removal of the dry rubber stopper from vials did not yield solutions with less latex allergen than solutions prepared according to conventional guidelines.

Recommendations for accreditation of laboratories in molecular biology of hematologic malignancies.

PubMed

Flandrin-Gresta, Pascale; Cornillet, Pascale; Hayette, Sandrine; Gachard, Nathalie; Tondeur, Sylvie; Mauté, Carole; Cayuela, Jean-Michel

2015-01-01

Over recent years, the development of molecular biology techniques has improved the hematological diseases diagnostic and follow-up. Consequently, these techniques are largely used in the biological screening of these diseases; therefore the Hemato-oncology molecular diagnostics laboratories must be actively involved in the accreditation process according the ISO 15189 standard. The French group of molecular biologists (GBMHM) provides requirements for the implementation of quality assurance for the medical molecular laboratories. This guideline states the recommendations for the pre-analytical, analytical (methods validation procedures, quality controls, reagents), and post-analytical conditions. In addition, herein we state a strategy for the internal quality control management. These recommendations will be regularly updated.

Overcoming the obstacles of implementing infection prevention and control guidelines.

PubMed

Birgand, G; Johansson, A; Szilagyi, E; Lucet, J-C

2015-12-01

Reasons for a successful or unsuccessful implementation of infection prevention and control (IPC) guidelines are often multiple and interconnected. This article reviews key elements from the national to the individual level that contribute to the success of the implementation of IPC measures and gives perspectives for improvement. Governance approaches, modes of communication and formats of guidelines are discussed with a view to improve collaboration and transparency among actors. The culture of IPC influences practices and varies according to countries, specialties and healthcare providers. We describe important contextual aspects, such as relationships between actors and resources and behavioural features including professional background or experience. Behaviour change techniques providing goal-setting, feedback and action planning have proved effective in mobilizing participants and may be key to trigger social movements of implementation. The leadership of international societies in coordinating actions at international, national and institutional levels using multidisciplinary approaches and fostering collaboration among clinical microbiology, infectious diseases and IPC will be essential for success. Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

A Review of Compression, Ventilation, Defibrillation, Drug Treatment, and Targeted Temperature Management in Cardiopulmonary Resuscitation

PubMed Central

Pan, Jian; Zhu, Jian-Yong; Kee, Ho Sen; Zhang, Qing; Lu, Yuan-Qiang

2015-01-01

Objective: Important studies of cardiopulmonary resuscitation (CPR) techniques influence the development of new guidelines. We systematically reviewed the efficacy of some important studies of CPR. Data Sources: The data analyzed in this review are mainly from articles included in PubMed and EMBASE, published from 1964 to 2014. Study Selection: Original articles and critical reviews about CPR techniques were selected for review. Results: The survival rate after out-of-hospital cardiac arrest (OHCA) is improving. This improvement is associated with the performance of uninterrupted chest compressions and simple airway management procedures during bystander CPR. Real-time feedback devices can be used to improve the quality of CPR. The recommended dose, timing, and indications for adrenaline (epinephrine) use may change. The appropriate target temperature for targeted temperature management is still unclear. Conclusions: New studies over the past 5 years have evaluated various aspects of CPR in OHCA. Some of these studies were high-quality randomized controlled trials, which may help to improve the scientific understanding of resuscitation techniques and result in changes to CPR guidelines. PMID:25673462

Policy on Hazard Analysis and Critical Control Point (HACCP) and adherence to food preparation guidelines: a cross sectional survey of stakeholders in food service in Kumasi, Ghana.

PubMed

Agyei-Baffour, Peter; Sekyere, Kofi Boateng; Addy, Ernestine Akosua

2013-11-04

Food borne diseases claim more lives and are growing public health concerns. Simple preventive techniques such as adoption and adherence to hazard analysis and critical control point (HACCP) policy can significantly reduce this disease burden. Though food screening and inspection are done, the ultimate regulation, Hazard Analysis and Critical Control Point, which is known and accepted worldwide, appears not to be popular among food operators in Ghana. This paper examines the level of awareness of the existence of policy on hazard analysis and critical control point (HACCP) and its adherence to food preparation guidelines among food service providers in Ghana. The results revealed the mean age of food providers as 33.1 years with a standard deviation of 7.5, range of 18-55 years, more females, in full time employment and with basic education. Of the fifty institutional managers, 42 (84%) were senior officers and had worked for more than five years. Education and type of food operator had strong statistically significant relationship with the implementation of HCCP policy and adherence with food preparation guidelines. The enforcement of HACCP policy and adherence with food safety guidelines was led by the Ghana Tourist Board, Public Health officers, and KMA, respectively. While a majority of food operators 373/450 (83.3%) did not know HACCP policy is part of food safety guidelines, staff of food safety law enforcement 44/50 (88%) confirmed knowing that food operators were not aware of the HACCP policy. The study documents evidence on the practice of food safety principles or HACCP policy or adherence to food preparation guidelines. Existing food safety guidelines incorporate varying principles of HACCP, however, awareness is low among food operators. The implication is that food production is likely to fall short of acceptable standards and not be wholesome putting consumers at health risk. Repeating this study in rural and urban areas in Ghana is necessary to provide much more evidence to inform food safety guidelines. Further studies on chemical analysis of food and implementing training modules on HACCP policy for food producers and law enforcement agencies may be helpful to improve existing situation.

Policy on Hazard Analysis and Critical Control Point (HACCP) and adherence to food preparation guidelines: a cross sectional survey of stakeholders in food service in Kumasi, Ghana

PubMed Central

2013-01-01

Background Food borne diseases claim more lives and are growing public health concerns. Simple preventive techniques such as adoption and adherence to hazard analysis and critical control point (HACCP) policy can significantly reduce this disease burden. Though food screening and inspection are done, the ultimate regulation, Hazard Analysis and Critical Control Point, which is known and accepted worldwide, appears not to be popular among food operators in Ghana. This paper examines the level of awareness of the existence of policy on hazard analysis and critical control point (HACCP) and its adherence to food preparation guidelines among food service providers in Ghana. Results The results revealed the mean age of food providers as 33.1 years with a standard deviation of 7.5, range of 18–55 years, more females, in full time employment and with basic education. Of the fifty institutional managers, 42 (84%) were senior officers and had worked for more than five years. Education and type of food operator had strong statistically significant relationship with the implementation of HCCP policy and adherence with food preparation guidelines. The enforcement of HACCP policy and adherence with food safety guidelines was led by the Ghana Tourist Board, Public Health officers, and KMA, respectively. While a majority of food operators 373/450 (83.3%) did not know HACCP policy is part of food safety guidelines, staff of food safety law enforcement 44/50 (88%) confirmed knowing that food operators were not aware of the HACCP policy. Conclusion The study documents evidence on the practice of food safety principles or HACCP policy or adherence to food preparation guidelines. Existing food safety guidelines incorporate varying principles of HACCP, however, awareness is low among food operators. The implication is that food production is likely to fall short of acceptable standards and not be wholesome putting consumers at health risk. Repeating this study in rural and urban areas in Ghana is necessary to provide much more evidence to inform food safety guidelines. Further studies on chemical analysis of food and implementing training modules on HACCP policy for food producers and law enforcement agencies may be helpful to improve existing situation. PMID:24180236

Projection Operator: A Step Towards Certification of Adaptive Controllers

NASA Technical Reports Server (NTRS)

Larchev, Gregory V.; Campbell, Stefan F.; Kaneshige, John T.

2010-01-01

One of the major barriers to wider use of adaptive controllers in commercial aviation is the lack of appropriate certification procedures. In order to be certified by the Federal Aviation Administration (FAA), an aircraft controller is expected to meet a set of guidelines on functionality and reliability while not negatively impacting other systems or safety of aircraft operations. Due to their inherent time-variant and non-linear behavior, adaptive controllers cannot be certified via the metrics used for linear conventional controllers, such as gain and phase margin. Projection Operator is a robustness augmentation technique that bounds the output of a non-linear adaptive controller while conforming to the Lyapunov stability rules. It can also be used to limit the control authority of the adaptive component so that the said control authority can be arbitrarily close to that of a linear controller. In this paper we will present the results of applying the Projection Operator to a Model-Reference Adaptive Controller (MRAC), varying the amount of control authority, and comparing controller s performance and stability characteristics with those of a linear controller. We will also show how adjusting Projection Operator parameters can make it easier for the controller to satisfy the certification guidelines by enabling a tradeoff between controller s performance and robustness.

From guideline modeling to guideline execution: defining guideline-based decision-support services.

PubMed Central

Tu, S. W.; Musen, M. A.

2000-01-01

We describe our task-based approach to defining the guideline-based decision-support services that the EON system provides. We categorize uses of guidelines in patient-specific decision support into a set of generic tasks--making of decisions, specification of work to be performed, interpretation of data, setting of goals, and issuance of alert and reminders--that can be solved using various techniques. Our model includes constructs required for representing the knowledge used by these techniques. These constructs form a toolkit from which developers can select modeling solutions for guideline task. Based on the tasks and the guideline model, we define a guideline-execution architecture and a model of interactions between a decision-support server and clients that invoke services provided by the server. These services use generic interfaces derived from guideline tasks and their associated modeling constructs. We describe two implementations of these decision-support services and discuss how this work can be generalized. We argue that a well-defined specification of guideline-based decision-support services will facilitate sharing of tools that implement computable clinical guidelines. PMID:11080007

Reentry Vehicle Flight Controls Design Guidelines: Dynamic Inversion

NASA Technical Reports Server (NTRS)

Ito, Daigoro; Georgie, Jennifer; Valasek, John; Ward, Donald T.

2002-01-01

This report addresses issues in developing a flight control design for vehicles operating across a broad flight regime and with highly nonlinear physical descriptions of motion. Specifically it addresses the need for reentry vehicles that could operate through reentry from space to controlled touchdown on Earth. The latter part of controlled descent is achieved by parachute or paraglider - or by all automatic or a human-controlled landing similar to that of the Orbiter. Since this report addresses the specific needs of human-carrying (not necessarily piloted) reentry vehicles, it deals with highly nonlinear equations of motion, and then-generated control systems must be robust across a very wide range of physics. Thus, this report deals almost exclusively with some form of dynamic inversion (DI). Two vital aspects of control theory - noninteracting control laws and the transformation of nonlinear systems into equivalent linear systems - are embodied in DI. Though there is no doubt that the mathematical tools and underlying theory are widely available, there are open issues as to the practicality of using DI as the only or primary design approach for reentry articles. This report provides a set of guidelines that can be used to determine the practical usefulness of the technique.

Asilomar Decision: Unprecedented Guidelines for Gene-Transplant Research

ERIC Educational Resources Information Center

Science News, 1975

1975-01-01

The hazards posed by new techniques of genetic manipulation have prompted scientists to regulate and in some cases restrict their own basic investigations. Describes some possible applications of the new techniques and outlines the established research guidelines. (GS)

Using a knowledge translation framework to implement asthma clinical practice guidelines in primary care.

PubMed

Licskai, Christopher; Sands, Todd; Ong, Michael; Paolatto, Lisa; Nicoletti, Ivan

2012-10-01

Quality problem International guidelines establish evidence-based standards for asthma care; however, recommendations are often not implemented and many patients do not meet control targets. Initial assessment Regional pilot data demonstrated a knowledge-to-practice gap. Choice of solutions We engineered health system change in a multi-step approach described by the Canadian Institutes of Health Research knowledge translation framework. Implementation Knowledge translation occurred at multiple levels: patient, practice and local health system. A regional administrative infrastructure and inter-disciplinary care teams were developed. The key project deliverable was a guideline-based interdisciplinary asthma management program. Six community organizations, 33 primary care physicians and 519 patients participated. The program operating cost was $290/patient. Evaluation Six guideline-based care elements were implemented, including spirometry measurement, asthma controller therapy, a written self-management action plan and general asthma education, including the inhaler device technique, role of medications and environmental control strategies in 93, 95, 86, 100, 97 and 87% of patients, respectively. Of the total patients 66% were adults, 61% were female, the mean age was 35.7 (SD = ± 24.2) years. At baseline 42% had two or more symptoms beyond acceptable limits vs. 17% (P< 0.001) post-intervention; 71% reported urgent/emergent healthcare visits at baseline (2.94 visits/year) vs. 45% (1.45 visits/year) (P< 0.001); 39% reported absenteeism (5.0 days/year) vs. 19% (3.0 days/year) (P< 0.001). The mean follow-up interval was 22 (SD = ± 7) months. Lessons learned A knowledge-translation framework can guide multi-level organizational change, facilitate asthma guideline implementation, and improve health outcomes in community primary care practices. Program costs are similar to those of diabetes programs. Program savings offset costs in a ratio of 2.1:1.

Using a knowledge translation framework to implement asthma clinical practice guidelines in primary care

PubMed Central

Licskai, Christopher; Sands, Todd; Ong, Michael; Paolatto, Lisa; Nicoletti, Ivan

2012-01-01

Quality problem International guidelines establish evidence-based standards for asthma care; however, recommendations are often not implemented and many patients do not meet control targets. Initial assessment Regional pilot data demonstrated a knowledge-to-practice gap. Choice of solutions We engineered health system change in a multi-step approach described by the Canadian Institutes of Health Research knowledge translation framework. Implementation Knowledge translation occurred at multiple levels: patient, practice and local health system. A regional administrative infrastructure and inter-disciplinary care teams were developed. The key project deliverable was a guideline-based interdisciplinary asthma management program. Six community organizations, 33 primary care physicians and 519 patients participated. The program operating cost was $290/patient. Evaluation Six guideline-based care elements were implemented, including spirometry measurement, asthma controller therapy, a written self-management action plan and general asthma education, including the inhaler device technique, role of medications and environmental control strategies in 93, 95, 86, 100, 97 and 87% of patients, respectively. Of the total patients 66% were adults, 61% were female, the mean age was 35.7 (SD = ±24.2) years. At baseline 42% had two or more symptoms beyond acceptable limits vs. 17% (P< 0.001) post-intervention; 71% reported urgent/emergent healthcare visits at baseline (2.94 visits/year) vs. 45% (1.45 visits/year) (P< 0.001); 39% reported absenteeism (5.0 days/year) vs. 19% (3.0 days/year) (P< 0.001). The mean follow-up interval was 22 (SD = ±7) months. Lessons learned A knowledge-translation framework can guide multi-level organizational change, facilitate asthma guideline implementation, and improve health outcomes in community primary care practices. Program costs are similar to those of diabetes programs. Program savings offset costs in a ratio of 2.1:1 PMID:22893665

HARV ANSER Flight Test Data Retrieval and Processing Procedures

NASA Technical Reports Server (NTRS)

Yeager, Jessie C.

1997-01-01

Under the NASA High-Alpha Technology Program the High Alpha Research Vehicle (HARV) was used to conduct flight tests of advanced control effectors, advanced control laws, and high-alpha design guidelines for future super-maneuverable fighters. The High-Alpha Research Vehicle is a pre-production F/A-18 airplane modified with a multi-axis thrust-vectoring system for augmented pitch and yaw control power and Actuated Nose Strakes for Enhanced Rolling (ANSER) to augment body-axis yaw control power. Flight testing at the Dryden Flight Research Center (DFRC) began in July 1995 and continued until May 1996. Flight data will be utilized to evaluate control law performance and aircraft dynamics, determine aircraft control and stability derivatives using parameter identification techniques, and validate design guidelines. To accomplish these purposes, essential flight data parameters were retrieved from the DFRC data system and stored on the Dynamics and Control Branch (DCB) computer complex at Langley. This report describes the multi-step task used to retrieve and process this data and documents the results of these tasks. Documentation includes software listings, flight information, maneuver information, time intervals for which data were retrieved, lists of data parameters and definitions, and example data plots.

An Overview of Controls and Flying Qualities Technology on the F/A-18 High Alpha Research Vehicle

NASA Technical Reports Server (NTRS)

Pahle, Joseph W.; Wichman, Keith D.; Foster, John V.; Bundick, W. Thomas

1996-01-01

The NASA F/A-18 High Alpha Research Vehicle (HARV) has been the flight test bed of a focused technology effort to significantly increase maneuvering capability at high angles of attack. Development and flight test of control law design methodologies, handling qualities metrics, performance guidelines, and flight evaluation maneuvers are described. The HARV has been modified to include two research control effectors, thrust vectoring, and actuated forebody strakes in order to provide increased control power at high angles of attack. A research flight control system has been used to provide a flexible, easily modified capability for high-angle-of-attack research controls. Different control law design techniques have been implemented and flight-tested, including eigenstructure assignment, variable gain output feedback, pseudo controls, and model-following. Extensive piloted simulation has been used to develop nonlinear performance guide-lines and handling qualities criteria for high angles of attack. This paper reviews the development and evaluation of technologies useful for high-angle-of-attack control. Design, development, and flight test of the research flight control system, control laws, flying qualities specifications, and flight test maneuvers are described. Flight test results are used to illustrate some of the lessons learned during flight test and handling qualities evaluations.

The Role of the Primary Care Physician in Helping Adolescent and Adult Patients Improve Asthma Control

PubMed Central

Yawn, Barbara P.

2011-01-01

Many adolescents and adults with asthma continue to have poorly controlled disease, often attributable to poor adherence to asthma therapy. Failure to adhere to recommended treatment may result from a desire to avoid regular reliance on medications, inappropriate high tolerance of asthma symptoms, failure to perceive the chronic nature of asthma, and poor inhaler technique. Primary care physicians need to find opportunities and methods to address these and other issues related to poor asthma control. Few adolescents or adults with asthma currently have asthma “checkup” visits, usually seeking medical care only with an exacerbation. Therefore, nonrespiratory-related office visits represent an important opportunity to assess baseline asthma control and the factors that most commonly lead to poor control. Tools such as the Asthma Control Test, the Asthma Therapy Assessment Questionnaire, the Asthma Control Questionnaire, and the Asthma APGAR provide standardized, patient-friendly ways to capture necessary asthma information. For uncontrolled asthma, physicians can refer to the stepwise approach in the 2007 National Asthma Education and Prevention Program guidelines to adjust medication use, but they must consider step-up decisions in the context of quality of the patient's inhaler technique, adherence, and ability to recognize and avoid or eliminate triggers. For this review, a literature search of PubMed from 2000 through August 31, 2010, was performed using the following terms (or a combination of these terms): asthma, asthma control, primary care, NAEPP guidelines, assessment, uncontrolled asthma, burden, impact, assessment tools, triggers, pharmacotherapy, safety. Studies were limited to human studies published in English. Articles were also identified by a manual search of bibliographies from retrieved articles and from article archives of the author. PMID:21878602

The role of the primary care physician in helping adolescent and adult patients improve asthma control.

PubMed

Yawn, Barbara P

2011-09-01

Many adolescents and adults with asthma continue to have poorly controlled disease, often attributable to poor adherence to asthma therapy. Failure to adhere to recommended treatment may result from a desire to avoid regular reliance on medications, inappropriate high tolerance of asthma symptoms, failure to perceive the chronic nature of asthma, and poor inhaler technique. Primary care physicians need to find opportunities and methods to address these and other issues related to poor asthma control. Few adolescents or adults with asthma currently have asthma "checkup" visits, usually seeking medical care only with an exacerbation. Therefore, nonrespiratory-related office visits represent an important opportunity to assess baseline asthma control and the factors that most commonly lead to poor control. Tools such as the Asthma Control Test, the Asthma Therapy Assessment Questionnaire, the Asthma Control Questionnaire, and the Asthma APGAR provide standardized, patient-friendly ways to capture necessary asthma information. For uncontrolled asthma, physicians can refer to the stepwise approach in the 2007 National Asthma Education and Prevention Program guidelines to adjust medication use, but they must consider step-up decisions in the context of quality of the patient's inhaler technique, adherence, and ability to recognize and avoid or eliminate triggers. For this review, a literature search of PubMed from 2000 through August 31, 2010, was performed using the following terms (or a combination of these terms): asthma, asthma control, primary care, NAEPP guidelines, assessment, uncontrolled asthma, burden, impact, assessment tools, triggers, pharmacotherapy, safety. Studies were limited to human studies published in English. Articles were also identified by a manual search of bibliographies from retrieved articles and from article archives of the author.

Guidelines for safe handling, use and disposal of nanoparticles

NASA Astrophysics Data System (ADS)

Amoabediny, G. H.; Naderi, A.; Malakootikhah, J.; Koohi, M. K.; Mortazavi, S. A.; Naderi, M.; Rashedi, H.

2009-05-01

Health, safety and environmental (HSE) risks of a technology is an inseparable part of it which threatens all exposed employees. It has been proved for many years that exposure to particles, in an occupational setting, could be linked with the onset of lung diseases, such as pneumoconiosis, chronic obstructive pulmonary disease (COPD), and mesotelioma and lung cancer. Nanoparticles, due to their unique characteristics including; small size, shape, high surface area, charge, chemical properties, solubility, and degree of agglomeration can cross cell boundaries or pass directly from the lungs into the blood stream and ultimately reach to all of the organs in the body. This is the reason why they may pose higher risk than the same mass and material of larger particles. Moreover, biodegradation of nanoparticles by some kinds of fungi (like wood decay fungi) may result in metabolites which may be toxic to microorganisms under aerobic and anaerobic conditions. Bacteria and living cells can take up nanoparticles, providing the basis for potential bioaccumulation in the food chain. Considering Iran's prominent position in nanotechnologies and fast-growing in research and industrial activities, controlling nanoparticles related HSE risks should be highly considered. In general, there are three main approaches to risk and exposure control: engineering techniques, administrative means and personal protective equipments. These complementary approaches especially engineering techniques should be considered starting with the design stage of an industrial process. Administrative means of control constitute an additional approach when the other methods have not achieved the expected control levels. Administrative means of control must never substitute for engineering techniques, which always be performed according to standard practices. In some situations, due to insufficiently advanced technology and prohibitive costs, engineering measerus can not be implemended. In these situations, performing administrative means of control constitute other ways of limiaiting the occupational exposure risks. Accordingly, to minimize the risks from know and unknown health, safety and invironment hazards in research and occupational setting of the country, guideline for safe handling, use and disposal of manopractical has provided.

Humans, 'things' and space: costing hospital infection control interventions.

PubMed

Page, K; Graves, N; Halton, K; Barnett, A G

2013-07-01

Previous attempts at costing infection control programmes have tended to focus on accounting costs rather than economic costs. For studies using economic costs, estimates tend to be quite crude and probably underestimate the true cost. One of the largest costs of any intervention is staff time, but this cost is difficult to quantify and has been largely ignored in previous attempts. To design and evaluate the costs of hospital-based infection control interventions or programmes. This article also discusses several issues to consider when costing interventions, and suggests strategies for overcoming these issues. Previous literature and techniques in both health economics and psychology are reviewed and synthesized. This article provides a set of generic, transferable costing guidelines. Key principles such as definition of study scope and focus on large costs, as well as pitfalls (e.g. overconfidence and uncertainty), are discussed. These new guidelines can be used by hospital staff and other researchers to cost their infection control programmes and interventions more accurately. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Applied photo interpretation for airbrush cartography

NASA Technical Reports Server (NTRS)

Inge, J. L.; Bridges, P. M.

1976-01-01

Lunar and planetary exploration has required the development of new techniques of cartographic portrayal. Conventional photo-interpretive methods employing size, shape, shadow, tone, pattern, and texture are applied to computer-processed satellite television images. Comparative judgements are affected by illumination, resolution, variations in surface coloration, and transmission or processing artifacts. The portrayal of tonal densities in a relief illustration is performed using a unique airbrush technique derived from hill-shading of contour maps. The control of tone and line quality is essential because the mid-gray to dark tone densities must be finalized prior to the addition of highlights to the drawing. This is done with an electric eraser until the drawing is completed. The drawing density is controlled with a reflectance-reading densitometer to meet certain density guidelines. The versatility of planetary photo-interpretive methods for airbrushed map portrayals is demonstrated by the application of these techniques to the synthesis of nonrelief data.

Control Automation in Undersea Search and Manipulation

NASA Technical Reports Server (NTRS)

Weltman, Gershon; Freedy, Amos

1974-01-01

Automatic decision making and control mechanisms of the type termed "adaptive" or "intelligent" offer unique advantages for exploration and manipulation of the undersea environment, particularly at great depths. Because they are able to carry out human-like functions autonomously, such mechanisms can aid and extend the capabilities of the human operator. This paper reviews past and present work in the areas of adaptive control and robotics with the purpose of establishing logical guidelines for the application of automatic techniques underwater. Experimental research data are used to illustrate the importance of information feedback, personnel training, and methods of control allocation in the interaction between operator and intelligent machine.

Reporting Quality of Social and Psychological Intervention Trials: A Systematic Review of Reporting Guidelines and Trial Publications

PubMed Central

Grant, Sean P.; Mayo-Wilson, Evan; Melendez-Torres, G. J.; Montgomery, Paul

2013-01-01

Background Previous reviews show that reporting guidelines have improved the quality of trial reports in medicine, yet existing guidelines may not be fully suited for social and psychological intervention trials. Objective/Design We conducted a two-part study that reviewed (1) reporting guidelines for and (2) the reporting quality of social and psychological intervention trials. Data Sources (1) To identify reporting guidelines, we systematically searched multiple electronic databases and reporting guideline registries. (2) To identify trials, we hand-searched 40 journals with the 10 highest impact factors in clinical psychology, criminology, education, and social work. Eligibility (1) Reporting guidelines consisted of articles introducing a checklist of reporting standards relevant to social and psychological intervention trials. (2) Trials reported randomised experiments of complex interventions with psychological, social, or health outcomes. Results (1) We identified 19 reporting guidelines that yielded 147 reporting standards relevant to social and psychological interventions. Social and behavioural science guidelines included 89 standards not found in CONSORT guidelines. However, CONSORT guidelines used more recommended techniques for development and dissemination compared to other guidelines. (2) Our review of trials (n = 239) revealed that many standards were poorly reported, such as identification as a randomised trial in titles (20% reported the information) and abstracts (55%); information about blinding (15%), sequence generation (23%), and allocation concealment (17%); and details about actual delivery of experimental (43%) and control interventions (34%), participant uptake (25%), and service environment (28%). Only 11 of 40 journals referenced reporting guidelines in “Instructions to Authors.” Conclusion Existing reporting guidelines have important limitations in content, development, and/or dissemination. Important details are routinely missing from trial publications; most leading journals in social and behavioural sciences do not ask authors to follow reporting standards. Findings demonstrate a need to develop a CONSORT extension with updated standards for social and psychological intervention trials. PMID:23734256

Quality Assurance Program for Molecular Medicine Laboratories

PubMed Central

Hajia, M; Safadel, N; Samiee, S Mirab; Dahim, P; Anjarani, S; Nafisi, N; Sohrabi, A; Rafiee, M; Sabzavi, F; Entekhabi, B

2013-01-01

Background: Molecular diagnostic methods have played and continuing to have a critical role in clinical laboratories in recent years. Therefore, standardization is an evolutionary process that needs to be upgrade with increasing scientific knowledge, improvement of the instruments and techniques. The aim of this study was to design a quality assurance program in order to have similar conditions for all medical laboratories engaging with molecular tests. Methods: We had to design a plan for all four elements; required space conditions, equipments, training, and basic guidelines. Necessary guidelines was prepared and confirmed by the launched specific committee at the Health Reference Laboratory. Results: Several workshops were also held for medical laboratories directors and staffs, quality control manager of molecular companies, directors and nominees from universities. Accreditation of equipments and molecular material was followed parallel with rest of program. Now we are going to accredit medical laboratories and to evaluate the success of the program. Conclusion: Accreditation of medical laboratory will be succeeding if its basic elements are provided in advance. Professional practice guidelines, holding training and performing accreditation the molecular materials and equipments ensured us that laboratories are aware of best practices, proper interpretation, limitations of techniques, and technical issues. Now, active external auditing can improve the applied laboratory conditions toward the defined standard level. PMID:23865028

Quality assurance program for molecular medicine laboratories.

PubMed

Hajia, M; Safadel, N; Samiee, S Mirab; Dahim, P; Anjarani, S; Nafisi, N; Sohrabi, A; Rafiee, M; Sabzavi, F; Entekhabi, B

2013-01-01

Molecular diagnostic methods have played and continuing to have a critical role in clinical laboratories in recent years. Therefore, standardization is an evolutionary process that needs to be upgrade with increasing scientific knowledge, improvement of the instruments and techniques. The aim of this study was to design a quality assurance program in order to have similar conditions for all medical laboratories engaging with molecular tests. We had to design a plan for all four elements; required space conditions, equipments, training, and basic guidelines. Necessary guidelines was prepared and confirmed by the launched specific committee at the Health Reference Laboratory. Several workshops were also held for medical laboratories directors and staffs, quality control manager of molecular companies, directors and nominees from universities. Accreditation of equipments and molecular material was followed parallel with rest of program. Now we are going to accredit medical laboratories and to evaluate the success of the program. Accreditation of medical laboratory will be succeeding if its basic elements are provided in advance. Professional practice guidelines, holding training and performing accreditation the molecular materials and equipments ensured us that laboratories are aware of best practices, proper interpretation, limitations of techniques, and technical issues. Now, active external auditing can improve the applied laboratory conditions toward the defined standard level.

A comparative review of pharmacoeconomic guidelines.

PubMed

Jacobs, P; Bachynsky, J; Baladi, J F

1995-09-01

We have reviewed 4 international sets of guidelines for the economic evaluation of pharmaceutical products-those of the Australian Pharmaceutical Benefits Advisory Committee, the Canadian Coordinating Office for Health Technology Assessment, the Ontario Ministry of Health, and the England and Wales Department of Health. Comparison of these guidelines reveals that there are a number of differences between them, including disparities in outcome selection, costs and perspectives. These observations were attributed to differences in study purpose, conceptual approach, measurement techniques and value judgements. Uniformity can be achieved only in conceptual approach and measurement technique. Guidelines should be flexible to accommodate differences in the study purposes and value judgements of the analysts.

Effectiveness of behavioural change techniques in physiotherapy interventions to promote physical activity adherence in patients with hip and knee osteoarthritis: a systematic review protocol

PubMed Central

Willett, Matthew; Duda, Joan; Gautrey, Charlotte; Fenton, Sally; Greig, Carolyn; Rushton, Alison

2017-01-01

Introduction Osteoarthritis (OA) is a common degenerative articular disease, the highest cause of individual level disability and a significant socioeconomic burden to healthcare services. Patient education and physical activity (PA) prescription are recommended components of interventions in several healthcare guidelines and are commonly provided by physiotherapists. However, these interventions lack long-term clinical effectiveness. Patient adherence to PA prescription requires patients to modify their PA behaviour and appears critical in maintaining symptomatic improvements. This systematic review aims to evaluate the effectiveness of behavioural change techniques (BCTs) used in physiotherapy interventions to improve PA adherence. Methods and analysis Medline, Cochrane and PEDro registers of Controlled Trials, EMBASE, CINAHL and PsycInfo databases, and key grey literature sources will be rigorously searched for randomised controlled trials that compared a physiotherapy intervention incorporating BCTs with other therapies, placebo interventions, usual care or no-treatment. Two independent researchers will conduct literature searches, assess trial eligibility, extract data, conduct risk of bias assessment (using Cochrane risk of bias tool), classify BCTs and evaluate the quality of the body of literature following Grading of Recommendations, Assessment, Development and Evaluation (GRADE) guidelines. Narrative synthesis of key outcomes will be presented and meta-analysis will be performed if included trials are clinically homogenous, based on their intervention and comparator groups and outcome measures. This review will be reported in line with the Preferred Reporting Items for Systematic review and Meta-Analysis guidelines. Ethics and dissemination Research ethics approval is not required. This review will help inform clinicians and researchers on the most effective behavioural change techniques used in physiotherapy interventions to enhance adherence to PA prescription for patients with lower limb OA. The findings will be disseminated through publication in a peer-reviewed journal and conference presentations. Trial registration number PROSPERO CRD42016039932. PMID:28667221

Effectiveness of behavioural change techniques in physiotherapy interventions to promote physical activity adherence in patients with hip and knee osteoarthritis: a systematic review protocol.

PubMed

Willett, Matthew; Duda, Joan; Gautrey, Charlotte; Fenton, Sally; Greig, Carolyn; Rushton, Alison

2017-06-30

Osteoarthritis (OA) is a common degenerative articular disease, the highest cause of individual level disability and a significant socioeconomic burden to healthcare services. Patient education and physical activity (PA) prescription are recommended components of interventions in several healthcare guidelines and are commonly provided by physiotherapists. However, these interventions lack long-term clinical effectiveness. Patient adherence to PA prescription requires patients to modify their PA behaviour and appears critical in maintaining symptomatic improvements. This systematic review aims to evaluate the effectiveness of behavioural change techniques (BCTs) used in physiotherapy interventions to improve PA adherence. Medline, Cochrane and PEDro registers of Controlled Trials, EMBASE, CINAHL and PsycInfo databases, and key grey literature sources will be rigorously searched for randomised controlled trials that compared a physiotherapy intervention incorporating BCTs with other therapies, placebo interventions, usual care or no-treatment. Two independent researchers will conduct literature searches, assess trial eligibility, extract data, conduct risk of bias assessment (using Cochrane risk of bias tool), classify BCTs and evaluate the quality of the body of literature following Grading of Recommendations, Assessment, Development and Evaluation (GRADE) guidelines. Narrative synthesis of key outcomes will be presented and meta-analysis will be performed if included trials are clinically homogenous, based on their intervention and comparator groups and outcome measures. This review will be reported in line with the Preferred Reporting Items for Systematic review and Meta-Analysis guidelines. Research ethics approval is not required. This review will help inform clinicians and researchers on the most effective behavioural change techniques used in physiotherapy interventions to enhance adherence to PA prescription for patients with lower limb OA. The findings will be disseminated through publication in a peer-reviewed journal and conference presentations. PROSPERO CRD42016039932. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

41 CFR 60-3.6 - Use of selection procedures which have not been validated.

Code of Federal Regulations, 2011 CFR

2011-07-01

... validation techniques contemplated by these guidelines. In such circumstances, the user should utilize... a formal and scored selection procedure is used which has an adverse impact, the validation... user cannot or need not follow the validation techniques anticipated by these guidelines, the user...

41 CFR 60-3.6 - Use of selection procedures which have not been validated.

Code of Federal Regulations, 2014 CFR

2014-07-01

... validation techniques contemplated by these guidelines. In such circumstances, the user should utilize... a formal and scored selection procedure is used which has an adverse impact, the validation... user cannot or need not follow the validation techniques anticipated by these guidelines, the user...

41 CFR 60-3.6 - Use of selection procedures which have not been validated.

Code of Federal Regulations, 2012 CFR

2012-07-01

... validation techniques contemplated by these guidelines. In such circumstances, the user should utilize... a formal and scored selection procedure is used which has an adverse impact, the validation... user cannot or need not follow the validation techniques anticipated by these guidelines, the user...

41 CFR 60-3.6 - Use of selection procedures which have not been validated.

Code of Federal Regulations, 2013 CFR

2013-07-01

... validation techniques contemplated by these guidelines. In such circumstances, the user should utilize... a formal and scored selection procedure is used which has an adverse impact, the validation... user cannot or need not follow the validation techniques anticipated by these guidelines, the user...

New NASA SEE LEO Spacecraft Charging Design Guidelines: How to Survive in LEO Rather than GEO

NASA Technical Reports Server (NTRS)

Ferguson, Dale C.; Hillard, G. Barry

2004-01-01

It has been almost two solar cycles since the GEO Guidelines of Purvis et al (1984) were published. In that time, interest in high voltage LEO systems has increased. The correct and conventional wisdom has been that LEO conditions are sufficiently different from GEO that the GEO Guidelines (and other GEO and POLAR documents produced since then) should not be used for LEO spacecraft. Because of significant recent GEO spacecraft failures that have been shown in ground testing to be likely to also occur on LEO spacecraft, the SEE program commissioned the production of the new LEO Spacecraft Charging Design Guidelines (hereafter referred to as the LEO Guidelines). Now available in CD-ROM form, the LEO Guidelines highlight mitigation techniques to prevent spacecraft arcing on LEO solar arrays and other systems. We compare and contrast the mitigation techniques for LEO and GEO in this paper. We also discuss the extensive bibliography included in the LEO Guidelines, so results can be found in their primary sources.

Guidelines for project-level traffic forecasting for Hawaii Department of Transportation.

DOT National Transportation Integrated Search

2015-12-01

These guidelines describe both best practice and acceptable practice for performing project-level traffic : forecasts for the State of Hawaii. The guidelines describe a number of techniques and options that are all : acceptable within their intended ...

[Spanish Adaptation of the 2016 European Guidelines on Cardiovascular Disease Prevention in Clinical Practice].

PubMed

Royo-Bordonada, Miguel Angel; Armario, Pedro; Lobos Bejarano, José María; Pedro-Botet, Juan; Villar Álvarez, Fernando; Elosua, Roberto; Brotons Cuixart, Carlos; Cortés, Olga; Serrano, Benilde; Camafort Babkowski, Miguel; Gil Núñez, Antonio; Pérez, Antonio; Maiques, Antonio; de Santiago Nocito, Ana; Castro, Almudena; Alegría, Eduardo; Baeza, Ciro; Herranz, María; Sans, Susana; Campos, Pilar

2016-11-24

The VI European Guidelines for Cardiovascular Prevention recommend combining population and high-risk strategies with lifestyle changes as a cornerstone of prevention, and propose the SCORE function to quantify cardiovascular risk. The guidelines highlight disease specific interventions, and conditions as women, young people and ethnic minorities. Screening for subclinical atherosclerosis with noninvasive imaging techniques is not recommended. The guidelines distinguish four risk levels (very high, high, moderate and low) with therapeutic objectives for lipid control according to risk. Diabetes mellitus confers a high risk, except for subjects with type 2 diabetes with less than 10 years of evolution, without other risk factors or complications, or type 1 diabetes of short evolution without complications. The decision to start pharmacological treatment of arterial hypertension will depend on the blood pressure level and the cardiovascular risk, taking into account the lesion of target organs. The guidelines don't recommend antiplatelet drugs in primary prevention because of the increased bleeding risk. The low adherence to the medication requires simplified therapeutic regimes and to identify and combat its causes. The guidelines highlight the responsibility of health professionals to take an active role in advocating evidence-based interventions at the population level, and propose effective interventions, at individual and population level, to promote a healthy diet, the practice of physical activity, the cessation of smoking and the protection against alcohol abuse.

The international water conference proceedings

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

Guseman, J.R.

1984-10-01

This book provides information on computer applications to water chemistry control, groundwater, membrane technology, instrumentation/analytical techniques and ion exchange. Other topics of discussion include cooling water, biocontrol, the hydraulic properties of ion exchange resins, steam electric power plant aqueous discharges and colorimetric determination of trace benzotriazole or tolytriazole. Water chemistry guidelines for large steam generating power plants is discussed, as well as wastewater treatment, boiler water conditioning and ion exchange/computer related topics.

Interventions for the endodontic management of non-vital traumatised immature permanent anterior teeth in children and adolescents: a systematic review of the evidence and guidelines of the European Academy of Paediatric Dentistry.

PubMed

Duggal, M; Tong, H J; Al-Ansary, M; Twati, W; Day, P F; Nazzal, H

2017-06-01

This systematic review was undertaken in order to develop guidelines for the European Academy of Paediatric Dentistry for the management of non-vital permanent anterior teeth with incomplete root development. Three techniques were considered; apexification by single or multiple applications of calcium hydroxide, use of Mineral Trioxide Aggregate (MTA) for the creation of an apical plug followed by obturation of the root canal, and finally a Regenerative Endodontic Technique (RET). Scottish Intercollegiate Guideline Network (SIGN) Guidelines (2008) were used for the synthesis of evidence and grade of recommendation. Variable levels of evidence were found and generally evidence related to these areas was found to be weak and of low quality. It was not possible to produce evidence-based guidelines based on the strength of evidence that is currently available for the management of non-vital immature permanent incisors. Based on the available evidence the European Academy of Paediatric Dentistry proposes Good Clinical Practice Points as a guideline for the management of such teeth. It is proposed that the long term use of calcium hydroxide in the root canals of immature teeth should be avoided and apexification with calcium hydroxide is no longer advocated. The evidence related to the use of a Regenerative Endodontic Technique is currently extremely weak and therefore this technique should only be used in very limited situations where the prognosis with other techniques is deemed to be extremely poor. The current review supports the use of MTA followed by root canal obturation as the treatment of choice.

Direct Field Acoustic Testing

NASA Technical Reports Server (NTRS)

Larkin, Paul; Goldstein, Bob

2008-01-01

This paper presents an update to the methods and procedures used in Direct Field Acoustic Testing (DFAT). The paper will discuss some of the recent techniques and developments that are currently being used and the future publication of a reference standard. Acoustic testing using commercial sound system components is becoming a popular and cost effective way of generating a required acoustic test environment both in and out of a reverberant chamber. This paper will present the DFAT test method, the usual setup and procedure and the development and use of a closed-loop, narrow-band control system. Narrow-band control of the acoustic PSD allows all standard techniques and procedures currently used in random control to be applied to acoustics and some examples are given. The paper will conclude with a summary of the development of a standard practice guideline that is hoped to be available in the first quarter of next year.

Nonlinear adaptive control of grid-connected three-phase inverters for renewable energy applications

NASA Astrophysics Data System (ADS)

Mahdian-Dehkordi, N.; Namvar, M.; Karimi, H.; Piya, P.; Karimi-Ghartemani, M.

2017-01-01

Distributed generation (DG) units are often interfaced to the main grid using power electronic converters including voltage-source converters (VSCs). A VSC offers dc/ac power conversion, high controllability, and fast dynamic response. Because of nonlinearities, uncertainties, and system parameters' changes involved in the nature of a grid-connected renewable DG system, conventional linear control methods cannot completely and efficiently address all control objectives. In this paper, a nonlinear adaptive control scheme based on adaptive backstepping strategy is presented to control the operation of a grid-connected renewable DG unit. As compared to the popular vector control technique, the proposed controller offers smoother transient responses, and lower level of current distortions. The Lyapunov approach is used to establish global asymptotic stability of the proposed control system. Linearisation technique is employed to develop guidelines for parameters tuning of the controller. Extensive time-domain digital simulations are performed and presented to verify the performance of the proposed controller when employed in a VSC to control the operation of a two-stage DG unit and also that of a single-stage solar photovoltaic system. Desirable and superior performance of the proposed controller is observed.

Space shuttle propulsion systems on-board checkout and monitoring system development study (extension). Volume 2: Guidelines for for incorporation of the onboard checkout and monitoring function on the space shuttle

NASA Technical Reports Server (NTRS)

1972-01-01

Guidelines are presented for incorporation of the onboard checkout and monitoring function (OCMF) into the designs of the space shuttle propulsion systems. The guidelines consist of and identify supporting documentation; requirements for formulation, implementation, and integration of OCMF; associated compliance verification techniques and requirements; and OCMF terminology and nomenclature. The guidelines are directly applicable to the incorporation of OCMF into the design of space shuttle propulsion systems and the equipment with which the propulsion systems interface. The techniques and general approach, however, are also generally applicable to OCMF incorporation into the design of other space shuttle systems.

Selected Guidelines for the Management of Records and Archives: A RAMP Reader.

ERIC Educational Resources Information Center

Walne, Peter, Comp.

The guidelines contained in this book are taken from studies published by UNESCO's Records and Archives Management Program (RAMP) between 1981 and 1987. Each set of guidelines is accompanied by an introduction to provide chronological or methodological context. The guidelines are titled as follows: (1) "The Use of Sampling Techniques in the…

Cryopreservation of human sperm: efficacy and use of a new nitrogen-free controlled rate freezer versus liquid nitrogen vapour freezing.

PubMed

Creemers, E; Nijs, M; Vanheusden, E; Ombelet, W

2011-12-01

Preservation of spermatozoa is an important aspect of assisted reproductive medicine. The aim of this study was to investigate the efficacy and use of a recently developed liquid nitrogen and cryogen-free controlled rate freezer and this compared with the classical liquid nitrogen vapour freezing method for the cryopreservation of human spermatozoa. Ten patients entering the IVF programme donated semen samples for the study. Samples were analysed according to the World Health Organization guidelines. No significant difference in total sperm motility after freeze-thawing between the new technique and classical technique was demonstrated. The advantage of the new freezing technique is that it uses no liquid nitrogen during the freezing process, hence being safer to use and clean room compatible. Investment costs are higher for the apparatus but running costs are only 1% in comparison with classical liquid nitrogen freezing. In conclusion, post-thaw motility of samples frozen with the classical liquid nitrogen vapour technique was comparable with samples frozen with the new nitrogen-free freezing technique. This latter technique can thus be a very useful asset to the sperm cryopreservation laboratory. © 2011 Blackwell Verlag GmbH.

Treatment of Focal Articular Cartilage Defects in the Knee

PubMed Central

Magnussen, Robert A.; Dunn, Warren R.; Carey, James L.

2008-01-01

We asked whether autologous chondrocyte implantation or osteochondral autograft transfer yields better clinical outcomes compared with one another or with traditional abrasive techniques for treatment of isolated articular cartilage defects and whether lesion size influences this clinical outcome. We performed a literature search and identified five randomized, controlled trials and one prospective comparative trial evaluating these treatment techniques in 421 patients. The operative procedures included autologous chondrocyte implantation, osteochondral autograft transfer, matrix-induced autologous chondrocyte implantation, and microfracture. Minimum followup was 1 year (mean, 1.7 years; range, 1–3 years). All studies documented greater than 95% followup for clinical outcome measures. No technique consistently had superior results compared with the others. Outcomes for microfracture tended to be worse in larger lesions. All studies reported improvement in clinical outcome measures in all treatment groups when compared with preoperative assessment; however, no control (nonoperative) groups were used in any of the studies. A large prospective trial investigating these techniques with the addition of a control group would be the best way to definitively address the clinical questions. Level of Evidence: Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18196358

Usability and Safety in Electronic Medical Records Interface Design: A Review of Recent Literature and Guideline Formulation.

PubMed

Zahabi, Maryam; Kaber, David B; Swangnetr, Manida

2015-08-01

The objectives of this study were to (a) review electronic medical record (EMR) and related electronic health record (EHR) interface usability issues, (b) review how EMRs have been evaluated with safety analysis techniques along with any hazard recognition, and (c) formulate design guidelines and a concept for enhanced EMR interfaces with a focus on diagnosis and documentation processes. A major impact of information technology in health care has been the introduction of EMRs. Although numerous studies indicate use of EMRs to increase health care quality, there remain concerns with usability issues and safety. A literature search was conducted using Compendex, PubMed, CINAHL, and Web of Science databases to find EMR research published since 2000. Inclusion criteria included relevant English-language papers with subsets of keywords and any studies (manually) identified with a focus on EMR usability. Fifty studies met the inclusion criteria. Results revealed EMR and EHR usability problems to include violations of natural dialog, control consistency, effective use of language, effective information presentation, and customization principles as well as a lack of error prevention, minimization of cognitive load, and feedback. Studies focusing on EMR system safety made no objective assessments and applied only inductive reasoning methods for hazard recognition. On the basis of the identified usability problems and structure of safety analysis techniques, we provide EMR design guidelines and a design concept focused on the diagnosis process and documentation. The design guidelines and new interface concept can be used for prototyping and testing enhanced EMRs. © 2015, Human Factors and Ergonomics Society.

Case study: design, operation, maintenance and water quality management of sustainable storm water ponds for roof runoff.

PubMed

Scholz, Miklas

2004-12-01

The purpose of this case study was to optimise design, operation and maintenance guidelines, and to assess the water treatment potential of a storm water pond system after 15 months of operation. The system was based on a combined silt trap, attenuation pond and vegetated infiltration basin. This combination was used as the basis for construction of a roof water runoff system from a single domestic property. United Kingdom Building Research Establishment and Construction Industry Research and Information Association, and German Association for Water, Wastewater and Waste design guidelines were tested. These design guidelines failed because they did not consider local conditions. The infiltration function for the infiltration basin was logarithmic. Algal control techniques were successfully applied, and treatment of rainwater runoff from roofs was found to be largely unnecessary for recycling (e.g., watering plants). However, seasonal and diurnal variations of biochemical oxygen demand, dissolved oxygen and pH were recorded.

American Association of Dental Schools Curricular Guidelines for Oral Radiology.

ERIC Educational Resources Information Center

Journal of Dental Education, 1980

1980-01-01

Oral radiology curricular guidelines developed by the American Association of Dental Schools are provided. The guidelines describe minimal conditions under which a satisfactory educational experience can be offered. Principles of x-radiation, radiobiological concepts, radiological health, radiographic technique, radiographic quality, and darkroom…

New NASA SEE LEO Spacecraft Charging Design Guidelines: How to Survive in LEO Rather Than GEO

NASA Technical Reports Server (NTRS)

Ferguson, Dale C.; Hillard, G. Barry

2003-01-01

It has been almost two solar cycles since the 1984 GEO Guidelines of Purvis, Garrett, Whittlesey, and Stevens were published. In that time, interest in high voltage LEO systems has increased. Correct and conventional wisdom has been that LEO conditions are sufficiently different from GEO that the GEO Guidelines (and other GEO and POLAR documents produced since then) should not be used for LEO spacecraft. Because of significant recent GEO spacecraft failures that have been shown in ground testing to be likely to also occur on LEO spacecraft, the SEE program commissioned the production of the new LEO Spacecraft Charging Design Guidelines. Now available in CD-ROM form, the LEO Guidelines highlight mitigation techniques to prevent spacecraft arcing on LEO solar arrays and other systems. We compare and contrast the mitigation techniques for LEO and GEO in this paper. We also discuss the extensive bibliography included in the LEO Guidelines, so results can be found in their primary sources.

The Effect of Appropriately and Inappropriately Applied Automation for the Control of Unmanned Systems on Operator Performance

DTIC Science & Technology

2009-09-01

2.1 Participants Twelve civilians (7 men and 5 women ) with no prior experience with the Robotic NCO simulation participated in this study. The mean...operators in a multitasking environment. 15. SUBJECT TERMS design guidelines, robotics, simulation, unmanned systems, automation 16. SECURITY...model of operator performance, or a hybrid method which combines one or more of these different invocation techniques (e.g., critical events and

Authoring and verification of clinical guidelines: a model driven approach.

PubMed

Pérez, Beatriz; Porres, Ivan

2010-08-01

The goal of this research is to provide a framework to enable authoring and verification of clinical guidelines. The framework is part of a larger research project aimed at improving the representation, quality and application of clinical guidelines in daily clinical practice. The verification process of a guideline is based on (1) model checking techniques to verify guidelines against semantic errors and inconsistencies in their definition, (2) combined with Model Driven Development (MDD) techniques, which enable us to automatically process manually created guideline specifications and temporal-logic statements to be checked and verified regarding these specifications, making the verification process faster and cost-effective. Particularly, we use UML statecharts to represent the dynamics of guidelines and, based on this manually defined guideline specifications, we use a MDD-based tool chain to automatically process them to generate the input model of a model checker. The model checker takes the resulted model together with the specific guideline requirements, and verifies whether the guideline fulfils such properties. The overall framework has been implemented as an Eclipse plug-in named GBDSSGenerator which, particularly, starting from the UML statechart representing a guideline, allows the verification of the guideline against specific requirements. Additionally, we have established a pattern-based approach for defining commonly occurring types of requirements in guidelines. We have successfully validated our overall approach by verifying properties in different clinical guidelines resulting in the detection of some inconsistencies in their definition. The proposed framework allows (1) the authoring and (2) the verification of clinical guidelines against specific requirements defined based on a set of property specification patterns, enabling non-experts to easily write formal specifications and thus easing the verification process. Copyright 2010 Elsevier Inc. All rights reserved.

Learning, techniques, and complications of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Guideline.

PubMed

Polkowski, M; Larghi, A; Weynand, B; Boustière, C; Giovannini, M; Pujol, B; Dumonceau, J-M

2012-02-01

This article is the second of a two-part publication that expresses the current view of the European Society of Gastrointestinal Endoscopy (ESGE) about endoscopic ultrasound (EUS)-guided sampling, including EUS-guided fine needle aspiration (EUS-FNA) and EUS-guided Trucut biopsy. The first part (the Clinical Guideline) focused on the results obtained with EUS-guided sampling, and the role of this technique in patient management, and made recommendations on circumstances that warrant its use. The current Technical Guideline discusses issues related to learning, techniques, and complications of EUS-guided sampling, and to processing of specimens. Technical issues related to maximizing the diagnostic yield (e.g., rapid on-site cytopathological evaluation, needle diameter, microcore isolation for histopathological examination, and adequate number of needle passes) are discussed and recommendations are made for various settings, including solid and cystic pancreatic lesions, submucosal tumors, and lymph nodes. The target readership for the Clinical Guideline mostly includes gastroenterologists, oncologists, internists, and surgeons while the Technical Guideline should be most useful to endoscopists who perform EUS-guided sampling. A two-page executive summary of evidence statements and recommendations is provided. © Georg Thieme Verlag KG Stuttgart · New York.

Guidelines for research on drugged driving

PubMed Central

Walsh, J. Michael; Verstraete, Alain G.; Huestis, Marilyn A.; Mørland, Jørg

2009-01-01

Aim A major problem in assessing the true public health impact of drug-use on driving and overall traffic safety is that the variables being measured across studies vary significantly. In studies reported in a growing global literature, basic parameters assessed, analytical techniques and drugs tested are simply not comparable due to lack of standardization in the field. These shortcomings severely limit the value of this research to add knowledge to the field. A set of standards to harmonize research findings is sorely needed. This project was initiated by several international organizations to develop guidelines for research on drugged driving. Methods A September 2006 meeting of international experts discussed the harmonization of protocols for future research on drugged driving. The principal objective of the meeting was to develop a consensus report setting guidelines, standards, core data variables and other controls that would form the basis for future international research. A modified Delphi method was utilized to develop draft guidelines. Subsequently, these draft guidelines were posted on the internet for global review, and comments received were integrated into the final document. Results The Guidelines Document is divided into three major sections, each focusing upon different aspects of drugged driving research (e.g. roadside surveys, prevalence studies, hospital studies, fatality and crash investigations, etc.) within the critical issue areas of ‘behavior’, ‘epidemiology’ and ‘toxicology’. The behavioral section contains 32 specific recommendations; (2) epidemiology 40 recommendations; and (3) toxicology 64 recommendations. Conclusions It is anticipated that these guidelines will improve significantly the overall quality of drugged driving research and facilitate future cross-study comparisons nationally and globally. PMID:18855814

Evidence-based protocol for structural rehabilitation of the spine and posture: review of clinical biomechanics of posture (CBP®) publications

PubMed Central

Oakley, Paul A.; Harrison, Donald D.; Harrison, Deed E.; Haas, Jason W.

2005-01-01

BACKGROUND Although practice protocols exist for SMT and functional rehabilitation, no practice protocols exist for structural rehabilitation. Traditional chiropractic practice guidelines have been limited to acute and chronic pain treatment, with limited inclusion of functional and exclusion of structural rehabilitation procedures. OBJECTIVE (1) To derive an evidence-based practice protocol for structural rehabilitation from publications on Clinical Biomechanics of Posture (CBP®) methods, and (2) to compare the evidence for Diversified, SMT, and CBP®. METHODS Clinical control trials utilizing CBP® methods and spinal manipulative therapy (SMT) were obtained from searches in Mantis, CINAHL, and Index Medicus. Using data from SMT review articles, evidence for Diversified Technique (as taught in chiropractic colleges), SMT, and CBP® were rated and compared. RESULTS From the evidence from Clinical Control Trials on SMT and CBP®, there is very little evidence support for Diversified (our rating = 18), as taught in chiropractic colleges, for the treatment of pain subjects, while CBP® (our rating = 46) and SMT for neck pain (rating = 58) and low back pain (our rating = 202) have evidence-based support. CONCLUSIONS While CBP® Technique has approximately as much evidence-based support as SMT for neck pain, CBP® has more evidence to support its methods than the Diversified technique taught in chiropractic colleges, but not as much as SMT for low back pain. The evolution of chiropractic specialization has occurred, and doctors providing structural-based chiropractic care require protocol guidelines for patient quality assurance and standardization. A structural rehabilitation protocol was developed based on evidence from CBP® publications. PMID:17549209

Safety and quality of food contact materials. Part 1: evaluation of analytical strategies to introduce migration testing into good manufacturing practice.

PubMed

Feigenbaum, A; Scholler, D; Bouquant, J; Brigot, G; Ferrier, D; Franzl, R; Lillemarktt, L; Riquet, A M; Petersen, J H; van Lierop, B; Yagoubi, N

2002-02-01

The results of a research project (EU AIR Research Programme CT94-1025) aimed to introduce control of migration into good manufacturing practice and into enforcement work are reported. Representative polymer classes were defined on the basis of chemical structure, technological function, migration behaviour and market share. These classes were characterized by analytical methods. Analytical techniques were investigated for identification of potential migrants. High-temperature gas chromatography was shown to be a powerful method and 1H-magnetic resonance provided a convenient fingerprint of plastic materials. Volatile compounds were characterized by headspace techniques, where it was shown to be essential to differentiate volatile compounds desorbed from those generated during the thermal desorption itself. For metal trace analysis, microwave mineralization followed by atomic absorption was employed. These different techniques were introduced into a systematic testing scheme that is envisaged as being suitable both for industrial control and for enforcement laboratories. Guidelines will be proposed in the second part of this paper.

Development of Improved Oil Field Waste Injection Disposal Techniques

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

Terralog Technologies

2002-11-25

The goals of this project have was to: (1) assemble and analyze a comprehensive database of past waste injection operations; (2) develop improved diagnostic techniques for monitoring fracture growth and formation changes; (3) develop operating guidelines to optimize daily operations and ultimate storage capacity of the target formation; and (4) to apply these improved models and guidelines in the field.

A recommended early goal-directed management guideline for the prevention of hypothermia-related transfusion, morbidity, and mortality in severely injured trauma patients.

PubMed

Perlman, Ryan; Callum, Jeannie; Laflamme, Claude; Tien, Homer; Nascimento, Barto; Beckett, Andrew; Alam, Asim

2016-04-20

Hypothermia is present in up to two-thirds of patients with severe injury, although it is often disregarded during the initial resuscitation. Studies have revealed that hypothermia is associated with mortality in a large percentage of trauma cases when the patient's temperature is below 32 °C. Risk factors include the severity of injury, wet clothing, low transport unit temperature, use of anesthesia, and prolonged surgery. Fortunately, associated coagulation disorders have been shown to completely resolve with aggressive warming. Selected passive and active warming techniques can be applied in damage control resuscitation. While treatment guidelines exist for acidosis and bleeding, there is no evidence-based approach to managing hypothermia in trauma patients. We synthesized a goal-directed algorithm for warming the severely injured patient that can be directly incorporated into current Advanced Trauma Life Support guidelines. This involves the early use of warming blankets and removal of wet clothing in the prehospital phase followed by aggressive rewarming on arrival at the hospital if the patient's injuries require damage control therapy. Future research in hypothermia management should concentrate on applying this treatment algorithm and should evaluate its influence on patient outcomes. This treatment strategy may help to reduce blood loss and improve morbidity and mortality in this population of patients.

World Health Organization Guidelines: Use of cryotherapy for cervical intraepithelial neoplasia.

PubMed

Santesso, Nancy; Schünemann, Holger; Blumenthal, Paul; De Vuyst, Hugo; Gage, Julia; Garcia, Francisco; Jeronimo, Jose; Lu, Ricky; Luciani, Silvana; Quek, Swee C; Awad, Tahany; Broutet, Nathalie

2012-08-01

In 2008, cervical cancer was responsible for 275000 deaths, of which approximately 88% occurred in low- and middle-income countries. In 2009, the World Health Organization (WHO) committed to updating recommendations for use of cryotherapy for cervical intraepithelial neoplasia (CIN). We followed the WHO Handbook for Guidelines Development to develop present guidelines. An expert panel was established, which included clinicians, researchers, program directors, and methodologists. An independent group conducted systematic reviews and produced evidence summaries following the GRADE approach. GRADE evidence profiles were created for 16 key questions about the effects of cryotherapy in the presence of histologically confirmed CIN compared with no treatment and with loop electrosurgical excision procedure, as well as the use of different cryotherapy techniques. We identified a small number of randomized controlled trials or independently controlled observational studies. Surrogate outcomes were reported when evidence about outcomes critical to decision making were not available. The panel made 14 recommendations and documented factors that determined the strength and direction of the recommendations in decision tables. The present document summarizes new evidence-based WHO recommendations about the use of cryotherapy in women with histologically confirmed CIN for low-, middle-, and high-income countries. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Exertional myopathy in whooping cranes (Grus americana) with prognostic guidelines.

PubMed

Hanley, Christopher S; Thomas, Nancy J; Paul-Murphy, Joanne; Hartup, Barry K

2005-09-01

Exertional myopathy developed in three whooping cranes (Grus americana) secondary to routine capture, handling, and trauma. Presumptive diagnosis of exertional myopathy was based on history of recent capture or trauma, clinical signs, and elevation of aspartate aminotransferase, alanine aminotransferase, creatine kinase, lactate dehydrogenase, and serum potassium. Treatments were attempted in each case, but ultimately were not successful. Gross and microscopic lesions at necropsy confirmed the diagnosis in each case, with the leg musculature most severely affected. Guidelines for determining prognosis of exertional myopathy in cranes have been included based on the analysis of these cases and others in the literature. As treatment is largely unrewarding, prevention remains the key in controlling exertional myopathy. Identification of predisposing factors and proper handling, immobilization, and transportation techniques can help prevent development of exertional myopathy in cranes.

[Spanish adaptation of the 2016 European Guidelines on cardiovascular disease prevention in clinical practice].

PubMed

Royo-Bordonada, Miguel Ángel; Armario, Pedro; Lobos Bejarano, José María; Pedro-Botet, Juan; Villar Álvarez, Fernando; Elosua, Roberto; Brotons Cuixart, Carlos; Cortés, Olga; Serrano, Benilde; Camafort Babkowski, Miguel; Gil Núñez, Antonio; Pérez, Antonio; Maiques, Antonio; de Santiago Nocito, Ana; de Castro, Almudena; Alegría, Eduardo; Baeza, Ciro; Herranz, María; Sans, Susana; Campos, Pilar

The VI European Guidelines for Cardiovascular Prevention recommend combining population and high-risk strategies with lifestyle changes as a cornerstone of prevention, and propose the SCORE function to quantify cardiovascular risk. The guidelines highlight disease specific interventions, and conditions as women, young people and ethnic minorities. Screening for subclinical atherosclerosis with noninvasive imaging techniques is not recommended. The guidelines distinguish four risk levels (very high, high, moderate and low) with therapeutic objectives for lipid control according to risk. Diabetes mellitus confers a high risk, except for subjects with type 2 diabetes with less than <10 years of evolution, without other risk factors or complications, or type 1 diabetes of short evolution without complications. The decision to start pharmacological treatment of arterial hypertension will depend on the blood pressure level and the cardiovascular risk, taking into account the lesion of target organs. The guidelines don't recommend antiplatelet drugs in primary prevention because of the increased bleeding risk. The low adherence to the medication requires simplified therapeutic regimes and to identify and combat its causes. The guidelines highlight the responsibility of health professionals to take an active role in advocating evidence-based interventions at the population level, and propose effective interventions, at individual and population level, to promote a healthy diet, the practice of physical activity, the cessation of smoking and the protection against alcohol abuse. Copyright © 2017. Publicado por Elsevier España, S.L.U.

[Spanish adaptation of the 2016 European Guidelines on cardiovascular disease prevention in clinical practice].

PubMed

Royo-Bordonada, M Á; Armario, P; Lobos Bejarano, J M; Pedro-Botet, J; Villar Alvarez, F; Elosua, R; Brotons Cuixart, C; Cortés, O; Serrano, B; Cammafort Babkowski, M; Gil Núñez, A; Pérez, A; Maiques, A; de Santiago Nocito, A; Castro, A; Alegría, E; Baeza, C; Herranz, M; Sans, S; Campos, P

The VI European Guidelines for Cardiovascular Prevention recommend combining population and high-risk strategies with lifestyle changes as a cornerstone of prevention, and propose the SCORE function to quantify cardiovascular risk. The guidelines highlight disease specific interventions, and conditions as women, young people and ethnic minorities. Screening for subclinical atherosclerosis with noninvasive imaging techniques is not recommended. The guidelines distinguish four risk levels (very high, high, moderate and low) with therapeutic objectives for lipid control according to risk. Diabetes mellitus confers a high risk, except for subjects with type 2 diabetes with less than <10 years of evolution, without other risk factors or complications, or type 1 diabetes of short evolution without complications. The decision to start pharmacological treatment of arterial hypertension will depend on the blood pressure level and the cardiovascular risk, taking into account the lesion of target organs. The guidelines don't recommend antiplatelet drugs in primary prevention because of the increased bleeding risk. The low adherence to the medication requires simplified therapeutic regimes and to identify and combat its causes. The guidelines highlight the responsibility of health professionals to take an active role in advocating evidence-based interventions at the population level, and propose effective interventions, at individual and population level, to promote a healthy diet, the practice of physical activity, the cessation of smoking and the protection against alcohol abuse. Copyright © 2016. Publicado por Elsevier España, S.L.U.

Spanish adaptation of the 2016 European Guidelines on cardiovascular disease prevention in clinical practice.

PubMed

Royo-Bordonada, M Á; Armario, P; Lobos Bejarano, J M; Pedro-Botet, J; Villar Alvarez, F; Elosua, R; Brotons Cuixart, C; Cortés, O; Serrano, B; Camafort Babkowski, M; Gil Núñez, A; Pérez, A; Maiques, A; de Santiago Nocito, A; Castro, A; Alegría, E; Baeza, C; Herranz, M; Sans, S; Campos, P

The VI European Guidelines for Cardiovascular Prevention recommend combining population and high-risk strategies with lifestyle changes as a cornerstone of prevention, and propose the SCORE function to quantify cardiovascular risk. The guidelines highlight disease specific interventions, and conditions as women, young people and ethnic minorities. Screening for subclinical atherosclerosis with noninvasive imaging techniques is not recommended. The guidelines distinguish four risk levels (very high, high, moderate and low) with therapeutic objectives for lipid control according to risk. Diabetes mellitus confers a high risk, except for subjects with type 2 diabetes with less than <10 years of evolution, without other risk factors or complications, or type 1 diabetes of short evolution without complications. The decision to start pharmacological treatment of arterial hypertension will depend on the blood pressure level and the cardiovascular risk, taking into account the lesion of target organs. The guidelines don't recommend antiplatelet drugs in primary prevention because of the increased bleeding risk. The low adherence to the medication requires simplified therapeutic regimes and to identify and combat its causes. The guidelines highlight the responsibility of health professionals to take an active role in advocating evidence-based interventions at the population level, and propose effective interventions, at individual and population level, to promote a healthy diet, the practice of physical activity, the cessation of smoking and the protection against alcohol abuse. Copyright © 2017. Publicado por Elsevier España, S.L.U.

Guidelines for preparing software user documentation

NASA Technical Reports Server (NTRS)

Miller, Diane F.

1987-01-01

Clear, easy-to-use software user's manuals make strong demands on special technical communication techniques. Principles and guidelines are given for analyzing the audience and dealing with wide-ranging backgrounds of potential users. Types of information to be included in a complete manual are suggested, with a technique for creating a user-oriented rather than process-oriented organization. Accuracy verification is emphasized. Simple tips are gievn for formatting for quick comprehension and reference, for deciding on packaging, for creating helpful illustrations and examples, and for setting up clear and consistent conventions. Simple guidelines are offered for writing clearly and concisely and for editing.

Evidence-based narratives to improve recall of opioid prescribing guidelines: a randomized experiment.

PubMed

Kilaru, Austin S; Perrone, Jeanmarie; Auriemma, Catherine L; Shofer, Frances S; Barg, Frances K; Meisel, Zachary F

2014-03-01

Physicians adopt evidence-based guidelines with variable consistency. Narratives, or stories, offer a novel dissemination strategy for clinical recommendations. The study objective was to compare whether evidence-based narrative versus traditional summary improved recall of opioid prescribing guidelines from the American College of Emergency Physicians (ACEP). This was a prospective, randomized controlled experiment to compare whether narrative versus summary promoted short-term recall of six themes contained in the ACEP opioid guideline. The experiment was modeled after the free-recall test, an established technique in studies of memory. At a regional conference, emergency physicians (EPs) were randomized to read either a summary of the guideline (control) or a narrative (intervention). The fictional narrative was constructed to match the summary in content and length. One hour after reading the text, participants listed all content that they could recall. Two reviewers independently scored the responses to assess recall of the six themes. The primary outcome was the total number of themes recalled per participant. Secondary outcomes included the proportion of responses in each study arm that recalled individual themes and the proportion of responses in each arm that contained falsely recalled or extraneous information. Ninety-five physicians were randomized. Eighty-two physicians completed the experiment, for a response rate of 86%. The mean of the total number of themes recalled per participant was 3.1 in the narrative arm versus 2.0 in the summary arm (difference = 1.1, 95% confidence interval [CI] = 0.6 to 1.7). For three themes, the proportion of responses that recalled the theme was significantly greater in the narrative arm compared to the summary arm, with the differences ranging from 20% to 51%. For one theme, recall was significantly greater in the summary arm. For two themes, there was no statistically significant difference in recall between the arms. In the summary arm, 54% of responses were found to contain falsely recalled or extraneous information versus 21% of responses in the narrative arm (difference = 33%, 95% CI = 14% to 53%). Physicians exposed to a narrative about opioid guidelines were more likely to recall guideline content at 1 hour than those exposed to a summary of the guidelines. Future studies should examine whether the incorporation of narratives in dissemination campaigns improves guideline adoption and changes clinical practice

Evidence-based Narratives to Improve Recall of Opioid Prescribing Guidelines: A Randomized Experiment

PubMed Central

Kilaru, Austin S.; Perrone, Jeanmarie; Auriemma, Catherine L.; Shofer, Frances S.; Barg, Frances K.; Meisel, Zachary F.

2014-01-01

Objectives Physicians adopt evidence-based guidelines with variable consistency. Narratives, or stories, offer a novel dissemination strategy for clinical recommendations. The study objective was to compare whether evidence-based narrative versus traditional summary improved recall of opioid prescribing guidelines from the American College of Emergency Physicians (ACEP). Methods This was a prospective, randomized controlled experiment to compare whether narrative versus summary promoted short-term recall of six themes contained in the ACEP opioid guideline. The experiment was modeled after the free-recall test, an established technique in studies of memory. At a regional conference, emergency physicians were randomized to read either a summary of the guideline (control) or a narrative (intervention). The fictional narrative was constructed to match the summary in content and length. One hour after reading the text, participants listed all content that they could recall. Two reviewers independently scored the responses to assess recall of the six themes. The primary outcome was the total number of themes recalled per participant. Secondary outcomes included the proportion of responses in each study arm that recalled individual themes and the proportion of responses in each arm that contained falsely recalled or extraneous information. Results Ninety-five physicians were randomized. Eighty-two physicians completed the experiment, for a response rate of 86%. The mean of the total number of themes recalled per participant was 3.1 in the narrative arm versus 2.0 in the summary arm (difference = 1.1, 95% confidence interval [CI] = 0.6 to 1.7). For three themes, the proportion of responses that recalled the theme was significantly greater in the narrative arm compared to the summary arm, with the differences ranging from 20% to 51%. For one theme, recall was significantly greater in the summary arm. For two themes, there was no statistically significant difference in recall between the arms. In the summary arm, 54% of responses were found to contain falsely recalled or extraneous information versus 21% of responses in the narrative arm (difference = 33%, 95% CI = 14% to 53%). Conclusions Physicians exposed to a narrative about opioid guidelines were more likely to recall guideline content at 1 hour than those exposed to a summary of the guidelines. Future studies should examine whether the incorporation of narratives in dissemination campaigns improves guideline adoption and changes clinical practice. PMID:24761456

Issues regarding the usage of MPPT techniques in micro grid systems

NASA Astrophysics Data System (ADS)

Szeidert, I.; Filip, I.; Dragan, F.; Gal, A.

2018-01-01

The main objective of the control strategies applied at hybrid micro grid systems (wind/hydro/solar), that function based on maximum power point tracking (MPPT) techniques is to improve the conversion system’s efficiency and to preserve the quality of the generated electrical energy (voltage and power factor). One of the main goals of maximum power point tracking strategy is to achieve the harvesting of the maximal possible energy within a certain time period. In order to implement the control strategies for micro grid, there are typically required specific transducers (sensor for wind speed, optical rotational transducers, etc.). In the technical literature, several variants of the MPPT techniques are presented and particularized at some applications (wind energy conversion systems, solar systems, hydro plants, micro grid hybrid systems). The maximum power point tracking implementations are mainly based on two-level architecture. The lower level controls the main variable and the superior level represents the MPPT control structure. The paper presents micro grid structures developed at Politehnica University Timisoara (PUT) within the frame of a research grant. The paper is focused on the application of MPPT strategies on hybrid micro grid systems. There are presented several structures and control strategies and are highlighted their advantages and disadvantages, together with practical implementation guidelines.

75 FR 34146 - Draft Guideline for the Prevention and Control of Norovirus Gastroenteritis Outbreaks in...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Draft Guideline for the Prevention and Control of Norovirus Gastroenteritis Outbreaks in Healthcare Settings AGENCY... and comment on the Draft Guideline for the Prevention and Control of Norovirus Gastroenteritis...

Hydroxychloroquine: balancing the need to maintain therapeutic levels with ocular safety: an update.

PubMed

Abdulaziz, Nada; Shah, Anjali R; McCune, William J

2018-05-01

Antimalarial drugs including chloroquine, its less toxic quinolone-derivative hydroxychloroquine (HCQ), and quinacrine have become cornerstones in the treatment of autoimmune diseases including systemic lupus, rheumatoid arthritis, sarcoidosis, and Sjogren syndrome; cutaneous disorders, antiphospholipid syndrome, and have recently been employed at higher dioses in oncology. Benefits include anti-inflammatory effects, protection against thrombosis, and improved control of hyperglycemia and hyperlipidemia. In general, both the therapeutic advantages and the toxic effects of the drugs correlate with the dose and the duration of therapy. Here we summarize the current literature regarding the administration and the safety profile of HCQ in management of rheumatologic disease and focus on the most recent revised American Academy of Ophthalmology (AAO) guidelines for prevention and detection of hydroxychloroquine retinopathy to help guide therapeutic decision-making for patients. The risk of antimalarial-induced retinal toxicity is better predicted by calculating the daily dosage based on 5 mg/kg total body weight rather than 6.5 mg/kg lean body weight and reducing dosage in patients with risk factors such as renal failure. The risk of retinal toxicity after 5 years is substantially increased even when these guidelines are followed; hence dose reduction is appropriate with long-term use. Newer techniques provide improved detection of early signs of retinal damage. These advances are reflected in the revised AAO guidelines 2016, which are in part based on the retrospective study by Melles and Marmor of HCQ toxicity. The most important changes in practice guidelines include dose calculation based on total body weight, dose reduction after long-term use, and intensified screening with techniques including optical coherence tomography (OCT) after 5 years.

Drug Development Pipeline

MedlinePlus

... Care Guidelines Newborn Screening Clinical Care Guidelines Sweat Test Clinical Care Guidelines Infection Prevention and Control Care Guidelines Allergic Bronchopulmonary Aspergillosis Clinical Care Guidelines ...

Long life assurance study for manned spacecraft long life hardware. Volume 3: Long life assurance studies of components

NASA Technical Reports Server (NTRS)

1972-01-01

The guidelines for selecting hardware to be used in manned spacecraft to obtain a five year operational lifetime without maintenance were developed. An analysis was conducted on the design, application, failure mechanisms, manufacturing processes and controls, screen and burn-in techniques, and quality control of hardware items. The equipment considered for evaluation include: (1) electric motors and bearings; (2) accelerometers; (3) gyroscopes and bearings; (4) compressors and pumps, (5) magnetic tape recorders; (6) plumbing components and tubing; (7) check valves; (8) pressure regulators and solenoid valves; (9) thermal control valves; (10) pressure vessels and positive expulsion devices; (11) nickel cadmium batteries; and (12) transducers.

Performance of aseptic technique during neuraxial analgesia for labor before and after the publication of international guidelines on aseptic technique

PubMed Central

2014-01-01

Background Aseptic technique and handwashing have been shown to be important factors in perioperative bacterial transmission, however compliance often remains low despite guidelines and educational programs. Infectious complications of neuraxial (epidural and spinal) anesthesia are severe but fortunately rare. We conducted a survey to assess aseptic technique practices for neuraxial anesthesia in Israel before and after publication of international guidelines (which focused on handwashing, jewelry/watch removal and the wearing of a mask and cap). Methods The sampling frame was the general anesthesiology workforce in hospitals selected from each of the four medical faculties in Israel. Data was collected anonymously over one week in each hospital in two periods: April 2006 and September 2009. Most anesthesiologists received the questionnaires at departmental staff meetings and filled them out during these meetings; additionally, a local investigator approached anesthesiologists not present at these staff meetings individually. Primary endpoint questions were: handwashing, removal of wristwatch/jewelry, wearing mask, wearing hat/cap, wearing sterile gown; answering options were: "always", "usually", "rarely" or "never". Primary endpoint for analysis: respondents who both always wash their hands and always wear a mask ("handwash-mask composite") - "always" versus "any other response". We used logistic regression to perform the analysis. Time (2006, 2009) and hospital were included in the analysis as fixed effects. Results 135/160 (in 2006) and 127/164 (in 2009) anesthesiologists responded to the surveys; response rate 84% and 77% respectively. Respondents constituted 23% of the national anesthesiologist workforce. The main outcome "handwash-mask composite" was significantly increased after guideline publication (33% vs 58%; p = 0.0003). In addition, significant increases were seen for handwashing (37% vs 63%; p = 0.0004), wearing of mask (61% vs 78%; p < 0.0001), hat/cap (53% vs 76%; p = 0.0011) and wearing sterile gown (32% vs 51%; p < 0.0001). An apparent improvement in aseptic technique from 2006 to 2009 is noted across all hospitals and all physician groups. Conclusion Self-reported aseptic technique by Israeli anesthesiologists improved in the survey conducted after the publication of international guidelines. Although the before-after study design cannot prove a cause-effect relationship, it does show an association between the publication of international guidelines and significant improvement in self-reported aseptic technique. PMID:24661425

78 FR 690 - Guidelines for the Control of Tuberculosis in Elephants

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-04

...] Guidelines for the Control of Tuberculosis in Elephants AGENCY: Animal and Plant Health Inspection Service... Association to assess compliance with the animal welfare regulations as related to elephant tuberculosis as... a document entitled ``Guidelines for the Control of Tuberculosis in Elephants'' developed by The...

Rehabilitation-Oriented Serious Game Development and Evaluation Guidelines for Musculoskeletal Disorders.

PubMed

Idriss, Mohamad; Tannous, Halim; Istrate, Dan; Perrochon, Anaick; Salle, Jean-Yves; Ho Ba Tho, Marie-Christine; Dao, Tien-Tuan

2017-07-04

The progress in information and communication technology (ICT) led to the development of a new rehabilitation technique called "serious game for functional rehabilitation." Previous works have shown that serious games can be used for general health and specific disease management. However, there is still lack of consensus on development and evaluation guidelines. It is important to note that the game performance depends on the designed scenario. The objective of this work was to develop specific game scenarios and evaluate them with a panel of musculoskeletal patients to propose game development and evaluation guidelines. A two-stage workflow was proposed using determinant framework. The development guideline includes the selection of three-dimensional (3D) computer graphics technologies and tools, the modeling of physical aspects, the design of rehabilitation scenarios, and the implementation of the proposed scenarios. The evaluation guideline consists of the definition of evaluation metrics, the execution of the evaluation campaign, the analysis of user results and feedbacks, and the improvement of the designed game. The case study for musculoskeletal disorders on the healthy control and patient groups showed the usefulness of these guidelines and associated games. All participants enjoyed the 2 developed games (football and object manipulation), and found them challenging and amusing. In particular, some healthy subjects increased their score when enhancing the level of difficulty. Furthermore, there were no risks and accidents associated with the execution of these games. It is expected that with the proven effectiveness of the proposed guidelines and associated games, this new rehabilitation game may be translated into clinical routine practice for the benefit of patients with musculoskeletal disorders. ©Mohamad Idriss, Halim Tannous, Dan Istrate, Anaick Perrochon, Jean-Yves Salle, Marie-Christine Ho Ba Tho, Tien-Tuan Dao. Originally published in JMIR Serious Games (http://games.jmir.org), 04.07.2017.

Rehabilitation-Oriented Serious Game Development and Evaluation Guidelines for Musculoskeletal Disorders

PubMed Central

Istrate, Dan; Perrochon, Anaick; Salle, Jean-Yves; Ho Ba Tho, Marie-Christine

2017-01-01

Background The progress in information and communication technology (ICT) led to the development of a new rehabilitation technique called “serious game for functional rehabilitation.” Previous works have shown that serious games can be used for general health and specific disease management. However, there is still lack of consensus on development and evaluation guidelines. It is important to note that the game performance depends on the designed scenario. Objective The objective of this work was to develop specific game scenarios and evaluate them with a panel of musculoskeletal patients to propose game development and evaluation guidelines. Methods A two-stage workflow was proposed using determinant framework. The development guideline includes the selection of three-dimensional (3D) computer graphics technologies and tools, the modeling of physical aspects, the design of rehabilitation scenarios, and the implementation of the proposed scenarios. The evaluation guideline consists of the definition of evaluation metrics, the execution of the evaluation campaign, the analysis of user results and feedbacks, and the improvement of the designed game. Results The case study for musculoskeletal disorders on the healthy control and patient groups showed the usefulness of these guidelines and associated games. All participants enjoyed the 2 developed games (football and object manipulation), and found them challenging and amusing. In particular, some healthy subjects increased their score when enhancing the level of difficulty. Furthermore, there were no risks and accidents associated with the execution of these games. Conclusions It is expected that with the proven effectiveness of the proposed guidelines and associated games, this new rehabilitation game may be translated into clinical routine practice for the benefit of patients with musculoskeletal disorders. PMID:28676468

Implementation guideline for non-freeway centerline rumble strips.

DOT National Transportation Integrated Search

2015-03-01

This document presents a guideline for the : implementation of non-freeway centerline rumble : strips on high speed rural highways. It includes : recommended practices, according to MDOT : standards, and describes effective strategies and : technique...

Guidelines for Health Assessment and Intervention Techniques for 3, 4, and 5 Year Old Children.

ERIC Educational Resources Information Center

Bentley, Judy K.

These guidelines were developed to help registered nurses identify preschoolers with potential handicaps in the course of health assessments. Contents include guidelines on 3-, 4-, and 5-year-olds. Contents are organized within age levels in terms of functioning levels and anticipatory guidance. Functional areas covered include physical,…

Canadian Thoracic Society 2012 guideline update: Diagnosis and management of asthma in preschoolers, children and adults

PubMed Central

Lougheed, M Diane; Lemiere, Catherine; Ducharme, Francine M; Licskai, Chris; Dell, Sharon D; Rowe, Brian H; FitzGerald, Mark; Leigh, Richard; Watson, Wade; Boulet, Louis-Philippe

2012-01-01

BACKGROUND: In 2010, the Canadian Thoracic Society (CTS) published a Consensus Summary for the diagnosis and management of asthma in children six years of age and older, and adults, including an updated Asthma Management Continuum. The CTS Asthma Clinical Assembly subsequently began a formal clinical practice guideline update process, focusing, in this first iteration, on topics of controversy and/or gaps in the previous guidelines. METHODS: Four clinical questions were identified as a focus for the updated guideline: the role of noninvasive measurements of airway inflammation for the adjustment of anti-inflammatory therapy; the initiation of adjunct therapy to inhaled corticosteroids (ICS) for uncontrolled asthma; the role of a single inhaler of an ICS/long-acting beta2-agonist combination as a reliever, and as a reliever and a controller; and the escalation of controller medication for acute loss of asthma control as part of a self-management action plan. The expert panel followed an adaptation process to identify and appraise existing guidelines on the specified topics. In addition, literature searches were performed to identify relevant systematic reviews and randomized controlled trials. The panel formally assessed and graded the evidence, and made 34 recommendations. RESULTS: The updated guideline recommendations outline a role for inclusion of assessment of sputum eosinophils, in addition to standard measures of asthma control, to guide adjustment of controller therapy in adults with moderate to severe asthma. Appraisal of the evidence regarding which adjunct controller therapy to add to ICS and at what ICS dose to begin adjunct therapy in children and adults with poor asthma control supported the 2010 CTS Consensus Summary recommendations. New recommendations for the adjustment of controller medication within written action plans are provided. Finally, priority areas for future research were identified. CONCLUSIONS: The present clinical practice guideline is the first update of the CTS Asthma Guidelines following the Canadian Respiratory Guidelines Committee’s new guideline development process. Tools and strategies to support guideline implementation will be developed and the CTS will continue to regularly provide updates reflecting new evidence. PMID:22536582

Development of display design and command usage guidelines for Spacelab experiment computer applications

NASA Technical Reports Server (NTRS)

Dodson, D. W.; Shields, N. L., Jr.

1979-01-01

Individual Spacelab experiments are responsible for developing their CRT display formats and interactive command scenarios for payload crew monitoring and control of experiment operations via the Spacelab Data Display System (DDS). In order to enhance crew training and flight operations, it was important to establish some standardization of the crew/experiment interface among different experiments by providing standard methods and techniques for data presentation and experiment commanding via the DDS. In order to establish optimum usage guidelines for the Spacelab DDS, the capabilities and limitations of the hardware and Experiment Computer Operating System design had to be considered. Since the operating system software and hardware design had already been established, the Display and Command Usage Guidelines were constrained to the capabilities of the existing system design. Empirical evaluations were conducted on a DDS simulator to determine optimum operator/system interface utilization of the system capabilities. Display parameters such as information location, display density, data organization, status presentation and dynamic update effects were evaluated in terms of response times and error rates.

Evaluation of sterilization of dental handpieces by heating in synthetic compressor lubricant.

PubMed

Silverstone, S E; Hill, D E

1999-01-01

The Centers for Disease Control and Prevention and the American Dental Association guidelines recommend sterilization of dental handpieces after each use. Steam autoclaving is the most commonly used sterilization method. However, pressurized steam causes corrosion and partial combustion of the handpiece lubricant, leaving a sticky carbon residue on the turbine which must then be replaced after several usages. Replacement of autoclave-damaged dental handpieces represents a major expense for dentists that may be avoided through the use of less destructive sterilization techniques.

World Association for the Advancement of Veterinary Parasitology (WAAVP): Guideline for the evaluation of drug efficacy against non-coccidial gastrointestinal protozoa in livestock and companion animals.

PubMed

Geurden, T; Olson, M E; O'Handley, R M; Schetters, T; Bowman, D; Vercruysse, J

2014-08-29

The current guideline was written to aid in the design, implementation and interpretation of studies for the assessment of drug efficacy against non-coccidial gastrointestinal protozoan parasites, with Giardia spp. as the leading example. The information provided in this guideline deals with aspects of how to conduct controlled studies using experimental infection models (dose determination and dose confirmation) and efficacy studies in commercial facilities (field effectiveness studies). Furthermore, the selection of suitable animals, housing, infection procedure, choice of diagnostic technique and data analysis are discussed. This guideline is intended to assist investigators in conducting specific studies, to provide specific information for registration authorities involved in the decision-making process, to assist in the approval and registration of new drugs and to facilitate the worldwide adoption of uniform procedures. The primary parameter for drug efficacy is the reduction in either parasite excretion or parasite counts and a minimum efficacy of 90% is required against non-coccidial gastrointestinal protozoa. A supporting efficacy parameter is a significant difference in the proportion of infected animals between treated and non-treated groups. Persistent efficacy is considered as an additional claim to therapeutic efficacy. Copyright © 2014 Elsevier B.V. All rights reserved.

LIFE CYCLE ENGINEERING GUIDELINES

EPA Science Inventory

This document provides guidelines for the implementation of LCE concepts, information, and techniques in engineering products, systems, processes, and facilities. To make this document as practical and useable as possible, a unifying LCE framework is presented. Subsequent topics ...

Use of economic evaluation guidelines: 2 years' experience in Canada.

PubMed

Baladi, J F; Menon, D; Otten, N

1998-05-01

Considerable effort has been expended in recent years in the development of methodology guidelines for economic evaluation of pharmaceutical products, driven in part by the desire to improve the rigour and quality of economic evaluations and to help decision making. Canada was one of the first countries to develop such guidelines and to encourage their use. This paper examines the extent to which the economic evaluations that were submitted to the Canadian Coordinating Office for Health Technology Assessment in the last two years adhered to Canadian guidelines. The analytic technique employed by twelve studies as well as the comparator used, the perspective taken, the outcome measure selected, the cost items that were taken into consideration and the extent of sensitivity analyses that were performed are reviewed in this paper. It can be concluded that although studies have been of variable quality, the majority of them were well presented, complete and transparent, due in part to the guidelines. Except for the perspective of the analysis, guidelines were, in many respects, adhered to and did not restrict investigators to specific methodologies or specific techniques. They were also instrumental in ensuring a minimum set of standards.

Reinforced soil structures. Volume I. Design and construction guidelines

DOT National Transportation Integrated Search

1990-11-01

This report presents comprehensive guidelines for evaluating and using soil reinforcement techniques in the construction of retaining walls, embankment slopes, and natural or cut slopes. A variety of available systems for reinforced soil including in...

Reinforced soil structures. Volume I, Design and construction guidelines

DOT National Transportation Integrated Search

1990-11-01

This report presents comprehensive guidelines for evaluating and using soil reinforcement techniques in the construction of retaining walls, embankment slopes, and natural or cut slopes. A variety of available systems for reinforced soil including in...

[Intraosseous infusion. An important technique also for paediatric anaesthesia].

PubMed

Weiss, M; Henze, G; Eich, C; Neuhaus, D

2009-09-01

Timely establishment of venous access in infants and toddlers can prove a particularly challenging task. Since the 1940s the technique of intraosseous infusion has established itself as a valuable alternative means for rapid, efficient and safe delivery of drugs and fluids to critically ill children. Whereas international guidelines for paediatric emergency medical care have assigned intraosseous infusion a high priority, most anaesthetists utilize this well-proven technique with great reluctance. This article describes the technique of intraosseous infusion, introduces two different cannulation systems, and discusses its potential indications in paediatric anaesthesia, based on current emergency medical care guidelines as well as some of our own case studies. In particular, children with acutely life-threatening conditions, such as circulatory arrest, laryngospasm, acute airway haemorrhage, hypovolaemic shock or hypothermia secondary to extensive burns, should receive an intraosseous cannula if intravenous access cannot be rapidly established. Future discussion may reveal whether a transiently inserted intraosseous infusion would also be indicated if the child with difficult or impossible venous access presents without acute life-threatening conditions for anaesthesia. Successful application of the intraosseous infusion technique requires immediate access to the necessary equipment, intensive education, continuous training and clear guidelines for its application in an anaesthesia department.

Food marketing in recreational sport settings in Canada: a cross-sectional audit in different policy environments using the Food and beverage Marketing Assessment Tool for Settings (FoodMATS).

PubMed

Prowse, Rachel J L; Naylor, Patti-Jean; Olstad, Dana Lee; Carson, Valerie; Storey, Kate; Mâsse, Louise C; Kirk, Sara F L; Raine, Kim D

2018-05-31

Children's recreational sport settings typically sell energy dense, low nutrient products; however, it is unknown whether the same types of food and beverages are also marketed in these settings. Understanding food marketing in sports settings is important because the food industry often uses the promotion of physical activity to justify their products. This study aimed to document the 'exposure' and 'power' of food marketing present in public recreation facilities in Canada and assess differences between provinces with and without voluntary provincial nutrition guidelines for recreation facilities. Food marketing was measured in 51 sites using the Food and beverage Marketing Assessment Tool for Settings (FoodMATS). The frequency and repetition ('exposure') of food marketing and the presence of select marketing techniques, including child-targeted, sports-related, size, and healthfulness ('power'), were assessed. Differences in 'exposure' and 'power' characteristics between sites in three guideline provinces (n = 34) and a non-guideline province (n = 17) were assessed using Pearson's Chi squared tests of homogeneity and Mann-Whitney U tests. Ninety-eight percent of sites had food marketing present. The frequency of food marketing per site did not differ between guideline and non-guideline provinces (median = 29; p = 0.576). Sites from guideline provinces had a significantly lower proportion of food marketing occasions that were "Least Healthy" (47.9%) than sites from the non-guideline province (73.5%; p < 0.001). Use of child-targeted and sports-related food marketing techniques was significantly higher in sites from guideline provinces (9.5% and 10.9%, respectively), than in the non-guideline province (1.9% and 4.5% respectively; p values < 0.001). It was more common in the non-guideline province to use child-targeted and sports-related techniques to promote "Least Healthy" items (100.0% and 68.4%, respectively), compared to the guideline provinces (59.3% and 52.0%, respectively). Recreation facilities are a source of children's exposure to unhealthy food marketing. Having voluntary provincial nutrition guidelines that recommend provision of healthier foods was not related to the frequency of food marketing in recreation facilities but was associated with less frequent marketing of unhealthy foods. Policy makers should provide explicit food marketing regulations that complement provincial nutrition guidelines to fulfill their ethical responsibility to protect children and the settings where children spend time.

[Pharmaceutical product quality control and good manufacturing practices].

PubMed

Hiyama, Yukio

2010-01-01

This report describes the roles of Good Manufacturing Practices (GMP) in pharmaceutical product quality control. There are three keys to pharmaceutical product quality control. They are specifications, thorough product characterization during development, and adherence to GMP as the ICH Q6A guideline on specifications provides the most important principles in its background section. Impacts of the revised Pharmaceutical Affairs Law (rPAL) which became effective in 2005 on product quality control are discussed. Progress of ICH discussion for Pharmaceutical Development (Q8), Quality Risk Management (Q9) and Pharmaceutical Quality System (Q10) are reviewed. In order to reconstruct GMP guidelines and GMP inspection system in the regulatory agencies under the new paradigm by rPAL and the ICH, a series of Health Science studies were conducted. For GMP guidelines, product GMP guideline, technology transfer guideline, laboratory control guideline and change control system guideline were written. For the GMP inspection system, inspection check list, inspection memo and inspection scenario were proposed also by the Health Science study groups. Because pharmaceutical products and their raw materials are manufactured and distributed internationally, collaborations with other national authorities are highly desired. In order to enhance the international collaborations, consistent establishment of GMP inspection quality system throughout Japan will be essential.

Controlling droplet-transmitted respiratory infections

PubMed Central

Hogg, William; Huston, Patricia

2006-01-01

OBJECTIVE To promote incorporation of new guidelines on control of respiratory infections into family physicians’ practices. SOURCES OF INFORMATION The World Health Organization website on pandemic influenza, the Canadian Pandemic Influenza Plan, the Ontario guidelines on respiratory infection control, and research on implementing guidelines into family practice were reviewed. We also researched and calculated what the costs of implementing the guidelines would be. MAIN MESSAGE Effective control of respiratory infections in physicians’ offices can be achieved by displaying signs in the waiting room, having reception staff give masks to patients with cough and fever, instructing these patients to clean their hands with alcohol gel and to sit at least 1 m from others, inquiring about patients’ or their close contacts’ recent travel, using disinfectant wipes to clean possibly contaminated surfaces in waiting rooms and examining areas, and having staff and care providers wear masks and wash hands or use alcohol gel. The approximate annual cost of incorporating the guidelines is about $800 per physician. CONCLUSION Because the outbreak of an influenza pandemic is likely imminent, implementing standard guidelines for control of respiratory infections in primary care offices seems wise. Following these guidelines would help prevent patients and staff from contracting serious respiratory illnesses. PMID:17279182

Dupuytren disease: European hand surgeons, hand therapists, and physical medicine and rehabilitation physicians agree on a multidisciplinary treatment guideline: results from the HANDGUIDE study.

PubMed

Huisstede, Bionka M A; Hoogvliet, Peter; Coert, J Henk; Fridén, Jan

2013-12-01

Multidisciplinary treatment guidelines for Dupuytren disease can aid in optimizing the quality of care for patients with this disorder. Therefore, this study aimed to achieve consensus on a multidisciplinary treatment guideline for Dupuytren disease. A European Delphi consensus strategy was initiated. A systematic review reporting on the effectiveness of interventions was conducted and used as an evidence-based starting point for this study. In total, 39 experts (hand surgeons, hand therapists, and physical medicine and rehabilitation physicians) participated in the Delphi consensus strategy. Each Delphi round consisted of a questionnaire, an analysis, and a feedback report. After four Delphi rounds, consensus was achieved on the description, symptoms, and diagnosis of Dupuytren disease. No nonsurgical interventions were included in the guideline. Needle and open fasciotomy, and a limited fasciectomy and dermofasciectomy, were seen as suitable surgical techniques for Dupuytren disease. Factors relevant for choosing one of these surgical techniques were identified and divided into patient-related (age, comorbidity), disease-related (palpable cord, previous surgery in the same area, skin involvement, time of recovery, recurrences), and surgeon-related (years of experience) factors. Associations of these factors with the choice of a specific surgical technique were reported in the guideline. Postsurgical rehabilitation should always include instructions and exercise therapy; postsurgical splinting should be performed on indication. Relevant details for the use of surgical and postsurgical interventions were described. This treatment guideline is likely to promote further discussion on related clinical and scientific issues and may therefore contribute to better treatment of patients with Dupuytren disease.

Student Enrollment Forecasting Techniques for Higher Education.

ERIC Educational Resources Information Center

Ahrens, Stephen W.

Various techniques used by state agencies, secondary schools, community colleges, and large universities to forecast enrollments are described and guidelines for constructing forecasting procedures are outlined. The forecasting techniques are divided into three categories: (1) quantitative techniques based on historical data that attempt curve…

Audiologic Assessment of Infants and Toddlers.

ERIC Educational Resources Information Center

Gravel, Judith S.

This paper provides guidelines for the audiologic assessment of infants and young children, highlighting recent technologic advances in auditory electrophysiology, acoustic immitance measure procedures, and behavioral audiometric techniques. First, audiologic assessment guidelines developed by the American Speech-Language-Hearing Association are…

Development of user guidelines for ECAS display design, volume 1

NASA Technical Reports Server (NTRS)

Dodson, D. W.; Shields, N. L., Jr.

1978-01-01

Experiment computer application software (ECAS) display design and command usage guidelines were developed, which if followed by spacelab experiments, would standardize methods and techniques for data presentation and commanding via ECAS. These guidelines would provide some commonality among experiments which would enhance crew training and flight operations. The guidelines are applicable to all onboard experiment displays, whether allocated by ECAS or a dedicated experiment processor. A brief description of the spacelab data display system characteristics and of the services provided by the experiment computer operating system is included. Guidelines concerning data presentation and layout of alphanumeric and graphic information are presented along with guidelines concerning keyboard commanding and command feedback.

Active Control of Inlet Noise on the JT15D Turbofan Engine

NASA Technical Reports Server (NTRS)

Smith, Jerome P.; Hutcheson, Florence V.; Burdisso, Ricardo A.; Fuller, Chris R.

1999-01-01

This report presents the key results obtained by the Vibration and Acoustics Laboratories at Virginia Tech over the year from November 1997 to December 1998 on the Active Noise Control of Turbofan Engines research project funded by NASA Langley Research Center. The concept of implementing active noise control techniques with fuselage-mounted error sensors is investigated both analytically and experimentally. The analytical part of the project involves the continued development of an advanced modeling technique to provide prediction and design guidelines for application of active noise control techniques to large, realistic high bypass engines of the type on which active control methods are expected to be applied. Results from the advanced analytical model are presented that show the effectiveness of the control strategies, and the analytical results presented for fuselage error sensors show good agreement with the experimentally observed results and provide additional insight into the control phenomena. Additional analytical results are presented for active noise control used in conjunction with a wavenumber sensing technique. The experimental work is carried out on a running JT15D turbofan jet engine in a test stand at Virginia Tech. The control strategy used in these tests was the feedforward Filtered-X LMS algorithm. The control inputs were supplied by single and multiple circumferential arrays of acoustic sources equipped with neodymium iron cobalt magnets mounted upstream of the fan. The reference signal was obtained from an inlet mounted eddy current probe. The error signals were obtained from a number of pressure transducers flush-mounted in a simulated fuselage section mounted in the engine test cell. The active control methods are investigated when implemented with the control sources embedded within the acoustically absorptive material on a passively-lined inlet. The experimental results show that the combination of active control techniques with fuselage-mounted error sensors and passive control techniques is an effective means of reducing radiated noise from turbofan engines. Strategic selection of the location of the error transducers is shown to be effective for reducing the radiation towards particular directions in the farfield. An analytical model is used to predict the behavior of the control system and to guide the experimental design configurations, and the analytical results presented show good agreement with the experimentally observed results.

Metrology: Calibration and measurement processes guidelines

NASA Technical Reports Server (NTRS)

Castrup, Howard T.; Eicke, Woodward G.; Hayes, Jerry L.; Mark, Alexander; Martin, Robert E.; Taylor, James L.

1994-01-01

The guide is intended as a resource to aid engineers and systems contracts in the design, implementation, and operation of metrology, calibration, and measurement systems, and to assist NASA personnel in the uniform evaluation of such systems supplied or operated by contractors. Methodologies and techniques acceptable in fulfilling metrology quality requirements for NASA programs are outlined. The measurement process is covered from a high level through more detailed discussions of key elements within the process, Emphasis is given to the flowdown of project requirements to measurement system requirements, then through the activities that will provide measurements with defined quality. In addition, innovations and techniques for error analysis, development of statistical measurement process control, optimization of calibration recall systems, and evaluation of measurement uncertainty are presented.

Impact of implementing electronic clinical practice guidelines for the diagnosis, control and treatment of cardiovascular risk factors: A pre-post controlled study.

PubMed

Comin, Eva; Catalan-Ramos, Arantxa; Iglesias-Rodal, Manuel; Grau, Maria; Del Val, Jose Luis; Consola, Alicia; Amado, Ester; Pons, Angels; Mata-Cases, Manel; Franzi, Alicia; Ciurana, Ramon; Frigola, Eva; Cos, Xavier; Davins, Josep; Verdu-Rotellar, Jose M

To evaluate the impact of computerized clinical practice guidelines on the management, diagnosis, treatment, control, and follow-up of the main cardiovascular risk factors: hypertension, hypercholesterolaemia, and type 2 diabetes mellitus. Pre-post controlled study. Catalonia, autonomous community located in north-eastern Spain. Individuals aged 35-74 years assigned to general practitioners of the Catalan Health Institute. The intervention group consisted of individuals whose general practitioners had accessed the computerized clinical practice guidelines at least twice a day, while the control group consisted of individuals whose general practitioner had never accessed the computerized clinical practice guidelines platform. The Chi-squared test was used to detect significant differences in the follow-up, control, and treatment variables for all three disorders (hypertension, hypercholesterolaemia, and type 2 diabetes mellitus) between individuals assigned to users and non-users of the computerized clinical practice guidelines, respectively. A total of 189,067 patients were included in this study, with a mean age of 56 years (standard deviation 12), and 55.5% of whom were women. Significant differences were observed in hypertension management, treatment and control; type 2 diabetes mellitus management, treatment and diagnoses, and the management and control of hypercholesterolaemia in both sexes. Computerized clinical practice guidelines are an effective tool for the control and follow-up of patients diagnosed with hypertension, type 2 diabetes mellitus, and hypercholesterolaemia. The usefulness of computerized clinical practice guidelines to diagnose and adequately treat individuals with these disorders remains unclear. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Efficacy of adding the Kinesio Taping method to guideline-endorsed conventional physiotherapy in patients with chronic nonspecific low back pain: a randomised controlled trial.

PubMed

Added, Marco Aurélio Nemitalla; Costa, Leonardo Oliveira Pena; Fukuda, Thiago Yukio; de Freitas, Diego Galace; Salomão, Evelyn Cassia; Monteiro, Renan Lima; Costa, Lucíola da Cunha Menezes

2013-10-24

Chronic nonspecific low back pain is a significant health condition with high prevalence worldwide and it is associated with enormous costs to society. Clinical practice guidelines show that many interventions are available to treat patients with chronic low back pain, but the vast majority of these interventions have a modest effect in reducing pain and disability. An intervention that has been widespread in recent years is the use of elastic bandages called Kinesio Taping. Although Kinesio Taping has been used extensively in clinical practice, current evidence does not support the use of this intervention; however these conclusions are based on a small number of underpowered studies. Therefore, questions remain about the effectiveness of the Kinesio Taping method as an additional treatment to interventions, such as conventional physiotherapy, that have already been recommended by the current clinical practice guidelines in robust and high-quality randomised controlled trials. We aim to determine the effectiveness of the addition of the use of Kinesio Taping in patients with chronic nonspecific low back pain who receive guideline-endorsed conventional physiotherapy. One hundred and forty-eight patients will be randomly allocated to receive either conventional physiotherapy, which consists of a combination of manual therapy techniques, general exercises, and specific stabilisation exercises (Guideline-Endorsed Conventional Physiotherapy Group) or to receive conventional physiotherapy with the addition of Kinesio Taping to the lumbar spine (Conventional Physiotherapy plus Kinesio Taping Group) over a period of 5 weeks (10 sessions of treatment). Clinical outcomes (pain intensity, disability and global perceived effect) will be collected at baseline and at 5 weeks, 3 months, and 6 months after randomisation. We will also collect satisfaction with care and adverse effects after treatment. Data will be collected by a blinded assessor. All statistical analysis will be conducted following the principles of intention to treat, and the effects of treatment will be calculated using Linear Mixed Models. The results of this study will provide new information about the usefulness of Kinesio Taping as an additional component of a guideline-endorsed physiotherapy program in patients with chronic nonspecific low back pain.

An implementation strategy to improve the guideline adherence of insurance physicians: an experiment in a controlled setting

PubMed Central

2011-01-01

Background The aim of this study was to investigate the efficacy of a newly developed implementation strategy for the insurance medicine guidelines for depression in the Netherlands. We hypothesized that an educational intervention would increase the insurance physicians' (IPs) guideline adherence in a controlled setting. Methods Forty IPs were allocated in a randomised controlled trial (RCT) to an intervention group (IG) (n = 21) and a control group (CG) (n = 19). The IG received tailored training in applying the guidelines for depression, while the CG received an alternative programme. Baseline (T0) and follow-up (T1) measurements were conducted before and after the intervention within a period of two weeks. The intervention consisted of a workshop in which the evidence-based theory of the guidelines was translated for use in practice, with the help of various tools. The IPs had to write a case-report on the basis of video cases, two before and two after the training. Specially trained and blinded test IPs judged the case reports independently on the basis of six performance indicators. Primary outcome measure in the controlled setting of the trial was guideline adherence measured by six performance indicators on a scale of one to seven. Secondary outcome measure was knowledge of the guidelines for depression. Analyses were performed using Linear Mixed Models, and ANCOVA. Results We found significantly higher scores in the IG than in the CG at T1 for both outcomes. The interaction effect (standard error; p-value) of group crossed with time was 0.97 (0.19; p < 0.0005) for guideline adherence in the controlled setting. The group effect at T1 for the knowledge test was 0.86 (0.40; p = 0.038). Conclusions The newly developed implementation strategy for the insurance medicine guidelines for depression improved the guideline adherence of the trained IPs in disability assessments of clients with depression when performed in a controlled setting. Furthermore, the trained IPs showed gains in knowledge of the guidelines for depression. Trial registration Netherlands' Trial Register NTR1863. PMID:22188876

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

EPA Science Inventory

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

Building Consensus: Development of Best Practice Guidelines on Wrong Level Surgery in Spinal Deformity.

PubMed

Vitale, Michael; Minkara, Anas; Matsumoto, Hiroko; Albert, Todd; Anderson, Richard; Angevine, Peter; Buckland, Aaron; Cho, Samuel; Cunningham, Matthew; Errico, Thomas; Fischer, Charla; Kim, Han Jo; Lehman, Ronald; Lonner, Baron; Passias, Peter; Protopsaltis, Themistocles; Schwab, Frank; Lenke, Lawrence

Consensus-building using the Delphi and nominal group technique. To establish best practice guidelines using formal techniques of consensus building among a group of experienced spinal deformity surgeons to avert wrong-level spinal deformity surgery. Numerous previous studies have demonstrated that wrong-level spinal deformity occurs at a substantial rate, with more than half of all spine surgeons reporting direct or indirect experience operating on the wrong levels. Nevertheless, currently, guidelines to avert wrong-level spinal deformity surgery have not been developed. The Delphi process and nominal group technique were used to formally derive consensus among 16 fellowship-trained spine surgeons. Surgeons were surveyed for current practices, presented with the results of a systematic review, and asked to vote anonymously for or against item inclusion during three iterative rounds. Agreement of 80% or higher was considered consensus. Items near consensus (70% to 80% agreement) were probed in detail using the nominal group technique in a facilitated group meeting. Participants had a mean of 13.4 years of practice (range: 2-32 years) and 103.1 (range: 50-250) annual spinal deformity surgeries, with a combined total of 24,200 procedures. Consensus was reached for the creation of best practice guidelines (BPGs) consisting of 17 interventions to avert wrong-level surgery. A final checklist consisting of preoperative and intraoperative methods, including standardized vertebral-level counting and optimal imaging criteria, was supported by 100% of participants. We developed consensus-based best practice guidelines for the prevention of wrong-vertebral-level surgery. This can serve as a tool to reduce the variability in preoperative and intraoperative practices and guide research regarding the effectiveness of such interventions on the incidence of wrong-level surgery. Level V. Copyright © 2017 Scoliosis Research Society. Published by Elsevier Inc. All rights reserved.

Correcting Blindness In the Nerve Center: How To Improve Situational Awareness

DTIC Science & Technology

2015-12-01

Civil Defence Emergency Management released the Response Management, Director’s Guideline for CDEM Group and Local Controllers document in October...Defence & Emergency Management, Response Management: Director’s Guideline for CDEM Group and Local Controllers (Wellington, New Zealand: Ministry of...Response Management: Director’s Guideline for CDEM Group and Local Controllers . Wellington, New Zealand: Ministry of Civil Defence & Emergency

Correlates of meeting the combined and independent aerobic and strength exercise guidelines in hematologic cancer survivors.

PubMed

Vallerand, James R; Rhodes, Ryan E; Walker, Gordon J; Courneya, Kerry S

2017-03-28

Most previous research on the correlates of physical activity has examined the aerobic or strength exercise guidelines separately. Such an approach does not allow an examination of the correlates of meeting the combined guidelines versus a single guideline, or one guideline versus the other. Here, we report the prevalence and correlates of meeting the combined and independent exercise guidelines in hematologic cancer survivors (HCS). In a population-based, cross-sectional survey of 606 HCS from Alberta, Canada using a mailed questionnaire, we obtained separate assessments of aerobic and strength exercise behaviors, as well as separate assessments for motivations, regulations, and reflective processes using the multi-process action control framework (M-PAC). Overall, 22% of HCS met the combined exercise guideline, 22% met aerobic-only, 10% met strength-only, and 46% met neither exercise guideline. HCS were more likely to meet the combined guideline over the aerobic-only guideline if they had no children living at home, and over both the aerobic and strength-only guidelines if they had completed university. As hypothesized, those meeting the combined guideline also had a more favorable strength-specific M-PAC profile (i.e., motivations, regulations, and reflective processes) than those meeting the aerobic-only guideline, and a more favorable aerobic-specific M-PAC profile than those meeting the strength-only guideline. Interestingly and unexpectedly, HCS meeting the combined guidelines also reported significantly greater aerobic-specific perceived control, planning, and obligation/regret than those meeting the aerobic-only guideline, and greater strength-specific perceived control, planning, and obligation/regret than those meeting the strength-only guideline. Few HCS are meeting the combined exercise guidelines. M-PAC based variables are strong correlates of meeting the combined guidelines compared to aerobic or strength only guidelines. Strategies to help HCS meet the combined guidelines may need to promote more favorable behavioral regulations and reflective processes for both types of exercise rather than just the type of exercise in which HCS are deficient.

Periodontics and the new CDC guidelines.

PubMed

Basquill, Linda C; Basquill, Patrick J

2004-07-01

On December 19, 2003, the Centers for Disease Control and Prevention released the Guidelines for Infection Control in Dental Health-Care Settings--2003. The publication was the first comprehensive dental infection control update since 1993. Although the guidelines are not directed toward a particular dental specialty, some recommendations may have a significant impact on the practice of periodontics because of the nature of the procedures that are considered routine to the specialty. This article deals with some of the issues addressed in the guidelines, highlighting topics of special interest to periodontists.

Successful emergency pain control for posterior rib fractures with ultrasound-guided erector spinae plane block.

PubMed

Luftig, Josh; Mantuani, Daniel; Herring, Andrew A; Dixon, Brittany; Clattenburg, Eben; Nagdev, Arun

2017-12-28

The Eastern Association for the Surgery of Trauma and Trauma Anesthesiology Society Guidelines recommend prompt and effective multimodal analgesia for rib fractures that combines regional anesthesia (RA) techniques with pharmacotherapy to treat pain, optimize pulmonary function, and reduce opioid related complications. However, RA techniques such as epidurals and paravertebral blocks, are generally underutilized or unavailable for emergency department (ED) patients. The recently described serratus anterior plane block (SAPB) is a promising technique, but failures with posterior rib fractures have been observed. The erector spinae plane block (ESPB) is conceptually similar to the SAPB, but targets the posterior thorax making it likely more effective for ED patients with posterior rib fractures. Our initial experience demonstrates consistent success with the ESPB for traumatic posterior rib fracture analgesia. Herein, we present the first description of the ESPB utilized in the ED. Copyright © 2017 Elsevier Inc. All rights reserved.

Research Gaps in Practice Guidelines for Acute Postoperative Pain Management in Adults: Findings From a Review of the Evidence for an American Pain Society Clinical Practice Guideline.

PubMed

Gordon, Debra B; de Leon-Casasola, Oscar A; Wu, Christopher L; Sluka, Kathleen A; Brennan, Timothy J; Chou, Roger

2016-02-01

Acute postoperative pain is a common clinical condition that, when poorly controlled, can result in a number of significant negative consequences. The American Pain Society commissioned an evidence-based guideline on the management of postoperative pain to promote evidence-based, safe, and effective perioperative pain management. An interdisciplinary panel developed 31 key questions and inclusion criteria to guide the evidence review. Investigators reviewed 6556 abstracts from multiple electronic databases up to November 2012, an updated evidence review to October 2014, and key references suggested by expert reviewers. More than 800 primary studies not included in a systematic review and 107 systematic reviews were included. Despite a large body of evidence, a number of critical research gaps were identified where only low-quality or insufficient evidence was found to help guide clinical practice recommendations. This report identifies evidence gaps including optimal methods and timing of perioperative patient education, nonpharmacological modalities, combinations of analgesic techniques, monitoring of patient response to treatment, techniques for neuraxial and regional analgesia, and organizational care delivery models. Recommendations to help guide the design of future perioperative studies are offered. Acute postoperative pain is a common clinical condition requiring an evidence-based, planned, and multimodal approach. Despite the plethora of published evidence, much of it is weak and key questions remain unanswered. Researchers are encouraged to work together to produce strong evidence to help guide clinical decisions in perioperative pain management. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

Application Guidelines for Quality Assurance Procedures for Hybrid Microcircuits.

DTIC Science & Technology

1983-03-01

INSPECTION LIMITS SYMBOL TEST CONDITIONS UNITS SUBGROUP 6 TC = -55 DEGREES C AVI0 1 SAME AS SUBGROUP 5 -0.1 5 Vpp VOS SAME AS SUBGROUP 4 50 m%LC V0 2 ... 1 . Line Certification 2 . Fabrication Techniques and Material Qualification Procedures 3. Design Guidelines e. Application Guidelines. Items a through... 1 2 . GENERAL ................... ......... ................. 3 2.1 Summary of documents generated ........................ 3 2.2 Contract objectives

Not of one mind: mental models of clinical practice guidelines in the Veterans Health Administration.

PubMed

Hysong, Sylvia J; Best, Richard G; Pugh, Jacqueline A; Moore, Frank I

2005-06-01

The purpose of this paper is to present differences in mental models of clinical practice guidelines (CPGs) among 15 Veterans Health Administration (VHA) facilities throughout the United States. Two hundred and forty-four employees from 15 different VHA facilities across four service networks around the country were invited to participate. Participants were selected from different levels throughout each service setting from primary care personnel to facility leadership. This qualitative study used purposive sampling, a semistructured interview process for data collection, and grounded theory techniques for analysis. A semistructured interview was used to collect information on participants' mental models of CPGs, as well as implementation strategies and barriers in their facility. Analysis of these interviews using grounded theory techniques indicated that there was wide variability in employees' mental models of CPGs. Findings also indicated that high-performing facilities exhibited both (a) a clear, focused shared mental model of guidelines and (b) a tendency to use performance feedback as a learning opportunity, thus suggesting that a shared mental model is a necessary but not sufficient step toward successful guideline implementation. We conclude that a clear shared mental model of guidelines, in combination with a learning orientation toward feedback are important components for successful guideline implementation and improved quality of care.

The Interview as a Technique for Assessing Oral Ability: Some Guidelines for Its Use.

ERIC Educational Resources Information Center

Nambiar, Mohana

1990-01-01

Some guidelines are offered that detail the complexities involved in interviewing for language testing purposes. They cover strategies for structuring interviews (informal conversational, interview guide, standardized open-ended), questions, interviewing skills, and physical setting. (five references) (LB)

INTERIM RADON-RESISTANT CONTRUCTION GUIDELINES FOR USE IN FLORIDA, 1989

EPA Science Inventory

The report gives results of a project to investigate, analyze, and develop radon-resistant construction guidelines that are consistent with other building codes and that could be applied to Florida. Literature search resulted in information on radon remediation techniques, new c...

Curricular Guidelines for Dental Auxiliary Radiology.

ERIC Educational Resources Information Center

Journal of Dental Education, 1981

1981-01-01

AADS curricular guidelines suggest objectives for these areas of dental auxiliary radiology: physical principles of X-radiation in dentistry, related radiobiological concepts, principles of radiologic health, radiographic technique, x-ray films and intensifying screens, factors contributing to film quality, darkroom, and normal variations in…

Clinical practice guidelines for the diagnosis and management of osteoporosis. Scientific Advisory Board, Osteoporosis Society of Canada.

PubMed Central

1996-01-01

OBJECTIVE: To recommend clinical practice guidelines for the assessment of people at risk for osteoporosis, and for effective diagnosis and management of the condition. OPTIONS: Screening and diagnostic methods: risk-factor assessment, clinical evaluation, measurement of bone mineral density, laboratory investigations. Prophylactic and corrective therapies: calcium and vitamin D nutritional supplementation, physical activity and fall-avoidance techniques, ovarian hormone therapy, bisphosphonate drugs, other drug therapies. Pain-management medications and techniques. OUTCOMES: Prevention of loss of bone mineral density and fracture; increased bone mass; and improved quality of life. EVIDENCE: Epidemiologic and clinical studies and reports were examined, with emphasis on recent randomized controlled trials. Clinical practice in Canada and elsewhere was surveyed. Availability of treatment products and diagnostic equipment in Canada was considered. VALUES: Cost-effective methods and products that can be adopted across Canada were considered. A high value was given to accurate assessment of fracture risk and osteoporosis, and to increasing bone mineral density, reducing fractures and fracture risk and minimizing side effects of diagnosis and treatment. BENEFITS, HARMS AND COSTS: Proper diagnosis and management of osteoporosis minimize injury and disability, improve quality of life for patients and reduce costs to society. Rationally targeted methods of screening and diagnosis are safe and cost effective. Harmful side effects and costs of recommended therapies are minimal compared with the harms and costs of untreated osteoporosis. Alternative therapies provide a range of choices for physicians and patients. RECOMMENDATIONS: Population sets at high risk should be identified and then the diagnosis confirmed through bone densitometry. Dual-energy x-ray absorptiometry is the preferred measurement technique. Radiography can be adjunct when indicated. Calcium and vitamin D nutritional supplementation should be at currently recommended levels. Patients should be counselled in fall-avoidance techniques and exercises. Immobilization should be avoided. Guidelines for management of acute pain are listed. Ovarian hormone therapy is the therapy of choice for osteoporosis prevention and treatment in postmenopausal women. Bisphosphonates are an alternative therapy for women with established osteoporosis who cannot or prefer not to take ovarian hormone therapy. PMID:8873639

Conceptual Design Optimization of an Augmented Stability Aircraft Incorporating Dynamic Response and Actuator Constraints

NASA Technical Reports Server (NTRS)

Welstead, Jason; Crouse, Gilbert L., Jr.

2014-01-01

Empirical sizing guidelines such as tail volume coefficients have long been used in the early aircraft design phases for sizing stabilizers, resulting in conservatively stable aircraft. While successful, this results in increased empty weight, reduced performance, and greater procurement and operational cost relative to an aircraft with optimally sized surfaces. Including flight dynamics in the conceptual design process allows the design to move away from empirical methods while implementing modern control techniques. A challenge of flight dynamics and control is the numerous design variables, which are changing fluidly throughout the conceptual design process, required to evaluate the system response to some disturbance. This research focuses on addressing that challenge not by implementing higher order tools, such as computational fluid dynamics, but instead by linking the lower order tools typically used within the conceptual design process so each discipline feeds into the other. In thisresearch, flight dynamics and control was incorporated into the conceptual design process along with the traditional disciplines of vehicle sizing, weight estimation, aerodynamics, and performance. For the controller, a linear quadratic regulator structure with constant gains has been specified to reduce the user input. Coupling all the disciplines in the conceptual design phase allows the aircraft designer to explore larger design spaces where stabilizers are sized according to dynamic response constraints rather than historical static margin and volume coefficient guidelines.

Aerodynamic investigations into various low speed L/D improvement devices on the 140A/B space shuttle orbiter configuration in the Rockwell International low speed wind tunnel (OA86)

NASA Technical Reports Server (NTRS)

Mennell, R. C.

1974-01-01

Tests were conducted to investigate various base drag reduction techniques in an attempt to improve Orbiter lift-to-drag ratios and to calculate sting interference effects on the Orbiter aerodynamic characteristics. Test conditions and facilites, and model dimensional data are presented along with the data reduction guidelines and data set/run number collation used for the studies. Aerodynamic force and moment data and the results of stability and control tests are also given.

Payload crew interface design criteria and techniques. Task 1: Inflight operations and training for payloads. [space shuttles

NASA Technical Reports Server (NTRS)

Carmean, W. D.; Hitz, F. R.

1976-01-01

Guidelines are developed for use in control and display panel design for payload operations performed on the aft flight deck of the orbiter. Preliminary payload procedures are defined. Crew operational concepts are developed. Payloads selected for operational simulations were the shuttle UV optical telescope (SUOT), the deep sky UV survey telescope (DUST), and the shuttle UV stellar spectrograph (SUSS). The advanced technology laboratory payload consisting of 11 experiments was selected for a detailed evaluation because of the availability of operational data and its operational complexity.

Prenatal Diagnosis Procedures and Techniques to Obtain a Diagnostic Fetal Specimen or Tissue: Maternal and Fetal Risks and Benefits.

PubMed

Wilson, R Douglas; Gagnon, Alain; Audibert, François; Campagnolo, Carla; Carroll, June

2015-07-01

To provide maternity care providers and their patients with current evidence-based guidelines for maternal risk/benefit counselling for a prenatally identified at-risk pregnancy that requires ultrasound-guided prenatal diagnostic procedures and/or techniques for a genetic diagnosis and for subsequent pregnancy management decisions on questions such as level of obstetrical care provider, antenatal surveillance, location of care and delivery, and continuation or termination of pregnancy. This guideline is limited to maternal risk/benefit counselling and pregnancy management decisions for women who require, or are considering, an invasive ultrasound-guided procedure or technique for prenatal diagnosis. Pregnant women identified as having an increased risk of a fetal genetic abnormality secondary to the process of established prenatal screening protocols (maternal serum±imaging, high-risk cell-free DNA results, abnormal diagnostic fetal imaging, or a positive family history of an inherited condition). These women may require or request counselling about pregnancy risks and benefits of an invasive ultrasound-guided procedure to determine the etiology, diagnosis, and/or pathology for the possible fetal anomaly or anomalies. Published literature was retrieved through searches of Medline, PubMed, and the Cochrane Library in and prior to June 2014 using an appropriate controlled vocabulary (prenatal diagnosis, amniocentesis, chorionic villi sampling, cordocentesis) and key words (prenatal screening, prenatal genetic counselling, post-procedural pregnancy loss rate). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies written in English and published from January 1985 to June 2014. Searches were updated on a regular basis and incorporated in the guideline to June 2014. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical speciality societies. The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table 1). Health benefits, side effects, and risks: Patient informed consent, knowledge translation, genetic prenatal risk assessment, anxiety relief, anxiety creation, advocacy, understanding or limitation for fetal testing, pregnancy management choice, pregnancy complication or loss, timely and improved care for birth of a neonate with recognized morbidity. Recommendations 1. The health care provider should counsel the at-risk pregnant woman on the different levels of genetic fetal testing in order for her to have a clear understanding and expectation of the level of testing and type of results that are offered. (III-B) 2. As part of the informed consent process, the health care provider should review with the at-risk pregnant woman the risks and benefits of in utero genetic diagnostic techniques associated with fetal genetic testing options. (III-A) 3. During risk/benefit counselling, the health care provider should advise that the best estimate of the pregnancy loss rate related to: a.amniocentesis is 0.5% to 1.0% (range 0.17 to 1.53%) (I) b.chorionic villus sampling is 0.5% to 1.0% (I) and c.cordocentesis or percutaneous umbilical blood sampling is 1.3% for fetuses with no anomalies and 1.3% to 25% for fetuses with single or multiple anomalies or intrauterine growth restriction. (II-2A).

Palliative radiation therapy for bone metastases: Update of an ASTRO Evidence-Based Guideline.

PubMed

Lutz, Stephen; Balboni, Tracy; Jones, Joshua; Lo, Simon; Petit, Joshua; Rich, Shayna E; Wong, Rebecca; Hahn, Carol

The purpose is to provide an update the Bone Metastases Guideline published in 2011 based on evidence complemented by expert opinion. The update will discuss new high-quality literature for the 8 key questions from the original guideline and implications for practice. A systematic PubMed search from the last date included in the original Guideline yielded 414 relevant articles. Ultimately, 20 randomized controlled trials, 32 prospective nonrandomized studies, and 4 meta-analyses/pooled analyses were selected and abstracted into evidence tables. The authors synthesized the evidence and reached consensus on the included recommendations. Available literature continues to support pain relief equivalency between single and multiple fraction regimens for bone metastases. High-quality data confirm single fraction radiation therapy may be delivered to spine lesions with acceptable late toxicity. One prospective, randomized trial confirms both peripheral and spine-based painful metastases can be successfully and safely palliated with retreatment for recurrence pain with adherence to published dosing constraints. Advanced radiation therapy techniques such as stereotactic body radiation therapy lack high-quality data, leading the panel to favor its use on a clinical trial or when results will be collected in a registry. The panel's conclusion remains that surgery, radionuclides, bisphosphonates, and kyphoplasty/vertebroplasty do not obviate the need for external beam radiation therapy. Updated data analysis confirms that radiation therapy provides excellent palliation for painful bone metastases and that retreatment is safe and effective. Although adherence to evidence-based medicine is critical, thorough expert radiation oncology physician judgment and discretion regarding number of fractions and advanced techniques are also essential to optimize outcomes when considering the patient's overall health, life expectancy, comorbidities, tumor biology, anatomy, previous treatment including prior radiation at or near current site of treatment, tumor and normal tissue response history to local and systemic therapies, and other factors related to the patient, tumor characteristics, or treatment. Copyright © 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Predictive Modeling and Optimization of Vibration-assisted AFM Tip-based Nanomachining

NASA Astrophysics Data System (ADS)

Kong, Xiangcheng

The tip-based vibration-assisted nanomachining process offers a low-cost, low-effort technique in fabricating nanometer scale 2D/3D structures in sub-100 nm regime. To understand its mechanism, as well as provide the guidelines for process planning and optimization, we have systematically studied this nanomachining technique in this work. To understand the mechanism of this nanomachining technique, we firstly analyzed the interaction between the AFM tip and the workpiece surface during the machining process. A 3D voxel-based numerical algorithm has been developed to calculate the material removal rate as well as the contact area between the AFM tip and the workpiece surface. As a critical factor to understand the mechanism of this nanomachining process, the cutting force has been analyzed and modeled. A semi-empirical model has been proposed by correlating the cutting force with the material removal rate, which was validated using experimental data from different machining conditions. With the understanding of its mechanism, we have developed guidelines for process planning of this nanomachining technique. To provide the guideline for parameter selection, the effect of machining parameters on the feature dimensions (depth and width) has been analyzed. Based on ANOVA test results, the feature width is only controlled by the XY vibration amplitude, while the feature depth is affected by several machining parameters such as setpoint force and feed rate. A semi-empirical model was first proposed to predict the machined feature depth under given machining condition. Then, to reduce the computation intensity, linear and nonlinear regression models were also proposed and validated using experimental data. Given the desired feature dimensions, feasible machining parameters could be provided using these predictive feature dimension models. As the tip wear is unavoidable during the machining process, the machining precision will gradually decrease. To maintain the machining quality, the guideline for when to change the tip should be provided. In this study, we have developed several metrics to detect tip wear, such as tip radius and the pull-off force. The effect of machining parameters on the tip wear rate has been studied using these metrics, and the machining distance before a tip must be changed has been modeled using these machining parameters. Finally, the optimization functions have been built for unit production time and unit production cost subject to realistic constraints, and the optimal machining parameters can be found by solving these functions.

NASA's Technical Handbook for Avoiding On-Orbit ESD Anomalies Due to Internal Charging Effects

NASA Technical Reports Server (NTRS)

Whittlesey, Albert; Garrett, Henry B.

1996-01-01

This paper describes NASA-HDBK-4002, "Avoiding Problems Caused by Spacecraft On-Orbit Internal Charging Effects". The handbook includes a description of internal charging and why it is of concern to spacecraft designers. It also suggests how to determine when a project needs to consider internal spacecraft charging, it contains an electron penetration depth chart, rationale for a critical electron flux criterion, a worst-case geosynchronous electron plasma spectrum, general design guidelines, quantitative design guidelines, and a typical materials characteristics list. Appendices include a listing of some environment codes, electron transport codes, a discussion of geostationary electron plasma environments, a brief description of electron beam and other materials tests, and transient susceptibility tests. The handbook will be in the web page, hftp://standards.nasa.gov. A prior document, NASA TP2361 "Design Guidelines for Assessing and controlling Spacecraft Charging Effects", 1984, is in use to describe mitigation techniques for the effects of surface charging of satellites in space plasma environments. HDBK-4002 is meant to complement 2361 and together, the pair of documents describe both cause and mitigation designs for problems caused by energetic space plasmas.

Guidelines for Preservation, Conservation, and Restoration of Local History and Local Genealogical Materials.

ERIC Educational Resources Information Center

RQ, 1993

1993-01-01

Presents guidelines adopted by the American Library Association (ALA) relating to the preservation, conservation, and restoration of local history and local genealogical materials. Topics addressed include assessing preservation needs; developing a plan; choosing appropriate techniques, including microduplication, photoduplication, electronic…

A "good practice" approach to the quality and consistency of morphological examination of the internal head structures of the term rabbit fetus.

PubMed

French, Julian M

2014-07-01

Variation in the interpretation of the regulatory guidelines has resulted in a diversity of techniques employed to examine the internal structures of the foetal rabbit head. Examination of the foetal rabbit brain, using a single transverse section as the sole technique, is considered not to be sufficiently thorough to be regarded as an adequate examination method. It is not compliant with published EPA and OECD guidelines covering required examination of the internal head structures, nor is it considered to conform to the spirit of the safety assessment required by the ICH guideline. Fixation of approximately half of the heads in each litter to allow the examination of multiple transverse sections enables the major structures within the head to be assessed effectively. This method is compliant with current guidelines, represents "good practice" and should be consistently adopted for the examination of the internal head structures of the term rabbit foetus. Copyright © 2014 Elsevier Inc. All rights reserved.

[Use of multiple regression models in observational studies (1970-2013) and requirements of the STROBE guidelines in Spanish scientific journals].

PubMed

Real, J; Cleries, R; Forné, C; Roso-Llorach, A; Martínez-Sánchez, J M

In medicine and biomedical research, statistical techniques like logistic, linear, Cox and Poisson regression are widely known. The main objective is to describe the evolution of multivariate techniques used in observational studies indexed in PubMed (1970-2013), and to check the requirements of the STROBE guidelines in the author guidelines in Spanish journals indexed in PubMed. A targeted PubMed search was performed to identify papers that used logistic linear Cox and Poisson models. Furthermore, a review was also made of the author guidelines of journals published in Spain and indexed in PubMed and Web of Science. Only 6.1% of the indexed manuscripts included a term related to multivariate analysis, increasing from 0.14% in 1980 to 12.3% in 2013. In 2013, 6.7, 2.5, 3.5, and 0.31% of the manuscripts contained terms related to logistic, linear, Cox and Poisson regression, respectively. On the other hand, 12.8% of journals author guidelines explicitly recommend to follow the STROBE guidelines, and 35.9% recommend the CONSORT guideline. A low percentage of Spanish scientific journals indexed in PubMed include the STROBE statement requirement in the author guidelines. Multivariate regression models in published observational studies such as logistic regression, linear, Cox and Poisson are increasingly used both at international level, as well as in journals published in Spanish. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Tokyo Guidelines 2018: management strategies for gallbladder drainage in patients with acute cholecystitis (with videos).

PubMed

Mori, Yasuhisa; Itoi, Takao; Baron, Todd H; Takada, Tadahiro; Strasberg, Steven M; Pitt, Henry A; Ukai, Tomohiko; Shikata, Satoru; Noguchi, Yoshinori; Teoh, Anthony Yuen Bun; Kim, Myung-Hwan; Asbun, Horacio J; Endo, Itaru; Yokoe, Masamichi; Miura, Fumihiko; Okamoto, Kohji; Suzuki, Kenji; Umezawa, Akiko; Iwashita, Yukio; Hibi, Taizo; Wakabayashi, Go; Han, Ho-Seong; Yoon, Yoo-Seok; Choi, In-Seok; Hwang, Tsann-Long; Chen, Miin-Fu; Garden, O James; Singh, Harjit; Liau, Kui-Hin; Huang, Wayne Shih-Wei; Gouma, Dirk J; Belli, Giulio; Dervenis, Christos; de Santibañes, Eduardo; Giménez, Mariano Eduardo; Windsor, John A; Lau, Wan Yee; Cherqui, Daniel; Jagannath, Palepu; Supe, Avinash Nivritti; Liu, Keng-Hao; Su, Cheng-Hsi; Deziel, Daniel J; Chen, Xiao-Ping; Fan, Sheung Tat; Ker, Chen-Guo; Jonas, Eduard; Padbury, Robert; Mukai, Shuntaro; Honda, Goro; Sugioka, Atsushi; Asai, Koji; Higuchi, Ryota; Wada, Keita; Yoshida, Masahiro; Mayumi, Toshihiko; Hirata, Koichi; Sumiyama, Yoshinobu; Inui, Kazuo; Yamamoto, Masakazu

2018-01-01

Since the publication of the Tokyo Guidelines in 2007 and their revision in 2013, appropriate management for acute cholecystitis has been more clearly established. Since the last revision, several manuscripts, especially for alternative endoscopic techniques, have been reported; therefore, additional evaluation and refinement of the 2013 Guidelines is required. We describe a standard drainage method for surgically high-risk patients with acute cholecystitis and the latest developed endoscopic gallbladder drainage techniques described in the updated Tokyo Guidelines 2018 (TG18). Our study confirmed that percutaneous transhepatic gallbladder drainage should be considered the first alternative to surgical intervention in surgically high-risk patients with acute cholecystitis. Also, endoscopic transpapillary gallbladder drainage or endoscopic ultrasound-guided gallbladder drainage can be considered in high-volume institutes by skilled endoscopists. In the endoscopic transpapillary approach, either endoscopic naso-gallbladder drainage or gallbladder stenting can be considered for gallbladder drainage. We also introduce special techniques and the latest outcomes of endoscopic ultrasound-guided gallbladder drainage studies. Free full articles and mobile app of TG18 are available at: http://www.jshbps.jp/modules/en/index.php?content_id=47. Related clinical questions and references are also included. © 2017 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

[Guidelines on medically assisted reproduction: legal issues and professional liability].

PubMed

Molinelli, A; Motroni Gherardi, S M; Picchioni, D M; Ventura, F

2007-08-01

The authors analyze the legal and medico-legal issues deriving from the recent Law No. 40 of February 19, 2004 concerning the Medically Assisted Reproduction. In particular, they analyze the contrasting points between the dispositions of Law No. 40/2004 and those of Law No. 194/1978 on the voluntary interruption of pregnancy, and they analyze the guidelines about the procedures and the techniques of the Medically Assisted Reproduction, issued by the Ministry of Health with D.M. of July 21, 2004. The Guidelines, as well as some sentences of several courts, lead to some reflections also about the consent and the professional liability, in particular considering the various moments of the medical action, from the first interview to the carrying out of the assisted reproduction techniques.

40 CFR 60.22 - Publication of guideline documents, emission guidelines, and final compliance times.

Code of Federal Regulations, 2010 CFR

2010-07-01

... for the design, installation, and startup of identified control systems. (5) An emission guideline... different emission guidelines or compliance times or both for different sizes, types, and classes of...

Ministerial Directive No. 1072, June 1985.

PubMed

1988-01-01

This Directive contains nonmandatory guidelines and recommendations for in vitro fertilization and embryo transfer in Chile. The Guidelines are based on the assumption that the constitutional guarantee of the right of the child to be born includes the right to procreate. They set forth the medical reasons for the use of these assisted reproduction techniques, procedures to be followed by institutions applying these techniques, technical facilities, qualifications of medical staff, and the manner in which records are kept. They recommend the mandatory appointment of an Ethics Committee and the obligation to advise couples using these techniques. They also recommend the requirement that all normal and fertilized ovules be returned to the mother and not stored or used for research. full text

Multilevel Modeling and Policy Development: Guidelines and Applications to Medical Travel.

PubMed

Garcia-Garzon, Eduardo; Zhukovsky, Peter; Haller, Elisa; Plakolm, Sara; Fink, David; Petrova, Dafina; Mahalingam, Vaishali; Menezes, Igor G; Ruggeri, Kai

2016-01-01

Medical travel has expanded rapidly in recent years, resulting in new markets and increased access to medical care. Whereas several studies investigated the motives of individuals seeking healthcare abroad, the conventional analytical approach is limited by substantial caveats. Classical techniques as found in the literature cannot provide sufficient insight due to the nested nature of data generated. The application of adequate analytical techniques, specifically multilevel modeling, is scarce to non-existent in the context of medical travel. This study introduces the guidelines for application of multilevel techniques in public health research by presenting an application of multilevel modeling in analyzing the decision-making patterns of potential medical travelers. Benefits and potential limitations are discussed.

Multilevel Modeling and Policy Development: Guidelines and Applications to Medical Travel

PubMed Central

Garcia-Garzon, Eduardo; Zhukovsky, Peter; Haller, Elisa; Plakolm, Sara; Fink, David; Petrova, Dafina; Mahalingam, Vaishali; Menezes, Igor G.; Ruggeri, Kai

2016-01-01

Medical travel has expanded rapidly in recent years, resulting in new markets and increased access to medical care. Whereas several studies investigated the motives of individuals seeking healthcare abroad, the conventional analytical approach is limited by substantial caveats. Classical techniques as found in the literature cannot provide sufficient insight due to the nested nature of data generated. The application of adequate analytical techniques, specifically multilevel modeling, is scarce to non-existent in the context of medical travel. This study introduces the guidelines for application of multilevel techniques in public health research by presenting an application of multilevel modeling in analyzing the decision-making patterns of potential medical travelers. Benefits and potential limitations are discussed. PMID:27252672

Guidelines for the effective operation and control of VDOT permanent variable message sign and highway advisory radio units : state of the practice and recommendations : technical assistance report.

DOT National Transportation Integrated Search

1996-01-01

On January 31, 1996, VDOT's Statewide Incident Management (SIM) Committee requested that guidelines for the control of permanent variable message sign (VMS) and permanent highway advisory radio (HAR) units be developed. The guidelines do not address ...

Oral History: Playing by the Rules.

ERIC Educational Resources Information Center

Oshinsky, David M.

1990-01-01

Describes oral history interviewing techniques that the author used to research his biography of Joseph McCarthy before the American Historical Association (AHA) issued its seven guidelines on interview use. These guidelines focus on taping sessions, signed releases, written transcripts, respecting human dignity, and placing materials in archive…

Noise Assessment Guidelines.

ERIC Educational Resources Information Center

Schultz, Theodore J.; McMahon, Nancy M.

The Department of Housing and Urban Development (HUD), in its efforts to provide decent housing and a suitable living environment, is concerned with noise as a major source of environmental pollution. To this end, these guidelines are presented to provide site screening techniques. The procedures described have been developed so that people…

Navajo Area Health and Physical Education Curriculum Guidelines.

ERIC Educational Resources Information Center

Tomah, Kent; And Others

Based on health education needs of Navajo children as established by the Navajo Area health and physical education committees, this curriculum guideline for health and physical education is delineated into three phases reflecting emphasis of instructional techniques (introductory, exploration/extended learning, widened learning) and three levels…

Extraterrestrial Hemorrhage Control: Terrestrial Developments in Technique, Technology, and Philosophy with Applicability to Traumatic Hemorrhage in Space

NASA Technical Reports Server (NTRS)

Kirkpatrick, Andrew; Dawson, David; Campbell, Mark; Jones, Jeff; Ball, Chad G.; Hamilton, Douglas R.; Dulchavsky, Scott; McBeth, Paul; Holcomb, John

2004-01-01

Managing injury and illness during long duration space flight limits efforts to explore beyond low earths orbit. Traumatic injury may be expected to occur in space and is a frequent cause of preventable deaths, often related to uncontrolled or ongoing hemorrhage (H). Such bleeding causes 40% of terrestrial injury mortality. Current guidelines emphasize early control of H compared to intravenous infusions. Recent advances in surgical and critical care may be applicable to trauma care in space, with appropriate considerations of the extreme logistical and personnel limitations. Methods: Recent developments in technique, resuscitation fluids, hemoglobin (Hb) substitutes, hemostatic agents, interventional angiography, damage control principles, and concepts related to suspended animation were reviewed. Results: H associated with instability frequently requires definitive intervention. Direct pressure should be applied to all compressible bleeding, but novel approaches are required for intracavitary noncompressible bleeding. Intravenous hemostatic agents such as recombinant Factor VII may facilitate hemostasis especially when combined with a controlled hypotension approach. Both open and laparoscopic techniques could be used in weightlessness, but require technical expertise not likely to be available. Specific rehearsed invasive techniques such as laparotomy with packing, or arterial catherterization with with robotic intravascular embolization might be considered . Hemodynamic support, thermal manipulation, or pharmacologic induction of a state of metabolic down regulation for whole body preservation may be appropriate. Hypertonic saline, with or without dextran, may temporize vascular support and decrease reperfusion injury, with less mass than other solutions. Hb substitutes have other theoretical advantages. Conclusions: Terrestrial developments suggest potential novel strategies to control H in space, but will required a coordinated program of evaluation and training to evaluate.

Technique for Periarticular Local Infiltrative Anesthesia Delivery Using Liposomal Bupivacaine in Total Knee Arthroplasty.

PubMed

Connelly, Jacob O; Edwards, Paul K; Mears, Simon C; Barnes, C Lowry

2015-01-01

Postoperative pain control after total knee arthroplasty is a major contributing factor to patient satisfaction, rehabilitation, and length of stay. Current clinical practice guidelines recommend a multimodal pain management protocol, including the use of regional anesthesia. Periarticular injection (PAI) has been shown to provide excellent pain relief after total knee arthroplasty. Recently, liposomal bupivacaine has been introduced as a long-acting alternative to traditional local anesthetics, such as bupivacaine or ropivacaine. Liposomal bupivacaine is a sustained-release preparation designed to provide local analgesia up to 72 hours after initial application. The efficacy of PAI relies significantly on a meticulous, systematic injection technique. This article details recommendations for solution preparation and injection during total knee arthroplasty on the basis of the experience of a high-volume orthopaedic reconstruction service.

Design guidelines for assessing and controlling spacecraft charging effects

NASA Technical Reports Server (NTRS)

Purvis, C. K.; Garrett, H. B.; Whittlesey, A. C.; Stevens, N. J.

1984-01-01

The need for uniform criteria, or guidelines, to be used in all phases of spacecraft design is discussed. Guidelines were developed for the control of absolute and differential charging of spacecraft surfaces by the lower energy space charged particle environment. Interior charging due to higher energy particles is not considered. A guide to good design practices for assessing and controlling charging effects is presented. Uniform design practices for all space vehicles are outlined.

Design guidelines for assessing and controlling spacecraft charging effects

NASA Technical Reports Server (NTRS)

Purvis, C. K.; Garrett, H. B.; Whittlesey, A.; Stevens, N. J.

1985-01-01

The need for uniform criteria, or guidelines, to be used in all phases of spacecraft design is discussed. Guidelines were developed for the control of absolute and differential charging of spacecraft surfaces by the lower energy space charged particle environment. Interior charging due to higher energy particles is not considered. A guide to good design practices for assessing and controlling charging effects is presented. Uniform design practices for all space vehicles are outlined.

The evidence-practice gap in specialist mental healthcare: systematic review and meta-analysis of guideline implementation studies.

PubMed

Girlanda, Francesca; Fiedler, Ines; Becker, Thomas; Barbui, Corrado; Koesters, Markus

2017-01-01

Clinical practice guidelines are not easily implemented, leading to a gap between research synthesis and their use in routine care. To summarise the evidence relating to the impact of guideline implementation on provider performance and patient outcomes in mental healthcare settings, and to explore the performance of different strategies for guideline implementation. A systematic review of randomised controlled trials, controlled clinical trials and before-and-after studies comparing guideline implementation strategies v. usual care, and different guideline implementation strategies, in patients with severe mental illness. In total, 19 studies met our inclusion criteria. The studies did not show a consistent positive effect of guideline implementation on provider performance, but a more consistent small to modest positive effect on patient outcomes. Guideline implementation does not seem to have an impact on provider performance, nonetheless it may influence patient outcomes positively. © The Royal College of Psychiatrists 2017.

Awareness of radiographic guidelines for low back pain: a survey of Australian chiropractors.

PubMed

Jenkins, Hazel J

2016-01-01

Chiropractors have been shown to refer for lumbar radiography in clinical scenarios inconsistent with the current clinical guidelines for low back pain. It is unknown whether this is due to lack of adherence with known guidelines or a lack of awareness of relevant guidelines. Therefore, the aim of this study is to determine Australian chiropractors' awareness of, and reported adherence to, radiographic guidelines for low back pain. Demographic, chiropractic practice and radiographic usage characteristics will be investigated for association with poor guideline adherence. An online survey was distributed to Australian chiropractors from July to September, 2014. Survey questions assessed demographic, chiropractic practice and radiographic usage characteristics, awareness of radiographic guidelines for low back pain and the level of agreement with current guidelines. Results were analysed with descriptive statistics and logistic regression analysis. There were 480 surveys completed online. Only 49.6 % (95 % confidence interval (95 % CI): 44.9, 54.4) reported awareness of radiographic guidelines for low back pain. Chiropractors reported a likelihood of referring for radiographs for low back pain: in new patients (47.6 % (95 % CI: 42.9, 52.3)); to confirm biomechanical pathologies (69.0 % (95 % CI: 64.5, 73.1)); to perform biomechanical analysis (37.5 % (95 % CI: 33.1, 42.0)); or to screen for contraindications (39.4 % (95 % CI: 35.0, 44.0)). Chiropractors agreed that radiographs for low back pain could be useful for: acute low back pain (54.0 % (95 % CI: 49.2, 58.7)); screening for contraindications (55.8 % (95 % CI: 51.0, 60.5)); or to confirm diagnosis and direct treatment (61.3 % (95 % CI: 56.5, 65.9)). Poorer adherence to current guidelines was seen if the chiropractor referred to in-house radiographic facilities, practiced a technique other than diversified technique or was unaware or unsure of current radiographic guidelines for low back pain. Only 50 % of Australian chiropractors report awareness of current radiographic guidelines for low back pain. A poorer awareness of guidelines is associated with an increase in the reported likelihood of use, and the perceived usefulness of radiographs for low back pain, in clinical situations that fall outside of current guidelines. Therefore, education strategies may help to increase guideline knowledge and compliance.

Implementation of a solvent management program to control paint shop volatile organic compounds

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

Floer, M.M.; Hicks, B.H.

1997-12-31

The majority of automobile assembly plant volatile organic compound (VOC) emissions are generated from painting operations. Typical paint operations generate more than 90 percent of the total plant emissions and, up to, 50 percent can be released by cleaning sources. Plant practices which contribute to the release of VOC emissions include the cleaning of paint lines and equipment, tanks, spray booths, floors and vehicles. Solvents continue to be the largest contributing source of VOC emissions in an automotive paint shop. To reduce overall VOC emissions, environmental regulations and guidelines were introduced under the Clean Air Act; Pollution Prevention and Wastemore » Minimization programs, Control Techniques, and special air permit conditions. The introduction of these regulations and guidelines has driven industry toward continual refinement of their present cleaning methods while pursuing new techniques and technologies. Industry has also shown a proactive approach by introducing new waterborne and powder coating paint technologies to reduce overall emissions. As new paint technologies are developed and introduced, special attention must be given to the types of materials utilized for cleaning. The development and implementation of a solvent management program allows a facility to standardize a program to properly implement materials, equipment, technologies and work practices to reduce volatile organic compound emissions, meet strict cleaning requirements posed by new paint technologies and produce a vehicle which meets the high quality standards of the customer. This paper will assess the effectiveness of a solvent management program by examining pollution prevention initiatives and data from four different painting operations.« less

Looking at Yourself through Loving Eyes.

ERIC Educational Resources Information Center

Childers, John H., Jr.

1989-01-01

Introduces and discusses Neuro-Linquistic Programming (NLP) using "Looking at Yourself through Loving Eyes" technique. Presents the seven steps necessary in implementing this technique, and provides guidelines. Presents results suggesting that this technique is useful when working with elementary school students, and is a useful tool for…

Management guidelines for monitoring use on backcountry trails

Treesearch

R. E. Leonard; H. E. Echelberger; H. J. Plumley; L. W. Van Meter

1980-01-01

This state-of-the-art management guideline describes the importance of knowing backcountry use patterns and the questions that should be asked before embarking on a use-monitoring program. It summarizes information about six techniques for monitoring use of backcountry trails and provides practical information about site suitabilities, installation and maintenance...

2008 interim guidelines for growing longleaf pine seedlings in container nurseries

Treesearch

R. Kasten Dumroese; James P. Barnett; D. Paul Jackson; Mark J. Hainds

2013-01-01

Production of container longleaf pine (Pinus palustris Mill.) seedlings for reforestation and restoration exceeds that of bare-root production, but information on container production techniques has been slow to develop. Because outplanting success requires quality seedlings, interim guidelines were proposed in 2002 to assist nursery managers and...

2008 interim guidelines for growing longleaf pine seedlings in container nurseries

Treesearch

R. Kasten Dumroese; James P. Barnett; D. Paul Jackson; Mark J. Hainds

2009-01-01

Production of container longleaf pine (Pinus palustris) seedlings for reforestation and restoration plantings exceeds that of bareroot production, but information on container production techniques has been slow to develop. Because success of those outplantings requires quality seedlings, interim guidelines were proposed in 2002 to assist nursery...

An Introduction to Archival Automation: A RAMP Study with Guidelines.

ERIC Educational Resources Information Center

Cook, Michael

Developed under a contract with the International Council on Archives, these guidelines are designed to emphasize the role of automation techniques in archives and records services, provide an indication of existing computer systems used in different archives services and of specific computer applications at various stages of archives…

Not of One Mind: Mental Models of Clinical Practice Guidelines in the Veterans Health Administration

PubMed Central

Hysong, Sylvia J; Best, Richard G; Pugh, Jacqueline A; Moore, Frank I

2005-01-01

Objective The purpose of this paper is to present differences in mental models of clinical practice guidelines (CPGs) among 15 Veterans Health Administration (VHA) facilities throughout the United States. Data Sources Two hundred and forty-four employees from 15 different VHA facilities across four service networks around the country were invited to participate. Participants were selected from different levels throughout each service setting from primary care personnel to facility leadership. Study Design This qualitative study used purposive sampling, a semistructured interview process for data collection, and grounded theory techniques for analysis. Data Collection A semistructured interview was used to collect information on participants' mental models of CPGs, as well as implementation strategies and barriers in their facility. Findings Analysis of these interviews using grounded theory techniques indicated that there was wide variability in employees' mental models of CPGs. Findings also indicated that high-performing facilities exhibited both (a) a clear, focused shared mental model of guidelines and (b) a tendency to use performance feedback as a learning opportunity, thus suggesting that a shared mental model is a necessary but not sufficient step toward successful guideline implementation. Conclusions We conclude that a clear shared mental model of guidelines, in combination with a learning orientation toward feedback are important components for successful guideline implementation and improved quality of care. PMID:15960693

Emerging technologies and procedures: results of an online survey and real-time poll.

PubMed

Verma, Richa; Eid, George; Ali, Mohamed; Saber, Alan; Pryor, Aurora D

2015-01-01

Many new techniques and bariatric endoluminal procedures are being developed and used for the treatment of obesity. Clear guidelines or opinions of the new techniques are not readily available. The aim of this study was to gauge the level of interest and opinions of bariatric surgeons regarding these new techniques, using online and real poll surveys. The American Society for Metabolic and Bariatric Surgery (ASMBS) Emerging Technologies committee developed a questionnaire that was distributed among the membership and conducted a live poll of attendees at Obesity Week 2013. Opinions of new technologies and techniques by practitioners were assessed. A total of 134 responses to the questionnaire were returned. Most responses (79%) expressed the belief that new bariatric techniques are needed to improve the practice of bariatric and metabolic surgery. The responses describing the effects of new procedures and technology as beneficial were (1) increased interest from patients or referring physicians (94%), (2) expanded indications for intervention (93%), and (3) lower risk intervention (96%). Nearly all respondents (90.2%) identified value in informational guidelines on new technologies and procedures, and most (88.7%) agreed that the ASMBS should coordinate clinical trials or registries to evaluate these therapies. Although most bariatric and metabolic surgeons agree that new endoluminal surgical techniques are beneficial, most also are unable to offer the procedures to their patients without more clinical evidence and clear guidelines from the society. Copyright © 2015 American Society for Metabolic and Bariatric Surgery. All rights reserved.

Hand hygiene prior to contact lens handling is problematical.

PubMed

McMonnies, Charles W

2012-04-01

To establish guidelines for contact lens wearers' hand hygiene practices which achieve a balance between minimising risk of infection and reasonable expectations on the ability of patients to follow them. Evidence has been obtained from publications via PubMed, Advanced Medline Search, Cochrane Reviews, Google Scholar and using the key words hand hygiene, washing and contact lens. Guidelines for effective hand washing and the bother involved vary according to the level of hygiene required. High levels of non-compliance with hand hygiene practices, even among healthcare workers, gives an indication of how important the level of bother involved when following guidelines can be in contributing to non-compliance. Better patient education to improve hand washing techniques as well as patient attitudes toward hand hygiene are needed to reduce high non-compliance levels. Better hand hygiene techniques and higher frequency of their application give the prospect of reduced risk of infection and of any discomfort that arises from increased lens and ocular bioburden. In order that adoption rates might be maximised, the guidelines which have been distilled from this review attempt to strike a balance between technique redundancy and the associated higher levels of hygiene achieved and the possibility that the perception of too much bother involved could reduce participation rates. The guidelines have been expanded by the inclusion of suggested explanatory information in the expectation that helping patients to understand why the recommendations are made will have the effect of increasing their adoption. Copyright © 2011 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Quality control in the diagnosis of Trichuris trichiura and Ascaris lumbricoides using the Kato-Katz technique: experience from three randomised controlled trials.

PubMed

Speich, Benjamin; Ali, Said M; Ame, Shaali M; Albonico, Marco; Utzinger, Jürg; Keiser, Jennifer

2015-02-05

An accurate diagnosis of soil-transmitted helminthiasis is important for individual patient management, for drug efficacy evaluation and for monitoring control programmes. The Kato-Katz technique is the most widely used method detecting soil-transmitted helminth eggs in faecal samples. However, detailed analyses of quality control, including false-positive and faecal egg count (FEC) estimates, have received little attention. Over a 3-year period, within the frame of a series of randomised controlled trials conducted in Pemba, United Republic of Tanzania, 10% of randomly selected Kato-Katz thick smears were re-read for Trichuris trichiura and Ascaris lumbricoides eggs. In case of discordant result (i.e. positive versus negative) the slides were re-examined a third time. A result was assumed to be false-positive or false-negative if the result from the initial reading did not agree with the quality control as well as the third reading. We also evaluated the general agreement in FECs between the first and second reading, according to internal and World Health Organization (WHO) guidelines. From the 1,445 Kato-Katz thick smears subjected to quality control, 1,181 (81.7%) were positive for T. trichiura and 290 (20.1%) were positive for A. lumbricoides. During quality control, very low rates of false-positive results were observed; 0.35% (n = 5) for T. trichiura and 0.28% (n = 4) for A. lumbricoides. False-negative readings of Kato-Katz thick smears were obtained in 28 (1.94%) and 6 (0.42%) instances for T. trichiura and A. lumbricoides, respectively. A high frequency of discordant results in FECs was observed (i.e. 10.0-23.9% for T. trichiura, and 9.0-11.4% for A. lumbricoides). Our analyses show that the rate of false-positive diagnoses of soil-transmitted helminths is low. As the probability of false-positive results increases after examination of multiple stool samples from a single individual, the potential influence of false-positive results on epidemiological studies and anthelminthic drug efficacy studies should be determined. Existing WHO guidelines for quality control might be overambitious and might have to be revised, specifically with regard to handling disagreements in FECs.

Guidelines for the processing and quality assurance of benthic invertebrate samples collected as part of the National Water-Quality Assessment Program

USGS Publications Warehouse

Cuffney, T.F.; Gurtz, M.E.; Meador, M.R.

1993-01-01

Benthic invertebrate samples are collected as part of the U.S. Geological Survey's National Water-Quality Assessment Program. This is a perennial, multidisciplinary program that integrates biological, physical, and chemical indicators of water quality to evaluate status and trends and to develop an understanding of the factors controlling observed water quality. The Program examines water quality in 60 study units (coupled ground- and surface-water systems) that encompass most of the conterminous United States and parts of Alaska and Hawaii. Study-unit teams collect and process qualitative and semi-quantitative invertebrate samples according to standardized procedures. These samples are processed (elutriated and subsampled) in the field to produce as many as four sample components: large-rare, main-body, elutriate, and split. Each sample component is preserved in 10-percent formalin, and two components, large-rare and main-body, are sent to contract laboratories for further processing. The large-rare component is composed of large invertebrates that are removed from the sample matrix during field processing and placed in one or more containers. The main-body sample component consists of the remaining sample materials (sediment, detritus, and invertebrates) and is subsampled in the field to achieve a volume of 750 milliliters or less. The remaining two sample components, elutriate and split, are used for quality-assurance and quality-control purposes. Contract laboratories are used to identify and quantify invertebrates from the large-rare and main-body sample components according to the procedures and guidelines specified within this document. These guidelines allow the use of subsampling techniques to reduce the volume of sample material processed and to facilitate identifications. These processing procedures and techniques may be modified if the modifications provide equal or greater levels of accuracy and precision. The intent of sample processing is to determine the quantity of each taxon present in the semi-quantitative samples or to list the taxa present in qualitative samples. The processing guidelines provide standardized laboratory forms, sample labels, detailed sample processing flow charts, standardized format for electronic data, quality-assurance procedures and checks, sample tracking standards, and target levels for taxonomic determinations. The contract laboratory (1) is responsible for identifications and quantifications, (2) constructs reference collections, (3) provides data in hard copy and electronic forms, (4) follows specified quality-assurance and quality-control procedures, and (5) returns all processed and unprocessed portions of the samples. The U.S. Geological Survey's Quality Management Group maintains a Biological Quality-Assurance Unit, located at the National Water-Quality Laboratory, Arvada, Colorado, to oversee the use of contract laboratories and ensure the quality of data obtained from these laboratories according to the guidelines established in this document. This unit establishes contract specifications, reviews contractor performance (timeliness, accuracy, and consistency), enters data into the National Water Information System-II data base, maintains in-house reference collections, deposits voucher specimens in outside museums, and interacts with taxonomic experts within and outside the U.S. Geological Survey. This unit also modifies the existing sample processing and quality-assurance guidelines, establishes criteria and testing procedures for qualifying potential contract laboratories, identifies qualified taxonomic experts, and establishes voucher collections.

78 FR 36698 - Microbiology Devices; Reclassification of Nucleic Acid-Based Systems for Mycobacterium tuberculosis

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-19

... specimens from class III (premarket approval) into class II (special controls). FDA is also issuing the draft special controls guideline entitled ``Class II Special Controls Guideline: Nucleic Acid-Based In... regulatory controls needed to provide reasonable assurance of their safety and effectiveness. The three...

Perioperative Pain Management in Total Hip Arthroplasty: Korean Hip Society Guidelines

PubMed Central

Kim, Yeesuk; Cho, Hong-Man; Park, Kyung-Soon; Yoon, Pil Whan; Nho, Jae-Hwi; Kim, Sang-Min; Lee, Kyung-Jae; Moon, Kyong-Ho

2016-01-01

Effective perioperative pain management techniques and accelerated rehabilitation programs can improve health-related quality of life and functional status of patients after total hip arthroplasty. Traditionally, postoperative analgesia following arthroplasty was provided by intravenous patient-controlled analgesia or epidural analgesia. Recently, peripheral nerve blockade has emerged alternative analgesic approach. Multimodal analgesia strategy combines analgesics with different mechanisms of action to improve pain management. Intraoperative periarticular injection of multimodal drugs is one of the most important procedures in perioperative pain control for total hip arthroplasty. The goal of this review article is to provide a concise overview of the principles of multimodal pain management regimens as a practical guide for the perioperative pain management for total hip arthroplasty. PMID:27536639

The Development of Human Factor Guidelines for Unmanned Aircraft System Control Stations

NASA Technical Reports Server (NTRS)

Hobbs, Alan

2014-01-01

Despite being referred to as unmanned some of the major challenges confronting unmanned aircraft systems (UAS) relate to human factors. NASA is conducting research to address the human factors relevant to UAS access to non-segregated airspace. This work covers the issues of pilot performance, interaction with ATC, and control station design. A major outcome of this research will be recommendations for human factors design guidelines for UAS control stations to support routine beyond-line-of-sight operations in the US national airspace system (NAS). To be effective, guidelines must be relevant to a wide range of systems, must not be overly prescriptive, and must not impose premature standardization on evolving technologies. In developing guidelines, we recognize that existing regulatory and guidance material may already provide adequate coverage of certain issues. In other cases suitable guidelines may be found in existing military or industry human factors standards. In cases where appropriate existing standards cannot be identified, original guidelines will be proposed.

Treatise on water hammer in hydropower standards and guidelines

NASA Astrophysics Data System (ADS)

Bergant, A.; Karney, B.; Pejović, S.; Mazij, J.

2014-03-01

This paper reviews critical water hammer parameters as they are presented in official hydropower standards and guidelines. A particular emphasize is given to a number of IEC standards and guidelines that are used worldwide. The paper critically assesses water hammer control strategies including operational scenarios (closing and opening laws), surge control devices (surge tank, pressure regulating valve, flywheel, etc.), redesign of the water conveyance system components (tunnel, penstock), or limitation of operating conditions (limited operating range) that are variably covered in standards and guidelines. Little information is given on industrial water hammer models and solutions elsewhere. These are briefly introduced and discussed in the light of capability (simple versus complex systems), availability of expertise (in house and/or commercial) and uncertainty. The paper concludes with an interesting water hammer case study referencing the rules and recommendations from existing hydropower standards and guidelines in a view of effective water hammer control. Recommendations are given for further work on development of a special guideline on water hammer (hydraulic transients) in hydropower plants.

Quality Control Guidelines for SAM Chemical Methods

EPA Pesticide Factsheets

Learn more about quality control guidelines and recommendations for the analysis of samples using the chemistry methods listed in EPA's Selected Analytical Methods for Environmental Remediation and Recovery (SAM).

Quality Control Guidelines for SAM Pathogen Methods

EPA Pesticide Factsheets

Learn more about quality control guidelines and recommendations for the analysis of samples using the biotoxin methods listed in EPA's Selected Analytical Methods for Environmental Remediation and Recovery (SAM).

Quality Control Guidelines for SAM Radiochemical Methods

EPA Pesticide Factsheets

Learn more about quality control guidelines and recommendations for the analysis of samples using the radiochemistry methods listed in EPA's Selected Analytical Methods for Environmental Remediation and Recovery (SAM).

General Quality Control (QC) Guidelines for SAM Methods

EPA Pesticide Factsheets

Learn more about quality control guidelines and recommendations for the analysis of samples using the methods listed in EPA's Selected Analytical Methods for Environmental Remediation and Recovery (SAM).

Quality Control Guidelines for SAM Biotoxin Methods

EPA Pesticide Factsheets

Learn more about quality control guidelines and recommendations for the analysis of samples using the pathogen methods listed in EPA's Selected Analytical Methods for Environmental Remediation and Recovery (SAM).

Adherence to infection control guidelines in surgery on MRSA positive patients : A cost analysis.

PubMed

Saegeman, V; Schuermans, A

2016-09-01

In surgical units, similar to other healthcare departments, guidelines are used to curb transmission of methicillin resistant Staphylococcus aureus (MRSA). The aim of this study was to calculate the extra costs for material and extra working hours for compliance to MRSA infection control guidelines in the operating rooms of a University Hospital. The study was based on observations of surgeries on MRSA positive patients. The average cost per surgery was calculated utilizing local information on unit costs. Robustness of the calculations was evaluated with a sensitivity analysis. The total extra costs of adherence to MRSA infection control guidelines averaged € 340.46 per surgical procedure (range € 207.76- € 473.15). A sensitivity analysis based on a standardized operating room hourly rate reached a cost of € 366.22. The extra costs of adherence to infection control guidelines are considerable. To reduce costs, the logistical planning of surgeries could be improved by for instance a dedicated room.

Guidelines for the creation and management of geographic data bases within a GIS environment, version 1.0

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

Durfee, R.C.; Land, M.L.; McCord, R.A.

1994-07-01

A Geographic Information System (GIS) provides the ability to manage and analyze all types of geographic and environmental information. It performs these functions by providing the tools necessary to capture, access, analyze, and display spatially referenced information in graphic and tabular form. Typical data elements that can be visualized in a map might include roads, buildings, topography, streams, waste areas, monitoring wells, groundwater measurements, soil sample results, landcover, and demography. The intent of this document is to provide data management and quality assurance (QA) guidelines that will aid implementors and users of GIS technology and data bases. These guidelines shouldmore » be useful in all, phases of GIS activities, including the following: (1) project planning, (2) data collection and generation, (3) data maintenance and management, (4) QA and standards, (5) project implementation, (6) spatial analysis and data interpretation, (7) data transformation and exchange, and (8) output and reporting. The daily use of desktop GIS technologies within Martin Marietta Energy Systems, Inc. (Energy Systems), is a relatively new phenomenon, but usage is increasing rapidly. Large volumes of GIS-related data are now being collected and analyzed for the U.S. Department of Energy (DOE) Oak Ridge Reservation (ORR) and its facilities. It is very important to establish and follow good data management practices for GIS. In the absence of such practices, data-related problems will overwhelm users for many years. In comparison with traditional data processing and software life-cycle management, there is limited information on GIS QA techniques, data standards and structures, configuration control, and documentation practices. This lack of information partially results from the newness of the technology and the complexity of spatial information and geographic analysis techniques as compared to typical tabular data management.« less

Salient Features and Outline of the Joint Japanese Guidelines for Safe Handling of Cancer Chemotherapy Drugs

PubMed Central

Kanda, Kiyoko; Hirai, Kazue; Iino, Keiko; Nomura, Hisanaga; Yasui, Hisateru; Kano, Taro; Ichikawa, Chisato; Hiura, Sumiko; Morita, Tomoko; Mitsuma, Ayako; Komatsu, Hiroko

2017-01-01

The purpose of this paper is to introduce the outline and describe the salient features of the “Joint Guidelines for Safe Handling of Cancer Chemotherapy Drugs” (hereinafter, “Guideline”), which were published in July 2015. The purpose of this Guideline is to provide guidance to protect against occupational exposure to hazardous drugs (HDs) to all medical personnel involved in cancer chemotherapy, including physicians, pharmacists, and nurses and home health-care providers. The Guideline was developed according to the Medical Information Network Distribution Service guidance for developing clinical practice guidelines, with reference to five authoritative guidelines used worldwide. PubMed, Cumulative Index to Nursing and Allied Health Literature, Ichushi-Web, and Cochrane Central Register of Controlled Trials were used for a systematic search of the literature. Eight clinical questions (CQs) were eventually established, and the strength of recommendation for each CQ is presented based on 867 references. The salient features of the Guideline are that it was jointly developed by three societies (Japanese Society of Cancer Nursing, Japanese Society of Medical Oncology, and Japanese Society of Pharmaceutical Oncology), contains descriptions including the definition of HDs and the concept of hierarchy of controls, and addresses exposure control measures during handling of chemotherapy drugs. Our future task is to collect additional evidence for the recommended exposure control measures and to assess whether publication of the Guideline has led to adherence of measures to prevent occupational exposure. PMID:28966958

ITC Guidelines on Quality Control in Scoring, Test Analysis, and Reporting of Test Scores

ERIC Educational Resources Information Center

Allalouf, Avi

2014-01-01

The Quality Control (QC) Guidelines are intended to increase the efficiency, precision, and accuracy of the scoring, analysis, and reporting process of testing. The QC Guidelines focus on large-scale testing operations where multiple forms of tests are created for use on set dates. However, they may also be used for a wide variety of other testing…

Laboratory guidelines for the diagnosis and follow-up of patients with monoclonal gammopathies.

PubMed

Bravo García-Morato, M; Padilla-Merlano, B; Nozal, P; Espiño, M; Juárez, C; Villar, L M; López-Trascasa, M

2016-04-01

We present guidelines from the Immunochemistry group of the Spanish Society for Immunology that are designed to provide a practical tool for the diagnosis and follow-up of monoclonal gammopathies. We review the clinical and analytical features of various monoclonal gammopathies, international consensus guidelines and techniques used to detect and follow-up monoclonal components. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

Quality assurance: recommended guidelines for safe heating by capacitive-type heating technique to treat patients with metallic implants.

PubMed

Kato, Hirokazu; Kondo, Motoharu; Imada, Hajime; Kuroda, Masahiro; Kamimura, Yoshitsugu; Saito, Kazuyuki; Kuroda, Kagayaki; Ito, Koichi; Takahashi, Hideaki; Matsuki, Hidetoshi

2013-05-01

This article is a redissemination of the previous Japanese Quality Assurance Guide guidelines. Specific absorption rate and temperature distribution were investigated with respect to various aspects including metallic implant size and shape, insertion site, insertion direction, blood flow and heating power, and simulated results were compared with adverse reactions of patients treated by radio frequency capacitive-type heating. Recommended guidelines for safe heating methods for patients with metallic implants are presented based on our findings.

Accounting guidelines for HMOs: issues and practices.

PubMed

Ingram, R W; Robbins, W A

1987-03-01

HMOs are fast becoming an important part of the healthcare industry today. Unfortunately, specific accounting guidelines have not yet been established for them. This concern has led the AICPA to describe and offer recommendations concerning preferred accounting techniques for HMOs. This article looks at the issues raised by the AICPA and how current HMO financial officers feel about the practices that are recommended. It is suggested that the organization, taxability, and other attributes of an HMO must be clearly understood before strict accounting guidelines are imposed.

National Economic Development Procedures Manual - Urban Flood Damage. Volume 2: Primer for Surveying Flood Damage for Residential Structures and Contents

DTIC Science & Technology

1991-10-01

procedures and techniques to measure flood damage and to further implement the Principles and Guidelines of the U.S. Water Resources Council. This manual... guidelines for using the OMB approved questionnaires are provided in Engineer Regulation 1105-2-100. The compendium provides the analyst with a helpful...question content, the analyst must also comply with OMB guidelines concerning implementation of the Privacy Act of 1974 (P.L. 93-579). This Act requires

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

PubMed

Giordana, P; Miserey, G

2014-12-01

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

Towards a new surface and internal charging design guideline for the 21st century

NASA Technical Reports Server (NTRS)

Garrett, Henry B.; Whittlesey, Albert C.

2005-01-01

This paper will describe the status of those on-going efforts to combine and update the two guidelines with emphasis on the proposed contents and on the differences and similarities between surface and internal charging mitigation techniques. It is planned to have a draft revision ready for review by the spacecraft charging community by the fall of 2005, with 2006 dedicated to implementing reviewers' comments and additions leading to a new, officially approved NASA guideline by the fall of 2006.

A randomized matched-pairs study of feasibility, acceptability, and effectiveness of systems consultation: a novel implementation strategy for adopting clinical guidelines for Opioid prescribing in primary care.

PubMed

Quanbeck, Andrew; Brown, Randall T; Zgierska, Aleksandra E; Jacobson, Nora; Robinson, James M; Johnson, Roberta A; Deyo, Brienna M; Madden, Lynn; Tuan, Wen-Jan; Alagoz, Esra

2018-01-25

This paper reports on the feasibility, acceptability, and effectiveness of an innovative implementation strategy named "systems consultation" aimed at improving adherence to clinical guidelines for opioid prescribing in primary care. While clinical guidelines for opioid prescribing have been developed, they have not been widely implemented, even as opioid abuse reaches epidemic levels. We tested a blended implementation strategy consisting of several discrete implementation strategies, including audit and feedback, academic detailing, and external facilitation. The study compares four intervention clinics to four control clinics in a randomized matched-pairs design. Each systems consultant aided clinics on implementing the guidelines during a 6-month intervention consisting of monthly site visits and teleconferences/videoconferences. The mixed-methods evaluation employs the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. Quantitative outcomes are compared using time series analysis. Qualitative methods included focus groups, structured interviews, and ethnographic field techniques. Seven clinics were randomly approached to recruit four intervention clinics. Each clinic designated a project team consisting of six to eight staff members, each with at least one prescriber. Attendance at intervention meetings was 83%. More than 80% of staff respondents agreed or strongly agreed with the statements: "I am more familiar with guidelines for safe opioid prescribing" and "My clinic's workflow for opioid prescribing is easier." At 6 months, statistically significant improvements were noted in intervention clinics in the percentage of patients with mental health screens, treatment agreements, urine drug tests, and opioid-benzodiazepine co-prescribing. At 12 months, morphine-equivalent daily dose was significantly reduced in intervention clinics compared to controls. The cost to deliver the strategy was $7345 per clinic. Adaptations were required to make the strategy more acceptable for primary care. Qualitatively, intervention clinics reported that chronic pain was now treated using approaches similar to those employed for other chronic conditions, such as hypertension and diabetes. The systems consultation implementation strategy demonstrated feasibility, acceptability, and effectiveness in a study involving eight primary care clinics. This multi-disciplinary strategy holds potential to mitigate the prevalence of opioid addiction and ultimately may help to improve implementation of clinical guidelines across healthcare. ClinicalTrials.gov (NCT02433496). https://clinicaltrials.gov/ct2/show/NCT02433496 Registered May 5, 2015.

Guidelines for chemical peeling in Japan (3rd edition).

PubMed

2012-04-01

Chemical peeling may be defined as the therapies, procedures and techniques used for the treatment of certain cutaneous diseases or conditions, and for aesthetic improvement. The procedures include the application of one or more chemical agents to the skin. Chemical peeling has been very popular in both medical and aesthetic fields. Because neither its scientific background is well understood nor a systematic approach established, medical and social problems have taken place. This prompted us to establish and distribute a standard guideline of care for chemical peeling. Previous guidelines such as the 2001 and 2004 versions included minimum standards of care such as indications, chemicals, applications, and any associated precautions, including post-peeling care. The principles in this updated version of chemical peeling are as follows: (i) chemical peeling should be performed under the strict technical control and responsibility of a physician; (ii) the physician should have sufficient knowledge of the structure and physiology of the skin and subcutaneous tissues, and understand the mechanisms of wound-healing induced by chemical peeling; (iii) the physician should be board-certified in an appropriate specialty such as dermatology; and (iv) the ultimate judgment regarding the appropriateness of any specific chemical peeling procedure must be made by the physician while considering all standard therapeutic protocols, which should be presented to each individual patient. Keeping these concepts in mind, this new version of the guidelines includes a more scientific and detailed approach from the viewpoint of evidence-based medicine. © 2011 Japanese Dermatological Association.

75 FR 27856 - Shipping Coordinating Committee; Notice of Committee Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-18

...; --Harmonization of port State control activities; --Port State Control (PSC) Guidelines on seafarers' working hours and PSC guidelines in relation to the Maritime Labour Convention, 2006; --Development of...

40 CFR 797.1950 - Mysid shrimp chronic toxicity test.

Code of Federal Regulations, 2011 CFR

2011-07-01

... control and treatment groups. This time cannot be specified because of possible delays in sexual... control groups; PCONTROL ACT (CONTINUED) ENVIRONMENTAL EFFECTS TESTING GUIDELINES Aquatic Guidelines § 797.1950...

40 CFR 797.1950 - Mysid shrimp chronic toxicity test.

Code of Federal Regulations, 2012 CFR

2012-07-01

... control and treatment groups. This time cannot be specified because of possible delays in sexual... control groups; PCONTROL ACT (CONTINUED) ENVIRONMENTAL EFFECTS TESTING GUIDELINES Aquatic Guidelines § 797.1950...

40 CFR 797.1950 - Mysid shrimp chronic toxicity test.

Code of Federal Regulations, 2013 CFR

2013-07-01

... control and treatment groups. This time cannot be specified because of possible delays in sexual... control groups; PCONTROL ACT (CONTINUED) ENVIRONMENTAL EFFECTS TESTING GUIDELINES Aquatic Guidelines § 797.1950...

40 CFR 797.1950 - Mysid shrimp chronic toxicity test.

Code of Federal Regulations, 2014 CFR

2014-07-01

... control and treatment groups. This time cannot be specified because of possible delays in sexual... control groups; PCONTROL ACT (CONTINUED) ENVIRONMENTAL EFFECTS TESTING GUIDELINES Aquatic Guidelines § 797.1950...

Business and Office Education Curriculum Guidelines. Bulletin No. 1246.

ERIC Educational Resources Information Center

Louisiana State Dept. of Education, Baton Rouge. Div. of Vocational Education.

The curriculum guide presents guidelines for planning and implementing a program in cooperative office education. Techniques include relating individual in-school instruction to individual job needs and career goals and to coordinate the student's education with actual work experience in an office in the community. A summary of Federal and State…

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

ERIC Educational Resources Information Center

Hahn, H. A.; And Others

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

Development of Techniques and Data for Evaluating Ride Quality, Volume III : Guidelines for Development of Ride-Quality Models and Their Applications

DOT National Transportation Integrated Search

1978-02-01

Ride-quality models for city buses and intercity trains are presented and discussed in terms of their ability to predict passenger comfort and ride acceptability. The report, the last of three volumes, contains procedural guidelines to be employed by...

Community Rehabilitation: "Home versus Centre" Guidelines for Choosing the Optimal Treatment Location

ERIC Educational Resources Information Center

Barker, Lauren N.; Ziino, Carlo

2010-01-01

This study aimed to produce indicators and guidelines for clinician use in determining whether individual therapy sessions for community rehabilitation services should be delivered in a home/community-based setting or centre-based setting within a flexible service delivery model. Concept mapping techniques as described by Tochrim and Kane (2005)…

Spatial effect of new municipal solid waste landfill siting using different guidelines.

PubMed

Ahmad, Siti Zubaidah; Ahamad, Mohd Sanusi S; Yusoff, Mohd Suffian

2014-01-01

Proper implementation of landfill siting with the right regulations and constraints can prevent undesirable long-term effects. Different countries have respective guidelines on criteria for new landfill sites. In this article, we perform a comparative study of municipal solid waste landfill siting criteria stated in the policies and guidelines of eight different constitutional bodies from Malaysia, Australia, India, U.S.A., Europe, China and the Middle East, and the World Bank. Subsequently, a geographic information system (GIS) multi-criteria evaluation model was applied to determine new suitable landfill sites using different criterion parameters using a constraint mapping technique and weighted linear combination. Application of Macro Modeler provided in the GIS-IDRISI Andes software helps in building and executing multi-step models. In addition, the analytic hierarchy process technique was included to determine the criterion weight of the decision maker's preferences as part of the weighted linear combination procedure. The differences in spatial results of suitable sites obtained signifies that dissimilarity in guideline specifications and requirements will have an effect on the decision-making process.

[The German guideline "legal evaluation after closed head injury"].

PubMed

Wallesch, C W; Fries, W; Marx, P; du Mesnil de Rochemont, R; Roschmann, R; Schmidt, R; Schwerdtfeger, K; Tegenthoff, M; Widder, B

2013-09-01

In 2005, the "Deutsche Gesellschaft für Neurowissenschaftliche Begutachtung" (German Society for Neuroscientific Legal Evaluation) together with other Societies published a guideline for the legal evaluation of patients with closed head injuries. Meanwhile, not only scientific progress in imaging techniques but also in other fields such as neuropsychology has necessitated a revision, which is presented here. In the mean time, the handling of guidelines has been systematised in Germany so that a registration with the Cooperation of German Medical Learned Societies is applied for and publication in the German Guideline Registry is expected. © Georg Thieme Verlag KG Stuttgart · New York.

SPAN security policies and guidelines

NASA Technical Reports Server (NTRS)

Sisson, Patricia L.; Green, James L.

1989-01-01

A guide is provided to system security with emphasis on requirements and guidelines that are necessary to maintain an acceptable level of security on the network. To have security for the network, each node on the network must be secure. Therefore, each system manager, must strictly adhere to the requirements and must consider implementing the guidelines discussed. There are areas of vulnerability within the operating system that may not be addressed. However, when a requirement or guideline is discussed, implementation techniques are included. Information related to computer and data security is discussed to provide information on implementation options. The information is presented as it relates to a VAX computer environment.

Adherence to malaria diagnosis and treatment guidelines among healthcare workers in Ogun State, Nigeria.

PubMed

Bamiselu, Oluyomi F; Ajayi, IkeOluwapo; Fawole, Olufunmilayo; Dairo, David; Ajumobi, Olufemi; Oladimeji, Abisola; Steven, Yoon

2016-08-19

Malaria case management remains a vital component of malaria control strategies. Despite the introduction of national malaria treatment guidelines and scale-up of malaria control interventions in Nigeria, anecdotal evidence shows some deviations from the guidelines in malaria case management. This study assessed factors influencing adherence to malaria diagnosis and treatment guidelines among healthcare workers in public and private sectors in Ogun State, Nigeria. A comparative cross-sectional study was carried out among 432 (216 public and 216 private) healthcare workers selected from nine Local Government Areas using a multistage sampling technique. A pre-tested interviewer administered questionnaire was used to collect information on availability and use of malaria Rapid Diagnostic Test (mRDT) and artemisinin combination therapy (ACT), for management of uncomplicated malaria. Adherence was defined as when choice of antimalarials for parasitological confirmed malaria cases was restricted to recommended antimalarial medicines. Association between adherence and independent variables were tested using Chi-square at 5 % level of significance. Malaria RDT was available in 81.9 % of the public health facilities and 19.4 % of the private health facilities (p = 0.001). Its use was higher among public healthcare workers (85.2 %) compared to 32.9 % in private facilities (p = 0.000). Presumptive diagnosis of malaria was higher among private healthcare workers (94.9 %) compared to 22.7 % public facilities (p = <0.0001). The main reason for non-usage of mRDT among private healthcare workers was its perceived unreliability of mRDT (40.9 %). Monotherapy including artesunate (58.3 % vs 12.5 %), amodiaquine (38.9 % vs 8.3 %) and chloroquine (26.4 % vs 4.2 %) were significantly more available in private than public health facilities, respectively. Adherence to guidelines was significantly higher among public healthcare workers (60.6 %) compared to those in private facilities (27.3 %). Availability of antimalarial medicine was the main factor that influenced treatment prescription in both healthcare settings (p = 0.27). However, drug promotion by manufactures (45.8 %) has a major influence on private healthcare workers' prescription practice. The findings of this study demonstrate significant difference between public and private healthcare workers on adherence to national malaria diagnosis and treatment guidelines. Interventions to improve private sector engagement in implementation of the guidelines, training and supply of recommended antimalarial medicines should be intensified.

DIET@NET: Best Practice Guidelines for dietary assessment in health research.

PubMed

Cade, Janet E; Warthon-Medina, Marisol; Albar, Salwa; Alwan, Nisreen A; Ness, Andrew; Roe, Mark; Wark, Petra A; Greathead, Katharine; Burley, Victoria J; Finglas, Paul; Johnson, Laura; Page, Polly; Roberts, Katharine; Steer, Toni; Hooson, Jozef; Greenwood, Darren C; Robinson, Sian

2017-11-15

Dietary assessment is complex, and strategies to select the most appropriate dietary assessment tool (DAT) in epidemiological research are needed. The DIETary Assessment Tool NETwork (DIET@NET) aimed to establish expert consensus on Best Practice Guidelines (BPGs) for dietary assessment using self-report. The BPGs were developed using the Delphi technique. Two Delphi rounds were conducted. A total of 131 experts were invited, and of these 65 accepted, with 48 completing Delphi round I and 51 completing Delphi round II. In all, a total of 57 experts from North America, Europe, Asia and Australia commented on the 47 suggested guidelines. Forty-three guidelines were generated, grouped into the following four stages: Stage I. Define what is to be measured in terms of dietary intake (what? who? and when?); Stage II. Investigate different types of DATs; Stage III. Evaluate existing tools to select the most appropriate DAT by evaluating published validation studies; Stage IV. Think through the implementation of the chosen DAT and consider sources of potential biases. The Delphi technique consolidated expert views on best practice in assessing dietary intake. The BPGs provide a valuable guide for health researchers to choose the most appropriate dietary assessment method for their studies. These guidelines will be accessible through the Nutritools website, www.nutritools.org .

THE CANADIAN PERSPECTIVE ON CORROSION CONTROL: HEALTH CANADA'S CORROSION CONTROL GUIDELINE

EPA Science Inventory

Health Canada has proposed a Corrosion Control Guideline, based on lead, which is undergoing public consultation and expected to be finalized in 2007. In Canada, there are no regulations and little guidance to address corrosion problems and existing sampling methods are inappropr...

Retrieval techniques: LVLH and inertially stabilized payloads

NASA Technical Reports Server (NTRS)

Yglesias, J. A.

1980-01-01

Procedures and techniques are discussed for retrieving payloads that are inertially or local vertical/local horizontal (LVLH) stabilized. Selection of the retrieval profile to be used depends on several factors: (1) control authority of the payload, (2) payload sensitivity to primary reaction control system (PRCS) plumes, (3) whether the payload is inertially or LVLH stabilized, (4) location of the grapple fixture, and (5) orbiter propellant consumption. The general retrieval profiles recommended are a V-bar approach for payloads that are LVLH or gravity-gradient stabilized, and the V-bar approach with one or two phase flyaround for inertially stabilized payloads. Once the general type of profile has been selected, the detailed retrieval profile and timeline should consider the various guidelines, groundrules, and constraints associated with a particular payload or flight. Reaction control system (RCS) propellant requirements for the recommended profiles range from 200 to 1500 pounds, depending on such factors as braking techniques, flyaround maneuvers (if necessary), and stationkeeping operations. The time required to perform a retrieval (starting from 1000 feet) varies from 20 to 130 minutes, depending on the complexity of the profile. The goals of this project are to develop a profile which ensures mission success; to make the retrieval profiles simple; and to keep the pilot workload to a minimum by making use of the automatic features of the orbiter flight software whenever possible.

Aluminium removal from water after defluoridation with the electrocoagulation process.

PubMed

Sinha, Richa; Mathur, Sanjay; Brighu, Urmila

2015-01-01

Fluoride is the most electronegative element and has a strong affinity for aluminium. Owing to this fact, most of the techniques used for fluoride removal utilized aluminium compounds, which results in high concentrations of aluminium in treated water. In the present paper, a new approach is presented to meet the WHO guideline for residual aluminium concentration as 0.2 mg/L. In the present work, the electrocoagulation (EC) process was used for fluoride removal. It was found that aluminium content in water increases with an increase in the energy input. Therefore, experiments were optimized for a minimum energy input to achieve the target value (0.7 mg/L) of fluoride in resultant water. These optimized sets were used for further investigations of aluminium control. The experimental investigations revealed that use of bentonite clay as coagulant in clariflocculation brings down the aluminium concentration of water below the WHO guideline. Bentonite dose of 2 g/L was found to be the best for efficient removal of aluminium.

Committee Opinion No. 655 Summary: Hepatitis B, Hepatitis C, and Human Immunodeficiency Virus Infections in Obstetrician-Gynecologists.

PubMed

2016-02-01

To prevent transmission of bloodborne pathogens, it is important that health care providers adhere to standard precautions, follow fundamental infection-control principles, and use appropriate procedural techniques. All obstetrician-gynecologists who provide clinical care should receive the hepatitis B virus vaccine series. The Society for Healthcare Epidemiology of America has established guidelines for the management of health care providers who are infected with hepatitis B virus, hepatitis C virus, or human immunodeficiency virus (HIV). The guidelines categorize representative obstetric and gynecologic procedures according to level of risk of bloodborne pathogen transmission and include recommendations for health care provider clinical activities, based on these categories and viral burden. It is important to note that when no restrictions are recommended, careful supervision should be carried out as highlighted. These recommendations provide a framework within which to consider such cases; however, each case should be independently considered in context by the expert review panel.

Assessing treatment-as-usual provided to control groups in adherence trials: Exploring the use of an open-ended questionnaire for identifying behaviour change techniques.

PubMed

Oberjé, Edwin J M; Dima, Alexandra L; Pijnappel, Frank J; Prins, Jan M; de Bruin, Marijn

2015-01-01

Reporting guidelines call for descriptions of control group support in equal detail as for interventions. However, how to assess the active content (behaviour change techniques (BCTs)) of treatment-as-usual (TAU) delivered to control groups in trials remains unclear. The objective of this study is to pre-test a method of assessing TAU in a multicentre cost-effectiveness trial of an HIV-treatment adherence intervention. HIV-nurses (N = 21) completed a semi-structured open-ended questionnaire enquiring about TAU adherence counselling. Two coders independently coded BCTs. Completeness and clarity of nurse responses, inter-coder reliabilities and the type of BCTs reported were examined. The clarity and completeness of nurse responses were adequate. Twenty-three of the 26 identified BCTs could be reliably coded (mean κ = .79; mean agreement rate = 96%) and three BCTs scored below κ = .60. Total number of BCTs reported per nurse ranged between 7 and 19 (M = 13.86, SD = 3.35). This study suggests that the TAU open-ended questionnaire is a feasible and reliable tool to capture active content of support provided to control participants in a multicentre adherence intervention trial. Considerable variability in the number of BCTs provided to control patients was observed, illustrating the importance of reliably collecting and accurately reporting control group support.

Effects of an Educational Intervention on Breast Self-Examination, Breast Cancer Prevention-Related Knowledge, and Healthy Lifestyles in Scholars from a Low-Income Area in Bogota, Colombia.

PubMed

Masso-Calderón, A M; Meneses-Echávez, J F; Correa-Bautista, J E; Tovar-Cifuentes, A; Alba-Ramírez, P A; Charry-Ángel, C E

2018-06-01

The aim of this study was to evaluate the effects of an educational intervention on breast self-examination, cancer prevention-related knowledge, practices, and behavior change in scholars from a low-income area in Bogota, Colombia. Uncontrolled trial was conducted in 155 scholars. Two educational sessions, 90 min each, were carried out in March 2015 according to the Colombian guidelines for educational communication in the framework of cancer control. All participants completed a self-reported questionnaire at pre- and post-intervention, as well as 1, 3, and 6 months after the intervention. Breast self-examination was practiced by 78.1% of the scholars, and the overall knowledge of breast cancer risk factors was poor. The educational intervention resulted in significant improvements on breast self-examination practice, the knowledge of the technique, and the knowledge of the main risk factors for breast cancer as well as the practice of physical activity and vegetable intake at 6 months follow-up. An educational intervention according to the Colombian guidelines for educational communication in the framework of cancer control improved the practice of breast self-examination, cancer prevention-related knowledge, as well as the practice of physical activity and vegetable consumption in scholars from a low-income area in Bogota, Colombia. Further randomized controlled studies are warranted.

29 CFR Appendix D to Subpart R of... - Illustration of the Use of Control Lines To Demarcate Controlled Decking Zones (CDZs): Non...

Code of Federal Regulations, 2012 CFR

2012-07-01

... of Control Lines To Demarcate Controlled Decking Zones (CDZs): Non-mandatory Guidelines for Complying... 29 Labor 8 2012-07-01 2012-07-01 false Illustration of the Use of Control Lines To Demarcate Controlled Decking Zones (CDZs): Non-mandatory Guidelines for Complying With § 1926.760(c)(3) D Appendix D...

29 CFR Appendix D to Subpart R of... - Illustration of the Use of Control Lines To Demarcate Controlled Decking Zones (CDZs): Non...

Code of Federal Regulations, 2010 CFR

2010-07-01

... of Control Lines To Demarcate Controlled Decking Zones (CDZs): Non-mandatory Guidelines for Complying... 29 Labor 8 2010-07-01 2010-07-01 false Illustration of the Use of Control Lines To Demarcate Controlled Decking Zones (CDZs): Non-mandatory Guidelines for Complying With § 1926.760(c)(3) D Appendix D...

29 CFR Appendix D to Subpart R of... - Illustration of the Use of Control Lines To Demarcate Controlled Decking Zones (CDZs): Non...

Code of Federal Regulations, 2013 CFR

2013-07-01

... of Control Lines To Demarcate Controlled Decking Zones (CDZs): Non-mandatory Guidelines for Complying... 29 Labor 8 2013-07-01 2013-07-01 false Illustration of the Use of Control Lines To Demarcate Controlled Decking Zones (CDZs): Non-mandatory Guidelines for Complying With § 1926.760(c)(3) D Appendix D...

The Prostate Exam

ERIC Educational Resources Information Center

Romero, Frederico R.; Romero, Antonio W.; Filho, Thadeu Brenny; Kulysz, David; Oliveira, Fernando C., Jr.; Filho, Renato Tambara

2012-01-01

Objective: To help students, residents, and general practitioners to improve the technique, skills, and reproducibility of their prostate examination. Methods: We developed a comprehensive guideline outlining prostate anatomy, indications, patient preparation, positioning, technique, findings, and limitations of this ancient art of urological…

Hepatocellular carcinoma: Advances in diagnostic imaging.

PubMed

Sun, Haoran; Song, Tianqiang

2015-10-01

Thanks to the growing knowledge on biological behaviors of hepatocellular carcinomas (HCC), as well as continuous improvement in imaging techniques and experienced interpretation of imaging features of the nodules in cirrhotic liver, the detection and characterization of HCC has improved in the past decade. A number of practice guidelines for imaging diagnosis have been developed to reduce interpretation variability and standardize management of HCC, and they are constantly updated with advances in imaging techniques and evidence based data from clinical series. In this article, we strive to review the imaging techniques and the characteristic features of hepatocellular carcinoma associated with cirrhotic liver, with emphasis on the diagnostic value of advanced magnetic resonance imaging (MRI) techniques and utilization of hepatocyte-specific MRI contrast agents. We also briefly describe the concept of liver imaging reporting and data systems and discuss the consensus and controversy of major practice guidelines.

Techniques for cytologic sampling of pancreatic and bile duct lesions: The Papanicolaou Society of Cytopathology Guidelines.

PubMed

Brugge, William R; De Witt, John; Klapman, Jason B; Ashfaq, Raheela; Shidham, Vinod; Chhieng, David; Kwon, Richard; Baloch, Zubair; Zarka, Matthew; Staerkel, Gregg

2014-01-01

The Papanicolaou Society of Cytopathology has developed a set of guidelines for pancreatobiliary cytology, including indications for endoscopic ultrasound guided fine-needle aspiration biopsy, techniques of the endoscopic retrograde cholangiopancreatography, terminology and nomenclature of pancreatobiliary disease, ancillary testing, and postbiopsy management. All documents are based on the expertise of the authors, a review of literature, discussions of the draft document at several national and international meetings over an 18 month period and synthesis of online comments of the draft document on the Papanicolaou Society of Cytopathology website [www.papsociety.org]. This document presents the results of these discussions regarding the use of sampling techniques in the cytological diagnosis of biliary and pancreatic lesions. This document summarizes the current state of the art for techniques in acquiring cytology specimens from the biliary tree as well as solid and cystic lesions of the pancreas.

Therapeutic endorsement enhances compliance with national glaucoma guidelines in Australian and New Zealand optometrists.

PubMed

Zangerl, Barbara; Hayen, Andrew; Mitchell, Paul; Jamous, Khalid F; Stapleton, Fiona; Kalloniatis, Michael

2015-03-01

Previous studies confirmed that optometrists have access to and confidence in applying clinical tests recommended for glaucoma assessment. Less is known about factors best predicting compliance with national clinical guidelines and thus by inference, the provision of suitable care by primary care ophthalmic practitioners. We utilised the unique two-tiered profession (therapeutic and non-therapeutic scope of practice) in Australia and New Zealand to assess the prospective adherence to glaucoma guidelines dependent on the clinician's background. Australian and New Zealand optometrists were surveyed on ophthalmic techniques for glaucoma assessment, criteria for the evaluation of the optic nerve head, glaucoma risk categories and review times while also recording background, training, and experience. Parameters identifying progression/conversion and patients' risk levels were analysed comparatively to ophthalmologists' opinions. Linear regression analysis identified variables significantly improving the likelihood of concordance with guidelines. Reported application of techniques complied well with glaucoma guidelines although gonioscopy and pachymetry, pupil dilation for optic nerve head examination, and acquisition of permanent records were less frequently employed. The main predictors for entry-level diagnostic standards were therapeutic endorsement together with the associated knowledge of relevant guidance and procedural confidence. Other findings suggested a potential underestimation in the value of optic disc size and intraocular pressure for the prediction of glaucoma risk, while optometrists more frequently relied on the outcomes of non-standardised automated perimetry and auxiliary imaging. Optometrists in Australia and New Zealand may not always exercise optimal clinical acumen regarding techniques/criteria for glaucoma diagnosis. Therapeutic endorsement was gradually adopted in different jurisdictions in various forms since 1999 and is mandatory for registration since late 2014. The result of the two-tiered optometric cohorts suggest that inclusion of therapeutic training as part of the core training is likely a key factor to enhanced compliance with glaucoma guidelines. Improved adherence to the current clinical standards should positively impact on the facilitation of appropriate glaucoma diagnosis and management. Obligatory knowledge and possibly accreditation of available guidelines might ensure a uniform standard in glaucoma testing protocols in concordance with compulsory entry-level skills. © 2015 The Authors Ophthalmic & Physiological Optics © 2015 The College of Optometrists.

29 CFR Appendix D to Subpart R of... - Illustration of the Use of Control Lines To Demarcate Controlled Decking Zones (CDZs): Non...

Code of Federal Regulations, 2014 CFR

2014-07-01

... Controlled Decking Zones (CDZs): Non-mandatory Guidelines for Complying With § 1926.760(c)(3) D Appendix D... of Control Lines To Demarcate Controlled Decking Zones (CDZs): Non-mandatory Guidelines for Complying..., tapes, or equivalent materials, and supporting stanchions as follows: (i) Each line is rigged and...

29 CFR Appendix D to Subpart R of... - Illustration of the Use of Control Lines To Demarcate Controlled Decking Zones (CDZs): Non...

Code of Federal Regulations, 2011 CFR

2011-07-01

... Controlled Decking Zones (CDZs): Non-mandatory Guidelines for Complying With § 1926.760(c)(3) D Appendix D... of Control Lines To Demarcate Controlled Decking Zones (CDZs): Non-mandatory Guidelines for Complying..., tapes, or equivalent materials, and supporting stanchions as follows: (i) Each line is rigged and...

Dense and dynamic 3D selection for game-based virtual environments.

PubMed

Cashion, Jeffrey; Wingrave, Chadwick; LaViola, Joseph J

2012-04-01

3D object selection is more demanding when, 1) objects densly surround the target object, 2) the target object is significantly occluded, and 3) when the target object is dynamically changing location. Most 3D selection techniques and guidelines were developed and tested on static or mostly sparse environments. In contrast, games tend to incorporate densly packed and dynamic objects as part of their typical interaction. With the increasing popularity of 3D selection in games using hand gestures or motion controllers, our current understanding of 3D selection needs revision. We present a study that compared four different selection techniques under five different scenarios based on varying object density and motion dynamics. We utilized two existing techniques, Raycasting and SQUAD, and developed two variations of them, Zoom and Expand, using iterative design. Our results indicate that while Raycasting and SQUAD both have weaknesses in terms of speed and accuracy in dense and dynamic environments, by making small modifications to them (i.e., flavoring), we can achieve significant performance increases.

Practical guidelines for the characterization and quality control of pure drug nanoparticles and nano-cocrystals in the pharmaceutical industry.

PubMed

Peltonen, Leena

2018-06-16

The number of poorly soluble drug candidates is increasing, and this is also seen in the research interest towards drug nanoparticles and (nano-)cocrystals; improved solubility is the most important application of these nanosystems. In order to confirm the functionality of these nanoparticles throughout their lifecycle, repeatability of the formulation processes, functional performance of the formed systems in pre-determined way and system stability, a thorough physicochemical understanding with the aid of necessary analytical techniques is needed. Even very minor deviations in for example particle size or size deviation in nanoscale can alter the product bioavailability, and the effect is even more dramatic with the smallest particle size fractions. Also, small particle size sets special requirements for the analytical techniques. In this review most important physicochemical properties of drug nanocrystals and nano-cocrystals are presented, suitable analytical techniques, their pros and cons, are described with the extra input on practical point of view. Copyright © 2018. Published by Elsevier B.V.

Systematic review of efficacy for manual lymphatic drainage techniques in sports medicine and rehabilitation: an evidence-based practice approach.

PubMed

Vairo, Giampietro L; Miller, Sayers John; McBrier, Nicole M; Buckley, William E

2009-01-01

Manual therapists question integrating manual lymphatic drainage techniques (MLDTs) into conventional treatments for athletic injuries due to the scarcity of literature concerning musculoskeletal applications and established orthopaedic clinical practice guidelines. The purpose of this systematic review is to provide manual therapy clinicians with pertinent information regarding progression of MLDTs as well as to critique the evidence for efficacy of this method in sports medicine. We surveyed English-language publications from 1998 to 2008 by searching PubMed, PEDro, CINAHL, the Cochrane Library, and SPORTDiscus databases using the terms lymphatic system, lymph drainage, lymphatic therapy, manual lymph drainage, and lymphatic pump techniques. We selected articles investigating the effects of MLDTs on orthopaedic and athletic injury outcomes. Nine articles met inclusion criteria, of which 3 were randomized controlled trials (RCTs). We evaluated the 3 RCTs using a validity score (PEDro scale). Due to differences in experimental design, data could not be collapsed for meta-analysis. Animal model experiments reinforce theoretical principles for application of MLDTs. When combined with concomitant musculoskeletal therapy, pilot and case studies demonstrate MLDT effectiveness. The best evidence suggests that efficacy of MLDT in sports medicine and rehabilitation is specific to resolution of enzyme serum levels associated with acute skeletal muscle cell damage as well as reduction of edema following acute ankle joint sprain and radial wrist fracture. Currently, there is limited high-ranking evidence available. Well-designed RCTs assessing outcome variables following implementation of MLDTs in treating athletic injuries may provide conclusive evidence for establishing applicable clinical practice guidelines in sports medicine and rehabilitation.

The Wrong Tool for the Job: Diabetes Public Health Programs and Practice Guidelines

PubMed Central

López, Andrea; Black, Karen; Schillinger, Dean

2011-01-01

We surveyed state diabetes programs to determine whether they develop and disseminate diabetes guidelines. We found they largely disseminate clinical practice guidelines developed from subspecialty organizations, do not prioritize among the many recommendations contained in diabetes guidelines, and have not adapted guidelines to focus on population rather than individual health. An opportunity exists for state diabetes control programs to better align guidelines with public health goals. PMID:21852653

Audit of sweat testing: a first report from Italian Cystic Fibrosis Centres.

PubMed

Cirilli, Natalia; Padoan, Rita; Raia, Valeria

2008-09-01

Cystic Fibrosis diagnosis is confirmed using sweat test. The aim of our study was to evaluate current techniques and methodologies in use at Italian CF Care Centres. A series of questions related to the performance of the sweat test was collected by all CF Care Centres in Italy. Answers were compared with UK and NCCLS guidelines. 39/41 Centres replied to the questionnaire. A good adherence to guidelines was registered for storing samples before analysis in 90.9%, while performing CF diagnosis by at least two sweat tests, and chloride analysis were reported respectively in 100% and 75.7% of Centres. Some inconsistencies were registered for minimum acceptable sweat quantity and time to collect sweat inadequate in respectively 42.5% and 24.2% of Centres, while performing quality control procedures and referring to an external quality assessment scheme were found inadequate in respectively 54.6% and 100%. 57.6% didn't provide any appropriate analytical ranges and only 15.1% of Centres offered proper information to patients/parents. A report form, including sweat quantity, reference ranges and interpretation, was adequate only for 9.4 up to 41.4% of CF Centres. Our study showed areas of inconsistencies in sweat testing current practices in Italy and highlights the need for evidence based national guidelines to improve practice and management strategies.

Assessment of Critical Care Provider's Application of Preventive Measures for Ventilator-Associated Pneumonia in Intensive Care Units.

PubMed

Bagheri-Nesami, Masoumeh; Amiri-Abchuyeh, Maryam; Gholipour-Baradari, Afshin; Yazdani-Cherati, Jamshid; Nikkhah, Attieh

2015-08-01

The implementation of guidelines for the prevention of Ventilator-associated pneumonia has been shown to have a significant effect in reducing the incidence of VAP. The aim of the present study was to evaluate the implementation of the preventive strategies for VAP in ICUs of university hospitals of Sari, Iran. This cross-sectional study was carried out in 600 beds/day in the ICUs of university hospitals of Sari from April to June 2012. Sampling was done by availability technique in patients receiving mechanical ventilation in the ICU. The implementation of the preventive measures was assessed by a standard checklist with previously approved validity and reliability. The percentage of implementing each of the measures was as follows: sterile suction, 88.44%; semi-recumbent position, 76.8%; oral hygiene, 58.45%; using heat and moisture exchanges (HMEs), 58%; controlling cuff pressure, 46.8%; hand hygiene, 32.8%; using anti-coagulants, 26.8% and physiotherapy, 25.5%. Closed suction system, continuous drainage of subglottic secretions and kinetic beds were not used at all. The overall mean percentage of implementing preventive measures was low and required designing integrated guidelines by considering the conditions of the ICUs in each country, as well as educating and encouraging the staffs to use the recommended guidelines.

Guidelines on Hair Restoration for East Asian Patients.

PubMed

Lee, In-Joon; Jung, Jae Heon; Lee, Young-Ran; Kim, Jung Chul; Hwang, Sungjoo Tommy

2016-07-01

In East Asian countries, hair transplantation is a quite common procedure for treating pattern hair loss, cosmetically correcting the hairline, and correcting eyebrow and pubic hair defects. Although there are general guidelines concerning hair transplantation, certain factors need to be addressed to make the guidelines more specific and suitable to East Asian requirements. To provide guidelines for hairline design, donor harvesting, graft preparation and placement, and medical treatment that are appropriate for hair transplantation in East Asian patients. Recommendations are based on the experience of the authors, surgeons who perform hair transplantation, and a comprehensive review of the available literature on hair transplantation in East Asians. Data on hair thickness and graft density, hairline design, and graft creation and placement techniques have been collaboratively evaluated and used to establish overall guidelines. The use of the proposed guidelines by surgeons will hopefully enhance outcomes and bring greater consistency to hair transplantation procedures for East Asian patients.

Implementation of GINA guidelines in Ho Chi Minh City: a model for Viet Nam.

PubMed

Tho, N V; Loan, H T H; Thao, N T P; Dung, N T T; Lan, L T T

2012-12-21

The Global Initiative for Asthma (GINA) guidelines have not been implemented effectively in primary care settings in Viet Nam. To estimate the proportion of patients with controlled asthma and the direct health care costs of managing asthma according to GINA guidelines at four out-patient clinics in Ho Chi Minh City (HCMC), Viet Nam. One hundred and six patients with asthma were treated and followed up according to GINA guidelines for 12 months. Clinical and pulmonary function responses and direct health care costs were evaluated every 3 months during the study. The proportion of patients with controlled asthma rose from 1.0% at the start of the study to 36.8% by the end of the study (P < 0.0001). The proportion of patients who had at least one hospitalisation per year decreased significantly, from 32.1% to 5.7% (P < 0.0001). The annual per patient median direct health care cost was US$169. Using asthma controllers continuously gave better asthma control than using them intermittently (OR 12.9, 95%CI 4.7-35.7). The implementation of GINA guidelines at out-patient clinics in HCMC, Viet Nam, improved asthma control with modest direct health care costs.

Effect of the emotional freedom technique on perceived stress, quality of life, and cortisol salivary levels in tension-type headache sufferers: a randomized controlled trial.

PubMed

Bougea, Anastasia M; Spandideas, Nick; Alexopoulos, Evangelos C; Thomaides, Thomas; Chrousos, George P; Darviri, Christina

2013-01-01

To evaluate the short-term effects of the emotional freedom technique (EFT) on tension-type headache (TTH) sufferers. We used a parallel-group design, with participants randomly assigned to the emotional freedom intervention (n = 19) or a control arm (standard care n = 16). The study was conducted at the outpatient Headache Clinic at the Korgialenio Benakio Hospital of Athens. Thirty-five patients meeting criteria for frequent TTH according to International Headache Society guidelines were enrolled. Participants were instructed to use the EFT method twice a day for two months. Study measures included the Perceived Stress Scale, the Multidimensional Health Locus of Control Scale, and the Short-Form questionnaire-36. Salivary cortisol levels and the frequency and intensity of headache episodes were also assessed. Within the treatment arm, perceived stress, scores for all Short-Form questionnaire-36 subscales, and the frequency and intensity of the headache episodes were all significantly reduced. No differences in cortisol levels were found in any group before and after the intervention. EFT was reported to benefit patients with TTH. This randomized controlled trial shows promising results for not only the frequency and severity of headaches but also other lifestyle parameters. Copyright © 2013 Elsevier Inc. All rights reserved.

Spinal Manipulative Therapy and Other Conservative Treatments for Low Back Pain: A Guideline From the Canadian Chiropractic Guideline Initiative.

PubMed

Bussières, André E; Stewart, Gregory; Al-Zoubi, Fadi; Decina, Philip; Descarreaux, Martin; Haskett, Danielle; Hincapié, Cesar; Pagé, Isabelle; Passmore, Steven; Srbely, John; Stupar, Maja; Weisberg, Joel; Ornelas, Joseph

2018-05-01

The objective of this study was to develop a clinical practice guideline on the management of acute and chronic low back pain (LBP) in adults. The aim was to develop a guideline to provide best practice recommendations on the initial assessment and monitoring of people with low back pain and address the use of spinal manipulation therapy (SMT) compared with other commonly used conservative treatments. The topic areas were chosen based on an Agency for Healthcare Research and Quality comparative effectiveness review, specific to spinal manipulation as a nonpharmacological intervention. The panel updated the search strategies in Medline. We assessed admissible systematic reviews and randomized controlled trials for each question using A Measurement Tool to Assess Systematic Reviews and Cochrane Back Review Group criteria. Evidence profiles were used to summarize judgments of the evidence quality and link recommendations to the supporting evidence. Using the Evidence to Decision Framework, the guideline panel determined the certainty of evidence and strength of the recommendations. Consensus was achieved using a modified Delphi technique. The guideline was peer reviewed by an 8-member multidisciplinary external committee. For patients with acute (0-3 months) back pain, we suggest offering advice (posture, staying active), reassurance, education and self-management strategies in addition to SMT, usual medical care when deemed beneficial, or a combination of SMT and usual medical care to improve pain and disability. For patients with chronic (>3 months) back pain, we suggest offering advice and education, SMT or SMT as part of a multimodal therapy (exercise, myofascial therapy or usual medical care when deemed beneficial). For patients with chronic back-related leg pain, we suggest offering advice and education along with SMT and home exercise (positioning and stabilization exercises). A multimodal approach including SMT, other commonly used active interventions, self-management advice, and exercise is an effective treatment strategy for acute and chronic back pain, with or without leg pain. Copyright © 2018. Published by Elsevier Inc.

High-Alpha Research Vehicle Lateral-Directional Control Law Description, Analyses, and Simulation Results

NASA Technical Reports Server (NTRS)

Davidson, John B.; Murphy, Patrick C.; Lallman, Frederick J.; Hoffler, Keith D.; Bacon, Barton J.

1998-01-01

This report contains a description of a lateral-directional control law designed for the NASA High-Alpha Research Vehicle (HARV). The HARV is a F/A-18 aircraft modified to include a research flight computer, spin chute, and thrust-vectoring in the pitch and yaw axes. Two separate design tools, CRAFT and Pseudo Controls, were integrated to synthesize the lateral-directional control law. This report contains a description of the lateral-directional control law, analyses, and nonlinear simulation (batch and piloted) results. Linear analysis results include closed-loop eigenvalues, stability margins, robustness to changes in various plant parameters, and servo-elastic frequency responses. Step time responses from nonlinear batch simulation are presented and compared to design guidelines. Piloted simulation task scenarios, task guidelines, and pilot subjective ratings for the various maneuvers are discussed. Linear analysis shows that the control law meets the stability margin guidelines and is robust to stability and control parameter changes. Nonlinear batch simulation analysis shows the control law exhibits good performance and meets most of the design guidelines over the entire range of angle-of-attack. This control law (designated NASA-1A) was flight tested during the Summer of 1994 at NASA Dryden Flight Research Center.

The minimum information required for a glycomics experiment (MIRAGE) project: sample preparation guidelines for reliable reporting of glycomics datasets.

PubMed

Struwe, Weston B; Agravat, Sanjay; Aoki-Kinoshita, Kiyoko F; Campbell, Matthew P; Costello, Catherine E; Dell, Anne; Ten Feizi; Haslam, Stuart M; Karlsson, Niclas G; Khoo, Kay-Hooi; Kolarich, Daniel; Liu, Yan; McBride, Ryan; Novotny, Milos V; Packer, Nicolle H; Paulson, James C; Rapp, Erdmann; Ranzinger, Rene; Rudd, Pauline M; Smith, David F; Tiemeyer, Michael; Wells, Lance; York, William S; Zaia, Joseph; Kettner, Carsten

2016-09-01

The minimum information required for a glycomics experiment (MIRAGE) project was established in 2011 to provide guidelines to aid in data reporting from all types of experiments in glycomics research including mass spectrometry (MS), liquid chromatography, glycan arrays, data handling and sample preparation. MIRAGE is a concerted effort of the wider glycomics community that considers the adaptation of reporting guidelines as an important step towards critical evaluation and dissemination of datasets as well as broadening of experimental techniques worldwide. The MIRAGE Commission published reporting guidelines for MS data and here we outline guidelines for sample preparation. The sample preparation guidelines include all aspects of sample generation, purification and modification from biological and/or synthetic carbohydrate material. The application of MIRAGE sample preparation guidelines will lead to improved recording of experimental protocols and reporting of understandable and reproducible glycomics datasets. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

77 FR 58419 - Guidelines for Preparing and Reviewing Licensing Applications for Instrumentation and Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-20

... Applications for Instrumentation and Control Upgrades for Non-Power Reactors AGENCY: Nuclear Regulatory...-Power Reactors: Format and Content,'' for instrumentation and control upgrades and NUREG-1537, Part 2, ``Guidelines for Preparing and Reviewing Applications for the Licensing of Non-Power Reactors: Standard Review...

40 CFR 797.1930 - Mysid shrimp acute toxicity test.

Code of Federal Regulations, 2013 CFR

2013-07-01

... in a control group. (ii) Acclimation. (A) Any change in the temperature and chemistry of the dilution... SUBSTANCES CONTROL ACT (CONTINUED) ENVIRONMENTAL EFFECTS TESTING GUIDELINES Aquatic Guidelines § 797.1930... test regulations under the Toxic Substances Control Act (TSCA) (Pub. L. 94-469, 90 Stat. 2003, 15 U.S.C...

40 CFR 795.120 - Gammarid acute toxicity test.

Code of Federal Regulations, 2014 CFR

2014-07-01

... culture container. The control group shall be exposed to the same dilution water, conditions and... CONTROL ACT (CONTINUED) PROVISIONAL TEST GUIDELINES Provisional Environmental Effects Guidelines § 795.120... under the Toxic Substances Control Act (TSCA) (Pub. L. 94-469, 90 Stat. 2003 (15 U.S.C. 2601 et seq...

40 CFR 797.1930 - Mysid shrimp acute toxicity test.

Code of Federal Regulations, 2014 CFR

2014-07-01

... in a control group. (ii) Acclimation. (A) Any change in the temperature and chemistry of the dilution... SUBSTANCES CONTROL ACT (CONTINUED) ENVIRONMENTAL EFFECTS TESTING GUIDELINES Aquatic Guidelines § 797.1930... test regulations under the Toxic Substances Control Act (TSCA) (Pub. L. 94-469, 90 Stat. 2003, 15 U.S.C...

40 CFR 795.120 - Gammarid acute toxicity test.

Code of Federal Regulations, 2011 CFR

2011-07-01

... culture container. The control group shall be exposed to the same dilution water, conditions and... CONTROL ACT (CONTINUED) PROVISIONAL TEST GUIDELINES Provisional Environmental Effects Guidelines § 795.120... under the Toxic Substances Control Act (TSCA) (Pub. L. 94-469, 90 Stat. 2003 (15 U.S.C. 2601 et seq...

40 CFR 795.120 - Gammarid acute toxicity test.

Code of Federal Regulations, 2010 CFR

2010-07-01

... culture container. The control group shall be exposed to the same dilution water, conditions and... CONTROL ACT (CONTINUED) PROVISIONAL TEST GUIDELINES Provisional Environmental Effects Guidelines § 795.120... under the Toxic Substances Control Act (TSCA) (Pub. L. 94-469, 90 Stat. 2003 (15 U.S.C. 2601 et seq...

40 CFR 797.1930 - Mysid shrimp acute toxicity test.

Code of Federal Regulations, 2012 CFR

2012-07-01

... in a control group. (ii) Acclimation. (A) Any change in the temperature and chemistry of the dilution... SUBSTANCES CONTROL ACT (CONTINUED) ENVIRONMENTAL EFFECTS TESTING GUIDELINES Aquatic Guidelines § 797.1930... test regulations under the Toxic Substances Control Act (TSCA) (Pub. L. 94-469, 90 Stat. 2003, 15 U.S.C...

40 CFR 797.1930 - Mysid shrimp acute toxicity test.

Code of Federal Regulations, 2011 CFR

2011-07-01

... in a control group. (ii) Acclimation. (A) Any change in the temperature and chemistry of the dilution... SUBSTANCES CONTROL ACT (CONTINUED) ENVIRONMENTAL EFFECTS TESTING GUIDELINES Aquatic Guidelines § 797.1930... test regulations under the Toxic Substances Control Act (TSCA) (Pub. L. 94-469, 90 Stat. 2003, 15 U.S.C...

40 CFR 795.120 - Gammarid acute toxicity test.

Code of Federal Regulations, 2012 CFR

2012-07-01

... culture container. The control group shall be exposed to the same dilution water, conditions and... CONTROL ACT (CONTINUED) PROVISIONAL TEST GUIDELINES Provisional Environmental Effects Guidelines § 795.120... under the Toxic Substances Control Act (TSCA) (Pub. L. 94-469, 90 Stat. 2003 (15 U.S.C. 2601 et seq...

40 CFR 795.120 - Gammarid acute toxicity test.

Code of Federal Regulations, 2013 CFR

2013-07-01

... culture container. The control group shall be exposed to the same dilution water, conditions and... CONTROL ACT (CONTINUED) PROVISIONAL TEST GUIDELINES Provisional Environmental Effects Guidelines § 795.120... under the Toxic Substances Control Act (TSCA) (Pub. L. 94-469, 90 Stat. 2003 (15 U.S.C. 2601 et seq...

Network Influences on Dissemination of Evidence-Based Guidelines in State Tobacco Control Programs

ERIC Educational Resources Information Center

Luke, Douglas A.; Wald, Lana M.; Carothers, Bobbi J.; Bach, Laura E.; Harris, Jenine K.

2013-01-01

Little is known regarding the social network relationships that influence dissemination of evidence-based public health practices and policies. In public health, it is critical that evidence-based guidelines, such as the Centers for Disease Control and Prevention's "Best Practices for Comprehensive Tobacco Control Programs," are…

PREVENTION GUIDELINES SYSTEM/DATABASE

EPA Science Inventory

The Prevention Guidelines System gives public health practitioners quick access to the most current CDC recommendations and guidelines for the prevention, control, treatment and detection of infectious and chronic diseases, environmental hazards, natural or human-generated disast...

Installation Guidelines for Solar DHW Systems in One- and Two-Family Dwellings. Second Edition.

ERIC Educational Resources Information Center

Hollander, Peter; And Others

Described are some of the better techniques for installing solar domestic hot water (DHW) systems. By using these guidelines, along with the manufacturer's manual, professional installation contractors and skilled homeowners should be able to install and fill a solar DHW system. Among the topics considered are system layouts, siting, mounting…

Evaluation of a tailored, multi-component intervention for implementation of evidence-based clinical practice guidelines in primary care physical therapy: a non-randomized controlled trial.

PubMed

Bernhardsson, Susanne; Larsson, Maria E H; Eggertsen, Robert; Olsén, Monika Fagevik; Johansson, Kajsa; Nilsen, Per; Nordeman, Lena; van Tulder, Maurits; Öberg, Birgitta

2014-03-04

Clinical practice guidelines are important for transmitting research findings into practice and facilitating the application of evidence-based practice (EBP). There is a paucity of knowledge about the impact of guideline implementation strategies in primary care physical therapy. The aim of this study was to evaluate the effect of a guideline implementation intervention in primary care physical therapy in western Sweden. An implementation strategy based on theory and current evidence was developed. A tailored, multi-component implementation intervention, addressing earlier identified determinants, was carried out in three areas comprising 28 physical therapy practices including 277 physical therapists (PTs) (intervention group). In two adjacent areas, 171 PTs at 32 practices received no intervention (control group). The core component of the intervention was an implementation seminar with group discussions. Among other components were a website and email reminders. Data were collected at baseline and follow-up with a web-based questionnaire. Primary outcomes were the self-reported awareness of, knowledge of, access to, and use of guidelines. Secondary outcomes were self-reported attitudes toward EBP and guidelines. Analyses were performed using Pearson's χ2 test and approximative z-test. 168 PTs (60.6%) in the intervention group and 88 PTs (51.5%) in the control group responded to the follow-up questionnaire. 186/277 PTs (67.1%) participated in the implementation seminars, of which 97 (52.2%) responded. The proportions of PTs reporting awareness of (absolute difference in change 20.6%, p = 0.023), knowledge where to find (20.4%, p = 0.007), access to (21.7%, p < 0.001), and frequent use of (9.5%, NS) guidelines increased more in the intervention group than in the control group. The proportion of PTs reporting frequent guideline use after participation in the implementation seminar was 15.2% (p = 0.043) higher than the proportion in the control group. A higher proportion considered EBP helpful in decision making (p = 0.018). There were no other significant differences in secondary outcomes. A tailored, theory- and evidence-informed, multi-component intervention for the implementation of clinical practice guidelines had a modest, positive effect on awareness of, knowledge of, access to, and use of guidelines, among PTs in primary care in western Sweden. In general, attitudes to EBP and guidelines were not affected.

ESPGHAN-NASPGHAN Guidelines for the Evaluation and Treatment of Gastrointestinal and Nutritional Complications in Children With Esophageal Atresia-Tracheoesophageal Fistula.

PubMed

Krishnan, Usha; Mousa, Hayat; Dall'Oglio, Luigi; Homaira, Nusrat; Rosen, Rachel; Faure, Christophe; Gottrand, Frédéric

2016-11-01

Esophageal atresia (EA) is one of the most common congenital digestive anomalies. With improvements in surgical techniques and intensive care treatments, the focus of care of these patients has shifted from mortality to morbidity and quality-of-life issues. These children face gastrointestinal (GI) problems not only in early childhood but also through adolescence and adulthood. There is, however, currently a lack of a systematic approach to the care of these patients. The GI working group of International Network on Esophageal Atresia comprises members from ESPGHAN/NASPGHAN and was charged with the task of developing uniform evidence-based guidelines for the management of GI complications in children with EA. Thirty-six clinical questions addressing the diagnosis, treatment, and prognosis of the common GI complications in patients with EA were formulated. Questions on the diagnosis, and treatment of gastroesophageal reflux, management of "cyanotic spells," etiology, investigation and management of dysphagia, feeding difficulties, anastomotic strictures, congenital esophageal stenosis in EA patients were addressed. The importance of excluding eosinophilic esophagitis and associated GI anomalies in symptomatic patients with EA is discussed as is the quality of life of these patients and the importance of a systematic transition of care to adulthood. A systematic literature search was performed from inception to March 2014 using Embase, MEDLINE, the Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Clinical Trials, and PsychInfo databases. The approach of the Grading of Recommendations Assessment, Development and Evaluation was applied to evaluate outcomes. During 2 consensus meetings, all recommendations were discussed and finalized. The group members voted on each recommendation, using the nominal voting technique. Expert opinion was used where no randomized controlled trials were available to support the recommendation.

Managing Asthma in Primary Care: Putting New Guideline Recommendations Into Context

PubMed Central

Wechsler, Michael E.

2009-01-01

Many patients with asthma are treated in the primary care setting. The primary care physician is therefore in a key position to recognize poorly controlled asthma and to improve asthma management for these patients. However, current evidence continues to show that, for a substantial number of patients, asthma control is inadequate for a wide variety of reasons, both physician-related and patient-related. The most recently updated treatment guidelines from the National Asthma Education and Prevention Program were designed to help clinicians, including primary care physicians, manage asthma more effectively with an increased focus on achieving and maintaining good asthma control over time. The current review is intended to assist primary care physicians in improving asthma control among their patients; this review clarifies the new guidelines and provides a specialist's perspective on diagnosis, appropriate therapy, disease control surveillance, and appropriate referral when necessary. This discussion is based primarily on the new guidelines and the references cited therein, supplemented by the author's own clinical experience. PMID:19648388

An overview of revised NASA safety standard 1740.14

NASA Technical Reports Server (NTRS)

Reynolds, Robert; Eichler, Peter; Johnson, Nicholas

1997-01-01

Following a broad review of the debris control guidelines outside of NASA and according to additional feedback on the guidelines from within NASA, revisions were made to the NASA safety standard 1740.14. The NASA policy to limit the generation of orbital debris on NASA missions, stated in the NASA management instruction 1700.8 and implemented in the form of the NASA safety standard (NSS) 1740.14 is described together with the revisions implemented. The overall direction of the guidelines is the same, but the details of many of the guidelines were changed, including: changes for tether programs and for the control of operational debris. The NASA will continue to review the guidelines as new measurements and improved models of the environment are obtained.

[Myocardial perfusion scintigraphy - short form of the German guideline].

PubMed

Lindner, O; Burchert, W; Hacker, M; Schaefer, W; Schmidt, M; Schober, O; Schwaiger, M; vom Dahl, J; Zimmermann, R; Schäfers, M

2013-01-01

This guideline is a short summary of the guideline for myocardial perfusion scintigraphy published by the Association of the Scientific Medical Societies in Ger-many (AWMF). The purpose of this guideline is to provide practical assistance for indication and examination procedures as well as image analysis and to present the state-of-the-art of myocardial-perfusion-scintigraphy. After a short introduction on the fundamentals of imaging, precise and detailed information is given on the indications, patient preparation, stress testing, radiopharmaceuticals, examination protocols and techniques, radiation exposure, data reconstruction as well as information on visual and quantitative image analysis and interpretation. In addition possible pitfalls, artefacts and key elements of reporting are described.

Towards a controlled vocabulary on software engineering education

NASA Astrophysics Data System (ADS)

Pizard, Sebastián; Vallespir, Diego

2017-11-01

Software engineering is the discipline that develops all the aspects of the production of software. Although there are guidelines about what topics to include in a software engineering curricula, it is usually unclear which are the best methods to teach them. In any science discipline the construction of a classification schema is a common approach to understand a thematic area. This study examines previous publications in software engineering education to obtain a first controlled vocabulary (a more formal definition of a classification schema) in the field. Publications from 1988 to 2014 were collected and processed using automatic clustering techniques and the outcomes were analysed manually. The result is an initial controlled vocabulary with a taxonomy form with 43 concepts that were identified as the most used in the research publications. We present the classification of the concepts in three facets: 'what to teach', 'how to teach' and 'where to teach' and the evolution of concepts over time.

Survival of falling robots

NASA Astrophysics Data System (ADS)

Cameron, Jonathan M.; Arkin, Ronald C.

1992-02-01

As mobile robots are used in more uncertain and dangerous environments, it will become important to design them so that they can survive falls. In this paper, we examine a number of mechanisms and strategies that animals use to withstand these potentially catastrophic events and extend them to the design of robots. A brief survey of several aspects of how common cats survive falls provides an understanding of the issues involved in preventing traumatic injury during a falling event. After outlining situations in which robots might fall, a number of factors affecting their survival are described. From this background, several robot design guidelines are derived. These include recommendations for the physical structure of the robot as well as requirements for the robot control architecture. A control architecture is proposed based on reactive control techniques and action-oriented perception that is geared to support this form of survival behavior.

Survival of falling robots

NASA Technical Reports Server (NTRS)

Cameron, Jonathan M.; Arkin, Ronald C.

1992-01-01

As mobile robots are used in more uncertain and dangerous environments, it will become important to design them so that they can survive falls. In this paper, we examine a number of mechanisms and strategies that animals use to withstand these potentially catastrophic events and extend them to the design of robots. A brief survey of several aspects of how common cats survive falls provides an understanding of the issues involved in preventing traumatic injury during a falling event. After outlining situations in which robots might fall, a number of factors affecting their survival are described. From this background, several robot design guidelines are derived. These include recommendations for the physical structure of the robot as well as requirements for the robot control architecture. A control architecture is proposed based on reactive control techniques and action-oriented perception that is geared to support this form of survival behavior.

40 CFR 60.33c - Emission guidelines for municipal solid waste landfill emissions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Guidelines and Compliance Times for Municipal Solid Waste Landfills § 60.33c Emission guidelines for municipal solid waste landfill emissions. (a) For approval, a State plan shall include control of MSW... 40 Protection of Environment 6 2010-07-01 2010-07-01 false Emission guidelines for municipal solid...

40 CFR 60.33c - Emission guidelines for municipal solid waste landfill emissions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Guidelines and Compliance Times for Municipal Solid Waste Landfills § 60.33c Emission guidelines for municipal solid waste landfill emissions. (a) For approval, a State plan shall include control of MSW... 40 Protection of Environment 6 2011-07-01 2011-07-01 false Emission guidelines for municipal solid...

Investigating the Effectiveness of Current and Modified World Health Organization Guidelines for the Control of Soil-Transmitted Helminth Infections.

PubMed

Farrell, Sam H; Coffeng, Luc E; Truscott, James E; Werkman, Marleen; Toor, Jaspreet; de Vlas, Sake J; Anderson, Roy M

2018-06-01

Considerable efforts have been made to better understand the effectiveness of large-scale preventive chemotherapy therapy for the control of morbidity caused by infection with soil-transmitted helminths (STHs): Ascaris lumbricoides, Trichuris trichiura, and the 2 hookworm species, Necator americanus and Ancylostoma duodenale. Current World Health Organization (WHO) guidelines for STH control include mass drug administration (MDA) programs based on prevalence measurements, aiming at reducing morbidity in pre-school-aged children (pre-SAC) and school-aged children (SAC) by lowering the prevalence of moderate- to heavy-intensity infections to <1%. We project the likely impact of following the current WHO guidelines and assess whether the WHO morbidity goals will be achieved across a range of transmission settings. We also investigate modifications that could be made to the current WHO treatment guidelines, and project their potential impacts in achieving morbidity and transmission control. While the standard guidelines are sufficient at low transmission levels, community-wide treatment (ie, involving pre-SAC, SAC, and adults) is essential if WHO morbidity goals are to be met in moderate- to high-transmission settings. Moreover, removing the recommendation of decreasing the treatment frequency at midline (5-6 years after the start of MDA) further improves the likelihood of achieving morbidity control in SAC. We meld analyses based on 2 mathematical models of parasite transmission and control by MDA for the dominant STH species, to generate a unified treatment approach applicable across all settings, regardless of which STH infection is most common. We recommend clearly defined changes to the current WHO guidelines.

External control of semiconductor nanostructure lasers

NASA Astrophysics Data System (ADS)

Naderi, Nader A.

2011-12-01

Novel semiconductor nanostructure laser diodes such as quantum-dot and quantum-dash are key optoelectronic candidates for many applications such as data transmitters in ultra fast optical communications. This is mainly due to their unique carrier dynamics compared to conventional quantum-well lasers that enables their potential for high differential gain and modified linewidth enhancement factor. However, there are known intrinsic limitations associated with semiconductor laser dynamics that can hinder the performance including the mode stability, spectral linewidth, and direct modulation capabilities. One possible method to overcome these limitations is through the use of external control techniques. The electrical and/or optical external perturbations can be implemented to improve the parameters associated with the intrinsic laser's dynamics, such as threshold gain, damping rate, spectral linewidth, and mode selectivity. In this dissertation, studies on the impact of external control techniques through optical injection-locking, optical feedback and asymmetric current bias control on the overall performance of the nanostructure lasers were conducted in order to understand the associated intrinsic device limitations and to develop strategies for controlling the underlying dynamics to improve laser performance. In turn, the findings of this work can act as a guideline for making high performance nanostructure lasers for future ultra fast data transmitters in long-haul optical communication systems, and some can provide an insight into making a compact and low-cost terahertz optical source for future implementation in monolithic millimeter-wave integrated circuits.

Treatment of fibromyalgia syndrome: recommendations of recent evidence-based interdisciplinary guidelines with special emphasis on complementary and alternative therapies.

PubMed

Ablin, Jacob; Fitzcharles, Mary-Ann; Buskila, Dan; Shir, Yoram; Sommer, Claudia; Häuser, Winfried

2013-01-01

Objective. Current evidence indicates that there is no single ideal treatment for fibromyalgia syndrome (FMS). First choice treatment options remain debatable, especially concerning the importance of complementary and alternative medicine (CAM) treatments. Methods. Three evidence-based interdisciplinary guidelines on FMS in Canada, Germany, and Israel were compared for their first choice and CAM-recommendations. Results. All three guidelines emphasized a patient-tailored approach according to the key symptoms. Aerobic exercise, cognitive behavioral therapy, and multicomponent therapy were first choice treatments. The guidelines differed in the grade of recommendation for drug treatment. Anticonvulsants (gabapentin, pregabalin) and serotonin noradrenaline reuptake inhibitors (duloxetine, milnacipran) were strongly recommended by the Canadian and the Israeli guidelines. These drugs received only a weak recommendation by the German guideline. In consideration of CAM-treatments, acupuncture, hypnosis/guided imagery, and Tai Chi were recommended by the German and Israeli guidelines. The Canadian guidelines did not recommend any CAM therapy. Discussion. Recent evidence-based interdisciplinary guidelines concur on the importance of treatment tailored to the individual patient and further emphasize the need of self-management strategies (exercise, and psychological techniques).

Applications of variable speed control for contending with recurrent highway congestion.

DOT National Transportation Integrated Search

2014-07-01

This research project developed vital operational guidelines for design of a variable speed limit (VSL) system and its integrated operations with ramp metering control in contending with recurrent highway congestion. The developed guidelines can serv...

Guidelines for Controlling Indoor Air Quality Problems Associated with Kilns, Copiers, and Welding in Schools. Technical Bulletin.

ERIC Educational Resources Information Center

Turner, Ronald W.; And Others

Guidelines for controlling indoor air quality problems associated with kilns, copiers, and welding in schools are provided in this document. Individual sections on kilns, duplicating equipment, and welding operations contain information on the following: sources of contaminants; health effects; methods of control; ventilation strategies; and…

Virginia Erosion and Sediment Control Handbook. Standards, Criteria and Guidelines.

ERIC Educational Resources Information Center

Virginia State Soil and Water Conservation Commission, Richmond, VA.

Guidelines and technical standards for development of local erosion and sediment control programs and conservation standards to meet the goals established by the Virginia Erosion and Sediment Control law are presented in this handbook. Part I defines natural and manmade erosion, sedimentation, and the hazards of uncontrolled wear and damage to the…

[Essential guidelines for Quality Management System].

PubMed

Daunizeau, A

2013-06-01

The guidelines describe the essential parts of the quality management system to fulfil the requirements of the standard EN ISO 15 189. It includes mainly the organisation, the definition of responsibilities, training of personnel, the document control, the quality control, identification and control of nonconformities, corrective actions, preventive actions and evaluation, as audits and the management review.

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

PubMed Central

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

2018-01-01

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

Post hoc evaluation of a common-sense intervention for asthma management in community pharmacy.

PubMed

Watkins, Kim; Seubert, Liza; Schneider, Carl R; Clifford, Rhonda

2016-11-18

The aim was to evaluate a common-sense, behavioural change intervention to implement clinical guidelines for asthma management in the community pharmacy setting. The components of the common-sense intervention were described in terms of categories and dimensions using the Intervention Taxonomy (ITAX) and Behaviour Change Techniques (BCTs) using the Behaviour Change Wheel (BCW), Capability, Opportunity and Motivation-Behaviour (COM-B) System and Behaviour Change Techniques Taxonomy (BCTTv1). The retrospective application of these existing tools facilitated evaluation of the mechanism, fidelity, logistics and rationale of the common-sense intervention. The initial intervention study was conducted in 336 community pharmacies in the metropolitan area of Perth, Western Australia. Small-group workshops were conducted in 25 pharmacies; 162 received academic detailing and 149 acted as controls. The intervention was designed to improve pharmacy compliance with guidelines for a non-prescription supply of asthma reliever medications. Retrospective application of ITAX identified mechanisms for the short-acting β agonists intervention including improving knowledge, behavioural skills, problem-solving skills, motivation and self-efficacy. All the logistical elements were considered in the intervention design but the duration and intensity of the intervention was minimal. The intervention was delivered as intended (as a workshop) to 13.4% of participants indicating compromised fidelity and significant adaptation. Retrospective application of the BCW, COM-B system and BCTTv1 identified 9 different behaviour change techniques as the rationale for promoting guideline-based practice change. There was a sound rationale and clear mechanism for all the components of the intervention but issues related to logistics, adaptability and fidelity might have affected outcomes. Small group workshops could be a useful implementation strategy in community pharmacy, if logistical issues can be overcome and less adaptation occurs. Duration, intensity and reinforcement need consideration for successful wider implementation. Further qualitative evaluations, triangulation of research and evaluations across interventions should be used to provide a greater understanding of unresolved issues. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Developing a Reporting Guideline for Social and Psychological Intervention Trials

PubMed Central

Mayo-Wilson, Evan; Hopewell, Sally; Macdonald, Geraldine; Moher, David; Grant, Sean

2013-01-01

Understanding randomized controlled trials of complex social and psychological interventions requires a detailed description of the interventions tested and the methods used to evaluate them. However, randomized controlled trial reports often omit, or inadequately report, this information. Incomplete and inaccurate reporting hinders the optimal use of research, wastes resources, and fails to meet ethical obligations to research participants and consumers. We explain how reporting guidelines have improved the quality of reports in medicine, and describe the ongoing development of a new reporting guideline for randomized controlled trials: an extension of the Consolidated Standards of Reporting Trials for social and psychological interventions. We invite readers to participate in the project by visiting our Web site, to help us reach the best-informed consensus on these guidelines (http://tinyurl.com/consort-study). PMID:23947317

A summary of the new GINA strategy: a roadmap to asthma control

PubMed Central

Bateman, Eric D.; Becker, Allan; Boulet, Louis-Philippe; Cruz, Alvaro A.; Drazen, Jeffrey M.; Haahtela, Tari; Hurd, Suzanne S.; Inoue, Hiromasa; de Jongste, Johan C.; Lemanske, Robert F.; Levy, Mark L.; O'Byrne, Paul M.; Paggiaro, Pierluigi; Pedersen, Soren E.; Pizzichini, Emilio; Soto-Quiroz, Manuel; Szefler, Stanley J.; Wong, Gary W.K.; FitzGerald, J. Mark

2015-01-01

Over the past 20 years, the Global Initiative for Asthma (GINA) has regularly published and annually updated a global strategy for asthma management and prevention that has formed the basis for many national guidelines. However, uptake of existing guidelines is poor. A major revision of the GINA report was published in 2014, and updated in 2015, reflecting an evolving understanding of heterogeneous airways disease, a broader evidence base, increasing interest in targeted treatment, and evidence about effective implementation approaches. During development of the report, the clinical utility of recommendations and strategies for their practical implementation were considered in parallel with the scientific evidence. This article provides a summary of key changes in the GINA report, and their rationale. The changes include a revised asthma definition; tools for assessing symptom control and risk factors for adverse outcomes; expanded indications for inhaled corticosteroid therapy; a framework for targeted treatment based on phenotype, modifiable risk factors, patient preference, and practical issues; optimisation of medication effectiveness by addressing inhaler technique and adherence; revised recommendations about written asthma action plans; diagnosis and initial treatment of the asthma−chronic obstructive pulmonary disease overlap syndrome; diagnosis in wheezing pre-school children; and updated strategies for adaptation and implementation of GINA recommendations. PMID:26206872

Fortuitously discovered liver lesions.

PubMed

Dietrich, Christoph F; Sharma, Malay; Gibson, Robert N; Schreiber-Dietrich, Dagmar; Jenssen, Christian

2013-06-07

The fortuitously discovered liver lesion is a common problem. Consensus might be expected in terms of its work-up, and yet there is none. This stems in part from the fact that there is no preventive campaign involving the early detection of liver tumors other than for patients with known liver cirrhosis and oncological patients. The work-up (detection and differential diagnosis) of liver tumors comprises theoretical considerations, history, physical examination, laboratory tests, standard ultrasound, Doppler ultrasound techniques, contrast-enhanced ultrasound (CEUS), computed tomography and magnetic resonance imaging, as well as image-guided biopsy. CEUS techniques have proved to be the most pertinent method; these techniques became part of the clinical routine about 10 years ago in Europe and Asia and are used for a variety of indications in daily clinical practice. CEUS is in many cases the first and also decisive technical intervention for detecting and characterizing liver tumors. This development is reflected in many CEUS guidelines, e.g., in the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) guidelines 2004, 2008 and 2012 as well as the recently published World Federation for Ultrasound in Medicine and Biology-EFSUMB guidelines 2012. This article sets out considerations for making a structured work-up of incidental liver tumors feasible.

Adaptation of Cost Analysis Studies in Practice Guidelines.

PubMed

Zervou, Fainareti N; Zacharioudakis, Ioannis M; Pliakos, Elina Eleftheria; Grigoras, Christos A; Ziakas, Panayiotis D; Mylonakis, Eleftherios

2015-12-01

Clinical guidelines play a central role in day-to-day practice. We assessed the degree of incorporation of cost analyses to guidelines and identified modifiable characteristics that could affect the level of incorporation.We selected the 100 most cited guidelines listed on the National Guideline Clearinghouse (http://www.guideline.gov) and determined the number of guidelines that used cost analyses in their reasoning and the overall percentage of incorporation of relevant cost analyses available in PubMed. Differences between medical specialties were also studied. Then, we performed a case-control study using incorporated and not incorporated cost analyses after 1:1 matching by study subject and compared them by the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement requirements and other criteria.We found that 57% of guidelines do not use any cost justification. Guidelines incorporate a weighted average of 6.0% (95% confidence interval [CI] 4.3-7.9) among 3396 available cost analyses, with cardiology and infectious diseases guidelines incorporating 10.8% (95% CI 5.3-18.1) and 9.9% (95% CI 3.9- 18.2), respectively, and hematology/oncology and urology guidelines incorporating 4.5% (95% CI 1.6-8.6) and 1.6% (95% CI 0.4-3.5), respectively. Based on the CHEERS requirements, the mean number of items reported by the 148 incorporated cost analyses was 18.6 (SD = 3.7), a small but significant difference over controls (17.8 items; P = 0.02). Included analyses were also more likely to directly relate cost reductions to healthcare outcomes (92.6% vs 81.1%, P = 0.004) and declare the funding source (72.3% vs 53.4%, P < 0.001), while similar number of cases and controls reported a noncommercial funding source (71% vs 72.7%; P = 0.8).Guidelines remain an underused mechanism for the cost-effective allocation of available resources and a minority of practice guidelines incorporates cost analyses utilizing only 6% of the available cost analyses. Fulfilling the CHEERS requirements, directly relating costs with healthcare outcomes and transparently declaring the funding source seem to be valued by guideline-writing committees.

Adherence of healthcare professionals to evidence-based clinical practice guidelines in the management of hemodialysis patients, Khartoum State, Sudan.

PubMed

Abdelwahab, Hisham; Shigidi, Mazin; El-Tohami, Alyaa; Ibrahim, Lamees

2013-05-01

Hemodialysis (HD) is a complex procedure with many specifications and requires adherence to a set of particular clinical practice guidelines. These guidelines had already been established by globally acclaimed renal authorities and their implementation was shown to correlate with patients' morbidity and mortality. This study was conducted to evaluate the adherence of healthcare professionals to the evidence-based clinical practice patterns in Khartoum State HD units. A cross-sectional study was conducted in Khartoum State HD units during the period from September 2010 to January of 2011. Data was collected from the healthcare professionals using a specially designed checklist. The checklist included the evidence-based clinical practice guidelines for the HD vascular access, HD adequacy, anemia of chronic kidney disease (CKD), nutrition, cardiovascular risk assessment, and hepatitis B and C virus infection control. Implementation of these guidelines was evaluated, and further graded using a Likert-type scale. Four randomly selected HD units were included in the study. The rate of implementation of the HD vascular access guidelines was 54.8%, adequacy guidelines 57%, anemia of CKD 68.8%, nutrition 58.4%, cardiovascular risk assessment 57%, and hepatitis B and C infection control guidelines was 79.2%. Overall, the four HD units assessed showed moderate deviations from the practice guidelines of anemia of CKD and hepatitis B and C infection control. Extreme deviations from the clinical practice guidelines were seen in HD vascular access practices, adequacy assessments, nutrition and cardiovascular risk assessment. Hemodialysis services in Khartoum State are in need of great improvements regarding adherence to protocols and the standards of care.

Propensity Score Techniques and the Assessment of Measured Covariate Balance to Test Causal Associations in Psychological Research

ERIC Educational Resources Information Center

Harder, Valerie S.; Stuart, Elizabeth A.; Anthony, James C.

2010-01-01

There is considerable interest in using propensity score (PS) statistical techniques to address questions of causal inference in psychological research. Many PS techniques exist, yet few guidelines are available to aid applied researchers in their understanding, use, and evaluation. In this study, the authors give an overview of available…

Tuberculosis infection control measures in health care facilities offering tb services in Ikeja local government area, Lagos, South West, Nigeria.

PubMed

Kuyinu, Y A; Mohammed, A S; Adeyeye, O O; Odugbemi, B A; Goodman, O O; Odusanya, O O

2016-03-15

Tuberculosis infection among health care workers is capable of worsening the existing health human resource problems of low--and middle-income countries. Tuberculosis infection control is often weakly implemented in these parts of the world therefore, understanding the reasons for poor implementation of tuberculosis infection control guidelines are important. This study was aimed at assessing tuberculosis infection control practices and barriers to its implementation in Ikeja, Nigeria. A cross-sectional study in 20 tuberculosis care facilities (16 public and 4 private) in Ikeja, Lagos was conducted. The study included a facility survey to assess the availability of tuberculosis infection control guidelines, the adequacy of facilities to prevent transmission of tuberculosis and observations of practices to assess the implementation of tuberculosis infection control guidelines. Four focus group discussions were carried out to highlight HCWs' perceptions on tuberculosis infection control guidelines and barriers to its implementation. The observational study showed that none of the clinics had a tuberculosis infection control plan. No clinic was consistently screening patients for cough. Twelve facilities (60%) consistently provided masks to patients who were coughing. Ventilation in the waiting areas was assessed to be adequate in 60% of the clinics while four clinics (20%) possessed N-95 respirators. Findings from the focus group discussions showed weak managerial support, poor funding, under-staffing, lack of space and not wanting to be seen as stigmatizing against tuberculosis patients as barriers that hindered the implementation of TB infection control measures. Tuberculosis infection control measures were not adequately implemented in health facilities in Ikeja, Nigeria. A multi-pronged approach is required to address the identified barriers to the implementation of tuberculosis infection control guidelines.

An analytical and experimental investigation of active structural acoustic control of noise transmission through double panel systems

NASA Astrophysics Data System (ADS)

Carneal, James P.; Fuller, Chris R.

2004-05-01

An analytical and experimental investigation of active control of sound transmission through double panel systems has been performed. The technique used was active structural acoustic control (ASAC) where the control inputs, in the form of piezoelectric actuators, were applied to the structure while the radiating pressure field was minimized. Results verify earlier experimental investigations and indicate the application of control inputs to the radiating panel of the double panel system resulted in greater transmission loss (TL) due to its direct effect on the nature of the structural-acoustic (or radiation) coupling between the radiating panel and the receiving acoustic space. Increased control performance was seen in a double panel system consisting of a stiffer radiating panel due to its lower modal density and also as a result of better impedance matching between the piezoelectric actuator and the radiating plate. In general the results validate the ASAC approach for double panel systems, demonstrating that it is possible to take advantage of double panel system passive behavior to enhance control performance, and provide design guidelines.

Acupressure for Educators: An Illustrated Workbook for the Practice of Simple Acupressure Techniques. Experiencing Energy. Third Edition.

ERIC Educational Resources Information Center

St. John, Jeanne

The guidelines are intended to familiarize educators with the basics of acupressure and to suggest ways in which the principles may help relieve anxiety and stress in school students. Eight energy exercises are introduced, followed by a review of the basic principles of energy and guidelines for giving and receiving acupressure. Illustrations of…

Contemporary behavior management techniques in clinical pediatric dentistry: out with the old and in with the new?

PubMed

Oliver, Kelly; Manton, David John

2015-01-01

Effective behavior management guides children through the complex social context of dentistry utilizing techniques based on a current understanding of the social, emotional, and cognitive development of children. Behavior management techniques facilitate effective communication and establish social and behavioral guidelines for the dental environment. Contemporary parenting styles, expectations, and attitudes of modern parents and society have influenced the use of behavior management techniques with a prevailing emphasis on communicative techniques and pharmacological management over aversive techniques.

GUIDELINES ON SELECTION AND USE OF SNOW AND ICE CONTROL MATERIALS.

DOT National Transportation Integrated Search

2017-09-19

This document presents guidelines for the selection of snow and ice control materials for winter weather roadway maintenance applications in Texas. The purpose of this document is to provide Texas Department of Transportation (TxDOT) roadway maintena...

Infection control in hemodialysis units: a quick access to essential elements.

PubMed

Karkar, Ayman; Bouhaha, Betty Mandin; Dammang, Mienalyn Lim

2014-05-01

Infection is the most common cause of hospitalization and the second most common cause of mortality among hemodialysis (HD) patients, after cardiovascular disease. HD patients as well as the dialysis staff are vulnerable to contracting health-care-associated infections (HAIs) due to frequent and prolonged exposure to many possible contaminants in the dialysis environment. The extracorporeal nature of the therapy, the associated common environmental conditions and the immune compromised status of HD patients are major predisposing factors. The evident increased potential for transmission of infections in the HD settings led to the creation and implementation of specific and stricter infection prevention and control measures in addition to the usual standard precautions. Different international organizations have generated guidelines and recommendations on infection prevention and control for implementation in the HD settings. These include the Centers for Disease Control and Prevention (CDC), the Association of Professionals in Infection Control (APIC), the Kidney Disease Outcomes Quality Initiative (K/DOQI), the European Best Practice Guidelines/European Renal Best Practice (EBPG/ERBP) and the Kidney Disease: Improving Global Outcomes (KDIGO). However, these guidelines are extensive and sometimes vary among different guideline-producing bodies. Our aim in this review is to facilitate the access, increase the awareness and encourage implementation among dialysis providers by reviewing, extracting and comparing the essential elements of guidelines and recommendations on infection prevention and control in HD units.

Improved model reduction and tuning of fractional-order PI(λ)D(μ) controllers for analytical rule extraction with genetic programming.

PubMed

Das, Saptarshi; Pan, Indranil; Das, Shantanu; Gupta, Amitava

2012-03-01

Genetic algorithm (GA) has been used in this study for a new approach of suboptimal model reduction in the Nyquist plane and optimal time domain tuning of proportional-integral-derivative (PID) and fractional-order (FO) PI(λ)D(μ) controllers. Simulation studies show that the new Nyquist-based model reduction technique outperforms the conventional H(2)-norm-based reduced parameter modeling technique. With the tuned controller parameters and reduced-order model parameter dataset, optimum tuning rules have been developed with a test-bench of higher-order processes via genetic programming (GP). The GP performs a symbolic regression on the reduced process parameters to evolve a tuning rule which provides the best analytical expression to map the data. The tuning rules are developed for a minimum time domain integral performance index described by a weighted sum of error index and controller effort. From the reported Pareto optimal front of the GP-based optimal rule extraction technique, a trade-off can be made between the complexity of the tuning formulae and the control performance. The efficacy of the single-gene and multi-gene GP-based tuning rules has been compared with the original GA-based control performance for the PID and PI(λ)D(μ) controllers, handling four different classes of representative higher-order processes. These rules are very useful for process control engineers, as they inherit the power of the GA-based tuning methodology, but can be easily calculated without the requirement for running the computationally intensive GA every time. Three-dimensional plots of the required variation in PID/fractional-order PID (FOPID) controller parameters with reduced process parameters have been shown as a guideline for the operator. Parametric robustness of the reported GP-based tuning rules has also been shown with credible simulation examples. Copyright © 2011 ISA. Published by Elsevier Ltd. All rights reserved.

Guidelines for disseminating road weather messages : improved road weather information for travelers.

DOT National Transportation Integrated Search

2013-01-01

The Federal Highway Administration (FHWA) Road Weather Management Program (RWMP) recently published a document titled Guidelines for Disseminating Road Weather Advisory and Control Information (FHWA-JPO-12- 046). The guidelines are intended for use b...

Formalization of treatment guidelines using Fuzzy Cognitive Maps and semantic web tools.

PubMed

Papageorgiou, Elpiniki I; Roo, Jos De; Huszka, Csaba; Colaert, Dirk

2012-02-01

Therapy decision making and support in medicine deals with uncertainty and needs to take into account the patient's clinical parameters, the context of illness and the medical knowledge of the physician and guidelines to recommend a treatment therapy. This research study is focused on the formalization of medical knowledge using a cognitive process, called Fuzzy Cognitive Maps (FCMs) and semantic web approach. The FCM technique is capable of dealing with situations including uncertain descriptions using similar procedure such as human reasoning does. Thus, it was selected for the case of modeling and knowledge integration of clinical practice guidelines. The semantic web tools were established to implement the FCM approach. The knowledge base was constructed from the clinical guidelines as the form of if-then fuzzy rules. These fuzzy rules were transferred to FCM modeling technique and, through the semantic web tools, the whole formalization was accomplished. The problem of urinary tract infection (UTI) in adult community was examined for the proposed approach. Forty-seven clinical concepts and eight therapy concepts were identified for the antibiotic treatment therapy problem of UTIs. A preliminary pilot-evaluation study with 55 patient cases showed interesting findings; 91% of the antibiotic treatments proposed by the implemented approach were in fully agreement with the guidelines and physicians' opinions. The results have shown that the suggested approach formalizes medical knowledge efficiently and gives a front-end decision on antibiotics' suggestion for cystitis. Concluding, modeling medical knowledge/therapeutic guidelines using cognitive methods and web semantic tools is both reliable and useful. Copyright © 2011 Elsevier Inc. All rights reserved.

Application of clinical techniques relevant for glaucoma assessment by optometrists: concordance with guidelines.

PubMed

Jamous, Khalid F; Kalloniatis, Michael; Hayen, Andrew; Mitchell, Paul; Stapleton, Fiona J; Zangerl, Barbara

2014-09-01

Guidelines for the screening, prognosis, diagnosis, management and prevention of glaucoma were released by the Australian National Health and Medical Research Council in 2010. Comparable guidance has been made available by respective bodies in the USA and UK at a similar time. Key to successful translation of guidelines into clinical practice includes clinicians having the necessary skills to perform required tests. Optometrists in Australia and New Zealand were invited to participate in an online survey exploring these aspects. The results provide insights for improving glaucoma diagnosis and management by optometric primary eye care practitioners. An online questionnaire was developed to investigate glaucoma assessment of optometrists as a function of demographic details, educational background and experience. Key points to ascertain compliance with current guidelines were the availability of equipment, procedural confidence in techniques, and preferences in visual field tests. Chi square statistics was employed to support similarity to national averages and highlight differences between the two countries. Multivariate linear regression analysis identified variables significantly associated with individual tests being available to optometrists and their confidence in applying them. Thirteen per cent of all Australian and 36% of the New Zealand optometrists responded to the survey in 2013, which reflected the demographics/geography of the practising populations. Techniques considered essential or preferred for glaucoma assessment were widely available in both countries with the exception of gonioscopy and pachymetry. After correcting for availability, regression models highlighted therapeutic endorsement and knowledge of glaucoma guidelines as the main variables to maintain high diagnostic confidence. Correlations to number of years in optometric practice mirrored a changed emphasis in teaching and technology over the past 10-15 years. Australian and New Zealand optometrists were well equipped to perform glaucoma assessments with the possible exception of gonioscopy. Advanced imaging modalities were not yet fully integrated into optometric practice, although optical coherence tomography has shown use by 23-32% of optometrists. A marked increase in use, availability and procedural confidence of gonioscopy and other techniques with therapeutically endorsed optometrists demonstrates the advantage and importance of additional training. © 2014 The Authors Ophthalmic & Physiological Optics © 2014 The College of Optometrists.

Endometrial ablation in the management of abnormal uterine bleeding.

PubMed

Laberge, Philippe; Leyland, Nicholas; Murji, Ally; Fortin, Claude; Martyn, Paul; Vilos, George; Leyland, Nicholas; Wolfman, Wendy; Allaire, Catherine; Awadalla, Alaa; Dunn, Sheila; Heywood, Mark; Lemyre, Madeleine; Marcoux, Violaine; Potestio, Frank; Rittenberg, David; Singh, Sukhbir; Yeung, Grace

2015-04-01

Abnormal uterine bleeding (AUB) is the direct cause of a significant health care burden for women, their families, and society as a whole. Up to 30% of women will seek medical assistance for the problem during their reproductive years. To provide current evidence-based guidelines on the techniques and technologies used in endometrial ablation (EA), a minimally invasive technique for the management of AUB of benign origin. Members of the guideline committee were selected on the basis of individual expertise to represent a range of practical and academic experience in terms of both location in Canada and type of practice, as well as subspecialty expertise and general background in gynaecology. The committee reviewed all available evidence in the English medical literature, including published guidelines, and evaluated surgical and patient outcomes for the various EA techniques. Recommendations were established by consensus. Published literature was retrieved through searches of MEDLINE and The Cochrane Library in 2013 and 2014 using appropriate controlled vocabulary and key words (endometrial ablation, hysteroscopy, menorrhagia, heavy menstrual bleeding, AUB, hysterectomy). RESULTS were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies written in English from January 2000 to November 2014. Searches were updated on a regular basis and incorporated in the guideline to December 2014. Grey (unpublished) literature was identifies through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table 1). This document reviews the evidence regarding the available techniques and technologies for EA, preoperative and postoperative care, operative set-up, anaesthesia, and practical considerations for practice. Implementation of the guideline recommendations will improve the provision of EA as an effective treatment of AUB. Following these recommendations would allow the surgical procedure to be performed safely and maximize success for patients. EA is a safe and effective minimally invasive option for the treatment of AUB of benign etiology. Summary Statements 1. Endometrial ablation is a safe and effective minimally invasive surgical procedure that has become a well-established alternative to medical treatment or hysterectomy to treat abnormal uterine bleeding in select cases. (I) 2. Endometrial preparation can be used to facilitate resectoscopic endometrial ablation (EA) and can be considered for some non-resectoscopic techniques. For resectoscopic EA, preoperative endometrial thinning results in higher short-term amenorrhea rates, decreased irrigant fluid absorption, and shorter operative time than no treatment. (I) 3. Non-resectoscopic techniques are technically easier to perform than resectoscopic techniques, have shorter operative times, and allow the use of local rather than general anaesthesia. However, both techniques have comparable patient satisfaction and reduction of heavy menstrual bleeding. (I) 4. Both resectoscopic and non-resectoscopic endometrial ablation (EA) have low complication rates. Uterine perforation, fluid overload, hematometra, and cervical lacerations are more common with resectoscopic EA; perioperative nausea/vomiting, uterine cramping, and pain are more common with non-resectoscopic EA. (I) 5. All non-resectoscopic endometrial ablation devices available in Canada have demonstrated effectiveness in decreasing menstrual flow and result in high patient satisfaction. The choice of which device to use depends primarily on surgical judgement and the availability of resources. (I) 6. The use of local anaesthetic and blocks, oral analgesia, and conscious sedation allows for the provision of non-resectoscopic EA in lower resource-intense environments including regulated non-hospital settings. (II-2) 7. Low-risk patients with satisfactory pain tolerance are good candidates to undergo endometrial ablation in settings outside the operating room or in free-standing surgical centres. (II-2) 8. Both resectoscopic and non-resectoscopic endometrial ablation are relatively safe procedures with low complication rates. The complications perforation with potential injury to contiguous structures, hemorrhage, and infection. (II-2) 9. Combined hysteroscopic sterilization and endometrial ablation can be safe and efficacious while favouring a minimally invasive approach. (II-2) Recommendations 1. Preoperative assessment should be comprehensive to rule out any contraindication to endometrial ablation. (II-2A) 2. Patients should be counselled about the need for permanent contraception following endometrial ablation. (II-2B) 3. Recommended evaluations for abnormal uterine bleeding, including but not limited to endometrial sampling and an assessment of the uterine cavity, are necessary components of the preoperative assessment. (II-2B) 4. Clinicians should be vigilant for complications unique to resectoscopic endometrial ablation such as those related to fluid distention media and electrosurgical injuries. (III-A) 5. For resectoscopic endometrial ablation, a strict protocol should be followed for fluid monitoring and management to minimize the risk of complications of distension medium overload. (III-A) 6. If uterine perforation is suspected to have occurred during cervical dilatation or with the resectoscope (without electrosurgery), the procedure should be abandoned and the patient should be closely monitored for signs of intraperitoneal hemorrhage or visceral injury. If the perforation occurs with electrosurgery or if the mechanism of perforation is uncertain, abdominal exploration is warranted to obtain hemostasis and rule out visceral injury. (III-B) 7. With resectoscopic endometrial ablation, if uterine perforation has been ruled out acute hemorrhage may be managed by using intrauterine Foley balloon tamponade, injecting intracervical vasopressors, or administering rectal misoprostol. (III-B) 8. If repeat endometrial ablation (EA) is considered following non-resectoscopic or resectoscopic EA, it should be performed by a hysteroscopic surgeon with direct visualization of the cavity. Patients should be counselled about the increased risk of complications with repeat EA. (II-2A) 9. If significant intracavitary pathology is present, resectoscopic endometrial ablation combined with hysteroscopic myomectomy or polypectomy should be considered in a non-fertility sparing setting. (II-3A).

COMP report: CPQR technical quality control guidelines for low-dose-rate permanent seed brachytherapy.

PubMed

Beaulieu, Luc; Radford, Dee-Ann; Eduardo Villarreal-Barajas, J

2018-03-14

The Canadian Organization of Medical Physicists (COMP), in close partnership with the Canadian Partnership for Quality Radiotherapy (CPQR) has developed a series of Technical Quality Control (TQC) guidelines for radiation treatment equipment. These guidelines outline the performance objectives that equipment should meet in order to ensure an acceptable level of radiation treatment quality. The TQC guidelines have been rigorously reviewed and field tested in a variety of Canadian radiation treatment facilities. The development process enables rapid review and update to keep the guidelines current with changes in technology. This article contains detailed performance objectives and safety criteria for low-dose-rate (LDR) permanent seed brachytherapy. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Measure Guideline. Steam System Balancing and Tuning for Multifamily Residential Buildings

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

Choi, Jayne; Ludwig, Peter; Brand, Larry

2013-04-01

This guideline provides building owners, professionals involved in multifamily audits, and contractors insights for improving the balance and tuning of steam systems. It provides readers an overview of one-pipe steam heating systems, guidelines for evaluating steam systems, typical costs and savings, and guidelines for ensuring quality installations. It also directs readers to additional resources for details not included here. Measures for balancing a distribution system that are covered include replacing main line vents and upgrading radiator vents. Also included is a discussion on upgrading boiler controls and the importance of tuning the settings on new or existing boiler controls. Themore » guideline focuses on one-pipe steam systems, though many of the assessment methods can be generalized to two-pipe steam systems.« less

Cell proliferation assessment in oncology.

PubMed

Hofstädter, F; Knüchel, R; Rüschoff, J

1995-01-01

A review of the current knowledge on cell cycle control and the techniques used to assess proliferation of normal and neoplastic cells was the focus of a workshop in Regensburg, Germany, held under the joint auspices of the Graduiertenkolleg: Therapieforschung Onkologie and the Committee on AgNOR Quantification. An overview of the recently discovered group of cyclins and their specific kinases, and of other proliferation-associated antigens, such as Ki67, PCNA and topoiseromase II alpha, was given. The topics continued with a reappraisal of modern imaging and flow-cytometric techniques. An update of the relation of AgNORs to cellular proliferation and differentiation was the link to presentations on clinical data, problems and strategies for standardization, as well as guidelines to establish the prognostic value of marker molecules. These lectures were supported by posters. Bringing together researchers from life sciences, technically oriented workers, pathologists, and clinicians resulted in a lively and constructive discussion, which is briefly summarized in the Concluding remarks.

Contemporary Management of Benign and Malignant Parotid Tumors.

PubMed

Thielker, Jovanna; Grosheva, Maria; Ihrler, Stephan; Wittig, Andrea; Guntinas-Lichius, Orlando

2018-01-01

To report the standard of care, interesting new findings and controversies about the treatment of parotid tumors. Relevant and actual studies were searched in PubMed and reviewed for diagnostics, treatment and outcome of both benign and malignant tumors. Prospective trials are lacking due to rarity of the disease and high variety of tumor subtypes. The establishment of reliable non-invasive diagnostics tools for the differentiation between benign and malignant tumors is desirable. Prospective studies clarifying the association between different surgical techniques for benign parotid tumors and morbidity are needed. The role of adjuvant or definitive radiotherapy in securing loco-regional control and improving survival in malignant disease is established. Prospective clinical trials addressing the role of chemotherapy/molecular targeted therapy for parotid cancer are needed. An international consensus on the classification of parotid surgery techniques would facilitate the comparison of different trials. Such efforts should lead into a clinical guideline.

ASVCP quality assurance guidelines: control of general analytical factors in veterinary laboratories.

PubMed

Flatland, Bente; Freeman, Kathy P; Friedrichs, Kristen R; Vap, Linda M; Getzy, Karen M; Evans, Ellen W; Harr, Kendal E

2010-09-01

Owing to lack of governmental regulation of veterinary laboratory performance, veterinarians ideally should demonstrate a commitment to self-monitoring and regulation of laboratory performance from within the profession. In response to member concerns about quality management in veterinary laboratories, the American Society for Veterinary Clinical Pathology (ASVCP) formed a Quality Assurance and Laboratory Standards (QAS) committee in 1996. This committee recently published updated and peer-reviewed Quality Assurance Guidelines on the ASVCP website. The Quality Assurance Guidelines are intended for use by veterinary diagnostic laboratories and veterinary research laboratories that are not covered by the US Food and Drug Administration Good Laboratory Practice standards (Code of Federal Regulations Title 21, Chapter 58). The guidelines have been divided into 3 reports on 1) general analytic factors for veterinary laboratory performance and comparisons, 2) hematology and hemostasis, and 3) clinical chemistry, endocrine assessment, and urinalysis. This report documents recommendations for control of general analytical factors within veterinary clinical laboratories and is based on section 2.1 (Analytical Factors Important In Veterinary Clinical Pathology, General) of the newly revised ASVCP QAS Guidelines. These guidelines are not intended to be all-inclusive; rather, they provide minimum guidelines for quality assurance and quality control for veterinary laboratory testing. It is hoped that these guidelines will provide a basis for laboratories to assess their current practices, determine areas for improvement, and guide continuing professional development and education efforts. ©2010 American Society for Veterinary Clinical Pathology.

Application of Piloted Simulation to High-Angle-of-Attack Flight-Dynamics Research for Fighter Aircraft

NASA Technical Reports Server (NTRS)

Ogburn, Marilyn E.; Foster, John V.; Hoffler, Keith D.

2005-01-01

This paper reviews the use of piloted simulation at Langley Research Center as part of the NASA High-Angle-of-Attack Technology Program (HATP), which was created to provide concepts and methods for the design of advanced fighter aircraft. A major research activity within this program is the development of the design processes required to take advantage of the benefits of advanced control concepts for high-angle-of-attack agility. Fundamental methodologies associated with the effective use of piloted simulation for this research are described, particularly those relating to the test techniques, validation of the test results, and design guideline/criteria development.

Environmental cleaning and disinfection.

PubMed

Traverse, Michelle; Aceto, Helen

2015-03-01

The guidelines in this article provide veterinarians, veterinary technicians, and veterinary health care workers with an overview of evidence-based recommendations for the best practices associated with environmental cleaning and disinfection of a veterinary clinic that deals with small animals. Hospital-associated infections and the control and prevention programs necessary to alleviate them are addressed from an environmental perspective. Measures of hospital cleaning and disinfection include understanding mechanisms and types of contamination in veterinary settings, recognizing areas of potential concern, addressing appropriate decontamination techniques and selection of disinfectants, the management of potentially contaminated equipment, laundry, and waste management, and environmental surveillance strategies. Copyright © 2015 Elsevier Inc. All rights reserved.

A Randomized Controlled Study of the Virginia Student Threat Assessment Guidelines in Kindergarten through Grade 12

ERIC Educational Resources Information Center

Cornell, Dewey G.; Allen, Korrie; Fan, Xitao

2012-01-01

This randomized controlled study examined disciplinary outcomes for 201 students who made threats of violence at school. The students attended 40 schools randomly assigned to use the Virginia Student Threat Assessment Guidelines or follow a business-as-usual disciplinary approach in a control group. Logistic regression analyses found, after…

10 CFR 960.4-2-8-2 - Site ownership and control.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Site ownership and control. 960.4-2-8-2 Section 960.4-2-8-2 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Postclosure Guidelines § 960.4-2-8-2 Site ownership and control. (a...

12 CFR Appendix E to Part 225 - Capital Adequacy Guidelines for Bank Holding Companies: Market Risk

Code of Federal Regulations, 2013 CFR

2013-01-01

... CONTROL (REGULATION Y) Pt. 225, App. E Appendix E to Part 225—Capital Adequacy Guidelines for Bank Holding... Method for Specific Risk Section 11Simplified Supervisory Formula Approach Section 12Market Risk... apply: Affiliate with respect to a company means any company that controls, is controlled by, or is...

12 CFR Appendix E to Part 225 - Capital Adequacy Guidelines for Bank Holding Companies: Market Risk

Code of Federal Regulations, 2014 CFR

2014-01-01

... CONTROL (REGULATION Y) Pt. 225, App. E Appendix E to Part 225—Capital Adequacy Guidelines for Bank Holding... Measurement Method for Specific Risk Section 11 Simplified Supervisory Formula Approach Section 12 Market Risk... apply: Affiliate with respect to a company means any company that controls, is controlled by, or is...

How-to-Do-It: Infection Control Guidelines for Blood Typing & Blood Smear Labs.

ERIC Educational Resources Information Center

Vetter, Edwin A.

1989-01-01

Provides a set of guidelines for infection control of the Acquired Immune Deficiency Syndrome and the serum hepatitis viruses during blood typing procedures. Emphasizes that disposal of blood contaminated materials should comply with local health department recommendations. (RT)

Guidelines for Effective Selective Listening.

ERIC Educational Resources Information Center

Schendel, Joel D.; Shields, Joyce L.

Defining selective listening as an intelligence gathering technique that depends on an individual's ability to access, monitor, and report oral messages accurately and to give processing priority to messages of possible intelligence value, this report describes one important application of the technique: overhearing the conversations of others…

Bioassay techniques for detecting root leakage of auxinic herbicides

USDA-ARS?s Scientific Manuscript database

Biological assay (bioassay) techniques are a simple way to determine the presence of herbicides in soil or other potting media. Understanding the fate of herbicides after absorption is important when guidelines for use are developed. Greenhouse studies were conducted with the herbicide aminocyclopyr...

Teacher-Directed and Student-Mediated Textbook Comprehension Strategies.

ERIC Educational Resources Information Center

Reynolds, Catharine J.; Salend, Spencer J.

1990-01-01

The article describes teacher-directed and student-mediated comprehension strategies to improve the text comprehension skills of mainstreamed students with mild disabilities. Techniques include advance organizers, study guides, color coding, oral reading, critical thinking maps, and self-questioning techniques. Guidelines are offered for assessing…

Black Oral Art Forms: Guided Group Interaction Techniques.

ERIC Educational Resources Information Center

Toldson, Ivory L.; Pasteur, Alfred B.

1981-01-01

Describes how oral art can positively influence the development of Black people through therapeutic guidance. Group techniques are suggested to stimulate the counselor's creative potential and enhance clients' self-worth Presents guidelines to enhance educational achievement and school retention, and develop determination and persistence. (JAC)

Tuberculosis epidemiology, diagnosis and infection control recommendations for dental settings: an update on the Centers for Disease Control and Prevention guidelines.

PubMed

Cleveland, Jennifer L; Robison, Valerie A; Panlilio, Adelisa L

2009-09-01

Although rates of tuberculosis (TB) in the United States have decreased in recent years, disparities in TB incidence still exist between U.S.-born and foreign-born people (people living in the United States but born outside it) and between white people and nonwhite people. In addition, the number of TB outbreaks among health care personnel and patients has decreased since the implementation of the 1994 Centers for Disease Control and Prevention (CDC) guidelines to prevent transmission of Mycobacterium tuberculosis. In this article, the authors provide updates on the epidemiology of TB, advances in TB diagnostic methods and TB infection control guidelines for dental settings. In 2008, 83 percent of all reported TB cases in the United States occurred in nonwhite people and 17 percent occurred in white people. Foreign-born people had a TB rate about 10 times higher than that of U.S.-born people. New blood assays for M. tuberculosis have been developed to diagnose TB infection and disease. Changes from the 1994 CDC guidelines incorporated into CDC's "Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005" include revised risk classifications, new TB diagnostic methods, decreased frequencies of tuberculin skin testing in various settings and changes in terminology. Although the principles of TB infection control have remained the same, the changing epidemiology of TB and the advent of new diagnostic methods for TB led to the development of the 2005 update to the 1994 guidelines. Dental health care personnel should be aware of the modifications that are pertinent to dental settings and incorporate them into their overall infection control programs.

Investigating the Effectiveness of Current and Modified World Health Organization Guidelines for the Control of Soil-Transmitted Helminth Infections

PubMed Central

Farrell, Sam H; Coffeng, Luc E; Truscott, James E; Werkman, Marleen; Toor, Jaspreet; de Vlas, Sake J; Anderson, Roy M

2018-01-01

Abstract Background Considerable efforts have been made to better understand the effectiveness of large-scale preventive chemotherapy therapy for the control of morbidity caused by infection with soil-transmitted helminths (STHs): Ascaris lumbricoides, Trichuris trichiura, and the 2 hookworm species, Necator americanus and Ancylostoma duodenale. Current World Health Organization (WHO) guidelines for STH control include mass drug administration (MDA) programs based on prevalence measurements, aiming at reducing morbidity in pre–school-aged children (pre-SAC) and school-aged children (SAC) by lowering the prevalence of moderate- to heavy-intensity infections to <1%. Methods We project the likely impact of following the current WHO guidelines and assess whether the WHO morbidity goals will be achieved across a range of transmission settings. We also investigate modifications that could be made to the current WHO treatment guidelines, and project their potential impacts in achieving morbidity and transmission control. Results While the standard guidelines are sufficient at low transmission levels, community-wide treatment (ie, involving pre-SAC, SAC, and adults) is essential if WHO morbidity goals are to be met in moderate- to high-transmission settings. Moreover, removing the recommendation of decreasing the treatment frequency at midline (5–6 years after the start of MDA) further improves the likelihood of achieving morbidity control in SAC. Conclusions We meld analyses based on 2 mathematical models of parasite transmission and control by MDA for the dominant STH species, to generate a unified treatment approach applicable across all settings, regardless of which STH infection is most common. We recommend clearly defined changes to the current WHO guidelines. PMID:29860285

Evaluation of a tailored, multi-component intervention for implementation of evidence-based clinical practice guidelines in primary care physical therapy: a non-randomized controlled trial

PubMed Central

2014-01-01

Background Clinical practice guidelines are important for transmitting research findings into practice and facilitating the application of evidence-based practice (EBP). There is a paucity of knowledge about the impact of guideline implementation strategies in primary care physical therapy. The aim of this study was to evaluate the effect of a guideline implementation intervention in primary care physical therapy in western Sweden. Methods An implementation strategy based on theory and current evidence was developed. A tailored, multi-component implementation intervention, addressing earlier identified determinants, was carried out in three areas comprising 28 physical therapy practices including 277 physical therapists (PTs) (intervention group). In two adjacent areas, 171 PTs at 32 practices received no intervention (control group). The core component of the intervention was an implementation seminar with group discussions. Among other components were a website and email reminders. Data were collected at baseline and follow-up with a web-based questionnaire. Primary outcomes were the self-reported awareness of, knowledge of, access to, and use of guidelines. Secondary outcomes were self-reported attitudes toward EBP and guidelines. Analyses were performed using Pearson’s χ2 test and approximative z-test. Results 168 PTs (60.6%) in the intervention group and 88 PTs (51.5%) in the control group responded to the follow-up questionnaire. 186/277 PTs (67.1%) participated in the implementation seminars, of which 97 (52.2%) responded. The proportions of PTs reporting awareness of (absolute difference in change 20.6%, p = 0.023), knowledge where to find (20.4%, p = 0.007), access to (21.7%, p < 0.001), and frequent use of (9.5%, NS) guidelines increased more in the intervention group than in the control group. The proportion of PTs reporting frequent guideline use after participation in the implementation seminar was 15.2% (p = 0.043) higher than the proportion in the control group. A higher proportion considered EBP helpful in decision making (p = 0.018). There were no other significant differences in secondary outcomes. Conclusions A tailored, theory- and evidence-informed, multi-component intervention for the implementation of clinical practice guidelines had a modest, positive effect on awareness of, knowledge of, access to, and use of guidelines, among PTs in primary care in western Sweden. In general, attitudes to EBP and guidelines were not affected. PMID:24589291

Middle East Respiratory Syndrome Infection Control and Prevention Guideline for Healthcare Facilities

PubMed Central

Kim, Jin Yong; Song, Joon Young; Yoon, Young Kyung; Choi, Seong-Ho; Song, Young Goo; Kim, Sung-Ran; Son, Hee-Jung; Jeong, Sun-Young; Choi, Jung-Hwa; Kim, Kyung Mi; Yoon, Hee Jung; Choi, Jun Yong; Kim, Tae Hyong; Choi, Young Hwa; Kim, Hong Bin; Yoon, Ji Hyun; Lee, Jacob; Eom, Joong Sik; Lee, Sang-Oh; Oh, Won Sup; Choi, Jung-Hyun; Yoo, Jin-Hong; Kim, Woo Joo

2015-01-01

Middle East Respiratory Syndrome (MERS) is an acute viral respiratory illness with high mortality caused by a new strain of betacoronavirus (MERS-CoV). Since the report of the first patient in Saudi Arabia in 2012, large-scale outbreaks through hospital-acquired infection and inter-hospital transmission have been reported. Most of the patients reported in South Korea were also infected in hospital settings. Therefore, to eliminate the spread of MERS-CoV, infection prevention and control measures should be implemented with rigor. The present guideline has been drafted on the basis of the experiences of infection control in the South Korean hospitals involved in the recent MERS outbreak and on domestic and international infection prevention and control guidelines. To ensure efficient MERS-CoV infection prevention and control, care should be taken to provide comprehensive infection control measures including contact control, hand hygiene, personal protective equipment, disinfection, and environmental cleaning. PMID:26788414

Middle East Respiratory Syndrome Infection Control and Prevention Guideline for Healthcare Facilities.

PubMed

Kim, Jin Yong; Song, Joon Young; Yoon, Young Kyung; Choi, Seong-Ho; Song, Young Goo; Kim, Sung-Ran; Son, Hee-Jung; Jeong, Sun-Young; Choi, Jung-Hwa; Kim, Kyung Mi; Yoon, Hee Jung; Choi, Jun Yong; Kim, Tae Hyong; Choi, Young Hwa; Kim, Hong Bin; Yoon, Ji Hyun; Lee, Jacob; Eom, Joong Sik; Lee, Sang-Oh; Oh, Won Sup; Choi, Jung-Hyun; Yoo, Jin-Hong; Kim, Woo Joo; Cheong, Hee Jin

2015-12-01

Middle East Respiratory Syndrome (MERS) is an acute viral respiratory illness with high mortality caused by a new strain of betacoronavirus (MERS-CoV). Since the report of the first patient in Saudi Arabia in 2012, large-scale outbreaks through hospital-acquired infection and inter-hospital transmission have been reported. Most of the patients reported in South Korea were also infected in hospital settings. Therefore, to eliminate the spread of MERS-CoV, infection prevention and control measures should be implemented with rigor. The present guideline has been drafted on the basis of the experiences of infection control in the South Korean hospitals involved in the recent MERS outbreak and on domestic and international infection prevention and control guidelines. To ensure efficient MERS-CoV infection prevention and control, care should be taken to provide comprehensive infection control measures including contact control, hand hygiene, personal protective equipment, disinfection, and environmental cleaning.

Use of cardiocerebral resuscitation or AHA/ERC 2005 Guidelines is associated with improved survival from out-of-hospital cardiac arrest: a systematic review and meta-analysis.

PubMed

Salmen, Marcus; Ewy, Gordon A; Sasson, Comilla

2012-01-01

To determine whether the use of cardiocerebral resuscitation (CCR) or AHA/ERC 2005 Resuscitation Guidelines improved patient outcomes from out-of-hospital cardiac arrest (OHCA) compared to older guidelines. Systematic review and meta-analysis. MEDLINE, EMBASE, Web of Science and the Cochrane Library databases. We also hand-searched study references and consulted experts. Design: randomised controlled trials and observational studies. OHCA patients, age >17 years. 'Control' protocol versus 'Study' protocol. 'Control' protocol defined as AHA/ERC 2000 Guidelines for cardiopulmonary resuscitation (CPR). 'Study' protocol defined as AHA/ERC 2005 Guidelines for CPR, or a CCR protocol. Survival to hospital discharge. High-quality or medium-quality studies, as measured by the Newcastle Ottawa Scale using predefined categories. Twelve observational studies met inclusion criteria. All the three studies using CCR demonstrated significantly improved survival compared to use of AHA 2000 Guidelines, as did five of the nine studies using AHA/ERC 2005 Guidelines. Pooled data demonstrate that use of a CCR protocol has an unadjusted OR of 2.26 (95% CI 1.64 to 3.12) for survival to hospital discharge among all cardiac arrest patients. Among witnessed ventricular fibrillation/ventricular tachycardia (VF/VT) patients, CCR increased survival by an OR of 2.98 (95% CI 1.92 to 4.62). Studies using AHA/ERC 2005 Guidelines showed an overall trend towards increased survival, but significant heterogeneity existed among these studies. We demonstrate an association with improved survival from OHCA when CCR protocols or AHA/ERC 2005 Guidelines are compared to use of older guidelines. In the subgroup of patients with witnessed VF/VT, there was a threefold increase in OHCA survival when CCR was used. CCR appears to be a promising resuscitation protocol for Emergency Medical Services providers in increasing survival from OHCA. Future research will need to be conducted to directly compare AHA/ERC 2010 Guidelines with the CCR approach.

Changes in insurance physicians' attitudes, self-efficacy, intention, and knowledge and skills regarding the guidelines for depression, following an implementation strategy.

PubMed

Zwerver, Feico; Schellart, Antonius J M; Anema, Johannes R; van der Beek, Allard J

2013-03-01

To improve guideline adherence by insurance physicians (IPs), an implementation strategy was developed and investigated in a randomized controlled trial. This implementation strategy involved a multifaceted training programme for a group of IPs in applying the guidelines for depression. In this study we report the impact of the implementation strategy on the physicians' attitude, intention, self-efficacy, and knowledge and skills as behavioural determinants of guideline adherence. Any links between these self-reported behavioural determinants and levels of guideline adherence were also determined. Just before and 3 months after the implementation of the multifaceted training, a questionnaire designed to measure behavioural determinants on the basis of the ASE (attitude, social norm, self-efficacy) model was completed by the intervention (n = 21) and the control group (n = 19). Items of the questionnaire were grouped to form scales of ASE determinants. Internal consistency of the scales was calculated using Cronbach's alphas. Differences between groups concerning changes in ASE determinants, and the association of these changes with improvements in guideline adherence, were analyzed using analysis of covariance. The internal consistency of the scales of ASE determinants proved to be sufficiently reliable, with Cronbach's alphas of at least 0.70. At follow-up after 3 months, the IPs given the implementation strategy showed significant improvement over the IPs in the control group for all ASE determinants investigated. Changes in knowledge and skills were only weakly associated with improvements in guideline adherence. The implementation strategy developed for insurance physicians can increase their attitude, intention, self-efficacy, and knowledge and skills when applying the guidelines for depression. These changes in behavioural determinants might indicate positive changes in IPs' behaviour towards the use of the guidelines for depression. However, only changes in knowledge and skills related to the use of the guidelines were associated with improvements in IPs' actual performance when applying the guidelines.

Personalized Guideline-Based Treatment Recommendations Using Natural Language Processing Techniques.

PubMed

Becker, Matthias; Böckmann, Britta

2017-01-01

Clinical guidelines and clinical pathways are accepted and proven instruments for quality assurance and process optimization. Today, electronic representation of clinical guidelines exists as unstructured text, but is not well-integrated with patient-specific information from electronic health records. Consequently, generic content of the clinical guidelines is accessible, but it is not possible to visualize the position of the patient on the clinical pathway, decision support cannot be provided by personalized guidelines for the next treatment step. The Systematized Nomenclature of Medicine - Clinical Terms (SNOMED CT) provides common reference terminology as well as the semantic link for combining the pathways and the patient-specific information. This paper proposes a model-based approach to support the development of guideline-compliant pathways combined with patient-specific structured and unstructured information using SNOMED CT. To identify SNOMED CT concepts, a software was developed to extract SNOMED CT codes out of structured and unstructured German data to map these with clinical pathways annotated in accordance with the systematized nomenclature.

Occupational therapy and physiotherapy for the patient with burns: principles and management guidelines.

PubMed

Simons, M; King, S; Edgar, D

2003-01-01

Clinical practice guidelines are a tool to assist with clinical decision making. They provide information about the care for a condition and make recommendations based on research evidence, which can be adapted locally. A focus group within the Allied Health Interest Group of the Australian and New Zealand Burn Association has compiled the "Occupational Therapy and Physiotherapy for the Patient with Burns--Principles and Management Guidelines." These guidelines are designed as a practical guide to the relevant clinical knowledge and therapy intervention techniques required for effective patient management. Content areas include respiratory management, edema management, splinting and positioning, physical function (mobility, function, exercise), scar management, and psychosocial and mutual elements. The document has undergone extensive review by members of the Australian and New Zealand Burn Association to ensure clarity, internal consistency, and acceptability. The guidelines have been endorsed by the Australian and New Zealand Burn Association. An abridged version of the guidelines is included in this article, with the full document available from www.anzba.org.au.

SCCT guidelines for the performance and acquisition of coronary computed tomographic angiography: A report of the society of Cardiovascular Computed Tomography Guidelines Committee: Endorsed by the North American Society for Cardiovascular Imaging (NASCI).

PubMed

Abbara, Suhny; Blanke, Philipp; Maroules, Christopher D; Cheezum, Michael; Choi, Andrew D; Han, B Kelly; Marwan, Mohamed; Naoum, Chris; Norgaard, Bjarne L; Rubinshtein, Ronen; Schoenhagen, Paul; Villines, Todd; Leipsic, Jonathon

In response to recent technological advancements in acquisition techniques as well as a growing body of evidence regarding the optimal performance of coronary computed tomography angiography (coronary CTA), the Society of Cardiovascular Computed Tomography Guidelines Committee has produced this update to its previously established 2009 "Guidelines for the Performance of Coronary CTA" (1). The purpose of this document is to provide standards meant to ensure reliable practice methods and quality outcomes based on the best available data in order to improve the diagnostic care of patients. Society of Cardiovascular Computed Tomography Guidelines for the Interpretation is published separately (2). The Society of Cardiovascular Computed Tomography Guidelines Committee ensures compliance with all existing standards for the declaration of conflict of interest by all authors and reviewers for the purpose ofclarity and transparency. Copyright © 2016 Society of Cardiovascular Computed Tomography. All rights reserved.

Effect of evidence-based feeding guidelines on mortality of critically ill adults: a cluster randomized controlled trial.

PubMed

Doig, Gordon S; Simpson, Fiona; Finfer, Simon; Delaney, Anthony; Davies, Andrew R; Mitchell, Imogen; Dobb, Geoff

2008-12-17

Evidence demonstrates that providing nutritional support to intensive care unit (ICU) patients within 24 hours of ICU admission reduces mortality. However, early feeding is not universally practiced. Changing practice in complex multidisciplinary environments is difficult. Evidence supporting whether guidelines can improve ICU feeding practices and patient outcomes is contradictory. To determine whether evidence-based feeding guidelines, implemented using a multifaceted practice change strategy, improve feeding practices and reduce mortality in ICU patients. Cluster randomized trial in ICUs of 27 community and tertiary hospitals in Australia and New Zealand. Between November 2003 and May 2004, 1118 critically ill adult patients expected to remain in the ICU longer than 2 days were enrolled. All participants completed the study. Intensive care units were randomly assigned to guideline or control groups. Guideline ICUs developed an evidence-based guideline using Browman's Clinical Practice Guideline Development Cycle. A practice-change strategy composed of 18 specific interventions, leveraged by educational outreach visits, was implemented in guideline ICUs. Hospital discharge mortality. Secondary outcomes included ICU and hospital length of stay, organ dysfunction, and feeding process measures. Guideline and control ICUs enrolled 561 and 557 patients, respectively. Guideline ICUs fed patients earlier (0.75 vs 1.37 mean days to enteral nutrition start; difference, -0.62 [95% confidence interval {CI}, -0.82 to -0.36]; P < .001 and 1.04 vs 1.40 mean days to parenteral nutrition start; difference, -0.35 [95% CI, -0.61 to -0.01]; P = .04) and achieved caloric goals more often (6.10 vs 5.02 mean days per 10 fed patient-days; difference, 1.07 [95% CI, 0.12 to 2.22]; P = .03). Guideline and control ICUs did not differ with regard to hospital discharge mortality (28.9% vs 27.4%; difference, 1.4% [95% CI, -6.3% to 12.0%]; P = .75) or to hospital length of stay (24.2 vs 24.3 days; difference, -0.08 [95% CI, -3.8 to 4.4]; P = .97) or ICU length of stay (9.1 vs 9.9 days; difference, -0.86 [95% CI, -2.6 to 1.3]; P = .42). Using a multifaceted practice change strategy, ICUs successfully developed and introduced an evidence-based nutritional support guideline that promoted earlier feeding and greater nutritional adequacy. However, use of the guideline did not improve clinical outcomes. Trial Registration anzctr.org.au Identifier: ACTRN12608000407392.

Managing problematic severe asthma: beyond the guidelines.

PubMed

Pike, Katharine C; Levy, Mark L; Moreiras, John; Fleming, Louise

2018-04-01

This review discusses issues related to managing problematic severe asthma in children and young people. A small minority of children have genuinely severe asthma symptoms which are difficult to control. Children with genuinely severe asthma need investigations and treatments beyond those described within conventional guidelines. However, the majority of children with poor symptom control despite high-intensity treatment achieve improvement in their asthma control once attention has been paid to the basics of asthma management. Basic asthma management requires optimisation of inhaler technique and treatment adherence, avoidance of environmental triggers and self-management education. It is also important that clinicians recognise risk factors that predispose patients to asthma exacerbations and potentially life-threatening attacks. These correctable issues need to be tackled in partnership with children and young people and their families. This requires a coordinated approach between professionals across healthcare settings. Establishing appropriate infrastructure for coordinated asthma care benefits not only those with problematic severe asthma, but also the wider asthma population as similar correctable issues exist for children with asthma of all severities. Investigation and management of genuine severe asthma requires specialist multidisciplinary expertise and a systematic approach to characterising patients' asthma phenotypes and delivering individualised care. While inhaled corticosteroids continue to play a leading role in asthma therapy, new treatments on the horizon might further support phenotype-specific therapy. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Wiring design for the control of electromagnetic interference (EMI)

NASA Technical Reports Server (NTRS)

Kopasakis, George

1995-01-01

Wiring design is only one important aspect of EMI control. Other important areas for EMI are: circuit design, filtering, grounding, bonding, shielding, lighting, electrostatic discharge (ESD), transient suppression, and electromagnetic pulse (EMP). Topics covered include: wire magnetic field emissions at low frequencies; wire radiated magnetic field emissions at frequencies; wire design guidelines for EMI control; wire design guidelines for EMI control; high frequency emissions from cables; and pulse frequency spectra.

Belgian guidelines for economic evaluations: second edition.

PubMed

Thiry, Nancy; Neyt, Mattias; Van De Sande, Stefaan; Cleemput, Irina

2014-12-01

The aim of this study was to present the updated methodological guidelines for economic evaluations of healthcare interventions (drugs, medical devices, and other interventions) in Belgium. The update of the guidelines was performed by three Belgian health economists following feedback from users of the former guidelines and personal experience. The updated guidelines were discussed with a multidisciplinary team consisting of other health economists, assessors of reimbursement request files, representatives of Belgian databases and representatives of the drugs and medical devices industry. The final document was validated by three external validators that were not involved in the previous discussions. The guidelines give methodological guidance for the following components of an economic evaluation: literature review, perspective of the evaluation, definition of the target population, choice of the comparator, analytic technique and study design, calculation of costs, valuation of outcomes, definition of the time horizon, modeling, handling uncertainty and discounting. We present a reference case that can be considered as the minimal requirement for Belgian economic evaluations of health interventions. These guidelines will improve the methodological quality, transparency and uniformity of the economic evaluations performed in Belgium. The guidelines will also provide support to the researchers and assessors performing or evaluating economic evaluations.

ASVCP quality assurance guidelines: control of preanalytical, analytical, and postanalytical factors for urinalysis, cytology, and clinical chemistry in veterinary laboratories.

PubMed

Gunn-Christie, Rebekah G; Flatland, Bente; Friedrichs, Kristen R; Szladovits, Balazs; Harr, Kendal E; Ruotsalo, Kristiina; Knoll, Joyce S; Wamsley, Heather L; Freeman, Kathy P

2012-03-01

In December 2009, the American Society for Veterinary Clinical Pathology (ASVCP) Quality Assurance and Laboratory Standards committee published the updated and peer-reviewed ASVCP Quality Assurance Guidelines on the Society's website. These guidelines are intended for use by veterinary diagnostic laboratories and veterinary research laboratories that are not covered by the US Food and Drug Administration Good Laboratory Practice standards (Code of Federal Regulations Title 21, Chapter 58). The guidelines have been divided into 3 reports: (1) general analytical factors for veterinary laboratory performance and comparisons; (2) hematology, hemostasis, and crossmatching; and (3) clinical chemistry, cytology, and urinalysis. This particular report is one of 3 reports and documents recommendations for control of preanalytical, analytical, and postanalytical factors related to urinalysis, cytology, and clinical chemistry in veterinary laboratories and is adapted from sections 1.1 and 2.2 (clinical chemistry), 1.3 and 2.5 (urinalysis), 1.4 and 2.6 (cytology), and 3 (postanalytical factors important in veterinary clinical pathology) of these guidelines. These guidelines are not intended to be all-inclusive; rather, they provide minimal guidelines for quality assurance and quality control for veterinary laboratory testing and a basis for laboratories to assess their current practices, determine areas for improvement, and guide continuing professional development and education efforts. © 2012 American Society for Veterinary Clinical Pathology.

ASVCP quality assurance guidelines: control of preanalytical and analytical factors for hematology for mammalian and nonmammalian species, hemostasis, and crossmatching in veterinary laboratories.

PubMed

Vap, Linda M; Harr, Kendal E; Arnold, Jill E; Freeman, Kathleen P; Getzy, Karen; Lester, Sally; Friedrichs, Kristen R

2012-03-01

In December 2009, the American Society for Veterinary Clinical Pathology (ASVCP) Quality Assurance and Laboratory Standards committee published the updated and peer-reviewed ASVCP Quality Assurance Guidelines on the Society's website. These guidelines are intended for use by veterinary diagnostic laboratories and veterinary research laboratories that are not covered by the US Food and Drug Administration Good Laboratory Practice standards (Code of Federal Regulations Title 21, Chapter 58). The guidelines have been divided into 3 reports: (1) general analytical factors for veterinary laboratory performance and comparisons; (2) hematology, hemostasis, and crossmatching; and (3) clinical chemistry, cytology, and urinalysis. This particular report is one of 3 reports and provides recommendations for control of preanalytical and analytical factors related to hematology for mammalian and nonmammalian species, hemostasis testing, and crossmatching and is adapted from sections 1.1 and 2.3 (mammalian hematology), 1.2 and 2.4 (nonmammalian hematology), 1.5 and 2.7 (hemostasis testing), and 1.6 and 2.8 (crossmatching) of the complete guidelines. These guidelines are not intended to be all-inclusive; rather, they provide minimal guidelines for quality assurance and quality control for veterinary laboratory testing and a basis for laboratories to assess their current practices, determine areas for improvement, and guide continuing professional development and education efforts. © 2012 American Society for Veterinary Clinical Pathology.

50 CFR 510.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Fisheries MARINE MAMMAL COMMISSION IMPLEMENTATION OF THE FEDERAL ADVISORY COMMITTEE ACT § 510.1 Purpose. The regulations prescribed in this part set forth the administrative guidelines and management controls for... 8(a) of the Federal Advisory Committee Act, 5 U.S.C. appendix I. Guidelines and controls are...

50 CFR 510.1 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Fisheries MARINE MAMMAL COMMISSION IMPLEMENTATION OF THE FEDERAL ADVISORY COMMITTEE ACT § 510.1 Purpose. The regulations prescribed in this part set forth the administrative guidelines and management controls for... 8(a) of the Federal Advisory Committee Act, 5 U.S.C. appendix I. Guidelines and controls are...

50 CFR 510.1 - Purpose.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Fisheries MARINE MAMMAL COMMISSION IMPLEMENTATION OF THE FEDERAL ADVISORY COMMITTEE ACT § 510.1 Purpose. The regulations prescribed in this part set forth the administrative guidelines and management controls for... 8(a) of the Federal Advisory Committee Act, 5 U.S.C. appendix I. Guidelines and controls are...

50 CFR 510.1 - Purpose.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Fisheries MARINE MAMMAL COMMISSION IMPLEMENTATION OF THE FEDERAL ADVISORY COMMITTEE ACT § 510.1 Purpose. The regulations prescribed in this part set forth the administrative guidelines and management controls for... 8(a) of the Federal Advisory Committee Act, 5 U.S.C. appendix I. Guidelines and controls are...

50 CFR 510.1 - Purpose.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Fisheries MARINE MAMMAL COMMISSION IMPLEMENTATION OF THE FEDERAL ADVISORY COMMITTEE ACT § 510.1 Purpose. The regulations prescribed in this part set forth the administrative guidelines and management controls for... 8(a) of the Federal Advisory Committee Act, 5 U.S.C. appendix I. Guidelines and controls are...

The impact of manual defibrillation technique on no-flow time during simulated cardiopulmonary resuscitation.

PubMed

Perkins, Gavin D; Davies, Robin P; Soar, Jasmeet; Thickett, David R

2007-04-01

Rapid defibrillation is the most effective strategy for establishing return of spontaneous circulation following cardiac arrest due to ventricular fibrillation. The aim of this study is to measure the delay due to of charging the defibrillator during chest compression in an attempt to reduce the duration of the pre-shock pause in between cessation of chest compressions and shock delivery as advocated by the American Heart Association (AHA) guidelines compared to charging the defibrillator immediately following rhythm analysis without resuming chest compressions as recommended by the European Resuscitation Council (ERC). This was a randomised controlled cross over trial comparing pre-shock pause times when defibrillation was performed on a manikin according to the AHA and ERC guidelines using paddles and hands free defibrillation systems. The pre-shock pause between cessation of chest compression and shock delivery was significantly different between techniques (Friedman test, P<0.0001). ERC paddles technique had the greatest pre-shock pause (7.4 s [6.7-11.2]) followed by ERC hands free (7.0 s [6.5-8.5]) and AHA paddles (1.6 s [1.1-2.3]). AHA hands free took the least amount of time (1.5 s [0.8-1.5]). Extrapolating these data to older defibrillators with longer charge times saw pre-shock pause intervals of 9 s (Codemaster XL) and 12 s (Lifepak 20) with the ERC approach. This study demonstrated clinically significant delays to defibrillation by analysing and charging the defibrillator without performing concurrent chest compressions. In a simulated scenario, charging the defibrillator whilst performing chest compressions was perceived as safe and significantly reduced the pre-shock pause between cessation of chest compression and shock delivery.

Introduction to the Centers for Disease Control and Prevention and Healthcare Infection Control Practices Advisory Committee Guideline for Prevention of Surgical Site Infection: Prosthetic Joint Arthroplasty Section.

PubMed

Segreti, John; Parvizi, Javad; Berbari, Elie; Ricks, Philip; Berríos-Torres, Sandra I

Peri-prosthetic joint infection (PJI) is a severe complication of total joint arthroplasty that appears to be increasing as more of these procedures are performed. Numerous risk factors for incisional (superficial and deep) and organ/space (e.g., PJI) surgical site infections (SSIs) have been identified. A better understanding and reversal of modifiable risk factors may lead to a reduction in the incidence of incisional SSI and PJI. The Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC) recently updated the national Guideline for Prevention of Surgical Site Infection. The updated guideline applies evidence-based methodology, presents recommendations for potential strategies to reduce the risk of SSI, and includes an arthroplasty-specific section. This article serves to introduce the guideline development process and to complement the Prosthetic Joint Arthroplasty section with background information on PJI-specific economic burden, epidemiology, pathogenesis and microbiology, and risk factor information.

Development document for proposed effluent-limitations guidelines and standards for shipbuilding and repair. Point-source category

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

Not Available

1979-12-01

The document contains a discussion of the technical rationale for effluent limitations guidelines for the Shipbuilding and Repair Point Source Category, and the control and treatment technologies which form the basis for these guidelines.

Patterns for Teaching Conflict; Part A, K-3 [And] Part B, 4-6. Global Perspectives: A Humanistic Influence on the Curriculum.

ERIC Educational Resources Information Center

King, David C., Ed.; Long, Cathryn J.

Ten lessons provide techniques for teaching about conflict in grades kindergarten through six. These lessons, developed to accompany the teaching guidelines outlined in SO 009 795, illustrate how the guidelines might be used in any elementary social studies classroom. Five sample lessons are described for each of two levels: grades K-3 and grades…

Risk of urinary retention after nerve-sparing surgery for deep infiltrating endometriosis: A systematic review and meta-analysis.

PubMed

de Resende, José Anacleto Dutra; Cavalini, Luciana Tricai; Crispi, Claudio Peixoto; de Freitas Fonseca, Marlon

2017-01-01

Recently, nerve-sparing (NS) techniques have been incorporated in surgeries for deep infiltrating endometriosis (DIE) to prevent urinary complications. Our aim was to perform a systematic review and meta-analysis to assess the risk of urinary retention after NS surgery for DIE compared with classical (non-NS) techniques. Following the MOOSE guidelines for systematic reviews of observational studies, data were collected from published research articles that compared NS techniques with non-NS techniques in DIE surgery, with regard to post-operative urinary complications. randomized clinical trials, intervention or observational (cohort and case-control) studies assessing women who underwent surgery for painful DIE. cancer surgery and women submitted to bladder or ureteral resections. The respective relative risks (RR) and 95% confidence intervals (CI) were extracted and a forest plot was generated to show individual and combined estimates. Preliminarily, 1,270 potentially relevant studies were identified from which four studies were selected. A meta-analysis was performed to assess the risk of urinary retention at discharge and 90 days after surgery. We found a common RR of 0.19 [95%CI: 0.03-1.17; (I 2  = 50.20%; P = 0.09)] for need of self-catheterization at discharge in the NS group in relation to the conventional technique. Based on two studies, common RR for persistent urinary retention (after 90 days) was 0.16 [95%CI: 0.03-0.84]. Our results suggest significant advantages of the NS technique when considering the RR of persistent urinary retention. Controlled studies evaluating the best approach to manage the urinary tract after complex surgery for DIE are needed. Neurourol. Urodynam. 36:57-61, 2017. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Review of sentinel node procedure in cN0 head and neck squamous cell carcinomas. Guidelines from the French evaluation cooperative subgroup of GETTEC.

PubMed

Garrel, R; Poissonnet, G; Temam, S; Dolivet, G; Fakhry, N; de Raucourt, D

2017-04-01

The reliability of the sentinel lymph node (SN) technique has been established for more than ten years in T1-T2 oral cavity and oropharynx squamous cell carcinoma. Although most authors stress the necessity of rigorous implementation, there are no agreed guidelines. Moreover, other indications have been described, in other anatomical areas of the upper aerodigestive tract and in case of previous surgery or radiotherapy. SN expert teams, under the GETTEC head and neck tumor study group, conducted a review of the key points for implementation in head and neck cancers through guidelines and a review of classical and extended indications. Reliability depends on respecting key points of preoperative landmarking by lymphoscintigraphy, and intraoperative SN sampling and histological analysis. The SN technique is the best means of diagnosing occult lymph node involvement, whatever the primary tumor location, T stage or patient history. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Guidelines on the management of atrial fibrillation in the emergency department: a critical appraisal.

PubMed

Costantino, Giorgio; Podda, Gian Marco; Falsetti, Lorenzo; Iannone, Primiano; Lages, Ana; Marra, Alberto M; Masala, Maristella; Reiakvam, Olaug Marie; Savva, Florentia; Schovanek, Jan; van Bree, Sjoerd; da Silva Chora, Inês João; Privitera, Graziella; Ragozzino, Silvio; von Rotz, Matthias; Woittiez, Lycke; Davidson, Christopher; Montano, Nicola

2017-08-01

Several guidelines often exist on the same topic, sometimes offering divergent recommendations. For the clinician, it can be difficult to understand the reasons for this divergence and how to select the right recommendations. The aim of this study is to compare different guidelines on the management of atrial fibrillation (AF), and provide practical and affordable advice on its management in the acute setting. A PubMed search was performed in May 2014 to identify the three most recent and cited published guidelines on AF. During the 1-week school of the European School of Internal Medicine, the attending residents were divided in five working groups. The three selected guidelines were compared with five specific questions. The guidelines identified were: the European Society of Cardiology guidelines on AF, the Canadian guidelines on emergency department management of AF, and the American Heart Association guidelines on AF. Twenty-one relevant sub-questions were identified. For five of these, there was no agreement between guidelines; for three, there was partial agreement; for three data were not available (issue not covered by one of the guidelines), while for ten, there was complete agreement. Evidence on the management of AF in the acute setting is largely based on expert opinion rather than clinical trials. While there is broad agreement on the management of the haemodynamically unstable patient and the use of drugs for rate-control strategy, there is less agreement on drug therapy for rhythm control and no agreement on several other topics.

[Practice guideline 'Management of patients with mild traumatic head/brain injury' in the Netherlands].

PubMed

van den Brand, Crispijn L; Rambach, A H J H Annelijn; Postma, Roelie; van de Craats, Victoria L; Lengers, Frank; Bénit, Christa P; Verbree, Femke C; Jellema, Korné

2014-01-01

To evaluate the effect of the revised practice guideline 'Management of patients with mild traumatic head/brain injury' (MHI) in the Netherlands using the number of CT scans of the cerebrum, number of hospital admissions, and the number of intracranial traumatic findings on CT scan. Retrospective before-and-after study. A structured chart review over the 3-month period considerable time after implementation of the MHI guideline (study period) was compared with the 3-month-period before its introduction (control period). Both children and adults were included. Primary outcome measures were the percentage of hospital admissions and percentage of cerebrum CT scans in patients with MHI. Secondary outcome measures were traumatic findings on CT scan, neurosurgical intervention and adherence to the guideline. During the study and control periods, respectively 1063 and 1026 patients with MHI attended the emergency department of the study centre. During the study period a CT scan was carried out in 34.2% of patients, significantly more than in the control period 18.8%; p < 0.01). The percentage of admissions also increased from 13.8% to 18.2% (p = 0.01). The differences between the two periods were mainly in adults and in children aged 6 and older. There was no significant change in traumatic intracranial findings or neurosurgical interventions. Adherence to the guideline in regard to hospitalization (81.7% guideline adherence) and CT brain imaging (88.3% guideline adherence) was reasonably high. After introduction of the current MHI guideline in the Netherlands, percentages of both hospitalization and CT of cerebrum have increased significantly. It was expected that the guideline would result in decreases of this percentages. This increase does not seem to be related to more or serious head/brain injury.

33 CFR 157.02 - Incorporation by reference: Where can I get a copy of the publications mentioned in this part?

Code of Federal Regulations, 2014 CFR

2014-07-01

... Item 11, Guidelines and Specifications for Oil Discharge Monitoring and Control Systems for Oil Tankers... Monitoring and Control Systems for Oil Tankers (“A.586(14)”), incorporation by reference approved for § 157... 1983, Guidelines for Plan Approval and Installation Survey of Oil Discharge Monitoring and Control...

33 CFR 157.02 - Incorporation by reference: Where can I get a copy of the publications mentioned in this part?

Code of Federal Regulations, 2011 CFR

2011-07-01

... Item 11, Guidelines and Specifications for Oil Discharge Monitoring and Control Systems for Oil Tankers... Monitoring and Control Systems for Oil Tankers (“A.586(14)”), incorporation by reference approved for § 157... 1983, Guidelines for Plan Approval and Installation Survey of Oil Discharge Monitoring and Control...

33 CFR 157.02 - Incorporation by reference: Where can I get a copy of the publications mentioned in this part?

Code of Federal Regulations, 2012 CFR

2012-07-01

... Item 11, Guidelines and Specifications for Oil Discharge Monitoring and Control Systems for Oil Tankers... Monitoring and Control Systems for Oil Tankers (“A.586(14)”), incorporation by reference approved for § 157... 1983, Guidelines for Plan Approval and Installation Survey of Oil Discharge Monitoring and Control...

33 CFR 157.02 - Incorporation by reference: Where can I get a copy of the publications mentioned in this part?

Code of Federal Regulations, 2013 CFR

2013-07-01

... Item 11, Guidelines and Specifications for Oil Discharge Monitoring and Control Systems for Oil Tankers... Monitoring and Control Systems for Oil Tankers (“A.586(14)”), incorporation by reference approved for § 157... 1983, Guidelines for Plan Approval and Installation Survey of Oil Discharge Monitoring and Control...

40 CFR 52.2420 - Identification of plan.

Code of Federal Regulations, 2011 CFR

2011-07-01

.../19/11, 76 FR 3023 Removal of “Reasonably available control technology” from 5-40-250C. 5-40-260... Volatile Organic Compounds 4/17/95 4/21/00, 65 FR 21315 120-04-0503. 5-40-460 Control Technology Guidelines... 4/21/00, 65 FR 21315 120-04-0603. 5-40-610 Control Technology Guidelines 4/17/95 4/21/00, 65 FR...

Preliminary Guidelines For Using Suppression Fires to Control Wildfires in the Southeast

Treesearch

Robert W. Cooper

1969-01-01

Suppression firing is defied as the application of fire to speed or strengthen control action on free-burning wildfires. The key to successful suppression firing is availability of personnel knowledgeable in specific application plus an adequate supply of manpower and equipment to contain the set fire. Preliminary guidelines for the use of this fire-control tool are...

Teaching or Facilitating Learning? Selecting the Optimal Approach for Your Educational Objectives and Audience

ERIC Educational Resources Information Center

Wise, Dena

2017-01-01

Both teaching and facilitation are effective instructional techniques, but each is appropriate for unique educational objectives and scenarios. This article briefly distinguishes between teaching and facilitative techniques and provides guidelines for choosing the better method for a particular educational scenario.

The Critical Incident Interview and Ethnoracial Identity.

ERIC Educational Resources Information Center

Montalvo, Frank F.

1999-01-01

Describes the critical-incident interview, a cross-cultural training technique that helps social work students assess clients' ethnic- and racial-identity development. Uses examples from student interviews to present the steps involved in teaching the technique. Includes guidelines for selecting and interviewing informants, and gives three scales…

Systematic methods for the design of a class of fuzzy logic controllers

NASA Astrophysics Data System (ADS)

Yasin, Saad Yaser

2002-09-01

Fuzzy logic control, a relatively new branch of control, can be used effectively whenever conventional control techniques become inapplicable or impractical. Various attempts have been made to create a generalized fuzzy control system and to formulate an analytically based fuzzy control law. In this study, two methods, the left and right parameterization method and the normalized spline-base membership function method, were utilized for formulating analytical fuzzy control laws in important practical control applications. The first model was used to design an idle speed controller, while the second was used to control an inverted control problem. The results of both showed that a fuzzy logic control system based on the developed models could be used effectively to control highly nonlinear and complex systems. This study also investigated the application of fuzzy control in areas not fully utilizing fuzzy logic control. Three important practical applications pertaining to the automotive industries were studied. The first automotive-related application was the idle speed of spark ignition engines, using two fuzzy control methods: (1) left and right parameterization, and (2) fuzzy clustering techniques and experimental data. The simulation and experimental results showed that a conventional controller-like performance fuzzy controller could be designed based only on experimental data and intuitive knowledge of the system. In the second application, the automotive cruise control problem, a fuzzy control model was developed using parameters adaptive Proportional plus Integral plus Derivative (PID)-type fuzzy logic controller. Results were comparable to those using linearized conventional PID and linear quadratic regulator (LQR) controllers and, in certain cases and conditions, the developed controller outperformed the conventional PID and LQR controllers. The third application involved the air/fuel ratio control problem, using fuzzy clustering techniques, experimental data, and a conversion algorithm, to develop a fuzzy-based control algorithm. Results were similar to those obtained by recently published conventional control based studies. The influence of the fuzzy inference operators and parameters on performance and stability of the fuzzy logic controller was studied Results indicated that, the selections of certain parameters or combinations of parameters, affect greatly the performance and stability of the fuzzy controller. Diagnostic guidelines used to tune or change certain factors or parameters to improve controller performance were developed based on knowledge gained from conventional control methods and knowledge gained from the experimental and the simulation results of this study.

40 CFR 423.14 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... control technology (BCT). [Reserved] 423.14 Section 423.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS STEAM ELECTRIC POWER GENERATING POINT SOURCE... by the application of the best conventional pollutant control technology (BCT). [Reserved] ...

40 CFR 424.67 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... control technology. 424.67 Section 424.67 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS FERROALLOY MANUFACTURING POINT SOURCE CATEGORY Electrolytic... reduction attainable by the application of the best conventional pollutant control technology. Except as...

40 CFR 424.77 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... control technology. 424.77 Section 424.77 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS FERROALLOY MANUFACTURING POINT SOURCE CATEGORY Electrolytic... attainable by the application of the best conventional pollutant control technology. Except as provided in...

40 CFR 424.37 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... control technology. 424.37 Section 424.37 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS FERROALLOY MANUFACTURING POINT SOURCE CATEGORY Slag Processing... by the application of the best conventional pollutant control technology. Except as provided in...

40 CFR 455.63 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... control technology (BCT). 455.63 Section 455.63 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS PESTICIDE CHEMICALS Repackaging of Agricultural Pesticides... effluent reduction attainable by the application of the best conventional pollutant control technology (BCT...

40 CFR 455.62 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... control technology (BPT). 455.62 Section 455.62 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS PESTICIDE CHEMICALS Repackaging of Agricultural Pesticides... effluent reduction attainable by the application of the best practicable pollutant control technology (BPT...

40 CFR 423.14 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2014 CFR

2014-07-01

... control technology (BCT). [Reserved] 423.14 Section 423.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS STEAM ELECTRIC POWER GENERATING POINT SOURCE... by the application of the best conventional pollutant control technology (BCT). [Reserved] ...

40 CFR 423.14 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2012 CFR

2012-07-01

... control technology (BCT). [Reserved] 423.14 Section 423.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS STEAM ELECTRIC POWER GENERATING POINT SOURCE... by the application of the best conventional pollutant control technology (BCT). [Reserved] ...

40 CFR 423.14 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2011 CFR

2011-07-01

... control technology (BCT). [Reserved] 423.14 Section 423.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS STEAM ELECTRIC POWER GENERATING POINT SOURCE... by the application of the best conventional pollutant control technology (BCT). [Reserved] ...

40 CFR 423.14 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2013 CFR

2013-07-01

... control technology (BCT). [Reserved] 423.14 Section 423.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS STEAM ELECTRIC POWER GENERATING POINT SOURCE... by the application of the best conventional pollutant control technology (BCT). [Reserved] ...

A pattern-based analysis of clinical computer-interpretable guideline modeling languages.

PubMed

Mulyar, Nataliya; van der Aalst, Wil M P; Peleg, Mor

2007-01-01

Languages used to specify computer-interpretable guidelines (CIGs) differ in their approaches to addressing particular modeling challenges. The main goals of this article are: (1) to examine the expressive power of CIG modeling languages, and (2) to define the differences, from the control-flow perspective, between process languages in workflow management systems and modeling languages used to design clinical guidelines. The pattern-based analysis was applied to guideline modeling languages Asbru, EON, GLIF, and PROforma. We focused on control-flow and left other perspectives out of consideration. We evaluated the selected CIG modeling languages and identified their degree of support of 43 control-flow patterns. We used a set of explicitly defined evaluation criteria to determine whether each pattern is supported directly, indirectly, or not at all. PROforma offers direct support for 22 of 43 patterns, Asbru 20, GLIF 17, and EON 11. All four directly support basic control-flow patterns, cancellation patterns, and some advance branching and synchronization patterns. None support multiple instances patterns. They offer varying levels of support for synchronizing merge patterns and state-based patterns. Some support a few scenarios not covered by the 43 control-flow patterns. CIG modeling languages are remarkably close to traditional workflow languages from the control-flow perspective, but cover many fewer workflow patterns. CIG languages offer some flexibility that supports modeling of complex decisions and provide ways for modeling some decisions not covered by workflow management systems. Workflow management systems may be suitable for clinical guideline applications.

On Polymorphic Circuits and Their Design Using Evolutionary Algorithms

NASA Technical Reports Server (NTRS)

Stoica, Adrian; Zebulum, Ricardo; Keymeulen, Didier; Lohn, Jason; Clancy, Daniel (Technical Monitor)

2002-01-01

This paper introduces the concept of polymorphic electronics (polytronics) - referring to electronics with superimposed built-in functionality. A function change does not require switches/reconfiguration as in traditional approaches. Instead the change comes from modifications in the characteristics of devices involved in the circuit, in response to controls such as temperature, power supply voltage (VDD), control signals, light, etc. The paper illustrates polytronic circuits in which the control is done by temperature, morphing signals, and VDD respectively. Polytronic circuits are obtained by evolutionary design/evolvable hardware techniques. These techniques are ideal for the polytronics design, a new area that lacks design guidelines, know-how,- yet the requirements/objectives are easy to specify and test. The circuits are evolved/synthesized in two different modes. The first mode explores an unstructured space, in which transistors can be interconnected freely in any arrangement (in simulations only). The second mode uses a Field Programmable Transistor Array (FPTA) model, and the circuit topology is sought as a mapping onto a programmable architecture (these experiments are performed both in simulations and on FPTA chips). The experiments demonstrated the synthesis. of polytronic circuits by evolution. The capacity of storing/hiding "extra" functions provides for watermark/invisible functionality, thus polytronics may find uses in intelligence/security applications.

40 CFR 426.117 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... control technology. 426.117 Section 426.117 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GLASS MANUFACTURING POINT SOURCE CATEGORY Television Picture Tube Envelope Manufacturing Subcategory § 426.117 Effluent limitations guidelines representing the...

Achieving and maintaining asthma control in an urban pediatric disease management program: the Breathmobile Program.

PubMed

Jones, Craig A; Clement, Loran T; Morphew, Tricia; Kwong, Kenny Yat Choi; Hanley-Lopez, Jean; Lifson, Francene; Opas, Lawrence; Guterman, Jeffrey J

2007-06-01

National guidelines suggest that, with appropriate care, most patients can control their asthma. The probabilities of children achieving and maintaining control with ongoing care are unknown. We sought to evaluate the degree to which children in a lower socioeconomic urban setting achieve and maintain control of asthma with regular participation in a disease management program that provides guideline-based care. Interdisciplinary teams of asthma specialists use mobile clinics to offer ongoing care at schools and county clinics. A guideline-derived construct of asthma control is recorded at each visit. Two thousand one hundred eighty-five enrollees were eligible to evaluate the time to first achieve control, and 1591 patients were eligible to evaluate subsequent control maintenance. Depending on severity, 70% to 87% of patients with persistent asthma achieved control by visit 3, and 89% to 98% achieved control by visit 6. Subsequent control maintenance was highly variable. Thirty-nine percent of patients displayed well-controlled asthma (control at >90% of subsequent visits), whereas 13% displayed difficult-to-control asthma (<50% of subsequent visits). Patients from each baseline severity category were found in each group. Maintenance of control was influenced by physician-estimated compliance with the treatment plan, baseline severity, and the interval between clinic visits. Many children can achieve asthma control with regular visit intervals and guideline-based care; however, long-term control can be highly variable among patients in all severity categories. These findings highlight the need and feasibility for systematically tracking each patient's clinical response to individualize therapy and guide the use of population management strategies.

Determination of asthma control using administrative data regarding short-acting beta-agonist inhaler purchase.

PubMed

Shlomi, Dekel; Katz, Irit; Segel, Michael J; Oberman, Bernice; Peled, Nir

2018-05-01

Symptom control is a primary goal in asthma. We hypothesized that administrative data regarding rescue inhaler purchases may correlate with asthma symptom control. We identified all patients who purchased short-acting beta-agonist (SABA) inhalers during the course of one year in the database of a Health Maintenance Organization (HMO). Primary physicians identified asthma patients and classified their asthma symptom control into three groups according to the Global Initiative for Asthma (GINA) guidelines. Asthma patients were asked to answer symptom questionnaires and grade their asthma control. SABA inhaler purchases were compared between asthma control groups as classified by the guidelines, the physicians and the patients. We also compared the agreement on asthma control between the three methods of classification. Of 241 asthma patients, 83 completed the questionnaires. Using the GINA guidelines criteria, 26 were symptom controlled, 46 were partially controlled and 11 were uncontrolled. SABA inhaler purchases were not significantly lower in the controlled group. Using patients' overall impression of their asthma control, the mean numbers of SABA inhalers purchased were 1.5, 4.4 and 6.4 per year in the controlled, partially controlled and uncontrolled groups, respectively (p = 0.03). Patients' classification of asthma control had better agreement (kappa = 0.34) with GINA guidelines than physician's' agreement (kappa = 0.05). When using administrative data for asthma patients, 2 or more SABA inhaler purchases in one year should alert the physician for the need for asthma control evaluation. Purchase of at least 4 SABA inhalers a year may be regarded as a marker for asthma that is not controlled.

Adapting clinical guidelines in low‐resources countries: a study on the guideline on the management and prevention of type 2 diabetes mellitus in Indonesia

PubMed Central

Wangge, Grace; van der Graaf, Yolanda; van der Heijden, Geert J. M. G.

2016-01-01

Abstract Rationale, aims and objectives Most of the clinical guidelines in low‐resource countries are adaptations from preexisting international guidelines. This adaptation can be problematic when those international guidelines are not based on current evidence or original evidence‐based international guidelines are not followed. This study aims to evaluate the quality of an Indonesian type 2 diabetes mellitus guideline adapted from selected international guidelines. Methods The “Consensus on the Management and Prevention of type 2 Diabetes in Indonesia 2011” is a guideline by the Indonesian Society of Endocrinology (Perkeni). Four parent guidelines identified from its list of references were from the International Diabetes Federation (IDF), American Association of Clinical Endocrinologist (AACE), American Diabetes Association (ADA), and one jointly released by ADA and European Association for the Study of Diabetes (EASD). Two reviewers independently assessed its quality using the Appraisal of Guidelines, Research and Evaluation Collaboration (AGREE II) instrument. Six recommendations were compared: (1) screening for diabetes; (2) diagnosis; (3) control of hyperglycemia; (4) target blood glucose; (5) target blood pressure; and (6) treatment of dyslipidemia. Results Perkeni's guideline satisfied 55% of the AGREE II items, while its parent guidelines satisfied 59% to 74%. Perkeni's shows low score on “rigor of development” and “applicability” and the lowest score in the “scope and purpose” domain. Differences were found in 4 recommendations: the screening of diabetes, control of hyperglycemia, target blood glucose, and treatment of dyslipidemia. In 3 of 4, Perkeni followed the ADA's recommendation. Conclusion Derivation of recommendations from parent guidelines and their adaptation to the context of Indonesian health care lacks transparency. When guidelines are either derived from other guidelines or adapted for use in different context, evidence‐based practice principles should be followed and adhered to. PMID:27592587

Adapting clinical guidelines in low-resources countries: a study on the guideline on the management and prevention of type 2 diabetes mellitus in Indonesia.

PubMed

Widyahening, Indah S; Wangge, Grace; van der Graaf, Yolanda; van der Heijden, Geert J M G

2017-02-01

Most of the clinical guidelines in low-resource countries are adaptations from preexisting international guidelines. This adaptation can be problematic when those international guidelines are not based on current evidence or original evidence-based international guidelines are not followed. This study aims to evaluate the quality of an Indonesian type 2 diabetes mellitus guideline adapted from selected international guidelines. The "Consensus on the Management and Prevention of type 2 Diabetes in Indonesia 2011" is a guideline by the Indonesian Society of Endocrinology (Perkeni). Four parent guidelines identified from its list of references were from the International Diabetes Federation (IDF), American Association of Clinical Endocrinologist (AACE), American Diabetes Association (ADA), and one jointly released by ADA and European Association for the Study of Diabetes (EASD). Two reviewers independently assessed its quality using the Appraisal of Guidelines, Research and Evaluation Collaboration (AGREE II) instrument. Six recommendations were compared: (1) screening for diabetes; (2) diagnosis; (3) control of hyperglycemia; (4) target blood glucose; (5) target blood pressure; and (6) treatment of dyslipidemia. Perkeni's guideline satisfied 55% of the AGREE II items, while its parent guidelines satisfied 59% to 74%. Perkeni's shows low score on "rigor of development" and "applicability" and the lowest score in the "scope and purpose" domain. Differences were found in 4 recommendations: the screening of diabetes, control of hyperglycemia, target blood glucose, and treatment of dyslipidemia. In 3 of 4, Perkeni followed the ADA's recommendation. Derivation of recommendations from parent guidelines and their adaptation to the context of Indonesian health care lacks transparency. When guidelines are either derived from other guidelines or adapted for use in different context, evidence-based practice principles should be followed and adhered to. © 2016 The Authors Journal of Evaluation in Clinical Practice Published by John Wiley & Sons Ltd.

[New guidelines on chronic pancreatitis : interdisciplinary treatment strategies].

PubMed

Lerch, M M; Bachmann, K A; Izbicki, J R

2013-02-01

Chronic pancreatitis is a common disorder associated with significant morbidity and mortality. Interdisciplinary consensus guidelines have recently updated the definitions and diagnostic criteria for chronic pancreatitis and provide a critical assessment of therapeutic procedures. Diagnostic imaging relies on endoscopic ultrasound (EUS) as the most sensitive technique, whereas computed tomography (CT) and magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP) remain a frequent preoperative requirement. Endoscopic retrograde cholangiopancreatography (ERCP) is now used mostly as a therapeutic procedure except for the differential diagnosis of autoimmune pancreatitis. Complications of chronic pancreatitis, such as pseudocysts, duct stricture and intractable pain can be treated with endoscopic interventions as well as open surgery. In the treatment of pseudocysts endoscopic drainage procedures now prevail while pain treatment has greater long-term effectiveness following surgical procedures. Currently, endocopic as well as surgical treatment of chronic pancreatitis require an ever increasing degree of technical and medical expertise and are provided increasingly more often by interdisciplinary centres. Surgical treatment is superior to interventional therapy regarding the outcome of pain control and duodenum-preserving pancreatic head resection is presently the surgical procedure of choice.

Accelerated partial breast irradiation: Past, present, and future

PubMed Central

Tann, Anne W; Hatch, Sandra S; Joyner, Melissa M; Wiederhold, Lee R; Swanson, Todd A

2016-01-01

Accelerated partial breast irradiation (APBI) focuses higher doses of radiation during a shorter interval to the lumpectomy cavity, in the setting of breast conserving therapy for early stage breast cancer. The utilization of APBI has increased in the past decade because of the shorter treatment schedule and a growing body of outcome data showing positive cosmetic outcomes and high local control rates in selected patients undergoing breast conserving therapy. Technological advances in various APBI modalities, including intracavitary and interstitial brachytherapy, intraoperative radiation therapy, and external beam radiation therapy, have made APBI more accessible in the community. Results of early APBI trials served as the basis for the current consensus guidelines, and multiple prospective randomized clinical trials are currently ongoing. The pending long term results of these trials will help us identify optimal candidates that can benefit from ABPI. Here we provide an overview of the clinical and cosmetic outcomes of various APBI techniques and review the current guidelines for selecting suitable breast cancer patients. We also discuss the impact of APBI on the economics of cancer care and patient reported quality of life. PMID:27777879

Efficient finite element simulation of slot spirals, slot radomes and microwave structures

NASA Technical Reports Server (NTRS)

Gong, J.; Volakis, J. L.

1995-01-01

This progress report contains the following two documents: (1) 'Efficient Finite Element Simulation of Slot Antennas using Prismatic Elements' - A hybrid finite element-boundary integral (FE-BI) simulation technique is discussed to treat narrow slot antennas etched on a planar platform. Specifically, the prismatic elements are used to reduce the redundant sampling rates and ease the mesh generation process. Numerical results for an antenna slot and frequency selective surfaces are presented to demonstrate the validity and capability of the technique; and (2) 'Application and Design Guidelines of the PML Absorber for Finite Element Simulations of Microwave Packages' - The recently introduced perfectly matched layer (PML) uniaxial absorber for frequency domain finite element simulations has several advantages. In this paper we present the application of PML for microwave circuit simulations along with design guidelines to obtain a desired level of absorption. Different feeding techniques are also investigated for improved accuracy.

Clinical guidelines and the fate of medical autonomy in Ontario.

PubMed

Rappolt, S G

1997-04-01

Conceptually, clinical guidelines and professional autonomy have a paradoxical relationship. Despite being the quintessence of medical knowledge at the corporate level, guidelines diminish the clinical autonomy of individual practitioners, and therefore threaten medicine's justification for its autonomy. Theorists have argued that professional autonomy will be retained through elite dominance of practitioners, while comparative research suggests that economic autonomy can be traded off to retain clinical autonomy. Under government pressure to regulate the growth of Ontario physicians' fee-for-service public expenditure, the profession's representative organization, the Ontario Medical Association (OMA), promoted voluntary clinical guidelines, hoping to both constrain costs and preserve professional control over the content of medical care. The OMA collaborated with the Ministry of Health in developing guidelines and establishing a provincial centre for health service research. Ontario's practitioners disregarded the OMA's exhortations to implement clinical guidelines, suggesting that in the absence of external constraints, practitioners can subvert elite dominance. However, practitioners' unchecked clinical and economic autonomy, combined with evidence of wide provincial variations in medical care, served to legitimize the government's increasingly unilateral control over the schedule of insured medical services, and, in 1993, their imposition of a global cap on physicians' fee-for-service income pool. When analysed in the context of ongoing Ministry-OMA relations, the failure of the OMA's guidelines strategy to constrain medical service costs has expedited an overall decline in medical autonomy in Ontario. The emergence and course of Ontario's clinical guidelines movement is consistent with the view that medical autonomy is contingent upon broad class forces, and the conceptualization of professional organizations as instruments for mediated occupational control.

Use of systematic reviews in clinical practice guidelines: case study of smoking cessation

PubMed Central

Silagy, C A; Stead, L F; Lancaster, T

2001-01-01

Objective To examine the extent to which recommendations in the national guidelines for the cessation of smoking are based on evidence from systematic reviews of controlled trials. Design Retrospective analysis of recommendations for the national guidelines for the cessation of smoking. Materials National guidelines in clinical practice on smoking cessation published in English. Main outcome measures The type of evidence (systematic review of controlled trials, individual trials, other studies, expert opinion) used to support each recommendation. We also assessed whether a Cochrane systematic review was available and could have been used in formulating the recommendation. Results Four national smoking cessation guidelines (from Canada, New Zealand, the United Kingdom, and the United States) covering 105 recommendations were identified. An explicit evidence base for 100%, 89%, 68%, and 98% of recommendations, respectively, was detected, of which 60%, 56%, 59%, and 47% were based on systematic reviews of controlled studies. Cochrane systematic reviews could have been used to develop between 39% and 73% of recommendations but were actually used in 0% to 36% of recommendations. The UK guidelines had the highest proportion of recommendations based on Cochrane systematic reviews. Conclusions Use of systematic reviews in guidelines is a measure of the “payback” on investment in research synthesis. Systematic reviews commonly underpinned recommendations in guidelines on smoking cessation. The extent to which they were used varied by country and there was evidence of duplication of effort in some areas. Greater international collaboration in developing and maintaining an evidence base of systematic reviews can improve the efficiency of use of research resources. PMID:11597966

Guideline-oriented perioperative management of patients with bronchial asthma and chronic obstructive pulmonary disease.

PubMed

Yamakage, Michiaki; Iwasaki, Sohshi; Namiki, Akiyoshi

2008-01-01

Increased airway hyperresponsiveness is a major concern in the perioperative management of patients with bronchial asthma and chronic obstructive pulmonary disease. Guidelines using evidence-based medicine are continually being updated and published regarding the diagnosis, treatment, and prevention of these respiratory disorders. Perioperative management in these patients involves: (1) adequate control of airway hyperresponsiveness, including detection of purulent sputum and infection before surgery; (2) evidence-based control of anesthesia; and (3) the aggressive use of beta-2 adrenergic stimulants and the systemic administration of steroids for the treatment of acute attacks. Good preoperative control, including the use of leukotriene antagonists, can reduce the incidence of life-threatening perioperative complications. Awareness of recent guidelines is thus important in the management of patients with airway hyperresponsiveness. This review covers the most recent guidelines for the perioperative management of patients with bronchial asthma and chronic obstructive pulmonary disease.

Adherence to best practice consensus guidelines for implant-based breast reconstruction: Results from the iBRA national practice questionnaire survey.

PubMed

Mylvaganam, Senthurun; Conroy, Elizabeth J; Williamson, Paula R; Barnes, Nicola L P; Cutress, Ramsey I; Gardiner, Matthew D; Jain, Abhilash; Skillman, Joanna M; Thrush, Steven; Whisker, Lisa J; Blazeby, Jane M; Potter, Shelley; Holcombe, Christopher

2018-05-01

The 2008 National Mastectomy and Breast Reconstruction Audit demonstrated marked variation in the practice and outcomes of breast reconstruction in the UK. To standardise practice and improve outcomes for patients, the British professional associations developed best-practice guidelines with specific guidance for newer mesh-assisted implant-based techniques. We explored the degree of uptake of best-practice guidelines within units performing implant-based reconstruction (IBBR) as the first phase of the implant Breast Reconstruction Evaluation (iBRA) study. A questionnaire developed by the iBRA Steering Group was completed by trainee and consultant leads at breast and plastic surgical units across the UK. Simple summary statistics were calculated for each survey item to assess compliance with current best-practice guidelines. 81 units from 79 NHS Trusts completed the questionnaire. Marked variation was observed in adherence to guidelines, especially those relating to clinical governance and infection prevention strategies. Less than half (n = 28, 47%) of units obtained local clinical governance board approval prior to offering new mesh-based techniques and prospective audit of the clinical, cosmetic and patient-reported outcomes of surgery was infrequent. Most units screened for methicillin-resistant staphylococcus aureus prior to surgery but fewer than 1 in 3 screened for methicillin-sensitive strains. Laminar-flow theatres (recommended for IBBR) were not widely-available with less than 1 in 5 units having regular access. Peri-operative antibiotics were widely-used, but the type and duration were highly-variable. The iBRA national practice questionnaire has demonstrated variation in reported practice and adherence to IBBR guidelines. High-quality evidence is urgently required to inform best practice. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

American College of Cardiology/American Heart Association preoperative assessment guidelines reduce resource utilization before aortic surgery.

PubMed

Froehlich, James B; Karavite, Dean; Russman, Pamela L; Erdem, Nurum; Wise, Chris; Zelenock, Gerald; Wakefield, Thomas; Stanley, James; Eagle, Kim A

2002-10-01

Methods used for evaluation of cardiac risk before noncardiac surgery vary widely. We evaluated the effect over time on practice and resource utilization of implementing the American College of Cardiology/American Heart Association Guidelines on Preoperative Risk Assessment. We compared 102 historical control patients who underwent elective abdominal aortic surgery (from January 1993 to December 1994) with 94 consecutive patients after guideline implementation (from July 1995 to December 1996) and 104 patients in a late after guideline implementation (from July 1, 1997, to September 30, 1998). Resource use (testing, revascularization, and costs) and outcomes (perioperative death and myocardial infarction) were examined. Patients with and without clinical markers of risk for perioperative cardiac complications were compared. The use of preoperative stress testing (88% to 47%; P <.00001), cardiac catheterization (24% to 11%; P <.05), and coronary revascularization (25% to 2%; P <.00001) decreased between control and postguideline groups, respectively. These changes persisted in the late postguideline group. Mean preoperative evaluation costs also fell ($1087 versus $171; P <.0001). Outcomes of death (4% versus 3% versus 2%) and myocardial infarction (7% versus 3% versus 5%) were not significantly different between control, postguideline, and late postguideline groups, respectively. Stress test rates were similar for patients at low risk versus high risk in the historical control group (84% versus 91%; P =.29) but lower for patients at low risk after guideline implementation (31% versus 61%; P =.003). Implementation of the American College of Cardiology/American Heart Association cardiac risk assessment guidelines appropriately reduced resource use and costs in patients who underwent elective aortic surgery without affecting outcomes. This effect was sustained 2 years after guideline implementation.

Passive solar design strategies: Remodeling guidelines for conserving energy at home

NASA Astrophysics Data System (ADS)

The idea of passive solar is simple, but applying it effectively does require information and attention to the details of design and construction. Some passive solar techniques are modest and low-cost, and require only small changes in remodeler's typical practice. At the other end of the spectrum, some passive solar systems can almost eliminate a house's need for purchased heating (and in some cases, cooling) energy - but probably at a relatively high first cost. In between are a broad range of energy-conserving passive solar techniques. Whether or not they are cost-effective, practical, and attractive enough to offer a market advantage to any individual remodeler depends on very specific factors such as local costs, climate, and market characteristics. Passive Solar Design Strategies: Remodeling Guidelines For Conserving Energy At Home is written to help give remodelers the information they need to make these decisions. Passive Solar Design Strategies is a package in three basic parts: the guidelines contain information about passive solar techniques and how they work, and provides specific examples of systems which will save various percentages of energy; the worksheets offer a simple, fill-in-the-blank method to pre-evaluate the performance of a specific design; and the worked example demonstrates how to complete the worksheets for a typical residence.

40 CFR 424.27 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... control technology. 424.27 Section 424.27 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS FERROALLOY MANUFACTURING POINT SOURCE CATEGORY Covered Electric... conventional pollutant control technology. Except as provided in §§ 125.30 through 125.32, any existing point...

40 CFR 426.17 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... control technology (BCT). 426.17 Section 426.17 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GLASS MANUFACTURING POINT SOURCE CATEGORY Insulation Fiberglass... by the application of the best conventional pollutant control technology (BCT). Except as provided in...

40 CFR 411.27 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... control technology (BCT). 411.27 Section 411.27 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS CEMENT MANUFACTURING POINT SOURCE CATEGORY Leaching Subcategory... application of the conventional pollutant control technology (BCT). Except as provided in §§ 125.30 through...

40 CFR 415.237 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... control technology (BCT). 415.237 Section 415.237 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS INORGANIC CHEMICALS MANUFACTURING POINT SOURCE... control technology (BCT). Except as provided in 40 CFR 125.30 through 125.32, any existing point source...

40 CFR 420.137 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... representing the degree of effluent reduction attainable by the application of the best control technology for... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS IRON AND STEEL MANUFACTURING POINT SOURCE CATEGORY... effluent reduction attainable by the application of the best control technology for conventional pollutants...

40 CFR 415.177 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... control technology (BCT). 415.177 Section 415.177 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS INORGANIC CHEMICALS MANUFACTURING POINT SOURCE... conventional pollutant control technology (BCT). Except as provided in 40 CFR 125.30 through 125.32, any...

40 CFR 426.67 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... control technology. 426.67 Section 426.67 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GLASS MANUFACTURING POINT SOURCE CATEGORY Automotive Glass... attainable by the application of the best conventional pollutant control technology. Except as provided in...

40 CFR 455.33 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... control technology (BCT). [Reserved] 455.33 Section 455.33 Protection of Environment ENVIRONMENTAL... Chemicals Manufacturing Subcategory § 455.33 Effluent limitations guidelines representing the degree of effluent reduction attainable by the application of the best conventional pollutant control technology (BCT...

40 CFR 426.77 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... control technology. 426.77 Section 426.77 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GLASS MANUFACTURING POINT SOURCE CATEGORY Automotive Glass... attainable by the application of the best conventional pollutant control technology. Except as provided in...

40 CFR Appendix A to Part 20 - Guidelines for Certification

Code of Federal Regulations, 2010 CFR

2010-07-01

... that pollution control facilities must be used in connection with a plant or other property in... FACILITIES Pt. 20, App. A Appendix A to Part 20—Guidelines for Certification 1. General. 2. Air Pollution.... Air pollution control facility boundaries. c. Examples of eligibility limits. d. Replacement of...

40 CFR Appendix A to Part 20 - Guidelines for Certification

Code of Federal Regulations, 2012 CFR

2012-07-01

... that pollution control facilities must be used in connection with a plant or other property in... FACILITIES Pt. 20, App. A Appendix A to Part 20—Guidelines for Certification 1. General. 2. Air Pollution.... Air pollution control facility boundaries. c. Examples of eligibility limits. d. Replacement of...

40 CFR Appendix A to Part 20 - Guidelines for Certification

Code of Federal Regulations, 2011 CFR

2011-07-01

... that pollution control facilities must be used in connection with a plant or other property in... FACILITIES Pt. 20, App. A Appendix A to Part 20—Guidelines for Certification 1. General. 2. Air Pollution.... Air pollution control facility boundaries. c. Examples of eligibility limits. d. Replacement of...

40 CFR Appendix A to Part 20 - Guidelines for Certification

Code of Federal Regulations, 2014 CFR

2014-07-01

... that pollution control facilities must be used in connection with a plant or other property in... FACILITIES Pt. 20, App. A Appendix A to Part 20—Guidelines for Certification 1. General. 2. Air Pollution.... Air pollution control facility boundaries. c. Examples of eligibility limits. d. Replacement of...

40 CFR Appendix A to Part 20 - Guidelines for Certification

Code of Federal Regulations, 2013 CFR

2013-07-01

... that pollution control facilities must be used in connection with a plant or other property in... FACILITIES Pt. 20, App. A Appendix A to Part 20—Guidelines for Certification 1. General. 2. Air Pollution.... Air pollution control facility boundaries. c. Examples of eligibility limits. d. Replacement of...

40 CFR 424.27 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2013 CFR

2013-07-01

... control technology. 424.27 Section 424.27 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS FERROALLOY MANUFACTURING POINT SOURCE CATEGORY Covered Electric... conventional pollutant control technology. Except as provided in §§ 125.30 through 125.32, any existing point...

40 CFR 424.27 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2014 CFR

2014-07-01

... control technology. 424.27 Section 424.27 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS FERROALLOY MANUFACTURING POINT SOURCE CATEGORY Covered Electric... conventional pollutant control technology. Except as provided in §§ 125.30 through 125.32, any existing point...

40 CFR 424.27 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2011 CFR

2011-07-01

... control technology. 424.27 Section 424.27 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS FERROALLOY MANUFACTURING POINT SOURCE CATEGORY Covered Electric... conventional pollutant control technology. Except as provided in §§ 125.30 through 125.32, any existing point...

40 CFR 424.27 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2012 CFR

2012-07-01

... control technology. 424.27 Section 424.27 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS FERROALLOY MANUFACTURING POINT SOURCE CATEGORY Covered Electric... conventional pollutant control technology. Except as provided in §§ 125.30 through 125.32, any existing point...

40 CFR 463.12 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... representing the degree of effluent reduction attainable by the application of the best practicable control... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS PLASTICS MOLDING AND FORMING POINT SOURCE CATEGORY... degree of effluent reduction attainable by the application of the best practicable control technology...

40 CFR 463.32 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... representing the degree of effluent reduction attainable by the application of the best practicable control... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS PLASTICS MOLDING AND FORMING POINT SOURCE CATEGORY... reduction attainable by the application of the best practicable control technology currently available...

40 CFR 463.22 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... representing the degree of effluent reduction attainable by the application of the best practicable control... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS PLASTICS MOLDING AND FORMING POINT SOURCE CATEGORY... reduction attainable by the application of the best practicable control technology currently available...

Completion techniques for horizontal wells in the Pearsall Austin Chalk

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

Pope, C.D.; Handren, P.J.

1992-05-01

Oryx Energy Co. used three basic completion techniques and various combinations of them to complete 20 horizontal wells in the Pearsall Austin Chalk. The completion method selected is based on a general set of guidelines. In this paper additionally, equipment selection and various types of workover operations are reviewed.

29 CFR 1607.6 - Use of selection procedures which have not been validated.

Code of Federal Regulations, 2010 CFR

2010-07-01

... circumstances in which a user cannot or need not utilize the validation techniques contemplated by these... which has an adverse impact, the validation techniques contemplated by these guidelines usually should be followed if technically feasible. Where the user cannot or need not follow the validation...

29 CFR 1607.6 - Use of selection procedures which have not been validated.

Code of Federal Regulations, 2014 CFR

2014-07-01

... circumstances in which a user cannot or need not utilize the validation techniques contemplated by these... which has an adverse impact, the validation techniques contemplated by these guidelines usually should be followed if technically feasible. Where the user cannot or need not follow the validation...

29 CFR 1607.6 - Use of selection procedures which have not been validated.

Code of Federal Regulations, 2011 CFR

2011-07-01

... circumstances in which a user cannot or need not utilize the validation techniques contemplated by these... which has an adverse impact, the validation techniques contemplated by these guidelines usually should be followed if technically feasible. Where the user cannot or need not follow the validation...

29 CFR 1607.6 - Use of selection procedures which have not been validated.

Code of Federal Regulations, 2013 CFR

2013-07-01

... circumstances in which a user cannot or need not utilize the validation techniques contemplated by these... which has an adverse impact, the validation techniques contemplated by these guidelines usually should be followed if technically feasible. Where the user cannot or need not follow the validation...

29 CFR 1607.6 - Use of selection procedures which have not been validated.

Code of Federal Regulations, 2012 CFR

2012-07-01

... circumstances in which a user cannot or need not utilize the validation techniques contemplated by these... which has an adverse impact, the validation techniques contemplated by these guidelines usually should be followed if technically feasible. Where the user cannot or need not follow the validation...

40 CFR 426.57 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... control technology. 426.57 Section 426.57 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GLASS MANUFACTURING POINT SOURCE CATEGORY Float Glass Manufacturing Subcategory § 426.57 Effluent limitations guidelines representing the degree of effluent reduction...

40 CFR 426.87 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... control technology. 426.87 Section 426.87 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GLASS MANUFACTURING POINT SOURCE CATEGORY Glass Container Manufacturing Subcategory § 426.87 Effluent limitations guidelines representing the degree of effluent reduction...

40 CFR 426.107 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... control technology. 426.107 Section 426.107 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GLASS MANUFACTURING POINT SOURCE CATEGORY Glass Tubing (Danner) Manufacturing Subcategory § 426.107 Effluent limitations guidelines representing the degree of effluent...

40 CFR 426.127 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... control technology. 426.127 Section 426.127 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GLASS MANUFACTURING POINT SOURCE CATEGORY Incandescent Lamp Envelope Manufacturing Subcategory § 426.127 Effluent limitations guidelines representing the degree of...

40 CFR 455.32 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2014 CFR

2014-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) PESTICIDE CHEMICALS Metallo-Organic Pesticide Chemicals Manufacturing Subcategory § 455.32 Effluent limitations guidelines representing the... controlled by this paragraph which may be discharged from the manufacture of metallo-organic active...

40 CFR 455.32 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2013 CFR

2013-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) PESTICIDE CHEMICALS Metallo-Organic Pesticide Chemicals Manufacturing Subcategory § 455.32 Effluent limitations guidelines representing the... controlled by this paragraph which may be discharged from the manufacture of metallo-organic active...

40 CFR 455.32 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2012 CFR

2012-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) PESTICIDE CHEMICALS Metallo-Organic Pesticide Chemicals Manufacturing Subcategory § 455.32 Effluent limitations guidelines representing the... controlled by this paragraph which may be discharged from the manufacture of metallo-organic active...

Regulations and guidelines should be strengthened urgently for re-evaluation on post-marketing medicines in China.

PubMed

Xie, Yan-Ming; Tian, Feng

2013-07-01

This paper reviewed the situation of regulations and guidelines on post-marketing medicines in the developed countries and in China. The developed countries have accumulated a lot of empirical principles and techniques on postmarketing surveillance (also named pharmacovigilance), therefore, their regulation systems are nearly perfect. In China, the regulations on post-marketing re-evaluation and relative technical guidelines do not cover the whole aspects, even lack in some important aspects, and long-term risk management mechanisms have not been established. So it is urgent to establish new regulations and improve the regulatory system in China based on the existing regulations and guidelines, by learning from the ideas of foreign advanced regulations, then fully integrating them with China's actual conditions, and cooperating with multidisciplinary researchers.

Total Body Irradiation: Guidelines from the International Lymphoma Radiation Oncology Group (ILROG).

PubMed

Wong, Jeffrey Y C; Filippi, Andrea Riccardo; Dabaja, Bouthaina Shbib; Yahalom, Joachim; Specht, Lena

2018-07-01

Total body irradiation (TBI) remains an effective myeloablative treatment in regimens used for preparation and conditioning before allogeneic stem cell transplantation for leukemia. The regimens used vary across institutions in terms of dose, dose rate, fractionation, and technique. The objective of this document is to provide comprehensive guidelines for the current practice of delivering total body irradiation. Copyright © 2018 Elsevier Inc. All rights reserved.

Estimating canopy cover in forest stands used by Mexican spotted owls: Do stand-exam routines provide estimates comparable to field-based techniques?

Treesearch

Joseph L. Ganey; Regis H. Cassidy; William M. Block

2008-01-01

Canopy cover has been identified as an important correlate of Mexican spotted owl (Strix occidentalis lucida) habitat, yet management guidelines in a 1995 U.S. Fish and Wildlife Service recovery plan for the Mexican spotted owl did not address canopy cover. These guidelines emphasized parameters included in U.S. Forest Service stand exams, and...

Capital Investment Motivational Techniques Used by Prime Contractors on Subcontractors

DTIC Science & Technology

1984-12-01

by block number) Productivity; Profit Policy; Subcontractors; Weighted Guidelines; Profitability; Profit 20. ABSTRACT (Continue on reverse aide If...probably productivity gains that could be made if defense contractors increased their investment [6:39]. A major deterrent to the Weighted Guideline...any profit gained would be offset to some degree by a profit loss from a reduction in profit based on costs . This result is a consequence of the cost

[A brief history of resuscitation - the influence of previous experience on modern techniques and methods].

PubMed

Kucmin, Tomasz; Płowaś-Goral, Małgorzata; Nogalski, Adam

2015-02-01

Cardiopulmonary resuscitation (CPR) is relatively novel branch of medical science, however first descriptions of mouth-to-mouth ventilation are to be found in the Bible and literature is full of descriptions of different resuscitation methods - from flagellation and ventilation with bellows through hanging the victims upside down and compressing the chest in order to stimulate ventilation to rectal fumigation with tobacco smoke. The modern history of CPR starts with Kouwenhoven et al. who in 1960 published a paper regarding heart massage through chest compressions. Shortly after that in 1961Peter Safar presented a paradigm promoting opening the airway, performing rescue breaths and chest compressions. First CPR guidelines were published in 1966. Since that time guidelines were modified and improved numerously by two leading world expert organizations ERC (European Resuscitation Council) and AHA (American Heart Association) and published in a new version every 5 years. Currently 2010 guidelines should be obliged. In this paper authors made an attempt to present history of development of resuscitation techniques and methods and assess the influence of previous lifesaving methods on nowadays technologies, equipment and guidelines which allow to help those women and men whose life is in danger due to sudden cardiac arrest. © 2015 MEDPRESS.

A Review of Recruitment, Adherence and Drop-Out Rates in Omega-3 Polyunsaturated Fatty Acid Supplementation Trials in Children and Adolescents.

PubMed

van der Wurff, Inge S M; Meyer, Barbara J; de Groot, Renate H M

2017-05-10

The influence of n -3 long-chain polyunsaturated fatty acids ( n -3 LCPUFA) supplementation on health outcomes has been studied extensively with randomized controlled trials (RCT). In many research fields, difficulties with recruitment, adherence and high drop-out rates have been reported. However, what is unknown is how common these problems are in n -3 LCPUFA supplementation studies in children and adolescents. Therefore, this paper will review n -3 LCPUFA supplementation studies in children and adolescents with regard to recruitment, adherence and drop-out rates. The Web of Science, PubMed and Ovid databases were searched for papers reporting on RCT supplementing children and adolescents (2-18 years) with a form of n -3 LCPUFA (or placebo) for at least four weeks. As a proxy for abiding to CONSORT guidelines, we noted whether manuscripts provided a flow-chart and provided dates defining the period of recruitment and follow-up. Ninety manuscripts (reporting on 75 studies) met the inclusion criteria. The majority of the studies did not abide by the CONSORT guidelines: 55% did not provide a flow-chart, while 70% did not provide dates. The majority of studies provided minimal details about the recruitment process. Only 25 of the 75 studies reported an adherence rate which was on average 85%. Sixty-five of the 75 studies included drop-out rates which were on average 17%. Less than half of the included studies abided by the CONSORT guidelines (45% included a flow chart, while 30% reported dates). Problems with recruitment and drop-out seem to be common in n -3 LCPUFA supplementation trials in children and adolescents. However, reporting about recruitment, adherence and dropout rates was very heterogeneous and minimal in the included studies. Some techniques to improve recruitment, adherence and dropout rates were identified from the literature, however these techniques may need to be tailored to n -3 LCPUFA supplementation studies in children and adolescents.

Dutch guideline for clinical foetal-neonatal and paediatric post-mortem radiology, including a review of literature.

PubMed

Sonnemans, L J P; Vester, M E M; Kolsteren, E E M; Erwich, J J H M; Nikkels, P G J; Kint, P A M; van Rijn, R R; Klein, W M

2018-06-01

Clinical post-mortem radiology is a relatively new field of expertise and not common practice in most hospitals yet. With the declining numbers of autopsies and increasing demand for quality control of clinical care, post-mortem radiology can offer a solution, or at least be complementary. A working group consisting of radiologists, pathologists and other clinical medical specialists reviewed and evaluated the literature on the diagnostic value of post-mortem conventional radiography (CR), ultrasonography, computed tomography (PMCT), magnetic resonance imaging (PMMRI), and minimally invasive autopsy (MIA). Evidence tables were built and subsequently a Dutch national evidence-based guideline for post-mortem radiology was developed. We present this evaluation of the radiological modalities in a clinical post-mortem setting, including MIA, as well as the recently published Dutch guidelines for post-mortem radiology in foetuses, neonates, and children. In general, for post-mortem radiology modalities, PMMRI is the modality of choice in foetuses, neonates, and infants, whereas PMCT is advised in older children. There is a limited role for post-mortem CR and ultrasonography. In most cases, conventional autopsy will remain the diagnostic method of choice. Based on a literature review and clinical expertise, an evidence-based guideline was developed for post-mortem radiology of foetal, neonatal, and paediatric patients. What is Known: • Post-mortem investigations serve as a quality check for the provided health care and are important for reliable epidemiological registration. • Post-mortem radiology, sometimes combined with minimally invasive techniques, is considered as an adjunct or alternative to autopsy. What is New: • We present the Dutch guidelines for post-mortem radiology in foetuses, neonates and children. • Autopsy remains the reference standard, however minimal invasive autopsy with a skeletal survey, post-mortem computed tomography, or post-mortem magnetic resonance imaging can be complementary thereof.

Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group.

PubMed

Ten Broek, Richard P G; Krielen, Pepijn; Di Saverio, Salomone; Coccolini, Federico; Biffl, Walter L; Ansaloni, Luca; Velmahos, George C; Sartelli, Massimo; Fraga, Gustavo P; Kelly, Michael D; Moore, Frederick A; Peitzman, Andrew B; Leppaniemi, Ari; Moore, Ernest E; Jeekel, Johannes; Kluger, Yoram; Sugrue, Michael; Balogh, Zsolt J; Bendinelli, Cino; Civil, Ian; Coimbra, Raul; De Moya, Mark; Ferrada, Paula; Inaba, Kenji; Ivatury, Rao; Latifi, Rifat; Kashuk, Jeffry L; Kirkpatrick, Andrew W; Maier, Ron; Rizoli, Sandro; Sakakushev, Boris; Scalea, Thomas; Søreide, Kjetil; Weber, Dieter; Wani, Imtiaz; Abu-Zidan, Fikri M; De'Angelis, Nicola; Piscioneri, Frank; Galante, Joseph M; Catena, Fausto; van Goor, Harry

2018-01-01

Adhesive small bowel obstruction (ASBO) is a common surgical emergency, causing high morbidity and even some mortality. The adhesions causing such bowel obstructions are typically the footprints of previous abdominal surgical procedures. The present paper presents a revised version of the Bologna guidelines to evidence-based diagnosis and treatment of ASBO. The working group has added paragraphs on prevention of ASBO and special patient groups. The guideline was written under the auspices of the World Society of Emergency Surgery by the ASBO working group. A systematic literature search was performed prior to the update of the guidelines to identify relevant new papers on epidemiology, diagnosis, and treatment of ASBO. Literature was critically appraised according to an evidence-based guideline development method. Final recommendations were approved by the workgroup, taking into account the level of evidence of the conclusion. Adhesion formation might be reduced by minimally invasive surgical techniques and the use of adhesion barriers. Non-operative treatment is effective in most patients with ASBO. Contraindications for non-operative treatment include peritonitis, strangulation, and ischemia. When the adhesive etiology of obstruction is unsure, or when contraindications for non-operative management might be present, CT is the diagnostic technique of choice. The principles of non-operative treatment are nil per os, naso-gastric, or long-tube decompression, and intravenous supplementation with fluids and electrolytes. When operative treatment is required, a laparoscopic approach may be beneficial for selected cases of simple ASBO.Younger patients have a higher lifetime risk for recurrent ASBO and might therefore benefit from application of adhesion barriers as both primary and secondary prevention. This guideline presents recommendations that can be used by surgeons who treat patients with ASBO. Scientific evidence for some aspects of ASBO management is scarce, in particular aspects relating to special patient groups. Results of a randomized trial of laparoscopic versus open surgery for ASBO are awaited.

Primary care guidelines on consultation practices: the effectiveness of computerized versus paper-based versions. A cluster randomized controlled trial among newly qualified primary care physicians.

PubMed

Jousimaa, Jukkapekka; Mäkelä, Marjukka; Kunnamo, Ilkka; MacLennan, Graeme; Grimshaw, Jeremy M

2002-01-01

To compare the effects of computerized and paper-based versions of guidelines on recently qualified physicians' consultation practices. Two arm cluster randomized controlled trial. Physicians were randomized to receive computerized or textbook-based versions of the same guidelines for a 4-week study period. Physicians' compliance with guideline recommendations about laboratory, radiological, physical and other examinations, procedures, nonpharmacologic and pharmacologic treatments, physiotherapy, and referrals were measured by case note review. There were 139 recently qualified physicians working in 96 primary healthcare centers in Finland who participated in the study. Data on 4,633 patient encounters were abstracted, of which 3,484 were suitable for further analysis. Physicians' compliance with guidelines was high (over 80% for use of laboratory, radiology, physical examinations, and referrals). There were no significant differences in physicians' consultation practices in any of the measured outcomes between the computerized and textbook group. Guidelines are a useful source of information for recently qualified physicians working in primary care. However, the method of presentation of the guidelines (electronic or paper) does not have an effect on guideline use or their impact on decisions. Other factors should be considered when choosing the method of presentation of guidelines, such as information-seeking time, ease of use during the consultation, ability to update, production costs, and the physician's own preferences.

UK audit of glomerular filtration rate measurement from plasma sampling in 2013.

PubMed

Murray, Anthony W; Lawson, Richard S; Cade, Sarah C; Hall, David O; Kenny, Bob; O'Shaughnessy, Emma; Taylor, Jon; Towey, David; White, Duncan; Carson, Kathryn

2014-11-01

An audit was carried out into UK glomerular filtration rate (GFR) calculation. The results were compared with an identical 2001 audit. Participants used their routine method to calculate GFR for 20 data sets (four plasma samples) in millilitres per minute and also the GFR normalized for body surface area. Some unsound data sets were included to analyse the applied quality control (QC) methods. Variability between centres was assessed for each data set, compared with the national median and a reference value calculated using the method recommended in the British Nuclear Medicine Society guidelines. The influence of the number of samples on variability was studied. Supplementary data were requested on workload and methodology. The 59 returns showed widespread standardization. The applied early exponential clearance correction was the main contributor to the observed variability. These corrections were applied by 97% of centres (50% - 2001) with 80% using the recommended averaged Brochner-Mortenson correction. Approximately 75% applied the recommended Haycock body surface area formula for adults (78% for children). The effect of the number of samples used was not significant. There was wide variability in the applied QC techniques, especially in terms of the use of the volume of distribution. The widespread adoption of the guidelines has harmonized national GFR calculation compared with the previous audit. Further standardization could further reduce variability. This audit has highlighted the need to address the national standardization of QC methods. Radionuclide techniques are confirmed as the preferred method for GFR measurement when an unequivocal result is required.

Surgery for esotropia under topical anesthesia.

PubMed

Tejedor, Jaime; Ogallar, Consuelo; Rodríguez, José M

2010-10-01

To compare a surgically adjusted dose of strabismus surgery using topical anesthesia in cooperative patients with dosage guidelines adapted to the surgeon's personal technique using sub-Tenon's anesthesia. Randomized, controlled, single-site clinical trial. Sixty patients with nonparalytic, nonrestrictive esotropia who were cooperative for surgery under topical anesthesia. Twenty-eight patients were assigned to topical anesthesia, and 32 patients were assigned to sub-Tenon's anesthesia. Visual acuity, refraction, and deviation angle were determined in all patients preoperatively and postoperatively, and stereoacuity was measured postoperatively. Deviation angle was measured by simultaneous and alternate prism and cover test, and stereoacuity was measured using Randot circles (Stereo Optical Co., Chicago, IL). The amount of surgery under topical anesthesia was adjusted intraoperatively. The amount of surgery used in the 2 treatment groups (measured in millimeters and millimeter/degree of deviation angle) and 6-month motor and stereoacuity outcomes. Patients in the topical group required 3.2 mm less surgery on average than those in the sub-Tenon's group (5.9 and 9.1 mm, respectively; 0.4 and 0.6 mm of recession/degree, respectively) (P<0.01). Motor success (84% and 75%, respectively, P=0.38) and stereoacuity (339.6 and 323.9 arc seconds, respectively, P=0.87) at 6 months were similar in the 2 groups. Topical anesthesia requires a smaller amount of surgery and number of operated muscles to correct esotropia compared with classic surgery guidelines adapted to the surgeon's personal technique. Copyright © 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Self-management for obesity and cardio-metabolic fitness: Description and evaluation of the lifestyle modification program of a randomised controlled trial

PubMed Central

Pettman, Tahna L; Misan, Gary MH; Owen, Katherine; Warren, Kate; Coates, Alison M; Buckley, Jonathan D; Howe, Peter RC

2008-01-01

Background Sustainable lifestyle modification strategies are needed to address obesity and cardiovascular risk factors. Intensive, individualised programs have been successful, but are limited by time and resources. We have formulated a group-based lifestyle education program based upon national diet and physical activity (PA) recommendations to manage obesity and cardio-metabolic risk factors. This article describes the content and delivery of this program, with information on compliance and acceptability. Methods Overweight/obese adults (n = 153) with metabolic syndrome were recruited from the community and randomly allocated to intervention (INT) or control (CON). Written copies of Australian national dietary and PA guidelines were provided to all participants. INT took part in a 16-week lifestyle program which provided a curriculum and practical strategies on 1) dietary and PA information based on national guidelines, 2) behavioural self-management tools, 3) food-label reading, supermarkets tour and cooking, 4) exercise sessions, and 5) peer-group support. Compliance was assessed using attendance records and weekly food/PA logs. Participants' motivations, perceived benefits and goals were assessed through facilitated discussion. Program acceptability feedback was collected through structured focus groups. Results Although completion of weekly food/PA records was poor, attendance at information/education sessions (77% overall) and exercise participation (66% overall) was high, and compared with CON, multiple markers of body composition and cardio-metabolic health improved in INT. Participants reported that the most useful program components included food-label reading, cooking sessions, and learning new and different physical exercises, including home-based options. Participants also reported finding self-management techniques helpful, namely problem solving and short-term goal setting. The use of a group setting and supportive 'peer' leaders were found to be supportive. More frequent clinical assessment was suggested for future programs. Conclusion This group-based lifestyle program achieved improvements in body composition and cardio-metabolic and physical fitness similar to individualised interventions which are more resource intensive to deliver. It confirmed that active training in lifestyle modification is more effective than passive provision of guidelines. Such programs should include social support and self-management techniques. Continued clinical follow up may be required for long-term maintenance in individuals attempting lifestyle behaviour change. Program facilitation by peers may help and should be further investigated in a community-based model. PMID:18954466

Analgesia/anesthesia for external cephalic version.

PubMed

Weiniger, Carolyn F

2013-06-01

Professional society guidelines recommend that women with breech presentation be delivered surgically due to a higher incidence of fetal risks compared with vaginal delivery. An alternative is attempted external cephalic version, which if successful, enables attempted vaginal delivery. Attitudes towards external cephalic version (ECV) will be considered in this review, along with pain relief methods and their impact on ECV success rates. Articles suggest that ECV is infrequently offered, due to both physician and patient factors. Success of ECV is higher in multiparous women, complete breech, posterior placenta, or smaller fetus. Preterm ECV performance does not increase vaginal delivery rates. Neuraxial techniques (spinal or epidural) significantly increase ECV success rates, as do moxibustion and hypnosis. Four reviews summarized studies considering ECV and neuraxial techniques. These reviews suggest that neuraxial techniques using high (surgical) doses of local anesthetic are efficacious compared with control groups not using anesthesia, whereas techniques using low-doses are not. Low-dose versus high-dose neuraxial analgesia/anesthesia has not been directly compared in a single study. Based on currently available data, the rate of cephalic presentation is not increased using neuraxial techniques, but vaginal delivery rates are higher. ECV appears to be a low-risk procedure. The logistics of routine ECV and provision of optimal neuraxial techniques for successful ECV require additional research. Safety aspects of neuraxial anesthesia for ECV require further investigation.

40 CFR 435.44 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 30 2011-07-01 2011-07-01 false Effluent limitations guidelines... control technology (BCT). 435.44 Section 435.44 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS OIL AND GAS EXTRACTION POINT SOURCE CATEGORY Coastal...

40 CFR 435.44 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 31 2013-07-01 2013-07-01 false Effluent limitations guidelines... control technology (BCT). 435.44 Section 435.44 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Coastal Subcategory § 435.44 Effluent limitations guidelines representing the degree of effluent reduction...

40 CFR 435.44 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 30 2014-07-01 2014-07-01 false Effluent limitations guidelines... control technology (BCT). 435.44 Section 435.44 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Coastal Subcategory § 435.44 Effluent limitations guidelines representing the degree of effluent reduction...

40 CFR 435.44 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Effluent limitations guidelines... control technology (BCT). 435.44 Section 435.44 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS OIL AND GAS EXTRACTION POINT SOURCE CATEGORY Coastal...

40 CFR 435.44 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 31 2012-07-01 2012-07-01 false Effluent limitations guidelines... control technology (BCT). 435.44 Section 435.44 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Coastal Subcategory § 435.44 Effluent limitations guidelines representing the degree of effluent reduction...

40 CFR 417.23 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... pollutant properties, controlled by this section and attributable to the hydrogenation of fatty acids, which... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS SOAP AND DETERGENT MANUFACTURING POINT SOURCE CATEGORY Fatty Acid Manufacturing by Fat Splitting Subcategory § 417.23 Effluent limitations guidelines representing...

40 CFR 426.47 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... control technology (BCT). 426.47 Section 426.47 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GLASS MANUFACTURING POINT SOURCE CATEGORY Plate Glass Manufacturing Subcategory § 426.47 Effluent limitations guidelines representing the degree of effluent reduction...

40 CFR 409.32 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2011 CFR

2011-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS SUGAR PROCESSING POINT SOURCE CATEGORY Liquid Cane Sugar Refining Subcategory § 409.32 Effluent limitations guidelines representing the degree of effluent... application of the best practicable control technology currently available (BPT): (a) Any liquid cane sugar...

40 CFR 409.32 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS SUGAR PROCESSING POINT SOURCE CATEGORY Liquid Cane Sugar Refining Subcategory § 409.32 Effluent limitations guidelines representing the degree of effluent... application of the best practicable control technology currently available (BPT): (a) Any liquid cane sugar...

40 CFR 409.32 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2013 CFR

2013-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS SUGAR PROCESSING POINT SOURCE CATEGORY Liquid Cane Sugar Refining Subcategory § 409.32 Effluent limitations guidelines representing the degree of effluent... application of the best practicable control technology currently available (BPT): (a) Any liquid cane sugar...

40 CFR 409.32 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2014 CFR

2014-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS SUGAR PROCESSING POINT SOURCE CATEGORY Liquid Cane Sugar Refining Subcategory § 409.32 Effluent limitations guidelines representing the degree of effluent... application of the best practicable control technology currently available (BPT): (a) Any liquid cane sugar...

40 CFR 409.32 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2012 CFR

2012-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS SUGAR PROCESSING POINT SOURCE CATEGORY Liquid Cane Sugar Refining Subcategory § 409.32 Effluent limitations guidelines representing the degree of effluent... application of the best practicable control technology currently available (BPT): (a) Any liquid cane sugar...

40 CFR 454.32 - Effluent limitations and guidelines representing the degree of effluent reduction attainable by...

Code of Federal Regulations, 2010 CFR

2010-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GUM AND WOOD CHEMICALS MANUFACTURING POINT SOURCE CATEGORY Wood Rosin, Turpentine and Pine Oil Subcategory § 454.32 Effluent limitations and guidelines... properties, controlled by this paragraph, which may be discharged from the manufacture of wood rosin...

40 CFR 454.32 - Effluent limitations and guidelines representing the degree of effluent reduction attainable by...

Code of Federal Regulations, 2011 CFR

2011-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GUM AND WOOD CHEMICALS MANUFACTURING POINT SOURCE CATEGORY Wood Rosin, Turpentine and Pine Oil Subcategory § 454.32 Effluent limitations and guidelines... properties, controlled by this paragraph, which may be discharged from the manufacture of wood rosin...

40 CFR 417.23 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2011 CFR

2011-07-01

... pollutant properties, controlled by this section and attributable to the hydrogenation of fatty acids, which... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS SOAP AND DETERGENT MANUFACTURING POINT SOURCE CATEGORY Fatty Acid Manufacturing by Fat Splitting Subcategory § 417.23 Effluent limitations guidelines representing...

Comparison of biodegradation performance of OECD test guideline 301C with that of other ready biodegradability tests.

PubMed

Kayashima, Takakazu; Taruki, Masanori; Katagiri, Kazuomi; Nabeoka, Ryosuke; Yoshida, Tomohiko; Tsuji, Toshiaki

2014-02-01

The Organisation for Economic Co-operatoin and development (OECD) Guidelines for the Testing of Chemicals list 7 types of tests for determining the ready biodegradability of chemical compounds (301A-F and 310). The present study compares the biodegradation performance of test guideline 301C, which is applied in Japan's Chemical Substances Control Law, with the performance of the other 6 ready biodegradability tests (RBTs) listed in the guidelines. Test guideline 301C specifies use of activated sludge precultured with synthetic sewage containing glucose and peptone (301C sludge) as a test inoculum; in the other RBTs, however, activated sludge from wastewater treatment plants (WWTP sludge) is frequently employed. Analysis based on percentage of biodegradation and pass levels revealed that the biodegradation intensity of test guideline 301C is relatively weak compared with the intensities of RBTs using WWTP sludge, and the following chemical compounds are probably not biodegraded under test guideline 301C conditions: phosphorus compounds; secondary, tertiary, and quaternary amines; and branched quaternary carbon compounds. The relatively weak biodegradation intensity of test guideline 301C may be related to the markedly different activities of the 301C and WWTP sludges. These findings will be valuable for evaluating RBT data in relation to Japan's Chemical Substances Control Law. © 2013 SETAC.

Considerations on the Improved Integration of Medical Guidelines into Routine Clinical Practice – a Review and Concept Proposal

PubMed Central

Beckmann, M. W.; Schlieter, H.; Richter, P.; Wesselmann, S.

2016-01-01

Medical guidelines have become established as the standard for the comprehensive synopsis of all available information (scientific trials, expert opinion) on diagnosis and treatment recommendations. The transfer of guidelines to clinical practice and subsequent monitoring has however proven difficult. In particular the potential interaction between guideline developers and guideline users has not been fully utilised. This review article analyses the status quo and existing methodological and technical information solutions supporting the guideline life cycle. It is shown that there are numerous innovative developments that in isolation do not provide comprehensive support. The vision of the “Living Guidelines 2.0” is therefore presented. This outlines the merging of guideline development and implementation on the basis of clinical pathways and guideline-based quality control, and building on this, the generation of information for guideline development and research. PMID:27134291

Computerization of guidelines: towards a "guideline markup language".

PubMed

Dart, T; Xu, Y; Chatellier, G; Degoulet, P

2001-01-01

Medical decision making is one of the most difficult daily tasks for physicians. Guidelines have been designed to reduce variance between physicians in daily practice, to improve patient outcomes and to control costs. In fact, few physicians use guidelines in daily practice. A way to ease the use of guidelines is to implement computerised guidelines (computer reminders). We present in this paper a method of computerising guidelines. Our objectives were: 1) to propose a generic model that can be instantiated for any specific guidelines; 2) to use eXtensible Markup Language (XML) as a guideline representation language to instantiate the generic model for a specific guideline. Our model is an object representation of a clinical algorithm, it has been validated by running two different guidelines issued by a French official Agency. In spite of some limitations, we found that this model is expressive enough to represent complex guidelines devoted to diabetes and hypertension management. We conclude that XML can be used as a description format to structure guidelines and as an interface between paper-based guidelines and computer applications.

The art of translating nutritional science into dietary guidance: history and evolution of the Dietary Guidelines for Americans.

PubMed

Watts, Mary Lee; Hager, Mary H; Toner, Cheryl D; Weber, Jennifer A

2011-07-01

The United States government has published official Dietary Guidelines for Americans (DGA) since 1980 and has recently released the 2010 version. Serving as a foundational cornerstone for federal nutrition policy, the DGA embrace current nutritional science and translate it into practical guidance to enhance the overall health of Americans. This article reviews the history and process for developing the DGA, including the incorporation of sophisticated and systematic techniques for reviewing emerging evidence. It also explores issues related to implementation of the guidelines through federal policy, the food supply, and consumer knowledge and behavior. © 2011 International Life Sciences Institute.

Can we influence prescribing patterns?

PubMed

Sbarbaro, J A

2001-09-15

A variety of programming techniques and methods of training have been employed to change physician behavior. Didactic continuing medical education lectures and clinical guidelines have had minimal impact, although endorsement of national professional guidelines by local opinion leaders appears to have a positive influence on the impact of professional guidelines. Interactive, hands-on workshops, performance reporting, and peer/patient feedback are also effective. Changing prescribing habits has been equally difficult. Drug utilization letters involving both pharmacist and physician have more impact than do letters sent only to the physician. Academic detailing, when properly executed, has been consistently effective. When combined with these strategies, closed formularies become a powerful tool in changing prescribing behavior.

Asthma in Asia: Physician perspectives on control, inhaler use and patient communications.

PubMed

Price, David; David-Wang, Aileen; Cho, Sang-Heon; Ho, James Chung-Man; Jeong, Jae-Won; Liam, Chong-Kin; Lin, Jiangtao; Muttalif, Abdul Razak; Perng, Diahn-Warng; Tan, Tze-Lee; Yunus, Faisal; Neira, Glenn

2016-09-01

We examined the physician perspectives on asthma management in Asia. An online/face-to-face, questionnaire-based survey of respiratory specialists and primary care physicians from eight Asian countries/region was carried out. The survey explored asthma control, inhaler selection, technique and use; physician-patient communications and asthma education. Inclusion criteria were >50% of practice time spent on direct patient care; and treated >30 patients with asthma per month, of which >60% were aged >12 years. REALISE Asia (Phase 2) involved 375 physicians with average 15.9(±6.8) years of clinical experience. 89.1% of physicians reporting use of guidelines estimated that 53.2% of their patients have well-controlled (GINA-defined) asthma. Top consideration for inhaler choice was asthma severity (82.4%) and lowest, socio-economic status (32.5%). Then 54.7% of physicians checked their patients' inhaler techniques during consultations but 28.2(±19.1)% of patients were using their inhalers incorrectly; 21.1-57.9% of physicians could spot improper inhaler techniques in video demonstrations. And 79.6% of physicians believed combination inhalers could increase adherence because of convenience (53.7%), efficacy (52.7%) and usability (18.9%). Initial and follow-up consultations took 16.8(±8.4) and 9.2(±5.3) minutes, respectively. Most (85.1%) physicians used verbal conversations and least (24.5%), video demonstrations of inhaler use; 56.8% agreed that patient attitudes influenced their treatment approach. Physicians and patients have different views of 'well-controlled' asthma. Although physicians informed patients about asthma and inhaler usage, they overestimated actual usage and patients' knowledge was sub-optimal. Physician-patient interactions can be augmented with understanding of patient attitudes, visual aids and ancillary support to perform physical demonstrations to improve treatment outcomes.

40 CFR 424.17 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... control technology. 424.17 Section 424.17 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS FERROALLOY MANUFACTURING POINT SOURCE CATEGORY Open Electric... control technology. Except as provided in §§ 125.30 through 125.32, any existing point source subject to...

40 CFR 428.92 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2011 CFR

2011-07-01

... pollutant properties, controlled by this section and attributable to pan, dry digestion, and mechanical... Digestion, and Mechanical Reclaimed Rubber Subcategory § 428.92 Effluent limitations guidelines representing... properties controlled by this section, which may be discharged by a point source subject to the provisions of...

40 CFR 428.93 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2011 CFR

2011-07-01

... pollutant properties, controlled by this section, and attributable to pan, dry digestion, and mechanical..., and Mechanical Reclaimed Rubber Subcategory § 428.93 Effluent limitations guidelines representing the... properties, controlled by this section, which may be discharged by a point source subject to the provisions...

40 CFR 424.17 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2013 CFR

2013-07-01

... control technology. 424.17 Section 424.17 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS FERROALLOY MANUFACTURING POINT SOURCE CATEGORY Open Electric... control technology. Except as provided in §§ 125.30 through 125.32, any existing point source subject to...

40 CFR 424.17 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2011 CFR

2011-07-01

... control technology. 424.17 Section 424.17 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS FERROALLOY MANUFACTURING POINT SOURCE CATEGORY Open Electric... control technology. Except as provided in §§ 125.30 through 125.32, any existing point source subject to...