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Sample records for death certificate based

  1. Quality of death certificates in Valencia, Spain.

    PubMed Central

    Benavides, F G; Bolumar, F; Peris, R

    1989-01-01

    Certificates of 1,454 deaths occurring over 11 months were retrieved from the Civil Register in Valencia, Spain. Relevant medical information was systematically gathered from hospital records, questionnaires, and Coroner reports. We compared the underlying cause of death (UCD) from the original death certificate, and a reference cause of death (RCD) determined by a panel of experts based on all available information. Overall, 80.2 percent of the certificates were concordant for disease category, but there was a great disparity among some specific disease categories. PMID:2782500

  2. Improving the accuracy of death certification

    PubMed Central

    Myers, K A; Farquhar, D R

    1998-01-01

    BACKGROUND: Population-based mortality statistics are derived from the information recorded on death certificates. This information is used for many important purposes, such as the development of public health programs and the allocation of health care resources. Although most physicians are confronted with the task of completing death certificates, many do not receive adequate training in this skill. Resulting inaccuracies in information undermine the quality of the data derived from death certificates. METHODS: An educational intervention was designed and implemented to improve internal medicine residents' accuracy in death certificate completion. A total of 229 death certificates (146 completed before and 83 completed after the intervention) were audited for major and minor errors, and the rates of errors before and after the intervention were compared. RESULTS: Major errors were identified on 32.9% of the death certificates completed before the intervention, a rate comparable to previously reported rates for internal medicine services in teaching hospitals. Following the intervention the major error rate decreased to 15.7% (p = 0.01). The reduction in the major error rate was accounted for by significant reductions in the rate of listing of mechanism of death without a legitimate underlying cause of death (15.8% v. 4.8%) (p = 0.01) and the rate of improper sequencing of death certificate information (15.8% v. 6.0%) (p = 0.03). INTERPRETATION: Errors are common in the completion of death certificates in the inpatient teaching hospital setting. The accuracy of death certification can be improved with the implementation of a simple educational intervention. PMID:9614825

  3. Mortality associated with neurofibromatosis type 1: A study based on Italian death certificates (1995-2006)

    PubMed Central

    2011-01-01

    Background Persons affected by neurofibromatosis type 1 (NF1) have a decreased survival, yet information on NF1-associated mortality is limited. Methods/Aim The National Mortality Database and individual Multiple-Causes-of-Death records were used to estimate NF1-associated mortality in Italy in the period 1995-2006, to compare the distribution of age at death (as a proxy of survival) to that of the general population and to evaluate the relation between NF1 and other medical conditions by determining whether the distribution of underlying causes of NF1-associated deaths differs from that of general population. Results Of the nearly 6.75 million deaths in the study period, 632 had a diagnosis of NF1, yet for nearly three-fourths of them the underlying cause was not coded as neurofibromatosis. The age distribution showed that NF1-associated deaths also occurred among the elderly, though mortality in early ages was high. The mean age for NF1-associated death was approximately 20 years lower than that for the general population. The gender differential may suggest that women are affected by more severe NF1-related complications, or they may simply reflect a greater tendency for NF1 to be reported on the death certificates of young women. Regarding the relation with other medical conditions, we found an excess, as the underlying cause of death, for malignant neoplasm of connective and other soft tissue and brain, but not for other sites. We also found an excess for obstructive chronic bronchitis and musculoskeletal system diseases among elderly persons. Conclusion This is the first nationally representative population-based study on NF1-associated mortality in Italy. It stresses the importance of the Multiple-Causes-of-Death Database in providing a more complete picture of mortality for conditions that are frequently not recorded as the underlying cause of death, or to study complex chronic diseases or diseases that have no specific International Classification of

  4. From Death to Death Certificate: What do the Dead say?

    PubMed

    Gill, James R

    2017-03-01

    This is an overview of medicolegal death investigation and death certification. Postmortem toxicological analysis, particularly for ethanol and drugs of abuse, plays a large role in the forensic investigation of natural and unnatural deaths. Postmortem drug concentrations must be interpreted in light of the autopsy findings and circumstances. Interpretations of drug and ethanol concentrations are important for death certification, but they also may be important for other stakeholders such as police, attorneys, public health practitioners, and the next-of-kin.

  5. Use of death certificates for mesothelioma surveillance.

    PubMed Central

    Davis, L K; Martin, T R; Kligler, B

    1992-01-01

    Data from the Massachusetts Cancer Registry and death certificates were linked for mesothelioma cases reported to the registry from 1982 through 1987 to determine the extent to which the cause of death information that is given on the death certificate is useful in identifying mesothelioma cases for disease surveillance. Only 12 percent of all persons reported with mesothelioma who had died were detected using underlying cause of death codes for cancers of the peritoneum and pleura, which are commonly used to identify mesothelioma cases. The rate increased to 83 percent when death certificates were reviewed manually for any mention of mesothelioma. Surveillance using only the coded cause of death data currently available will result in a large underascertainment of mesothelioma cases. PMID:1641448

  6. Using Literal Text From the Death Certificate to Enhance Mortality Statistics: Characterizing Drug Involvement in Deaths.

    PubMed

    Trinidad, James P; Warner, Margaret; Bastian, Brigham A; Minino, Arialdi M; Hedegaard, Holly

    2016-12-01

    Objectives-This report describes the development and use of a method for analyzing the literal text from death certificates to enhance national mortality statistics on drug-involved deaths. Drug-involved deaths include drug overdose deaths as well as other deaths where, according to death certificate literal text, drugs were associated with or contributed to the death. Methods-The method uses final National Vital Statistics System-Mortality files linked to electronic files containing literal text information from death certificates. Software programs were designed to search the literal text from three fields of the death certificate (the cause of death from Part I, significant conditions contributing to the death from Part II, and a description of how the injury occurred from Box 43) to identify drug mentions as well as contextual information. The list of drug search terms was developed from existing drug classification systems as well as from manual review of the literal text. Literal text surrounding the identified drug search terms was analyzed to ascertain the context. Drugs mentioned in the death certificate literal text were assumed to be involved in the death unless contextual information suggested otherwise (e.g., "METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS INFECTION"). The literal text analysis method was assessed by comparing the results from application of the method with results based on ICD-10 codes, and by conducting a manual review of a sample of records.

  7. Principles and Pitfalls: a Guide to Death Certification

    PubMed Central

    Brooks, Erin G.; Reed, Kurt D.

    2015-01-01

    Death certificates serve the critical functions of providing documentation for legal/administrative purposes and vital statistics for epidemiologic/health policy purposes. In order to satisfy these functions, it is important that death certificates be filled out completely, accurately, and promptly. The high error rate in death certification has been documented in multiple prior studies, as has the effectiveness of educational training interventions at mitigating errors. The following guide to death certification is intended to illustrate some basic principles and common pitfalls in electronic death registration with the goal of improving death certification accuracy. PMID:26185270

  8. Causes of death in Minamata disease: analysis of death certificates.

    PubMed

    Tamashiro, H; Akagi, H; Arakaki, M; Futatsuka, M; Roht, L H

    1984-01-01

    The causes of death in Minamata disease were analyzed and compared with those of control subjects. Of the 1422 Minamata disease patients in the Kumamoto Prefecture, 378 had died by the end of 1980. Of these 378, the first death occurred in 1954 with a peak incidence in 1956 when Minamata disease was officially reported for the first time. The number of deaths increased rapidly after 1972 with a second peak in 1976. The male:female ratio was 1.8:1 and the mean age-at-death was 67.2 years (SD = +/- 18.65). The mean age-at-death was younger in the cases of the initial outbreak than in those recently. There were, on the average, 2.8 causes of death per person. Of these cases, 157 (41.5%) had Minamata disease indicated on the death certificate, though 64 (16.9%) had Minamata disease coded as the underlying cause. Minamata disease and the noninflammatory diseases of the central nervous system (CNS) were the main underlying causes of death between 1954 and 1969, while, in the multiple cause data, pneumonia and non-ischemic heart disease were the most prevalent. Cerebrovascular diseases (18.0%) were the main underlying causes of death followed by malignant neoplasms (14.7%), cardiovascular diseases (14.1%) and Minamata disease (14.1%) in 1970 or later, while cardiovascular diseases (18.6%), Minamata disease (14.5%), cerebrovascular diseases (10.4%) and malignant neoplasms (7.1%) were the major multiple causes of death. As compared with the control, the proportions of deaths due to noninflammatory diseases of CNS and pneumonia were higher in the initial outbreak. Although the difference in the causes of death was less apparent recently, malignant neoplasms and hypertensive diseases tended to be lower. These results suggest that there is a need for a long-term follow-up of Minamata disease patients. The data also show the potential value of multiple causes of death coding in analyses of mortality.

  9. Inadequacies of death certification in Beirut: who is responsible?

    PubMed Central

    Sibai, Abla M.; Nuwayhid, Iman; Beydoun, May; Chaaya, Monique

    2002-01-01

    OBJECTIVE: To assess the completeness of data on death certificates over the past 25 years in Beirut, Lebanon, and to examine factors associated with the absence of certifiers' signatures and the non-reporting of the underlying cause of death. METHODS: A systematic 20% sample comprising 2607 death certificates covering the 1974, 1984, 1994, 1997 and 1998 registration periods was retrospectively reviewed for certification practices and missing data. FINDINGS: The information on the death certificates was almost complete in respect of all demographic characteristics of the deceased persons except for occupation and month of birth. Data relating to these variables were missing on approximately 95% and 78% of the certificates, respectively. Around half of the certificates did not carry a certifier's signature. Of those bearing such a signature, 21.6% lacked documentation of the underlying cause of death. The certifier's signature was more likely to be absent on: certificates corresponding to the younger and older age groups than on those of persons aged 15-44 years; those of females than on those of males; those of persons who had been living remotely from the registration governorate than on those of other deceased persons; and those for which there had been delays in registration exceeding six months than on certificates for which registration had been quicker. For certificates that carried the certifier's signature there was no evidence that any of the demographic characteristics of the deceased person was associated with decreased likelihood of reporting an underlying cause of death. CONCLUSION: The responsibility for failure to report causes of death in Beirut lies with families who lack an incentive to call for a physician and with certifying physicians who do not carry out this duty. The deficiencies in death certification are rectifiable. However, any changes should be sensitive to the constraints of the organizational and legal infrastructure governing death

  10. An application of the Sentinel Health Event (Occupational) concept to death certificates.

    PubMed Central

    Lalich, N R; Schuster, L L

    1987-01-01

    This article describes a computer-based application of the Sentinel Health Event (Occupational) [SHE(O)] concept, developed in conjunction with five states, to monitor deaths which are occupationally related. The states have coded their state death certificate files for industry and occupation, using the decedent's usual occupation and industry as reported on the death certificate. From these files, the SHE(O) computer program selects deaths which are likely to be work-related, based on a previously published SHE(O) list of 50 disease rubrics and associated industries and occupations. The computer program matches the SHE(O) list with the recorded industry, occupation, and underlying cause of death. The program has been tested using 1984 death certificate data from Maine, upstate New York (excluding New York City), North Carolina, Pennsylvania, and Rhode Island. Approximately 1 to 2 per cent of all deaths were selected by the program, with lung cancer and coal workers' pneumoconiosis being the most frequent cause of death. The SHE(O) program may be useful for identifying deaths which are potentially occupationally related, but its utility and its application to death certificates needs further evaluation before recommending widespread use. Limitations are discussed, as well as plans for improving the application of the SHE(O) concept to death certificates. PMID:3631365

  11. Using vital statistics to estimate the population-level impact of osteoporotic fractures on mortality based on death certificates, with an application to France (2000-2004)

    PubMed Central

    Ziadé, Nelly; Jougla, Eric; Coste, Joël

    2009-01-01

    Background We developed a methodology using vital statistics to estimate the impact of osteoporotic fractures on the mortality of an entire population, and applied it to France for the period 2000-2004. Methods Current definitions of osteoporotic fractures were reviewed and their components identified. We used the International Classification of Diseases with national vital statistics data for the French adult population and performed cross-classifications between various components: age, sex, I-code (site) and E-code (mechanism of fracture). This methodology allowed identification of appropriate thresholds and categorization for each pertinent component. Results 2,625,743 death certificates were analyzed, 2.2% of which carried a mention of fracture. Hip fractures represented 55% of all deaths from fracture. Both sexes showed a similar pattern of mortality rates for all fracture sites, the rate increased with age from the age of 70 years. The E-high-energy code (present in 12% of death certificates with fractures) was found to be useful to rule-out non-osteoporotic fractures, and to correct the overestimation of mortality rates. Using this methodology, the crude number of deaths associated with fractures was estimated to be 57,753 and the number associated with osteoporotic fractures 46,849 (1.85% and 1.78% of all deaths, respectively). Conclusion Osteoporotic fractures have a significant impact on overall population mortality. PMID:19761614

  12. Agreement between death certificate and autopsy diagnoses among atomic bomb survivors.

    PubMed

    Ron, E; Carter, R; Jablon, S; Mabuchi, K

    1994-01-01

    Based on the Atomic Bomb Casualty Commission/Radiation Effects Research Foundation series of over 5,000 autopsies, we examined death certificate accuracy for 12 disease categories and assessed the effect of potential modifying factors on agreement and accuracy. The overall percentage agreement between death certificate and autopsy diagnoses was only 52.5%. Although neoplasms had the highest detection rate, almost 25% of cancers diagnosed at autopsy were nevertheless missed on death certificates. Confirmation and detection rates were above 70% for neoplasms and external causes of death only. Confirmation rates were between 50 and 70% for infectious diseases and heart and other vascular diseases. Detection rates reached a similar level for infectious, cerebrovascular, and digestive diseases. Specificity rates were above 90% for all except the cerebrovascular disease category. Overall agreement decreased with increasing age at death and was worse for deaths occurring outside of hospital. There was some suggestion that agreement improved over time, but no indication that radiation dose, sex, city of residence, or inclusion in a biennial clinical examination program influenced agreement. Since the inaccuracy of death certificate diagnoses can have major implications for health research and planning, it is important to be aware that their accuracy is low and that it can vary widely depending on cause, age and place of death.

  13. Commentary: death certificate reporting needs to be fixed.

    PubMed

    Robbins, John A

    2012-05-01

    Something is wrong with the death reporting when there is a fivefold difference in the reported rates of fall mortality between Alabama and Vermont, two states in the United States. The problem is not unique here, as even the Swedish have trouble with their death certificate data. We understand that some of the reason is poor reporting, but how do we figure out how to do it right?

  14. Validity of death certificates for injury-related causes of death.

    PubMed

    Moyer, L A; Boyle, C A; Pollock, D A

    1989-11-01

    Exploration of the validity of death certificate information for classifying underlying causes of death has historically focused on "natural" or disease-related causes of death. Current interest in injury-related deaths has emphasized the need for proper certification and coding of these deaths. In this study, the authors compared agreement of the underlying cause of death as determined from death certificate information with that determined from an independent review of all relevant medical and legal documents of death by a panel of physicians. The study sample included all deaths (n = 446) occurring over an approximately 18-year follow-up period (1965-1983) in a randomly selected cohort of 18,313 US Army Veterans of the Vietnam era. Using the physician panel as the "gold standard," sensitivity and specificity were 90% or greater for broad groupings of motor vehicle crash deaths (International Classification of Diseases, Ninth Revision (ICD-9), codes E810-E825), suicides (codes E950-E959), and homicides (codes E960-E969). Agreement for deaths from unintentional poisonings (codes E850-E869), mostly drug- and alcohol-related, was poor (sensitivity, 50 percent); in general, the ICD-9 drug- and alcohol-specific nomenclature is difficult to apply. The specificity and sensitivity for the individual three-digit suicide and homicide codes were all greater than 90%, and although the specificity for three-digit motor vehicle crash deaths was also above 90%, the sensitivity was lower, from 29% to 83%. Agreement on the fourth digit of ICD-9--for example, the role of the decedent in a motor vehicle crash death--was generally poor. The lack of descriptive information on death certificates to allow detailed coding was chiefly responsible for the poor agreement.

  15. Contemporary accuracy of death certificates for coding prostate cancer as a cause of death: Is reliance on death certification good enough? A comparison with blinded review by an independent cause of death evaluation committee

    PubMed Central

    Turner, Emma L; Metcalfe, Chris; Donovan, Jenny L; Noble, Sian; Sterne, Jonathan A C; Lane, J Athene; I Walsh, Eleanor; Hill, Elizabeth M; Down, Liz; Ben-Shlomo, Yoav; Oliver, Steven E; Evans, Simon; Brindle, Peter; Williams, Naomi J; Hughes, Laura J; Davies, Charlotte F; Ng, Siaw Yein; Neal, David E; Hamdy, Freddie C; Albertsen, Peter; Reid, Colette M; Oxley, Jon; McFarlane, John; Robinson, Mary C; Adolfsson, Jan; Zietman, Anthony; Baum, Michael; Koupparis, Anthony; Martin, Richard M

    2016-01-01

    Background: Accurate cause of death assignment is crucial for prostate cancer epidemiology and trials reporting prostate cancer-specific mortality outcomes. Methods: We compared death certificate information with independent cause of death evaluation by an expert committee within a prostate cancer trial (2002–2015). Results: Of 1236 deaths assessed, expert committee evaluation attributed 523 (42%) to prostate cancer, agreeing with death certificate cause of death in 1134 cases (92%, 95% CI: 90%, 93%). The sensitivity of death certificates in identifying prostate cancer deaths as classified by the committee was 91% (95% CI: 89%, 94%); specificity was 92% (95% CI: 90%, 94%). Sensitivity and specificity were lower where death occurred within 1 year of diagnosis, and where there was another primary cancer diagnosis. Conclusions: UK death certificates accurately identify cause of death in men with prostate cancer, supporting their use in routine statistics. Possible differential misattribution by trial arm supports independent evaluation in randomised trials. PMID:27253172

  16. Completing Death Certificates from an EMR: Analysis of a Novel Public-Private Partnership

    PubMed Central

    Tripp, Jacob S.; Duncan, Jeffrey D.; Finch, Leisa; Huff, Stanley M.

    2015-01-01

    With the objective of increasing electronic death registration, Intermountain Healthcare and the Utah Office of Vital Records and Statistics have developed a system enabling death certification from within Intermountain’s electronic medical record (EMR), consisting of an EMR module and an HL7 interface. Comparison of post-intervention death certification at Intermountain Healthcare against a baseline study found a slight increase in the percentage of deaths certified electronically (73% pre vs. 77% post). Analysis of deaths certified using the EMR-module found that they were completed significantly sooner than those certified on paper or using the state’s web-based electronic death registration system (EDRS) (Mean time: Paper = 114.72 hours, EDRS = 81.84 hours, EMR = 43.92 hours; p < 0.0001). EMR-certified deaths also contained significantly more causes of deaths than either alternative method (Mean number of causes: Paper = 3.9 causes, EDRS = 4.0 causes, EMR = 5.5 causes; p < 0.0001). PMID:26958261

  17. Evaluating an educational intervention to improve the accuracy of death certification among trainees from various specialties

    PubMed Central

    Villar, Jesús; Pérez-Méndez, Lina

    2007-01-01

    Background The inaccuracy of death certification can lead to the misallocation of resources in health care programs and research. We evaluated the rate of errors in the completion of death certificates among medical residents from various specialties, before and after an educational intervention which was designed to improve the accuracy in the certification of the cause of death. Methods A 90-min seminar was delivered to seven mixed groups of medical trainees (n = 166) from several health care institutions in Spain. Physicians were asked to read and anonymously complete a same case-scenario of death certification before and after the seminar. We compared the rates of errors and the impact of the educational intervention before and after the seminar. Results A total of 332 death certificates (166 completed before and 166 completed after the intervention) were audited. Death certificates were completed with errors by 71.1% of the physicians before the educational intervention. Following the seminar, the proportion of death certificates with errors decreased to 9% (p < 0.0001). The most common error in the completion of death certificates was the listing of the mechanism of death instead of the cause of death. Before the seminar, 56.8% listed respiratory or cardiac arrest as the immediate cause of death. None of the participants listed any mechanism of death after the educational intervention (p < 0.0001). Conclusion Major errors in the completion of the correct cause of death on death certificates are common among medical residents. A simple educational intervention can dramatically improve the accuracy in the completion of death certificates by physicians. PMID:18005414

  18. Assessing quality of medical death certification: Concordance between gold standard diagnosis and underlying cause of death in selected Mexican hospitals

    PubMed Central

    2011-01-01

    Background In Mexico, the vital registration system relies on information collected from death certificates to generate official mortality figures. Although the death certificate has high coverage across the country, there is little information regarding its validity. The objective of this study was to assess the concordance between the underlying cause of death in official statistics obtained from death certificates and a gold standard diagnosis of the same deaths derived from medical records of hospitals. Methods The study sample consisted of 1,589 deaths that occurred in 34 public hospitals in the Federal District and the state of Morelos, Mexico in 2009. Neonatal, child, and adult cases were selected for causes of death that included infectious diseases, noncommunicable diseases, and injuries. We compared the underlying cause of death, obtained from medical death certificates, against a gold standard diagnosis derived from a review of medical records developed by the Population Health Metrics Research Consortium. We used chance-corrected concordance and accuracy as metrics to evaluate the quality of performance of the death certificate. Results Analysis considering only the underlying cause of death resulted in a median chance-corrected concordance between the cause of death in medical death certificates versus the gold standard of 54.3% (95% uncertainty interval [UI]: 52.2, 55.6) for neonates, 38.5% (37.0, 40.0) for children, and 66.5% (65.9, 66.9) for adults. The accuracy resulting from the same analysis was 0.756 (0.747, 0.769) for neonates, 0.683 (0.663, 0.701) for children, and 0.780 (0.774, 0.785) for adults. Median chance-corrected concordance and accuracy increased when considering the mention of any cause of death in the death certificate, not just the underlying cause. Concordance varied substantially depending on cause of death, and accuracy varied depending on the true cause-specific mortality fraction composition. Conclusions Although we cannot

  19. Occupation and bladder cancer: a death-certificate study.

    PubMed Central

    Dolin, P. J.; Cook-Mozaffari, P.

    1992-01-01

    Occupational statements on death certificates of 2,457 males aged 25-64 who died from bladder cancer in selected coastal and estaurine regions of England and Wales during 1965-1980 were studied. Excess mortality was found for deck and engine room crew of ships, railway workers, electrical and electronic workers, shoemakers and repairers, and tobacco workers. An excess of cases also occurred among food workers, particularly those employed in the bread and flour confectionary industry or involved in the extraction of animal and vegetable oils and fats. Use of a job-exposure matrix revealed elevated risk for occupations in which most workers were exposed to paints and pigments, benzene and cutting oils. PMID:1520596

  20. Temporal changes in liver cancer incidence rates in Japan: accounting for death certificate inaccuracies and improving diagnostic techniques.

    PubMed

    Sharp, G B; Cologne, J B; Fukuhara, T; Itakura, H; Yamamoto, M; Tokuoka, S

    2001-09-01

    Primary liver cancer (PLC) rates have risen dramatically during the past few decades in some regions, particularly in Japan, where PLC is now the third major cause of cancer death. PLC is one of the most difficult tumors to diagnose correctly, because (i) the liver is a frequent site of cancer metastasis and (ii) death from PLC is often attributed to cirrhosis or chronic hepatitis. Also, because the disease is often rapidly fatal, a large proportion of liver cancer cases are identified based on death certificates alone without confirmation by clinical records. Thus, worldwide differences in published incidence rates for this disease reflect regional or national differences in both the accuracy of death certificates and the sensitivity of diagnostic methods. By comparing death certificate causes of death with those based on pathology review, we were able to adjust 1958--1994 incidence rates for a large Japanese cohort for these errors. Although the death certificate false-positive error rate declined, the false-negative error rate remained high throughout the study. The introduction of improved liver cancer diagnostic methods in Japan in the early 1980s was associated with a sharp increase in PLC incidence. We conclude that errors in death certificate causes of death and changes in liver cancer diagnostic techniques have had an important impact on the reported incidence of this disease. Taking these factors into account, rates of hepatocellular carcinoma rose between 2.4- and 4.3-fold in our Japanese cohort from 1960 to 1985, peaked about 1993 and declined thereafter. Incidence rates of cholangiocarcinoma remained stable through 1987.

  1. Organic solvents and presenile dementia: a case referent study using death certificates.

    PubMed Central

    O'Flynn, R R; Monkman, S M; Waldron, H A

    1987-01-01

    Occupational exposure to organic solvents has been implicated in the development of "presenile dementia" in several studies. The death certificates of all men aged under 65 dying in England and Wales bearing presenile dementia as cause of death were collected for the years 1970-9 (n = 557): control death certificates were obtained, matched for age and sex. No significant differences were found between the groups as regards estimated occupational exposure to either organic solvents or lead. PMID:3567100

  2. Accuracy in certification of cause of death in a tertiary care hospital--a retrospective analysis.

    PubMed

    Dash, Shreemanta Kumar; Behera, Basanta Kumar; Patro, Shubhransu

    2014-05-01

    Every physician is duty bound to issue a "Cause of Death" certificate in the unfortunate event death of his/her patient. Incomplete and inaccurate entry in these certificates poses difficulty in obtaining reliable information pertaining to causes of mortality, leads to faulty public health surveillance, and causes hindrance in research. This study intends to evaluate the completeness and accuracy of Medical Certification of Cause of Death in our Institute and to formulate strategy to improve the quality of reporting of cause of death. During the period from January 2012 to December 2012, a total of 151 certificates of cause of death were issued by the faculty members of various departments. Maximum number of death certificates were issued for patients in the extremes of the age <10 years (n = 42, 27.82%) and in >60 years (n = 46, 30.46%). The various inadequacies observed by us are as follows: 40 (26.49%) cases had inaccurate cause of death, interval between onset and terminal event was missing in 94 (62.25%) cases, in 68 (45.03%)cases the seal with registration number of the physician was not available on the certificate, incomplete antecedent & underlying cause of death was found in 35 (23.18%) & 84 (55.63%) cases, in 66 (43.71%) cases there was use of abbreviations and the handwriting was illegible in 79(52.32%) cases.

  3. Death certification and doctors' dilemmas: a qualitative study of GPs' perspectives

    PubMed Central

    McAllum, Carol; St George, Ian; White, Gillian

    2005-01-01

    Background Death certificate inaccuracies have implications for funding and planning public health services, health research and family settlements. Improved training has been identified as a way of reducing inaccuracies. Understanding the influences on certifying doctors should inform that training. Aim To explore what factors influence GPs as they complete death certificates. Design Focus groups held by teleconference with 16 GPs. Setting New Zealand general practice. Method Four teleconferenced focus groups were taped and transcribed. Transcripts were examined for emerging themes. Credibility, transferability and confirmability were underwritten by a clear audit trail. Results Participants identified two factors that influenced death certification: clinical uncertainty and the family. Other themes provided an understanding of the personal and professional concerns for GPs. Conclusion Improving death certification accuracy is a complex issue and needs to take into consideration factors that influence certifiers. PMID:16176734

  4. Certification-Based Process Analysis

    NASA Technical Reports Server (NTRS)

    Knight, Russell L.

    2013-01-01

    Space mission architects are often challenged with knowing which investment in technology infusion will have the highest return. Certification-based analysis (CBA) gives architects and technologists a means to communicate the risks and advantages of infusing technologies at various points in a process. Various alternatives can be compared, and requirements based on supporting streamlining or automation can be derived and levied on candidate technologies. CBA is a technique for analyzing a process and identifying potential areas of improvement. The process and analysis products are used to communicate between technologists and architects. Process means any of the standard representations of a production flow; in this case, any individual steps leading to products, which feed into other steps, until the final product is produced at the end. This sort of process is common for space mission operations, where a set of goals is reduced eventually to a fully vetted command sequence to be sent to the spacecraft. Fully vetting a product is synonymous with certification. For some types of products, this is referred to as verification and validation, and for others it is referred to as checking. Fundamentally, certification is the step in the process where one insures that a product works as intended, and contains no flaws.

  5. 38 CFR 3.806 - Death gratuity; certification.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Death gratuity... ADJUDICATION Pension, Compensation, and Dependency and Indemnity Compensation Special Benefits § 3.806 Death... claim filed with it that: (1) Death resulted from: (i) Disease or injury incurred or aggravated while...

  6. 38 CFR 3.806 - Death gratuity; certification.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Death gratuity... ADJUDICATION Pension, Compensation, and Dependency and Indemnity Compensation Special Benefits § 3.806 Death... claim filed with it that: (1) Death resulted from: (i) Disease or injury incurred or aggravated while...

  7. 38 CFR 3.806 - Death gratuity; certification.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Death gratuity... ADJUDICATION Pension, Compensation, and Dependency and Indemnity Compensation Special Benefits § 3.806 Death... claim filed with it that: (1) Death resulted from: (i) Disease or injury incurred or aggravated while...

  8. 38 CFR 3.806 - Death gratuity; certification.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Death gratuity... ADJUDICATION Pension, Compensation, and Dependency and Indemnity Compensation Special Benefits § 3.806 Death... claim filed with it that: (1) Death resulted from: (i) Disease or injury incurred or aggravated while...

  9. 38 CFR 3.806 - Death gratuity; certification.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Death gratuity... ADJUDICATION Pension, Compensation, and Dependency and Indemnity Compensation Special Benefits § 3.806 Death... claim filed with it that: (1) Death resulted from: (i) Disease or injury incurred or aggravated while...

  10. Increasing certification through unit-based education.

    PubMed

    Fischer-Cartlidge, Erica; Mahon, Suzanne

    2014-04-01

    Certification has been identified by multiple organizations as an important component and means of elevating the level of nursing care provided to patients and demonstrating to the public that the nursing staff has subspecialty knowledge. Certification may lead to improved patient satisfaction and outcomes as well as increased nurse satisfaction and retention. Despite the known potential benefits associated with certification, institutions struggle to improve certification rates. One possible method to overcome system barriers to certification is the implementation of a unit-based study course to prepare nurses for the Certified Breast Care Nurse (CBCN) examination. Data collected by an author-developed tool as one institution created and executed a unit-based study course suggest that such an approach increased certification rates and improved disease-specific knowledge and confidence among the staff, despite no official data existing on the tool's reliability and validity. Implementation of similar programs may be successful in improving certification at other institutions seeking to raise certification rates.

  11. A Representative Study of Deaths of North Indian Migrants and Its Medical Certification Across the World.

    PubMed

    Vidua, Raghvendra K; Dubey, Nisha; Pramanik, Parthsarthi; Mattoo, Sanjay K; Jakher, Naresh

    2016-09-26

    Many Indians is moving to other nations of the world in the search of employment, education or other reasons. The process of globalization along with the faster mode of traveling and communication has facilitated this movement in the hope of getting more opportunities and earning of easy money abroad, than in India. Unfortunately, sometimes they meet a tragic end and their families in India get only their dead bodies back from abroad. This study focuses on these kind of unfortunate tragic events faced by Indians in different countries and thereby raise a concern on their safety abroad and necessitate the need of relooking in to the quality of medical certification of death and medico legal investigations to find out the real reasons of deaths to avoid any kind of doubt in mind. Data was collected from medical death certificates and passports of the deceased Indians. There was a total of 711 dead bodies/human remains received in 2012 at IGI airport New Delhi. The Middle East countries together contributed a total of 398 (55.98 %) cases. The distribution as per manner of death shows that in maximum number of cases (269), the manner of death was ambiguous with unspecified aetiology. The study therefore recommends for upgradation of the level of medico legal investigations in form of 2nd autopsy in recipient country and proper medical death certification.

  12. Comments on "Teen Suicide and Changing Cause-of-Death Certification, 1953-1987."

    ERIC Educational Resources Information Center

    Smith, Kim

    1991-01-01

    Responds to previous article by Males on teenage suicides and changing cause-of-death certification from 1953 through 1987. After closely examining Males' arguments, author comes to different conclusions concerning increase in teenage suicides during that time period. Concludes that increase in youth suicide is real and that increase is twice that…

  13. 34 CFR 682.402 - Death, disability, closed school, false certification, unpaid refunds, and bankruptcy payments.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 4 2014-07-01 2014-07-01 false Death, disability, closed school, false certification, unpaid refunds, and bankruptcy payments. 682.402 Section 682.402 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED) FEDERAL FAMILY EDUCATION LOAN...

  14. 34 CFR 682.402 - Death, disability, closed school, false certification, unpaid refunds, and bankruptcy payments.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 4 2013-07-01 2013-07-01 false Death, disability, closed school, false certification, unpaid refunds, and bankruptcy payments. 682.402 Section 682.402 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED) FEDERAL FAMILY EDUCATION LOAN...

  15. Mortality incidence estimation using federal death certificate and natality data with an application to Tay-Sachs disease.

    PubMed

    Jalal, Kabir; Carter, Randy L

    2015-09-01

    For confidentiality reasons, US federal death certificate data are incomplete with regards to the dates of birth and death for the decedents, making calculation of total lifetime of a decedent impossible and thus estimation of mortality incidence difficult. This paper proposes the use of natality data and an imputation-based method to estimate age-specific mortality incidence rates in the face of this missing information. By utilizing previously determined probabilities of birth, a birth date and death date are imputed for every decedent in the dataset. Thus, the birth cohort of each individual is imputed, and the total on-study time can be calculated. This idea is implemented in two approaches for estimation of mortality incidence rates. The first is an extension of a person-time approach, while the second is an extension of a life table approach. Monte Carlo simulations showed that both approaches perform well in comparison to the ideal complete data methods, but that the person-time method is preferred. An application to Tay-Sachs disease is demonstrated. It is concluded that the imputation methods proposed provide valid estimates of the incidence of death from death certificate data without the need for additional assumptions under which usual mortality rates provide valid estimates.

  16. Differences in place of death between lung cancer and COPD patients: a 14-country study using death certificate data.

    PubMed

    Cohen, Joachim; Beernaert, Kim; Van den Block, Lieve; Morin, Lucas; Hunt, Katherine; Miccinesi, Guido; Cardenas-Turanzas, Marylou; Onwuteaka-Philipsen, Bregje; MacLeod, Rod; Ruiz-Ramos, Miguel; Wilson, Donna M; Loucka, Martin; Csikos, Agnes; Rhee, Yong-Joo; Teno, Joan; Ko, Winne; Deliens, Luc; Houttekier, Dirk

    2017-12-01

    Chronic obstructive pulmonary disease and lung cancer are leading causes of death with comparable symptoms at the end of life. Cross-national comparisons of place of death, as an important outcome of terminal care, between people dying from chronic obstructive pulmonary disease and lung cancer have not been studied before. We collected population death certificate data from 14 countries (year: 2008), covering place of death, underlying cause of death, and demographic information. We included patients dying from lung cancer or chronic obstructive pulmonary disease and used descriptive statistics and multivariable logistic regressions to describe patterns in place of death. Of 5,568,827 deaths, 5.8% were from lung cancer and 4.4% from chronic obstructive pulmonary disease. Among lung cancer decedents, home deaths ranged from 12.5% in South Korea to 57.1% in Mexico, while hospital deaths ranged from 27.5% in New Zealand to 77.4% in France. In chronic obstructive pulmonary disease patients, the proportion dying at home ranged from 10.4% in Canada to 55.4% in Mexico, while hospital deaths ranged from 41.8% in Mexico to 78.9% in South Korea. Controlling for age, sex, and marital status, patients with chronic obstructive pulmonary disease were significantly less likely die at home rather than in hospital in nine countries. Our study found in almost all countries that those dying from chronic obstructive pulmonary disease as compared with those from lung cancer are less likely to die at home and at a palliative care institution and more likely to die in a hospital or a nursing home. This might be due to less predictable disease trajectories and prognosis of death in chronic obstructive pulmonary disease.

  17. Complete republication: National Association of Medical Examiners position paper: Recommendations for the investigation, diagnosis, and certification of deaths related to opioid drugs.

    PubMed

    Davis, Gregory G

    2014-03-01

    The American College of Medical Toxicology and the National Association of Medical Examiners convened an expert panel to generate evidence-based recommendations for the practice of death investigation and autopsy, toxicological analysis, interpretation of toxicology findings, and death certification to improve the precision of death certificate data available for public health surveillance. The panel finds the following: 1. A complete autopsy is necessary for optimal interpretation of toxicology results, which must also be considered in the context of the circumstances surrounding death, medical history, and scene findings. 2. A complete scene investigation extends to reconciliation of prescription information and pill counts. 3. Blood, urine, and vitreous humor, when available, should be retained in all cases. Blood from the femoral vein is preferable to blood from other sites. 4. A toxicological panel should be comprehensive and include opioid and benzodiazepine analytes, as well as other potent depressant, stimulant, and anti-depressant medications. 5. Interpretation of postmortem opioid concentrations requires correlation with medical history, scene investigation, and autopsy findings. 6. If death is attributed to any drug or combination of drugs (whether as cause or contributing factor), the certifier should list all the responsible substances by generic name in the autopsy report and on the death certificate. 7. The best classification for manner of death in deaths due to the misuse or abuse of opioids without any apparent intent of self-harm is "accident." Reserve "undetermined" as the manner for the rare cases in which evidence exists to support more than one possible determination.

  18. Reporting of clinically diagnosed dementia on death certificates: retrospective cohort study

    PubMed Central

    Perera, Gayan; Stewart, Robert; Higginson, Irene J.; Sleeman, Katherine E.

    2016-01-01

    Background: mortality statistics are a frequently used source of information on deaths in dementia but are limited by concerns over accuracy. Objective: to investigate the frequency with which clinically diagnosed dementia is recorded on death certificates, including predictive factors. Methods: a retrospective cohort study assembled using a large mental healthcare database in South London, linked to Office for National Statistics mortality data. People with a clinical diagnosis of dementia, aged 65 or older, who died between 2006 and 2013 were included. The main outcome was death certificate recording of dementia. Results: in total, 7,115 people were identified. Dementia was recorded on 3,815 (53.6%) death certificates. Frequency of dementia recording increased from 39.9% (2006) to 63.0% (2013) (odds ratio (OR) per year increment 1.11, 95% CI 1.07–1.15). Recording of dementia was more likely if people were older (OR per year increment 1.02, 95% CI 1.01–1.03), and for those who died in care homes (OR 1.89, 95% CI 1.50–2.40) or hospitals (OR 1.14, 95% CI 1.03–1.46) compared with home, and less likely for people with less severe cognitive impairment (OR 0.95, 95% CI 0.94–0.96), and if the diagnosis was Lewy body (OR 0.30, 95% CI 0.15–0.62) or vascular dementia (OR 0.79, 95% CI 0.68–0.93) compared with Alzheimer's disease. Conclusions: changes in certification practices may have contributed to the rise in recorded prevalence of dementia from mortality data. However, mortality data still considerably underestimate the population burden of dementia. Potential biases affecting recording of dementia need to be taken into account when interpreting mortality data. PMID:27146301

  19. Death-certificate case-control study of non-Hodgkin's lymphoma and occupation in men in North Carolina

    SciTech Connect

    Schumacher, M.C.; Delzell, E.

    1988-01-01

    A death certificate-based case-control study was performed to investigate associations between occupation and non-Hodgkin's lymphoma (NHL) in North Carolina. Cases consisted of 501 men who died of NHL (International Classification of Diseases codes 200 and 202) during the years 1968-1970, 1975-1977, and 1980-1982. Controls were selected from other noncancer deaths, and were frequency matched for age, year of death, and race. Occupation and industry were obtained from the death certificates and coded without knowledge of case-control status. An increased risk for men in professional, technical, and managerial occupations, compared with all others, was detected among whites (OR = 2.69, 1.95-3.72). Black men classified as having low exposures by an occupational exposure linkage system had an odds ratio of 1.74 (0.84-3.60). Because of this finding, the occupations were ranked by social class and a statistically significant linear relationship was noted in whites, with risk increasing from lower social class to upper social class. An increased risk was also detected among whites in the rubber, plastics, and synthetics industries (p = .03), and among blacks employed in machine trades occupations (OR = 3.63, 1.32-9.97) and structural work occupations (OR = 2.38, 0.93-6.05). An increased risk was also detected for black painters (p = .02), but not for whites. There was no association found between NHL and employment in the following areas: textile industry; farming; laborers; or occupations with exposures to asbestos or benzene. The association with farming was further examined in counties with high use of pesticides and herbicides, and no increased risk of NHL was detected. Cases were more likely to live in the western part of the state than the eastern. However, NHL mortality rates provided by the North Carolina State Center for Health Statistics did not confirm the relationship.

  20. Sentinel Health Events (Occupational): analysis of death certificates among residents of Nassau County, NY between 1980-82 for occupationally related causes of death.

    PubMed Central

    Feldman, J P; Gerber, L M

    1990-01-01

    Death certificates for residents of Nassau County, New York dying between 1980 and 1982 were examined for causes of death defined as Sentinel Health Events (Occupational) (SHE(O]. Of 16,193 deaths from all causes, 2,286 (14.1 percent) were identified as SHE(O) deaths; 142 (6.2 percent) of these were matched for occupational and/or industry, 13 (9.2 percent) of which required no further match [corrected] because the cause of death was inherently related to the occupation or industry. Malignant neoplasms of the trachea, bronchus, or lung were the most frequently occurring SHE(O), accounting for 60 percent of all SHE(O) deaths and 81 percent of matched SHE(O) deaths. The construction industry was associated with the vast majority of such deaths. PMID:2297057

  1. Using death certificates and medical examiner records for adolescent occupational fatality surveillance and research: a case study.

    PubMed

    Rauscher, Kimberly J; Runyan, Carol W; Radisch, Deborah

    2012-01-01

    Death certificates and medical examiner records have been useful yet imperfect data sources for work-related fatality research and surveillance among adult workers. It is unclear whether this holds for work-related fatalities among adolescent workers who suffer unique detection challenges in part because they are not often thought of as workers. This study investigated the utility of using these data sources for surveillance and research pertaining to adolescent work-related fatalities. Using the state of North Carolina as a case study, we analyzed data from the death certificates and medical examiner records of all work-related fatalities data among 11- to 17-year-olds between 1990-2008 (N = 31). We compared data sources on case identification, of completeness, and consistency information. Variables examined included those on the injury (e.g., means), occurrence (e.g., place), demographics, and employment (e.g., occupation). Medical examiner records (90%) were more likely than death certificates (71%) to identify adolescent work-related fatalities. Data completeness was generally high yet varied between sources. The most marked difference being that in medical examiner records, type of business/industry and occupation were complete in 72 and 67% of cases, respectively, while on the death certificates these fields were complete in 90 and 97% of cases, respectively. Taking the two sources together, each field was complete in upward of 94% of cases. Although completeness was high, data were not always of good quality and sometimes conflicted across sources. In many cases, the decedent's occupation was misclassified as "student" and their employer as "school" on the death certificate. Even though each source has its weaknesses, medical examiner records and death certificates, especially when used together, can be useful for conducting surveillance and research on adolescent work-related fatalities. However, extra care is needed by data recorders to ensure that

  2. 34 CFR 682.402 - Death, disability, closed school, false certification, unpaid refunds, and bankruptcy payments.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... the payment to the Secretary. (b) Death. (1) If an individual borrower dies, or the student for whom a... student in the case of a PLUS loan) must be based on an original or certified copy of the death.... (3) After receiving reliable information indicating that the borrower (or student) has died,...

  3. Certification

    NASA Technical Reports Server (NTRS)

    Hayhurst, Kelly

    2010-01-01

    Objective 1: Provide regulators with a methodology for development of airworthiness requirements for certification of UAS. a) Rationale: a comprehensive methodology does not currently exist to support development of regulation for certification of UAS. Regulation is essential to enable routine access to the NAS. b) Approach: 1) assess existing approaches and classification schemes for deriving acceptable means of compliance to airworthiness requirements. 2) investigate a service-based approach to classification of UAS. 3) conduct comparative analysis of different methodologies. 4) work with FAA to determine best approach and conduct case study. 5) participate in regulatory/standards organizations developing safety and performance requirements for UAS. Objective 2: Provide regulators and industry with hazard and risk-related data to support criteria for UAS type design. a) Rationale: There is presently little UAS specific data (incident, accident, and reliability), especially in a civil context, to support risk assessment and development of standards and regulation. b) Approach: Identify gaps in existing data, provide measured data as needed, and formulate recommendations by: 1) evaluating UAS incident/accident data collection efforts and determining additional support necessary for regulation. 2) assessing UAS-specific hazards and risks. 3) evaluating need for reliability data for UAS-unique systems, components and subsystem, and determining additional measurement requirements. 4) developing guidance and best practices for UAS type design.

  4. Amended cause and manner of death certification: a six-year review of the New Mexico experience.

    PubMed

    Croft, Philip R; Lathrop, Sarah L; Zumwalt, Ross E

    2006-05-01

    Little is known about the amendment of death certificates (DCs) issued by medical examiners and coroners. This retrospective study examined why, how, and with what frequency cause and manner of death were amended on DCs issued by forensic pathologists over a 6-year period at the New Mexico Office of the Medical Investigator. Approximately 1% of DCs had either cause or manner of death amendments, with arteriosclerotic cardiovascular disease and intoxicants the most commonly amended and resulting causes of death, respectively. There was a significant association between manner of death and number of DCs amended (p<0.001). By percent, natural and suicide DCs were the most frequently amended. The way in which manner of death changed was significantly associated with the amount of time elapsed between DCs (p=0.04). Toxicology was the most common reason for DC amendment.

  5. Occupation and five cancers: a case-control study using death certificates.

    PubMed Central

    Magnani, C; Coggon, D; Osmond, C; Acheson, E D

    1987-01-01

    A case-control approach has been used to examine mortality from five cancers--oesophagus, pancreas, cutaneous melanoma, kidney, and brain--among young and middle aged men resident in three English counties. The areas studied were chosen because they include major centres of chemical manufacture. By combining data from 20 years it was possible to look at local industries with greater statistical power than is possible using routine national statistics. Each case was matched with up to four controls of similar age who died in the same year from other causes. The occupations and industries recorded on death certificates were coded to standard classifications and risk estimates derived for each job category. Where positive associations were found the records of the cases concerned were examined in greater detail to see whether the risk was limited to specific combinations of occupation and industry. The most interesting findings to emerge were risks of brain cancer associated with the production of meat and fish products (relative risk (RR) = 9.7, 95% confidence interval (CI) 2.6-36.8) and with mineral oil refining (RR = 2.9, CI 1.2-7.0), and a cluster of four deaths from melanoma among refinery workers (RR = 16.0, CI CI 1.8-143.2). A job-exposure matrix was applied to the data but gave no strong indications of further disease associations. Local analyses of occupational mortality such as this can usefully supplement national statistics. PMID:3689708

  6. Mandated Competency-Based Teacher Certification and the Public Interest.

    ERIC Educational Resources Information Center

    Spaulding, Robert L.

    Responding to the current lack of an empirical basis for competency-based teacher certification, Georgia has mandated studies leading to the establishment of empirical criteria. In the Carroll County Competency-Based Teacher Certification Project, the instructional behaviors of some 60 certified teachers and the classroom behaviors of the…

  7. Product-based Safety Certification for Medical Devices Embedded Software.

    PubMed

    Neto, José Augusto; Figueiredo Damásio, Jemerson; Monthaler, Paul; Morais, Misael

    2015-01-01

    Worldwide medical device embedded software certification practices are currently focused on manufacturing best practices. In Brazil, the national regulatory agency does not hold a local certification process for software-intensive medical devices and admits international certification (e.g. FDA and CE) from local and international industry to operate in the Brazilian health care market. We present here a product-based certification process as a candidate process to support the Brazilian regulatory agency ANVISA in medical device software regulation. Center of Strategic Technology for Healthcare (NUTES) medical device embedded software certification is based on a solid safety quality model and has been tested with reasonable success against the Class I risk device Generic Infusion Pump (GIP).

  8. Cause-Specific Mortality and Death Certificate Reporting in Adults with Moderate to Profound Intellectual Disability

    ERIC Educational Resources Information Center

    Tyrer, F.; McGrother, C.

    2009-01-01

    Background: The study of premature deaths in people with intellectual disability (ID) has become the focus of recent policy initiatives in England. This is the first UK population-based study to explore cause-specific mortality in adults with ID compared with the general population. Methods: Cause-specific standardised mortality ratios (SMRs) and…

  9. A post-mortem survey on end-of-life decisions using a representative sample of death certificates in Flanders, Belgium: research protocol

    PubMed Central

    Chambaere, Kenneth; Bilsen, Johan; Cohen, Joachim; Pousset, Geert; Onwuteaka-Philipsen, Bregje; Mortier, Freddy; Deliens, Luc

    2008-01-01

    Background Reliable studies of the incidence and characteristics of medical end-of-life decisions with a certain or possible life shortening effect (ELDs) are indispensable for an evidence-based medical and societal debate on this issue. This article presents the protocol drafted for the 2007 ELD Study in Flanders, Belgium, and outlines how the main aims and challenges of the study (i.e. making reliable incidence estimates of end-of-life decisions, even rare ones, and describing their characteristics; allowing comparability with past ELD studies; guaranteeing strict anonymity given the sensitive nature of the research topic; and attaining a sufficient response rate) are addressed in a post-mortem survey using a representative sample of death certificates. Study design Reliable incidence estimates are achievable by using large at random samples of death certificates of deceased persons in Flanders (aged one year or older). This entails the cooperation of the appropriate administrative authorities. To further ensure the reliability of the estimates and descriptions, especially of less prevalent end-of-life decisions (e.g. euthanasia), a stratified sample is drawn. A questionnaire is sent out to the certifying physician of each death sampled. The questionnaire, tested thoroughly and avoiding emotionally charged terms is based largely on questions that have been validated in previous national and European ELD studies. Anonymity of both patient and physician is guaranteed through a rigorous procedure, involving a lawyer as intermediary between responding physicians and researchers. To increase response we follow the Total Design Method (TDM) with a maximum of three follow-up mailings. Also, a non-response survey is conducted to gain insight into the reasons for lack of response. Discussion The protocol of the 2007 ELD Study in Flanders, Belgium, is appropriate for achieving the objectives of the study; as past studies in Belgium, the Netherlands, and other European

  10. 34 CFR 682.402 - Death, disability, closed school, false certification, unpaid refunds, and bankruptcy payments.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... identity theft. For purposes of a false certification discharge, the term “borrower” includes all endorsers... FFEL Program loan as a result of the crime of identity theft committed against the individual, as that... individual's consent. (iii) If a loan was made as a result of the crime of identity theft that was...

  11. 34 CFR 682.402 - Death, disability, closed school, false certification, unpaid refunds, and bankruptcy payments.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... identity theft. For purposes of a false certification discharge, the term “borrower” includes all endorsers... FFEL Program loan as a result of the crime of identity theft committed against the individual, as that... individual's consent. (iii) If a loan was made as a result of the crime of identity theft that was...

  12. A Program Certification Assistant Based on Fully Automated Theorem Provers

    NASA Technical Reports Server (NTRS)

    Denney, Ewen; Fischer, Bernd

    2005-01-01

    We describe a certification assistant to support formal safety proofs for programs. It is based on a graphical user interface that hides the low-level details of first-order automated theorem provers while supporting limited interactivity: it allows users to customize and control the proof process on a high level, manages the auxiliary artifacts produced during this process, and provides traceability between the proof obligations and the relevant parts of the program. The certification assistant is part of a larger program synthesis system and is intended to support the deployment of automatically generated code in safety-critical applications.

  13. 75 FR 27182 - Energy Conservation Program: Web-Based Compliance and Certification Management System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-14

    ... Part 430 RIN 1904-AC10 Energy Conservation Program: Web-Based Compliance and Certification Management... electronic Web-based tool, the Compliance and Certification Management System (CCMS), which will be the... Certification Management System (CCMS)--via the Web portal: http://regulations.doe.gov/ccms . Follow...

  14. Efficient certificate-based signcryption secure against public key replacement attacks and insider attacks.

    PubMed

    Lu, Yang; Li, Jiguo

    2014-01-01

    Signcryption is a useful cryptographic primitive that achieves confidentiality and authentication in an efficient manner. As an extension of signcryption in certificate-based cryptography, certificate-based signcryption preserves the merits of certificate-based cryptography and signcryption simultaneously. In this paper, we present an improved security model of certificate-based signcryption that covers both public key replacement attack and insider security. We show that an existing certificate-based signcryption scheme is insecure in our model. We also propose a new certificate-based signcryption scheme that achieves security against both public key replacement attacks and insider attacks. We prove in the random oracle model that the proposed scheme is chosen-ciphertext secure and existentially unforgeable. Performance analysis shows that the proposed scheme outperforms all the previous certificate-based signcryption schemes in the literature.

  15. Efficient Certificate-Based Signcryption Secure against Public Key Replacement Attacks and Insider Attacks

    PubMed Central

    Li, Jiguo

    2014-01-01

    Signcryption is a useful cryptographic primitive that achieves confidentiality and authentication in an efficient manner. As an extension of signcryption in certificate-based cryptography, certificate-based signcryption preserves the merits of certificate-based cryptography and signcryption simultaneously. In this paper, we present an improved security model of certificate-based signcryption that covers both public key replacement attack and insider security. We show that an existing certificate-based signcryption scheme is insecure in our model. We also propose a new certificate-based signcryption scheme that achieves security against both public key replacement attacks and insider attacks. We prove in the random oracle model that the proposed scheme is chosen-ciphertext secure and existentially unforgeable. Performance analysis shows that the proposed scheme outperforms all the previous certificate-based signcryption schemes in the literature. PMID:24959606

  16. Windshear certification data base for forward-look detection systems

    NASA Technical Reports Server (NTRS)

    Switzer, George F.; Hinton, David A.; Proctor, Fred H.

    1994-01-01

    Described is an introduction to a comprehensive database that is to be used for certification testing of airborne forward-look windshear detection systems. The database was developed by NASA Langley Research Center, at the request of the Federal Aviation Administration (FAA), to support the industry initiative to certify and produce forward-looking windshear detection equipment. The database contains high-resolution three-dimensional fields for meteorological variables that may be sensed by forward-looking systems. The database is made up of seven case studies that are generated by the Terminal Area Simulation System, a state-of-the-art numerical system for the realistic modeling of windshear phenomena. The selected cases contained in the certification documentation represent a wide spectrum of windshear events. The database will be used with vendor-developed sensor simulation software and vendor-collected ground-clutter data to demonstrate detection performance in a variety of meteorological conditions using NASA/FAA pre-defined path scenarios for each of the certification cases. A brief outline of the contents and sample plots from the database documentation are included. These plots show fields of hazard factor, or F-factor (Bowles 1990), radar reflectivity, and velocity vectors on a horizontal plane overlayed with the applicable certification paths. For the plot of the F-factor field the region of 0.105 and above signify an area of hazardous, performance decreasing windshear, while negative values indicate regions of performance increasing windshear. The values of F-factor are based on 1-Km averaged segments along horizontal flight paths, assuming an air speed of 150 knots (approx. 75 m/s). The database has been released to vendors participating in the certification process. The database and associated document have been transferred to the FAA for archival storage and distribution.

  17. Teen Suicide and Changing Cause-of-Death Certification, 1953-1987.

    ERIC Educational Resources Information Center

    Males, Mike

    1991-01-01

    Examined whether tripling in teenage suicides since 1950s represents increase in suicides or in skill of medical examiners. Examined firearms and poisoning death from 1953-87. Concludes that increase in youth suicide is less dramatic than reported, and suicide increase indicated among youths and adults occurred from 1964-71 and has since…

  18. Using National Inpatient Death Rates as a Benchmark to Identify Hospitals with Inaccurate Cause of Death Reporting - Missouri, 2009-2012.

    PubMed

    Lloyd, Jennifer; Jahanpour, Ehsan; Angell, Brian; Ward, Craig; Hunter, Andy; Baysinger, Cherri; Turabelidze, George

    2017-01-13

    Reporting causes of death accurately is essential to public health and hospital-based programs; however, some U.S. studies have identified substantial inaccuracies in cause of death reporting. Using CDC's national inpatient hospital death rates as a benchmark, the Missouri Department of Health and Senior Services (DHSS) analyzed inpatient death rates reported by hospitals with high inpatient death rates in St. Louis and Kansas City metro areas. Among the selected hospitals with high inpatient death rates, 45.8% of death certificates indicated an underlying cause of death that was inconsistent with CDC's Guidelines for Death Certificate completion. Selected hospitals with high inpatient death rates were more likely to overreport heart disease and renal disease, and underreport cancer as an underlying cause of death. Based on these findings, the Missouri DHSS initiated a new web-based training module for death certificate completion based on the CDC guidelines in an effort to improve accuracy in cause of death reporting.

  19. Space Based Range Demonstration and Certification (SBRDC)

    NASA Technical Reports Server (NTRS)

    Sakahara, Robert

    2005-01-01

    This viewgraph presentation describes the development, utilization and testing of technologies for range safety and range user systems. The contents include: 1) Space Based Range (SBR) Goals and Objectives; 2) Today s United States Range; 3) Future Range; 4) Another Vision for the Future Range; 5) STARS Project Goals; 6) STARS Content; 7) STARS Configuration Flight Demonstrations 1 & 2; 8) Spaceport And Range Technologies STARS Objectives and Results; 9) Spaceport And Range Technologies STARS FD2 Objectives; 10) Range Safety Hardware; 11) Range User Hardware; and 12) Past/Future Flight Demo Plans

  20. GPS-based certification for the microwave landing system

    NASA Technical Reports Server (NTRS)

    Thornton, C. L.; Young, L. E.; Wu, S. C.; Thomas, J. B.

    1984-01-01

    An MLS (microwave landing system) certification system based on the Global Positioning System (GPS) is described. To determine the position history of the flight inspection aircraft during runway approach, signals from the GPS satellites, together with on-board radar altimetry, are used. It is shown that the aircraft position relative to a fixed point on the runway at threshold can be determined to about 30 cm vertically and 1 m horizontally. A requirement of the system is that the GPS receivers be placed on each flight inspection aircraft and at selected ground sites. The effects of different error sources on the determination of aircraft instantaneous position and its dynamics are analyzed.

  1. Development of Empirically Based Time-to-death Curves for Combat Casualty Deaths in Iraq and Afghanistan

    DTIC Science & Technology

    2015-01-01

    Naval Health Research Center Development of Empirically Based Time-to- death Curves for Combat Casualty Deaths In Iraq and Afghanistan Edwin...10.1177/1548512914531353 dms.sagepub.com Development of empirically based time-to- death curves for combat casualty deaths in Iraq and Afghanistan...casualties with life-threatening injuries. The curves developed from that research were based on a small dataset (n = 160, with 26 deaths and 134

  2. 40 CFR 745.238 - Fees for accreditation and certification of lead-based paint activities.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... certification of lead-based paint activities. 745.238 Section 745.238 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Lead-Based Paint Activities § 745.238 Fees for accreditation and certification of...

  3. 40 CFR 745.238 - Fees for accreditation and certification of lead-based paint activities.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... certification of lead-based paint activities. 745.238 Section 745.238 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Lead-Based Paint Activities § 745.238 Fees for accreditation and certification of...

  4. 40 CFR 745.238 - Fees for accreditation and certification of lead-based paint activities.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... certification of lead-based paint activities. 745.238 Section 745.238 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Lead-Based Paint Activities § 745.238 Fees for accreditation and certification of...

  5. 40 CFR 745.238 - Fees for accreditation and certification of lead-based paint activities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... certification of lead-based paint activities. 745.238 Section 745.238 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Lead-Based Paint Activities § 745.238 Fees for accreditation and certification of...

  6. 40 CFR 745.238 - Fees for accreditation and certification of lead-based paint activities.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... certification of lead-based paint activities. 745.238 Section 745.238 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Lead-Based Paint Activities § 745.238 Fees for accreditation and certification of...

  7. Competency-based certification project. Phase I: Job analysis.

    PubMed

    Gessaroli, M E; Poliquin, M

    1994-08-01

    The Canadian Association of Medical Radiation Technologists (C.A.M.R.T.) is transforming its existing certification process into a competency-based process, consistent with the knowledge and skills required by entry-level radiography, radiation therapy and nuclear medicine technology practitioners. The project concurs with the change in focus advocated by the Conjoint Committee on Allied Medical Education Accreditation. The Committee supports new accreditation requirements that, among other things, place more emphasis on competency-based learning outcomes. Following is the first of three papers prepared by the C.A.M.R.T. to explain the project and the strategy for its implementation, focusing respectively on each phase. This paper discusses Phase One: the job analysis.

  8. Leukemia as a cause of death among patients with myelodysplastic syndromes (MDS) in a population- based cancer registry: improving estimates of MDS-related mortality in the population.

    PubMed

    Polednak, Anthony P; Phillips, Cathryn

    2012-01-01

    Myelodysplastic syndromes (MDS), a heterogeneous group of myeloid neoplasms diagnosed mostly in elderly persons, are of increasing interest in an aging population and are associated with variable risk of progression to acute myeloid leukemia (AML). The numbers of deaths related to MDS in the population are underestimated in routine US cancer mortality statistics which are based on only the underlying cause (UC) rather than multiple causes (MCs) of death recorded on death certificates. Additional MDS-related deaths, however, may be missed if some MDS patients die with mention of leukemia but not MDS on their death certificate. This requires studies of MCs of death among all MDS patients in population-based tumor registries. This study examined MCs of death among patients diagnosed with MDS in 2001- 2009 and reported to the population-based Connecticut Tumor Registry. MDS was the UC for 199 deaths (25.7% of all 773) and was coded as other than UC for 160 (20.7%). Another 121 (15.7%) death records, however, had leukemia without mention of MDS; the majority were coded to AML and most of the others as unspecified type of acute leukemia. If these 121 deaths are added to the 359 with mention of MDS, the total of MDS-related deaths would be 480 (or 62.1% of all 773 deaths). A total of 178 deaths (23.0% of all 773) were coded to leukemia as the UC, and would be included with leukemia (not MDS) in routine cancer mortality statistics. Leukemia diagnosed since 2010 in MDS patients is reportable to registries as a new primary cancer. This new rule will help central cancer registries to confirm leukemia diagnoses coded on death records, as part of the process of improving surveillance of cancer mortality rates in the population.

  9. Using a State Teacher Certification Test to Assess an Inquiry-Based Science Education Program

    ERIC Educational Resources Information Center

    Otto, Charlotte A.; Everett, Susan A.; Moyer, Richard H.; Zitzewitz, Paul W.

    2012-01-01

    In this study, we looked at the impact of our specially designed inquiry-based science courses for pre-service elementary teachers on their science content knowledge as measured by a high-stakes state certification test for elementary education. We conducted a pre/post-analysis of the certification test scores of 1,003 pre-service teachers. Cohort…

  10. 20 CFR 655.204 - Determinations based on temporary labor certification applications.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Determinations based on temporary labor... believes will rebut the basis of the OFLC Administrator's denial of certification; and (3) State that, if... Judge within the five days: (i) The OFLC Administrator will advise the DHS that the certification...

  11. 38 CFR 51.20 - Application for recognition based on certification.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Nursing Home Care in State Homes § 51.20 Application for recognition based on certification. To apply for recognition and certification of a State home for nursing home care, a State must: (a) Send...

  12. 38 CFR 51.20 - Application for recognition based on certification.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Nursing Home Care in State Homes § 51.20 Application for recognition based on certification. To apply for recognition and certification of a State home for nursing home care, a State must: (a) Send...

  13. 38 CFR 51.20 - Application for recognition based on certification.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Nursing Home Care in State Homes § 51.20 Application for recognition based on certification. To apply for recognition and certification of a State home for nursing home care, a State must: (a) Send...

  14. 38 CFR 51.20 - Application for recognition based on certification.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Nursing Home Care in State Homes § 51.20 Application for recognition based on certification. To apply for recognition and certification of a State home for nursing home care, a State must: (a) Send...

  15. 38 CFR 51.20 - Application for recognition based on certification.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Nursing Home Care in State Homes § 51.20 Application for recognition based on certification. To apply for recognition and certification of a State home for nursing home care, a State must: (a) Send...

  16. 38 CFR 52.20 - Application for recognition based on certification.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Adult Day Health Care in State Homes § 52.20 Application for recognition based on certification. To apply for recognition and certification of a State home for adult day health care, a...

  17. Decisional involvement among staff nurses based on educational level and certification status.

    PubMed

    Ugur, Esra; Scherb, Cindy A; Specht, Janet K

    2015-05-01

    Mechanisms to enhance the work environment are nurse decisional involvement (DI), obtainment of a baccalaureate or higher degree, and specialty certification. The purpose of this descriptive comparative study was to determine the difference between actual and preferred DI of staff nurses on the overall Decisional Involvement Scale (DIS), the differences based on its subscales, and those based on education level and certification. The sample included 163 staff nurses from a Midwestern health care organization. A statistically significant difference was found between actual and preferred DI, but no difference was found based on educational level and certification. There is a need to focus on nurses with a BSN/master's degree or specialty certification and to conduct comprehensive studies to address the effects of education and certification on DI. An additional strategy that can be useful for organizations is to provide nurses with the empowerment structures, expectations, and mentoring/coaching to become involved in the process of decision making.

  18. Rectal temperature-based death time estimation in infants.

    PubMed

    Igari, Yui; Hosokai, Yoshiyuki; Funayama, Masato

    2016-03-01

    In determining the time of death in infants based on rectal temperature, the same methods used in adults are generally used. However, whether the methods for adults are suitable for infants is unclear. In this study, we examined the following 3 methods in 20 infant death cases: computer simulation of rectal temperature based on the infinite cylinder model (Ohno's method), computer-based double exponential approximation based on Marshall and Hoare's double exponential model with Henssge's parameter determination (Henssge's method), and computer-based collinear approximation based on extrapolation of the rectal temperature curve (collinear approximation). The interval between the last time the infant was seen alive and the time that he/she was found dead was defined as the death time interval and compared with the estimated time of death. In Ohno's method, 7 cases were within the death time interval, and the average deviation in the other 12 cases was approximately 80 min. The results of both Henssge's method and collinear approximation were apparently inferior to the results of Ohno's method. The corrective factor was set within the range of 0.7-1.3 in Henssge's method, and a modified program was newly developed to make it possible to change the corrective factors. Modification A, in which the upper limit of the corrective factor range was set as the maximum value in each body weight, produced the best results: 8 cases were within the death time interval, and the average deviation in the other 12 cases was approximately 80min. There was a possibility that the influence of thermal isolation on the actual infants was stronger than that previously shown by Henssge. We conclude that Ohno's method and Modification A are useful for death time estimation in infants. However, it is important to accept the estimated time of death with certain latitude considering other circumstances.

  19. The effectiveness of market-based conservation in the tropics: forest certification in Ecuador and Bolivia.

    PubMed

    Ebeling, Johannes; Yasué, Maï

    2009-02-01

    During the last decade, forest certification has gained momentum as a market-based conservation strategy in tropical forest countries. Certification has been promoted to enhance forest management in countries where governance capacities are insufficient to adequately manage natural resources and enforce pertinent regulations, given that certification relies largely on non-governmental organisations and private businesses. However, at present there are few tropical countries with large areas of certified forests. In this study, we conducted semi-structured stakeholder interviews in Ecuador and Bolivia to identify key framework conditions that influence the costs and benefits for companies to switch from conventional to certified forestry operations. Bolivia has a much greater relative area under certified forest management than Ecuador and also significantly more certified producers. The difference in the success of certification between both countries is particularly notable because Bolivia is a poorer country with more widespread corruption, and is landlocked with less access to export routes. Despite these factors, several characteristics of the Bolivian forest industry contribute to lower additional costs of certified forest management compared to Ecuador. Bolivia has stronger government enforcement of forestry regulations a fact that increases the cost of illegal logging, management units are larger, and vertical integration in the process chain from timber extraction to markets is higher. Moreover, forestry laws in Bolivia are highly compatible with certification requirements, and the government provides significant tax benefits to certified producers. Results from this study suggest that certification can be successful in countries where governments have limited governance capacity. However, the economic incentives for certification do not only arise from favourable market conditions. Certification is likely to be more successful where governments enforce

  20. Moving toward Standards-Based Alternative Certification in Special Education

    ERIC Educational Resources Information Center

    Sears, Sue; Burstein, Nancy; Ashton, Tamarah; Murawski, Wendy

    2009-01-01

    Alternative programs in special education are often developed in response to chronic personnel shortages. At issue, however, is the quality of alternative programs and their graduates. This paper describes the design, implementation and evaluation of a large special education alternative certification program that adheres to both professional…

  1. Implications of incomplete registration of deaths on long-term survival estimates from population-based cancer registries.

    PubMed

    Brenner, Hermann; Hakulinen, Timo

    2009-07-15

    International comparison of population-based cancer survival is a key component of monitoring progress against cancer. Its validity depends to an unknown degree on completeness of ascertainment of deaths in the cancer registries involved which may vary according to legal and administrative circumstances. The aim of this study was to assess the impact of incomplete registration of deaths through various mechanisms on the validity of long-term absolute and relative survival estimates. For that purpose, we simulated underascertainment of deaths through linkage failure of registry data with death certificates with probabilities between 0.1 and 5%, and underascertainment of deaths by unregistered annual emigration with probabilities between 0.05 and 2%, using data from the Finnish Cancer Registry. The expected impact on estimates of 5-, 10- and 15-year absolute and relative survival was assessed. We demonstrate that even modest levels of under-registration of deaths may lead to severe overestimation of long-term survival estimates, ranging from 0 to 31 percent units in the scenarios assessed. In general, relative survival is much more affected than absolute survival, and potential problems are much larger for relative survival estimates in older compared with younger patients. Potential overestimation strongly increases with length of follow-up, and this increase is particularly pronounced for under-registration of deaths because of unrecorded emigration. Every effort should be made in cancer registry based survival analyses to ascertain deaths with close to 100% completeness. When such completeness cannot be achieved, long-term relative survival estimates and their comparison across populations must be interpreted with much caution.

  2. Early Childhood Injury Deaths in Washington State.

    ERIC Educational Resources Information Center

    Starzyk, Patricia M.

    This paper discusses data on the deaths of children aged 1-4 years in Washington State. A two-fold approach was used in the analysis. First, Washington State death certificate data for 1979-85 were used to characterize the deaths and identify hazardous situations. Second, death certificates were linked to birth certificates of children born in…

  3. Accuracy of cause of death determination without forensic autopsy examination.

    PubMed

    Nashelsky, Marcus B; Lawrence, Christopher H

    2003-12-01

    Medical examiners and coroners commonly determine cause and manner of death without an autopsy examination. Some death certificates generated in this way may not state the correct cause and manner of death. From the case files of the Department of Forensic Medicine in Sydney, Australia, the authors retrospectively reviewed investigative information of all cases in a 6-month period that were initially considered natural deaths (429). The authors, blinded to autopsy results, accepted 261 cases as appropriate for certification without autopsy and assigned a cause of death to each. Per standard local practice, all cases had been autopsied. The actual causes of death as determined by autopsy were then revealed and compared with the presumed causes of death. Most presumed and actual causes of death were cardiovascular (94% and 80%, respectively). The majority of presumed causes of death were listed as ASCVD as the cases lacked features of a more specific cardiovascular process. A large majority of cases had a presumed cause of death of ischemic heart disease based on individual case details. The actual causes of death demonstrated a large breadth of cardiovascular and noncardiovascular disease processes, even though ischemic heart disease accounted for 62% of deaths. The presumed cause of death was completely wrong in 28% of cases. A nonnatural manner of death was present in 3% of cases. This study demonstrates that experienced forensic pathologists may generate erroneous death certificates for cases that are not autopsied.

  4. Competency-Based Teacher Certification in the United States. A Working Paper of the Pennsylvania Competency-Assessment Certification Program.

    ERIC Educational Resources Information Center

    Maurer, Wallace M., Ed.

    With the exception of Vermont, all state educational agencies responded to a survey questionnaire designed to ascertain the current status of competency assessment teacher certification (CAC). Only 19 states presently award certificates through CAC. This can be explained partially by the fact that state educational agencies can attain the goal of…

  5. Certification Framework Based on Effective Trapping for Geologic Carbon Sequestration

    SciTech Connect

    Oldenburg, Curtis M.; Bryant, Steven L.; Nicot, Jean-Philippe

    2009-01-15

    We have developed a certification framework (CF) for certifying the safety and effectiveness of geologic carbon sequestration (GCS) sites. Safety and effectiveness are achieved if CO{sub 2} and displaced brine have no significant impact on humans, other living things, resources, or the environment. In the CF, we relate effective trapping to CO{sub 2} leakage risk which takes into account both the impact and probability of leakage. We achieve simplicity in the CF by using (1) wells and faults as the potential leakage pathways, (2) compartments to represent environmental resources that may be impacted by leakage, (3) CO{sub 2} fluxes and concentrations in the compartments as proxies for impact to vulnerable entities, (4) broad ranges of storage formation properties to generate a catalog of simulated plume movements, and (5) probabilities of intersection of the CO{sub 2} plume with the conduits and compartments. We demonstrate the approach on a hypothetical GCS site in a Texas Gulf Coast saline formation. Through its generality and flexibility, the CF can contribute to the assessment of risk of CO{sub 2} and brine leakage as part of the certification process for licensing and permitting of GCS sites around the world regardless of the specific regulations in place in any given country.

  6. 38 CFR 51.10 - Per diem based on recognition and certification.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Nursing Home Care in State Homes § 51.10 Per diem based on recognition and certification. VA will pay per diem to a State for providing nursing home care to eligible veterans in a facility if...

  7. 38 CFR 51.10 - Per diem based on recognition and certification.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Nursing Home Care in State Homes § 51.10 Per diem based on recognition and certification. VA will pay per diem to a State for providing nursing home care to eligible veterans in a facility if...

  8. 38 CFR 51.10 - Per diem based on recognition and certification.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Nursing Home Care in State Homes § 51.10 Per diem based on recognition and certification. VA will pay per diem to a State for providing nursing home care to eligible veterans in a facility if...

  9. 38 CFR 51.10 - Per diem based on recognition and certification.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Nursing Home Care in State Homes § 51.10 Per diem based on recognition and certification. VA will pay per diem to a State for providing nursing home care to eligible veterans in a facility if...

  10. 38 CFR 51.10 - Per diem based on recognition and certification.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Nursing Home Care in State Homes § 51.10 Per diem based on recognition and certification. VA will pay per diem to a State for providing nursing home care to eligible veterans in a facility if...

  11. 38 CFR 52.10 - Per diem based on recognition and certification.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Adult Day Health Care in State Homes § 52.10 Per diem based on recognition and certification. VA will pay per diem to a State for providing adult day health care to eligible veterans in...

  12. Multiple cause of death mortality patterns among Californians

    SciTech Connect

    White, M.C.

    1989-11-28

    The purpose of this study was to describe mortality patterns among the elderly using single versus multiple cause of death data and examine ways that multiple cause of death data can best be processed, analyzed and presented. Deaths among white California aged 65 and older for the years 1970, 1975 and 1980 were analyzed. Overall, mortality rates decreased over time, at all ages and for both sexes but more so for females, although the number of causes of death increased with age. Underlying cause mortality rates were compared to rates based on any mention of a cause on the death certificate; diabetes and atherosclerosis were more frequent causes of both than would be indicated by single cause statistics, and heart diseases other than ischemic heart disease increased in mentions on the death certificated while ischemic heart disease underlying mortality rates decreased. Pairs of causes of death showed increased likelihood of occurrence of a number of combinations of chronic diseases. In all pair combinations studied, the addition of another serious chronic disease lowered the mean age of death resulted in an older mean age of death. This result combined with higher number of causes per death but lower mortality rates among females raised interesting questions about interpreting more causes on death certificates as an indication of a sicker person at time of death. This study confirmed morbidity and mortality work on other that mortality of older adults in decreasing but that the number of causes of death per person is increasing. 82 refs., 30 figs., 59 tabs.

  13. 2015 Edition Health Information Technology (Health IT) Certification Criteria, 2015 Edition Base Electronic Health Record (EHR) Definition, and ONC Health IT Certification Program Modifications. Final rule.

    PubMed

    2015-10-16

    This final rule finalizes a new edition of certification criteria (the 2015 Edition health IT certification criteria or "2015 Edition'') and a new 2015 Edition Base Electronic Health Record (EHR) definition, while also modifying the ONC Health IT Certification Program to make it open and accessible to more types of health IT and health IT that supports various care and practice settings. The 2015 Edition establishes the capabilities and specifies the related standards and implementation specifications that Certified Electronic Health Record Technology (CEHRT) would need to include to, at a minimum, support the achievement of meaningful use by eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) under the Medicare and Medicaid EHR Incentive Programs (EHR Incentive Programs) when such edition is required for use under these programs.

  14. [The extraordinary death].

    PubMed

    Plattner, Thomas; Zollinger, Ulrich

    2008-07-01

    The examination of a deceased person is an important duty for physicians. It comprises the certification of death, the certification of the identity of the deceased, a thorough examination of the body, an estimation of the moment of death and ends with the decision, if death was caused by a certain or possible violent cause in which case it must be reported to the authorities. Problems and pitfalls are discussed on the basis of practical case presentations.

  15. 23 CFR Appendix C to Part 1240 - Certification (Calendar Year 1998 Survey Based on Survey Approved Under 23 U.S.C. 153)

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 23 Highways 1 2012-04-01 2012-04-01 false Certification (Calendar Year 1998 Survey Based on Survey... 1240—Certification (Calendar Year 1998 Survey Based on Survey Approved Under 23 U.S.C. 153) State Certification-Calendar Year 1998 Seat Belt Use Survey State of Seat Belt Use Rate Reported for Calendar...

  16. 23 CFR Appendix C to Part 1240 - Certification (Calendar Year 1998 Survey Based on Survey Approved Under 23 U.S.C. 153)

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 23 Highways 1 2014-04-01 2014-04-01 false Certification (Calendar Year 1998 Survey Based on Survey... 1240—Certification (Calendar Year 1998 Survey Based on Survey Approved Under 23 U.S.C. 153) State Certification-Calendar Year 1998 Seat Belt Use Survey State of Seat Belt Use Rate Reported for Calendar...

  17. 23 CFR Appendix C to Part 1240 - Certification (Calendar Year 1998 Survey Based on Survey Approved Under 23 U.S.C. 153)

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 23 Highways 1 2013-04-01 2013-04-01 false Certification (Calendar Year 1998 Survey Based on Survey... 1240—Certification (Calendar Year 1998 Survey Based on Survey Approved Under 23 U.S.C. 153) State Certification-Calendar Year 1998 Seat Belt Use Survey State of Seat Belt Use Rate Reported for Calendar...

  18. 5 CFR 843.310 - Annuity based on death of an employee.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Annuity based on death of an employee... SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Current and Former Spouse Benefits § 843.310 Annuity based on death of an employee. Except as provided...

  19. 5 CFR 843.310 - Annuity based on death of an employee.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Annuity based on death of an employee... SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Current and Former Spouse Benefits § 843.310 Annuity based on death of an employee. Except as provided...

  20. 5 CFR 843.310 - Annuity based on death of an employee.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Annuity based on death of an employee... SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Current and Former Spouse Benefits § 843.310 Annuity based on death of an employee. Except as provided...

  1. Food-related choking deaths among the elderly.

    PubMed

    Kramarow, Ellen; Warner, Margaret; Chen, Li-Hui

    2014-06-01

    During 2007-2010 in the USA, 2214 deaths among people aged ≥65 were attributed to choking on food. The death rate for this cause is higher among the elderly than among any other age group. Using data from the US National Vital Statistics System, we examined the relationship between food suffocation and other causes of death listed on the death certificate. Among decedents aged ≥65, the three most common additional conditions listed on the death certificate were heart disease, dementia and diabetes. However, after estimating the expected joint frequency of other causes based on the overall distribution of all causes of death, we find that three causes-dementia (including Alzheimer's disease), Parkinson's disease and pneumonitis-are most strongly associated with deaths from choking on food among older people.

  2. Development and Effectiveness Analysis of a Personalized Ubiquitous Multi-Device Certification Tutoring System Based on Bloom's Taxonomy of Educational Objectives

    ERIC Educational Resources Information Center

    Hwang, Gwo-Haur; Chen, Beyin; Huang, Cin-Wei

    2016-01-01

    In recent years, with the gradual increase in the importance of professional certificates, improvement in certification tutoring systems has become more important. In this study, we have developed a personalized ubiquitous multi-device certification tutoring system (PUMDCTS) based on "Bloom's Taxonomy of Educational Objectives," and…

  3. 38 CFR 3.1704 - Burial allowance based on service-connected death.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... service-connected death. 3.1704 Section 3.1704 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF....1704 Burial allowance based on service-connected death. Pt. 3, Subpt. B, Nt. (a) General rule. VA will... of the veteran's death that the expenses incurred were less than that amount. Payment of the...

  4. 5 CFR 843.311 - Annuity based on death of a separated employee.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... beginning on the day after the death of the separated employee. (ii) The rate of the adjusted annuity equals... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Annuity based on death of a separated... SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE...

  5. Certification Aspects in Critical Embedded Software Development with Model Based Techniques: Detection of Unintended Functions

    NASA Astrophysics Data System (ADS)

    Atencia Yepez, A.; Autrán Cerqueira, J.; Urueña, S.; Jurado, R.

    2012-01-01

    This paper, developed under contract with European Aviation Safety Agency (EASA), analyses in detail which may be the certification implications in the aeronautic industry associated to the application of model-level verification and validation techniques. Particularly, this paper focuses on the problematic of detecting unintended functions by applying Model Coverage Criteria at model level. This point is significantly important for the future extensive use of Model Based approaches in safety critical software, since the uncertainty in the system performance introduced by the unintended functions, which may also lead to unacceptable hazardous or catastrophic events, prevents the system to be compliance with certification requirements. The paper provides a definition and a categorization of unintended functions and gives some relevant examples to assess the efficiency of model- coverage techniques in the detection of UF. The paper explains how this analysis is supported by a methodology based on the study of sources for introducing unintended functions. Finally it is analysed the feasibility of using Model-level verification techniques to support the software certification process.

  6. 5 CFR 880.205 - Determinations of death.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Determinations of death. 880.205 Section... Determinations of death. OPM does not make findings of presumed death. A claimant for CSRS, FERS, or FEGLI death... § 880.207 must submit a death certificate or other legal certification of death issued by an...

  7. 5 CFR 880.205 - Determinations of death.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Determinations of death. 880.205 Section... Determinations of death. OPM does not make findings of presumed death. A claimant for CSRS, FERS, or FEGLI death... § 880.207 must submit a death certificate or other legal certification of death issued by an...

  8. 5 CFR 880.205 - Determinations of death.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Determinations of death. 880.205 Section... Determinations of death. OPM does not make findings of presumed death. A claimant for CSRS, FERS, or FEGLI death... § 880.207 must submit a death certificate or other legal certification of death issued by an...

  9. 5 CFR 880.205 - Determinations of death.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Determinations of death. 880.205 Section... Determinations of death. OPM does not make findings of presumed death. A claimant for CSRS, FERS, or FEGLI death... § 880.207 must submit a death certificate or other legal certification of death issued by an...

  10. 5 CFR 880.205 - Determinations of death.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Determinations of death. 880.205 Section... Determinations of death. OPM does not make findings of presumed death. A claimant for CSRS, FERS, or FEGLI death... § 880.207 must submit a death certificate or other legal certification of death issued by an...

  11. Competency-Based Program for Certification: Gifted and Talented.

    ERIC Educational Resources Information Center

    North Carolina State Dept. of Public Instruction, Raleigh. Div. for Exceptional Children.

    Discussed is a comptency-based program (CBP) for certifying teachers of gifted and talented students in North Carolina by 1977. It is explained that the CBP offers an alternative to required graduate study and involves a visiting team's evaluation of the teacher's knowledge of the gifted and ability to develop and implement a comprehensive…

  12. On the Reliability of Vocational Workplace-Based Certifications

    ERIC Educational Resources Information Center

    Harth, H.; Hemker, B.T.

    2013-01-01

    The assessment of vocational workplace-based qualifications in England relies on human assessors (raters). These assessors observe naturally occurring, non-standardised evidence, unique to each learner and evaluate the learner as competent/not yet competent against content standards. Whilst these are considered difficult to measure, this study…

  13. Place and Cause of Death in Centenarians: A Population-Based Observational Study in England, 2001 to 2010

    PubMed Central

    Evans, Catherine J.; Ho, Yuen; Daveson, Barbara A.; Hall, Sue; Higginson, Irene J.; Gao, Wei

    2014-01-01

    Background Centenarians are a rapidly growing demographic group worldwide, yet their health and social care needs are seldom considered. This study aims to examine trends in place of death and associations for centenarians in England over 10 years to consider policy implications of extreme longevity. Methods and Findings This is a population-based observational study using death registration data linked with area-level indices of multiple deprivations for people aged ≥100 years who died 2001 to 2010 in England, compared with those dying at ages 80-99. We used linear regression to examine the time trends in number of deaths and place of death, and Poisson regression to evaluate factors associated with centenarians’ place of death. The cohort totalled 35,867 people with a median age at death of 101 years (range: 100–115 years). Centenarian deaths increased 56% (95% CI 53.8%–57.4%) in 10 years. Most died in a care home with (26.7%, 95% CI 26.3%–27.2%) or without nursing (34.5%, 95% CI 34.0%–35.0%) or in hospital (27.2%, 95% CI 26.7%–27.6%). The proportion of deaths in nursing homes decreased over 10 years (−0.36% annually, 95% CI −0.63% to −0.09%, p = 0.014), while hospital deaths changed little (0.25% annually, 95% CI −0.06% to 0.57%, p = 0.09). Dying with frailty was common with “old age” stated in 75.6% of death certifications. Centenarians were more likely to die of pneumonia (e.g., 17.7% [95% CI 17.3%–18.1%] versus 6.0% [5.9%–6.0%] for those aged 80–84 years) and old age/frailty (28.1% [27.6%–28.5%] versus 0.9% [0.9%–0.9%] for those aged 80–84 years) and less likely to die of cancer (4.4% [4.2%–4.6%] versus 24.5% [24.6%–25.4%] for those aged 80–84 years) and ischemic heart disease (8.6% [8.3%–8.9%] versus 19.0% [18.9%–19.0%] for those aged 80–84 years) than were younger elderly patients. More care home beds available per 1,000 population were associated with fewer deaths in hospital (PR 0.98, 95% CI 0.98

  14. A population-based descriptive study of housefire deaths in North Carolina.

    PubMed Central

    Patetta, M J; Cole, T B

    1990-01-01

    We report a population-based study of housefire deaths in North Carolina in 1985 using data obtained from fire investigators and the North Carolina medical examiner system. The crude death rate was 3.2 per 100,000 population; age-specific death rates were highest for ages 75-84 years. Death rates for Whites were one-third as high as death rates for other races. Of those decedents tested for alcohol, 56 percent had blood alcohol levels greater than or equal to 22 mmol/L. Most fatal fires were caused by heating units or cigarettes. PMID:2382752

  15. 40 CFR 745.229 - Certification of individuals and firms engaged in lead-based paint activities: public and...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... SUBSTANCES CONTROL ACT LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Lead-Based Paint Activities § 745.229 Certification of individuals and firms engaged in lead-based paint activities... engaged in lead-based paint activities: public and commercial buildings, bridges and superstructures....

  16. 40 CFR 745.226 - Certification of individuals and firms engaged in lead-based paint activities: target housing and...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Lead-Based Paint Activities § 745.226 Certification of individuals and firms engaged in lead-based paint activities: target housing... engaged in lead-based paint activities: target housing and child-occupied facilities. 745.226 Section...

  17. 40 CFR 745.226 - Certification of individuals and firms engaged in lead-based paint activities: target housing and...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Lead-Based Paint Activities § 745.226 Certification of individuals and firms engaged in lead-based paint activities: target housing... engaged in lead-based paint activities: target housing and child-occupied facilities. 745.226 Section...

  18. 40 CFR 745.229 - Certification of individuals and firms engaged in lead-based paint activities: public and...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... SUBSTANCES CONTROL ACT LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Lead-Based Paint Activities § 745.229 Certification of individuals and firms engaged in lead-based paint activities... engaged in lead-based paint activities: public and commercial buildings, bridges and superstructures....

  19. 40 CFR 745.226 - Certification of individuals and firms engaged in lead-based paint activities: target housing and...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Lead-Based Paint Activities § 745.226 Certification of individuals and firms engaged in lead-based paint activities: target housing... engaged in lead-based paint activities: target housing and child-occupied facilities. 745.226 Section...

  20. 40 CFR 745.229 - Certification of individuals and firms engaged in lead-based paint activities: public and...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... SUBSTANCES CONTROL ACT LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Lead-Based Paint Activities § 745.229 Certification of individuals and firms engaged in lead-based paint activities... engaged in lead-based paint activities: public and commercial buildings, bridges and superstructures....

  1. 40 CFR 745.229 - Certification of individuals and firms engaged in lead-based paint activities: public and...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... SUBSTANCES CONTROL ACT LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Lead-Based Paint Activities § 745.229 Certification of individuals and firms engaged in lead-based paint activities... engaged in lead-based paint activities: public and commercial buildings, bridges and superstructures....

  2. 40 CFR 745.226 - Certification of individuals and firms engaged in lead-based paint activities: target housing and...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Lead-Based Paint Activities § 745.226 Certification of individuals and firms engaged in lead-based paint activities: target housing... engaged in lead-based paint activities: target housing and child-occupied facilities. 745.226 Section...

  3. 40 CFR 745.229 - Certification of individuals and firms engaged in lead-based paint activities: public and...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... SUBSTANCES CONTROL ACT LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Lead-Based Paint Activities § 745.229 Certification of individuals and firms engaged in lead-based paint activities... engaged in lead-based paint activities: public and commercial buildings, bridges and superstructures....

  4. 40 CFR 745.226 - Certification of individuals and firms engaged in lead-based paint activities: target housing and...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Lead-Based Paint Activities § 745.226 Certification of individuals and firms engaged in lead-based paint activities: target housing... engaged in lead-based paint activities: target housing and child-occupied facilities. 745.226 Section...

  5. Probabilistic thinking and death anxiety: a terror management based study.

    PubMed

    Hayslip, Bert; Schuler, Eric R; Page, Kyle S; Carver, Kellye S

    2014-01-01

    Terror Management Theory has been utilized to understand how death can change behavioral outcomes and social dynamics. One area that is not well researched is why individuals willingly engage in risky behavior that could accelerate their mortality. One method of distancing a potential life threatening outcome when engaging in risky behaviors is through stacking probability in favor of the event not occurring, termed probabilistic thinking. The present study examines the creation and psychometric properties of the Probabilistic Thinking scale in a sample of young, middle aged, and older adults (n = 472). The scale demonstrated adequate internal consistency reliability for each of the four subscales, excellent overall internal consistency, and good construct validity regarding relationships with measures of death anxiety. Reliable age and gender effects in probabilistic thinking were also observed. The relationship of probabilistic thinking as part of a cultural buffer against death anxiety is discussed, as well as its implications for Terror Management research.

  6. Development of the Knowledge-Based Standard for the Written Certification Examination of the American Board of Anesthesiology.

    ERIC Educational Resources Information Center

    Slogoff, Stephen; And Others

    1992-01-01

    Application of a knowledge-based standard in evaluating a written certification examination developed by the American Board of Anesthesiology established a standard of 57 percent correct over two years' examinations. This process is recommended for developing mastery-based (rather than normative-based) success criteria for evaluation of medical…

  7. Conditional probability distribution (CPD) method in temperature based death time estimation: Error propagation analysis.

    PubMed

    Hubig, Michael; Muggenthaler, Holger; Mall, Gita

    2014-05-01

    Bayesian estimation applied to temperature based death time estimation was recently introduced as conditional probability distribution or CPD-method by Biermann and Potente. The CPD-method is useful, if there is external information that sets the boundaries of the true death time interval (victim last seen alive and found dead). CPD allows computation of probabilities for small time intervals of interest (e.g. no-alibi intervals of suspects) within the large true death time interval. In the light of the importance of the CPD for conviction or acquittal of suspects the present study identifies a potential error source. Deviations in death time estimates will cause errors in the CPD-computed probabilities. We derive formulae to quantify the CPD error as a function of input error. Moreover we observed the paradox, that in cases, in which the small no-alibi time interval is located at the boundary of the true death time interval, adjacent to the erroneous death time estimate, CPD-computed probabilities for that small no-alibi interval will increase with increasing input deviation, else the CPD-computed probabilities will decrease. We therefore advise not to use CPD if there is an indication of an error or a contra-empirical deviation in the death time estimates, that is especially, if the death time estimates fall out of the true death time interval, even if the 95%-confidence intervals of the estimate still overlap the true death time interval.

  8. Maternal death audit in Rwanda 2009–2013: a nationwide facility-based retrospective cohort study

    PubMed Central

    Sayinzoga, Felix; Bijlmakers, Leon; van Dillen, Jeroen; Mivumbi, Victor; Ngabo, Fidèle; van der Velden, Koos

    2016-01-01

    Objective Presenting the results of 5 years of implementing health facility-based maternal death audits in Rwanda, showing maternal death classification, identification of substandard (care) factors that have contributed to death, and conclusive recommendations for quality improvements in maternal and obstetric care. Design Nationwide facility-based retrospective cohort study. Settings All cases of maternal death audited by district hospital-based audit teams between January 2009 and December 2013 were reviewed. Maternal deaths that were not subjected to a local audit are not part of the cohort. Population 987 audited cases of maternal death. Main outcome measures Characteristics of deceased women, timing of onset of complications, place of death, parity, gravida, antenatal clinic attendance, reported cause of death, service factors and individual factors identified by committees as having contributed to death, and recommendations made by audit teams. Results 987 cases were audited, representing 93.1% of all maternal deaths reported through the national health management information system over the 5-year period. Almost 3 quarters of the deaths (71.6%) occurred at district hospitals. In 44.9% of these cases, death occurred in the post-partum period. Seventy per cent were due to direct causes, with post-partum haemorrhage as the leading cause (22.7%), followed by obstructed labour (12.3%). Indirect causes accounted for 25.7% of maternal deaths, with malaria as the leading cause (7.5%). Health system failures were identified as the main responsible factor for the majority of cases (61.0%); in 30.3% of the cases, the main factor was patient or community related. Conclusions The facility-based maternal death audit approach has helped hospital teams to identify direct and indirect causes of death, and their contributing factors, and to make recommendations for actions that would reduce the risk of reoccurrence. Rwanda can complement maternal death audits with other

  9. Model-based validation procedure for the certification of advanced chassis control systems

    NASA Astrophysics Data System (ADS)

    Horiuchi, Shinichiro; Okada, Kazuyuki; Nohtomi, Shinya

    2010-12-01

    Many modern road vehicles are designed on the assumption that advanced chassis control systems must be installed in order to meet performance requirements on handling, stability and ride comfort. These control systems have to be certified for the safety of driving under a wide variety of conditions. In this paper, a model-based validation procedure for advanced chassis control systems is proposed. This new procedure combines a bifurcation-based method that assesses static properties with an optimisation-based method that evaluates the dynamic characteristics of the vehicle to time-varying input. The proposed procedure is applied to certificate a nominal chassis control system that uses differential braking. The results show the capability of the procedure to significantly improve both the reliability and the efficiency of the validation process.

  10. Cigarette Smoking as a Risk Factor for Sudden Infant Death Syndrome: A Population-Based Study.

    ERIC Educational Resources Information Center

    Haglund, Bengt; Cnattingius, Sven

    1990-01-01

    Examines risk factors for sudden infant death syndrome based on Swedish births between 1983 and 1985. Results indicate that maternal smoking doubles the risk of infant death, and infants of smokers also died sooner. The more the mother smoked the more likely her infant was to die. (JS)

  11. 29 CFR 1919.50 - Eligibility for accreditation to certificate shore-based material handling devices covered by...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... material handling devices covered by § 1917.50 of this chapter, safety and health regulations for marine... Shore-Based Equipment § 1919.50 Eligibility for accreditation to certificate shore-based material handling devices covered by § 1917.50 of this chapter, safety and health regulations for marine...

  12. Two new reference materials based on tobacco leaves: certification for over a dozen of toxic and essential elements.

    PubMed

    Samczyński, Zbigniew; Dybczyński, Rajmund S; Polkowska-Motrenko, Halina; Chajduk, Ewelina; Pyszynska, Marta; Danko, Bożena; Czerska, Elżbieta; Kulisa, Krzysztof; Doner, Katarzyna; Kalbarczyk, Paweł

    2012-01-01

    The preparation, certification, and characterization of two new biological certified reference materials for inorganic trace analysis have been presented. They are based on two different varieties of tobacco leaves, namely, Oriental Basma Tobacco Leaves (INCT-OBTL-5), grown in Greece, and Polish Virginia Tobacco Leaves (INCT-PVTL-6), grown in Poland. Certification of the materials was based on the statistical evaluation of results obtained in a worldwide interlaboratory comparison, in which 87 laboratories from 18 countries participated, providing 2568 laboratory averages on nearly 80 elements. It was possible to establish the certified values of concentration for many elements in the new materials, that is, 37 in INCT-OBTL-5 and 36 in INCT-PVTL-6, including several toxic ones like As, Cd, Hg, Pb, and so forth. The share and the role of instrumental analytical techniques used in the process of certification of the new CRMs are discussed.

  13. Two New Reference Materials Based on Tobacco Leaves: Certification for over a Dozen of Toxic and Essential Elements

    PubMed Central

    Samczyński, Zbigniew; Dybczyński, Rajmund S.; Polkowska-Motrenko, Halina; Chajduk, Ewelina; Pyszynska, Marta; Danko, Bożena; Czerska, Elżbieta; Kulisa, Krzysztof; Doner, Katarzyna; Kalbarczyk, Paweł

    2012-01-01

    The preparation, certification, and characterization of two new biological certified reference materials for inorganic trace analysis have been presented. They are based on two different varieties of tobacco leaves, namely, Oriental Basma Tobacco Leaves (INCT-OBTL-5), grown in Greece, and Polish Virginia Tobacco Leaves (INCT-PVTL-6), grown in Poland. Certification of the materials was based on the statistical evaluation of results obtained in a worldwide interlaboratory comparison, in which 87 laboratories from 18 countries participated, providing 2568 laboratory averages on nearly 80 elements. It was possible to establish the certified values of concentration for many elements in the new materials, that is, 37 in INCT-OBTL-5 and 36 in INCT-PVTL-6, including several toxic ones like As, Cd, Hg, Pb, and so forth. The share and the role of instrumental analytical techniques used in the process of certification of the new CRMs are discussed. PMID:22536124

  14. Workshop-based methodology to understand the risks in grain export inspection and certification.

    PubMed

    Wilson, John R; Vaegen-Lloyd, Jo-Roxy; Caponecchia, Carlo

    2009-07-01

    Much of the human factors contribution in risk assessment and risk management has been focused on systems or product safety; the profession has a much smaller research base regarding risks to do with regulation, certification and public policy, for example. This paper discusses an explicitly human factors contribution to understanding and managing risk for the inspection and export certification of grain and plant products in Australia. Training and awareness workshops, incorporating elements of focus groups, were run for 12 groups of staff and managers from the government department concerned. As well as training in risk management the workshops were used to come to an understanding of the work of the inspectors and other staff, to identify the sources of risk to the successful completion of their work and to develop the basis for a risk assessment framework and tool. The paper is methodological in focus and describes the development and running of the workshops and explains how a human factors oriented risk register was developed on the basis of identification of potential threats and errors in the system. Whilst the contribution of ergonomics is increasingly important as regards safety risk assessment, professionals have been less active as regards business, public policy and even engineering risk. This paper describes an approach within which a new domain was studied and the risks of all kinds identified, preparatory to development of a risk assessment tool.

  15. Modular Certification

    NASA Technical Reports Server (NTRS)

    Rushby, John; Miner, Paul S. (Technical Monitor)

    2002-01-01

    Airplanes are certified as a whole: there is no established basis for separately certifying some components, particularly software-intensive ones, independently of their specific application in a given airplane. The absence of separate certification inhibits the development of modular components that could be largely "precertified" and used in several different contexts within a single airplane, or across many different airplanes. In this report, we examine the issues in modular certification of software components and propose an approach based on assume-guarantee reasoning. We extend the method from verification to certification by considering behavior in the presence of failures. This exposes the need for partitioning, and separation of assumptions and guarantees into normal and abnormal cases. We then identify three classes of property that must be verified within this framework: safe function, true guarantees, and controlled failure. We identify a particular assume-guarantee proof rule (due to McMillan) that is appropriate to the applications considered, and formally verify its soundness in PVS.

  16. Certificate-Based Approach to Marketing Green Power and Constructing New Wind Energy Facilities: Preprint

    SciTech Connect

    Blank, E.; Bird, L.; Swezey, B.

    2002-05-01

    The availability of wind energy certificates in Pennsylvania's retail electricity market has made a critical difference in the economic feasibility of developing 140 MW of new wind energy projects in the region. Certificates offer important benefits to both green power suppliers and buyers by reducing transaction barriers and thus lowering the cost of renewable energy. Buyers also benefit through the increased flexibility offered by certificate products. The experience described in this paper offers important insights for selling green power certificates and achieving new wind energy development in other areas of the country.

  17. Tobacco cessation skills certification in Arizona: application of a state wide, community based model for diffusion of evidence based practice guidelines

    PubMed Central

    Muramoto, M.; Connolly, T.; Strayer, L.; Ranger-Moore, J.; Blatt, W.; Leischow, R.; Leischow, S.

    2000-01-01

    OBJECTIVE—To describe the development and preliminary results from a community based certification model for training in tobacco cessation skills in Arizona.
DESIGN—A programme evaluation using both quantitative pre-post measures and qualitative methods.
SETTING—Arizona's comprehensive tobacco control programme of state funded, community based local projects and their community partners providing tobacco treatment services for geographically, socioeconomically, and ethnically diverse communities.
INTERVENTION—A three tiered model of skills based training emphasising Agency for Health Care Policy and Research guidelines, and utilising a training of trainers approach to build community capacity. Certification roles addressed basic tobacco cessation skills, tobacco cessation specialist, and tobacco treatment services manager.
PARTICIPANTS—Initial target audience was community based local project personnel and their community partners, with later adoption by community organisations unaffiliated with local projects, and the general public.
MAIN EVALUATION MEASURES—Process measures: participant satisfaction, knowledge, skills, and self-efficacy. Outcome: participant demographics, community organisations represented, post-training, cessation related activities.
RESULTS—During the model's implementation year, 1075 participants attended certification training, 947 participants received basic skills certificates and 82 received specialist certificates. Pre, post, and three month measures of self efficacy showed significant and durable increases. Analysis of participant characteristics demonstrated broad community representation. At post-training follow up, 80.9% of basic skills trainees had performed at least one brief intervention and 74.8% had made a referral to intensive services. Among cessation specialists, 48.8% were delivering intensive services and 69.5% were teaching basic skills classes.
CONCLUSIONS—Initial experience with Arizona

  18. [Estimated coverage of death counts and adult mortality in Mozambique based on census data].

    PubMed

    Alberto, Serafim Adriano; Queiroz, Bernardo Lanza

    2015-10-01

    In 1997 and 2007, the questionnaire used in the Population Census in Mozambique included a question on deaths at home in the previous 12 months. This study aimed to evaluate the quality of mortality data for the country as a whole and its three major geographic regions. More specifically, based on formal demographic methods, the authors sought to evaluate the quality of information in terms of degree of coverage of death counts and mortality structure, summarized by the probability of death between 15 and 60 years of age. The 2007 census enumerated between 65% and 90% of deaths in Mozambique, suggesting that mortality estimates using direct methods underestimate mortality in the country. The study showed that there has been progress in the quality of death counts in the census, and that in the absence of high-quality vital statistics, population censuses can be a good source of mortality data in developing countries.

  19. A Perspective Evaluation of Problem-Based Learning in ESL Classroom in the Malaysian Higher School Certificate Program

    ERIC Educational Resources Information Center

    Rashid, Radzuwan Ab.

    2011-01-01

    This study was initiated to explore how pre-university students who enrolled in the Malaysian Higher School Certificate program perceived their experiences in learning ESL through Problem-Based Learning (PBL). This small scale study involved 35 pre-university students in an upper sixth form in a secondary school in Kelantan, Malaysia. Participants…

  20. Predictive Power of School Based Assessment Scores on Students' Achievement in Junior Secondary Certificate Examination (JSCE) in English and Mathematics

    ERIC Educational Resources Information Center

    Opara, Ijeoma M.; Onyekuru, Bruno U.; Njoku, Joyce U.

    2015-01-01

    The study investigated the predictive power of school based assessment scores on students' achievement in Junior Secondary Certificate Examination (JSCE) in English and Mathematics. Two hypotheses tested at 0.05 level of significance guided the study. The study adopted an ex-post facto research design. A sample of 250 students were randomly drawn…

  1. School-Based Initial Vocational Education in the Republic of Ireland: The Parity of Esteem and Fitness for Purpose of the Leaving Certificate Applied

    ERIC Educational Resources Information Center

    Gleeson, Jim; O'Flaherty, Joanne

    2013-01-01

    The Irish Leaving Certificate Applied (LCA) is a school-based, pre-vocational alternative to the "high stakes" established Leaving Certificate. Its origins lie in European Union funded "school to work" initiatives and it is currently taken to completion by some 5% of Irish senior cycle students. Since it was designed 20 years…

  2. Information Technology Student-Based Certification in Formal Education Settings: Who Benefits and What Is Needed

    ERIC Educational Resources Information Center

    Randall, Michael H.; Zirkle, Christopher J.

    2005-01-01

    There is a growing trend within secondary and post-secondary institutions to offer information technology (IT) certification programs as instructional vehicles to provide students with viable skills needed by the workforce, to satisfy state skill standards, and to prepare students for post-secondary IT studies. The use of IT certification programs…

  3. [Sleeping habits related to sudden infant death syndrome: a population-based study].

    PubMed

    Geib, Lorena Teresinha Consalter; Nunes, Magda Lahorgue

    2006-02-01

    This cross-sectional study on sleeping habits with potential risk for sudden infant death syndrome included all live births in Passo Fundo, Rio Grande do Sul, Brazil, in 2003 with data collection from Certificates of Live Birth and interviews, analyzed with descriptive statistics and the chi-squared test. From the 2,634 live births, 2,285 children were selected (86.75%), with 8.4% exclusion and 5.2% losses. Protective habits included 77% of infants with appropriate clothing, 90% loosely wrapped, 69% with thin blankets, 98% sleeping in the parents' bedroom, and 56% in the crib. Potentially risky habits included lateral decubitus (92%), use of a pillow (88%), and feet far from the lower edge of the crib (96%). Among low-income families, bed-sharing with other children was significant (p = 0.00). Thus, in a county with a low prevalence of sudden infant death syndrome, infants are exposed to both protective and risk factors, suggesting that in underprivileged populations in developing countries, other risk factors for this syndrome should be considered.

  4. [A study on death: an analysis based on Vigotski's dialectical method].

    PubMed

    Combinato, Denise Stefanoni; Queiroz, Marcos de Souza

    2011-09-01

    This article focuses on the concept of death and, in particular, the social construction of its meaning for a professional healthcare team working in an intensive hospital care unit. Thirteen professionals (six physicians and seven nurses) participated in the research, through semi-structured interviews. Despite the fact that death is part of the human cycle and is present in the daily working life of these health professionals, the denial of its existence imposed by the culture of the modern western world prevents the development of specific strategies to address this problem. Based on the Vigotski's dialectical method, three main conceptions of death were extracted from the interviews: death as a natural consequence of life; death as a biological process and death as a divine blessing. In the absence of a proper space for a more systematical approach, the social representations from the professionals on this theme are restricted to subjective opinions. In the conclusion, the need for change in the institutional context and in health education is emphasized, with a specific focus directed on death and on the process of dying.

  5. Towards FAA Certification of UAVs

    NASA Technical Reports Server (NTRS)

    Nelson, Stacy

    2003-01-01

    As of June 30, 2003, all Unmanned Aerial Vehicles (UAV), no matter how small, must adhere to the same FAA regulations as human-piloted aircraft. These regulations include certification for flying in controlled airspace and certification of flight software based on RTCA DO-178B. This paper provides an overview of the steps necessary to obtain certification, as well as a discussion about the challenges UAV's face when trying to meet these requirements. It is divided into two parts: 1) Certifications for Flying in Controlled Airspace; 2) Certification of Flight Software per RTCA DO-178B.

  6. A telepathology based Virtual Reference and Certification Centre for DNA image cytometry.

    PubMed

    Haroske, G; Giroud, F; Kunze, K D; Meyer, W

    2000-01-01

    An increasing need for flexible consultation between pathologists, including the application of fast evolving supplementary technologies, has been identified during the last years. Although pathology is already one of the most advanced application of telemedicine there is more to come from the fast evolution towards computerized microscope image analysis: A reproducible quantification of measurable descriptors of the lesions in cells and tissues (so-called biological markers) is an indispensable adjunct to routine diagnostic application. Among such quantitative methods DNA image cytometry is increasingly applied by pathologists for assistance in diagnostics. As for other pathological issues, too, a reference center for the clinical application of DNA image cytometry might be therefore of utmost value for pathologists using that method. Based on advanced telematic technologies, a Virtual Reference and Certification Center (VRCC) could be installed for certifying the cytometry hardware and software, the analytical procedures, and the basic interpretation of the results. It will be designed to be operated as a non-attended service, based on quantification servers accessible via Internet round the clock. The VRCC will supply appropriate standardization and normalization materials and run a GroupWare platform for consensus making by experts.

  7. Combined prediction model of death toll for road traffic accidents based on independent and dependent variables.

    PubMed

    Feng, Zhong-xiang; Lu, Shi-sheng; Zhang, Wei-hua; Zhang, Nan-nan

    2014-01-01

    In order to build a combined model which can meet the variation rule of death toll data for road traffic accidents and can reflect the influence of multiple factors on traffic accidents and improve prediction accuracy for accidents, the Verhulst model was built based on the number of death tolls for road traffic accidents in China from 2002 to 2011; and car ownership, population, GDP, highway freight volume, highway passenger transportation volume, and highway mileage were chosen as the factors to build the death toll multivariate linear regression model. Then the two models were combined to be a combined prediction model which has weight coefficient. Shapley value method was applied to calculate the weight coefficient by assessing contributions. Finally, the combined model was used to recalculate the number of death tolls from 2002 to 2011, and the combined model was compared with the Verhulst and multivariate linear regression models. The results showed that the new model could not only characterize the death toll data characteristics but also quantify the degree of influence to the death toll by each influencing factor and had high accuracy as well as strong practicability.

  8. 28 CFR 32.15 - Prerequisite certification.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32.15 Judicial Administration DEPARTMENT OF JUSTICE PUBLIC SAFETY OFFICERS' DEATH, DISABILITY, AND EDUCATIONAL ASSISTANCE BENEFIT CLAIMS Death Benefit Claims § 32.15 Prerequisite certification. (a) Except as... received (or legally are entitled to receive) the maximum death benefits legally payable by the agency...

  9. Modeling and using a web-based and tutored portfolio to support certification of professional competence in transfusion medicine

    PubMed Central

    Staccini, Pascal; Rouger, Philippe

    2008-01-01

    In order to manage a nationwide assessment program leading to certification of professional competence in blood transfusion throughout France, the National Institute of Blood Transfusion (INTS) and the University of Nice-Sophia Antipolis designed and developed a structured and tutored web-based portfolio. The entire process of certification has been approved by the national healthcare agency (HAS). Eleven assessment programs have been written. The structure of this e-portfolio is based on a matrix of actions defined according to standards of practice. For each action, elements of proof are uploaded by the physician and peer-reviewed by an expert (a tutor) before validation. The electronic portfolio stores all the history of the actions performed by users. This tracking feature generates alerts which are e-mailed to users (physicians and tutors) according to a list of monitored events. After one year of design and development, the application is now being used routinely. PMID:18999167

  10. Record-linkage comparison of verbal autopsy and routine civil registration death certification in rural north-east South Africa: 2006–09

    PubMed Central

    Joubert, Jané; Bradshaw, Debbie; Kabudula, Chodziwadziwa; Rao, Chalapati; Kahn, Kathleen; Mee, Paul; Tollman, Stephen; Lopez, Alan D; Vos, Theo

    2014-01-01

    Background: South African civil registration (CR) provides a key data source for local health decision making, and informs the levels and causes of mortality in data-lacking sub-Saharan African countries. We linked mortality data from CR and the Agincourt Health and Socio-demographic Surveillance System (Agincourt HDSS) to examine the quality of rural CR data. Methods: Deterministic and probabilistic techniques were used to link death data from 2006 to 2009. Causes of death were aggregated into the WHO Mortality Tabulation List 1 and a locally relevant short list of 15 causes. The matching rate was compared with informant-reported death registration. Using the VA diagnoses as reference, misclassification patterns, sensitivity, positive predictive values and cause-specific mortality fractions (CSMFs) were calculated for the short list. Results: A matching rate of 61% [95% confidence interval (CI): 59.2 to 62.3] was attained, lower than the informant-reported registration rate of 85% (CI: 83.4 to 85.8). For the 2264 matched cases, cause agreement was 15% (kappa 0.1083, CI: 0.0995 to 0.1171) for the WHO list, and 23% (kappa 0.1631, CI: 0.1511 to 0.1751) for the short list. CSMFs were significantly different for all but four (tuberculosis, cerebrovascular disease, other heart disease, and ill-defined natural) of the 15 causes evaluated. Conclusion: Despite data limitations, it is feasible to link official CR and HDSS verbal autopsy data. Data linkage proved a promising method to provide empirical evidence about the quality and utility of rural CR mortality data. Agreement of individual causes of death was low but, at the population level, careful interpretation of the CR data can assist health prioritization and planning. PMID:25146564

  11. National Disaster Health Consortium: Competency-Based Training and a Report on the American Nurses Credentialing Center Disaster Certification Development.

    PubMed

    Smith, Sherrill J; Farra, Sharon L

    2016-12-01

    As the largest profession of health care providers, nurses are an integral component of disaster response. Having clearly delineated competencies and developing training to acquire those competencies are needed to ensure nurses are ready when disasters occur. This article provides a review of nursing and interprofessional disaster competencies and development of a new interprofessional disaster certification. An overview of a standardized disaster training program, the National Disaster Health Consortium, is provided as an exemplar of a competency-based interprofessional disaster education program.

  12. Preventing sudden cardiac death in athletes: in search of evidence-based, cost-effective screening.

    PubMed

    Angelini, Paolo; Vidovich, Mladen I; Lawless, Christine E; Elayda, Macarthur A; Lopez, J Alberto; Wolf, Dwayne; Willerson, James T

    2013-01-01

    Sudden cardiac death in athletes is a recurrent phenomenon at sporting events and during training. Recent studies have associated sudden cardiac death with such cardiovascular conditions as coronary artery anomalies, cardiomyopathies, and electrocardiographic abnormalities, most of which are screenable with modern imaging techniques. We recently inaugurated the Center for Coronary Artery Anomalies at the Texas Heart Institute, which is dedicated to preventing sudden cardiac death in the young and investigating coronary artery anomalies. There, we are conducting 2 cross-sectional studies intended to firmly establish and quantify, in a large group of individuals from a general population, risk factors for sudden cardiac death that arise from specific cardiovascular conditions. In a pilot screening study, we are using a brief, focused clinical questionnaire, electrocardiography, and a simplified novel cardiovascular magnetic resonance screening protocol in approximately 10,000 unselected 11- to 15-year-old children. Concurrently, we are prospectively studying the prevalence of these same conditions, their severity, and their relation to exercise and mode of death in approximately 6,500 consecutive necropsy cases referred to a large forensic center. Eventually, we hope to use our findings to develop a more efficient method of preventing sudden cardiac death in athletes. We believe that these studies will help quantify sudden cardiac death risk factors and the relevance of associated physical activities--crucial information in evaluating the feasibility and affordability of cardiovascular magnetic resonance-based screening. We discuss the rationale for and methods of this long-term endeavor, in advance of reporting the results.

  13. An Open Letter to Deans of Teacher Education and Directors of Teacher Certification on Performance-Based Teacher Education/Certification (Is It a "No Exit" Syndrome?) AFT QuEST Paper No. 14.

    ERIC Educational Resources Information Center

    Bhaerman, Robert D.

    This open letter focuses on performance-based teacher education and certification (PBTE/C). The first section of the letter deals with anxieties about PBTE/C and about some of the people who have brought about this innovation. It comprises a survey. The second part of the paper makes various recommendations: a) the establishment of an independent…

  14. 38 CFR - § 3.1705 Burial allowance based on non-service-connected death.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false § 3.1705 Burial... OF VETERANS AFFAIRS ADJUDICATION Burial Benefits Burial Benefits: Allowances & Expenses Paid by Va A08se3. § 3.1705 Burial allowance based on non-service-connected death. (a) General rule. VA will pay...

  15. The Issue of Death and Dying: Employing Problem-Based Learning in Nursing Education.

    ERIC Educational Resources Information Center

    Mok, Esther; Lee, Wai Man; Wong, Frances Kam-yuet

    2002-01-01

    Hong Kong nursing students used journals to problem-based learning (PBL) related to dying patients. Increased self-awareness, positive attitude toward death, and culturally sensitive care resulted. PBL methods included information searches, interviews with experts and patients, and tutorials for sharing feelings and information. (Contains 21…

  16. Ceramide, sphingoid bases, and sphingoid base metabolites as lipid mediators in signaling pathways leading to cell death and disease

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Increased ceramide generation de novo is known to be involved in the mechanism of action of many chemotherapeutic agents and conditions which disrupt cell cycle progression and induce cell death. Conversely, the metabolism of ceramide to sphingoid bases and and sphingoid base 1-phosphates has been i...

  17. An Exploration of Initial Certification Candidates' TPACK and Mathematics-Based Applications Using Touch Device Technology

    ERIC Educational Resources Information Center

    McCrory, Michael Ray

    2010-01-01

    This qualitative research study employed a multiple-case study approach to describe the experiences of a group of Initial Certification Candidates (ICCs) as they participated in explorations of readings and third-party applications (apps) run on touch screen technology devices. The group of ICCs was comprised of two Undergraduate Teacher…

  18. Certification trails for data structures

    NASA Technical Reports Server (NTRS)

    Sullivan, Gregory F.; Masson, Gerald M.

    1993-01-01

    Certification trails are a recently introduced and promising approach to fault detection and fault tolerance. The applicability of the certification trail technique is significantly generalized. Previously, certification trails had to be customized to each algorithm application; trails appropriate to wide classes of algorithms were developed. These certification trails are based on common data-structure operations such as those carried out using these sets of operations such as those carried out using balanced binary trees and heaps. Any algorithms using these sets of operations can therefore employ the certification trail method to achieve software fault tolerance. To exemplify the scope of the generalization of the certification trail technique provided, constructions of trails for abstract data types such as priority queues and union-find structures are given. These trails are applicable to any data-structure implementation of the abstract data type. It is also shown that these ideals lead naturally to monitors for data-structure operations.

  19. Healthcare teams over the Internet: programming a certificate-based approach.

    PubMed

    Georgiadis, Christos K; Mavridis, Ioannis K; Pangalos, George I

    2003-07-01

    Healthcare environments are a representative case of collaborative environments since individuals (e.g. doctors) in many cases collaborate in order to provide care to patients in a more proficient way. At the same time modern healthcare institutions are increasingly interested in sharing access of their information resources in the networked environment. Healthcare applications over the Internet offer an attractive communication infrastructure at worldwide level but with a noticeably great factor of risk. Security has, therefore, become a major concern. However, although an adequate level of security can be relied upon digital certificates, if an appropriate security model is used, additional security considerations are needed in order to deal efficiently with the above team-work concerns. The already known Hybrid Access Control (HAC) security model supports and handles efficiently healthcare teams with active security capabilities and is capable to exploit the benefits of certificate technology. In this paper we present the way for encoding the appropriate authoritative information in various types of certificates, as well as the overall operational architecture of the implemented access control system for healthcare collaborative environments over the Internet. A pilot implementation of the proposed methodology in a major Greek hospital has shown the applicability of the proposals and the flexibility of the access control provided.

  20. Online Information Technologies Certificate Program

    ERIC Educational Resources Information Center

    Yukselturk, Erman

    2005-01-01

    In this study, Information Technologies Certificate Program which is based on synchronous and asynchronous communication methods over the Internet offered by cooperation of Middle East Technical University, Computer Engineering Department and Continuing Education Center were examined. This online certificate program started in May 1998 and it is…

  1. Analyzing EEG of quasi-brain-death based on dynamic sample entropy measures.

    PubMed

    Ni, Li; Cao, Jianting; Wang, Rubin

    2013-01-01

    To give a more definite criterion using electroencephalograph (EEG) approach on brain death determination is vital for both reducing the risks and preventing medical misdiagnosis. This paper presents several novel adaptive computable entropy methods based on approximate entropy (ApEn) and sample entropy (SampEn) to monitor the varying symptoms of patients and to determine the brain death. The proposed method is a dynamic extension of the standard ApEn and SampEn by introducing a shifted time window. The main advantages of the developed dynamic approximate entropy (DApEn) and dynamic sample entropy (DSampEn) are for real-time computation and practical use. Results from the analysis of 35 patients (63 recordings) show that the proposed methods can illustrate effectiveness and well performance in evaluating the brain consciousness states.

  2. 20 CFR 655.165 - Partial certification.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... certification. The CO may issue a partial certification, reducing either the period of need or the number of H-2A workers being requested or both for certification, based upon information the CO receives during... the CO. The notice will also state that the employer may submit any legal arguments which the...

  3. Neonatal Death

    MedlinePlus

    ... Home > Complications & Loss > Loss & grief > Neonatal death Neonatal death E-mail to a friend Please fill in ... cope with your baby’s death. What is neonatal death? Neonatal death is when a baby dies in ...

  4. PREPARING FOR A SUCCESSFUL EVMS CERTIFICATION

    SciTech Connect

    CROWE SL; BASCHE AD

    2011-02-09

    The client, a government agency, requires its contractor to obtain an Earned Value Management System (EVMS) certification that meets the intent of ANSI/EIA-748-B, Earned Value Management Systems. The contractor has extensive experience with certification preparation, having completed two certifications within two years. Information from a previous EVMS certification and internal system surveillances are used to prepare for client-based EVMS certifications and bi-annual surveillances. The contractor also sent members of its group to assist other companies preparing for surveillances and certifications to perform 'Black Hat Reviews.' This paper is a lessons learned on preparing a team for EVMS certification. The information is also applicable for surveillances, since the contractor prepares its team for the surveillance in the same manner as the initial certification. Some of the areas covered include required documents, tracing the data through the systems, Control Account Manager (CAM) preparation, and system verification.

  5. Infant Maltreatment-Related Mortality in Alaska: Correcting the Count and Using Birth Certificates to Predict Mortality

    ERIC Educational Resources Information Center

    Parrish, Jared W.; Gessner, Bradford D.

    2010-01-01

    Objectives: To accurately count the number of infant maltreatment-related fatalities and to use information from the birth certificates to predict infant maltreatment-related deaths. Methods: A population-based retrospective cohort study of infants born in Alaska for the years 1992 through 2005 was conducted. Risk factor variables were ascertained…

  6. Spectrum Certification

    DTIC Science & Technology

    2010-03-01

    Radars • Transmitters • Receivers • Electronic Warfare Systems, e. g., Counter IED jammers • Simulators • Equipment using civilian bands • Off-the...milestone  Box Level: Stage 3  Platform: Stage 4 • JTIDS /MIDS: DoD 4650.1-R1 Link 16 EMC Features Certification Process & Requirements • Satellite

  7. [Analysis and design of signaling transfer mechanism based on third-party certification: quality prestige index of traditional Chinese medicine enterprises].

    PubMed

    Yang, Guang; Wang, Nuo; Guo, Lan-Ping; Huang, Lu-Qi

    2014-03-01

    Traditional Chinese medicine market is a typical market with information asymmetry, which may lead to "lemons" problem. Third-Party Certification is efficient path to solve the problem of information asymmetry. For this reason geo-authentic and commodity classes certification seems to be very important. But as we know, information asymmetry happen in the stages of traditional Chinese patent medicines market. So a signaling transfer mechanism, which can deliver the quality signal, is badly needed in TCM market. This paper analysis and design of signaling transfer mechanism based on Third-Party Certification, which called quality prestige index of TCM enterprises (QPITCM). QPITCM can display quality information as a signal run through the TCM market.

  8. Brain Death Determination.

    PubMed

    Spinello, Irene M

    2015-09-01

    In the United States, each year 1% to 2% of deaths are brain deaths. Considerable variation in the practice of determining brain death still remains, despite the publication of practice parameters in 1995 and an evidence-based guideline update in 2010. This review is intended to give bedside clinicians an overview of definition, the causes and pitfalls of misdiagnosing brain death, and a focus on the specifics of the brain death determination process.

  9. Predictors of Death among Patients Who Completed Tuberculosis Treatment: A Population-Based Cohort Study

    PubMed Central

    Millet, Juan-Pablo; Orcau, Angels; Rius, Cristina; Casals, Marti; de Olalla, Patricia Garcia; Moreno, Antonio; Nelson, Jeanne L.; Caylà, Joan A.

    2011-01-01

    Background Mortality among patients who complete tuberculosis (TB) treatment is still high among vulnerable populations. The objective of the study was to identify the probability of death and its predictive factors in a cohort of successfully treated TB patients. Methods A population-based retrospective longitudinal study was performed in Barcelona, Spain. All patients who successfully completed TB treatment with culture-confirmation and available drug susceptibility testing between 1995–1997 were retrospectively followed-up until December 31, 2005 by the Barcelona TB Control Program. Socio-demographic, clinical, microbiological and treatment variables were examined. Mortality, TB Program and AIDS registries were reviewed. Kaplan-Meier and a Cox regression methods with time-dependent covariates were used for the survival analysis, calculating the hazard ratio (HR) with 95% confidence intervals (CI). Results Among the 762 included patients, the median age was 36 years, 520 (68.2%) were male, 178 (23.4%) HIV-infected, and 208 (27.3%) were alcohol abusers. Of the 134 (17.6%) injecting drug users (IDU), 123 (91.8%) were HIV-infected. A total of 30 (3.9%) recurrences and 173 deaths (22.7%) occurred (mortality rate: 3.4/100 person-years of follow-up). The predictors of death were: age between 41–60 years old (HR: 3.5; CI:2.1–5.7), age greater than 60 years (HR: 14.6; CI:8.9–24), alcohol abuse (HR: 1.7; CI:1.2–2.4) and HIV-infected IDU (HR: 7.9; CI:4.7–13.3). Conclusions The mortality rate among TB patients who completed treatment is associated with vulnerable populations such as the elderly, alcohol abusers, and HIV-infected IDU. We therefore need to fight against poverty, and promote and develop interventions and social policies directed towards these populations to improve their survival. PMID:21980423

  10. "We Brought It upon Ourselves": University-Based Teacher Education and the Emergence of Boot-Camp-Style Routes to Teacher Certification

    ERIC Educational Resources Information Center

    Friedrich, Daniel

    2014-01-01

    The proliferation of boot-camp-style routes to teacher certification in the last two decades is seen by many university-based teacher educators as the result of the advancement of conservative interests aimed at de-professionalizing teaching. This essay argues that this view only accounts for one piece of the answer, the other one being that some…

  11. 23 CFR Appendix C to Part 1240 - Certification (Calendar Year 1998 Survey Based on Survey Approved Under 23 U.S.C. 153)

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... GRANTS FOR USE OF SEAT BELTS-ALLOCATIONS BASED ON SEAT BELT USE RATES Pt. 1240, App. C Appendix C to Part... Certification-Calendar Year 1998 Seat Belt Use Survey State of Seat Belt Use Rate Reported for Calendar Year... cars, pickup trucks, vans, minivans, and sport utility vehicles), measures seat belt use by all...

  12. 23 CFR Appendix C to Part 1240 - Certification (Calendar Year 1998 Survey Based on Survey Approved Under 23 U.S.C. 153)

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... GRANTS FOR USE OF SEAT BELTS-ALLOCATIONS BASED ON SEAT BELT USE RATES Pt. 1240, App. C Appendix C to Part... Certification-Calendar Year 1998 Seat Belt Use Survey State of Seat Belt Use Rate Reported for Calendar Year... cars, pickup trucks, vans, minivans, and sport utility vehicles), measures seat belt use by all...

  13. Brain death: the Asian perspective.

    PubMed

    Chua, Hoe Chin; Kwek, Tong Kiat; Morihara, Hirofumi; Gao, Daiquan

    2015-04-01

    Asia is the largest and most populous continent in the world with people from many diverse ethnic groups, religions and government systems. The authors surveyed 14 countries accounting for the majority of Asia's population and found that, although the concept of brain death is widely accepted, there is wide variability in the criteria for certification. Although most Asian countries have adopted the "whole-brain" concept of brain death, most countries with past colonial links to the United Kingdom follow the UK "brainstem" concept of brain death. Despite this difference, most countries require only neurologic testing of irreversible coma and absent brainstem reflexes as criteria for certification of brain death. Variability exists in the number of personnel required, qualifications of certifying doctors, need for repeat examination, minimum time interval between examinations, and requirement for and choice of confirmatory tests.

  14. 34 CFR 674.61 - Discharge for death or disability.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 3 2014-07-01 2014-07-01 false Discharge for death or disability. 674.61 Section 674... Discharge for death or disability. (a) Death. An institution must discharge the unpaid balance of a borrower... discharge the loan on the basis of an original or certified copy of the death certificate, or an...

  15. 34 CFR 674.61 - Discharge for death or disability.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 3 2012-07-01 2012-07-01 false Discharge for death or disability. 674.61 Section 674... Discharge for death or disability. (a) Death. An institution must discharge the unpaid balance of a borrower... discharge the loan on the basis of an original or certified copy of the death certificate, or an...

  16. 34 CFR 674.61 - Discharge for death or disability.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false Discharge for death or disability. 674.61 Section 674... Discharge for death or disability. (a) Death. An institution must discharge the unpaid balance of a borrower... discharge the loan on the basis of an original or certified copy of the death certificate, or an...

  17. 34 CFR 674.61 - Discharge for death or disability.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 3 2011-07-01 2011-07-01 false Discharge for death or disability. 674.61 Section 674... Discharge for death or disability. (a) Death. An institution must discharge the unpaid balance of a borrower... discharge the loan on the basis of an original or certified copy of the death certificate, or an...

  18. 34 CFR 674.61 - Discharge for death or disability.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 3 2013-07-01 2013-07-01 false Discharge for death or disability. 674.61 Section 674... Discharge for death or disability. (a) Death. An institution must discharge the unpaid balance of a borrower... discharge the loan on the basis of an original or certified copy of the death certificate, or an...

  19. Using textual cause-of-death data to study drug poisoning deaths.

    PubMed

    Ossiander, Eric M

    2014-04-01

    Death certificate data are often used to study the epidemiology of poisoning deaths, but the International Classification of Diseases (ICD) codes used to tabulate death data do not convey all of the available information about the drugs and other substances named on death certificates. In the United States and some other countries, the SuperMICAR computer system is used to assign ICD codes to deaths. The SuperMICAR system also stores a verbatim record of the text entered for the cause of death. We used the SuperMICAR text entries to study the 7,817 poisoning deaths that occurred among Washington State residents between 2003 and 2010. We tabulated the drugs named on death certificates and computed age-adjusted and age-specific death rates for the top-named drugs and for prescription and illicit drugs. Methadone was named on 2,149 death certificates and was the most frequently named substance, followed by alcohol, opiate, cocaine, oxycodone, and methamphetamine. For both men and women and at all ages, prescription drugs were involved in more deaths than were illicit drugs. Among the 25 drugs named most frequently, only 4 have unique ICD codes; the other 21 can be identified only by using the SuperMICAR data.

  20. Certificate Regulations for School Personnel.

    ERIC Educational Resources Information Center

    Kansas State Dept. of Education, Topeka.

    This certification handbook provides regulations and systematic procedures for initial issuance of educational certificates as well as renewal requirements in the state of Kansas. The certification topics include--secondary certificates, special certificates, elementary certificates, administrator certificates, vocational education certificates,…

  1. Performance-based regulation: enterprise responsibility for reducing death, injury, and disease caused by consumer products.

    PubMed

    Sugarman, Stephen D

    2009-12-01

    This article offers a bold new idea for confronting the staggering level of death, injury, and disease caused by five consumer products: cigarettes, alcohol, guns, junk food, and motor vehicles. Business leaders try to frame these negative outcomes as "collateral damage" that is someone else's problem. That framing not only is morally objectionable but also overlooks the possibility that, with proper prodding, industry could substantially lessen these public health disasters. I seek to reframe the public perception of who is responsible and propose to deploy a promising approach called "performance-based regulation" to combat the problem. Performance-based regulation would impose on manufacturers a legal obligation to reduce the negative social costs of their products. Rather than involving them in litigation or forcing them to operate differently (as "command-and-control" regimes do), performance-based regulation allows the firms to determine how best to decrease bad public health consequences. Like other public health strategies, performance-based regulation focuses on those who are far more likely than individual consumers to achieve real gains. Analogous to a tax on causing harm that exceeds a threshold level, performance-based regulation seeks to harness private initiative in pursuit of the public good.

  2. Facility-based maternal death reviews: effects on maternal mortality in a district hospital in Senegal.

    PubMed Central

    Dumont, Alexandre; Gaye, Alioune; de Bernis, Luc; Chaillet, Nils; Landry, Anne; Delage, Joanne; Bouvier-Colle, Marie-Hélène

    2006-01-01

    OBJECTIVE: The improvement of obstetric services is one of the key components of the Safe Motherhood Programme. Reviewing maternal deaths and complications is one method that may make pregnancy safer, but there is no evidence about the effectiveness of this strategy. The objective of our before and after study is to assess the effect of facility-based maternal deaths reviews (MDR) on maternal mortality rates in a district hospital in Senegal that provides primary and referral maternity services. METHODS: We included all women who were admitted to the maternity unit for childbirth, or within 24 hours of delivery. We recorded maternal mortality during a 1-year baseline period from January to December 1997, and during a 3-year period from January 1998 to December 2000 after MDR had been implemented. Effects of MDR on organization of care were qualitatively evaluated. FINDINGS: The MDR strategy led to changes in organizational structure that improved life-saving interventions with a relatively large financial contribution from the community. Overall mortality significantly decreased from 0.83 (95% CI (confidence interval) = 0.60 -1.06) in baseline period to 0.41 (95% CI = 0.25 -0.56) per 100 women 3 years later. CONCLUSION: MDR had a marked effect on resources, management and maternal outcomes in this facility. However, given the design of our study and the local specific context, further research is needed to confirm the feasibility of MDR in other settings and to confirm the benefits of this approach for maternal health in developing countries. PMID:16583081

  3. Certification/enforcement analysis

    SciTech Connect

    1980-06-01

    Industry compliance with minimum energy efficiency standards will be assured through a two-part program approach of certification and enforcement activities. The technical support document (TSD) presents the analyses upon which the proposed rule for assuring that consumer product comply with applicable energy efficiency standards is based. Much of the TSD is based upon support provided DOE by Vitro Laboratories. The OAO Corporation provided additional support in the development of the sampling plan incorporated in the proposed rule. Vitro's recommended approach to appliance certification and enforcement, developed after consideration of various program options, benefits, and impacts, establishes the C/E program framework, general criteria, and procedures for assuring a specified level of energy efficiency performance of covered consumer products. The results of the OAO analysis are given in Volume II of the TSD.

  4. Medical Examiners and Manner of Death.

    ERIC Educational Resources Information Center

    Jarvis, George K.; And Others

    1991-01-01

    Experimental study of medical examiners produced manner of death determinations from simulated cases to examine interexaminer variation in certification judgments. Found that experience, residence, and religious background of examiner were related to judgments as were victim characteristics of gender, medical cause of death, and the presence of…

  5. Age-at-death estimation based on radiological and image analysis methods in clavicle in a current Spanish population.

    PubMed

    Benito, María; Sánchez, José Antonio; Codinha, Sónia

    2014-05-01

    Age-at-death estimation in adult individuals is one of the most challenging issues in forensic anthropology, namely, due to the large age intervals provided by the current methods, which demand the development of more reliable investigations. The clavicle has been studied as an age-at-death indicator in many researches for its accessibility, low biomechanical implication in locomotion and accuracy to predict age at death when other age indicators are not available. The present study was developed on a sample of 332 clavicles from adult individuals of known sex and age from the current Spanish population. They were x-rayed and digitalized, in a standardized way, using a Sedecal X-ray generator, model SHF 415. Three indices were calculated at the mid-diaphysis point (anterior index, posterior index, and total index) which relate the cortical thickness and the total clavicle thickness to age at death. The average grey level was also calculated in a 0.5-cm(2) area of the sternal and acromial ends (sternal grey average, acromial grey average), using Image J software. The data were subjected to a statistical analysis, using SPSS, version 15.0. The results show that average grey level has a weaker correlation with age than the variables which are based on the cortical thickness. On the other hand, the regression equations, which were calculated combining all the variables, provided smaller age-at-death intervals, demonstrating the usefulness of this method for adult age-at-death estimation in forensic anthropology.

  6. Brain death.

    PubMed

    Wijdicks, Eelco F M

    2013-01-01

    The diagnosis of brain death should be based on a simple premise. If every possible confounder has been excluded and all possible treatments have been tried or considered, irreversible loss of brain function is clinically recognized as the absence of brainstem reflexes, verified apnea, loss of vascular tone, invariant heart rate, and, eventually, cardiac standstill. This condition cannot be reversed - not even partly - by medical or surgical intervention, and thus is final. Many countries in the world have introduced laws that acknowledge that a patient can be declared brain-dead by neurologic standards. The U.S. law differs substantially from all other brain death legislation in the world because the U.S. law does not spell out details of the neurologic examination. Evidence-based practice guidelines serve as a standard. In this chapter, I discuss the history of development of the criteria, the current clinical examination, and some of the ethical and legal issues that have emerged. Generally, the concept of brain death has been accepted by all major religions. But patients' families may have different ideas and are mostly influenced by cultural attitudes, traditional customs, and personal beliefs. Suggestions are offered to support these families.

  7. A district-based audit of the causes and circumstances of maternal deaths in South Kalimantan, Indonesia.

    PubMed Central

    Supratikto, Gunawan; Wirth, Meg E.; Achadi, Endang; Cohen, Surekha; Ronsmans, Carine

    2002-01-01

    A district-based audit of maternal and perinatal mortality began during 1994 in three provinces of South Kalimantan, Indonesia. Both medical and non-medical factors were documented and an effort was made to progress from merely assessing substandard care to recommending improvements in access to care and the quality of care. Extensive discussions of cases of maternal death were held during regular meetings with providers, policy-makers and community members. The sources of information included verbal autopsies with family members and medical records. Between 1995 and 1999 the audit reviewed 130 maternal deaths. The leading causes of death were haemorrhage (41%) and hypertensive diseases (32%). Delays in decision-making and poor quality of care in health facilities were seen as contributory factors in 77% and 60% of the deaths, respectively. Economic constraints were believed to have contributed to 37% of the deaths. The distance between a patient's home and a health provider or facility did not appear to have a significant influence, nor did transport problems. The audit led to changes in the quality of obstetric care in the district. Its success was particularly attributable to the process of accountability of both health providers and policy-makers and to improved working relationships between health providers at different levels and between providers and the community. With a view to the continuation and further expansion of the audit it may be necessary to reconsider the role of the provincial team, the need of health providers for confidentiality, the added benefit of facility-based audits, the need to incorporate scientific evidence into the review process, and the possible consideration of severe complications as well as deaths. It may also be necessary to recognize that village midwives are not solely responsible for maternal deaths. PMID:11984609

  8. Effect of medium/ω-6 long chain triglyceride-based emulsion on leucocyte death and inflammatory gene expression

    PubMed Central

    Cury-Boaventura, M F; Gorjão, R; Martins de Lima, T; Fiamoncini, J; Godoy, A B P; Deschamphs, F C; Soriano, F G; Curi, R

    2011-01-01

    Lipid emulsion (LE) containing medium/ω-6 long chain triglyceride-based emulsion (MCT/ω-6 LCT LE) has been recommended in the place of ω-6 LCT-based emulsion to prevent impairment of immune function. The impact of MCT/ω-6 LCT LE on lymphocyte and neutrophil death and expression of genes related to inflammation was investigated. Seven volunteers were recruited and infusion of MCT/ω-6 LCT LE was performed for 6 h. Four volunteers received saline and no change was found. Blood samples were collected before, immediately afterwards and 18 h after LE infusion. Lymphocytes and neutrophils were studied immediately after isolation and after 24 and 48 h in culture. The following determinations were carried out: plasma-free fatty acids, triacylglycerol and cholesterol concentrations, plasma fatty acid composition, neutral lipid accumulation in lymphocytes and neutrophils, signs of lymphocyte and neutrophil death and lymphocyte expression of genes related to inflammation. MCT/ω-6 LCT LE induced lymphocyte and neutrophil death. The mechanism for MCT/ω-6 LCT LE-dependent induction of leucocyte death may involve changes in neutral lipid content and modulation of expression of genes related to cell death, proteolysis, cell signalling, inflammatory response, oxidative stress and transcription. PMID:21682721

  9. Befriending death: A mindfulness-based approach to cultivating self-awareness in counselling students.

    PubMed

    Stella, Maria

    2016-01-01

    The importance of self-awareness in counselling education is widely recognized; however, strengthening this vital aspect is often left to educators' discretion. The author addresses this deficiency by first exploring four theoretical constructs: mindfulness, emotional regulation, death anxiety, and relationship dynamics. Then, she outlines a practical learning activity on the topic of death. The main exercise involves a guided meditation in which students imagine both a worst-case and best-case scenario of their own death, while practicing mindfulness, followed by a debriefing period and a written self-reflection. This activity can be used by educators to promote greater self-awareness in master's level counselling students.

  10. Parity, Age at First Birth, and Risk of Death from Non-Hodgkin's Lymphoma: A Population-Based Cohort Study in Taiwan.

    PubMed

    Chen, Brian K; Yang, Chun-Yuh

    2015-08-05

    We undertook this study to examine whether there exists an association between parity and age at first birth and risk of death from non-Hodgkin's lymphoma (NHL). Our sample included a total of 1,292,462 women who had a first and singleton childbirth between 1 January 1978 and 31 December 1987. We followed each subject from their first childbirth to 31 December 2009, and determined their vital status by merging natality data with Taiwan's national death certificate database. Hazard ratios (HR) of death from NHL associated with parity and age at first birth were estimated using Cox proportional hazard regression models. In all, 412 NHL deaths were recorded during 34,980,246 person-years of follow-up. NHL mortality rate was 1.18 cases per 100,000 person-years. Older age at first birth (>23 vs. ≤23 years) was linked to an increased risk of death from NHL (adjusted HR = 1.41; 95% CI = 1.13-1.75). Controlling for age at first birth, the adjusted HR were 0.74 (95% CI = 0.55-0.98) for women with 2 births, and 0.71 (95% CI = 0.53-0.95) for women with 3 births or more, respectively, when compared with women with only 1 birth. A statistically significant downward trend in the adjusted HR for NHL death was detected with increasing parity (p for trend = 0.05). The HR of death from NHL was decreased by 7% (HR = 0.93; 95% CI = 0.87-0.99) for each additional parity. Our findings are consistent with reproductive factors (parity and early age at first birth) conferring a protective effect against the risk of NHL death.

  11. Fast and secure handover of intra-ASN IEEE802.16 network by proposed certificate based pre-authentication

    NASA Astrophysics Data System (ADS)

    Sridevi, B.; Supriya, T. S.; Rajaram, S.

    2013-01-01

    The current generation of wireless networks has been designed predominantly to support voice and more recently data traffic. WiMAX is currently one of the hottest technologies in wireless. The main motive of the mobile technologies is to provide seamless cost effective mobility. But this is affected by Authentication cost and handover delay since on each handoff the Mobile Station (MS) has to undergo all steps of authentication. Pre-Authentication is used to reduce the handover delay and increase the speed of the Intra-ASN Handover. Proposed Pre-Authentication method is intended to reduce the authentication delay by getting pre authenticated by central authority called Pre Authentication Authority (PAA). MS requests PAA for Pre Authentication Certificate (PAC) before performing handoff. PAA verifies the identity of MS and provides PAC to MS and also to the neighboring target Base Stations (tBSs). MS having time bound PAC can skip the authentication process when recognized by target BS during handoff. It also prevents the DOS (Denial Of Service) attack and Replay attack. It has no wastage of unnecessary key exchange of the resources. The proposed work is simulated by NS2 model and by MATLAB.

  12. Certification Change versus Actual Behavior Change in Teenage Suicide Rates, 1955-1979.

    ERIC Educational Resources Information Center

    Gist, Richard; Welch, Q. B.

    1989-01-01

    Examined national data on firearm suicides and accidental deaths for 15- through 19-year-olds from 1955-1979. Considered improved accuracy in determination and certification of suicide in equivocal firearm deaths, actual increases in rate of firearm suicides, or combination. Data support hypothesis of certification changes as primary factor…

  13. Reflection on family consent: based on a pregnant death in a Beijing hospital.

    PubMed

    Zhang, Xinqing

    2012-12-01

    The 'family consent' process has been placed at the centre of Chinese clinical practice. Although there has been critical analysis of how the process functions in relation to the autonomy and rights of patients, there has been little examination of the perceptions and attitude of patients and their families and the medical professionals, in relation to moral dilemmas that arise in real cases in the bioethical discourse. When faced with a consent form in an emergency situation, the family member's capacity to act is reduced, as he/she becomes enmeshed in the hospital structure of tacit, socially-imposed rules. In a questionnaires based on a real death case in 2008, 70.9% of the surveyed medical professionals (n = 3,665) disagreed with performing surgery without the consent of the family even if the patient's life was in danger, while 36.6% of the surveyed patients (n = 1,198) hold the same position. This work demonstrates the weakness of the family consent process as a safeguard of patient's autonomy. Finally, I argue that saving the patient's life should be the overriding obligation rather than the respect for the surrogate's autonomous choice at such a decisive moment.

  14. DNA methylation-based measures of biological age: meta-analysis predicting time to death.

    PubMed

    Chen, Brian H; Marioni, Riccardo E; Colicino, Elena; Peters, Marjolein J; Ward-Caviness, Cavin K; Tsai, Pei-Chien; Roetker, Nicholas S; Just, Allan C; Demerath, Ellen W; Guan, Weihua; Bressler, Jan; Fornage, Myriam; Studenski, Stephanie; Vandiver, Amy R; Moore, Ann Zenobia; Tanaka, Toshiko; Kiel, Douglas P; Liang, Liming; Vokonas, Pantel; Schwartz, Joel; Lunetta, Kathryn L; Murabito, Joanne M; Bandinelli, Stefania; Hernandez, Dena G; Melzer, David; Nalls, Michael; Pilling, Luke C; Price, Timothy R; Singleton, Andrew B; Gieger, Christian; Holle, Rolf; Kretschmer, Anja; Kronenberg, Florian; Kunze, Sonja; Linseisen, Jakob; Meisinger, Christine; Rathmann, Wolfgang; Waldenberger, Melanie; Visscher, Peter M; Shah, Sonia; Wray, Naomi R; McRae, Allan F; Franco, Oscar H; Hofman, Albert; Uitterlinden, André G; Absher, Devin; Assimes, Themistocles; Levine, Morgan E; Lu, Ake T; Tsao, Philip S; Hou, Lifang; Manson, JoAnn E; Carty, Cara L; LaCroix, Andrea Z; Reiner, Alexander P; Spector, Tim D; Feinberg, Andrew P; Levy, Daniel; Baccarelli, Andrea; van Meurs, Joyce; Bell, Jordana T; Peters, Annette; Deary, Ian J; Pankow, James S; Ferrucci, Luigi; Horvath, Steve

    2016-09-28

    Estimates of biological age based on DNA methylation patterns, often referred to as "epigenetic age", "DNAm age", have been shown to be robust biomarkers of age in humans. We previously demonstrated that independent of chronological age, epigenetic age assessed in blood predicted all-cause mortality in four human cohorts. Here, we expanded our original observation to 13 different cohorts for a total sample size of 13,089 individuals, including three racial/ethnic groups. In addition, we examined whether incorporating information on blood cell composition into the epigenetic age metrics improves their predictive power for mortality. All considered measures of epigenetic age acceleration were predictive of mortality (p≤8.2x10(-9)), independent of chronological age, even after adjusting for additional risk factors (p<5.4x10(-4)), and within the racial/ethnic groups that we examined (non-Hispanic whites, Hispanics, African Americans). Epigenetic age estimates that incorporated information on blood cell composition led to the smallest p-values for time to death (p=7.5x10(-43)). Overall, this study a) strengthens the evidence that epigenetic age predicts all-cause mortality above and beyond chronological age and traditional risk factors, and b) demonstrates that epigenetic age estimates that incorporate information on blood cell counts lead to highly significant associations with all-cause mortality.

  15. DNA methylation-based measures of biological age: meta-analysis predicting time to death

    PubMed Central

    Chen, Brian H.; Marioni, Riccardo E.; Colicino, Elena; Peters, Marjolein J.; Ward-Caviness, Cavin K.; Tsai, Pei-Chien; Roetker, Nicholas S.; Just, Allan C.; Demerath, Ellen W.; Guan, Weihua; Bressler, Jan; Fornage, Myriam; Studenski, Stephanie; Vandiver, Amy R.; Moore, Ann Zenobia; Tanaka, Toshiko; Kiel, Douglas P.; Liang, Liming; Vokonas, Pantel; Schwartz, Joel; Lunetta, Kathryn L.; Murabito, Joanne M.; Bandinelli, Stefania; Hernandez, Dena G.; Melzer, David; Nalls, Michael; Pilling, Luke C.; Price, Timothy R.; Singleton, Andrew B.; Gieger, Christian; Holle, Rolf; Kretschmer, Anja; Kronenberg, Florian; Kunze, Sonja; Linseisen, Jakob; Meisinger, Christine; Rathmann, Wolfgang; Waldenberger, Melanie; Visscher, Peter M.; Shah, Sonia; Wray, Naomi R.; McRae, Allan F.; Franco, Oscar H.; Hofman, Albert; Uitterlinden, André G.; Absher, Devin; Assimes, Themistocles; Levine, Morgan E.; Lu, Ake T.; Tsao, Philip S.; Hou, Lifang; Manson, JoAnn E.; Carty, Cara L.; LaCroix, Andrea Z.; Reiner, Alexander P.; Spector, Tim D.; Feinberg, Andrew P.; Levy, Daniel; Baccarelli, Andrea; van Meurs, Joyce; Bell, Jordana T.; Peters, Annette; Deary, Ian J.; Pankow, James S.; Ferrucci, Luigi; Horvath, Steve

    2016-01-01

    Estimates of biological age based on DNA methylation patterns, often referred to as “epigenetic age”, “DNAm age”, have been shown to be robust biomarkers of age in humans. We previously demonstrated that independent of chronological age, epigenetic age assessed in blood predicted all-cause mortality in four human cohorts. Here, we expanded our original observation to 13 different cohorts for a total sample size of 13,089 individuals, including three racial/ethnic groups. In addition, we examined whether incorporating information on blood cell composition into the epigenetic age metrics improves their predictive power for mortality. All considered measures of epigenetic age acceleration were predictive of mortality (p≤8.2×10−9), independent of chronological age, even after adjusting for additional risk factors (p<5.4×10−4), and within the racial/ethnic groups that we examined (non-Hispanic whites, Hispanics, African Americans). Epigenetic age estimates that incorporated information on blood cell composition led to the smallest p-values for time to death (p=7.5×10−43). Overall, this study a) strengthens the evidence that epigenetic age predicts all-cause mortality above and beyond chronological age and traditional risk factors, and b) demonstrates that epigenetic age estimates that incorporate information on blood cell counts lead to highly significant associations with all-cause mortality. PMID:27690265

  16. Certificates: Gateway to Gainful Employment and College Degrees

    ERIC Educational Resources Information Center

    Carnevale, Anthony P.; Rose, Stephen J.; Hanson, Andrew R.

    2012-01-01

    Certificates are recognition of completion of a course of study based on a specific field, usually associated with a limited set of occupations. Certificates differ from other kinds of labor market credentials such as industry-based certifications and licenses, which typically involve passing an examination to prove a specific competency,…

  17. Deaths from heart failure: using coarsened exact matching to correct cause-of-death statistics

    PubMed Central

    2010-01-01

    Background Incomplete information on death certificates makes recorded cause-of-death data less useful for public health monitoring and planning. Certifying physicians sometimes list only the mode of death without indicating the underlying disease or diseases that led to the death. Inconsistent cause-of-death assignment among cardiovascular causes of death is of particular concern. This can prevent valid epidemiologic comparisons across countries and over time. Methods We propose that coarsened exact matching be used to infer the underlying causes of death where only the mode of death is known. We focus on the case of heart failure in US, Mexican, and Brazilian death records. Results Redistribution algorithms derived using this method assign the largest proportion of heart failure deaths to ischemic heart disease in all three countries (53%, 26%, and 22% respectively), with larger proportions assigned to hypertensive heart disease and diabetes in Mexico and Brazil (16% and 23% vs. 7% for hypertensive heart disease, and 13% and 9% vs. 6% for diabetes). Reassigning these heart failure deaths increases the US ischemic heart disease mortality rate by 6%. Conclusions The frequency with which physicians list heart failure in the causal chain for various underlying causes of death allows for inference about how physicians use heart failure on the death certificate in different settings. This easy-to-use method has the potential to reduce bias and increase comparability in cause-of-death data, thereby improving the public health utility of death records. PMID:20388206

  18. Killing by organ procurement: brain-based death and legal fictions.

    PubMed

    Veatch, Robert M

    2015-06-01

    The dead donor rule (DDR) governs procuring life-prolonging organs. They should be taken only from deceased donors. Miller and Truog have proposed abandoning the rule when patients have decided to forgo life-sustaining treatment and have consented to procurement. Organs could then be procured from living patients, thus killing them by organ procurement. This proposal warrants careful examination. They convincingly argue that current brain or circulatory death pronouncement misidentifies the biologically dead. After arguing convincingly that physicians already cause death by withdrawing treatment, they claim no bright-line differences preclude organ removal from the living. The argument fails for those who accept the double effect doctrine or other grounds for distinguishing forgoing life support from active, intentional killing. If the goal is determining irreversible loss of somatic function, they correctly label current death pronouncement a "legal fiction." Recognizing a second, public policy meaning of the term death provides grounds for maintaining the DDR without jeopardizing procurement.

  19. Hospital-based study of severe malaria and associated deaths in Myanmar.

    PubMed Central

    Ejov, M. N.; Tun, T.; Aung, S.; Lwin, S.; Sein, K.

    1999-01-01

    The present study identifies factors that contribute to malaria deaths in township hospitals reporting large numbers of such deaths in Myanmar. Between July and December 1995, we identified a total of 101 patients with severe and complicated malaria by screening the cases admitted to hospital with a primary diagnosis of falciparum malaria. Unrousable coma and less marked impairment of consciousness with or without other severe malaria complications, in contrast to severe malaria anaemia, were associated with all malaria deaths. Adult patients with severe malaria were 2.8 times more likely to die than child patients, with the higher risk of death among adults probably being associated with previous exposure to malaria, delay in seeking treatment and severity of the illness before admission. In view of this, we consider that malaria mortality could be reduced by improving peripheral facilities for the management of severe malaria and providing appropriate education to communities, without stepping up vector control activities. PMID:10327709

  20. Voodoo death.

    PubMed

    Lester, David

    2009-01-01

    Scholarly writing on voodoo death is reviewed. Criticisms that voodoo deaths in indigenous societies have never been well documented are refuted with cases medically documented in developed nations. The work of Cannon and Richter on sudden death in animals is reviewed and dismissed as irrelevant for understanding voodoo death. The role of starvation and dehydration is discussed, and it is suggested that the given-up/giving-up hypothesis best fits the phenomenon of voodoo death. Hypotheses for future research are suggested.

  1. Bereavement after sibling death: a population-based longitudinal case-control study.

    PubMed

    Bolton, James M; Au, Wendy; Chateau, Dan; Walld, Randy; Leslie, William D; Enns, Jessica; Martens, Patricia J; Katz, Laurence Y; Logsetty, Sarvesh; Sareen, Jitender

    2016-02-01

    The objective of this study was to examine mental disorders and treatment use among bereaved siblings in the general population. Siblings (N=7243) of all deceased children in the population of Manitoba, Canada who died between 1984 and 2009 were matched 1:3 to control siblings (N=21,729) who did not have a sibling die in the study period. Generalized estimating equations were used to compare the two sibling groups in the two years before and after the index child's death on physician-diagnosed mental disorders and treatment utilization, with adjustment for confounding factors including pre-existing mental illness. Analyses were stratified by age of the bereaved (<13 vs. 13+). Results revealed that, in the two years after the death of the child, bereaved siblings had significantly higher rates of mental disorders than control siblings, even after adjusting for pre-existing mental illness. When comparing the effect of a child's death on younger versus older siblings, the rise in depression rates from pre-death to post-death was significantly higher for siblings aged under 13 (p<0.0001), increasing more than 7-fold (adjusted relative rate, ARR=7.25, 95% CI: 3.65-14.43). Bereaved siblings aged 13+ had substantial morbidity in the two years after the death: 25% were diagnosed with a mental disorder (vs. 17% of controls), and they had higher rates of almost all mental disorder outcomes compared to controls, including twice the rate of suicide attempts (ARR=2.01, 95% CI: 1.29-3.12). Siblings in the bereaved cohort had higher rates of alcohol and drug use disorders already before the death of their sibling. In conclusion, the death of a child is associated with considerable mental disorder burden among surviving siblings. Pre-existing health problems and social disadvantage do not fully account for the increase in mental disorder rates.

  2. Community based maternal death review: lessons learned from ten districts in Andhra Pradesh, India.

    PubMed

    Singh, Samiksha; Murthy, Gudlavalleti V S; Thippaiah, Anitha; Upadhyaya, Sanjeev; Krishna, Murali; Shukla, Rajan; Srikrishna, S R

    2015-07-01

    Maternal death is as much a social phenomenon as a medical event. Maternal death review (MDR), a strategy for monitoring maternal deaths, provides information on medical, social and health system factors that should be addressed to redress gaps in service provision or utilisation. To strengthen MDR implementation in the state of Andhra Pradesh, India. The project involved development of state specific guidelines, technical assistance in operationalization and analysing processes and findings of MDR in ten districts. 284 deaths were recorded over 6 months (April-September 2012) of which 193 (75.4 %) could be reviewed. Post-partum haemorrhage (24 %) and hypertensive disorders (27.4 %) followed by puerperal sepsis in the post-partum period (16.8 %) were the leading causes of maternal deaths. 68.3 % deaths occurred at health facilities. 67 % of mothers dying during the natal or post-natal period, delivered at home, though the death occurred in a health facility. Type 1 delay (58.9 %) was the most common underlying cause of death, followed by type 3 delay (33.3 %). Under or nil reporting from the facilities was observed. Program staff could identify broad areas of intervention but lacked capacity to monitor, analyse, interpret and utilize the generated information to develop feasible actionable plans. Information gathered was incomplete and inaccurate in many cases. Challenges observed showed that it will require more time and continuous committed efforts of health staff for implementation of high quality MDR. Successful implementation will improve the response of the health system and contribute to improved maternal health.

  3. Predictors of Place of Death for Seniors in Ontario: A Population-Based Cohort Analysis

    ERIC Educational Resources Information Center

    Motiwala, Sanober S.; Croxford, Ruth; Guerriere, Denise N.; Coyte, Peter C.

    2006-01-01

    Place of death was determined for all 58,689 seniors (age greater than or equal to 66 years) in Ontario who died during fiscal year 2001/2002. The relationship of place of death to medical and socio-demographic characteristics was examined using a multinomial logit model. Half (49.2 %) of these individuals died in hospital, 30.5 per cent died in a…

  4. Alternative certification science teachers' understanding and implementation of inquiry-based instruction in their beginning years of teaching

    NASA Astrophysics Data System (ADS)

    Demir, Abdulkadir

    The purpose of this phenomenographic study was to: (a) understand how beginning science teachers recruited from various science disciplines and prepared in an Alternative Teacher Certification Program (ATCP) implemented inquiry during their initial years of teaching; (b) describe constraints and needs that these beginning science teachers perceived in implementing inquiry-based science instruction; and (c) understand the relation between what they learned in their ATCP and their practice of teaching science through inquiry. The participants of this study consisted of four ATCP teachers who are in their beginning years of teaching. Semi-structured interviews, classroom observation, field notes, and artifacts used as source of data collection. The beginning science teachers in this study held incomplete views of inquiry. These views of inquiry did not reflect inquiry as described in NRC (2000)---essential features of inquiry,---nor did they reflect views of faculty members involved in teaching science methods courses. Although the participants described themselves as reform-oriented, there were inconsistencies between their views and practices. Their practice of inquiry did not reflect inquiry either as outlined by essential features of inquiry (NRC, 2000) or inquiry as modeled in activities used in their ATCP. The research participants' perceived constraints and needs in their implementation of inquiry-based activities. Their perceived constraints included logistical and student constraints and school culture. The perceived needs included classroom management, pedagogical skills, practical knowledge, discipline, successful grade-specific models of inquiry, and access to a strong support system. Prior professional work experience, models and activities used in the ATCP, and benefits of inquiry to student learning were the declared factors that facilitated the research participants' practice of inquiry-based teaching.

  5. A toxicology-based review of fentanyl-related deaths in New Mexico (1986-2007).

    PubMed

    Krinsky, Clarissa S; Lathrop, Sarah L; Crossey, Michael; Baker, Ginger; Zumwalt, Ross

    2011-12-01

    Since its approval in the United States, fentanyl has become increasingly popular for the medical management of pain and as a substance of abuse. Fentanyl is unique among the opioids in its widespread use with a transdermal delivery system, which contributes to its unique pharmacokinetics and abuse potential. We examined the demographics of deaths with fentanyl identified on toxicologic analysis and reviewed specific challenges in the laboratory detection of postmortem fentanyl levels. The New Mexico Office of the Medical Investigator database was searched for all cases from January 1986 through December 2007 with fentanyl reported as present or quantified. Those deaths with a cause of death identified as drug overdose were then analyzed separately. From 1986 to 2007, 154 cases were identified with fentanyl present in postmortem samples, with 96 of the cases identified as fentanyl-related drug overdoses. The number of fentanyl-related deaths has increased over the past 20 years, corresponding to both statewide increases in the medical use of fentanyl and the abuse of prescription opioids. The demographics of these fentanyl-related overdoses showed that subjects were more likely to be female, white non-Hispanic, and older than those in previously described overdose deaths. Several cases were identified with central and peripheral blood samples and antemortem and postmortem samples available for fentanyl quantification. Given the uncharacteristic demographics of fentanyl-related deaths and the complexity of the laboratory analysis of fentanyl, forensic scientists must use caution in both the detection and interpretation of fentanyl concentrations.

  6. Application of Principles of Performance-Based Assessment to Corporate Certifications

    ERIC Educational Resources Information Center

    Foshay, Wellesley R.; Hale, Judith

    2017-01-01

    Performance based assessment is currently receiving renewed attention as an alternative to conventional testing. We argue that performance based assessment, supported by a microcredentialing system, is particularly well suited to corporate environments that stress strategic development of their workforce capacities. There are important…

  7. 78 FR 35115 - Listing of Color Additives Exempt From Certification; Mica-Based Pearlescent Pigments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-12

    ... provide for the safe use of mica-based pearlescent pigments prepared from titanium dioxide and mica as... weight in the distilled spirits. Mica-based pearlescent pigments prepared from titanium dioxide and mica... from titanium dioxide, iron oxide, and mica are permitted for use as color additives in ingested...

  8. Effect of Cause-of-Death Training on Agreement Between Hospital Discharge Diagnoses and Cause of Death Reported, Inpatient Hospital Deaths, New York City, 2008–2010

    PubMed Central

    Ong, Paulina; Gambatese, Melissa; Begier, Elizabeth; Zimmerman, Regina; Soto, Antonio

    2015-01-01

    Introduction Accurate cause-of-death reporting is required for mortality data to validly inform public health programming and evaluation. Research demonstrates overreporting of heart disease on New York City death certificates. We describe changes in reported causes of death following a New York City health department training conducted in 2009 to improve accuracy of cause-of-death reporting at 8 hospitals. The objective of our study was to assess the degree to which death certificates citing heart disease as cause of death agreed with hospital discharge data and the degree to which training improved accuracy of reporting. Methods We analyzed 74,373 death certificates for 2008 through 2010 that were linked with hospital discharge records for New York City inpatient deaths and calculated the proportion of discordant deaths, that is, death certificates reporting an underlying cause of heart disease with no corresponding discharge record diagnosis. We also summarized top principal diagnoses among discordant reports and calculated the proportion of inpatient deaths reporting sepsis, a condition underreported in New York City, to assess whether documentation practices changed in response to clarifications made during the intervention. Results Citywide discordance between death certificates and discharge data decreased from 14.9% in 2008 to 9.6% in 2010 (P < .001), driven by a decrease in discordance at intervention hospitals (20.2% in 2008 to 8.9% in 2010; P < .001). At intervention hospitals, reporting of sepsis increased from 3.7% of inpatient deaths in 2008 to 20.6% in 2010 (P < .001). Conclusion Overreporting of heart disease as cause of death declined at intervention hospitals, driving a citywide decline, and sepsis reporting practices changed in accordance with health department training. Researchers should consider the effect of overreporting and data-quality changes when analyzing New York City heart disease mortality trends. Other vital records jurisdictions

  9. 78 FR 54758 - Listing of Color Additives Exempt From Certification; Mica-Based Pearlescent Pigments...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-06

    ... regulations to provide for the safe use of mica-based pearlescent pigments prepared from titanium dioxide and... titanium dioxide and mica as color additives in distilled spirits containing not less than 18 percent...

  10. Cardiovascular Deaths among Alaskan Natives, 1980-86.

    ERIC Educational Resources Information Center

    Middaugh, John P.

    1990-01-01

    Analyzes death certificate data to discover the number of deaths of Alaskan natives caused by cardiovascular disease. Rates from cardiovascular diseases and atherosclerosis from 1980-86 among Alaskan natives were lower than rates among other Alaskans, while death rates from other causes were higher. Discusses the possible impact of diet. (JS)

  11. Software Certification and Software Certificate Management Systems

    NASA Technical Reports Server (NTRS)

    Denney, Ewen; Fischer, Bernd

    2005-01-01

    Incremental certification and re-certification of code as it is developed and modified is a prerequisite for applying modem, evolutionary development processes, which are especially relevant for NASA. For example, the Columbia Accident Investigation Board (CAIB) report 121 concluded there is "the need for improved and uniform statistical sampling, audit, and certification processes". Also, re-certification time has been a limiting factor in making changes to Space Shuttle code close to launch time. This is likely to be an even bigger problem with the rapid turnaround required in developing NASA s replacement for the Space Shuttle, the Crew Exploration Vehicle (CEV). Hence, intelligent development processes are needed which place certification at the center of development. If certification tools provide useful information, such as estimated time and effort, they are more likely to be adopted. The ultimate impact of such a tool will be reduced effort and increased reliability.

  12. A CRISPR-Based Screen Identifies Genes Essential for West-Nile-Virus-Induced Cell Death.

    PubMed

    Ma, Hongming; Dang, Ying; Wu, Yonggan; Jia, Gengxiang; Anaya, Edgar; Zhang, Junli; Abraham, Sojan; Choi, Jang-Gi; Shi, Guojun; Qi, Ling; Manjunath, N; Wu, Haoquan

    2015-07-28

    West Nile virus (WNV) causes an acute neurological infection attended by massive neuronal cell death. However, the mechanism(s) behind the virus-induced cell death is poorly understood. Using a library containing 77,406 sgRNAs targeting 20,121 genes, we performed a genome-wide screen followed by a second screen with a sub-library. Among the genes identified, seven genes, EMC2, EMC3, SEL1L, DERL2, UBE2G2, UBE2J1, and HRD1, stood out as having the strongest phenotype, whose knockout conferred strong protection against WNV-induced cell death with two different WNV strains and in three cell lines. Interestingly, knockout of these genes did not block WNV replication. Thus, these appear to be essential genes that link WNV replication to downstream cell death pathway(s). In addition, the fact that all of these genes belong to the ER-associated protein degradation (ERAD) pathway suggests that this might be the primary driver of WNV-induced cell death.

  13. 47 CFR 64.606 - Internet-based TRS provider and TRS program certification.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... CARRIER SERVICES (CONTINUED) MISCELLANEOUS RULES RELATING TO COMMON CARRIERS Telecommunications Relay... of Internet-based TRS to be provided (i.e., VRS, IP Relay, and/or IP captioned telephone relay... IP Relay providers certified under this section must notify the Commission of substantive changes...

  14. 47 CFR 64.606 - Internet-based TRS provider and TRS program certification.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... CARRIER SERVICES (CONTINUED) MISCELLANEOUS RULES RELATING TO COMMON CARRIERS Telecommunications Relay... of Internet-based TRS to be provided (i.e., VRS, IP Relay, and/or IP captioned telephone relay... IP Relay providers certified under this section must notify the Commission of substantive changes...

  15. 47 CFR 64.606 - Internet-based TRS provider and TRS program certification.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... CARRIER SERVICES (CONTINUED) MISCELLANEOUS RULES RELATING TO COMMON CARRIERS Telecommunications Relay... of Internet-based TRS to be provided (i.e., VRS, IP Relay, and/or IP captioned telephone relay... IP Relay providers certified under this section must notify the Commission of substantive changes...

  16. 47 CFR 64.606 - Internet-based TRS provider and TRS program certification.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... CARRIER SERVICES (CONTINUED) MISCELLANEOUS RULES RELATING TO COMMON CARRIERS Telecommunications Relay... of Internet-based TRS to be provided (i.e., VRS, IP Relay, and/or IP captioned telephone relay... IP Relay providers certified under this section must notify the Commission of substantive changes...

  17. 16 CFR 1204.14 - Certification tests.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... STANDARD FOR OMNIDIRECTIONAL CITIZENS BAND BASE STATION ANTENNAS Certification § 1204.14 Certification... testing program for a particular model of CB antennas is one which demonstrates with a high degree of assurance that all the antennas of that model will meet all requirements of the standard. Manufacturers...

  18. 16 CFR 1204.14 - Certification tests.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... STANDARD FOR OMNIDIRECTIONAL CITIZENS BAND BASE STATION ANTENNAS Certification § 1204.14 Certification... testing program for a particular model of CB antennas is one which demonstrates with a high degree of assurance that all the antennas of that model will meet all requirements of the standard. Manufacturers...

  19. 16 CFR 1204.14 - Certification tests.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... STANDARD FOR OMNIDIRECTIONAL CITIZENS BAND BASE STATION ANTENNAS Certification § 1204.14 Certification... testing program for a particular model of CB antennas is one which demonstrates with a high degree of assurance that all the antennas of that model will meet all requirements of the standard. Manufacturers...

  20. 16 CFR 1204.14 - Certification tests.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 2 2012-01-01 2012-01-01 false Certification tests. 1204.14 Section 1204.14... tests. (a) General. As explained in § 1204.11 of this subpart, certificates of compliance required by section 14(a) of the act must be based on either a test of each item or on a reasonable testing...

  1. Mortality, Causes of Death and Associated Factors Relate to a Large HIV Population-Based Cohort

    PubMed Central

    Miró, Josep M.; Ocaña, Inma; Knobel, Hernando; Barberá, Maria Jesús; Humet, Victoria; Domingo, Pere; Gatell, Josep M.; Ribera, Esteve; Gurguí, Mercè; Marco, Andrés

    2015-01-01

    Introduction Antiretroviral therapy has led to a decrease in HIV-related mortality and to the emergence of non-AIDS defining diseases as competing causes of death. This study estimates the HIV mortality rate and their risk factors with regard to different causes in a large city from January 2001 to June 2013. Materials and Methods We followed-up 3137 newly diagnosed HIV non-AIDS cases. Causes of death were classified as HIV-related, non-HIV-related and external. We examined the effect of risk factors on survival using mortality rates, Kaplan-Meier plots and Cox models. Finally, we estimated survival for each main cause of death groups through Fine and Gray models. Mortality Results 182 deaths were found [14.0/1000 person-years of follow-up (py); 95% confidence interval (CI):12.0–16.1/1000 py], 81.3% of them had a known cause of death. Mortality rate by HIV-related causes and non-HIV-related causes was the same (4.9/1000 py; CI:3.7–6.1/1000 py), external was lower [1.7/1000 py; (1.0–2.4/1000 py)]. Survival Results Kaplan-Meier estimate showed worse survival in intravenous drug user (IDU) and heterosexuals than in men having sex with men (MSM). Factors associated with HIV-related causes of death include: IDU male (subHazard Ratio (sHR):3.2; CI:1.5–7.0) and <200 CD4 at diagnosis (sHR:2.7; CI:1.3–5.7) versus ≥500 CD4. Factors associated with non-HIV-related causes of death include: ageing (sHR:1.5; CI:1.4–1.7) and heterosexual female (sHR:2.8; CI:1.1–7.3) versus MSM. Factors associated with external causes of death were IDU male (sHR:28.7; CI:6.7–123.2) and heterosexual male (sHR:11.8; CI:2.5–56.4) versus MSM. Conclusion and Recommendation There are important differences in survival among transmission groups. Improved treatment is especially necessary in IDUs and heterosexual males. PMID:26716982

  2. Cot Deaths.

    ERIC Educational Resources Information Center

    Tyrrell, Shelagh

    1985-01-01

    Addresses the tragedy of crib deaths, giving particular attention to causes, prevention, and medical research on Sudden Infant Death Syndrome (SIDS). Gives anecdotal accounts of coping strategies used by parents and families of SIDS infants. (DT)

  3. 20 CFR 410.679 - Finality of findings with respect to other claims for benefits based on the disability or death...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... claims for benefits based on the disability or death of a miner. 410.679 Section 410.679 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK... claims for benefits based on the disability or death of a miner. Findings of fact made in a...

  4. 78 FR 3311 - Safety Enhancements, Certification of Airports

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-16

    ... Administration 14 CFR Part 139 RIN 2120-AJ70 Safety Enhancements, Certification of Airports AGENCY: Federal... pertaining to certification of airports to clarify that the applicability of these regulations is based only... intentionally false statements concerning an airport operating certificate. Finally, this final rule...

  5. Certificate Production and the Race toward Higher Degree Attainment

    ERIC Educational Resources Information Center

    State Higher Education Executive Officers, 2010

    2010-01-01

    Complete College America and FutureWorks conducted an analysis of certificate production, the value of the certificate program, and the economic benefit it provides to the region and nation. The conclusion, based on labor market demand and both personal and economic returns, is that certificates count and the policy and trends around certificates…

  6. Infant death scene investigation.

    PubMed

    Tabor, Pamela D; Ragan, Krista

    2015-01-01

    The sudden unexpected death of an infant is a tragedy to the family, a concern to the community, and an indicator of national health. To accurately determine the cause and manner of the infant's death, a thorough and accurate death scene investigation by properly trained personnel is key. Funding and resources are directed based on autopsy reports, which are only as accurate as the scene investigation. The investigation should include a standardized format, body diagrams, and a photographed or videotaped scene recreation utilizing doll reenactment. Forensic nurses, with their basic nursing knowledge and additional forensic skills and abilities, are optimally suited to conduct infant death scene investigations as well as train others to properly conduct death scene investigations. Currently, 49 states have child death review teams, which is an idea avenue for a forensic nurse to become involved in death scene investigations.

  7. Using multiple cause-of-death data to improve surveillance of drug-related mortality

    PubMed Central

    Nordstrom, David L.; Yokoi-Shelton, Mieko L.; Zosel, Amy

    2015-01-01

    Context Many state and local areas are affected by the national epidemic of drug-related mortality, which recently has shown signs of a rising licit-to-illicit drug death ratio. Appropriate local public health surveillance can help to monitor and control this epidemic. Objective Using our state as an example, we sought to illustrate how to describe the changes in drug death rates, causes, and circumstances. In contrast to most other surveillance reports, our approach includes both drug-induced and drug-related deaths and both demographic and socioeconomic decedent characteristics. Design Cross-sectional study. Setting All residents of the State of Wisconsin. Participants Decedents from 1999–2008. Main outcome measure Annual numbers and population-based rates of deaths due to drugs, including both identified and unidentified drugs. Information was obtained from death certificates with any of approximately 270 underlying, immediate, or contributing cause of death codes from the International Classification of Diseases 10th Revision. Results Drug-related death rates increased during much of the 10-year study period, and the ratio of male to female deaths rose. The median age at death from drug-related causes was 43 years. Opioid analgesic poisoning surpassed cocaine and heroin poisoning as the most frequent type of fatal drug poisoning. Of all 4828 deaths from drug-related causes--virtually all of which were certified by a county medical examiner or coroner--3,410 (71%) were unintentional, and 1,053 (22%) were suicide. The unintentional-to-suicide death rate ratio grew from 1.6 to 3.5 during the study period. Methadone-related deaths increased from 10 in 1999 to 118 in 2008 (1080%), while benzodiazepine-related deaths rose from 23 to 106 (361%). Conclusions Although premature deaths from drug use and abuse continue to rise, in some states even surpassing motor vehicle crash deaths, multiple cause of death information from death certificates is available to monitor

  8. The "Last Mile" in Standards-Based Reform: Conducting a Match Study Linking Teacher-Certification Tests to Student Standards

    ERIC Educational Resources Information Center

    Murphy, Edward J.

    2006-01-01

    States have invested significant resources in developing student academic standards. Mr. Murphy argues that, for these standards to be effective, teacher preparation and certification must be aligned with them. He proposes "match studies" as a way to ensure this alignment. (Contains 3 endnotes.)

  9. The Global Burden of Snakebite: A Literature Analysis and Modelling Based on Regional Estimates of Envenoming and Deaths

    PubMed Central

    Kasturiratne, Anuradhani; Wickremasinghe, A. Rajitha; de Silva, Nilanthi; Gunawardena, N. Kithsiri; Pathmeswaran, Arunasalam; Premaratna, Ranjan; Savioli, Lorenzo; Lalloo, David G; de Silva, H. Janaka

    2008-01-01

    Background Envenoming resulting from snakebites is an important public health problem in many tropical and subtropical countries. Few attempts have been made to quantify the burden, and recent estimates all suffer from the lack of an objective and reproducible methodology. In an attempt to provide an accurate, up-to-date estimate of the scale of the global problem, we developed a new method to estimate the disease burden due to snakebites. Methods and Findings The global estimates were based on regional estimates that were, in turn, derived from data available for countries within a defined region. Three main strategies were used to obtain primary data: electronic searching for publications on snakebite, extraction of relevant country-specific mortality data from databases maintained by United Nations organizations, and identification of grey literature by discussion with key informants. Countries were grouped into 21 distinct geographic regions that are as epidemiologically homogenous as possible, in line with the Global Burden of Disease 2005 study (Global Burden Project of the World Bank). Incidence rates for envenoming were extracted from publications and used to estimate the number of envenomings for individual countries; if no data were available for a particular country, the lowest incidence rate within a neighbouring country was used. Where death registration data were reliable, reported deaths from snakebite were used; in other countries, deaths were estimated on the basis of observed mortality rates and the at-risk population. We estimate that, globally, at least 421,000 envenomings and 20,000 deaths occur each year due to snakebite. These figures may be as high as 1,841,000 envenomings and 94,000 deaths. Based on the fact that envenoming occurs in about one in every four snakebites, between 1.2 million and 5.5 million snakebites could occur annually. Conclusions Snakebites cause considerable morbidity and mortality worldwide. The highest burden exists in

  10. An Evidence-Based Infant Safe Sleep Program to Reduce Sudden Unexplained Infant Deaths.

    PubMed

    Zachritz, Whitney; Fulmer, Megan; Chaney, Nicole

    2016-11-01

    : Objective: The purpose of this project was to design, implement, and evaluate a safe sleep program for expectant mothers and the families of infants discharged from our hospital's neonatal intensive care unit (NICU). It was prompted by the sleep-related deaths of two infants in the community, both of whom had been discharged from our NICU.

  11. Building secure wireless access point based on certificate authentication and firewall captive portal

    NASA Astrophysics Data System (ADS)

    Soewito, B.; Hirzi

    2014-03-01

    Wireless local area network or WLAN more vulnerability than wired network even though WLAN has many advantages over wired. Wireless networks use radio transmissions to carry data between end users and access point. Therefore, it is possible for someone to sit in your office building's lobby or parking lot or parking lot to eavesdrop on the wireless network communication. This paper discussed securing wires local area network used WPA2 Enterprise based PEAP MS-CHAP and Captive portal firewall. We also divided the network for employer and visitor to increase the level of security. Our experiment showed that the WLAN could be broken using the attacker tool such as airodump, aireply, and aircrack.

  12. The PD Certificate.

    ERIC Educational Resources Information Center

    Marty, Keith; Barranco, Kathy; Van Caster, Nancy

    2002-01-01

    Describes efforts by teachers and administrators in Menomonee Falls School District near Milwaukee, Wisconsin, to jointly develop a professional-development certificate for teachers. Describes requirements for earning the certificate and benefits related thereto. (PKP)

  13. The Great Certification Caper

    ERIC Educational Resources Information Center

    Tracy, Margaret H.

    1972-01-01

    A brief account is given of the author's two-year struggle to obtain school librarian certification in Pennsylvania. Current trends in several states for certification are also included. (6 references) (NH)

  14. Maternal infection and risk of intrapartum death: a population based observational study in South Asia

    PubMed Central

    2013-01-01

    Background Approximately 1.2 million stillbirths occur in the intrapartum period, and a further 717,000 annual neonatal deaths are caused by intrapartum events, most of which occur in resource poor settings. We aim to test the ‘double-hit’ hypothesis that maternal infection in the perinatal period predisposes to neurodevelopmental sequelae from an intrapartum asphyxia insult, increasing the likelihood of an early neonatal death compared with asphyxia alone. This is an observational study of singleton newborn infants with signs of intrapartum asphyxia that uses data from three previously conducted cluster randomized controlled trials taking place in rural Bangladesh and India. Methods From a population of 81,778 births in 54 community clusters in rural Bangladesh and India, we applied mixed effects logistic regression to data on 3890 singleton infants who had signs of intrapartum asphyxia, of whom 769 (20%) died in the early neonatal period. Poor infant condition at five minutes post-delivery was our proxy measure of intrapartum asphyxia. We had data for two markers of maternal infection: fever up to three days prior to labour, and prolonged rupture of membranes (PROM). Cause-specific verbal autopsy data were used to validate our findings using previously mentioned mixed effect logistic regression methods and the outcome of a neonatal death due to intrapartum asphyxia. Results Signs of maternal infection as indicated by PROM, combined with intrapartum asphyxia, increased the risk of an early neonatal death relative to intrapartum asphyxia alone (adjusted odds ratio (AOR) 1.28, 95% CI 1.03 – 1.59). Results from cause-specific verbal autopsy data verified our findings where there was a significantly increased odds of a early neonatal death due to intrapartum asphyxia in newborns exposed to both PROM and intrapartum asphyxia (AOR: 1.52, 95% CI 1.15 – 2.02). Conclusions Our data support the double-hit hypothesis for signs of maternal infection as indicated by

  15. The epidemiological transition in Antananarivo, Madagascar: an assessment based on death registers (1900–2012)

    PubMed Central

    Masquelier, Bruno; Waltisperger, Dominique; Ralijaona, Osée; Pison, Gilles; Ravélo, Arsène

    2014-01-01

    Background Madagascar today has one of the highest life expectancies in sub-Saharan Africa, despite being among the poorest countries in the continent. There are relatively few detailed accounts of the epidemiological transition in this country due to the lack of a comprehensive death registration system at the national level. However, in Madagascar’s capital city, death registration was established around the start of the 20th century and is now considered virtually complete. Objective We provide an overview of trends in all-cause and cause-specific mortality in Antananarivo to document the timing and pace of the mortality decline and the changes in the cause-of-death structure. Design Death registers covering the period 1976–2012 were digitized and the population at risk of dying was estimated from available censuses and surveys. Trends for the period 1900–1976 were partly reconstructed from published sources. Results The crude death rate stagnated around 30‰ until the 1940s in Antananarivo. Mortality declined rapidly after the World War II and then resurged again in the 1980s as a result of the re-emergence of malaria and the collapse of Madagascar’s economy. Over the past 30 years, impressive gains in life expectancy have been registered thanks to the unabated decline in child mortality, despite political instability, a lasting economic crisis and the persistence of high rates of chronic malnutrition. Progress in adult survival has been more modest because reductions in infectious diseases and diseases of the respiratory system have been partly offset by increases in cardiovascular diseases, neoplasms, and other diseases, particularly at age 50 years and over. Conclusions The transition in Antananarivo has been protracted and largely dependent on anti-microbial and anti-parasitic medicine. The capital city now faces a double burden of communicable and non-communicable diseases. The ongoing registration of deaths in the capital generates a unique

  16. Immunogenic Cell Death Induced by Ginsenoside Rg3: Significance in Dendritic Cell-based Anti-tumor Immunotherapy.

    PubMed

    Son, Keum-Joo; Choi, Ki Ryung; Lee, Seog Jae; Lee, Hyunah

    2016-02-01

    Cancer is one of the leading causes of morbidity and mortality worldwide; therefore there is a need to discover new therapeutic modules with improved efficacy and safety. Immune-(cell) therapy is a promising therapeutic strategy for the treatment of intractable cancers. The effectiveness of certain chemotherapeutics in inducing immunogenic tumor cell death thus promoting cancer eradication has been reported. Ginsenoside Rg3 is a ginseng saponin that has antitumor and immunomodulatory activity. In this study, we treated tumor cells with Rg3 to verify the significance of inducing immunogenic tumor cell death in antitumor therapy, especially in DC-based immunotherapy. Rg3 killed the both immunogenic (B16F10 melanoma cells) and non-immunogenic (LLC: Lewis Lung Carcinoma cells) tumor cells by inducing apoptosis. Surface expression of immunogenic death markers including calreticulin and heat shock proteins and the transcription of relevant genes were increased in the Rg3-dying tumor. Increased calreticulin expression was directly related to the uptake of dying tumor cells by dendritic cells (DCs): the proportion of CRT(+) CD11c(+) cells was increased in the Rg3-treated group. Interestingly, tumor cells dying by immunogenic cell death secreted IFN-γ, an effector molecule for antitumor activity in T cells. Along with the Rg3-induced suppression of pro-angiogenic (TNF-α) and immunosuppressive cytokine (TGF-β) secretion, IFN-γ production from the Rg3-treated tumor cells may also indicate Rg3 as an effective anticancer immunotherapeutic strategy. The data clearly suggests that Rg3-induced immunogenic tumor cell death due its cytotoxic effect and its ability to induce DC function. This indicates that Rg3 may be an effective immunotherapeutic strategy.

  17. Ill-defined causes of death in Brazil: a redistribution method based on the investigation of such causes.

    PubMed

    França, Elisabeth; Teixeira, Renato; Ishitani, Lenice; Duncan, Bruce Bartholow; Cortez-Escalante, Juan José; Morais Neto, Otaliba Libânio de; Szwarcwald, Célia Landman

    2014-08-01

    OBJECTIVE To propose a method of redistributing ill-defined causes of death (IDCD) based on the investigation of such causes. METHODS In 2010, an evaluation of the results of investigating the causes of death classified as IDCD in accordance with chapter 18 of the International Classification of Diseases (ICD-10) by the Mortality Information System was performed. The redistribution coefficients were calculated according to the proportional distribution of ill-defined causes reclassified after investigation in any chapter of the ICD-10, except for chapter 18, and used to redistribute the ill-defined causes not investigated and remaining by sex and age. The IDCD redistribution coefficient was compared with two usual methods of redistribution: a) Total redistribution coefficient, based on the proportional distribution of all the defined causes originally notified and b) Non-external redistribution coefficient, similar to the previous, but excluding external causes. RESULTS Of the 97,314 deaths by ill-defined causes reported in 2010, 30.3% were investigated, and 65.5% of those were reclassified as defined causes after the investigation. Endocrine diseases, mental disorders, and maternal causes had a higher representation among the reclassified ill-defined causes, contrary to infectious diseases, neoplasms, and genitourinary diseases, with higher proportions among the defined causes reported. External causes represented 9.3% of the ill-defined causes reclassified. The correction of mortality rates by the total redistribution coefficient and non-external redistribution coefficient increased the magnitude of the rates by a relatively similar factor for most causes, contrary to the IDCD redistribution coefficient that corrected the different causes of death with differentiated weights. CONCLUSIONS The proportional distribution of causes among the ill-defined causes reclassified after investigation was not similar to the original distribution of defined causes. Therefore

  18. Ill-defined causes of death in Brazil: a redistribution method based on the investigation of such causes

    PubMed Central

    França, Elisabeth; Teixeira, Renato; Ishitani, Lenice; Duncan, Bruce Bartholow; Cortez-Escalante, Juan José; de Morais, Otaliba Libânio; Szwarcwald, Célia Landman

    2014-01-01

    OBJECTIVE To propose a method of redistributing ill-defined causes of death (IDCD) based on the investigation of such causes. METHODS In 2010, an evaluation of the results of investigating the causes of death classified as IDCD in accordance with chapter 18 of the International Classification of Diseases (ICD-10) by the Mortality Information System was performed. The redistribution coefficients were calculated according to the proportional distribution of ill-defined causes reclassified after investigation in any chapter of the ICD-10, except for chapter 18, and used to redistribute the ill-defined causes not investigated and remaining by sex and age. The IDCD redistribution coefficient was compared with two usual methods of redistribution: a) Total redistribution coefficient, based on the proportional distribution of all the defined causes originally notified and b) Non-external redistribution coefficient, similar to the previous, but excluding external causes. RESULTS Of the 97,314 deaths by ill-defined causes reported in 2010, 30.3% were investigated, and 65.5% of those were reclassified as defined causes after the investigation. Endocrine diseases, mental disorders, and maternal causes had a higher representation among the reclassified ill-defined causes, contrary to infectious diseases, neoplasms, and genitourinary diseases, with higher proportions among the defined causes reported. External causes represented 9.3% of the ill-defined causes reclassified. The correction of mortality rates by the total redistribution coefficient and non-external redistribution coefficient increased the magnitude of the rates by a relatively similar factor for most causes, contrary to the IDCD redistribution coefficient that corrected the different causes of death with differentiated weights. CONCLUSIONS The proportional distribution of causes among the ill-defined causes reclassified after investigation was not similar to the original distribution of defined causes. Therefore

  19. Fetal deaths in Brazil: a systematic review

    PubMed Central

    Barbeiro, Fernanda Morena dos Santos; Fonseca, Sandra Costa; Tauffer, Mariana Girão; Ferreira, Mariana de Souza Santos; da Silva, Fagner Paulo; Ventura, Patrícia Mendonça; Quadros, Jesirée Iglesias

    2015-01-01

    OBJECTIVE To review the frequency of and factors associated with fetal death in the Brazilian scientific literature. METHODS A systematic review of Brazilian studies on fetal deaths published between 2003 and 2013 was conducted. In total, 27 studies were analyzed; of these, 4 studies addressed the quality of data, 12 were descriptive studies, and 11 studies evaluated the factors associated with fetal death. The databases searched were PubMed and Lilacs, and data extraction and synthesis were independently performed by two or more examiners. RESULTS The level of completeness of fetal death certificates was deficient, both in the completion of variables, particularly sociodemographic variables, and in defining the underlying causes of death. Fetal deaths have decreased in Brazil; however, inequalities persist. Analysis of the causes of death indicated maternal morbidities that could be prevented and treated. The main factors associated with fetal deaths were absent or inadequate prenatal care, low education level, maternal morbidity, and adverse reproductive history. CONCLUSIONS Prenatal care should prioritize women that are most vulnerable (considering their social environment or their reproductive history and morbidities) with the aim of decreasing the fetal mortality rate in Brazil. Adequate completion of death certificates and investment in the committees that investigate fetal and infant deaths are necessary. PMID:25902565

  20. Insights into sepsis therapeutic design based on the apoptotic death pathway.

    PubMed

    Hattori, Yuichi; Takano, Ken-ichi; Teramae, Hiroki; Yamamoto, Seiji; Yokoo, Hiroki; Matsuda, Naoyuki

    2010-01-01

    Sepsis remains the leading cause of death in critically ill patients. A major problem contributing to sepsis-related high mortality is the lack of effective medical treatment. Thus, the key goal in critical care medicine is to develop novel therapeutic strategies that will impact favorably on septic patient outcome. While it is generally accepted that sepsis is an inflammatory state resulting from the systemic response to infection, apoptosis is implicated to be an important mechanism of the death of lymphocytes, gastrointestinal and lung epithelial cells, and vascular endothelial cells associated with the development of multiple organ failure in sepsis. The pivotal role of cell apoptosis is now highlighted by multiple studies demonstrating that prevention of cell apoptosis can improve survival in clinically relevant animal models of sepsis. In this review article, we address the scientific rationale for remedying apoptotic cell death in sepsis and propose that therapeutic efforts aimed at blocking cell signaling pathways leading to apoptosis may represent an attractive target for sepsis therapy.

  1. Assessment of Computer-based Geologic Mapping of Rock Units in the LANDSAT-4 Scene of Northern Death Valley, California

    NASA Technical Reports Server (NTRS)

    Short, N. M.

    1984-01-01

    Results from a series of geologic classifications conducted on a thematic mapper subscene of the northern Death Valley, California are reported. Measurements of accuracy are made through comparison with the 1977 edition of the Death Valley geologic sheet. This employs a simplified map version which is registered by computer to the image data base, allowing a pixel by pixel match with the classified scene. The results show accuracy ranges from 36 to 79% depending on the type of classifier used and the statistical adjustments made to the data. Accuracy values in identifying geologic units were 2 to 3 times higher for those in the relatively flat valleys than for units in the rugged mountainous terrain. Improvements in accuracy will be sought by correcting for slope/aspect variations in mountainous terrain using topographic data recorded in Defense Mapping Agency (DMA) tapes. The above classification results will also be compared with ratio and principal component image classifications made from the same scene.

  2. PKIX Certificate Status in Hybrid MANETs

    NASA Astrophysics Data System (ADS)

    Muñoz, Jose L.; Esparza, Oscar; Gañán, Carlos; Parra-Arnau, Javier

    Certificate status validation is a hard problem in general but it is particularly complex in Mobile Ad-hoc Networks (MANETs) because we require solutions to manage both the lack of fixed infrastructure inside the MANET and the possible absence of connectivity to trusted authorities when the certification validation has to be performed. In this sense, certificate acquisition is usually assumed as an initialization phase. However, certificate validation is a critical operation since the node needs to check the validity of certificates in real-time, that is, when a particular certificate is going to be used. In such MANET environments, it may happen that the node is placed in a part of the network that is disconnected from the source of status data at the moment the status checking is required. Proposals in the literature suggest the use of caching mechanisms so that the node itself or a neighbour node has some status checking material (typically on-line status responses or lists of revoked certificates). However, to the best of our knowledge the only criterion to evaluate the cached (obsolete) material is the time. In this paper, we analyse how to deploy a certificate status checking PKI service for hybrid MANET and we propose a new criterion based on risk to evaluate cached status data that is much more appropriate and absolute than time because it takes into account the revocation process.

  3. Sudden infant death syndrome in Japan 1995-1998.

    PubMed

    Fujita, T

    2002-09-14

    This study examined the effects of birth characteristics, which reported on birth certificates, on sudden infant death syndrome (SIDS) based on vital statistics between 1995 and 1998 in Japan. One thousand eight hundred and fifty-nine cases of SIDS and 4,787,537 live births were analyzed. The mortality rate from SIDS was 0.388 SIDS deaths per 1000 live births. Based on multivariate analysis using Poisson regression model, risk factors associated with significantly increased SIDS rates included low birth weight, being a male infant, young maternal age, late birth in multiparity, maternal stillbirth experience, residential region of Kyusyu, Tokai or Hokuriku, and employment status as "unemployed or unknown". However, there was no significant difference between single and multiple birth groups after adjusting other characteristics. A decreasing postnatal age of death was observed as birth weight increased. However, there was no difference in postconceptional age of death between birth weight groups. Preterm infants died of SIDS at a later postnatal age than term infants, but there appeared to be little difference in postconceptional age of death amongst preterm infants. This association between birth characteristics and SIDS were consistent with other studies from western countries, suggesting that recommendations for SIDS in western countries are also applicable for Japan.

  4. Preventing Fire Death and Injury, Conducting a Fire Drill in a Group Home [and] When You Need a Fire Safety Expert. National Fire Safety Certification System. Continuing Education Program. Volume 1, Numbers 1-3.

    ERIC Educational Resources Information Center

    Walker, Bonnie

    Three booklets provide fire safety information for staff of residential facilities serving people with developmental disabilities. Booklets focus on: (1) preventing fire death and injury, (2) conducting a fire drill in a group home, and (3) the role of fire safety experts. The first booklet stresses the elimination of the following dangers:…

  5. Parental socioeconomic status and unintentional injury deaths in early childhood: consideration of injury mechanisms, age at death, and gender.

    PubMed

    Hong, Juhee; Lee, Boeun; Ha, Eun Hee; Park, Hyesook

    2010-01-01

    The aim of this study was to determine whether the socioeconomic status (SES) of parents influences early childhood unintentional injury deaths for different injury mechanisms and the gender and age at death of the child. Study design is a population-based retrospective study. Death certificate data from 1995 to 2004 were linked to birth certificate data from 1995 to 1996 for each child who died when aged < or = 8 years. Parental age, birth order, marital status, residence area, educational level, and occupation were used as indices for SES. Cox proportional-hazards analysis was employed. Our results indicate that nonmetropolitan residence, low parental education level, and a father working in a nonadministrative job or as a farmer were associated with a higher risk of death from injury for both boys and girls. A mother aged younger than 20 years and parents working in manual jobs were associated with a higher risk in boys only. The risks of some socioeconomic factors (low parental education and a father working in a manual job or as a farmer) were evident for children aged 1-4 years. The risks of rural residency tended to increase in older children, and the risk of injury from having a mother aged younger than 20 years increased for younger children. The risks of childhood injury deaths from traffic accidents, falls, and fire/burns were associated with the SES of the parents. Younger parents were associated with higher risks of injury deaths from traffic accidents (hazard ratio [HR]: father, 7.9; mother, 1.9) and falls (HR: father, 2.0; mother, 2.5). A father working as a farmer was associated with a higher risk of childhood injury death from fire/burns (HR = 4.0). In conclusion, the parental SES risk profiles of childhood injury deaths varied with the age and gender of the child, and with the injury mechanism. Therefore, reducing excess injury deaths during early childhood requires preventive efforts targeted at high-risk parents, and based on injury mechanism

  6. Maintenance of Certification for Radiation Oncology

    SciTech Connect

    Kun, Larry E.; Ang, Kian; Erickson, Beth; Harris, Jay; Hoppe, Richard; Leibel, Steve; Davis, Larry; Hattery, Robert

    2005-06-01

    Maintenance of Certification (MOC) recognizes that in addition to medical knowledge, several essential elements involved in delivering quality care must be developed and maintained throughout one's career. The MOC process is designed to facilitate and document professional development of American Board of Radiology (ABR) diplomates in the essential elements of quality care in Radiation Oncology and Radiologic Physics. ABR MOC has been developed in accord with guidelines of the American Board of Medical Specialties. All Radiation Oncology certificates issued since 1995 are 10-year, time-limited certificates; diplomates with time-limited certificates who wish to maintain specialty certification must complete specific requirements of the American Board of Radiology MOC program. Diplomates with lifelong certificates are not required to participate but are strongly encouraged to do so. Maintenance of Certification is based on documentation of participation in the four components of MOC: (1) professional standing, (2) lifelong learning and self-assessment, (3) cognitive expertise, and (4) performance in practice. Through these components, MOC addresses six competencies-medical knowledge, patient care, interpersonal and communication skills, professionalism, practice-based learning and improvement, and systems-based practice. Details of requirements for components 1, 2, and 3 of MOC are outlined along with aspects of the fourth component currently under development.

  7. Invariant death.

    PubMed

    Frank, Steven A

    2016-01-01

    In nematodes, environmental or physiological perturbations alter death's scaling of time. In human cancer, genetic perturbations alter death's curvature of time. Those changes in scale and curvature follow the constraining contours of death's invariant geometry. I show that the constraints arise from a fundamental extension to the theories of randomness, invariance and scale. A generalized Gompertz law follows. The constraints imposed by the invariant Gompertz geometry explain the tendency of perturbations to stretch or bend death's scaling of time. Variability in death rate arises from a combination of constraining universal laws and particular biological processes.

  8. Maternal Deaths Databases Analysis: Ecuador 2003-2013.

    PubMed

    Pino, Antonio; Albán, María; Rivas, Alejandra; Rodríguez, Erika

    2016-08-19

    Background: Maternal mortality ratio in Ecuador is the only millennium goal on which national agencies are still making strong efforts to reach 2015 target. The purpose of the study was to process national maternal death databases to identify a specific association pattern of variable included in the death certificate. Design and methods: The study processed mortality databases published yearly by the National Census and Statistics Institute (INEC). Data analysed were exclusively maternal deaths. Data corresponds to the 2003-2013 period, accessible through INEC's website. Comparisons are based on number of deaths and use an ecological approach for geographical coincidences. Results: The study identified variable association into the maternal mortality national databases showing that to die at home or in a different place than a hospital is closely related to women's socioeconomic characteristics; there was an association with the absence of a public health facility. Also, to die in a different place than the usual residence could mean that women and families are searching for or were referred to a higher level of attention when they face complications. Conclusions: Ecuadorian maternal deaths showed Patterns of inequity in health status, health care provision and health risks. A predominant factor seems unclear to explain the variable association found processing national databases; perhaps every pattern of health systems development played a role in maternal mortality or factors different from those registered by the statistics system may remain hidden. Some random influences might not be even considered in an explanatory model yet.

  9. Home-based viewing (el velorio) after death: a cost-effective alternative for some families.

    PubMed

    Gonzalez, Faustino; Hereira, Mildreys

    2008-01-01

    After the death of a loved one, giving an opportunity to view the body helps bring families and friends together to celebrate the life and mourn the passing of a person. This gathering, known as a Wake or a Viewing, precedes the burial and usually lasts from 1 to several days. In the United States, the viewing now takes place in funeral parlors, away from the decedent's home. However, there are still several countries and people who keep the body at home where the family and friends are invited to say their goodbyes. We present here 2 cases for which our Hospice assisted the families with a home viewing. These were indigent people who could not afford embalming or the additional cost of a viewing in a parlor and who, without this opportunity, would have not had time to get together and mourn and celebrate life as friends, family, and community.

  10. Certification report for the CALMAC solar powered pump

    NASA Technical Reports Server (NTRS)

    1978-01-01

    The certification of the CALMAC solar powered thermopump is presented. Each element of the specification is delineated, together with the verification, based on analysis, similarity, inspection, or testing.

  11. Eighth Amendment & Death Penalty.

    ERIC Educational Resources Information Center

    Shortall, Joseph M.; Merrill, Denise W.

    1987-01-01

    Presents a lesson on capital punishment for juveniles based on three hypothetical cases. The goal of the lesson is to have students understand the complexities of decisions regarding the death penalty for juveniles. (JDH)

  12. Mass Spectrometry Based Metabolomics Comparison of Liver Grafts from Donors after Circulatory Death (DCD) and Donors after Brain Death (DBD) Used in Human Orthotopic Liver Transplantation

    PubMed Central

    Laing, Richard; Kirwan, Jennifer; Silva, Michael A.; Richards, Douglas A.; Murphy, Nick; Mirza, Darius F.; Viant, Mark R.

    2016-01-01

    Use of marginal liver grafts, especially those from donors after circulatory death (DCD), has been considered as a solution to organ shortage. Inferior outcomes have been attributed to donor warm ischaemic damage in these DCD organs. Here we sought to profile the metabolic mechanisms underpinning donor warm ischaemia. Non-targeted Fourier transform ion cyclotron resonance (FT-ICR) mass spectrometry metabolomics was applied to biopsies of liver grafts from donors after brain death (DBD; n = 27) and DCD (n = 10), both during static cold storage (T1) as well as post-reperfusion (T2). Furthermore 6 biopsies from DBD donors prior to the organ donation (T0) were also profiled. Considering DBD and DCD together, significant metabolic differences were discovered between T1 and T2 (688 peaks) that were primarily related to amino acid metabolism, meanwhile T0 biopsies grouped together with T2, denoting the distinctively different metabolic activity of the perfused state. Major metabolic differences were discovered between DCD and DBD during cold-phase (T1) primarily related to glucose, tryptophan and kynurenine metabolism, and in the post-reperfusion phase (T2) related to amino acid and glutathione metabolism. We propose tryptophan/kynurenine and S-adenosylmethionine as possible biomarkers for the previously established higher graft failure of DCD livers, and conclude that the associated pathways should be targeted in more exhaustive and quantitative investigations. PMID:27835640

  13. Mass Spectrometry Based Metabolomics Comparison of Liver Grafts from Donors after Circulatory Death (DCD) and Donors after Brain Death (DBD) Used in Human Orthotopic Liver Transplantation.

    PubMed

    Hrydziuszko, Olga; Perera, M Thamara P R; Laing, Richard; Kirwan, Jennifer; Silva, Michael A; Richards, Douglas A; Murphy, Nick; Mirza, Darius F; Viant, Mark R

    2016-01-01

    Use of marginal liver grafts, especially those from donors after circulatory death (DCD), has been considered as a solution to organ shortage. Inferior outcomes have been attributed to donor warm ischaemic damage in these DCD organs. Here we sought to profile the metabolic mechanisms underpinning donor warm ischaemia. Non-targeted Fourier transform ion cyclotron resonance (FT-ICR) mass spectrometry metabolomics was applied to biopsies of liver grafts from donors after brain death (DBD; n = 27) and DCD (n = 10), both during static cold storage (T1) as well as post-reperfusion (T2). Furthermore 6 biopsies from DBD donors prior to the organ donation (T0) were also profiled. Considering DBD and DCD together, significant metabolic differences were discovered between T1 and T2 (688 peaks) that were primarily related to amino acid metabolism, meanwhile T0 biopsies grouped together with T2, denoting the distinctively different metabolic activity of the perfused state. Major metabolic differences were discovered between DCD and DBD during cold-phase (T1) primarily related to glucose, tryptophan and kynurenine metabolism, and in the post-reperfusion phase (T2) related to amino acid and glutathione metabolism. We propose tryptophan/kynurenine and S-adenosylmethionine as possible biomarkers for the previously established higher graft failure of DCD livers, and conclude that the associated pathways should be targeted in more exhaustive and quantitative investigations.

  14. A Death in the Family: Death as a Zen Concept

    ERIC Educational Resources Information Center

    Black, Helen K.; Rubinstein, Robert L.

    2013-01-01

    This study is based on original research that explored family reaction to the death of an elderly husband and father. We interviewed 34 families (a family included a widow and two adult biological children) approximately 6 to 10 months after the death. In one-on-one interviews, we discussed family members' initial reaction to the death, how the…

  15. An ostracode based paleolimnologic and paleohydrologic history of Death Valley: 200 to 0 ka

    USGS Publications Warehouse

    Forester, R.M.; Lowenstein, T.K.; Spencer, R.J.

    2005-01-01

    Death Valley, a complex tectonic and hydrologic basin, was cored from its lowest surface elevation to a depth of 186 m. The sediments range from bedded primary halite to black muds. Continental ostracodes found in the black muds indicate that those sediments were deposited in a variety of hydrologic settings ranging from deep, relatively fresh water to shallow saline lakes to spring discharge supported wetlands. The alkaline-enriched, calcium-depleted paleolake waters indicate extrabasinal streamflow and basin-margin spring discharge. The alkaline-depleted, calcium-enriched paleowetland waters indicate intrabasinal spring discharge. During Marine Isotope Stage 6 (MIS 6, ca. 180-140 ka) the hydrologic settings were highly variable, implying that complex relations existed between climate and basin hydrology. Termination II (MIS 6 to MIS 5E) was a complex multicyclic sequence of paleoenvironments, implying that climates oscillated between high and low effective moisture. MIS 4 (ca. 73-61 ka) was a spring discharge supported wetland complex. During MIS 2 (ca. 20-12 ka) the hydrologic settings were variable, although they are not fully understood because some black muds deposited during that time were lost during coring. ?? 2005 Geological Society of America.

  16. Brain Death and Islam

    PubMed Central

    Ziad-Miller, Amna; Elamin, Elamin M.

    2014-01-01

    How one defines death may vary. It is important for clinicians to recognize those aspects of a patient’s religious beliefs that may directly influence medical care and how such practices may interface with local laws governing the determination of death. Debate continues about the validity and certainty of brain death criteria within Islamic traditions. A search of PubMed, Scopus, EMBASE, Web of Science, PsycNet, Sociological Abstracts, DIALOGUE ProQuest, Lexus Nexus, Google, and applicable religious texts was conducted to address the question of whether brain death is accepted as true death among Islamic scholars and clinicians and to discuss how divergent opinions may affect clinical care. The results of the literature review inform this discussion. Brain death has been acknowledged as representing true death by many Muslim scholars and medical organizations, including the Islamic Fiqh Academies of the Organization of the Islamic Conference and the Muslim World League, the Islamic Medical Association of North America, and other faith-based medical organizations as well as legal rulings by multiple Islamic nations. However, consensus in the Muslim world is not unanimous, and a sizable minority accepts death by cardiopulmonary criteria only. PMID:25287999

  17. Causes of death in Japanese patients with diabetes based on the results of a survey of 45,708 cases during 2001-2010: Report of the Committee on Causes of Death in Diabetes Mellitus.

    PubMed

    Nakamura, Jiro; Kamiya, Hideki; Haneda, Masakazu; Inagaki, Nobuya; Tanizawa, Yukio; Araki, Eiichi; Ueki, Kohjiro; Nakayama, Takeo

    2017-03-27

    The principal causes of death among 45,708 patients with diabetes (29,801 men and 15,907 women) who died in 241 hospitals throughout Japan during 2001-2010 were determined based on a survey of the hospital records. Autopsy had been conducted in 978 of the 45,708 cases. The most frequent cause of death was malignant neoplasia (38.3%), followed by, in order of descending frequency: infections (17.0%); and then vascular diseases (14.9%), including renal failure (3.5%), ischemic heart diseases (4.8%) and cerebrovascular diseases (6.6%). Diabetic coma associated with hyperglycemia with or without ketoacidosis accounted for only 0.6% of the deaths. In regard to the relationship between the age and cause of death in patients with diabetes, the incidence of death due to vascular diseases was higher in patients over the age of 30 or 40 years, and the 97.0% of the total death due to vascular diseases was observed in patients over the age of 50 years. The incidence of death due to infectious diseases, especially pneumonia, increased in an age-dependent fashion, and the 80.7% of the total death due to pneumonia was observed in patients over the age of 70 years. 'Poorer' glycemic control was associated with the reduced lifespan of patients with diabetes, especially of those with nephropathy. The average age at death in the survey population was 72.6 years. The lifespan was 1.6 years shorter in patients with 'poorer' glycemic control than in those with 'better' glycemic control. In patients with diabetes of less than 10 years' duration, the incidence of death due to macroangiopathy was higher than that due to nephropathy. Of the 45,708 patients with diabetes, 33.9% were on oral medication, 41.9% received insulin therapy and 18.8% were treated by diet alone. Among the patients in whom the cause of death was diabetic nephropathy, a high percentage, 53.7%, was on insulin therapy. The average age at death of the 45,708 patients with diabetes was 71.4 years in men and 75.1

  18. Abuse of alcohol in sudden out-of-hospital deaths in Finland.

    PubMed

    Perola, M; Vuori, E; Penttilä, A

    1994-04-01

    Alcoholism is known to be greatly underdiagnosed in death certificates, a fact that biases in estimates of alcohol-related mortality. An autopsy series of 1658 cases (920 with natural cause of death and 738 nonnatural) was reviewed to evaluate the extent of this bias, and also to see how well different sources of information served as indicators of alcoholism when alcohol-related disease diagnosed at autopsy was considered as a gold standard. A stepwise logistic regression model adjusted by age and sex showed police reports of individual's alcohol usage and blood alcohol concentration (BAC) of > 2.9/1000 at autopsy to be the two most significant predictors of chronic alcohol abuse (p < 0.0001). The specificities of these two parameters as predictors of chronic alcohol abuse were generally high and sensitivities low. The authors see high BAC (> 2.9/1000), due to its high specificity, as particularly suggestive of chronic heavy drinking. However, it is wise to use these parameters only as an aid in decision-making, not as sole indicators of alcoholism. Deaths associated with chronic heavy drinking were frequent, 50.5% of the total series (male 56.4%, female 37.1%). For all but one age-group (male 45-64 years), however, death certificates mentioned alcohol-related diseases in less than half of these cases. Especially evident underdiagnosis was found for female and males 65 years and older. These results indicate that alcoholism is frequent in such a highly selected population as a series of forensic autopsies and suggest that estimates of prevalence of alcoholism based only on review of death certificates are to be considered with great caution.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. Teacher Certification in Manitoba.

    ERIC Educational Resources Information Center

    Manitoba Dept. of Education, Winnipeg.

    This booklet provides information for teachers wishing to qualify for certification in the Canadian province of Manitoba. Written in French and English, the booklet's topics include: (1) requirements for types of teaching certificates (provisional teaching; permanent teaching; special, vocational-industrial, and vocational-business education;…

  20. Certification Programs for Citrus

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Citrus certification programs designed to ensure that healthy plants of the highest genetic potential are being planted in the field are the basic building block of an integrated pest management program. Certification programs began for citrus began with the discovery that the diseases were graft t...

  1. Directory of Fitness Certifications.

    ERIC Educational Resources Information Center

    Parks, Janet B.

    1990-01-01

    This article discusses the need for certification of fitness instructors in the aerobic dance/dance-exercise industry and presents results of a survey of 18 agencies that certify instructors. Survey data has been compiled and published. An excerpt is included which lists organizations, training, certification and renewal procedures, publications,…

  2. Rapid Detection of an ABT-737-Sensitive Primed for Death State in Cells Using Microplate-Based Respirometry

    PubMed Central

    Clerc, Pascaline; Carey, Gregory B.; Mehrabian, Zara; Wei, Michael; Hwang, Hyehyun; Girnun, Geoffrey D.; Chen, Hegang; Martin, Stuart S.; Polster, Brian M.

    2012-01-01

    Cells that exhibit an absolute dependence on the anti-apoptotic BCL-2 protein for survival are termed “primed for death” and are killed by the BCL-2 antagonist ABT-737. Many cancers exhibit a primed phenotype, including some that are resistant to conventional chemotherapy due to high BCL-2 expression. We show here that 1) stable BCL-2 overexpression alone can induce a primed for death state and 2) that an ABT-737-induced loss of functional cytochrome c from the electron transport chain causes a reduction in maximal respiration that is readily detectable by microplate-based respirometry. Stable BCL-2 overexpression sensitized non-tumorigenic MCF10A mammary epithelial cells to ABT-737-induced caspase-dependent apoptosis. Mitochondria within permeabilized BCL-2 overexpressing cells were selectively vulnerable to ABT-737-induced cytochrome c release compared to those from control-transfected cells, consistent with a primed state. ABT-737 treatment caused a dose-dependent impairment of maximal O2 consumption in MCF10A BCL-2 overexpressing cells but not in control-transfected cells or in immortalized mouse embryonic fibroblasts lacking both BAX and BAK. This impairment was rescued by delivering exogenous cytochrome c to mitochondria via saponin-mediated plasma membrane permeabilization. An ABT-737-induced reduction in maximal O2 consumption was also detectable in SP53, JeKo-1, and WEHI-231 B-cell lymphoma cell lines, with sensitivity correlating with BCL-2:MCL-1 ratio and with susceptibility (SP53 and JeKo-1) or resistance (WEHI-231) to ABT-737-induced apoptosis. Multiplexing respirometry assays to ELISA-based determination of cytochrome c redistribution confirmed that respiratory inhibition was associated with cytochrome c release. In summary, cell-based respiration assays were able to rapidly identify a primed for death state in cells with either artificially overexpressed or high endogenous BCL-2. Rapid detection of a primed for death state in individual cancers

  3. Causes of death and associated risk factors among climacteric women from Southern Brazil: a population based-study

    PubMed Central

    2014-01-01

    Background Aging and menopause are particular cardiovascular risk factors for women, due to estrogen deprivation at the time of menopause. Studies show that diabetes mellitus (DM), smoking, hypertension, high body mass index (BMI), and serum lipids are associated with increased risk of cardiovascular disease (CVD), the main cause of female mortality in Brazil. The aim of this study was to assess the mortality rate, causes of death and associated risk factors in a cohort of women from Brazil. Methods A longitudinal population-based study of menopausal status is currently underway in a city in South Brazil. In 2010, a third follow-up of this population was performed to assess cardiovascular risk and mortality rate between 1995 and 2011. For this analysis, 358 participants were studied. At baseline, participants had completed a standardized questionnaire including demographic, lifestyle, medical and reproductive characteristics. In addition to the contacts with relatives, mortality data were obtained through review of medical records in all city hospitals and the Center for Health Information (NIS/RS-SES). Multivariate-adjusted hazard risk (HR) and 95% confidence intervals (CI95%) were estimated using Cox proportional hazards regression. Survival curves were estimated using the Kaplan-Meier curve. Results There were 17 (4.7%) deaths from all causes during the study period. Seven (41.2%) deaths were caused by CVD, including four cases of stroke and three cases of myocardial infarction. Six (35.3%) deaths were due to cancer, and four (23.5%) were due to other reasons. In the age and smoking-adjusted multivariate models, diabetes (HR 6.645, 95% CI: 1.938–22.79, p = 0.003), alcohol intake (HR 1.228, 95% CI: 1.014-1.487, p = 0.035) and postmenopausal status (HR = 6.216, 95% CI: 0.963–40.143, p = 0.055) were associated with all-cause mortality. A significant association was found between abdominal obesity (WHR ≥ 0.85) and mortality even after the adjustment for BMI

  4. Anticoagulation and population risk of stroke and death in incident atrial fibrillation: a population-based cohort study

    PubMed Central

    Yu, Amy Y.X.; Malo, Shaun; Wilton, Stephen; Parkash, Ratika; Svenson, Lawrence W.; Hill, Michael D.

    2016-01-01

    Background: Atrial fibrillation increases the risk of stroke and death. Anticoagulation therapy is an effective treatment for stroke prevention, but remains underused in the community. We sought to determine the effectiveness and safety of anticoagulation therapy in an inception cohort with new-onset atrial fibrillation in the province of Alberta, Canada. Methods: We conducted a population-based cohort study of atrial fibrillation using an administrative database from Alberta's publicly funded and universally available health care system. All new-onset atrial fibrillation patients from Jan. 1, 2009, to Dec. 31, 2010, were included in the cohort and followed through Dec. 31, 2013. We assessed anticoagulation status as a predictor of stroke and death using time-to-event analysis and adjusted for sex and CHADS2 (congestive heart failure, hypertension, age ≥ 75 yr, diabetes mellitus and prior stroke or transient ischemic attack) score using Cox proportional hazards modelling. Results: We identified 10 745 patients, 7358 (68.5%) of whom received anticoagulation therapy, principally with warfarin (n = 6997, 95.1%). Anticoagulation therapy was associated with significantly decreased risk of ischemic stroke (hazard ratio [HR] 0.69, 95% confidence interval [CI] 0.58-0.82), all stroke (HR 0.77, 95% CI 0.65-0.91), all stroke and death (HR 0.70, 95% CI 0.62-0.72) and all-cause mortality (HR 0.67, 95% CI 0.62-0.72), despite an association with increased risk of hemorrhagic stroke (HR 1.92, 95% CI 1.17-3.16). There was a neutral association with subdural (HR 1.01, 95% CI 0.53-1.93) and gastrointestinal (HR 0.96, 95% CI 0.70-1.31) hemorrhage. Interpretation: Anticoagulation therapy is effective and safe for stroke prevention and decreases mortality in patients with incident atrial fibrillation. These population data support an aggressive approach to screening for atrial fibrillation and treatment with anticoagulant medicines to prevent stroke and death. PMID:27280108

  5. Cesarean birth in the border region: a descriptive analysis based on US Hispanic and Mexican birth certificates.

    PubMed

    McDonald, Jill A; Mojarro Davila, Octavio; Sutton, Paul D; Ventura, Stephanie J

    2015-01-01

    Cesarean birth (CB) is more prevalent in the US-Mexico border region than among all US Hispanics. Comparable data from US and Mexican birth certificates can be used to compare prevalence and identify risk factors on either side of the border. Using 2009 US and Mexican birth certificates, we compared the characteristics of US Hispanic and Mexican CBs in six geographic subgroups: US and Mexican border counties/municipios, US and Mexican non-border counties/municipios and the US and Mexico overall. We also explored cesarean prevalence over time. During 2000-2009, CB rates increased from 22.1 to 31.6 % among US Hispanics and from 25.9 to 37.9 % among Hispanics in the US border region. 2009 rates were 44.5 % in Mexico and 43.1 % in the Mexican border region. In both countries, CB rates were similar for primiparas and multiparas. Higher education, being married and parity >4 were associated with CB in Mexico; being married was associated in the US. Hispanic rates were higher in the US border than non-border region for all age groups. Along the border, cesarean rates for Hispanics were highest in Texas (43.5 %) and neighboring Tamaulipas (49.8 %). Higher cesarean prevalence in Mexico than in US Hispanics, while unexplained, is consistent with high prevalence in some Latin American countries. Higher cesarean prevalence among Hispanics in the US border region than among Hispanics nationwide cannot be explained by maternal age or parity. Medical indications are also unlikely to explain such high rates, which are undesirable for mothers and infants.

  6. Comparison of Prevalence- and Smoking Impact Ratio-Based Methods of Estimating Smoking-Attributable Fractions of Deaths

    PubMed Central

    Kong, Kyoung Ae; Jung-Choi, Kyung-Hee; Lim, Dohee; Lee, Hye Ah; Lee, Won Kyung; Baik, Sun Jung; Park, Su Hyun; Park, Hyesook

    2016-01-01

    Background Smoking is a major modifiable risk factor for premature mortality. Estimating the smoking-attributable burden is important for public health policy. Typically, prevalence- or smoking impact ratio (SIR)-based methods are used to derive estimates, but there is controversy over which method is more appropriate for country-specific estimates. We compared smoking-attributable fractions (SAFs) of deaths estimated by these two methods. Methods To estimate SAFs in 2012, we used several different prevalence-based approaches using no lag and 10- and 20-year lags. For the SIR-based method, we obtained lung cancer mortality rates from the Korean Cancer Prevention Study (KCPS) and from the United States-based Cancer Prevention Study-II (CPS-II). The relative risks for the diseases associated with smoking were also obtained from these cohort studies. Results For males, SAFs obtained using KCPS-derived SIRs were similar to those obtained using prevalence-based methods. For females, SAFs obtained using KCPS-derived SIRs were markedly greater than all prevalence-based SAFs. Differences in prevalence-based SAFs by time-lag period were minimal among males, but SAFs obtained using longer-lagged prevalence periods were significantly larger among females. SAFs obtained using CPS-II-based SIRs were lower than KCPS-based SAFs by >15 percentage points for most diseases, with the exceptions of lung cancer and chronic obstructive pulmonary disease. Conclusions SAFs obtained using prevalence- and SIR-based methods were similar for males. However, neither prevalence-based nor SIR-based methods resulted in precise SAFs among females. The characteristics of the study population should be carefully considered when choosing a method to estimate SAF. PMID:26477995

  7. Comparison of weight- and height-based indices for assessing the risk of death in severely malnourished children.

    PubMed

    Prudhon, C; Briend, A; Laurier, D; Golden, M H; Mary, J Y

    1996-07-15

    To compare the effectiveness of treating malnourished children in different centers, the authors believe there is a need to have a simple method of adjusting mortality rates so that differences in the nutritional status of the children are taken into account. The authors compared different anthropometric indices based on weight and height to predict the risk of death among severely malnourished children. Anthropometric data from 1,047 children who survived were compared with those of 147 children who died during treatment in therapeutic feeding centers set up in African countries in 1993. The optimal ratio of weight to height determined by logistic regression was weight (kg)/height (m)1.74 (95% confidence interval of beta estimate 1.65-1.84). The receiver operating curves (sensitivity vs. specificity) showed that the body mass index (weight (kg)/height (m)2), optimal ratio of weight to height, and weight/height index expressed as the percentage of the median of the National Center for Health Statistics' standard were equivalent and superior to the weight/height index expressed as the z score of the National Center for Health Statistics' standard to predict death. As the optimal ratio of weight to height is easier to calculate than the weight/height index expressed as the percentage of the median or z score and does not depend upon either standards or tables, the optimal ratio of weight to height could be conveniently used to adjust mortality rates for nutritional status in therapeutic feeding centers.

  8. Characteristics of Opioid-Users Whose Death Was Related to Opioid-Toxicity: A Population-Based Study in Ontario, Canada

    PubMed Central

    Madadi, Parvaz; Hildebrandt, Doris; Lauwers, Albert E.; Koren, Gideon

    2013-01-01

    Background The impact of the prescription opioid public health crisis has been illustrated by the dramatic increase in opioid-related deaths in North America. We aimed to identify patterns and characteristics amongst opioid-users whose cause of death was related to opioid toxicity. Methods This was a population-based study of Ontarians between the years 2006 and 2008. All drug-related deaths which occurred during this time frame were reviewed at the Office of the Chief Coroner of Ontario, and opioid-related deaths were identified. Medical, toxicology, pathology, and police reports were comprehensively reviewed. Narratives, semi-quantitative, and quantitative variables were extracted, tabulated, and analyzed. Results Out of 2330 drug-related deaths in Ontario, 58% were attributed either in whole or in part, to opioids (n = 1359). Oxycodone was involved in approximately one-third of all opioid-related deaths. At least 7% of the entire cohort used opioids that were prescribed for friends and/or family, 19% inappropriately self-administered opioids (injection, inhalation, chewed patch), 3% were recently released from jail, and 5% had been switched from one opioid to another near the time of death. Accidental deaths were significantly associated with personal history of substance abuse, enrollment in methadone maintenance programs, cirrhosis, hepatitis, and cocaine use. Suicides were significantly associated with mental illness, previous suicide attempts, chronic pain, and a history of cancer. Significance/Conclusion These results identify novel, susceptible groups of opioid-users whose cause of death was related to opioids in Ontario and provide the first evidence to assist in quantifying the contribution of opioid misuse and diversion amongst opioid-related mortality in Canada. Multifaceted prevention strategies need to be developed based on subpopulations of opioid users. PMID:23577131

  9. Deaths from cerebrovascular diseases correlated to month of birth: elevated risk of death from subarachnoid hemorrhage among summer-born

    NASA Astrophysics Data System (ADS)

    Nonaka, K.; Imaizumi, Y.

    It has been suggested that maternal nutrition, and fetal and infant growth have an important effect on the risk of cardiovascular disease in adult life. We investigated the population-based distribution of deaths from cerebrovascular diseases (ICD9 codes 430, 431, or 434) in Japan in 1986-1994 as a function of birth month, by examining death-certificate records. For a total of 853 981 people born in the years 1900-1959, the distribution of the number of deaths according to the month of birth was compared with the distribution expected from the monthly numbers of all births for each sex and for the corresponding birth decade. For those born between 1920 and 1949, there were significant discrepancies between the actual numbers of deaths from subarachnoid hemorrhage (ICD9 430) and the numbers expected, and these differences were related to the month of birth. Those born in summer, June-September, consistently had an elevated risk of death, particularly men, where the excess risk was 8%-23%. This tendency was also observed, less distinctly but significantly, for deaths from intracerebral hemorrhage (ICD9 431), but was not observed for those dying from occlusion of the cerebral arteries (ICD9 434). The observation that the risk of dying from subarachnoid hemorrhage was more than 10% higher among those born in the summer implies that at least one in ten deaths from subarachnoid hemorrhage has its origin at a perinatal stage. Although variations in hypertension in later life, which could possibly be ''programmed'' during the intra-uterine stages, could be an explanation for this observation, the disease-specific nature of the observation suggests the involvement of aneurysm formation, which is a predominant cause of subarachnoid hemorrhage.

  10. Death foretold.

    PubMed

    Biderman, A; Herman, J

    2000-01-01

    We briefly trace the history of a belief in the possibility that a person in apparent good health may accurately predict his or her own demise. The phenomenon is referred to as death foretold and we present presumed examples of it from the Bible, world literature, medical writings and newspaper reports without pretending to completeness. In two widely quoted scientific papers, death foretold is subsumed under the wider heading of decease due to psychic stress. We speculate on a possible link between the two, taking into consideration the fact that most people who prophesy their end are of an advanced age.

  11. Quantifying cause-related mortality by weighting multiple causes of death

    PubMed Central

    Moreno-Betancur, Margarita; Lamarche-Vadel, Agathe; Rey, Grégoire

    2016-01-01

    Abstract Objective To investigate a new approach to calculating cause-related standardized mortality rates that involves assigning weights to each cause of death reported on death certificates. Methods We derived cause-related standardized mortality rates from death certificate data for France in 2010 using: (i) the classic method, which considered only the underlying cause of death; and (ii) three novel multiple-cause-of-death weighting methods, which assigned weights to multiple causes of death mentioned on death certificates: the first two multiple-cause-of-death methods assigned non-zero weights to all causes mentioned and the third assigned non-zero weights to only the underlying cause and other contributing causes that were not part of the main morbid process. As the sum of the weights for each death certificate was 1, each death had an equal influence on mortality estimates and the total number of deaths was unchanged. Mortality rates derived using the different methods were compared. Findings On average, 3.4 causes per death were listed on each certificate. The standardized mortality rate calculated using the third multiple-cause-of-death weighting method was more than 20% higher than that calculated using the classic method for five disease categories: skin diseases, mental disorders, endocrine and nutritional diseases, blood diseases and genitourinary diseases. Moreover, this method highlighted the mortality burden associated with certain diseases in specific age groups. Conclusion A multiple-cause-of-death weighting approach to calculating cause-related standardized mortality rates from death certificate data identified conditions that contributed more to mortality than indicated by the classic method. This new approach holds promise for identifying underrecognized contributors to mortality. PMID:27994280

  12. Effect of misclassified underlying cause of death on survival estimates of colon and rectal cancer.

    PubMed

    Yin, Daixin; Morris, Cyllene R; Bates, Janet H; German, Robert R

    2011-07-20

    Inaccurate coding of patients' Underlying Cause of Death (UCOD) has constrained cause-specific survival estimates for colon and rectal cancers. Using California data from the Accuracy of Cancer Mortality study, we compared the cancer site data from the California Cancer Registry (CCR) with UCODs reported on death certificates and reclassified the UCODs based on cancer registry data when they disagreed. We then calculated 1-, 3-, 5-, and 10-year cause-specific survival for colon and rectal cancers separately, before and after the reclassification. Records from 26 312 colon and 10 687 rectal cancer patients were examined. UCOD records disagreed with CCR records for 700 (6%) of 11 404 colon cancer deaths and with 1958 (39%) of 5011 rectal cancer deaths, and 82% of the misclassified rectal cancer deaths were coded as colon cancer deaths in the UCOD. Reclassification decreased cause-specific survival for both colon and rectal cancers, but the impact was more pronounced for rectal cancer (eg, 5-year cause-specific survival of colon cancer decreased by 2.8% and of rectal cancer decreased by 20.0% relative to previous estimates; absolute rates changed from 65.4% to 63.6%, and 81.2% to 64.9%, respectively, after reclassification). Interchangeable use of the terms colon cancer and colorectal cancer is likely to be one of the reasons for UCOD misclassification. Educational measures could improve the accuracy of UCOD for colon and rectal cancer deaths.

  13. [Reliability of the individual age assessment at the time of death based on sternal rib end morphology in Balkan population].

    PubMed

    Donić, Danijela; Durić, Marija; Babić, Dragan; Popović, Dorde

    2005-06-01

    This paper analyzes the reliability of the Iscan's sternal rib-ends phase method for the assessment of individual age at the time of death in the Balkan population. The method is based on the morphological age changes of the sternal rib ends. The tested samples consisted of 65 ribs from autopsy cases in the Institute for Forensic Medicine, University of Belgrade, during 1999-2002 (23 females, and 42 males of various ages, ranged from 17-91 years), according to the forensic documents. Significant differences between the real chronological age of the individuals and the values established by the Iscan's method was found, especially in the older categories (phases 6 and 7), in both males and females. The results of the discriminative analysis showed the values of the highest diagnostic relevance for the assessment of age in our population: the change of the depth of the articular fossa, the thickness of its walls, and the quality of the bones.

  14. Mortality and Causes of Death in Patients With Osteogenesis Imperfecta: A Register-Based Nationwide Cohort Study.

    PubMed

    Folkestad, Lars; Hald, Jannie Dahl; Canudas-Romo, Vladimir; Gram, Jeppe; Hermann, Anne Pernille; Langdahl, Bente; Abrahamsen, Bo; Brixen, Kim

    2016-12-01

    Osteogenesis imperfecta (OI) is a hereditary connective tissue disease that causes frequent fractures. Little is known about causes of death and length of survival in OI. The objective of this work was to calculate the risk and cause of death, and the median survival time in patients with OI. This study was a Danish nationwide, population-based and register-based cohort study. We used National Patient Register data from 1977 until 2013 with complete long-term follow-up. Participants comprised all patients registered with the diagnosis of OI from 1977 until 2013, and a reference population matched five to one to the OI cohort. We calculated hazard ratios for all-cause mortality and subhazard ratios for cause-specific mortality in a comparison of the OI cohort and the reference population. We also calculated all-cause mortality hazard ratios for males, females, and age groups (0 to 17.99 years, 18.00 to 34.99 years, 35.00 to 54.99 years, 55.00 to 74.99 years, and >75 years). We identified 687 cases of OI (379 women) and included 3435 reference persons (1895 women). A total of 112 patients with OI and 257 persons in the reference population died during the observation period. The all-cause mortality hazard ratio between the OI cohort and the reference population was 2.90. The median survival time for males with OI was 72.4 years, compared to 81.9 in the reference population. The median survival time for females with OI was 77.4 years, compared to 84.5 years in the reference population. Patients with OI had a higher risk of death from respiratory diseases, gastrointestinal diseases, and trauma. We were limited by the lack of clinical information about phenotype and genotype of the included patients. Patients with OI had a higher mortality rate throughout their life compared to the general population. © 2016 American Society for Bone and Mineral Research.

  15. Looking at: Competency-Based Teacher Education, Public Doublespeak, Oral History, Death and Dying.

    ERIC Educational Resources Information Center

    ERIC Clearinghouse for Social Studies/Social Science Education, Boulder, CO.

    Four issues of a current awareness bulletin published occasionally by the ERIC Clearinghouse for Social Studies for use by elementary and secondary social studies teachers are combined in this document. The first issue deals with the application of competency-based curriculum to teacher education, focusing on teacher growth and evidence of pupil…

  16. Reliability of cause of death coding: an international comparison.

    PubMed

    Antini, Carmen; Rajs, Danuta; Muñoz-Quezada, María Teresa; Mondaca, Boris Andrés Lucero; Heiss, Gerardo

    2015-07-01

    This study evaluates the agreement of nosologic coding of cardiovascular causes of death between a Chilean coder and one in the United States, in a stratified random sample of death certificates of persons aged ≥ 60, issued in 2008 in the Valparaíso and Metropolitan regions, Chile. All causes of death were converted to ICD-10 codes in parallel by both coders. Concordance was analyzed with inter-coder agreement and Cohen's kappa coefficient by level of specification ICD-10 code for the underlying cause and the total causes of death coding. Inter-coder agreement was 76.4% for all causes of death and 80.6% for the underlying cause (agreement at the four-digit level), with differences by the level of specification of the ICD-10 code, by line of the death certificate, and by number of causes of death per certificate. Cohen's kappa coefficient was 0.76 (95%CI: 0.68-0.84) for the underlying cause and 0.75 (95%CI: 0.74-0.77) for the total causes of death. In conclusion, causes of death coding and inter-coder agreement for cardiovascular diseases in two regions of Chile are comparable to an external benchmark and with reports from other countries.

  17. Building Intercultural Competence through Intercultural Competency Certification of Undergraduate Students

    ERIC Educational Resources Information Center

    Janeiro, Maria G. Fabregas; Fabre, Ricardo Lopez; Nuno de la Parra, Jose Pablo

    2014-01-01

    The Intercultural Competency Certificate (CCI in Spanish) designed for the Universidad Popular Autonoma del Estado de Puebla (UPAEP University) is a theory based comprehensive plan to develop undergraduate students' intercultural competence. This Certificate is based in the Developmental Model of Intercultural Sensitivity (DMIS) developed by…

  18. Trends and racial disparities in muscular dystrophy deaths in the United States, 1983-1998: an analysis of multiple cause mortality data.

    PubMed

    Kenneson, Aileen; Kolor, Katherine; Yang, Quanhe; Olney, Richard S; Rasmussen, Sonja A; Friedman, J M

    2006-11-01

    To identify trends and patterns associated with muscular dystrophy (MD)-associated deaths, we analyzed population-based data from death certificates in the Multiple Cause Mortality Files compiled by the National Center for Health Statistics. From 1983 to 1998, 14,499 deaths in the United States were associated with ICD-9 codes for MD. The mortality rate for MD in the general U.S. population over this time period was 0.365 per 100,000 persons per year. Stratification by age at death revealed a trimodal distribution with peaks at 0, 17, and 62 years. The male-to-female ratio varied with age at death, a pattern consistent with a mixture of autosomal and X-linked MDs with different prognoses. Deaths related to MD appeared to be equally divided between presumed autosomal and X-linked MDs. The mortality rate was higher in Whites than in Blacks, for both autosomal and X-linked MDs. The median age at death was lower in Blacks than Whites for both males and females. Cardiac complications were more commonly noted among MD-associated deaths in Blacks (38.9%) than Whites (28.6%). Respiratory infections were noted in about 20% of MD-associated deaths and were more common in winter than summer months. Potential reasons for the racial differences include differences in prevalence rates, rates of diagnosis, and reporting on death certificates. Additional studies are needed to resolve these issues. Challenges in the interpretation of these data include the lack of ICD-9 codes specific for individual MDs and potential recording biases in underlying cause of death and contributing factors. We also present a method for estimating autosomal and X-linked contributions to the overall mortality rate of a genetically heterogeneous condition such as MD.

  19. Commentary: Building the evidence base in support of the American Board of Medical Specialties maintenance of certification program.

    PubMed

    Hawkins, Richard E; Weiss, Kevin B

    2011-01-01

    In this issue, Lipner and colleagues describe research supporting the value of the examinations used in the maintenance of certification (MOC) programs of the American Board of Internal Medicine and the American Board of Surgery. The authors of this commentary review the contribution of this research and previous investigations that underscore the value of this component of the American Board of Medical Specialties (ABMS) MOC program. In addition, they point out that the MOC examination is one element of a comprehensive approach to physician lifelong learning, assessment, and quality improvement. The ABMS MOC program requires diplomates of the ABMS member boards to engage in continuous professional development in the six domains of competence and performance previously defined by the ABMS and the Accreditation Council for Graduate Medical Education. Although evidence and a sound rationale exist to support educational and assessment methods that target all six domains, it will be important to continue to build the body of evidence demonstrating the value of MOC to the public and to the profession.

  20. PEM public key certificate cache server

    NASA Astrophysics Data System (ADS)

    Cheung, T.

    1993-12-01

    Privacy Enhanced Mail (PEM) provides privacy enhancement services to users of Internet electronic mail. Confidentiality, authentication, message integrity, and non-repudiation of origin are provided by applying cryptographic measures to messages transferred between end systems by the Message Transfer System. PEM supports both symmetric and asymmetric key distribution. However, the prevalent implementation uses a public key certificate-based strategy, modeled after the X.509 directory authentication framework. This scheme provides an infrastructure compatible with X.509. According to RFC 1422, public key certificates can be stored in directory servers, transmitted via non-secure message exchanges, or distributed via other means. Directory services provide a specialized distributed database for OSI applications. The directory contains information about objects and then provides structured mechanisms for accessing that information. Since directory services are not widely available now, a good approach is to manage certificates in a centralized certificate server. This document describes the detailed design of a centralized certificate cache serve. This server manages a cache of certificates and a cache of Certificate Revocation Lists (CRL's) for PEM applications. PEMapplications contact the server to obtain/store certificates and CRL's. The server software is programmed in C and ELROS. To use this server, ISODE has to be configured and installed properly. The ISODE library 'libisode.a' has to be linked together with this library because ELROS uses the transport layer functions provided by 'libisode.a.' The X.500 DAP library that is included with the ELROS distribution has to be linked in also, since the server uses the DAP library functions to communicate with directory servers.

  1. Young Children's Probability of Dying Before and After Their Mother's Death: A Rural South African Population-Based Surveillance Study

    PubMed Central

    Clark, Samuel J.; Kahn, Kathleen; Houle, Brian; Arteche, Adriane; Collinson, Mark A.; Tollman, Stephen M.; Stein, Alan

    2013-01-01

    Background There is evidence that a young child's risk of dying increases following the mother's death, but little is known about the risk when the mother becomes very ill prior to her death. We hypothesized that children would be more likely to die during the period several months before their mother's death, as well as for several months after her death. Therefore we investigated the relationship between young children's likelihood of dying and the timing of their mother's death and, in particular, the existence of a critical period of increased risk. Methods and Findings Data from a health and socio-demographic surveillance system in rural South Africa were collected on children 0–5 y of age from 1 January 1994 to 31 December 2008. Discrete time survival analysis was used to estimate children's probability of dying before and after their mother's death, accounting for moderators. 1,244 children (3% of sample) died from 1994 to 2008. The probability of child death began to rise 6–11 mo prior to the mother's death and increased markedly during the 2 mo immediately before the month of her death (odds ratio [OR] 7.1 [95% CI 3.9–12.7]), in the month of her death (OR 12.6 [6.2–25.3]), and during the 2 mo following her death (OR 7.0 [3.2–15.6]). This increase in the probability of dying was more pronounced for children whose mothers died of AIDS or tuberculosis compared to other causes of death, but the pattern remained for causes unrelated to AIDS/tuberculosis. Infants aged 0–6 mo at the time of their mother's death were nine times more likely to die than children aged 2–5 y. The limitations of the study included the lack of knowledge about precisely when a very ill mother will die, a lack of information about child nutrition and care, and the diagnosis of AIDS deaths by verbal autopsy rather than serostatus. Conclusions Young children in lower income settings are more likely to die not only after their mother's death but also in the months before, when

  2. Hydrochemical data base for the Death Valley Region, California and Nevada

    SciTech Connect

    Perfect, D.L.; Faunt, C.C.; Steinkampf, W.C.; Turner, A.K.

    1995-02-01

    Ground-water chemistry data derived from samples collected within an approximately 100,000-square-kilometer area in the Southern Great Basin have been compiled into a digital data base. The data were compiled from published reports, the U.S. Geological Survey (USGS) National Water Information System (NWIS), and previously unpublished USGS files. The data are contained in two compressed files which self-expand into Lotus (.WK1) files. The first file contains 4,738 records (4.84 megabytes) and represents the basic compilation of all identified analyses. The second file is an edited version of the first and contains 3,733 records (3.84 megabytes). Editing included the removal of duplicate records and the combining of records, when appropriate. The analyses presented are of variable quality and comprehensiveness and include no isotopic data. Of the 3,733 analyses in the edited data base, 58 percent of the major ion concentrations balance to within {+-}10 percent. Most of the remaining records are not sufficiently complete for a balance to be calculated.

  3. 38 CFR 11.116 - Death of veteran before final settlement.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Death of veteran before final settlement. If the veteran dies after making application under the... death occurs after the application is filed but before payment is received under this Act, or if the application is filed after death occurs but before the maturity of the certificate and before payment is...

  4. 38 CFR 11.116 - Death of veteran before final settlement.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Death of veteran before final settlement. If the veteran dies after making application under the... death occurs after the application is filed but before payment is received under this Act, or if the application is filed after death occurs but before the maturity of the certificate and before payment is...

  5. Underrepresentation of heroin involvement in unintentional drug overdose deaths in Allegheny County, PA.

    PubMed

    Mertz, Kristen J; Janssen, Jennifer K; Williams, Karl E

    2014-11-01

    Drugs contributing to overdose deaths are listed on death certificates, but their validity is rarely studied. To assess the accuracy of "morphine" and "codeine" listings on death certificates for unintentional overdose deaths in Allegheny County, PA, investigative and laboratory reports were reviewed. Deaths were reclassified as heroin-related if documentation showed 6-monoacetylmorphine in blood or urine, "stamp bags" or drug paraphernalia at scene, history of heroin use, or track marks. Deaths were considered morphine-related if notes indicated morphine use, prescription, or morphine at scene, or codeine-related if the codeine blood level exceeded morphine. Of 112 deaths with morphine but not heroin listed on the death certificate, 74 met heroin criteria and 21 morphine criteria. Of 20 deaths with both morphine and heroin listed, only one met morphine criteria. Of 34 deaths with codeine listed, only five were attributed to codeine. Consideration of patient history, death scene evidence, and expanded toxicology testing may improve the accuracy of death certificate drug listings.

  6. Operator Certification Study Guide.

    ERIC Educational Resources Information Center

    American Water Works Association, Denver, CO.

    This study guide contains typical questions and answers that all levels of water treatment plant operators might expect to find on a certification examination. The manual covers the basic sciences, treatment techniques, testing procedures, and federal legislation. (Author/SB)

  7. Renewable Energy Certificates (RECs)

    EPA Pesticide Factsheets

    Renewable Energy Certificates (RECs), are tradable, non-tangible energy commodities in the United States that represent proof that 1 megawatt-hour (MWh) of electricity was generated from an eligible renewable energy resource.

  8. An A+ Certification Program.

    ERIC Educational Resources Information Center

    Rubenstein, Charles

    2003-01-01

    Describes the computer technology program at Thomas A. Edison Vocational and Technical High School in Queens, New York, all of whose graduates go on to specialty secondary schools for additional certification or to postsecondary education programs. (JOW)

  9. Section 608 Technician Certification

    EPA Pesticide Factsheets

    Overview page with information about certification of technicians who maintain, service, repair, or dispose of equipment that could release ozone depleting refrigerants or, after January 1, 2018, substitute refrigerants into the atmosphere.

  10. Laminar Flow Aircraft Certification

    NASA Technical Reports Server (NTRS)

    Williams, Louis J. (Compiler)

    1986-01-01

    Various topics telative to laminar flow aircraft certification are discussed. Boundary layer stability, flaps for laminar flow airfoils, computational wing design studies, manufacturing requirements, windtunnel tests, and flow visualization are among the topics covered.

  11. Waterfront Certification Changes.

    ERIC Educational Resources Information Center

    O'Brien, Laurie

    1995-01-01

    Overviews certification changes affecting lifeguard training, progressive swimming instructors, CPR and first aid training, canoeing and kayaking instructors, sailing instructors, water skiing instructors, and instructor trainers. Addresses how changes impact American Camping Association standards. Provides addresses of training organizations. (LP)

  12. Accuracy of cause of death data routinely recorded in a population-based cancer registry: impact on cause-specific survival and validation using the Geneva cancer registry

    PubMed Central

    2013-01-01

    Background Information on the underlying cause of death of cancer patients is of interest because it can be used to estimate net survival. The population-based Geneva Cancer Registry is unique because registrars are able to review the official cause of death. This study aims to describe the difference between the official and revised cause-of-death variables and the impact on cancer survival estimates. Methods The recording process for each cause of death variable is summarised. We describe the differences between the two cause-of-death variables for the 5,065 deceased patients out of the 10,534 women diagnosed with breast cancer between 1970 and 2009. The Kappa statistic and logistic regression are applied to evaluate the degree of concordance. The impact of discordance on cause-specific survival is examined using the Kaplan Meier method. Results The overall agreement between the two variables was high. However, several subgroups presented a lower concordance, suggesting differences in calendar time and less attention given to older patients and more advanced diseases. Similarly, the impact of discordance on cause-specific survival was small on overall survival but larger for several subgroups. Conclusion Estimation of cancer-specific survival could therefore be prone to bias when using the official cause of death. Breast cancer is not the more lethal cancer and our results can certainly not be generalised to more lethal tumours. PMID:24373194

  13. Certification of training

    NASA Technical Reports Server (NTRS)

    Gibson, Richard S.

    1994-01-01

    Training has been around as an informal process for countless years. Most higher order animals require some level of training in hunting, social skills, or other survival related skills to continue their existence beyond early infancy. Much of the training is accomplished through imitation, trial and error, and good luck. In some ways the essentials of training in aviation have not deviated from this original formula a great deal. One of the major changes in aviation and other technical areas is that more complex response chains based on a broader base of knowledge are now required. 'To certify' means many things according to the American Heritage dictionary of the English Language. These meanings range from 'to guarantee as meeting a standard' to 'to declare legally insane'. For this discussion, we will use the definition 'an action taken by some authoritative body that essentially guarantees that the instruction meets some defined standard'. In order to make this certification, the responsible body subjects the educational process, training, training device, or simulator to some type of examination to determine its adequacy or validity.

  14. Certification of computational results

    NASA Technical Reports Server (NTRS)

    Sullivan, Gregory F.; Wilson, Dwight S.; Masson, Gerald M.

    1993-01-01

    A conceptually novel and powerful technique to achieve fault detection and fault tolerance in hardware and software systems is described. When used for software fault detection, this new technique uses time and software redundancy and can be outlined as follows. In the initial phase, a program is run to solve a problem and store the result. In addition, this program leaves behind a trail of data called a certification trail. In the second phase, another program is run which solves the original problem again. This program, however, has access to the certification trail left by the first program. Because of the availability of the certification trail, the second phase can be performed by a less complex program and can execute more quickly. In the final phase, the two results are compared and if they agree the results are accepted as correct; otherwise an error is indicated. An essential aspect of this approach is that the second program must always generate either an error indication or a correct output even when the certification trail it receives from the first program is incorrect. The certification trail approach to fault tolerance is formalized and realizations of it are illustrated by considering algorithms for the following problems: convex hull, sorting, and shortest path. Cases in which the second phase can be run concurrently with the first and act as a monitor are discussed. The certification trail approach are compared to other approaches to fault tolerance.

  15. Adolescent births in the border region: a descriptive analysis based on US Hispanic and Mexican birth certificates.

    PubMed

    McDonald, Jill A; Mojarro, Octavio; Sutton, Paul D; Ventura, Stephanie J

    2015-01-01

    Adolescent childbearing adversely affects both mothers and infants. The birth rate for US adolescent women of Hispanic origin is higher than that for US adolescents overall. Birth rates among US Hispanic adolescents in the border region are higher than rates among other US Hispanic adolescents, and rates among Mexican border adolescents are higher than rates among other Mexican adolescents. We used binational birth certificate data for US Hispanic and Mexican adolescent women living inside the border region, elsewhere within the border states, and in the US and Mexico overall to compare birth rates and other health indicators among these groups. From 2000 to 2009, birth rates for 15-19 year-olds declined 19-28 % among US Hispanic geographic subgroups and 8-13 % among Mexican geographic subgroups; rates in the border region in 2009 were 73.8/1,000 women ages 15-19 for US Hispanics and 87.2/1,000 for Mexicans and were higher than rates in other US and Mexican subgroups, respectively. Less than one in five US Hispanic and Mexican adolescent mothers in the border region was married. About one in three delivered by cesarean. Late or no prenatal care was more prevalent among US Hispanic (17.6 %) than Mexican (14.3 %) border adolescents. Birth weight and gestational age outcomes were generally poorest in Texas border counties compared with border counties in other US states and in municipios of Mexican states bordering Texas. High birth rates and low prenatal care utilization among adolescents are problems along the US-Mexico border.

  16. Viking site selection and certification

    NASA Technical Reports Server (NTRS)

    Masursky, H.; Crabill, N. L.

    1981-01-01

    The landing site selection and certification effort for the Viking mission to Mars is reviewed from the premission phase through the acquisition of data and decisions during mission operations and the immediate postlanding evaluation. The utility and limitations of the orbital television and infrared data and ground based radar observation of candidate and actual landing sites are evaluated. Additional instruments and types of observations which would have been useful include higher resolution cameras, radar altimeters, and terrain hazard avoidance capability in the landing system. Suggestions based on this experience that might be applied to future missions are included.

  17. Dig1 protects against cell death provoked by glyphosate-based herbicides in human liver cell lines

    PubMed Central

    2010-01-01

    Background Worldwide used pesticides containing different adjuvants like Roundup formulations, which are glyphosate-based herbicides, can provoke some in vivo toxicity and in human cells. These pesticides are commonly found in the environment, surface waters and as food residues of Roundup tolerant genetically modified plants. In order to know their effects on cells from liver, a major detoxification organ, we have studied their mechanism of action and possible protection by precise medicinal plant extracts called Dig1. Methods The cytotoxicity pathways of four formulations of glyphosate-based herbicides were studied using human hepatic cell lines HepG2 and Hep3B, known models to study xenobiotic effects. We monitored mitochondrial succinate dehydrogenase activity and caspases 3/7 for cell mortality and protection by Dig1, as well as cytochromes P450 1A1, 1A2, 3A4 and 2C9 and glutathione-S-transferase to approach the mechanism of actions. Results All the four Roundup formulations provoke liver cell death, with adjuvants having stronger effects than glyphosate alone. Hep3B are 3-5 times more sensitive over 48 h. Caspases 3/7 are greatly activated in HepG2 by Roundup at non-cytotoxic levels, and some apoptosis induction by Roundup is possible together with necrosis. CYP3A4 is specifically enhanced by Roundup at doses 400 times less than used in agriculture (2%). CYP1A2 is increased to a lesser extent together with glutathione-S-transferase (GST) down-regulation. Dig 1, non cytotoxic and not inducing caspases by itself, is able to prevent Roundup-induced cell death in a time-dependant manner with an important efficiency of up to 89%, within 48 h. In addition, we evidenced that it prevents Caspases 3/7 activation and CYP3A4 enhancement, and not GST reduction, but in turn it slightly inhibited CYP2C9 when added before Roundup. Conclusion Roundup is able to provoke intracellular disruption in hepatic cell lines at different levels, but a mixture of medicinal plant

  18. SIDS and Other Sleep-Related Infant Deaths: Evidence Base for 2016 Updated Recommendations for a Safe Infant Sleeping Environment.

    PubMed

    Moon, Rachel Y

    2016-11-01

    Approximately 3500 infants die annually in the United States from sleep-related infant deaths, including sudden infant death syndrome (SIDS), ill-defined deaths, and accidental suffocation and strangulation in bed. After an initial decrease in the 1990s, the overall sleep-related infant death rate has not declined in more recent years. Many of the modifiable and nonmodifiable risk factors for SIDS and other sleep-related infant deaths are strikingly similar. The American Academy of Pediatrics recommends a safe sleep environment that can reduce the risk of all sleep-related infant deaths. Recommendations for a safe sleep environment include supine positioning, use of a firm sleep surface, room-sharing without bed-sharing, and avoidance of soft bedding and overheating. Additional recommendations for SIDS risk reduction include avoidance of exposure to smoke, alcohol, and illicit drugs; breastfeeding; routine immunization; and use of a pacifier. New evidence and rationale for recommendations are presented for skin-to-skin care for newborn infants, bedside and in-bed sleepers, sleeping on couches/armchairs and in sitting devices, and use of soft bedding after 4 months of age. In addition, expanded recommendations for infant sleep location are included. The recommendations and strength of evidence for each recommendation are published in the accompanying policy statement, "SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment," which is included in this issue.

  19. 76 FR 36001 - Noise Certification Standards for Tiltrotors

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-21

    ... major incremental cost. To meet the proposed requirements of noise control, acoustical measurements are... current costs to noise certificate any other new aircraft type. Based on the above analyses, this proposed.... Statement of the Problem Current regulations in part 36 do not contain noise certification...

  20. 30 CFR 35.9 - Certificates of approval.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... APPROVAL OF MINING PRODUCTS FIRE-RESISTANT HYDRAULIC FLUIDS General Provisions § 35.9 Certificates of approval. (a) Upon completion of an investigation of a hydraulic fluid MSHA will issue to the applicant... hydraulic fluid upon which the certificate of approval is based. In addition to the applicant's record...

  1. 30 CFR 35.9 - Certificates of approval.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... APPROVAL OF MINING PRODUCTS FIRE-RESISTANT HYDRAULIC FLUIDS General Provisions § 35.9 Certificates of approval. (a) Upon completion of an investigation of a hydraulic fluid MSHA will issue to the applicant... hydraulic fluid upon which the certificate of approval is based. In addition to the applicant's record...

  2. 30 CFR 35.9 - Certificates of approval.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... APPROVAL OF MINING PRODUCTS FIRE-RESISTANT HYDRAULIC FLUIDS General Provisions § 35.9 Certificates of approval. (a) Upon completion of an investigation of a hydraulic fluid MSHA will issue to the applicant... hydraulic fluid upon which the certificate of approval is based. In addition to the applicant's record...

  3. 30 CFR 35.9 - Certificates of approval.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... APPROVAL OF MINING PRODUCTS FIRE-RESISTANT HYDRAULIC FLUIDS General Provisions § 35.9 Certificates of approval. (a) Upon completion of an investigation of a hydraulic fluid MSHA will issue to the applicant... hydraulic fluid upon which the certificate of approval is based. In addition to the applicant's record...

  4. 14 CFR 63.15 - Duration of certificates.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ....15 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED... this part is effective until it is surrendered, suspended, or revoked. (b) A flight engineer... that certificate only while the foreign flight engineer license on which that certificate is based...

  5. 14 CFR 63.15 - Duration of certificates.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ....15 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED... this part is effective until it is surrendered, suspended, or revoked. (b) A flight engineer... that certificate only while the foreign flight engineer license on which that certificate is based...

  6. 14 CFR 63.15 - Duration of certificates.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ....15 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED... this part is effective until it is surrendered, suspended, or revoked. (b) A flight engineer... that certificate only while the foreign flight engineer license on which that certificate is based...

  7. 14 CFR 63.15 - Duration of certificates.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ....15 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED... this part is effective until it is surrendered, suspended, or revoked. (b) A flight engineer... that certificate only while the foreign flight engineer license on which that certificate is based...

  8. 14 CFR 63.15 - Duration of certificates.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ....15 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED... this part is effective until it is surrendered, suspended, or revoked. (b) A flight engineer... that certificate only while the foreign flight engineer license on which that certificate is based...

  9. Developing an Online Certification Program for Nutrition Education Assistants

    ERIC Educational Resources Information Center

    Christofferson, Debra; Christensen, Nedra; LeBlanc, Heidi; Bunch, Megan

    2012-01-01

    Objective: To develop an online certification program for nutrition education paraprofessionals to increase knowledge and confidence and to overcome training barriers of programming time and travel expenses. Design: An online interactive certification course based on Supplemental Nutrition Assistance Program-Education and Expanded Food and…

  10. Postsecondary Certificates and Degrees in the State of Alaska.

    ERIC Educational Resources Information Center

    Alaska State Commission on Postsecondary Education, Juneau.

    The number of certificate and degree programs offered and awarded at public and private nonproprietary, postsecondary institutions in Alaska is listed statewide and by institution. Programs that may be underproductive based on the number of formal awards over a four-year period are also identified. A total of 252 unduplicated certificate and…

  11. Subspecialty Certification by the American Board of Psychiatry and Neurology

    ERIC Educational Resources Information Center

    Juul, Dorthea; Scheiber, Stephen C.; Kramer, Thomas A. M.

    2004-01-01

    Objective: The authors describe the approval processes for subspecialties and the mechanisms for certification and recertification and review the status of training programs and numbers of diplomates with subspecialty certification. Methods: Published information and relevant data bases were reviewed. To date, 5,327 child and adolescent…

  12. 42 CFR 493.639 - Fee for revised certificate.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ....639 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... or location, the laboratory must pay a fee to cover the cost of issuing a revised registration certificate. The fee for the revised registration certificate is based on the cost to issue the...

  13. 7 CFR 35.7 - Certificate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... AND PLUMS Definitions § 35.7 Certificate. Certificate or Certificate of Inspection means any of the official forms of inspection certificate, bearing the statement “meets Export Grape and Plum Act,”...

  14. 7 CFR 35.7 - Certificate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... AND PLUMS Definitions § 35.7 Certificate. Certificate or Certificate of Inspection means any of the official forms of inspection certificate, bearing the statement “meets Export Grape and Plum Act,”...

  15. 7 CFR 35.7 - Certificate.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... AND PLUMS Definitions § 35.7 Certificate. Certificate or Certificate of Inspection means any of the official forms of inspection certificate, bearing the statement “meets Export Grape and Plum Act,”...

  16. 7 CFR 35.7 - Certificate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AND PLUMS Definitions § 35.7 Certificate. Certificate or Certificate of Inspection means any of the official forms of inspection certificate, bearing the statement “meets Export Grape and Plum Act,”...

  17. 7 CFR 35.7 - Certificate.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AND PLUMS Definitions § 35.7 Certificate. Certificate or Certificate of Inspection means any of the official forms of inspection certificate, bearing the statement “meets Export Grape and Plum Act,”...

  18. 15 CFR 996.22 - Certification.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES Certification of a Hydrographic Product and Decertification... automatically be considered for certification by NOAA. NOAA shall make its certification determination, if...

  19. 15 CFR 996.22 - Certification.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES Certification of a Hydrographic Product and Decertification... automatically be considered for certification by NOAA. NOAA shall make its certification determination, if...

  20. 15 CFR 996.22 - Certification.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES Certification of a Hydrographic Product and Decertification... automatically be considered for certification by NOAA. NOAA shall make its certification determination, if...

  1. 15 CFR 996.22 - Certification.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES Certification of a Hydrographic Product and Decertification... automatically be considered for certification by NOAA. NOAA shall make its certification determination, if...

  2. 15 CFR 996.22 - Certification.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES Certification of a Hydrographic Product and Decertification... automatically be considered for certification by NOAA. NOAA shall make its certification determination, if...

  3. Guidelines for the verification and validation of expert system software and conventional software: Evaluation of knowledge base certification methods. Volume 4

    SciTech Connect

    Miller, L.A.; Hayes, J.E.; Mirsky, S.M.

    1995-03-01

    This report presents the results of the Knowledge Base Certification activity of the expert systems verification and validation (V&V) guideline development project which is jointly funded by the US Nuclear Regulatory Commission and the Electric Power Research Institute. The ultimate objective is the formulation of guidelines for the V&V of expert systems for use in nuclear power applications. This activity is concerned with the development and testing of various methods for assuring the quality of knowledge bases. The testing procedure used was that of behavioral experiment, the first known such evaluation of any type of V&V activity. The value of such experimentation is its capability to provide empirical evidence for -- or against -- the effectiveness of plausible methods in helping people find problems in knowledge bases. The three-day experiment included 20 participants from three nuclear utilities, the Nuclear Regulatory Commission`s Technical training Center, the University of Maryland, EG&G Idaho, and SAIC. The study used two real nuclear expert systems: a boiling water reactor emergency operating procedures tracking system and a pressurized water reactor safety assessment systems. Ten participants were assigned to each of the expert systems. All participants were trained in and then used a sequence of four different V&V methods selected as being the best and most appropriate for study on the basis of prior evaluation activities. These methods either involved the analysis and tracing of requirements to elements in the knowledge base (requirements grouping and requirements tracing) or else involved direct inspection of the knowledge base for various kinds of errors. Half of the subjects within each system group used the best manual variant of the V&V methods (the control group), while the other half were supported by the results of applying real or simulated automated tools to the knowledge bases (the experimental group).

  4. Certification of damage tolerant composite structure

    NASA Technical Reports Server (NTRS)

    Rapoff, Andrew J.; Dill, Harold D.; Sanger, Kenneth B.; Kautz, Edward F.

    1990-01-01

    A reliability based certification testing methodology for impact damage tolerant composite structure was developed. Cocured, adhesively bonded, and impact damaged composite static strength and fatigue life data were statistically analyzed to determine the influence of test parameters on the data scatter. The impact damage resistance and damage tolerance of various structural configurations were characterized through the analysis of an industry wide database of impact test results. Realistic impact damage certification requirements were proposed based on actual fleet aircraft data. The capabilities of available impact damage analysis methods were determined through correlation with experimental data. Probabilistic methods were developed to estimate the reliability of impact damaged composite structures.

  5. Supplier certification modified for health care.

    PubMed

    Schneider, C F

    1997-11-01

    There have been numerous articles written in detail regarding industrial-based supplier certification programs. These programs generally concentrate on suppliers of raw materials. After reviewing them, it is difficult to visualize how these programs could support the ambulatory or inpatient operations of a healthcare institution. The University of Maryland Medical Center, a 747-bed teaching hospital in Baltimore, took on the challenge to adapt the supplier certification program to support its healthcare institution. After months of struggle, a program emerged by expanding the Medical Center's current process management philosophy, to include its suppliers. Documentation from the program developed by the Medical Center indicates the level of supplier support has increased. Through this certification program, the supplier is aware of the Medical Center's expectations and needs. In turn, the Medical Center has become aware of how its internal processes can hinder the supplier's operation. The supplier certification program has provided a valuable communication conduit. This article covers a brief summation of the industrial-based supplier certification program and how the University of Maryland Medical Center has adapted the program to support all its operations.

  6. [Accompany death].

    PubMed

    Salvador Borrell, Montserrat

    2010-11-01

    One of the roles of nursing is to take care of the patients in terminal situation. The time, the experience, the formation, and the personal and professional attitudes that the nurse has will propitiate that taking care of moribund patients might turn into one of the more rewarding human experiences in life. There for, it is indispensable that nurses assume death as a natural and inevitable reality to achieve. The principal aim of the study is to evaluate the competence of confrontation and the autoefficiency of the welfare among nurses who work with adult patients at the end of the life. Descriptive study realized in the units of Oncology, Hametology and Palliative Care of the following centers: La Fe, Clínico, Dr. Peset, H. General, Arnau de Vilanova and Dr. Moliner de Portacoelli in Valencia (Spain). The following instruments were used: the Bugen Scale of confrontation of the Death (1980-1981) and the Robbins Scale of Autoefficiency (1992). Data suggests that major coping gives major autoeffciency and vice versa. The realized study opens numerous questions, specially related with training and the burden of preparation along the whole professional career, in order to achieve competence for coping and autoefficiency.

  7. IR spectroscopic characteristics of cell cycle and cell death probed by synchrotron radiation based Fourier transform IR spectromicroscopy

    NASA Technical Reports Server (NTRS)

    Holman, H. Y.; Martin, M. C.; Blakely, E. A.; Bjornstad, K.; McKinney, W. R.

    2000-01-01

    Synchrotron radiation based Fourier transform IR (SR-FTIR) spectromicroscopy allows the study of individual living cells with a high signal to noise ratio. Here we report the use of the SR-FTIR technique to investigate changes in IR spectral features from individual human lung fibroblast (IMR-90) cells in vitro at different points in their cell cycle. Clear changes are observed in the spectral regions corresponding to proteins, DNA, and RNA as a cell changes from the G(1)-phase to the S-phase and finally into mitosis. These spectral changes include markers for the changing secondary structure of proteins in the cell, as well as variations in DNA/RNA content and packing as the cell cycle progresses. We also observe spectral features that indicate that occasional cells are undergoing various steps in the process of cell death. The dying or dead cell has a shift in the protein amide I and II bands corresponding to changing protein morphologies, and a significant increase in the intensity of an ester carbonyl C===O peak at 1743 cm(-1) is observed. Copyright John Wiley & Sons, Inc. Biopolymers (Biospectroscopy) 57: 329-335, 2000.

  8. 20 CFR 656.26 - Board of Alien Labor Certification Appeals review of denials of labor certification.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... IN THE UNITED STATES Labor Certification Process § 656.26 Board of Alien Labor Certification Appeals... received from any court, DHS, or the Department of State, upon which the debarment was based. (2) The....S. Department of Labor, 200 Constitution Ave., NW., Washington, DC 20210....

  9. [Relationship between alcohol consumption and external causes of death based on the forensic autopsy cases in Yamaguchi].

    PubMed

    Hakucho, Ayako; Kawamura, Haruka; Liu, Jinyao; Liu, Xu; Takase, Izumi; Fujimiya, Tatsuya

    2014-06-01

    We analyzed forensic autopsy cases to assess the relationship between alcohol consumption and external causes of death. We divided 605 autopsy cases which had been performed from 2000 to 2011 at our department into Alcohol group (n = 172, 28.4%) and Non-alcohol group (n = 433, 71.6%) according to whether alcohol could be detected in the deceased's blood. The individuals' sex and age, season when the death occurred, cause of death, type of death and circumstances of death were analyzed. Alcohol group had a significantly higher ratio of males and younger ages (both p < 0.05). There was no significant between-group difference regarding the seasons when the deaths occurred. Alcohol group had significantly greater rates of spinal injuries, abdominal injuries, traffic accidents, and accidental drowning. "Bicycling" was revealed as a related factor of the traffic accidents only in Alcohol group. In contrast, "accident on the expressway," "riding a motorcycle," and "a passenger in a vehicle" were related factors only in Non-alcohol group. We concluded that the factors of male gender and middle-to-senior age are responsible for the increased risk of external causes of death after alcohol consumption, and that alcohol consumption is one of the risk factors for accidental death. In Japan, drunk-driving-related accidents have shown a downward trend whereas bicycling-related accidents have shown an upward trend, and similar results were obtained in the present study. The low awareness of drinking-induced pitfalls may be responsible for drinking-related bicycle accidents.

  10. Certificate Revocation Using Fine Grained Certificate Space Partitioning

    NASA Astrophysics Data System (ADS)

    Goyal, Vipul

    A new certificate revocation system is presented. The basic idea is to divide the certificate space into several partitions, the number of partitions being dependent on the PKI environment. Each partition contains the status of a set of certificates. A partition may either expire or be renewed at the end of a time slot. This is done efficiently using hash chains.

  11. [Deaths in hotels].

    PubMed

    Risse, Manfred; Weilbächer, Nadine; Birngruber, Christoph; Verhoff, Marcel A

    2010-01-01

    There are no verified statistics about deaths occurring in hotels, and only a few cases have been described in the literature. A recent case induced us to conduct a systematic search for deaths in hotels in the autopsy reports of the Institute of Legal Medicine in Giessen for the period from 1968 to 2009. This search yielded 22 evaluable cases in which persons had been found dead or had died in hotels. Data evaluated in the study were sex and age of the deceased, reason for the stay in the hotel and cause of death. Among the deaths, 18 were males and 4 females and the average age was 41 and 40 years respectively. 6 of the male guests had died from a natural and 10 from a non-natural cause. In the remaining two cases, the cause of death could not be determined, but as there was no evidence that another party had been involved, the cases were not further investigated. Of the 4 female guests, 3 had died of a natural cause; in one case, the cause of death remained unclear even after morphological and toxicological investigations. Surprisingly, a third of the men were found to be temporarily living in hotels due to social circumstances. This was not true for any of the women. Our retrospective analysis is based on a comparatively small number of deaths in what were mostly hotels in small to medium-sized towns. Interestingly, the gender ratio of 18:4 for deceased men and women was significantly higher than the usual gender ratio of 2:1 found for forensic autopsies. To be able to draw further conclusions, a greater number of cases would have to be analysed, for example by recruiting additional case files from other institutes of legal medicine. This would also open up the option of investigating possible regional variations.

  12. Certification as a Quality Initiative.

    PubMed

    Leyden, Christine

    2015-10-01

    The vice president of the Certification and Measurement Services for the American Nurses Credentialing Center presents this month's column focused on the value of certification for both the patient and the organization.

  13. Rehabilitation Counselor Certification: Moving Forward

    ERIC Educational Resources Information Center

    Saunders, Jodi L.; Barros-Bailey, Mary; Chapman, Cindy; Nunez, Patricia

    2009-01-01

    This article provides a brief history of the Commission on Rehabilitation Counselor Certification and presents recent changes and strategic goals for moving forward. Challenges and opportunities for the profession in relation to certification are also discussed. (Contains 3 tables.)

  14. Invariant death

    PubMed Central

    Frank, Steven A.

    2016-01-01

    In nematodes, environmental or physiological perturbations alter death’s scaling of time. In human cancer, genetic perturbations alter death’s curvature of time. Those changes in scale and curvature follow the constraining contours of death’s invariant geometry. I show that the constraints arise from a fundamental extension to the theories of randomness, invariance and scale. A generalized Gompertz law follows. The constraints imposed by the invariant Gompertz geometry explain the tendency of perturbations to stretch or bend death’s scaling of time. Variability in death rate arises from a combination of constraining universal laws and particular biological processes. PMID:27785361

  15. [Near death experiences].

    PubMed

    Rubia Vila, Francisco José

    2012-01-01

    Near Death Experiences are those accounted by people who after being clinically dead return to life spontaneously or after reanimation. These experiences have been used traditionally to support the belief in the existence of the soul and of life after death. However, today neuroscience tries to explain these experiences from the scientific point of view, i.e. explaining them based on their brain substrates. Their resemblance to mystic experiences and to altered states of consciousness seems to indicate that they may be produced by hyperactivity of limbic structures caused by anoxia or hypercapnia.

  16. Spontaneous fetal death among multigravid fertile women in relation to sport fish consumption and PCB exposure, New York State Angler Study

    SciTech Connect

    Mendola, P.

    1994-01-01

    Spontaneous fetal death, a sentinel event for environmental reproductive toxicity, has been observed among various mammalian species following polychlorinated biphenyl (PCB) exposure. This exposure-based cohort study assessed the relationship between PCB exposure due to consumption of contaminated Lake Ontario sport fish and spontaneous fetal death. Using 1,820 women from the 1990-1991 New York State Angler Study, fish consumption data were obtained from food frequency questionnaires and reproductive histories from live birth certificates. A reliability study demonstrated an excellent level of agreement between the exact number of spontaneous fetal deaths recorded on the birth certificate compared with telephone interview data (kappa = 0.83). Women who had never eaten Lake Ontario sport fish were unexposed (n = 979) and 841 women reported various levels of exposure. Analyses were stratified by maternal gravidity and controlled for smoking status and maternal age. No significant increases in risk for spontaneous fetal death were seen for any estimate of PCB exposure including lifetime estimate of PCB exposure based on species-specific PCB levels, years of fish consumption, and kilograms of fish consumed, either in the 1990-1991 season or in a lifetime estimate. The only significant finding was a slight risk reduction for women of gravidity three or more with years of fish consumption (odds ratio = 0.97; p = 0.03; 95% confidence interval = 0.94-0.99). These findings suggest that PCB exposure from contaminated sport fish does not increase the risk of spontaneous fetal death.

  17. [Brain death diagnosis].

    PubMed

    Escudero, Dolores

    2009-05-01

    Brain death has been recognized by the scientific community as the person's death, and accepted in the legislation of different countries. Brain death is defined as the irreversible ending of the functions of all the intracranial neurological structure in both the brain and brain stem. This clinical situation appears when intracranial pressure exceeds the patient's systolic blood pressure, leading to brain circulatory arrest. The most frequent are cerebral hemorrhage and cranioencephalic trauma. Clinical diagnostic must be done by doctors with expertise in neurocritical patient treatment. This diagnosis is based on a systematic, complete and extremely rigorous clinical examination that confirms a non-reactive coma, absence of brain stem reflex, and absence of spontaneous breathing. Instrumental tests may be obligatory in some cases, this depending on each country. Electroencephalogram and evoked potentials are the electrophysiological tests used. In patients treated with sedative drugs, cerebral blood flow evaluation tests, such as cerebral angiography, transcranial Doppler or 99Tc-HMPAO scintigraphy, will be used. More than 92% of the transplants performed in Spain are performed with brain death donor organs. Brain death confirmation is a high responsibility act, with medical, ethical and legal significance since it requires removal of all artificial support, or organs extraction for transplant. Extensive knowledge on its diagnostic and correct decision making avoid unnecessary use of resources and improves management of organs for transplant.

  18. Board Certification in Counseling Psychology

    ERIC Educational Resources Information Center

    Crowley, Susan L.; Lichtenberg, James W.; Pollard, Jeffrey W.

    2012-01-01

    Although specialty board certification by the American Board of Professional Psychology (ABPP) has been a valued standard for decades, the vast majority of counseling psychologists do not pursue board certification in the specialty. The present article provides a brief history of board certification in general and some historical information about…

  19. Board certification in psychology: insights from medicine and hospital psychology.

    PubMed

    Robiner, William N; Dixon, Kim E; Miner, Jacob L; Hong, Barry A

    2012-03-01

    For physicians board certification is an accepted tradition that research suggests improves services and outcomes. In contrast, relatively few psychologists pursue board certification suggesting ambivalence or limited contingencies reinforcing it. The authors report on medical school and hospital-based psychologists' attitudes toward board certification and current certification status. About one-fifth (21.7%) of the sample were certified by the American Board of Professional Psychology, a greater proportion than psychologists generally: Highest rates were seen in neuropsychology (7.5%), clinical psychology (6.4%), clinical child and adolescent psychology (3.2%) and clinical health psychology (2.8%). Few (<2%) reported their hospitals required board certification. Half recognized benefits to the profession for psychologists pursuing board certification, yet 70% opposed requiring it for their hospital-based practice. Forces seeking to promote healthcare quality ultimately may increase expectations for board certification. If consumers, employers, hospitals and managed care organizations demand board certification for health professionals, greater numbers of psychologists would likely seek it.

  20. Consumption of PCB-contaminated sport fish and risk of spontaneous fetal death

    SciTech Connect

    Mendola, P.; Buck, G.M.; Vena, J.E.; Zielezny, M.; Sever, L.E.

    1995-05-01

    Spontaneous fetal death has been observed among various mammalian species after exposure to polychlorinated biphenyls (PCBs). Our exposure-based cohort study assessed the relationship between consumption of PCB-contaminated Lake Ontario sport fish and spontaneous fetal death using 1820 multigravid fertile women from the 1990-1991 New York State Angler Cohort Study. Fish consumption data were obtained from food frequency questionnaires and history of spontaneous fetal death from live birth certificates. Analyses were stratified by number of prior pregnancies and controlled for smoking and maternal age. No significant increases in risk for fetal death were observed across four measures of exposure: a lifetime estimate of PCB exposure based on species-specific PCB levels; the number of years of fish consumption; kilograms of sport fish consumed in 1990-1991; and a lifetime estimate of kilograms eaten. A slight risk reduction was seen for women with two prior pregnancies at the highest level of PCB exposure (odds ratio = 0.36; 95% CI, 0.14-0.92) and for women with three or more prior pregnancies with increasing years of fish consumption (odds ratio = 0.97; 95% CI, 0.94-0.99). These findings suggest that consumption of PCB-contaminated sport fish does not increase the risk of spontaneous fetal death. 50 refs., 2 tabs.

  1. Consumption of PCB-contaminated sport fish and risk of spontaneous fetal death.

    PubMed Central

    Mendola, P; Buck, G M; Vena, J E; Zielezny, M; Sever, L E

    1995-01-01

    Spontaneous fetal death has been observed among various mammalian species after exposure to polychlorinated biphenyls (PCBs). Our exposure-based cohort study assessed the relationship between consumption of PCB-contaminated Lake Ontario sport fish and spontaneous fetal death using 1820 multigravid fertile women from the 1990-1991 New York State Angler Cohort Study. Fish consumption data were obtained from food frequency questionnaires and history of spontaneous fetal death from live birth certificates. Analyses were stratified by number of prior pregnancies and controlled for smoking and maternal age. No significant increases in risk for fetal death were observed across four measures of exposure: a lifetime estimate of PCB exposure based on species-specific PCB levels; the number of years of fish consumption; kilograms of sport fish consumed in 1990-1991; and a lifetime estimate of kilograms eaten. A slight risk reduction was seen for women with two prior pregnancies at the highest level of PCB exposure (odds ratio = 0.36; 95% CI, 0.14-0.92) and for women with three or more prior pregnancies with increasing years of fish consumption (odds ratio = 0.97; 95% CI, 0.94-0.99). These findings suggest that consumption of PCB-contaminated sport fish does not increase the risk of spontaneous fetal death. PMID:7656880

  2. Encountering Death: Structured Activities for Death Awareness.

    ERIC Educational Resources Information Center

    Welch, Ira David; And Others

    This book is intended to be used as a supplement to standard textbooks on death and dying for college students. Chapter 1 "Encountering Death in the Self" builds the foundation for increased self-awareness for the study of death and dying. Chapter 2 "Encountering Death in the Family" provides activities which are appropriate for a wide variety of…

  3. Parental bereavement after the death of an offspring in a motor vehicle collision: a population-based study.

    PubMed

    Bolton, James M; Au, Wendy; Walld, Randy; Chateau, Dan; Martens, Patricia J; Leslie, William D; Enns, Murray W; Sareen, Jitender

    2014-01-15

    Motor vehicle collisions (MVCs) are the leading cause of death in young people in North America. The effects of such deaths on parents have not been systematically studied. Administrative data sets were used to identify all parents (n = 1,458) who had an offspring die in a MVC between 1996 and 2008 in the province of Manitoba, Canada. They were matched to general population control parents who had not had offspring die from any sudden cause during the study period. Generalized estimating equations were used to compare the rates of physician-diagnosed mental and physical disorders, social factors, and treatment utilization in the 2 parent groups in the 2 years before and after offspring death, with adjustment for confounding factors. The risk of depression among bereaved parents almost tripled (adjusted prevalence ratio = 2.85, 95% confidence interval: 2.44, 3.33; P < 0.001) during the 2 years after death of an offspring. Significant increases in the risk of anxiety disorders (adjusted prevalence ratio = 1.45, 95% confidence interval: 1.26, 1.67; P < 0.001) were also observed. When compared with nonbereaved parents, bereaved parents had significant increases in the risks of depression (P < 0.001), anxiety disorders (P < 0.001), marital break-up (P = 0.015), and physician visits for mental illness (P < 0.001) in the post-death period. In conclusion, parents who lose an offspring in a MVC experience considerable mental illness and marital disruption.

  4. Demographic, clinical and pathological features of sudden deaths due to myocarditis: Results from a state-wide population-based autopsy study.

    PubMed

    Li, Liliang; Zhang, Yang; Burke, Allen; Xue, Aimin; Zhao, Ziqin; Fowler, David; Shen, Yiwen; Li, Ling

    2017-03-01

    Causes of sudden cardiac deaths have been widely reported with limited data focused specifically on myocarditis. A retrospective review of cases from the Office of the Chief Medical Examiner (OCME), State of Maryland yielded a total of 103 sudden unexpected deaths (SUDs) due to myocarditis (0.17% of all SUDs and 0.70% of autopsied SUDs) from 2005 through 2014. Most deaths occurred in patients <30 years of age with a male:female ratio 1.3:1. Of the 103 cases, 45 (43.7%) patients were witnessed collapsed. Four deaths occurred during exertion, such as exercising at the gym or performing heavy physical work, and 2 deaths were associated with emotional stress. The common cardiac macroscopic findings included ventricular dilatation (39.8%), mild coronary stenosis (17.5%), mottled myocardial appearance (15.5%), and myocardial fibrosis (10.7%). The histological classification of myocarditis was based on the predominant type of inflammatory cell infiltration. In our study group, lymphocytic myocarditis was most common, accounting for 56 cases (54.4%), followed by neutrophilic (32 cases, 31.7%), eosinophilic (13 cases, 12.6%) and giant cell type (2 cases, 1.9%). Microscopic examination revealed myocyte necrosis in 69 cases (67.0%) and interstitial or perivascular fibrosis in 48 cases (46.6%). The percentage of myocyte necrosis was 75.0% (42/58 cases) in lymphocytic, 65.6% (21/31 cases) in neutrophilic, 30.8% (4/13 cases) in eosinophilic, and 100% (2/2 cases) in giant cell myocarditis. Determination of myocarditis as cause of death continues to present a major challenge to forensic pathologists, because histopathologic findings can be subtle and the diagnosis of myocarditis remains difficult.

  5. Mortality among immigrants in England and Wales by major causes of death, 1971-2012: A longitudinal analysis of register-based data.

    PubMed

    Wallace, Matthew; Kulu, Hill

    2015-12-01

    Recent research has found a migrant mortality advantage among immigrants relative to the UK-born population living in England and Wales. However, while all-cause mortality is useful to show differences in mortality between immigrants and the host population, it can mask variation in mortality patterns from specific causes of death. This study analyses differences in the causes of death among immigrants living in England and Wales. We extend previous research by applying competing-risks survival analysis to study a large-scale longitudinal dataset from 1971 to 2012 to directly compare causes of death. We confirm low all-cause mortality among nearly all immigrants, except immigrants from Scotland, Northern Ireland and the Republic of Ireland (who have high mortality). In most cases, low all-cause mortality among immigrants is driven by lower mortality from chronic diseases (in nearly all cases by lower cancer mortality and in some cases by lower mortality from cardiovascular diseases (CVD)). This low all-cause mortality often coexists with low respiratory disease mortality and among non-western immigrants, coexists with high mortality from infectious diseases; however, these two causes of death contribute little to mortality among immigrants. For men, CVD is the leading cause of death (particularly among South Asians). For women, cancer is the leading cause of death (except among South Asians, for whom CVD is also the leading cause). Differences in CVD mortality over time remain constant between immigrants relative to UK-born, but immigrant cancer patterns shows signs of some convergence to the cancer mortality among the UK-born (though cancer mortality is still low among immigrants by age 80). The study provides the most up-to-date, reliable UK-based analysis of immigrant mortality.

  6. Atomic oxygen interaction with spacecraft materials: Relationship between orbital and ground-based testing for materials certification

    NASA Technical Reports Server (NTRS)

    Cross, Jon B.; Koontz, Steven L.; Lan, Esther H.

    1993-01-01

    The effects of atomic oxygen on boron nitride (BN), silicon nitride (Si3N4), Intelsat 6 solar cell interconnects, organic polymers, and MoS2 and WS2 dry lubricant, were studied in Low Earth Orbit (LEO) flight experiments and in a ground based simulation facility. Both the inflight and ground based experiments employed in situ electrical resistance measurements to detect penetration of atomic oxygen through materials and Electron Spectroscopy for Chemical Analysis (ESCA) analysis to measure chemical composition changes. Results are given. The ground based results on the materials studied to date show good qualitative correlation with the LEO flight results, thus validating the simulation fidelity of the ground based facility in terms of reproducing LEO flight results. In addition it was demonstrated that ground based simulation is capable of performing more detailed experiments than orbital exposures can presently perform. This allows the development of a fundamental understanding of the mechanisms involved in the LEO environment degradation of materials.

  7. 13 CFR 315.7 - Certification requirements.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...) Minimum certification thresholds. (1) Twelve-month decline. Based upon a comparison of the most recent 12... Significant Number or Proportion of Workers in the Firm has undergone Total or Partial Separation or a Threat of Total or Partial Separation; (ii) Either sales or production, or both, of the Firm has...

  8. 13 CFR 315.7 - Certification requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) Minimum certification thresholds. (1) Twelve-month decline. Based upon a comparison of the most recent 12... Significant Number or Proportion of Workers in the Firm has undergone Total or Partial Separation or a Threat of Total or Partial Separation; (ii) Either sales or production, or both, of the Firm has...

  9. 24 CFR 91.325 - Certifications.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... following certifications: (1) If it plans to use program funds for tenant-based rental assistance, a... CONSOLIDATED SUBMISSIONS FOR COMMUNITY PLANNING AND DEVELOPMENT PROGRAMS State Governments; Contents of... effect and is following a residential antidisplacement and relocation assistance plan in connection...

  10. 40 CFR 745.89 - Firm certification.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 31 2011-07-01 2011-07-01 false Firm certification. 745.89 Section 745.89 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Residential Property...

  11. 40 CFR 745.89 - Firm certification.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 32 2013-07-01 2013-07-01 false Firm certification. 745.89 Section 745.89 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Residential Property...

  12. 40 CFR 745.89 - Firm certification.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 31 2014-07-01 2014-07-01 false Firm certification. 745.89 Section 745.89 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Residential Property...

  13. 40 CFR 745.89 - Firm certification.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Firm certification. 745.89 Section 745.89 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Residential Property...

  14. 40 CFR 745.89 - Firm certification.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 32 2012-07-01 2012-07-01 false Firm certification. 745.89 Section 745.89 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Residential Property...

  15. 10 CFR 431.36 - Compliance Certification.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... motor which is subject to an energy efficiency standard set forth in this subpart unless it has... DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY EFFICIENCY PROGRAM FOR CERTAIN COMMERCIAL AND INDUSTRIAL... the Compliance Certification must be based upon the basic model's energy efficiency as determined...

  16. 10 CFR 431.36 - Compliance Certification.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... motor which is subject to an energy efficiency standard set forth in this subpart unless it has... DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY EFFICIENCY PROGRAM FOR CERTAIN COMMERCIAL AND INDUSTRIAL... the Compliance Certification must be based upon the basic model's energy efficiency as determined...

  17. What is organic certification?

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Certified organic crop production is a holistic approach to sustainable and healthy food production to enhance the well being of the consumer, while protecting natural resources. Organic certification was implemented by the National Organic Program (NOP) in 2002 in recognition of the necessity for c...

  18. Standards and Certification. Symposium.

    ERIC Educational Resources Information Center

    2002

    This document contains three papers from a symposium on standards and certification in human resource development (HRD). "Implementing Management Standards in the UK" (Jonathan Winterton, Ruth Winterton) reports on a study that explored the implementation of management standards in 16 organizations and identified 36 key themes and…

  19. School Nursing Certification Review

    ERIC Educational Resources Information Center

    Selekman, Janice; Wolfe, Linda C.

    2010-01-01

    The 2010 update to the resource you have been waiting for to help you prepare to take the National School Nurse Certification Exam. Dr. Janice Selekman DNSc, RN, NCSN, a recognized expert in pediatric nursing, and NASN Past President Linda C. Wolfe MEd, BSN, RN, NCSN, FNASN are the authors. This text was created in response to many years of…

  20. Place of death among Botswana's oldest old.

    PubMed

    Lazenby, J Mark; Olshvevski, Jodi

    2012-01-01

    Botswana, a country in sub-Saharan Africa, has been in the midst of an HIV/AIDs pandemic that has halted its previously lengthening life expectancy trend. However, one group to escape immediate effects on falling life span is the oldest old age group (> 80 years). Their roles in the community due to the pandemic, however, have changed. Place of death is an important consideration in end-of-life care for older adults, and one which has been well studied in the Global North. The purpose of this article is to determine where Botswana's oldest old die (home or hospital), and to see whether cause of death, gender, or residence in a city, town, or rural area is associated with place of death. We use death certificate data from 2005 and 2006 to describe where the oldest old Batswana (the name for the people of Botswana) died, home or hospital. Two-thirds died at home. The mean age at death was 88.46 (+/- 6.21) years; more were female (56.9%); and of known causes of death, cardiovascular disease was the leading cause (16.8%). Most stated causes of death (62.4%) were listed as "unknown." Most oldest-old Batswana died in rural areas (70.1%), and in rural areas, proportionally more oldest old died at home compared to cities and towns. On multivariate analysis, being a woman > 80 years of age at death predicted home death. Future longitudinal study needs to determine preferences of place of death and the quality of death of Batswana > 80 years, especially women.

  1. Certification Considerations for Adaptive Systems

    NASA Technical Reports Server (NTRS)

    Bhattacharyya, Siddhartha; Cofer, Darren; Musliner, David J.; Mueller, Joseph; Engstrom, Eric

    2015-01-01

    Advanced capabilities planned for the next generation of aircraft, including those that will operate within the Next Generation Air Transportation System (NextGen), will necessarily include complex new algorithms and non-traditional software elements. These aircraft will likely incorporate adaptive control algorithms that will provide enhanced safety, autonomy, and robustness during adverse conditions. Unmanned aircraft will operate alongside manned aircraft in the National Airspace (NAS), with intelligent software performing the high-level decision-making functions normally performed by human pilots. Even human-piloted aircraft will necessarily include more autonomy. However, there are serious barriers to the deployment of new capabilities, especially for those based upon software including adaptive control (AC) and artificial intelligence (AI) algorithms. Current civil aviation certification processes are based on the idea that the correct behavior of a system must be completely specified and verified prior to operation. This report by Rockwell Collins and SIFT documents our comprehensive study of the state of the art in intelligent and adaptive algorithms for the civil aviation domain, categorizing the approaches used and identifying gaps and challenges associated with certification of each approach.

  2. Determining 'age at death' for forensic purposes using human bone by a laboratory-based biomechanical analytical method.

    PubMed

    Zioupos, P; Williams, A; Christodoulou, G; Giles, R

    2014-05-01

    Determination of age-at-death (AAD) is an important and frequent requirement in contemporary forensic science and in the reconstruction of past populations and societies from their remains. Its estimation is relatively straightforward and accurate (±3yr) for immature skeletons by using morphological features and reference tables within the context of forensic anthropology. However, after skeletal maturity (>35yr) estimates become inaccurate, particularly in the legal context. In line with the general migration of all the forensic sciences from reliance upon empirical criteria to those which are more evidence-based, AAD determination should rely more-and-more upon more quantitative methods. We explore here whether well-known changes in the biomechanical properties of bone and the properties of bone matrix, which have been seen to change with age even after skeletal maturity in a traceable manner, can be used to provide a reliable estimate of AAD. This method charts a combination of physical characteristics some of which are measured at a macroscopic level (wet & dry apparent density, porosity, organic/mineral/water fractions, collagen thermal degradation properties, ash content) and others at the microscopic level (Ca/P ratios, osteonal and matrix microhardness, image analysis of sections). This method produced successful age estimates on a cohort of 12 donors of age 53-85yr (7 male, 5 female), where the age of the individual could be approximated within less than ±1yr. This represents a vastly improved level of accuracy than currently extant age estimation techniques. It also presents: (1) a greater level of reliability and objectivity as the results are not dependent on the experience and expertise of the observer, as is so often the case in forensic skeletal age estimation methods; (2) it is purely laboratory-based analytical technique which can be carried out by someone with technical skills and not the specialised forensic anthropology experience; (3) it can

  3. Midcourse Space Experiment Data Certification and Technology Transfer

    NASA Technical Reports Server (NTRS)

    Pollock, David B.

    1998-01-01

    The Midcourse Space Experiment spacecraft, launched April 24, 1996, is expected to have a 5 year useful lifetime with a 12 month lifetime for the cryogenically cooled IR sensor. A pre-launch, ground based calibration of the instruments provided a basis for the pre-launch certification of the Level 2 data base these instruments produce. With the spacecraft in-orbit the certification of the instrument's Level 2 data base is being extended to the in-orbit environment.

  4. Young People's Risk of Suicide Attempts in Relation to Parental Death: A Population-Based Register Study

    ERIC Educational Resources Information Center

    Jakobsen, Ida Skytte; Christiansen, Erik

    2011-01-01

    Background: The objective of this study was to examine the association between the death of a biological parent and subsequent suicide attempts by young people (aged 10-22 years), and to explore sociodemographic factors as modifying factors in the process. Methods: The study used a nested case-control design. The full study population was obtained…

  5. Sex-Based Differences in Rates, Causes, and Predictors of Death Among Injection Drug Users in Vancouver, Canada.

    PubMed

    Hayashi, Kanna; Dong, Huiru; Marshall, Brandon D L; Milloy, Michael-John; Montaner, Julio S G; Wood, Evan; Kerr, Thomas

    2016-03-15

    In the present study, we sought to identify rates, causes, and predictors of death among male and female injection drug users (IDUs) in Vancouver, British Columbia, Canada, during a period of expanded public health interventions. Data from prospective cohorts of IDUs in Vancouver were linked to the provincial database of vital statistics to ascertain rates and causes of death between 1996 and 2011. Mortality rates were analyzed using Poisson regression and indirect standardization. Predictors of mortality were identified using multivariable Cox regression models stratified by sex. Among the 2,317 participants, 794 (34.3%) of whom were women, there were 483 deaths during follow-up, with a rate of 32.1 (95% confidence interval (CI): 29.3, 35.0) deaths per 1,000 person-years. Standardized mortality ratios were 7.28 (95% CI: 6.50, 8.14) for men and 15.56 (95% CI: 13.31, 18.07) for women. During the study period, mortality rates related to infection with human immunodeficiency virus (HIV) declined among men but remained stable among women. In multivariable analyses, HIV seropositivity was independently associated with mortality in both sexes (all P < 0.05). The excess mortality burden among IDUs in our cohorts was primarily attributable to HIV infection; compared with men, women remained at higher risk of HIV-related mortality, indicating a need for sex-specific interventions to reduce mortality among female IDUs in this setting.

  6. Personnel Issues in School-Based Physical Therapy: A Look at Supply and Demand, Professional Preparation, Licensure, and Certification

    ERIC Educational Resources Information Center

    Rapport, Mary Jane K.; Effgen, Susan K.

    2004-01-01

    Physical therapy in school settings focuses on outcomes and is based on meeting the educational needs of the child or student. Despite the expansion in delivery models beyond direct one-to-one intervention, and the use of multiple team members, to achieve outcomes for students in educational environments, there continue to be shortages of physical…

  7. Causes of death among undocumented migrants in Sweden, 1997–2010

    PubMed Central

    Wahlberg, Anna; Källestål, Carina; Lundgren, AnnaCarin; Essén, Birgitta

    2014-01-01

    Background Undocumented migrants are one of the most vulnerable groups in Swedish society, where they generally suffer from poor health and limited health care access. Due to their irregular status, such migrants are an under-researched group and are not included in the country’s Cause of Death Register (CDR). Objective To determine the causes of death among undocumented migrants in Sweden and to ascertain whether there are patterns in causes of death that differ between residents and undocumented migrants. Design This is a cross-sectional study of death certificates issued from 1997 to 2010 but never included in the CDR from which we established our study sample of undocumented migrants. As age adjustments could not be performed due to lack of data, comparisons between residents and undocumented migrants were made at specific age intervals, based on the study sample’s mean age at death±a half standard deviation. Results Out of 7,925 individuals surveyed, 860 were classified as likely to have been undocumented migrants. External causes (49.8%) were the most frequent cause of death, followed by circulatory system diseases, and then neoplasms. Undocumented migrants had a statistically significant increased risk of dying from external causes (odds ratio [OR] 3.57, 95% confidence interval [CI]: 2.83–4.52) and circulatory system diseases (OR 2.20, 95% CI: 1.73–2.82) compared to residents, and a lower risk of dying from neoplasms (OR 0.07, 95% CI: 0.04–0.14). Conclusions We believe our study is the first to determine national figures on causes of death of undocumented migrants. We found inequity in health as substantial differences in causes of death between undocumented migrants and residents were seen. Legal ambiguities regarding health care provision must be addressed if equity in health is to be achieved in a country otherwise known for its universal health coverage. PMID:24909409

  8. Spatial analysis of deaths from pulmonary tuberculosis in the city of São Luís, Brazil*

    PubMed Central

    Santos-Neto, Marcelino; Yamamura, Mellina; Garcia, Maria Concebida da Cunha; Popolin, Marcela Paschoal; Silveira, Tatiane Ramos dos Santos; Arcêncio, Ricardo Alexandre

    2014-01-01

    OBJECTIVE: To characterize deaths from pulmonary tuberculosis, according to sociodemographic and operational variables, in the city of São Luís, Brazil, and to describe their spatial distribution. METHODS: This was an exploratory ecological study based on secondary data from death certificates, obtained from the Brazilian Mortality Database, related to deaths from pulmonary tuberculosis. We included all deaths attributed to pulmonary tuberculosis that occurred in the urban area of São Luís between 2008 and 2012. We performed univariate and bivariate analyses of the sociodemographic and operational variables of the deaths investigated, as well as evaluating the spatial distribution of the events by kernel density estimation. RESULTS: During the study period, there were 193 deaths from pulmonary tuberculosis in São Luís. The median age of the affected individuals was 52 years. Of the 193 individuals who died, 142 (73.60%) were male, 133 (68.91%) were Mulatto, 102 (53.13%) were single, and 64 (33.16%) had completed middle school. There was a significant positive association between not having received medical care prior to death and an autopsy having been performed (p = 0.001). A thematic map by density of points showed that the spatial distribution of those deaths was heterogeneous and that the density was as high as 8.12 deaths/km2. CONCLUSIONS: The sociodemographic and operational characteristics of the deaths from pulmonary tuberculosis evaluated in this study, as well as the identification of priority areas for control and surveillance of the disease, could promote public health policies aimed at reducing health inequities, allowing the optimization of resources, as well as informing decisions regarding the selection of strategies and specific interventions targeting the most vulnerable populations. PMID:25410843

  9. 16 CFR 1204.13 - Certificate of compliance.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... SAFETY STANDARD FOR OMNIDIRECTIONAL CITIZENS BAND BASE STATION ANTENNAS Certification § 1204.13... that the records provide a reasonable assurance that all antennas imported comply with the standard....

  10. 16 CFR 1204.13 - Certificate of compliance.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... SAFETY STANDARD FOR OMNIDIRECTIONAL CITIZENS BAND BASE STATION ANTENNAS Certification § 1204.13... that the records provide a reasonable assurance that all antennas imported comply with the standard....

  11. 16 CFR 1204.13 - Certificate of compliance.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... SAFETY STANDARD FOR OMNIDIRECTIONAL CITIZENS BAND BASE STATION ANTENNAS Certification § 1204.13... that the records provide a reasonable assurance that all antennas imported comply with the standard....

  12. 16 CFR 1204.13 - Certificate of compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... SAFETY STANDARD FOR OMNIDIRECTIONAL CITIZENS BAND BASE STATION ANTENNAS Certification § 1204.13... that the records provide a reasonable assurance that all antennas imported comply with the standard....

  13. 16 CFR 1204.13 - Certificate of compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... SAFETY STANDARD FOR OMNIDIRECTIONAL CITIZENS BAND BASE STATION ANTENNAS Certification § 1204.13... that the records provide a reasonable assurance that all antennas imported comply with the standard....

  14. 40 CFR 91.118 - Certification procedure-testing.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... use as a test engine any engine which incurs major mechanical failure necessitating disassembly of the... certificate of conformity; or (ii) Model year 2003 based on good engineering judgement. (2) Upon request...

  15. Certification in Distance Learning for Online Instructors: Exploration of the Creation of an Organic Model for a Research-Based State Institution

    ERIC Educational Resources Information Center

    Graham, Lee; Thomas, Lisa

    2011-01-01

    The traditional and most highly utilized manner of instruction in the online Certification Course focuses on training instructors to teach a pre-designed course with common features. This model limits instructional options for faculty to those which are available in the course. Faculty who are accustomed to academic freedom and autonomy may not be…

  16. Aging and Death Education.

    ERIC Educational Resources Information Center

    Pinder, Margaret M.; Hayslip, Bert, Jr.

    1980-01-01

    The elderly death rate is somewhat higher than the death rate in general. Numbers of schools with gerontological curricula and frequency of death education courses are positively related to elderly death rates. The contention that elderly deaths have less social impact is not supported. (JAC)

  17. 14 CFR 21.41 - Type certificate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Type certificate. 21.41 Section 21.41 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT CERTIFICATION PROCEDURES FOR PRODUCTS AND PARTS Type Certificates § 21.41 Type certificate. Each type certificate...

  18. Expressing death risk as condensed life experience and death intensity.

    PubMed

    Ioannidis, John P A

    2013-08-01

    Some risk exposures, including many medical and surgical procedures, typically carry hazards of death that are difficult to convey and appreciate in absolute terms. I propose presenting the death risk as a condensed life experience (i.e., the equivalent amount of life T that would carry the same cumulative mortality hazard for a person of the same age and sex based on life tables). For example, if the risk of death during an elective 1-hour procedure is 0.01%, and same-age and same-sex people have a 0.01% death risk over 1 month, one can inform the patient that "this procedure carries the same death risk as living 1 month of normal life." Comparative standards from other risky activities or from a person with the same disease at the same stage and same predictive profile could also be used. A complementary metric that may be useful to consider is the death intensity. The death intensity λ is the hazard function that shows the fold-risk estimate of dying compared with the reference person. The death intensity can vary substantially for different phases of the event, operation, or procedure (e.g., intraoperative, early postoperative, late postoperative), and this variability may also be useful to convey. T will vary depending on the time window for which it is computed. I present examples for calculating T and λ using literature data on accidents, ascent to Mount Everest, and medical and surgical procedures.

  19. First in line: Prioritizing receipt of Social Security disability benefits based on likelihood of death during adjudication

    PubMed Central

    Rasch, Elizabeth K.; Huynh, Minh; Ho, Pei-Shu; Heuser, Aaron; Houtenville, Andrew; Chan, Leighton

    2014-01-01

    Background: Given the complexity of the adjudication process and volume of applications to Social Security Administration’s (SSA) disability programs, many individuals with serious medical conditions die while awaiting an application decision. Limitations of traditional survival methods called for a new empirical approach to identify conditions resulting in rapid mortality. Objective: To identify health conditions associated with significantly higher mortality than a key reference group among applicants for SSA disability programs. Research design: We identified mortality patterns and generated a survival surface for a reference group using conditions already designated for expedited processing. We identified conditions associated with significantly higher mortality than the reference group and prioritized them by the expected likelihood of death during the adjudication process. Subjects: Administrative records of 29 million Social Security disability applicants, who applied for benefits from 1996 – 2007, were analyzed. Measures: We computed survival spells from time of onset of disability to death, and from date of application to death. Survival data were organized by entry cohort. Results: In our sample, we observed that approximately 42,000 applicants died before a decision was made on their disability claims. We identified 24 conditions with survival profiles comparable to the reference group. Applicants with these conditions were not likely to survive adjudication. Conclusions: Our approach facilitates ongoing revision of the conditions SSA designates for expedited awards and has applicability to other programs where survival profiles are a consideration. PMID:25310524

  20. [Illness and death of the violin virtuoso Nicolò Paganini--interpretation based on new hair investigations].

    PubMed

    Kijewski, Harald; Beck, Jens; Reus, Ulrich

    2012-01-01

    The violin virtuoso Paganini died at Nice in 1840 after a long, severe illness. It is undisputed that Paganini was treated with mercury for suspected syphilis and lost all his teeth in 1828 because of that treatment. In the comprehensive literature published on this topic, most authors assume that the terminal complaints and his death were caused by tuberculosis. On the other hand, the hypothesis that he may have died from mercury poisoning was rejected, because there was no information available supporting this assumption. The authors performed morphological investigations using light microscopy and raster electron microscopy (REM). The examined hairs corresponded to a growth phase of > 1 year and < 3 years before death. Structural damage to the hairs indicate heavy metal intoxication in that phase of life; compatible results were supplied by the complex investigations using ICP mass spectrometry and TXRF, which revealed high concentrations of mercury. Using ICP-MS, the mean value for mercury found in the hair sample was 15.4 microg/g with a standard deviation of 0.7 microg/g. The values obtained when investigating segments of single hairs showed high dispersion, but overlapped with the values from the area investigated using ICP-MS. Information not yet considered in the literature support the diagnosis of syphilis and provide a complete and unambiguous explanation for Paganini's death on the basis of the mercury concentrations found.

  1. When Brain Death Belies Belief.

    PubMed

    Yanke, Greg; Rady, Mohamed Y; Verheijde, Joseph L

    2016-12-01

    The case of Jahi McMath has reignited a discussion concerning how society should define death. Despite pronouncing McMath brain dead based on the American Academy of Neurology criteria, the court ordered continued mechanical ventilation to accommodate the family's religious beliefs. Recent case law suggests that the potential for a successful challenge to the neurologic criteria of death provisions of the Uniform Determination of Death Act are greater than ever in the majority of states that have passed religious freedom legislation. As well, because standard ethical claims regarding brain death are either patently untrue or subject to legitimate dispute, those whose beliefs do not comport with the brain death standard should be able to reject it.

  2. Cloning and characterization of two rice long-chain base kinase genes and their function in disease resistance and cell death.

    PubMed

    Zhang, Huijuan; Li, Li; Yu, Yongmei; Mo, Jibo; Sun, Lijun; Liu, Bo; Li, Dayong; Song, Fengming

    2013-01-01

    Sphingolipid metabolites such as long-chain base 1-phosphates (LCBPs) have been shown to play an important role in plants; however, little is known about their function in plant disease resistance and programmed cell death (PCD). In the present study, we cloned and identified two rice long-chain base kinase (LCBK) genes (OsLCBK1 and OsLCBK2), which are involved in biosynthesis of LCBPs, and performed functional analysis in transgenic tobacco. Expression of OsLCBK1 and OsLCBK2 was induced in rice seedlings after treatments with defense signaling molecules and after infection by Magnaporthe grisea, the causal agent of blast disease. Transgenic tobacco plants overexpressing OsLCBK1 were generated and disease resistance assays indicate that the OsLCBK1-overexpressing plants showed enhanced disease resistance against Pseudmonas syringae pv. tabacci, the causal agent of wildfire disease, and tobacco mosaic virus. Expression levels of some defense-related genes were constitutively up-regulated and further induced after pathogen infection in the OsLCBK1-overexpressing plants. Treatment with fungal toxin fumonisin B1, an effective inducer of PCD in plants, resulted in reduced level of cell death in the OsLCBK1-overexpressing plants, as indicated by cell death staining, leakage of electrolyte and expression of hypersensitive response indicator genes. These data suggest that rice LCBKs, probably through regulation of endogenous LCBP level, play important roles in disease resistance response and PCD in plants.

  3. Child Maltreatment Fatalities in Children under 5: Findings from the National Violence Death Reporting System

    ERIC Educational Resources Information Center

    Klevens, Joanne; Leeb, Rebecca T.

    2010-01-01

    Objective: To describe the distribution of child maltreatment fatalities of children under 5 by age, sex, race/ethnicity, type of maltreatment, and relationship to alleged perpetrator using data from the National Violent Death Reporting System (NVDRS). Study design: Two independent coders reviewed information from death certificates, medical…

  4. Death: 'nothing' gives insight.

    PubMed

    Ettema, Eric J

    2013-08-01

    According to a widely accepted belief, we cannot know our own death--death means 'nothing' to us. At first sight, the meaning of 'nothing' just implies the negation or absence of 'something'. Death then simply refers to the negation or absence of life. As a consequence, however, death has no meaning of itself. This leads to an ontological paradox in which death is both acknowledged and denied: death is … nothing. In this article, I investigate whether insight into the ontological paradox of the nothingness of death can contribute to a good end-of-life. By analysing Aquinas', Heidegger's and Derrida's understanding of death as nothingness, I explore how giving meaning to death on different ontological levels connects to, and at the same time provides resistance against, the harsh reality of death. By doing so, I intend to demonstrate that insight into the nothingness of death can count as a framework for a meaningful dealing with death.

  5. Sudden infant death syndrome

    MedlinePlus

    Crib death; SIDS ... However, SIDS is still a major cause of death in infants under 1 year old. Thousands of ... affects boys more often than girls. Most SIDS deaths occur in the winter. The following may increase ...

  6. Causes and Predictors of Death in Patients With Coronary Heart Disease (from the Heart and Soul Study).

    PubMed

    Wang, Elizabeth Y; Dixson, Jeffrey; Schiller, Nelson B; Whooley, Mary A

    2017-01-01

    Although the prevalence of coronary heart disease (CHD) in the United States has increased during the past 25 years, cardiovascular mortality has decreased due to advances in CHD therapy and prevention. We sought to determine the proportion of patients with CHD who die from cardiovascular versus noncardiovascular causes and the causes and predictors of death, in a cohort of patients with CHD. The Heart and Soul Study enrolled 1,024 participants with stable CHD from 2000 to 2002 and followed them for 10 years. Causes of mortality were assigned based on detailed review of medical records, death certificates, and coroner reports by blinded adjudicators. During 7,680 person-years of follow-up, 401 participants died. Of these deaths, 42.4% were cardiovascular and 54.4% were noncardiovascular. Myocardial infarction, stroke, and sudden death accounted for 72% of cardiovascular deaths. Cancer, pneumonia, and sepsis accounted for 67% of noncardiovascular deaths. Independent predictors of cardiac mortality were older age, inducible ischemia on stress echocardiography, higher heart rate at rest, smoking, lower hemoglobin, and higher N-terminal pro-brain natriuretic peptide (all p values <0.05); independent predictors of noncardiac mortality included older age, inducible ischemia, higher heart rate, lower exercise capacity, and nonuse of statins (all p values <0.05). In conclusion, mortality in this cohort was more frequently due to noncardiovascular causes, and predictors of noncardiovascular mortality included factors traditionally associated with cardiovascular mortality.

  7. Linkages to improve mortality data for American Indians and Alaska Natives: a new model for death reporting?

    PubMed

    Anderson, Robert N; Copeland, Glenn; Hayes, John Mosely

    2014-06-01

    Racial misclassification is a well-documented weakness of mortality data taken from death certificates. As a result, mortality statistics for American Indians and Alaska Natives (AI/ANs) present, at best, an inaccurate and misleading assessment of mortality in this population. Studies evaluating the quality of race/ethnicity reporting on death certificates have linked data from death certificates to other data sources collected when the decedent was still alive (e.g., Census, Current Population Survey). Such studies have shown substantial misclassification of AI/AN decedents. Despite limitations, linking mortality data from death certificates with data from other sources collected when decedents were living provides opportunities to evaluate and correct misclassification of populations such as AI/AN persons and facilitates the calculation and presentation of more accurate mortality statistics.

  8. Clinical molecular testing: subspecialty, entry-level or specialist certification?

    PubMed

    Lennon, Alan; Hu, Peter

    2011-01-01

    Some clinical laboratories require workers who have basic knowledge in molecular techniques (such as fluorescent in situ hybridization and polymerase chain reaction). Exclusively molecular diagnostic laboratories need workers to be competent in a variety of cutting edge molecular technologies, such as DNA sequencing, array-based comparative genomic hybridization, quantitative polymerase chain reaction, and many other techniques. Having only one certification for molecular biology at the entry level, as newly prescribed by the Board of Certification, doesn't accurately define the two very differently trained types of people these differing types of laboratories require. Creating a second molecular certification, at the specialist level, would address this issue positively.

  9. Studies on time of death estimation in the early post mortem period -- application of a method based on eyeball temperature measurement to human bodies.

    PubMed

    Kaliszan, Michał

    2013-09-01

    This paper presents a verification of the thermodynamic model allowing an estimation of the time of death (TOD) by calculating the post mortem interval (PMI) based on a single eyeball temperature measurement at the death scene. The study was performed on 30 cases with known PMI, ranging from 1h 35min to 5h 15min, using pin probes connected to a high precision electronic thermometer (Dostmann-electronic). The measured eye temperatures ranged from 20.2 to 33.1°C. Rectal temperature was measured at the same time and ranged from 32.8 to 37.4°C. Ambient temperatures which ranged from -1 to 24°C, environmental conditions (still air to light wind) and the amount of hair on the head were also recorded every time. PMI was calculated using a formula based on Newton's law of cooling, previously derived and successfully tested in comprehensive studies on pigs and a few human cases. Thanks to both the significantly faster post mortem decrease of eye temperature and a residual or nonexistent plateau effect in the eye, as well as practically no influence of body mass, TOD in the human death cases could be estimated with good accuracy. The highest TOD estimation error during the post mortem intervals up to around 5h was 1h 16min, 1h 14min and 1h 03min, respectively in three cases among 30, while for the remaining 27 cases it was not more than 47min. The mean error for all 30 cases was ±31min. All that indicates that the proposed method is of quite good precision in the early post mortem period, with an accuracy of ±1h for a 95% confidence interval. On the basis of the presented method, TOD can be also calculated at the death scene with the use of a proposed portable electronic device (TOD-meter).

  10. [Unobserved death of an infant: cot death?].

    PubMed

    van Wouwe, J P; Dandachli, T H; Huber, J

    1999-10-02

    Three children, two girls aged 8 and 12 months and one boy aged 7 weeks, were found dead unexpectedly. Autopsy revealed pneumonia in two children, following which the diagnosis of 'natural, explained death' was made; one child showed no abnormalities and the diagnosis read 'natural, unexplained death' (cot death). Autopsy may currently only be performed with parental permission or, in case of doubt about unnatural cause of death, by order of the public prosecutor. The authors propose routine performance of a protocolled autopsy by GP, pediatrician, pathologist and medical examiner in order to avoid subsequent and possibly incorrect doubt about the cause of death.

  11. Neonatal Death Dwarfism in a Girl with Distinctive Bone Dysplasia Compatible with Grebe Chondrodysplasia: Analysis by CT Scan-based Phenotype

    PubMed Central

    Al Kaissi, Ali; Chehida, Farid Ben; Ganger, Rudolf; Grill, Franz

    2014-01-01

    We report on a female fetus noted to have severe malformative type of skeletal dysplasia on ultrasonography done at 35 weeks gestation. The girl died shortly after birth. Clinical examination showed a fetus with severe dwarfism, extensive long and short bones, and bone deficiencies associated with multiple dislocations. Computed tomography (CT) scan-based phenotype showed a complex constellation of malformations consistent with the diagnosis of Grebe syndrome. Parents being first cousins (consanguineous marriage) strongly suggests autosomal recessive pattern of inheritance. To our knowledge, this is the first report of neonatal death dwarfism of Grebe syndrome analyzed by CT scan-based phenotype. PMID:25337439

  12. Certification plan for safety and PRA codes

    SciTech Connect

    Toffer, H.; Crowe, R.D. ); Ades, M.J. )

    1990-05-01

    A certification plan for computer codes used in Safety Analyses and Probabilistic Risk Assessment (PRA) for the operation of the Savannah River Site (SRS) reactors has been prepared. An action matrix, checklists, and a time schedule have been included in the plan. These items identify what is required to achieve certification of the codes. A list of Safety Analysis and Probabilistic Risk Assessment (SA PRA) computer codes covered by the certification plan has been assembled. A description of each of the codes was provided in Reference 4. The action matrix for the configuration control plan identifies code specific requirements that need to be met to achieve the certification plan's objectives. The checklist covers the specific procedures that are required to support the configuration control effort and supplement the software life cycle procedures based on QAP 20-1 (Reference 7). A qualification checklist for users establishes the minimum prerequisites and training for achieving levels of proficiency in using configuration controlled codes for critical parameter calculations.

  13. Certification plan for safety and PRA codes

    SciTech Connect

    Toffer, H.; Crowe, R.D.; Ades, M.J.

    1990-05-01

    A certification plan for computer codes used in Safety Analyses and Probabilistic Risk Assessment (PRA) for the operation of the Savannah River Site (SRS) reactors has been prepared. An action matrix, checklists, and a time schedule have been included in the plan. These items identify what is required to achieve certification of the codes. A list of Safety Analysis and Probabilistic Risk Assessment (SA&PRA) computer codes covered by the certification plan has been assembled. A description of each of the codes was provided in Reference 4. The action matrix for the configuration control plan identifies code specific requirements that need to be met to achieve the certification plan`s objectives. The checklist covers the specific procedures that are required to support the configuration control effort and supplement the software life cycle procedures based on QAP 20-1 (Reference 7). A qualification checklist for users establishes the minimum prerequisites and training for achieving levels of proficiency in using configuration controlled codes for critical parameter calculations.

  14. Mortality of urban transit workers: indications of an excess of deaths by suicide using gas.

    PubMed

    Guidotti, T L

    1992-08-01

    Urban bus drivers are exposed to a variety of discomforts and physical hazards associated with their occupation. We obtained death certificates for 99 per cent of 219 decreased members of the Amalgamated Transit Union Local 596 of Edmonton, Alberta, and conducted a proportionate mortality study against the distribution of all deaths among men in the province of Alberta, standardized by age and year of death. We found a highly significant excess from undetermined accidents due to gas (proportionate mortality ratio (PMR) 3761, based on 3 cases; p less than 0.003), which may bear a relationship to an elevation observed for suicide due to gas, which failed to achieve statistical significance (PMR 242, based on 2 cases). Collateral evidence suggests that this excess may include misclassification of some suicides. Gas inhalation as an instrument of suicide may be suggested by familiarity with vehicle exhaust. No other excess achieved statistical significance. Several causes of death showed elevated PMRs of relatively modest magnitude; elevations in PMR for lung cancer (PMR 154) and chronic obstructive pulmonary disease (PMR 176) suggest a mutual association with smoking.

  15. 40 CFR 92.306 - Certification.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... certificate of conformity for such engine families. The certificate of conformity may be voided ab initio for..., and the certificate may be deemed void ab initio. (3) The manufacturer or remanufacturer...

  16. 9 CFR 151.4 - Pedigree certificate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AGRICULTURE ANIMAL BREEDS RECOGNITION OF BREEDS AND BOOKS OF RECORD OF PUREBRED ANIMALS Certification of Purebred Animals § 151.4 Pedigree certificate. A pedigree certificate for an animal of a breed listed...

  17. 9 CFR 151.4 - Pedigree certificate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... AGRICULTURE ANIMAL BREEDS RECOGNITION OF BREEDS AND BOOKS OF RECORD OF PUREBRED ANIMALS Certification of Purebred Animals § 151.4 Pedigree certificate. A pedigree certificate for an animal of a breed listed...

  18. 9 CFR 151.4 - Pedigree certificate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... AGRICULTURE ANIMAL BREEDS RECOGNITION OF BREEDS AND BOOKS OF RECORD OF PUREBRED ANIMALS Certification of Purebred Animals § 151.4 Pedigree certificate. A pedigree certificate for an animal of a breed listed...

  19. 9 CFR 151.4 - Pedigree certificate.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AGRICULTURE ANIMAL BREEDS RECOGNITION OF BREEDS AND BOOKS OF RECORD OF PUREBRED ANIMALS Certification of Purebred Animals § 151.4 Pedigree certificate. A pedigree certificate for an animal of a breed listed...

  20. 9 CFR 151.4 - Pedigree certificate.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... AGRICULTURE ANIMAL BREEDS RECOGNITION OF BREEDS AND BOOKS OF RECORD OF PUREBRED ANIMALS Certification of Purebred Animals § 151.4 Pedigree certificate. A pedigree certificate for an animal of a breed listed...

  1. 20 CFR 655.52 - Approved certification.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR TEMPORARY EMPLOYMENT OF FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process and Enforcement of Attestations for... Workers) Labor Certification Determinations § 655.52 Approved certification. If a temporary...

  2. Death Education for the Health Professional.

    ERIC Educational Resources Information Center

    Benoliel, Jeanne Quint, Ed.

    The perspectives of a number of health professionals based on their experiences in providing death education courses are presented in essays. In "Interdisciplinary Death Education in a Nursing School" (Helen L. Swain and Kathleen V. Cowles), the development of an undergraduate elective course in death, dying, and bereavement at the…

  3. Dealing with Human Death: The Floating Perspective.

    ERIC Educational Resources Information Center

    Kenyon, Gary M.

    1991-01-01

    Explores approach to dealing with human death. Describes floating perspective, based on insights from Choron and Jaspers, as suggesting it is possible to deal with human death by refraining from taking ultimate position on the problem. Position encourages openness to death. Examines role of anxiety and describes possible meaningful outcomes of…

  4. Sex Differences in Dose Escalation and Overdose Death during Chronic Opioid Therapy: A Population-Based Cohort Study

    PubMed Central

    Kaplovitch, Eric; Gomes, Tara; Camacho, Ximena; Dhalla, Irfan A.; Mamdani, Muhammad M.; Juurlink, David N.

    2015-01-01

    Background The use of opioids for noncancer pain is widespread, and more than 16,000 die of opioid-related causes in the United States annually. The patients at greatest risk of death are those receiving high doses of opioids. Whether sex influences the risk of dose escalation or opioid-related mortality is unknown. Methods and Findings We conducted a cohort study using healthcare records of 32,499 individuals aged 15 to 64 who commenced chronic opioid therapy for noncancer pain between April 1, 1997 and December 31, 2010 in Ontario, Canada. Patients were followed from their first opioid prescription until discontinuation of therapy, death from any cause or the end of the study period. Among patients receiving chronic opioid therapy, 589 (1.8%) escalated to high dose therapy and n = 59 (0.2%) died of opioid-related causes while on treatment. After multivariable adjustment, men were more likely than women to escalate to high-dose opioid therapy (adjusted hazard ratio 1.44; 95% confidence interval 1.21 to 1.70) and twice as likely to die of opioid-related causes (adjusted hazard ratio 2.04; 95% confidence interval 1.18 to 3.53). These associations were maintained in a secondary analysis of 285,520 individuals receiving any opioid regardless of the duration of therapy. Conclusions Men are at higher risk than women for escalation to high-dose opioid therapy and death from opioid-related causes. Both outcomes were more common than anticipated. PMID:26291716

  5. Parity, Age at First Birth, and Risk of Death from Bladder Cancer: A Population-Based Cohort Study in Taiwan

    PubMed Central

    Chiu, Hui-Fen; Chen, Brian K.; Yang, Chun-Yuh

    2016-01-01

    The evidence is limited on the relationship between reproductive factors and bladder cancer (BC). We studied 1,292,462 women who had a first and singleton delivery between 1 January 1978 and 31 December 1987. Each woman in the study cohort was tracked from their first childbirth to 31 December 2009. Vital status of the women was determined by crosswalking records with a computerized mortality database. We used Cox proportional hazard regression models to estimate the hazard ratios (HRs) of death from BC associated with maternal age at first birth and parity. The data showed 63 BC deaths during 34,980,246 person-years of follow-up. BC mortality rate was 0.90 cases for every 100,000 person-years. Compared with women who gave birth under the age of 23, the adjusted HR was 1.24 (95% confidence interval (CI) = 0.66–2.35) for women who gave birth between age 23 and 26 and 2.30 (95% CI = 1.21–4.39) for women who gave birth over the age of 26. Increasing age at first birth (p for trend = 0.01) is associated with a trend in increasing risk of BC mortality. Relative to women who had a single childbirth, the adjusted HRs were 1.17 (95% CI = 0.51–2.69) for women who gave birth to two children, and 1.31 (95% CI = 0.56–3.10) for women with three or more childbirths, respectively. These results were not statistically significant. Study results suggests that giving birth at an early age may confer a protective effect on the risk of death from BC. PMID:27918463

  6. Comprehensive review of sleep-related sudden unexpected infant deaths and their investigations: Florida 2008.

    PubMed

    Sauber-Schatz, Erin K; Sappenfield, William M; Shapiro-Mendoza, Carrie K

    2015-02-01

    To describe 2008 Florida sleep-related sudden unexpected infant deaths (SUIDs) by describing (a) percentage distribution of medical examiner (ME) cause-of-death determinations; (b) mortality rates by maternal and infant characteristics; (c) prevalence of selected suffocation or sudden infant death syndrome (SIDS) risk and protective factors; (d) frequency of selected scene investigation and autopsy components (including extent of missing data); and (e) percentage with public health program contact. In this population-based study, we identified sleep-related SUIDs occurring among Florida residents from the 2008-linked Florida infant death and birth certificates. Information about the circumstances of death was abstracted from ME, law enforcement, and hospital records. We used frequencies and percentages to describe characteristics of sleep-related SUID cases. Of 215 sleep-related SUID cases, MEs identified 47.9% as accidental suffocation and strangulation in bed, 35.4% as unknown or undetermined cause, and 16.7% as SIDS. Sleep-related SUID most frequently occurred in an adult bed (n = 108; 50.2%). At death, 82.4% of sleep-related SUIDs had ≥1 suffocation or SIDS risk factor with 54.4% infants sharing a sleep surface, 38.1% placed nonsupine, 24.2% placed on a pillow, and 10.2% having head covering. Missing data frequently resulted from incomplete scene investigation and autopsy components. SUID contributed to ≥1 in seven Florida infant deaths in 2008. Approximately 80% of sleep-related SUIDs were reported among infants placed in unsafe sleeping environments. Effective interventions are needed to promote safe sleep among caregivers of Florida infants. These interventions must reach infant caregivers at highest risk and change unsafe sleep practices. The substantial percentage of missing investigation data reinforces the need for standardized reporting.

  7. Mind your manners. Part II: General results from the National Association of Medical Examiners Manner of Death Questionnaire, 1995.

    PubMed

    Goodin, J; Hanzlick, R

    1997-09-01

    More than 700 physician medical examiner/coroners (ME/Cs) were surveyed to assess differences in manner of death classifications for typical but often controversial death scenarios: 198 physicians participated by choosing the manner of death (homicide, suicide, accident, natural, undetermined) for 23 such scenarios. Sixteen questions related to death certificate training, work location, and manner of death issues were also asked. The classification of manner of death by ME/Cs was highly variable. For some challenging death scenarios, majority agreement was lacking. Agreement was > or = 80% for only 11 of the 23 scenarios and was 100% for only 1. Manner of death classification method was not influenced by forensic pathology board certification status, by whether or not the physician actually completed death certificates, or by previous threats of lawsuits over manner of death classification. However, there were some differences by state. No textbook or individual was widely recognized as authoritative on manner of death issues. Few ME/Cs had formal death certification training in medical school or residency. The data lend credence to the practice of the National Center for Health Statistics (NCHS) of classifying manner of death for statistical purposes by using coding and classification rules and selection criteria rather than solely on the basis of the classification of manner chosen by ME/Cs. The data also indicate that caution is in order when one compares manner of death statistics of one ME/C with those of another Published guidelines and more uniform training are needed so that ME/Cs may become more consistent in their manner of death classifications. Further information is presented in Part I (history of manner of death classification) and in Part III (individual death scenarios and their analysis) companion articles in this issue of the Journal.

  8. High-dimensional entanglement certification

    PubMed Central

    Huang, Zixin; Maccone, Lorenzo; Karim, Akib; Macchiavello, Chiara; Chapman, Robert J.; Peruzzo, Alberto

    2016-01-01

    Quantum entanglement is the ability of joint quantum systems to possess global properties (correlation among systems) even when subsystems have no definite individual property. Whilst the 2-dimensional (qubit) case is well-understood, currently, tools to characterise entanglement in high dimensions are limited. We experimentally demonstrate a new procedure for entanglement certification that is suitable for large systems, based entirely on information-theoretics. It scales more efficiently than Bell’s inequality and entanglement witness. The method we developed works for arbitrarily large system dimension d and employs only two local measurements of complementary properties. This procedure can also certify whether the system is maximally entangled. We illustrate the protocol for families of bipartite states of qudits with dimension up to 32 composed of polarisation-entangled photon pairs. PMID:27311935

  9. 49 CFR 583.13 - Supplier certification and certificates.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Supplier certification and certificates. 583.13 Section 583.13 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AUTOMOBILE PARTS CONTENT...

  10. 49 CFR 583.13 - Supplier certification and certificates.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Supplier certification and certificates. 583.13 Section 583.13 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AUTOMOBILE PARTS CONTENT...

  11. 49 CFR 583.13 - Supplier certification and certificates.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 false Supplier certification and certificates. 583.13 Section 583.13 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AUTOMOBILE PARTS CONTENT...

  12. 49 CFR 583.13 - Supplier certification and certificates.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Supplier certification and certificates. 583.13 Section 583.13 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AUTOMOBILE PARTS CONTENT...

  13. 49 CFR 583.13 - Supplier certification and certificates.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Supplier certification and certificates. 583.13 Section 583.13 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AUTOMOBILE PARTS CONTENT...

  14. The Effectiveness of Texas Teacher Certification Programs as Evidenced through Pass Rates on TExES PPR 160 Exam

    ERIC Educational Resources Information Center

    Clouse, Scarlet

    2013-01-01

    The purpose of this study was to investigate the differences between alternative certification pathways, specifically those offered through a university-based, post baccalaureate certification program and a regional education service center certification program. A quantitative research design was implemented and archived scores on the TExES PPR…

  15. 22 CFR 97.5 - Certification of Hague Convention Compliance in an incoming convention case where final adoption...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) A copy of the certificate issued by a consular officer pursuant to 22 CFR 42.24(j) certifying that... Secretary's discretion. A certification will not be issued to a non-party requestor unless the requestor... decree, when based upon the certificate issued by a consular officer pursuant to 22 CFR...

  16. [Brain death--a certain sign of death].

    PubMed

    Angstwurm, H

    1990-10-01

    Brain death means a complete and irreversible loss of all brain activity during intensive care with mechanical ventilation. On autopsy is seen an ischemic infarct of the whole brain following the stopped blood flow in the intracranial cavity after the elevation of the pressure. With brain death a human being loses two characteristics of its earthly life, the physical base needed for his spirit and his soul in this world, and the integration, the unity as the independent and self-contained organism.

  17. Performance or marketing benefits? The case of LEED certification.

    PubMed

    Matisoff, Daniel C; Noonan, Douglas S; Mazzolini, Anna M

    2014-01-01

    Green building adoption is driven by both performance-based benefits and marketing based benefits. Performance based benefits are those that improve performance or lower operating costs of the building or of building users. Marketing benefits stem from the consumer response to green certification. This study illustrates the relative importance of the marketing based benefits that accrue to Leadership in Energy and Environmental Design (LEED) buildings due to green signaling mechanisms, specifically related to the certification itself are identified. Of course, all participants in the LEED certification scheme seek marketing benefits. But even among LEED participants, the interest in green signaling is pronounced. The green signaling mechanism that occurs at the certification thresholds shifts building patterns from just below to just above the threshold level, and motivates builders to cluster buildings just above each threshold. Results are consistent across subsamples, though nonprofit organizations appear to build greener buildings and engage in more green signaling than for-profit entities. Using nonparametric regression discontinuity, signaling across different building types is observed. Marketing benefits due to LEED certification drives organizations to build "greener" buildings by upgrading buildings at the thresholds to reach certification levels.

  18. 49 CFR 178.337-18 - Certification.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION HAZARDOUS MATERIALS REGULATIONS SPECIFICATIONS FOR PACKAGINGS... certification on the specification plate and issue a Certificate of Compliance to the owner of the cargo...

  19. Ferroptosis: Death by Lipid Peroxidation.

    PubMed

    Yang, Wan Seok; Stockwell, Brent R

    2016-03-01

    Ferroptosis is a regulated form of cell death driven by loss of activity of the lipid repair enzyme glutathione peroxidase 4 (GPX4) and subsequent accumulation of lipid-based reactive oxygen species (ROS), particularly lipid hydroperoxides. This form of iron-dependent cell death is genetically, biochemically, and morphologically distinct from other cell death modalities, including apoptosis, unregulated necrosis, and necroptosis. Ferroptosis is regulated by specific pathways and is involved in diverse biological contexts. Here we summarize the discovery of ferroptosis, the mechanism of ferroptosis regulation, and its increasingly appreciated relevance to both normal and pathological physiology.

  20. USING RISK-BASED CORRECTIVE ACTION (RBCA) TO ASSESS (THEORETICAL) CANCER DEATHS AVERTED COMPARED TO THE (REAL) COST OF ENVIRONMENTAL REMEDIATION

    SciTech Connect

    Miller, M. L.; Hylko, J. M.

    2002-02-25

    In 1978, on the basis of existing health studies at the time, the Uranium Mill Tailings Remedial Action (UMTRA) Project legislation was proposed that would authorize remedial action at inactive uranium processing sites and vicinity properties. The cost of the program to the Federal Government was expected to be $180 million. With the completion of this project, approximately 1300 theoretical cancer deaths were prevented in the next 100 years at a cost of $1.45 billion, based on the Fiscal Year 1998 Federal UMTRA budget. The individual site costs ranged from $0.2 million up to $18 billion spent per theoretical cancer death averted over the next 100 years. Resources required to sustain remediation activities such as this are subject to reduction over time, and are originally based on conservative assumptions that tend to overestimate risks to the general public. This evaluation used a process incorporating risk-based corrective action (RBCA); a three-tiered, decision-making process tailoring corrective action activities according to site-specific conditions and risks. If RBCA had been applied at the start of the UMTRA Project, and using a criterion of >1 excess cancer death prevented as justification to remediate the site, only 50% of the existing sites would have been remediated, yielding a cost savings of $303.6 million to the Federal Government and affected States, which share 10% of the cost. This cost savings equates to 21% of the overall project budget. In addition, only 22% of the vicinity properties had structural contamination contributing to elevated interior gamma exposure and radon levels. Focusing only on these particular properties could have saved an additional $269.3 million, yielding a total savings of $573 million; 40% of the overall project budget. As operational experience is acquired, including greater understanding of the radiological and nonradiological risks, decisions should be based on the RBCA process, rather than relying on conservative

  1. Differences in age-standardized mortality rates for avoidable deaths based on urbanization levels in Taiwan, 1971-2008.

    PubMed

    Chen, Brian K; Yang, Chun-Yuh

    2014-02-05

    The World is undergoing rapid urbanization, with 70% of the World population expected to live in urban areas by 2050. Nevertheless, nationally representative analysis of the health differences in the leading causes of avoidable mortality disaggregated by urbanization level is lacking. We undertake a study of temporal trends in mortality rates for deaths considered avoidable by the Concerted Action of the European Community on Avoidable Mortality for four different levels of urbanization in Taiwan between 1971 and 2008. We find that for virtually all causes of death, age-standardized mortality rates (ASMRs) were lower in more urbanized than less urbanized areas, either throughout the study period, or by the end of the period despite higher rates in urbanized areas initially. Only breast cancer had consistently higher AMSRs in more urbanized areas throughout the 38-year period. Further, only breast cancer, lung cancer, and ischemic heart disease witnessed an increase in ASMRs in one or more urbanization categories. More urbanized areas in Taiwan appear to enjoy better indicators of health outcomes in terms of mortality rates than less urbanized areas. Access to and the availability of rich healthcare resources in urban areas may have contributed to this positive result.

  2. Differences in Age-Standardized Mortality Rates for Avoidable Deaths Based on Urbanization Levels in Taiwan, 1971–2008

    PubMed Central

    Chen, Brian K.; Yang, Chun-Yuh

    2014-01-01

    The World is undergoing rapid urbanization, with 70% of the World population expected to live in urban areas by 2050. Nevertheless, nationally representative analysis of the health differences in the leading causes of avoidable mortality disaggregated by urbanization level is lacking. We undertake a study of temporal trends in mortality rates for deaths considered avoidable by the Concerted Action of the European Community on Avoidable Mortality for four different levels of urbanization in Taiwan between 1971 and 2008. We find that for virtually all causes of death, age-standardized mortality rates (ASMRs) were lower in more urbanized than less urbanized areas, either throughout the study period, or by the end of the period despite higher rates in urbanized areas initially. Only breast cancer had consistently higher AMSRs in more urbanized areas throughout the 38-year period. Further, only breast cancer, lung cancer, and ischemic heart disease witnessed an increase in ASMRs in one or more urbanization categories. More urbanized areas in Taiwan appear to enjoy better indicators of health outcomes in terms of mortality rates than less urbanized areas. Access to and the availability of rich healthcare resources in urban areas may have contributed to this positive result. PMID:24503974

  3. SU-B-213-00: Education Council Symposium: Accreditation and Certification: Establishing Educational Standards and Evaluating Candidates Based on these Standards

    SciTech Connect

    2015-06-15

    The North American medical physics community validates the education received by medical physicists and the clinical qualifications for medical physicists through accreditation of educational programs and certification of medical physicists. Medical physics educational programs (graduate education and residency education) are accredited by the Commission on Accreditation of Medical Physics Education Programs (CAMPEP), whereas medical physicists are certified by several organizations, the most familiar of which is the American Board of Radiology (ABR). In order for an educational program to become accredited or a medical physicist to become certified, the applicant must meet certain specified standards set by the appropriate organization. In this Symposium, representatives from both CAMPEP and the ABR will describe the process by which standards are established as well as the process by which qualifications of candidates for accreditation or certification are shown to be compliant with these standards. The Symposium will conclude with a panel discussion. Learning Objectives: Recognize the difference between accreditation of an educational program and certification of an individual Identify the two organizations primarily responsible for these tasks Describe the development of educational standards Describe the process by which examination questions are developed GS is Executive Secretary of CAMPEP.

  4. Measurement, Certification, and Quality: Meeting Enduring Challenges with Modern Tools.

    PubMed

    Wachter, Robert M

    2016-09-01

    The author, a former chair of the ABIM, describes the challenges that the board certification enterprise is experiencing as medicine shifts from being a paper-based to a digital industry. While there are clearly threats to board certification, he argues that boards can remain highly relevant if they focus on areas in which they can make unique contributions, such as the measurement of cognitive skills, diagnostic accuracy, "keeping up," and procedural skills.

  5. Improving obstetric care in low-resource settings: implementation of facility-based maternal death reviews in five pilot hospitals in Senegal

    PubMed Central

    Dumont, Alexandre; Tourigny, Caroline; Fournier, Pierre

    2009-01-01

    Background In sub-Saharan Africa, maternal and perinatal mortality and morbidity are major problems. Service availability and quality of care in health facilities are heterogeneous and most often inadequate. In resource-poor settings, the facility-based maternal death review or audit is one of the most promising strategies to improve health service performance. We aim to explore and describe health workers' perceptions of facility-based maternal death reviews and to identify barriers to and facilitators of the implementation of this approach in pilot health facilities of Senegal. Methods This study was conducted in five reference hospitals in Senegal with different characteristics. Data were collected from focus group discussions, participant observations of audit meetings, audit documents and interviews with the staff of the maternity unit. Data were analysed by means of both quantitative and qualitative approaches. Results Health professionals and service administrators were receptive and adhered relatively well to the process and the results of the audits, although some considered the situation destabilizing or even threatening. The main barriers to the implementation of maternal deaths reviews were: (1) bad quality of information in medical files; (2) non-participation of the head of department in the audit meetings; (3) lack of feedback to the staff who did not attend the audit meetings. The main facilitators were: (1) high level of professional qualifications or experience of the data collector; (2) involvement of the head of the maternity unit, acting as a moderator during the audit meetings; (3) participation of managers in the audit session to plan appropriate and realistic actions to prevent other maternal deaths. Conclusion The identification of the barriers to and the facilitators of the implementation of maternal death reviews is an essential step for the future adaptation of this method in countries with few resources. We recommend for future

  6. Correction of vital statistics based on a proactive search of deaths and live births: evidence from a study of the North and Northeast regions of Brazil

    PubMed Central

    2014-01-01

    Background In the last 20 years, Brazil has undergone dramatic changes in terms of socioeconomic development and health care. In the first decade of the 2000s, the Ministry of Health (MoH) developed a series of programs focused on reducing infant mortality, including the Family Health Program as a national policy for primary care. In this paper, we propose a method to correct underreporting of deaths and live births. After vital statistics are corrected, infant mortality trends are analyzed for the period 2000–2010 by macro-geographical region. Methods A proactive search of live births and deaths was carried out in the Amazon and Northeast regions in 2010 to find vital events that occurred in 2008 and were not reported to the Ministry of Health. The probabilistic sample of 133 municipalities was stratified by adequacy of vital information reporting. For each municipality, the adequacy analysis was based on the reported age-standardized mortality rate per 1,000 population and the ratio between reported and estimated live births. Correction factors were estimated by strata based on additional vital events found in the proactive search. The procedure was generalized to correct municipal vital statistics for the period 2000–2010. Results In the proactive search, 35% of non-reported deaths were found within the health system (hospitals and other health establishments), but 28% were found in non-official sources, like illegal cemeteries. In areas of extreme poverty and unreliable vital information, the estimated completeness of infant death reporting was only 33%. After correction of vital information, the estimated infant mortality rate decreased from 26.1 in 2000 to 16.0 in 2010, with an annual rate of decrease of 4.7%, greater than the required rate to achieve the Millennium Development Goal. Among Brazilian regions, the Northeast showed the largest decrease, from 38.4 to 20.1 per 1,000 live births. Conclusions The proactive search for vital events was shown to

  7. Deaths From Bites and Stings of Venomous Animals

    PubMed Central

    Ennik, Franklin

    1980-01-01

    Data abstracted from 34 death certificates indicate that the three venomous animal groups most often responsible for human deaths in California from 1960 through 1976 were Hymenoptera (bees, wasps, ants and the like) (56 percent), snakes (35 percent) and spiders (6 percent). An average incidence of 2.0 deaths per year occurred during these 17 years, or an average death rate of 0.01 per 100,000 population per year. Nearly three times more males than females died of venomous animal bites and stings. Half of the deaths from venomous snake bites occurred in children younger than 5 years of age. Susceptible persons 40 years or older appeared to be particularly vulnerable to hymenopterous insect stings and often quickly died of anaphylaxis. Fatal encounters with venomous animals occurred more often around the home than at places of employment or during recreational activities. Deaths resulting from spider bites are rare in California but many bites are reported. Medical practitioners are urged to seek professional assistance in identifying offending animals causing human discomfort and to use these animals' scientific names on death certificates and in journal articles. ImagesIGN. PMID:7467305

  8. A simple protocol for using a LDH-based cytotoxicity assay to assess the effects of death and growth inhibition at the same time.

    PubMed

    Smith, Shilo M; Wunder, Michael B; Norris, David A; Shellman, Yiqun G

    2011-01-01

    Analyzing the effects on cell growth inhibition and/or cell death has been an important component of biological research. The MTS assay and LDH-based cytotoxicity assays are two of the most commonly used methods for this purpose. However, data here showed that MTS cell proliferation assay could not distinguish the effects of cell death or cell growth inhibition. In addition, the original LDH-based cytotoxicity protocol grossly underestimated the proportion of dead cells in conditions with growth inhibition. To overcome the limitation, we present here a simple modified LDH-based cytotoxicity protocol by adding additional condition-specific controls. This modified protocol thus can provide more accurate measurement of killing effects in addition to the measurement of overall effects, especially in conditions with growth inhibition. In summary, we present here a simple, modified cytotoxicity assay, which can determine the overall effects, percentage of cell killing and growth inhibition in one 96-well based assay. This is a viable option for primary screening for many laboratories, and could be adapted for high throughput screening.

  9. Counterfactual quantum certificate authorization

    NASA Astrophysics Data System (ADS)

    Shenoy H., Akshata; Srikanth, R.; Srinivas, T.

    2014-05-01

    We present a multipartite protocol in a counterfactual paradigm. In counterfactual quantum cryptography, secure information is transmitted between two spatially separated parties even when there is no physical travel of particles transferring the information between them. We propose here a tripartite counterfactual quantum protocol for the task of certificate authorization. Here a trusted third party, Alice, authenticates an entity Bob (e.g., a bank) that a client Charlie wishes to securely transact with. The protocol is counterfactual with respect to either Bob or Charlie. We prove its security against a general incoherent attack, where Eve attacks single particles.

  10. Occupational injury deaths of 16 and 17 year olds in the US: trends and comparisons with older workers.

    PubMed Central

    Castillo, D. N.; Malit, B. D.

    1997-01-01

    OBJECTIVE: To examine patterns of occupational injury deaths of 16 and 17 year olds in the United States for the three year period 1990-2, examine trends since the 1980s, and compare fatality rates with those of older workers. METHODS: Occupational injury deaths were analyzed using the death certificate based National Traumatic Occupational Fatalities (NTOF) surveillance system. Fatality rates were calculated using estimates of full time equivalent (FTE) workers based on data from the Current Population Survey, a monthly household survey. RESULTS: There were 111 deaths of 16 and 17 year olds for the years 1990-2. The average yearly rate was 3.5 deaths/100,000 FTE. The leading causes of death were motor vehicle related, homicide, and machinery related. All causes occupational injury fatality rates for 16 and 17 year olds were lower than for adults for 1990-2. Rates for the leading causes of death (motor vehicle related, homicide, and machinery related) were comparable or slightly higher than the rates for young and middle aged adult workers. Although rates decreased dramatically from 1980 to 1983, the decreasing trend attenuated in later years. CONCLUSIONS: Comparisons of youth fatality rates to those of adult workers should address differences in patterns of employment, most importantly hours of work. Comparisons to narrow age groupings of adults is preferable to a single category of all workers 18 years and older. Increasing compliance with federal child labor regulations could help reduce work related deaths of youth. Other measures are needed, however, as there are many work hazards, including those associated with homicides, that are not addressed by United States federal child labor law regulations. PMID:9493624

  11. Are you considering organic certification?

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Organic certification was developed in recognition of the necessity for consistent standards across the U.S. for the benefit of producers, processors, wholesalers, retailers, and consumers. Prior to establishment of federal guidelines (National Organic Program) for organic certification in 2002, a ...

  12. Alternative Teacher Certification in Texas.

    ERIC Educational Resources Information Center

    Texas Education Agency, Austin.

    This publication describes alternative teacher certification programs in Texas that train interns who are generally mature, mid-career individuals. The document is organized into seven sections: (1) "Alternative Certification in Texas" discusses the history and background of the programs including legislation, the first alternative…

  13. Maternal Deaths Databases Analysis: Ecuador 2003-2013

    PubMed Central

    Pino, Antonio; Albán, María; Rivas, Alejandra; Rodríguez, Erika

    2016-01-01

    Background: Maternal mortality ratio in Ecuador is the only millennium goal on which national agencies are still making strong efforts to reach 2015 target. The purpose of the study was to process national maternal death databases to identify a specific association pattern of variable included in the death certificate. Design and methods: The study processed mortality databases published yearly by the National Census and Statistics Institute (INEC). Data analysed were exclusively maternal deaths. Data corresponds to the 2003-2013 period, accessible through INEC’s website. Comparisons are based on number of deaths and use an ecological approach for geographical coincidences. Results: The study identified variable association into the maternal mortality national databases showing that to die at home or in a different place than a hospital is closely related to women’s socioeconomic characteristics; there was an association with the absence of a public health facility. Also, to die in a different place than the usual residence could mean that women and families are searching for or were referred to a higher level of attention when they face complications. Conclusions: Ecuadorian maternal deaths showed Patterns of inequity in health status, health care provision and health risks. A predominant factor seems unclear to explain the variable association found processing national databases; perhaps every pattern of health systems development played a role in maternal mortality or factors different from those registered by the statistics system may remain hidden. Some random influences might not be even considered in an explanatory model yet. Significance for public health General agreement on maternal mortality reduction suggests that to reach the millennium target a health system must to be able to provide essential, and emergency obstetric care in a well allocate, geographic, ethnic, and socioeconomic distribution of resources. Patterns of inequity in health status

  14. In vitro study of cell death with 5-aminolevulinic acid based photodynamic therapy to improve the efficiency of cancer treatment

    NASA Astrophysics Data System (ADS)

    Firdous, S.; Nawaz, M.; Ikram, M.; Ahmed, M.

    2012-03-01

    Photodynamic therapy (PDT) is a kind of photochemo therapeutic treatment that exerts its effect mainly through the induction of cell death. Distinct types of cell death may be elicited by different PDT regimes. In this study, efforts are underway to optimize PDT protocols for improved efficacy and combination of all three PDT mechanisms involved in the different human carcinomas cell narcosis. Our in vitro cell culture experiments with 5-aminolevulanic acid (ALA) a clinically approved photiosensitizer (PS) and 635 nm laser light have yielded promising results, as follow: (1) (human cervical cancer (HeLa) cell line incubated, for 18 h, with 30 μg/ml of 5-ALA, treated with laser light dose of 50 J/cm2 can produce 85% of cell killing (2) human larynx carcinoma (Hep2c) cell line incubated, for 7 h, with 55 μg/ml of 5-ALA, treated with laser light dose of 85 J/cm2 can produce 75% of cell killing (3) human liver cancer (HepG2) cell line incubated, for 22-48 h, with 262 μg/ml of 5-ALA, treated with laser light dose of 120 J/cm2 can produce 95% of cell killing (4) human muscle cancer (RD) cell line incubated, for 47 h, with 250 μg/ml of 5-ALA, treated with laser light dose of 80 J/cm2 can produce 76% of cell killing (5) Human embryonic kidney (HEK293T) cell line incu-bated, for 18 h, with 400 μg/ml of 5-ALA, treated with laser light dose of 40 J/cm2 can produce 82% of cell killing confirming the efficacy of photodynamic therapy.

  15. Heparin based prophylaxis to prevent venous thromboembolic events and death in patients with cancer - a subgroup analysis of CERTIFY

    PubMed Central

    2011-01-01

    Background Patients with cancer have an increased risk of VTE. We compared VTE rates and bleeding complications in 1) cancer patients receiving LMWH or UFH and 2) patients with or without cancer. Methods Acutely-ill, non-surgical patients ≥70 years with (n = 274) or without cancer (n = 2,965) received certoparin 3,000 UaXa o.d. or UFH 5,000 IU t.i.d. for 8-20 days. Results 1) Thromboembolic events in cancer patients (proximal DVT, symptomatic non-fatal PE and VTE-related death) occurred at 4.50% with certoparin and 6.03% with UFH (OR 0.73; 95% CI 0.23-2.39). Major bleeding was comparable and minor bleedings (0.75 vs. 5.67%) were nominally less frequent. 7.5% of certoparin and 12.8% of UFH treated patients experienced serious adverse events. 2) Thromboembolic event rates were comparable in patients with or without cancer (5.29 vs. 4.13%) as were bleeding complications. All cause death was increased in cancer (OR 2.68; 95%CI 1.22-5.86). 10.2% of patients with and 5.81% of those without cancer experienced serious adverse events (OR 1.85; 95% CI 1.21-2.81). Conclusions Certoparin 3,000 UaXa o.d. and 5,000 IU UFH t.i.d. were equally effective and safe with respect to bleeding complications in patients with cancer. There were no statistically significant differences in the risk of thromboembolic events in patients with or without cancer receiving adequate anticoagulation. Trial Registration clinicaltrials.gov, NCT00451412 PMID:21791091

  16. Software Certification for Temporal Properties With Affordable Tool Qualification

    NASA Technical Reports Server (NTRS)

    Xia, Songtao; DiVito, Benedetto L.

    2005-01-01

    It has been recognized that a framework based on proof-carrying code (also called semantic-based software certification in its community) could be used as a candidate software certification process for the avionics industry. To meet this goal, tools in the "trust base" of a proof-carrying code system must be qualified by regulatory authorities. A family of semantic-based software certification approaches is described, each different in expressive power, level of automation and trust base. Of particular interest is the so-called abstraction-carrying code, which can certify temporal properties. When a pure abstraction-carrying code method is used in the context of industrial software certification, the fact that the trust base includes a model checker would incur a high qualification cost. This position paper proposes a hybrid of abstraction-based and proof-based certification methods so that the model checker used by a client can be significantly simplified, thereby leading to lower cost in tool qualification.

  17. Death and the Oldest Old: Attitudes and Preferences for End-of-Life Care - Qualitative Research within a Population-Based Cohort Study

    PubMed Central

    Fleming, Jane; Farquhar, Morag; Brayne, Carol; Barclay, Stephen

    2016-01-01

    Introduction Increasing longevity means more people will be dying in very old age, but little is known about the preferences of the ‘oldest old’ regarding their care at the end of life. Aims To understand very old people’s preferences regarding care towards the end of life and attitudes towards dying, to inform policy and practice. Methods Qualitative data collection for n = 42 population-based cohort study participants aged 95–101 (88% women, 42% in long-term-care): topic-guided interviews with n = 33 participants and n = 39 proxy informants, most with both (n = 30: 4 jointly + separate interviews for 26 dyads). Results Death was a part of life: these very old people mainly live day-to-day. Most were ready to die, reflecting their concerns regarding quality of life, being a nuisance, having nothing to live for and having lived long enough. Contrasting views were rare exceptions but voiced firmly. Most were not worried about death itself, but concerned more about the dying process and impacts on those left behind; a peaceful and pain-free death was a common ideal. Attitudes ranged from not wanting to think about death, through accepting its inevitable approach to longing for its release. Preferring to be made comfortable rather than have life-saving treatment if seriously ill, and wishing to avoid hospital, were commonly expressed views. There was little or no future planning, some consciously choosing not to. Uncertainty hampered end-of-life planning even when death was expected soon. Some stressed circumstances, such as severe dependency and others’ likely decision-making roles, would influence choices. Carers found these issues harder to raise but felt they would know their older relatives’ preferences, usually palliative care, although we found two discrepant views. Conclusions This study’s rare data show ≥95-year-olds are willing to discuss dying and end-of-life care but seldom do. Formal documentation of wishes is extremely rare and may not be

  18. Evidence for a heritable predisposition to death due to influenza.

    PubMed

    Albright, Frederick S; Orlando, Patricia; Pavia, Andrew T; Jackson, George G; Cannon Albright, Lisa A

    2008-01-01

    Animal model studies and human epidemiological studies have shown that some infectious diseases develop primarily in individuals with an inherited predisposition. A heritable contribution to the development of severe influenza virus infection (i.e., that which results in death) has not previously been hypothesized or tested. Evidence for a heritable contribution to death due to influenza was examined using a resource consisting of a genealogy of the Utah population linked to death certificates in Utah over a period of 100 years. The relative risks of death due to influenza were estimated for the relatives of 4,855 individuals who died of influenza. Both close and distant relatives of individuals who died of influenza were shown to have a significantly increased risk of dying of influenza, consistent with a combination of shared exposure and genetic effects. These data provide strong support for a heritable contribution to predisposition to death due to influenza.

  19. Understanding perinatal death: a systematic analysis of New York City fetal and neonatal death vital record data and implications for improvement, 2007-2011.

    PubMed

    Lee, Erica J; Gambatese, Melissa; Begier, Elizabeth; Soto, Antonio; Das, Tara; Madsen, Ann

    2014-10-01

    We aimed to compare demographic, medical, and cause-of-death information reported for third-trimester fetal and neonatal death vital records collected in New York City (NYC) before and after implementation of the revised fetal death certificate to identify: (1) the limitations of combining fetal and neonatal death records for the purpose of perinatal death prevention; and (2) improvement opportunities for fetal death vital records registration. Using Chi squared tests, we compared data completeness and cause-of-death information between third-trimester NYC fetal (n = 1,930) and neonatal deaths (n = 735) from 2007 to 2011. We also compared fetal death data before and after the 2011 implementation of the 2003 United States (US) Standard Report of Fetal Death and an electronic reporting system. Compared with neonatal deaths, fetal death data were generally less complete (P < 0.0001). Fetal death data much more frequently reported an ill-defined cause of death (67 vs. 5 %). Most ill-defined reported causes of fetal death (73 %) were attributed to stillbirth synonyms (e.g., "fetal demise"). Ill-defined causes of fetal death decreased from 68 to 61 % (P < 0.01) after 2011. Both data completeness and ill-defined causes of death varied widely by hospital. In NYC, fetal deaths lack demographic, medical, and cause-of-death information compared with neonatal deaths, with implications for research that uses combined perinatal mortality data sets. Electronic implementation of the US Standard Report of Fetal Death minimally improved cause-of-death information. Substantial variability by hospital suggests opportunities for improvement exist.

  20. Methods for determining time of death.

    PubMed

    Madea, Burkhard

    2016-12-01

    Medicolegal death time estimation must estimate the time since death reliably. Reliability can only be provided empirically by statistical analysis of errors in field studies. Determining the time since death requires the calculation of measurable data along a time-dependent curve back to the starting point. Various methods are used to estimate the time since death. The current gold standard for death time estimation is a previously established nomogram method based on the two-exponential model of body cooling. Great experimental and practical achievements have been realized using this nomogram method. To reduce the margin of error of the nomogram method, a compound method was developed based on electrical and mechanical excitability of skeletal muscle, pharmacological excitability of the iris, rigor mortis, and postmortem lividity. Further increasing the accuracy of death time estimation involves the development of conditional probability distributions for death time estimation based on the compound method. Although many studies have evaluated chemical methods of death time estimation, such methods play a marginal role in daily forensic practice. However, increased precision of death time estimation has recently been achieved by considering various influencing factors (i.e., preexisting diseases, duration of terminal episode, and ambient temperature). Putrefactive changes may be used for death time estimation in water-immersed bodies. Furthermore, recently developed technologies, such as H magnetic resonance spectroscopy, can be used to quantitatively study decompositional changes. This review addresses the gold standard method of death time estimation in forensic practice and promising technological and scientific developments in the field.

  1. Whither brain death?

    PubMed

    Bernat, James L

    2014-01-01

    The publicity surrounding the recent McMath and Muñoz cases has rekindled public interest in brain death: the familiar term for human death determination by showing the irreversible cessation of clinical brain functions. The concept of brain death was developed decades ago to permit withdrawal of therapy in hopeless cases and to permit organ donation. It has become widely established medical practice, and laws permit it in all U.S. jurisdictions. Brain death has a biophilosophical justification as a standard for determining human death but remains poorly understood by the public and by health professionals. The current controversies over brain death are largely restricted to the academy, but some practitioners express ambivalence over whether brain death is equivalent to human death. Brain death remains an accepted and sound concept, but more work is necessary to establish its biophilosophical justification and to educate health professionals and the public.

  2. 8 CFR 1103.4 - Certifications.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Certifications. 1103.4 Section 1103.4... REGULATIONS APPEALS, RECORDS, AND FEES § 1103.4 Certifications. (a) Certification of other than special... affected party using a Notice of Certification (Form I-290C). The affected party may submit a brief to...

  3. 40 CFR 90.208 - Certification.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Certification. 90.208 Section 90.208... EMISSIONS FROM NONROAD SPARK-IGNITION ENGINES AT OR BELOW 19 KILOWATTS Certification Averaging, Banking, and Trading Provisions § 90.208 Certification. (a) In the application for certification a manufacturer...

  4. 5 CFR 179.208 - Certification.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Certification. 179.208 Section 179.208... Salary Offset § 179.208 Certification. (a) OPM salary offset coordinator shall provide a certification to... certification must be in writing and must state: (1) That the employee owes the debt; (2) The amount and...

  5. 49 CFR 24.602 - Certification application.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Certification application. 24.602 Section 24.602... ACQUISITION FOR FEDERAL AND FEDERALLY-ASSISTED PROGRAMS Certification § 24.602 Certification application. An Agency wishing to proceed on the basis of a certification may request an application for...

  6. 5 CFR 1639.24 - Certification.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Certification. 1639.24 Section 1639.24... Certification. (a) The Board will provide a certification to the paying agency in all cases in which: (1) The... to appear at a hearing. (b) The certification must be in writing and must include: (1) A...

  7. 21 CFR 80.31 - Certification.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Certification. 80.31 Section 80.31 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL COLOR ADDITIVE CERTIFICATION Certification Procedures § 80.31 Certification. (a) If the Commissioner determines, after...

  8. 40 CFR 91.208 - Certification.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Certification. 91.208 Section 91.208... Certification. (a) In the application for certification a manufacturer must: (1) Submit a statement that the engines for which certification is requested will not, to the best of the manufacturer's belief, cause...

  9. 2010 Guide to National Board Certification

    ERIC Educational Resources Information Center

    National Board for Professional Teaching Standards, 2010

    2010-01-01

    This "Guide to National Board Certification" introduces teachers to the assessment process and provides them with useful information as they apply for National Board Certification or certification renewal, or order the "Take One!"[R] professional development kit. By participating in the National Board Certification process, teachers are joining…

  10. 46 CFR 107.258 - Crane certification.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Crane certification. 107.258 Section 107.258 Shipping... CERTIFICATION Inspection and Certification § 107.258 Crane certification. (a) The Coast Guard may accept current... West 44th Street, New York, NY 10036, on the Internet at http://www.icgb.com. (b) Crane...

  11. 49 CFR 624.7 - Certification.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Certification. 624.7 Section 624.7 Transportation... TRANSPORTATION CLEAN FUELS GRANT PROGRAM § 624.7 Certification. The applicant must use the certification contained in the Annual Notice of Assurances and Certifications published in the Federal Register...

  12. 8 CFR 103.4 - Certifications.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Certifications. 103.4 Section 103.4 Aliens...; AVAILABILITY OF RECORDS § 103.4 Certifications. (a) Certification of other than special agricultural worker and... affected party using a Notice of Certification (Form I-290C). The affected party may submit a brief to...

  13. 14 CFR 21.267 - Production certificates.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Production certificates. 21.267 Section 21... CERTIFICATION PROCEDURES FOR PRODUCTS AND PARTS Delegation Option Authorization Procedures § 21.267 Production... certificate listed on his production certificate (issued under subpart G of this part), the manufacturer...

  14. 10 CFR 501.61 - Certification contents.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Certification contents. 501.61 Section 501.61 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS ADMINISTRATIVE PROCEDURES AND SANCTIONS Exemptions and Certifications § 501.61 Certification contents. (a) A self-certification filed under section 201(d) of FUA should include the following information:...

  15. 10 CFR 501.61 - Certification contents.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Certification contents. 501.61 Section 501.61 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS ADMINISTRATIVE PROCEDURES AND SANCTIONS Exemptions and Certifications § 501.61 Certification contents. (a) A self-certification filed under section 201(d) of FUA should include the following information:...

  16. 23 CFR 657.15 - Certification content.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 23 Highways 1 2014-04-01 2014-04-01 false Certification content. 657.15 Section 657.15 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS CERTIFICATION OF SIZE AND WEIGHT ENFORCEMENT § 657.15 Certification content. The certification shall consist of the following elements and each...

  17. 10 CFR 501.61 - Certification contents.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Certification contents. 501.61 Section 501.61 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS ADMINISTRATIVE PROCEDURES AND SANCTIONS Exemptions and Certifications § 501.61 Certification contents. (a) A self-certification filed under section 201(d) of FUA should include the following information:...

  18. 10 CFR 501.61 - Certification contents.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Certification contents. 501.61 Section 501.61 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS ADMINISTRATIVE PROCEDURES AND SANCTIONS Exemptions and Certifications § 501.61 Certification contents. (a) A self-certification filed under section 201(d) of FUA should include the following information:...

  19. Teacher Certification Reconsidered: Stumbling for Quality.

    ERIC Educational Resources Information Center

    Walsh, Kate

    This report examines research on teacher certification, reviewing every published study or paper, and many unpublished dissertations, cited by prominent advocates of teacher certification. It reveals shortcomings found in the research upon which teacher certification advocates rest their claims, suggesting that the teacher certification process is…

  20. 15 CFR 2012.3 - Export certificates.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Export certificates. 2012.3 Section... STATES TRADE REPRESENTATIVE IMPLEMENTATION OF TARIFF-RATE QUOTAS FOR BEEF § 2012.3 Export certificates... export certificate is in effect with respect to the beef. (b) To be valid, an export certificate...

  1. 46 CFR 107.258 - Crane certification.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 4 2014-10-01 2014-10-01 false Crane certification. 107.258 Section 107.258 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS INSPECTION AND CERTIFICATION Inspection and Certification § 107.258 Crane certification. (a) The Coast Guard may accept...

  2. 46 CFR 107.258 - Crane certification.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 4 2013-10-01 2013-10-01 false Crane certification. 107.258 Section 107.258 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS INSPECTION AND CERTIFICATION Inspection and Certification § 107.258 Crane certification. (a) The Coast Guard may accept...

  3. 46 CFR 107.258 - Crane certification.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 4 2011-10-01 2011-10-01 false Crane certification. 107.258 Section 107.258 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS INSPECTION AND CERTIFICATION Inspection and Certification § 107.258 Crane certification. (a) The Coast Guard may accept...

  4. 46 CFR 107.258 - Crane certification.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 4 2012-10-01 2012-10-01 false Crane certification. 107.258 Section 107.258 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS INSPECTION AND CERTIFICATION Inspection and Certification § 107.258 Crane certification. (a) The Coast Guard may accept...

  5. 7 CFR 1401.4 - Commodity certificates.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... transferred, exchanged for the inventory of CCC (including the receipt in accordance with paragraph (e) of... exchanged for cash, as provided for in this section. Commodity certificates shall be subject to the... certificate to CCC shall endorse the certificate to CCC. (d) Exchange of commodity certificate for...

  6. Stochastic Evolution Dynamic of the Rock–Scissors–Paper Game Based on a Quasi Birth and Death Process

    PubMed Central

    Yu, Qian; Fang, Debin; Zhang, Xiaoling; Jin, Chen; Ren, Qiyu

    2016-01-01

    Stochasticity plays an important role in the evolutionary dynamic of cyclic dominance within a finite population. To investigate the stochastic evolution process of the behaviour of bounded rational individuals, we model the Rock-Scissors-Paper (RSP) game as a finite, state dependent Quasi Birth and Death (QBD) process. We assume that bounded rational players can adjust their strategies by imitating the successful strategy according to the payoffs of the last round of the game, and then analyse the limiting distribution of the QBD process for the game stochastic evolutionary dynamic. The numerical experiments results are exhibited as pseudo colour ternary heat maps. Comparisons of these diagrams shows that the convergence property of long run equilibrium of the RSP game in populations depends on population size and the parameter of the payoff matrix and noise factor. The long run equilibrium is asymptotically stable, neutrally stable and unstable respectively according to the normalised parameters in the payoff matrix. Moreover, the results show that the distribution probability becomes more concentrated with a larger population size. This indicates that increasing the population size also increases the convergence speed of the stochastic evolution process while simultaneously reducing the influence of the noise factor. PMID:27346701

  7. Assessment of Computer-based Geologic Mapping of Rock Units in the LANDSAT-4 Scene of Northern Death Valley, California

    NASA Technical Reports Server (NTRS)

    Short, N. M.

    1985-01-01

    Geologists obtain low accuracy levels when maps derived from LANDSAT MSS data are compared with those made by conventional methods. Procedures developed for the IDIMS computer system and used to classify a subset of a TM image of the Death Valley, California - Nevada border are described. Despite the superior resolution, broader spectral coverage, and greater sensitivity inherent to the TM, the actual recorded measured accuracy was in the same narrow range (30 to 60%) recorded for MSS data from earlier LANDSATs. The supervised classification approach appears to be superior to the unsupervised approach when applied to vegetation-sparse surfaces composed of spectrally contrasting rock/soil units distributed in relatively flat to low relief terrain. As spatial resolution improves and optimal spectral bands for identifying rock materials are specified, use of classified multispectral remote sensing data from air and space when coupled with supporting field calibration and checks should become the dominant way in which geologic mapping is carried out in future decades.

  8. Stochastic Evolution Dynamic of the Rock–Scissors–Paper Game Based on a Quasi Birth and Death Process

    NASA Astrophysics Data System (ADS)

    Yu, Qian; Fang, Debin; Zhang, Xiaoling; Jin, Chen; Ren, Qiyu

    2016-06-01

    Stochasticity plays an important role in the evolutionary dynamic of cyclic dominance within a finite population. To investigate the stochastic evolution process of the behaviour of bounded rational individuals, we model the Rock-Scissors-Paper (RSP) game as a finite, state dependent Quasi Birth and Death (QBD) process. We assume that bounded rational players can adjust their strategies by imitating the successful strategy according to the payoffs of the last round of the game, and then analyse the limiting distribution of the QBD process for the game stochastic evolutionary dynamic. The numerical experiments results are exhibited as pseudo colour ternary heat maps. Comparisons of these diagrams shows that the convergence property of long run equilibrium of the RSP game in populations depends on population size and the parameter of the payoff matrix and noise factor. The long run equilibrium is asymptotically stable, neutrally stable and unstable respectively according to the normalised parameters in the payoff matrix. Moreover, the results show that the distribution probability becomes more concentrated with a larger population size. This indicates that increasing the population size also increases the convergence speed of the stochastic evolution process while simultaneously reducing the influence of the noise factor.

  9. Security Equipment and Systems Certification Program (SESCP)

    SciTech Connect

    Steele, B.J.; Papier, I.I.

    1996-06-20

    Sandia National Laboratories (SNL) and Underwriters Laboratories, Inc., (UL) have jointly established the Security Equipment and Systems Certification Program (SESCP). The goal of this program is to enhance industrial and national security by providing a nationally recognized method for making informed selection and use decisions when buying security equipment and systems. The SESCP will provide a coordinated structure for private and governmental security standardization review. Members will participate in meetings to identify security problems, develop ad-hoc subcommittees (as needed) to address these identified problems, and to maintain a communications network that encourages a meaningful exchange of ideas. This program will enhance national security by providing improved security equipment and security systems based on consistent, reliable standards and certification programs.

  10. Trends in Continuous Deep Sedation until Death between 2007 and 2013: A Repeated Nationwide Survey

    PubMed Central

    Cohen, Joachim; Rietjens, Judith

    2016-01-01

    Background Continuous deep sedation until death is a highly debated medical practice, particularly regarding its potential to hasten death and its proper use in end-of-life care. A thorough analysis of important trends in this practice is needed to identify potentially problematic developments. This study aims to examine trends in the prevalence and practice characteristics of continuous deep sedation until death in Flanders, Belgium between 2007 and 2013, and to study variation on physicians’ degree of palliative training. Methods Population-based death certificate study in 2007 and 2013 in Flanders, Belgium. Reporting physicians received questionnaires about medical practices preceding the patient’s death. Patient characteristics, clinical characteristics (drugs used, duration, artificial nutrition/hydration, intention and consent), and palliative care training of attending physician were recorded. We posed the following question regarding continuous deep sedation: ‘Was the patient continuously and deeply sedated or kept in a coma until death by the use of one or more drugs’. Results After the initial rise of continuous deep sedation to 14.5% in 2007 (95%CI 13.1%-15.9%), its use decreased to 12.0% in 2013 (95%CI 10.9%-13.2%). Compared with 2007, in 2013 opioids were less often used as sole drug and the decision to use continuous deep sedation was more often preceded by patient request. Compared to non-experts, palliative care experts more often used benzodiazepines and less often opioids, withheld artificial nutrition/hydration more often and performed sedation more often after a request from or with the consent of the patient or family. Conclusion Worldwide, this study is the first to show a decrease in the prevalence of continuous deep sedation. Despite positive changes in performance and decision-making towards more compliance with due care requirements, there is still room for improvement in the use of recommended drugs and in the involvement of

  11. Cohorts based on Decade of Death: No Evidence for Secular Trends Favoring Later Cohorts in Cognitive Aging and Terminal Decline in the AHEAD Study

    PubMed Central

    Hülür, Gizem; Infurna, Frank J.; Ram, Nilam; Gerstorf, Denis

    2012-01-01

    Studies of birth-year cohorts examined over the same age range often report secular trends favoring later-born cohorts, who are cognitively fitter and show less steep cognitive declines than earlier-born cohorts. However, there is initial evidence that those advantages of later-born cohorts do not carry into the last years of life, suggesting that pervasive mortality-related processes minimize differences that were apparent earlier in life. Elaborating this work from an alternative perspective on cohort differences, we compared rates of cognitive aging and terminal decline in episodic memory between cohorts based on the year participants had died, earlier (between 1993 and 1999) or later in historical time (between 2000 and 2010). Specifically, we compared trajectories of cognitive decline in two death-year cohorts of participants in the Asset and Health Dynamics among the Oldest Old (AHEAD) Study that were matched on age at death and education and controlled for a variety of additional covariates. Results revealed little evidence of secular trends favoring later cohorts. To the contrary, the cohort that died in the 2000s showed a less favorable trajectory of age-related memory decline than the cohort who died in the 1990s. In examinations of change in relation to time-to-death, the cohort dying in the 2000s experienced even steeper terminal declines than the cohort dying in the 1990s. We suggest that secular increases in “manufacturing” survival may exacerbate age- and mortality-related cognitive declines among the oldest old. PMID:23046001

  12. NATO HLA Certification

    DTIC Science & Technology

    2002-06-01

    les M&S (NMSG), a été implantée au sein de l’organisation de recherche et technologie (RTO). Les activités du NMSG sont organisées selon un plan...le cadre de son plan d’action, le NMSG a décidé la création d’un groupe de travail chargé de comparer différentes possibilités pour implanter ... une capacité de certification de conformité au standard HLA des simulations développées et utilisées par l’OTAN. Ce groupe de travail (le MSG-011

  13. Renewable Energy Certificate Program

    SciTech Connect

    Gwendolyn S. Andersen

    2012-07-17

    This project was primarily to develop and implement a curriculum which will train undergraduate and graduate students at the University seeking a degree as well as training for enrollees in a special certification program to prepare individuals to be employed in a broad range of occupations in the field of renewable energy and energy conservation. Curriculum development was by teams of Saint Francis University Faculty in the Business Administration and Science Departments and industry experts. Students seeking undergraduate and graduate degrees are able to enroll in courses offered within these departments which will combine theory and hands-on training in the various elements of wind power development. For example, the business department curriculum areas include economic modeling, finance, contracting, etc. The science areas include meteorology, energy conversion and projection, species identification, habitat protection, field data collection and analysis, etc.

  14. Field-testing ecological and economic benefits of coffee certification programs.

    PubMed

    Philpott, Stacy M; Bichier, Peter; Rice, Robert; Greenberg, Russell

    2007-08-01

    Coffee agroecosystems are critical to the success of conservation efforts in Latin America because of their ecological and economic importance. Coffee certification programs may offer one way to protect biodiversity and maintain farmer livelihoods. Established coffee certification programs fall into three distinct, but not mutually exclusive categories: organic, fair trade, and shade. The results of previous studies demonstrate that shade certification can benefit biodiversity, but it remains unclear whether a farmer's participation in any certification program can provide both ecological and economic benefits. To assess the value of coffee certification for conservation efforts in the region, we examined economic and ecological aspects of coffee production for eight coffee cooperatives in Chiapas, Mexico, that were certified organic, certified organic and fair trade, or uncertified. We compared vegetation and ant and bird diversity in coffee farms and forests, and interviewed farmers to determine coffee yield, gross revenue from coffee production, and area in coffee production. Although there are no shade-certified farms in the study region, we used vegetation data to determine whether cooperatives would qualify for shade certification. We found no differences in vegetation characteristics, ant or bird species richness, or fraction of forest fauna in farms based on certification. Farmers with organic and organic and fair-trade certification had more land under cultivation and in some cases higher revenue than uncertified farmers. Coffee production area did not vary among farm types. No cooperative passed shade-coffee certification standards because the plantations lacked vertical stratification, yet vegetation variables for shade certification significantly correlated with ant and bird diversity. Although farmers in the Chiapas highlands with organic and/or fair-trade certification may reap some economic benefits from their certification status, their farms may

  15. Expert system-based mineral mapping in northern Death Valley, California/Nevada, using the Airborne Visible/Infrared Imaging Spectrometer (AVIRIS)

    NASA Technical Reports Server (NTRS)

    Kruse, F. A.; Lefkoff, A. B.; Dietz, J. B.

    1993-01-01

    Integrated analysis of imaging spectrometer data and field spectral measurements were used in conjunction with conventional geologic field mapping to characterize bedrock and surficial geology at the northern end of Death Valley, California and Nevada. A knowledge-based expert system was used to automatically produce image maps showing the principal surface mineralogy from Airborne Visible/Infrared Imaging Spectrometer (AVIRIS) data. Linear spectral unmixing of the AVIRIS data allowed further determination of relative mineral, abundances and identification of mineral assemblages and mixtures. The imaging spectrometer data show the spatial distribution of spectrally distinct minerals occurring both as primary rockforming minerals and as alteration and weathering products. Field spectral measurements were used to verify the mineral maps and field mapping was used to extend the remote sensing results. Geographically referenced image maps produced from these data form new base maps from which to develop improved understanding of the processes of deposition and erosion affecting the present land surface.

  16. Restaurant manager and worker food safety certification and knowledge.

    PubMed

    Brown, Laura G; Le, Brenda; Wong, Melissa R; Reimann, David; Nicholas, David; Faw, Brenda; Davis, Ernestine; Selman, Carol A

    2014-11-01

    Over half of foodborne illness outbreaks occur in restaurants. To combat these outbreaks, many public health agencies require food safety certification for restaurant managers, and sometimes workers. Certification entails passing a food safety knowledge examination, which is typically preceded by food safety training. Current certification efforts are based on the assumption that certification leads to greater food safety knowledge. The Centers for Disease Control and Prevention conducted this study to examine the relationship between food safety knowledge and certification. We also examined the relationships between food safety knowledge and restaurant, manager, and worker characteristics. We interviewed managers (N=387) and workers (N=365) about their characteristics and assessed their food safety knowledge. Analyses showed that certified managers and workers had greater food safety knowledge than noncertified managers and workers. Additionally, managers and workers whose primary language was English had greater food safety knowledge than those whose primary language was not English. Other factors associated with greater food safety knowledge included working in a chain restaurant, working in a larger restaurant, having more experience, and having more duties. These findings indicate that certification improves food safety knowledge, and that complex relationships exist among restaurant, manager, and worker characteristics and food safety knowledge.

  17. Clinical Profiles Related to Timing of Death, Including In-Hospital Deaths Before Admission, in Patients With ST-Elevation Myocardial Infarction.

    PubMed

    Bogaty, Peter; L'Allier, Philippe L; Segal, Eli; Rinfret, Stéphane; Racine, Normand; Harvey, Richard; Ross, Dave; Maire, Sébastien; Kouz, Simon; Carroll, Céline; Boothroyd, Lucy J; Kezouh, Abbas; Azzi, Leila; Brown, Kevin A; Nasmith, James; Lambert, Laurie J

    2016-02-01

    Patients with ST-elevation myocardial infarction (STEMI) who die in hospital before inpatient admission are generally not included in clinical studies and registries, and the clinical profiles of patients who die earlier versus later are not well defined. We aimed to characterize all patients with STEMI who arrived at emergency departments in the province of Quebec (Canada) based on inpatient admission status and when they died. All patients who presented with symptoms and core laboratory-confirmed STEMI or left bundle branch block during 6 months in 82 hospitals in Quebec were included. Death certificates were used to identify nonadmitted deaths. Of the 2017 patients with STEMI, 340 (16.9%) died within 1 year. Of the latter, 63 (18.5%) were nonadmitted deaths (group A), 179 (52.6%) were deaths after admission but within 30 days (group B), and 98 (28.8%) were deaths after 30 days to 1 year (group C). Group A was younger and most often hemodynamically unstable, followed for both features by B then C. Earliest presentation from symptom onset and most frequent ambulance use were found in group A, followed by B, then C. Presenting electrocardiogram (ECG) features were most severe in A, then B, then C (more arrhythmias, more anterior STEMI, more leads with ST elevation, and higher ST elevation). Patients who died earliest had the least frequency of previous myocardial infarction, coronary revascularization, vascular disease, and heart failure, and the least noncardiac co-morbidity. In conclusion, patients with STEMI dying in hospital before inpatient admission contributed substantially to overall STEMI mortality. Although dying patients who presented earlier had severer presenting clinical profiles, they were paradoxically younger and had less co-morbidity. Previous co-morbidities may favor adaptive protective mechanisms on initial presentation with STEMI.

  18. Attitude Toward Death, Fear of Being Declared Dead Too Soon, and Donation of Organs After Death.

    ERIC Educational Resources Information Center

    Hessing, Dick J.; Elffers, Henk

    1987-01-01

    Describes a study of willingness to donate organs for transplantation after death based on Weyant's cost-benefit model for altruistic behavior. Two death anxieties (the attitude toward death and the fear of being declared dead too soon) were introduced to help explain the discrepancy between attitudes and behavior in the matter of organ donation.…

  19. Is it possible and worth keeping track of deaths within general practice? Results of a 15 year observational study

    PubMed Central

    Beaumont, B; Hurwitz, B

    2003-01-01

    Aim: To assess the value of maintaining a death register in a general practice with particular reference to monitoring quality of care. Design of study: Observational study. Setting: Inner London general practice. Method: The practice maintained a manual death register, retained medical records of all deceased patients, and requested information on cause of death from health authorities and coroners for 15 years. Main outcome measures: Number and causes of deaths; 3 yearly age standardised death rates; proportion of deaths formally notified to the practice; place of death; source of cause of death information. Results: During the study period 578 patients died. Practice age standardised death rates fell significantly from 35.59 to 27.12/1000. 498 (86.2%) deaths were formally notified to the practice, 392 within 7 days of death. Of 143 deaths reported to the coroner, only 45 coroners' reports were received. 360 (64.1%) died in hospital, 139 (24.8%) at home, and 38 (6.8%) in a hospice. Death certificate cause of death information was obtained from patients' records in 33.6% (n=194) of cases and from health authority sources for 50% (n=289). The pattern of ascertained causes of deaths was similar to the national pattern. Conclusion: A death register can examine trends in practice deaths by age and place of death and comparisons undertaken with nationally published mortality data. An accurate picture of cause of death cannot be generated from routine data flows alone. There is delay in informing GPs of patient deaths. Meaningful and timely monitoring of deaths cannot be undertaken by individual practices. National Statistics should provide routine analysis of GP death certificate information. PMID:14532364

  20. Are Death Anxiety and Death Depression Distinct Entities?

    ERIC Educational Resources Information Center

    Alvarado, Katherine A.; And Others

    1993-01-01

    Administered Death Anxiety Scale and Death Depression Scale to 200 individuals. Two scales correlated 0.55. Factor analysis of combined 32 items revealed factors: "death anxiety" having highest factor loadings with Death Anxiety Scale, "death depression" having highest factor loadings with Death Depression Scale, "death of…

  1. Forensic Analysis of Parachute Deaths.

    PubMed

    Burke, Michael Philip; Chitty, Johannes

    2017-03-01

    Deaths associated with parachuting are very uncommon. However, these deaths do tend to be "high profile" in the traditional and social media. When forensic pathologists examine the deceased after a fatal parachuting incident, the anatomical cause of death is usually not in question. For most forensic pathologists, it is usually the case that we will have very limited knowledge of parachuting equipment or the mechanics of a typical successful parachute jump. As such, the investigation of the death should involve a multidisciplinary approach with an appropriate expert providing the formal forensic examination of the parachuting equipment. We have endeavored to describe, in simple terms, the usual components of a typical parachute rig, a précis of the sequence of events in a routine skydive and BASE jump, and the various types of malfunctions that may occur. Last, we present a case report of a BASE jump fatality to illustrate how an expert examination of the BASE jumper's gear aided the medicolegal investigation of the death with some important aspects in the forensic examination of the jumper's equipment.

  2. Children's Experience with Death.

    ERIC Educational Resources Information Center

    Zeligs, Rose

    Children's concepts of death grow with their age and development The three-year-old begins to notice that living things move and make sounds. The five-year-old thinks that life and death are reversable, but the six-year-old knows that death is final and brings sorrow. Children from eight through ten are interested in the causes of death and what…

  3. Dialysis technicians' perception of certification.

    PubMed

    Williams, Helen F; Garbin, Margery

    2015-03-01

    The Nephrology Nursing Certification Commission initiated this research project to study the viewpoint of dialysis technicians regarding the value of certification. A national convenience sample was obtained using both paper-and-pencil and online forms of the survey instrument. Demographic characteristics were obtained concerning age, race, ethnicity, education, and future employment planning. Technicians' primary work settings, the roles they fill, and the types of certification they hold are described. Incentives offered by employers are considered to explore how they contribute to job satisfaction. Understanding the perceptions of technicians regarding the benefits of certification and the limitations of workplace incentives should enable employers to improve their recruitment and retention programs. Information obtained may offer a baseline for future observations of the characteristics of these significant and essential contributors to the nephrology workforce.

  4. Bias in the attribution of lung cancer as cause of death and its possible consequences for calculating smoking-related risks.

    PubMed

    Sterling, T D; Rosenbaum, W L; Weinkam, J J

    1992-01-01

    Most published calculations of mortality risk, especially those for lung cancer associated with smoking, are based almost exclusively on the underlying cause as recorded on death certificates. Such risk calculations implicitly assume that the conditional probability of recording lung cancer as the underlying cause of death, given that it really is the underlying cause, is the same for all exposure groups. If these probabilities are not equal for all exposure groups, we call the resulting bias a cause of death attribution bias. We analyzed the 1986 National Mortality Followback Survey, a sample of 18,733 U.S. death certificates, and the 1954-1962 Dorn study, a follow-up study of approximately 250,000 holders of U.S. Veterans Life Insurance. Both data sets include information on the smoking habits of decedents and on the underlying and contributing causes of their deaths. We found that lung cancer as an underlying cause is recorded with a much smaller relative frequency if the decedent is known to be a never-smoker and with a much larger relative frequency when the decedent is known to be a smoker. On the other hand, lung cancer as a contributing cause is recorded with a much larger frequency if the decedent is known to be a never-smoker and with a much smaller frequency when the decedent is known to be a smoker. The reverse is true for cancers other than of the lung. There is no similar pattern related to smoking for other causes of death (specifically for myocardial infarction, other chronic ischemic heart disease, diabetes, or cerebrovascular disease).(ABSTRACT TRUNCATED AT 250 WORDS)

  5. The concept and practice of brain death.

    PubMed

    Bernat, James L

    2005-01-01

    Brain death, the colloquial term for the determination of human death by showing the irreversible cessation of the clinical functions of the brain, has been practiced since the 1960s and is growing in acceptance throughout the world. Of the three concepts of brain death--the whole-brain formulation, the brain stem formulation, and the higher brain formulation--the whole-brain formulation is accepted and practiced most widely. There is a rigorous conceptual basis for regarding whole-brain death as human death based on the biophilosophical concept of the loss of the organism as a whole. The diagnosis of brain death is primarily a clinical determination but laboratory tests showing the cessation of intracranial blood flow can be used to confirm the clinical diagnosis in cases in which the clinical tests cannot be fully performed or correctly interpreted. Because of evidence that some physicians fail to perform or record brain death tests properly, it is desirable to require a confirmatory test when inadequately experienced physicians conduct brain death determinations. The world's principal religions accept brain death with a few exceptions. Several scholars continue to reject brain death on conceptual grounds and urge that human death determination be based on the irreversible cessation of circulation. But despite the force of their arguments they have neither persuaded any jurisdictions to abandon brain death statutes nor convinced medical groups to change clinical practice guidelines. Other scholars who, on more pragmatic grounds, have called for the abandonment of brain death as an anachronism or an unnecessary prerequisite for multi-organ procurement, similarly have not convinced public policy makers to withdraw the dead-donor rule. Despite a few residual areas of controversy, brain death is a durable concept that has been accepted well and has formed the basis of successful public policy in diverse societies throughout the world.

  6. Death with dignity from the Confucian perspective.

    PubMed

    Li, Yaming; Li, Jianhui

    2017-02-01

    Death with dignity is a significant issue in modern bioethics. In modern healthcare, the wide use of new technologies at the end of life has caused heated debate on how to protect human dignity. The key point of contention lies in the different understandings of human dignity and the dignity of death. Human dignity has never been a clear concept in Western ethical explorations, and the dignity of death has given rise to more confusions. Although there is no such term as "dignity" in Confucian ethics, there are discussions of a number of ideas related to human dignity and the dignity of death. Therefore, Confucian bioethics can offer a new perspective for understanding the theoretical difficulties associated with the dignity of death and new methods for solving them. In this article, we attempt to reconstruct Confucian views on human dignity and the dignity of death and, based on those views, to analyze the following issues: the relationship between the dignity of death and biological life, the relationship between the dignity of death and suffering, the relationship between the dignity of death and the autonomy of human beings, and the relationship between the dignity of death and social justice. This article will also compare the Confucian views on these issues with the views of Western philosophers. Confucian ethics can offer distinct answers to the above issues and help resolve some confusions concerning concepts and theories in Western research on the dignity of death.

  7. Studies of benzamide- and thiol-based histone deacetylase inhibitors in models of oxidative-stress-induced neuronal death: identification of some HDAC3-selective inhibitors.

    PubMed

    Chen, Yufeng; He, Rong; Chen, Yihua; D'Annibale, Melissa A; Langley, Brett; Kozikowski, Alan P

    2009-05-01

    We compare three structurally different classes of histone deacetylase (HDAC) inhibitors that contain benzamide, hydroxamate, or thiol groups as the zinc binding group (ZBG) for their ability to protect cortical neurons in culture from cell death induced by oxidative stress. This study reveals that none of the benzamide-based HDAC inhibitors (HDACIs) provides any neuroprotection whatsoever, in distinct contrast to HDACIs that contain other ZBGs. Some of the sulfur-containing HDACIs, namely the thiols, thioesters, and disulfides present modest neuroprotective activity but show toxicity at higher concentrations. Taken together, these data demonstrate that the HDAC6-selective mercaptoacetamides that were reported previously provide the best protection in the homocysteic acid model of oxidative stress, thus further supporting their study in animal models of neurodegenerative diseases.

  8. Experimental evaluation of the certification-trail method

    NASA Technical Reports Server (NTRS)

    Sullivan, Gregory F.; Wilson, Dwight S.; Masson, Gerald M.; Itoh, Mamoru; Smith, Warren W.; Kay, Jonathan S.

    1993-01-01

    Certification trails are a recently introduced and promising approach to fault-detection and fault-tolerance. A comprehensive attempt to assess experimentally the performance and overall value of the method is reported. The method is applied to algorithms for the following problems: huffman tree, shortest path, minimum spanning tree, sorting, and convex hull. Our results reveal many cases in which an approach using certification-trails allows for significantly faster overall program execution time than a basic time redundancy-approach. Algorithms for the answer-validation problem for abstract data types were also examined. This kind of problem provides a basis for applying the certification-trail method to wide classes of algorithms. Answer-validation solutions for two types of priority queues were implemented and analyzed. In both cases, the algorithm which performs answer-validation is substantially faster than the original algorithm for computing the answer. Next, a probabilistic model and analysis which enables comparison between the certification-trail method and the time-redundancy approach were presented. The analysis reveals some substantial and sometimes surprising advantages for ther certification-trail method. Finally, the work our group performed on the design and implementation of fault injection testbeds for experimental analysis of the certification trail technique is discussed. This work employs two distinct methodologies, software fault injection (modification of instruction, data, and stack segments of programs on a Sun Sparcstation ELC and on an IBM 386 PC) and hardware fault injection (control, address, and data lines of a Motorola MC68000-based target system pulsed at logical zero/one values). Our results indicate the viability of the certification trail technique. It is also believed that the tools developed provide a solid base for additional exploration.

  9. Mortality and Causes of Death in Patients with Sporadic Inclusion Body Myositis: Survey Study Based on the Clinical Experience of Specialists in Australia, Europe and the USA

    PubMed Central

    Price, Mark A.; Barghout, Victoria; Benveniste, Olivier; Christopher-Stine, Lisa; Corbett, Alastair; de Visser, Marianne; Hilton-Jones, David; Kissel, John T.; Lloyd, Thomas E.; Lundberg, Ingrid E.; Mastaglia, Francis; Mozaffar, Tahseen; Needham, Merrilee; Schmidt, Jens; Sivakumar, Kumaraswamy; DeMuro, Carla; Tseng, Brian S.

    2016-01-01

    Background: There is a paucity of data on mortality and causes of death (CoDs) in patients with sporadic inclusion body myositis (sIBM), a rare, progressive, degenerative, inflammatory myopathy that typically affects those aged over 50 years. Objective: Based on patient records and expertise of clinical specialists, this study used questionnaires to evaluate physicians’ views on clinical characteristics of sIBM that may impact on premature mortality and CoDs in these patients. Methods: Thirteen physicians from seven countries completed two questionnaires online between December 20, 2012 and January 15, 2013. Responses to the first questionnaire were collated and presented in the second questionnaire to seek elaboration and identify consensus. Results: All 13 physicians completed both questionnaires, providing responses based on 585 living and 149 deceased patients under their care. Patients were reported to have experienced dysphagia (60.2%) and injurious falls (44.3%) during their disease. Over half of physicians reported that a subset of their patients with sIBM had a shortened lifespan (8/13), and agreed that bulbar dysfunction/dysphagia/oropharyngeal involvement (12/13), early-onset disease (8/13), severe symptoms (8/13), and falls (7/13) impacted lifespan. Factors related to sIBM were reported as CoDs in 40% of deceased patients. Oropharyngeal muscle dysfunction was ranked as the leading feature of sIBM that could contribute to death. The risk of premature mortality was higher than the age-matched comparison population. Conclusions: In the absence of data from traditional sources, this study suggests that features of sIBM may contribute to premature mortality and may be used to inform future studies. PMID:27854208

  10. Hardware cleanliness methodology and certification

    NASA Technical Reports Server (NTRS)

    Harvey, Gale A.; Lash, Thomas J.; Rawls, J. Richard

    1995-01-01

    Inadequacy of mass loss cleanliness criteria for selection of materials for contamination sensitive uses, and processing of flight hardware for contamination sensitive instruments is discussed. Materials selection for flight hardware is usually based on mass loss (ASTM E-595). However, flight hardware cleanliness (MIL 1246A) is a surface cleanliness assessment. It is possible for materials (e.g. Sil-Pad 2000) to pass ASTM E-595 and fail MIL 1246A class A by orders of magnitude. Conversely, it is possible for small amounts of nonconforming material (Huma-Seal conformal coating) to not present significant cleanliness problems to an optical flight instrument. Effective cleaning (precleaning, precision cleaning, and ultra cleaning) and cleanliness verification are essential for contamination sensitive flight instruments. Polish cleaning of hardware, e.g. vacuum baking for vacuum applications, and storage of clean hardware, e.g. laser optics, is discussed. Silicone materials present special concerns for use in space because of the rapid conversion of the outgassed residues to glass by solar ultraviolet radiation and/or atomic oxygen. Non ozone depleting solvent cleaning and institutional support for cleaning and certification are also discussed.

  11. Programmed Cell Death in Breast Cancer.

    DTIC Science & Technology

    1996-10-01

    TITLE: Programmed Cell Death in Breast Cancer PRINCIPAL INVESTIGATOR: Clark W. Distelhorst, M.D. CONTRACTING ORGANIZATION: Case Western Reserve...Programmed Cell Death in Breast Cancer DAMD17-94-J-4451 6. AUTHOR(S) Clark W. Distelhorst, M.D. 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8...cell death , apoptosis, in breast cancer cells has been developed. This model is based on induction of apoptosis by the selective endoplasmic reticulum

  12. 7 CFR 301.32-5 - Issuance and cancellation of certificates and limited permits.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Flies § 301.32-5 Issuance and cancellation of certificates and limited permits. (a) A certificate may be... from fruit flies; or (iii) Based on inspection of the regulated article, the regulated article is free of fruit flies; or (iv) The regulated articles are Hass variety avocados that have been...

  13. 7 CFR 301.32-5 - Issuance and cancellation of certificates and limited permits.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Flies § 301.32-5 Issuance and cancellation of certificates and limited permits. (a) A certificate may be... from fruit flies; or (iii) Based on inspection of the regulated article, the regulated article is free of fruit flies; or (iv) The regulated articles are Hass variety avocados that have been...

  14. 7 CFR 301.32-5 - Issuance and cancellation of certificates and limited permits.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Flies § 301.32-5 Issuance and cancellation of certificates and limited permits. (a) A certificate may be... from fruit flies; or (iii) Based on inspection of the regulated article, the regulated article is free of fruit flies; or (iv) The regulated articles are Hass variety avocados that have been...

  15. 7 CFR 301.32-5 - Issuance and cancellation of certificates and limited permits.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Flies § 301.32-5 Issuance and cancellation of certificates and limited permits. (a) A certificate may be... from fruit flies; or (iii) Based on inspection of the regulated article, the regulated article is free of fruit flies; or (iv) The regulated articles are Hass variety avocados that have been...

  16. 42 CFR 438.606 - Source, content, and timing of certification.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... specified in § 438.604, the data the MCO or PIHP submits to the State must be certified by one of the... certification must attest, based on best knowledge, information, and belief, as follows: (1) To the accuracy... specified by the State. (c) Timing of certification. The MCO or PIHP must submit the...

  17. Graduating STEM Competent and Confident Teachers: The Creation of a STEM Certificate for Elementary Education Majors

    ERIC Educational Resources Information Center

    Murphy, Tony P.; Mancini-Samuelson, Gina J.

    2012-01-01

    A collaborative of STEM (science, technology, engineering, and mathematics) and education faculty developed a STEM certificate aimed at elementary education majors. A four-phase process model was used to create and evaluate courses. The certificate is comprised of three interdisciplinary, team-taught, lab-based courses: Environmental Biology,…

  18. 76 FR 59003 - Energy Conservation Program: Compliance Certification for Electric Motors

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-23

    ... ``Department'') through an electronic Web-based tool, the Compliance and Certification Management System (CCMS... of 10 CFR Part 431 to be consistent with the Energy Independence and Security Act of 2007 (EISA 2007... the following means: 1. Compliance and Certification Management System (CCMS)--via the Web...

  19. A Fair Trade Approach to Community Forest Certification? A Framework for Discussion

    ERIC Educational Resources Information Center

    Taylor, Peter Leigh

    2005-01-01

    Forest certification has gained growing attention as a market-based instrument to make globalizing markets a force for mitigating rather than fostering environmental degradation. Yet in practice, market mechanisms currently appear to encourage concentration of forest certification in Northern temperate and boreal forests, rather than in the…

  20. Examining Changes in Certification/Licensure Requirements and the International Medical Graduate Examinee Pool

    ERIC Educational Resources Information Center

    McKinley, Danette W.; Hess, Brian J.; Boulet, John R.; Lipner, Rebecca S.

    2014-01-01

    Changes in certification requirements and examinee characteristics are likely to influence the validity of the evidence associated with interpretations made based on test data. We examined whether changes in Educational Commission for Foreign Medical Graduates (ECFMG) certification requirements over time were associated with changes in internal…