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Sample records for death certificate based

  1. An assessment of occupation and industry data from death certificates and hospital medical records for population-based cancer surveillance.

    PubMed

    Swanson, G M; Schwartz, A G; Burrows, R W

    1984-05-01

    This study analyzed 30,194 incident cases and 4,301 death certificates for completeness of occupational reporting. Analysis of data accuracy was based upon a comparison of more than 2,000 death certificates with incident abstracts and 352 death certificates with interview data. Death certificates had a higher proportion with occupation (94.3%) and industry (93.4%) reported than did incident abstracts of hospital medical records (39.0% and 63.5%, respectively). Compared with occupational history data obtained by interview, 76.1% of the death certificates were exact matches for usual occupation and industry.

  2. 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

  3. 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

  4. Occupation, socioeconomic status, and brain tumor mortality: a death certificate-based case-control study.

    PubMed

    Demers, P A; Vaughan, T L; Schommer, R R

    1991-09-01

    The relationships between brain tumor mortality and occupation and socioeconomic status (SES) were evaluated in a death certificate-based case-control study. The cases consisted of 904 white men aged 20 years and older who died of a brain tumor in Washington state between 1969 and 1978. For each case a white male control of the same age was chosen. A consistent pattern of increasing risk with increasing SES was seen for all brain tumors as well as for gliomas and astrocytomas. After adjustment for SES, stationary engineers were found to be at excess risk across all histologies based on six cases vs no controls with lower 95% confidence intervals of 2.3 for all brain tumors, 2.8 for gliomas (based on three cases), and 2.1 for astrocytic tumors (based on two cases). Excesses of astrocytic tumors also were observed for petroleum refinery workers (OR = 8.8, CI = 2.2-35.2), forestry workers (OR = 8.5, CI = 1.1-63.4), and cleaning service workers (OR = 2.7, CI = 1.1-6.7).

  5. [Death certificates of women in childbearing age: search for maternal deaths].

    PubMed

    Gil, Mariana Marcos; Gomes-Sponholz, Flavia Azevedo

    2013-01-01

    In Brazil, there is a lack of complete records on death certificates, and its reliability is questioned, especially for causes attributed to pregnancy and childbirth. We investigated, based on death certificates of women in reproductive age, any fields for identifying maternal deaths. Documentary research, conducted in hospital records. We analyzed in death certificates, maternal and no maternal deaths, inconclusive deaths and hidden deaths. To analyze the underlying causes of death we used ICD 10th Revision. Of the 301 death certificates reviewed, 60% had the fields 43/44 completed, and 40% had these fields blank and/or ignored. We found 58.5% of no maternal deaths, 2% of maternal deaths and 39.5% inconclusive. The analysis of inconclusive deaths allowed us to classify 4.3% as hidden deaths. To overcome the incompletitudes of civil registries, it is necessary that all health professionals be committed to the reliability of the information, so the priority target could be reached.

  6. An accessible method for teaching doctors about death certification.

    PubMed

    Walker, Sue; Rampatige, Rasika; Wainiqolo, Iris; Aumua, Audrey

    2012-01-01

    The World Health Organization (WHO) recommends that data on mortality in its member countries are collected utilising the Medical Certificate of Cause of Death published in the instruction volume of the ICD-10. However, investment in health information processes necessary to promote the use of this certificate and improve mortality information is lacking in many countries. An appeal for support to make improvements has been launched through the Health Metrics Network's MOVE-IT strategy (Monitoring of Vital Events Information Technology) (WHO 2011). Despite this international spotlight on the need for capture of mortality data and in the use of the ICD-10 to code the data reported on such certificates, there is little cohesion in the way that certifiers of deaths receive instruction in how to complete the death certificate, which is the main source document for mortality statistics. Complete and accurate documentation of the immediate, underlying and contributory causes of death of the decedent on the death certificate is a requirement to produce standardised statistical information and to the ability to produce cause-specific mortality statistics that can be compared between populations and across time. This paper reports on a research project conducted to determine the efficacy and accessibility of the certification module of the WHO's newly-developed web based training tool for coders and certifiers of deaths. Involving a population of medical students from the Fiji School of Medicine and a pre- and post-research design, the study entailed completion of death certificates based on vignettes before and after access to the training tool. The ability of the participants to complete the death certificates and analysis of the completeness and specificity of the ICD-10 coding of the reported causes of death were used to measure the effect of the students' learning from the training tool. The quality of death certificate completion was assessed using a Quality Index

  7. [Death certificates of women in childbearing age: search for maternal deaths].

    PubMed

    Gil, Mariana Marcos; Gomes-Sponholz, Flavia Azevedo

    2013-01-01

    In Brazil, there is a lack of complete records on death certificates, and its reliability is questioned, especially for causes attributed to pregnancy and childbirth. We investigated, based on death certificates of women in reproductive age, any fields for identifying maternal deaths. Documentary research, conducted in hospital records. We analyzed in death certificates, maternal and no maternal deaths, inconclusive deaths and hidden deaths. To analyze the underlying causes of death we used ICD 10th Revision. Of the 301 death certificates reviewed, 60% had the fields 43/44 completed, and 40% had these fields blank and/or ignored. We found 58.5% of no maternal deaths, 2% of maternal deaths and 39.5% inconclusive. The analysis of inconclusive deaths allowed us to classify 4.3% as hidden deaths. To overcome the incompletitudes of civil registries, it is necessary that all health professionals be committed to the reliability of the information, so the priority target could be reached. PMID:23887780

  8. Principles and Pitfalls: a Guide to Death Certification.

    PubMed

    Brooks, Erin G; Reed, Kurt D

    2015-06-01

    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.

  9. 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

  10. Occupation and industry data obtained from death certificates: the effect and influence of case selection.

    PubMed

    Nelson, D E; Swanson, G M; Schwartz, A G; Brix, K; Fine, L J

    1987-01-01

    This study first examined the accuracy of death certificate diagnoses of 4,954 cases of cancer of the lung, liver, nasopharynx, and pleura/peritoneum, then compared usual occupation and industry based on case selection from the Metropolitan Detroit Cancer Surveillance System (MDCSS), a population-based cancer registry, with cases selected from death certificates for the above types of tumors to examine the effect of misclassification. Accuracy of death certificate cancer diagnoses ranged from 93.4% for lung cancer to 28.6% for malignancies of the pleura/peritoneum. The mix of usual occupation/industry titles obtained from death certificate cases and MDCSS cases was similar for lung cancer but not for malignancies of the pleura/peritoneum (35.7% of cases from the registry v 11.1% from death certificates for the automobile industry, P = .05). The effect of misclassification and utility of usual occupation/industry statements on death certificates is discussed.

  11. Lawsuits against medical examiners or coroners arising from death certificates.

    PubMed

    Hanzlick, R

    1997-06-01

    A data base search through Westlaw was conducted to ascertain lawsuits in which a medical examiner or coroner (ME/C) was sued because of the cause or manner of death stated on the death certificate. Sixteen reported cases were found between 1948 and 1995, with 10 of the cases occurring since 1985. The frequency of reported cases is approximately 1/400,000 ME/C death certificates, but based on certain assumptions, the actual frequency may be estimated at 1/40,000 ME/C death certificates. Nine cases involved plaintiffs who contested when the manner of death was indicated as suicide. In 15 of the 16 cases, the lower court decision favored the ME/C viewpoint. Five of the 15 decisions were ultimately reversed by a higher court, but the ultimate outcomes of these cases were not available. Overall, it appears that most courts and decisions have recognized ME/C actions as discretionary or immune and that ME/Cs have been at low risk for such suits to date. This seems especially true if the ME/C position is defensible and the ME/C has acted in accordance with statute and without evidence of corruption, incompetence, arbitrariness, capriciousness, abuse of discretion, or outrageous conduct.

  12. Age-based disparities in end-of-life decisions in Belgium: a population-based death certificate survey

    PubMed Central

    2012-01-01

    Background A growing body of scientific research is suggesting that end-of-life care and decision making may differ between age groups and that elderly patients may be the most vulnerable to exclusion of due care at the end of life. This study investigates age-related disparities in the rate of end-of-life decisions with a possible or certain life shortening effect (ELDs) and in the preceding decision making process in Flanders, Belgium in 2007, where euthanasia was legalised in 2002. Comparing with data from an identical survey in 1998 we also study the plausibility of the ‘slippery slope’ hypothesis which predicts a rise in the rate of administration of life ending drugs without patient request, especially among elderly patients, in countries where euthanasia is legal. Method We performed a post-mortem survey among physicians certifying a large representative sample (n = 6927) of death certificates in 2007, identical to a 1998 survey. Response rate was 58.4%. Results While the rates of non-treatment decisions (NTD) and administration of life ending drugs without explicit request (LAWER) did not differ between age groups, the use of intensified alleviation of pain and symptoms (APS) and euthanasia/assisted suicide (EAS), as well as the proportion of euthanasia requests granted, was bivariately and negatively associated with patient age. Multivariate analysis showed no significant effects of age on ELD rates. Older patients were less often included in decision making for APS and more often deemed lacking in capacity than were younger patients. Comparison with 1998 showed a decrease in the rate of LAWER in all age groups except in the 80+ age group where the rate was stagnant. Conclusion Age is not a determining factor in the rate of end-of-life decisions, but is in decision making as patient inclusion rates decrease with old age. Our results suggest there is a need to focus advance care planning initiatives on elderly patients. The slippery slope hypothesis

  13. 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

  14. Accuracy of death certification of pleural mesothelioma in Italy.

    PubMed

    Bruno, C; Comba, P; Maiozzi, P; Vetrugno, T

    1996-08-01

    In order to provide estimates of the accuracy of death certification of malignant pleural mesothelioma in Italy, the causes of death of a series of ascertained cases were investigated. The study included 523 cases of pleural mesothelioma diagnosed in 1984-1988 by 88 hospital departments and clinics. Vital status at 7 May 1990 was ascertained for 92.7% of subjects. The overall concordance between pathological diagnosis and death certification was about 75%.

  15. 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

  16. Temporal Trends in Recording of Diabetes on Death Certificates

    PubMed Central

    McEwen, Laura N.; Karter, Andrew J.; Curb, J. David; Marrero, David G.; Crosson, Jesse C.; Herman, William H.

    2011-01-01

    OBJECTIVE To determine the frequency that diabetes is reported on death certificates of decedents with known diabetes and describe trends in reporting over 8 years. RESEARCH DESIGN AND METHODS Data were obtained from 11,927 participants with diabetes who were enrolled in Translating Research into Action for Diabetes, a multicenter prospective observational study of diabetes care in managed care. Data on decedents (N = 2,261) were obtained from the National Death Index from 1 January 2000 through 31 December 2007. The primary dependent variables were the presence of the ICD-10 codes for diabetes listed anywhere on the death certificate or as the underlying cause of death. RESULTS Diabetes was recorded on 41% of death certificates and as the underlying cause of death for 13% of decedents with diabetes. Diabetes was significantly more likely to be reported on the death certificate of decedents dying of cardiovascular disease than all other causes. There was a statistically significant trend of increased reporting of diabetes as the underlying cause of death over time (P < 0.001), which persisted after controlling for duration of diabetes at death. The increase in reporting of diabetes as the underlying cause of death was associated with a decrease in the reporting of cardiovascular disease as the underlying cause of death (P < 0.001). CONCLUSIONS Death certificates continue to underestimate the prevalence of diabetes among decedents. The increase in reporting of diabetes as the underlying cause of death over the past 8 years will likely impact estimates of the burden of diabetes in the U.S. PMID:21709292

  17. Representativeness of deaths identified through the injury-at-work item on the death certificate: implications for surveillance.

    PubMed Central

    Russell, J; Conroy, C

    1991-01-01

    BACKGROUND. This research investigated the accuracy of the injury-at-work item on the death certificate for surveillance of occupational injury deaths in Oklahoma during 1985 and 1986. METHODS. Representativeness of occupational injury deaths identified by death certificates was assessed by comparing these deaths with all occupational injury deaths identified through death certificates, workers' compensation reports, medical examiner reports, and OSHA records for categories of occupation, industry, and external causes of death. RESULTS. Certain external causes of death (e.g., motor vehicle traffic deaths) and certain occupations (e.g., farming) and industries (agriculture and services) are more often underidentified through death certificates. CONCLUSIONS. The findings of this study support Baker's observation that no single data source contains all deaths or all the data elements necessary to describe occupational injury deaths. Data sources may be combined to improve representativeness through more complete case ascertainment. PMID:1836109

  18. Using Death Certificate Reports to Find Severe Leptospirosis Cases, Brazil

    PubMed Central

    Spichler, Anne; Athanazio, Daniel; Buzzar, Marcia; Castro, Bronislawa; Chapolla, Erica; Seguro, Antonio

    2007-01-01

    Severe leptospirosis with pulmonary hemorrhage is emerging globally. Measures to control leptospirosis through sanitation depend on accurate case finding and reporting. Rapid death certificate reporting, plus necropsy of persons who died of leptospirosis, facilitates public health intervention and could provide an important tool in assessing the global burden of leptospirosis. PMID:18258007

  19. The accuracy of occupation and industry data on death certificates.

    PubMed

    Steenland, K; Beaumont, J

    1984-04-01

    To assess the accuracy of occupation and industry data on death certificates, we compared the known occupation and industry of 3,789 individuals with information on their death certificates. All individuals were members of the National Institute for Occupational Safety and Health cohort studies and their occupation and industry were known from personnel or union records. We focused our analysis on 2,198 long-term workers who had 10 or more years of work experience (average, 18 years). Our principal finding was that for the long-term workers in our sample, the probability of the known occupation being listed on their death certificates was 64.7% (SE = 1.1) (for white workers this figure was 73.5% (SE = 1.2). Furthermore, for the long-term workers the probability of the plant or industry being named on their death certificates was 70.1% (SE = 1.2). Women and non-whites had lower matching rates. For women the probability of a matched listing was 45.1% for occupation and 60.4% for industry. For nonwhites, it was only 30.1% for occupation and 49.2% for industry. Our results for white long-term workers generally agree with the results of previous investigators who have used different methods.

  20. 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

  1. [Updated medical death documents: Medical Death Certificate and the Birth Statistics Bulletin].

    PubMed

    Cirera, Lluís; Segura, Andreu

    2010-08-01

    Public health physicians have constantly urged that the Medical Death Certificate (CMD in Spain) and the notification of perinatal deaths be adapted to WHO standards. The new CMD came into effect in January 2009, whilst significant changes were made to the Birth Statistics Bulletin (BEP acronym in Spanish) in 2007. In this article the certifying doctor is informed on their novel and key aspects. The health significance of this medico-legal act is emphasised. At the same time associated issues are mentioned that still need to be resolved in Spain. The CMD unifies the medical certificate and the death statistics bulletin on one form and complies with WHO recommendations. It asks whether the death has been the result of an already registered traffic or work accident, and if an autopsy (clinical) has been performed. For place of death, it means the place where the cadaver has been recognised and the death certified. The approximate time of the causes of death must also be indicated. The BEP registers the births and deaths in labour. It includes the education level and occupation levels of the mother and father, and still has the number of weeks gestation and the birth weight in grams. Notification of legal deaths and perinatal deaths still need to be improved; the confidential transfer of causes of death to doctors and researchers; and death statistics according to cause with less delay between the events and their availability and publication.

  2. Autopsies and death certification in deaths due to blunt trauma: What are we missing?

    PubMed Central

    Hodgson, Nicole Fink; Stewart, Tanya Charyk; Girotti, Murray J.

    2000-01-01

    Objectives To determine the frequency, body region and severity of injuries missed by the clinical team in patients who die of blunt trauma, and to examine the accuracy of the cause of death as recorded on death certificates. Design A retrospective review. Setting London Health Sciences Centre, London, Ont. Patients One hundred and eight deaths due to blunt trauma occurring during the period Apr. 1, 1991, to Mar. 31, 1997. Two groups were considered: clinically significant missed injuries were identified by comparing patient charts only (group1) and more detailed injury lists from the autopsies and charts of the patients (group 2). Outcome measures Chart and autopsy findings. Results Of the 108 patients, 78 (72%) were male, and they had a median age of 39 years (range from 2 to 90 years). The most common cause of death was neurologic injury (27%), followed by sepsis (17%) and hemorrhage (15%). There was disagreement between the treating physicians and the causes of death listed on the death certificate in 40% of cases and with the coroner in 7% of cases. Seventy-seven clinically significant injuries were missed in 51 (47%) of the 108 patient deaths. Injuries were missed in 29% of inhospital deaths and 100% of emergency department deaths. Abdominal and head injuries accounted for 43% and 34% of the missed injuries, respectively. Conclusions The information contained on the death certificate can be misleading. Health care planners utilizing this data may draw inaccurate conclusions regarding causes of death, which may have an impact on trauma system development. Missed injuries continue to be a concern in the management of patients with major blunt trauma. PMID:10812348

  3. A death certificate analysis of nasal cancer among furniture workers in North Carolina.

    PubMed

    Brinton, L A; Blot, W J; Stone, B J; Fraumeni, J F

    1977-10-01

    A case-control study of nasal cancer, based on death certificate statements on occupation in North Carolina counties with furniture-manufacturing industries, revealed a 4-fold excess risk linked to this occupation. Although woodworking exposures have been associated with nasal adenocarcinomas in several areas of the world, this is the first report of such a relationship in the United States.

  4. Determining injury at work on the California death certificate.

    PubMed Central

    Peek-Asa, C; McArthur, D L; Kraus, J F

    1997-01-01

    OBJECTIVES: This study examined decisions of California Country Coroner's offices in determining injury at work and identified factors influencing this decision. METHODS: Surveys were sent to California County Coroner's offices (response rate = 93%). The survey included 23 vignettes that required the respondent to determine whether the fatality involved an injury at work. The Rasch method was used to determine internal consistency in endorsing vignettes and to determine overall endorsability of vignettes based on underlying factors. RESULTS: Respondents showed internal consistency but much disagreement in their endorsement of vignettes. Decedents who were performing paid work or were on their work site during working hours were almost unanimously endorsed as having incurred an injury at work. Non-payment, travel/transportation, suicide, and nontraditional work sites and work hours led to disagreement and uncertainty among respondents. CONCLUSIONS: Coroners have different methods of determining injury at work on the death certificate, and available guidelines do not define many of the ambiguous situations encountered by coroners. PMID:9224183

  5. Medical death certification by forensic physicians in the Netherlands: Validity and interdoctorvariation.

    PubMed

    Dorn, Tina; Ceelen, Manon; Reijnders, Udo; Das, Kees

    2016-10-01

    The aim of the study was to assess interdoctorvariation and validity in death certification by forensic physicians using 19 written scenarios. The scenarios described typical cases from forensic-medical practice. Physicians were asked to determine the manner of death (natural/unnatural) and to provide an ICD-10 code for the cause of death. In contrast to most studies on this topic, the measure of agreement among physicians was chance-corrected and a standard was used to assess the correctness of the assigned cause and manner of death. Forty-seven physicians participated in the survey. The study demonstrated that forensic physicians varied widely in their conclusions. With respect to manner of death, adequate agreement (defined as kappa>0.70) was achieved in six scenarios (32% of all scenarios). Concerning the underlying cause of death, adequate agreement was reached in three cases (16% of all scenarios). Furthermore, predictors for the correctness of manner and cause of death were studied using logistic regression. Years of experience as a forensic physician significantly predicted the correctness of cause of death (p < 0.05). Other predictors remained insignificant. With regard to manner of death, none of the studied predictors proved to be significant. To conclude, there appears to be a lack of consistency among forensic physicians regarding death certification. The ICD-10 coding of causes of death applied by forensic physicians is questionable. Less experienced physicians need supervision by more experienced colleagues when making judgments concerning the cause of death. Altogether, there is an urgent need to work out consensus-based guidelines for forensic physicians on how to certify deaths.

  6. 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

  7. Medical certification of death in South Africa--moving forward.

    PubMed

    Burger, E H; Groenewald, P; Rossouw, A; Bradshaw, D

    2015-01-01

    Despite improvements to the Death Notification Form (DNF) used in South Africa (SA), the quality of cause-of-death information remains suboptimal. To address these inadequacies, the government ran a train-the-trainer programme on completion of the DNF, targeting doctors in public sector hospitals. Training materials were developed and workshops were held in all provinces. This article reflects on the lessons learnt from the training and highlights issues that need to be addressed to improve medical certification and cause-of-death data in SA. The DNF should be completed truthfully and accurately, and confidentiality of the information on the form should be maintained. The underlying cause of death should be entered on the lowest completed line in the cause-of-death section, and if appropriate, HIV should be entered here. Exclusion clauses for HIV in life insurance policies with Association of Savings and Investments South Africa companies were scrapped in 2005. Interactive workshops provide a good learning environment, but are logistically challenging. More use should be made of online training resources, particularly with continuing professional development accreditation and helpline support. In addition, training in the completion of the DNF should become part of the curriculum in all medical schools, and part of the orientation of interns and community service doctors in all facilities.

  8. The accuracy of industry data from death certificates for workplace homicide victims.

    PubMed

    Davis, H

    1988-12-01

    This study compared death certificate data on usual industry for workplace homicide victims in five urban Texas counties, with medical examiners' data on the industries where victims were working when injured. The overall positive predictive value of the death certificate data was 72 per cent. Death certificate data on usual industry underestimated the number of victims working in high-risk industries when injured, partly because of victims whose usual industry was recorded as student, housewife, or military personnel.

  9. 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

  10. 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

  11. Accuracy of industry and occupation on death certificates of electric utility workers: implications for epidemiologic studies of magnetic fields and cancer.

    PubMed

    Andrews, K W; Savitz, D A

    1999-12-01

    A substantial epidemiologic literature has relied on occupation and industry information from death certificates to make inferences about the association of electric and magnetic field exposure with cancer, but the validity of the occupational data on death certificates is questionable. We compared occupation and industry information from death certificates to company work histories for 793 electric utility workers who died from brain cancer (n=143), leukemia (n=156), lung cancer (n=246, randomly sampled), and non-cancer causes (n=248, randomly sampled). Nearly 75% of death certificates correctly indicated utility industry employment and of those, 48% matched the longest held occupation derived from company work histories. Hence, only 36% matched on both industry and occupation. We computed odds ratios relating occupations involving magnetic field exposure to brain cancer and leukemia both for the occupation listed on the death certificate and for the longest-held occupation based on company records in order to examine the impact of exposure misclassification based on reliance on the death certificate information. For brain cancer, the odds ratio was 1.2 based on death certificates and 1.7 based on company work history, suggesting some attenuation due to misclassification. For leukemia, death certificate information yielded an odds ratio of 0.9, whereas company work histories yielded an odds ratio of 1.3. Although work histories are limited to the period of employment in a specific company, these data suggest that there is substantial misclassification in use of death certificate information on industry and occupation of utility workers, as found in other industries. The limited quality of occupation and industry information on death certificates argues against relying on such information to evaluate modest associations with mortality.

  12. 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

  13. Quality of death certificate occupation data for a cohort of aluminum industry workers.

    PubMed

    Houck, P; Milham, S

    1992-02-01

    Occupational data from death certificates have been used extensively in health studies but their quality has been questioned. In this study, data from the death certificates of aluminum plant workers were analyzed. Aluminum industry employment was indicated in the certificate occupation/industry statement of 321 (80%) of the 403 total workers, 263 (94%) of the 280 workers who had been employed for 10 years or more, 156 (94%) of the 166 workers who died while employed, and 131 (95%) of the 138 workers who died after retirement. Of 82 certificates that did not indicate aluminum industry employment, 57 (70%) were from workers who were employed for fewer than 10 years and terminated employment for reasons other than death or retirement. This study supports the usefulness of death certificate occupational information.

  14. Comparison of death certificate occupation and industry data with lifetime occupational histories obtained by interview: variations in the accuracy of death certificate entries.

    PubMed

    Schade, W J; Swanson, G M

    1988-01-01

    This study compares usual and recent occupation and industry data from lifetime work histories obtained by interview with death certificate entries for occupation and industry for 2,435 persons diagnosed with cancer. Match rates are calculated as the percent of death certificate occupation and industry entries that were confirmed by interview data and are compared for exact 3-digit 1980 U.S. Census Bureau occupation and industry codes and for groups of these codes. The overall match rate for individual usual occupation codes was 47.9% and for exact usual industry codes it was 61.8%. Significant differences between the interview data for usual occupation or industry and the death certificate entry were observed by race and gender, marital status, number of years worked, and occupation and industry groups and by age for industry. Misclassification or overreporting of occupation and industry data on the death certificate ranged from 30 to 50% in this study. Our results suggest that the utility of death certificate data for investigations into the occupational risk factors for cancer may be quite limited.

  15. Comparison of information on death certificates and matching 1960 census records: age, marital status, race, nativity and country of origin.

    PubMed

    Hambright, T Z

    1969-11-01

    A sample of death certificates matched with 1960 Census records permitted comparison of response data for items asked on both records. Estimates of bias in death rates which are based on information from the two records are derived from the comparison data. Most of the comparisons yielded small discrepancies of inconsequential effect on the mortality rates. Some large inconsistencies, however, of potentially serious impact on the death rates were observed. The comparisons are examined and the implications of the results for the relevant mortality rates are discussed. In addition, age-specific death rates "corrected" for the disparities found in the age information on the two records are presented.

  16. Varying Estimates of Sepsis Mortality Using Death Certificates and Administrative Codes--United States, 1999-2014.

    PubMed

    Epstein, Lauren; Dantes, Ray; Magill, Shelley; Fiore, Anthony

    2016-04-01

    Sepsis is a clinical syndrome caused by a dysregulated host response to infection (1). Because there is no confirmatory diagnostic test, the diagnosis of sepsis is based on evidence of infection and clinical judgement. Both death certificates and health services utilization data (administrative claims) have been used to assess sepsis incidence and mortality, but estimates vary depending on the surveillance definition and data source. To highlight the challenges and variability associated with estimating sepsis mortality, CDC compared national estimates of sepsis-related mortality based on death certificates using the CDC WONDER database with published sepsis mortality estimates generated using administrative claims data from hospital discharges reported in the Nationwide Inpatient Sample, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality (2). During 2004-2009, using data rounded to thousands, the annual range of published sepsis-related mortality estimates based on administrative claims data was 15% to 140% higher (range = 168,000-381,000) than annual estimates generated using death certificate data (multiple causes) (range = 146,000-159,000). Differences in sepsis-related mortality reported using death certificates and administrative claims data might be explained by limitations inherent in each data source. These findings underscore the need for a reliable sepsis surveillance definition based on objective clinical data to more accurately track national sepsis trends and enable objective assessment of the impact of efforts to increase sepsis awareness and prevention. PMID:27054476

  17. 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

  18. 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...

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. Coroners and death certification law reform: the Coroners and Justice Act 2009 and its aftermath.

    PubMed

    Luce, Tom

    2010-10-01

    After considering various different options for half a decade, the last Government legislated in 2009 to reform the England and Wales coroner and death certification systems. The Coroners and Justice Act 2009 provides for the creation of a new Chief Coroner post to lead the jurisdiction and for local medical examiners to oversee a new death certification scheme applicable equally to burial and cremation cases. In October 2010 the new Government announced that it judges the main coroner reform to be unaffordable, will not proceed with it and plans to repeal the provisions. It intends to implement the new death certification arrangements, which is welcome. The decision to abort the main coroner reform in spite of longstanding and widespread recognition of the need for major change is deplorable though in line with other failures over the last century to properly modernise this neglected service. PMID:21539281

  4. Coroners and death certification law reform: the Coroners and Justice Act 2009 and its aftermath.

    PubMed

    Luce, Tom

    2010-10-01

    After considering various different options for half a decade, the last Government legislated in 2009 to reform the England and Wales coroner and death certification systems. The Coroners and Justice Act 2009 provides for the creation of a new Chief Coroner post to lead the jurisdiction and for local medical examiners to oversee a new death certification scheme applicable equally to burial and cremation cases. In October 2010 the new Government announced that it judges the main coroner reform to be unaffordable, will not proceed with it and plans to repeal the provisions. It intends to implement the new death certification arrangements, which is welcome. The decision to abort the main coroner reform in spite of longstanding and widespread recognition of the need for major change is deplorable though in line with other failures over the last century to properly modernise this neglected service.

  5. Job strain, hypoxia and risk of amyotrophic lateral sclerosis: Results from a death certificate study.

    PubMed

    Vanacore, Nicola; Cocco, Pierluigi; Fadda, Domenica; Dosemeci, Mustafa

    2010-10-01

    Amyotrophic lateral sclerosis (ALS) most likely results from a multifactorial gene-environment interaction. Strenuous physical activity and occupational exposures have been suggested to play a role, and an abnormal response to hypoxia has been proposed in ALS pathogenesis. To test the hypothesis of an excess risk in occupations typically leading to intermittent hypoxia at the tissue level, we accessed a large publicly available database, including death certificates from 24 U.S. states in 1984-1998. We conducted a case-control analysis of 14,628 deaths due to ALS therein reported and 58,512 controls deceased from other selected causes of death, frequency matched by age, gender and broad geographic area. ALS risk associated with physical activity, and occupations leading to intermittent hypoxia, such as fire fighters and professional athletes, were calculated with unconditional logistic regression, adjusting by age, marital status, residence, and socioeconomic status. Physical activity in general did not show an association with ALS risk. Risk associated with occupation as a professional athlete was elevated (OR = 1.81, 99% CI 0.69-4.78), but not significantly so. Fire fighters showed a significant two-fold excess ALS risk (OR = 2.0; 99% CI 1.2-3.2). Based on our findings and the current clinical, epidemiological and experimental evidence, we suggest that occupational conditions typically leading to intermittent hypoxia, such as fire fighting, might be an ALS risk factor in subjects genetically prone to an abnormal response to hypoxia. PMID:20698805

  6. Hyaline membrane disease is underreported in a linked birth-infant death certificate database.

    PubMed Central

    Hamvas, A; Kwong, P; DeBaun, M; Schramm, W; Cole, F S

    1998-01-01

    OBJECTIVE: This study compared the Missouri State Department of Health linked birth-infant death certificate database and medical records with respect to recording hyaline membrane disease in very low-birth-weight infants. METHODS: We reviewed the records for all 976 infants weighing 500 to 1500 g who were born to St. Louis, Mo, residents in 1989, 1991, and 1992. RESULTS: Eighteen percent of the birth certificates and 54% of the medical records documented hyaline membrane disease, resulting in 34% sensitivity and 99% specificity. CONCLUSIONS: The Missouri State Department of Health birth-infant death certificate database underestimates the incidence of hyaline membrane disease, which suggest that national statistics for the disease are also underestimated. PMID:9736884

  7. 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...

  8. [On the mistakes during the completion of the medical certificate of death].

    PubMed

    Pogorelova, E I

    2007-01-01

    The article deals with the typical mistakes made by physicians during the completion of the medical certificate of death. To enhance the reliability of mortality statistics such means as canvass of mistakes and application of the new technologies (the software package "The monitoring of natality and mortality" and the courseware "RUTEN-DON") are proposed. PMID:17402577

  9. 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.

  10. 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. PMID:26080753

  11. Comparison of occupation and industry information from death certificates and interviews.

    PubMed

    Schumacher, M C

    1986-06-01

    Information on occupation and industry obtained via an interview prior to death was compared to occupation and industry on the death certificate of 184 colon cancer patients in Utah. The data were coded blindly using a five-digit code. Overall, agreement in the five-digit codes was found for 63 per cent. The industry codes agreed for 67 per cent of the individuals, and the occupation was identical for 68 per cent. Agreement by subjective evaluation of the two data sources, disregarding the five-digit codes, was 73 per cent. There were no differences in agreement of the five-digit codes by age, sex, and county of residence. The number of years worked at the job given by interview was related to agreement. Misclassification occurred in a random manner. It is concluded that the use of death certificates to study the association of occupation and disease is most appropriate for pilot studies.

  12. 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.

  13. 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

  14. Using the UMLS and Simple Statistical Methods to Semantically Categorize Causes of Death on Death Certificates.

    PubMed

    Riedl, Bill; Than, Nhan; Hogarth, Michael

    2010-11-13

    Cause of death data is an invaluable resource for shaping our understanding of population health. Mortality statistics is one of the principal sources of health information and in many countries the most reliable source of health data. 1 A quick classification process for this data can significantly improve public health efforts. Currently, cause of death data is captured in unstructured form requiring months to process. We think this process can be automated, at least partially, using simple statistical Natural Language Processing, NLP, techniques and the Unified Medical Language System, UMLS, as a vocabulary resource. A system, Medical Match Master, MMM, was built to exercise this theory. We evaluate this simple NLP approach in the classification of causes of death. This technique performed well if we engaged the use of a large biomedical vocabulary and applied certain syntactic maneuvers made possible by textual relationships within the vocabulary.

  15. Agreement of occupation and industry data on Rhode Island death certificates with two alternative sources of information.

    PubMed

    Gute, D M; Fulton, J P

    1985-01-01

    There is increasing interest in documenting the putative health effects of occupational hazards, prompting Federal and State efforts that rely primarily on occupational information obtained from the death certificate. Previous studies have assessed the agreement of occupational data on death certificates with actual lifetime employment by using current employment data from census records for comparisons. Such analyses have largely been confined to males. We compared lifetime occupational information obtained from a panel survey for both sexes with death certificate data for 446 deceased panel members. After adjusting for inadequate information, the occupation recorded on the death certificates of the men agreed with the occupation recorded in the survey 66 percent of the time. The comparable percentage for the industry where the deceased had been employed was 78 percent. Among the women's records, agreement on occupation was 65 percent, and on industry, 69 percent. Using another sample of death certificates, comparisons of the information for 322 decedents with city directory data produced similar results. The higher level of agreement for women was due in part to the large number who were reported as "housewives." In a separate analysis, the agreement rate for nonhousewives declined. Suggestions for improvements in the recording of occupational data and the constraints imposed by the use of death certificate data in occupational epidemiology are presented.

  16. Occupational silica exposure and risk of various diseases: an analysis using death certificates from 27 states of the United States

    PubMed Central

    Calvert, G; Rice, F; Boiano, J; Sheehy, J; Sanderson, W

    2003-01-01

    Background: Although crystalline silica exposure is associated with silicosis, lung cancer, pulmonary tuberculosis, and chronic obstructive pulmonary disease (COPD), there is less support for an association with autoimmune disease, and renal disease. Methods: Using data from the US National Occupational Mortality Surveillance (NOMS) system, a matched case-control design was employed to examine each of several diseases (including silicosis, lung cancer, stomach cancer, oesophageal cancer, COPD, pulmonary tuberculosis, sarcoidosis, systemic lupus erythematosus, systemic sclerosis, rheumatoid arthritis, and various types of renal disease). Cases were subjects whose death certificate mentioned the disease of interest. A separate control group for each of the diseases of interest was selected from among subjects whose death certificate did not mention the disease of interest or any of several diseases reported to be associated with crystalline silica exposure. Subjects were assigned into a qualitative crystalline silica exposure category based on the industry/occupation pairing found on their death certificate. We also investigated whether silicotics had a higher risk of disease compared to those without silicosis. Results: Those postulated to have had detectable crystalline silica exposure had a significantly increased risk for silicosis, COPD, pulmonary tuberculosis, and rheumatoid arthritis. In addition, a significant trend of increasing risk with increasing silica exposure was observed for these same conditions and for lung cancer. Those postulated to have had the greatest crystalline silica exposure had a significantly increased risk for silicosis, lung cancer, COPD, and pulmonary tuberculosis only. Finally, those with silicosis had a significantly increased risk for COPD, pulmonary tuberculosis, and rheumatoid arthritis. Conclusions: This study corroborates the association between crystalline silica exposure and silicosis, lung cancer, COPD, and pulmonary

  17. Reliability of recording uterine cancer in death certification in France and age-specific proportions of deaths from cervix and corpus uteri.

    PubMed

    Rogel, Agnès; Belot, Aurélien; Suzan, Florence; Bossard, Nadine; Boussac, Marjorie; Arveux, Patrick; Buémi, Antoine; Colonna, Marc; Danzon, Arlette; Ganry, Olivier; Guizard, Anne-Valérie; Grosclaude, Pascale; Velten, Michel; Jougla, Eric; Iwaz, Jean; Estève, Jacques; Chérié-Challine, Laurence; Remontet, Laurent

    2011-06-01

    French uterine cancer recordings in death certificates include 60% of "uterine cancer, Not Otherwise Specified (NOS)"; this hampers the estimation of mortalities from cervix and corpus uteri cancers. The aims of this work were to study the reliability of uterine cancer recordings in death certificates using a case matching with cancer registries and estimate age-specific proportions of deaths from cervix and corpus uteri cancers among all uterine cancer deaths by a statistical approach that uses incidence and survival data. Deaths from uterine cancer between 1989 and 2001 were extracted from the French National database of causes of death and case-to-case matched to women diagnosed with uterine cancer between 1989 and 1997 in 8 cancer registries. Registry data were considered as "gold-standard". Among the 1825 matched deaths, cancer registries recorded 830 cervix and 995 corpus uteri cancers. In death certificates, 5% and 40% of "true" cervix cancers were respectively coded "corpus" and "uterus, NOS" and 5% and 59% of "true" corpus cancers respectively coded "cervix" and "uterus, NOS". Miscoding cervix cancers was more frequent at advanced ages at death and in deaths at home or in small urban areas. Miscoding corpus cancers was more frequent in deaths at home or in small urban areas. From the statistical method, the estimated proportion of deaths from cervix cancer among all uterine cancer deaths was higher than 95% in women aged 30-40 years old but declined to 35% in women older than 70 years. The study clarifies the reason for poor encoding of uterus cancer mortality and refines the estimation of mortalities from cervix and corpus uteri cancers allowing future studies on the efficacy of cervical cancer screening.

  18. 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.

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

    PubMed

    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. 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

  1. The recording of demographic information on death certificates: a national survey of funeral directors.

    PubMed Central

    Hahn, Robert A.; Wetterhall, Scott F.; Gay, George A.; Harshbarger, Dorothy S.; Burnett, Carol A.; Parrish, Roy Gibson; Orend, Richard J.

    2002-01-01

    OBJECTIVE: The authors sought to ascertain the methods used by funeral directors to determine the demographic information recorded on death certificates. METHODS: Standardized questionnaires were administered to funeral directors in five urban locations in the U.S. In addition, personnel on four Indian reservations were interviewed. Study sites were selected for diverse racial/ethnic populations and variability in recording practices; funeral homes were selected by stratified random sampling. RESULTS: Fifty-two percent of responding funeral directors reported receiving no formal training in death certification. Seventy-nine percent of respondents reported finding certain demographic items difficult to complete--26% first specified race as the problematic item, and 25% first specified education. The decedent's race was "sometimes" or "often" determined through personal knowledge of the family by 58% of respondents; 43% reported "sometimes" or "often" determining race by observation. Only three respondents reported that occupation was a problematic item. CONCLUSIONS: The authors recommend that the importance of demographic data and the instructions for data collection be clarified for funeral directors, that standard data collection worksheets be developed, and that training videos be developed. PMID:12297680

  2. ["Manual on physician behavior at the time of death certification" created through collaboration with different local healthcare workers].

    PubMed

    Kusakabe, Akihiko; Hirano, Kazue; Ikenaga, Keiko; Saitou, Naohiro; Mikan, Fukiko; Okita, Masato; Inamori, Masahiko; Shirado, Akemi; Morita, Tatsuya

    2014-12-01

    It is thought that physicians' behavior at the scene of death certification has a considerable influence on the grief of the bereaved. We constructed a manual to guide the physician's behavior at death certification and educate residents and medical students. We collaborated locally across several occupations(e.g., visiting nurse, visiting pharmacist)for the purpose of upgrading the manual. We conducted interviews with physicians and nurses who perform home medical care in this area regarding the scene at a real death certification in making our manual. It was evaluated well in this trial, and participants were cooperative with the interview. We can conduct many collaborations locally in various forms. The regional alliances become smoother as a function of such collaborations. In addition, it is thought that the manual that was constructed following this process will be easily received in the area.

  3. 34 CFR 682.402 - Death, disability, closed school, false certification, unpaid refunds, and bankruptcy payments.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... (or student in the case of a PLUS loan) must be based on an original or certified copy of the death... date of the borrower's (or student's) death. (6) In the case of a Federal Consolidation Loan that... section, if the borrower (or the student for whom a parent received a PLUS loan) could not complete...

  4. Occupation and industry on death certificates of long-term chemical workers: concordance with work history records.

    PubMed

    Olsen, G W; Brondum, J; Bodner, K M; Kravat, B A; Mandel, J S; Mandel, J H; Bond, G G

    1990-01-01

    This study evaluated the concordance between occupation and industry listed on death certificates with actual work history information for a group (n = 5,882) of long-term (10 years or more) workers at a chemical company. Match rates were calculated as the percent of death certificate occupation and company entries that were confirmed by work history data using 3-digit 1980 U.S. Census Bureau group codes. The concordance rate for industry differed by employment status at death: employed, 94.9%; inactive, 30.8%; and retired, 91.1%. Concordance on occupation was analyzed for employed (n = 467) and retired (n = 932) subjects who had computerized work histories (randomly done prior to the study) and who had matched on the company on the death certificate. Concordance ranged from 0 to 50% for the first job, to 50 to 70% for the last job, longest job, and longest job in the last 10 years of company employment. The most consistent predictor of concordance was job duration. Misclassification was reviewed by occupational category. Results from this and other investigations lead to the inevitable conclusion that usual occupation data from death certificates are grossly inadequate for studies of occupational risks.

  5. 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.

  6. 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

  7. Risk for prostate cancer by occupation and industry: a 24-state death certificate study.

    PubMed

    Krstev, S; Baris, D; Stewart, P A; Hayes, R B; Blair, A; Dosemeci, M

    1998-11-01

    Current knowledge of the etiology of prostate cancer is limited. Numerous studies have suggested that certain occupations and industries may be associated with the occurrence of prostate cancer. Information on occupation and industry on death certificates from 24 states gathered from 1984 to 1993 was used in case control study on prostate cancer. A total of 60,878 men with prostate cancer as underlying cause of death was selected and matched with controls who died of all other causes except cancer. Similar to the findings of our parallel large case control study of prostate cancer, we observed excess risks in some white-collar occupations, such as administrators, managers, teachers, engineers, and sales occupations. However, some blue-collar occupations, such as power plant operators and stationary engineers, brickmasons, machinery maintenance workers, airplane pilots, longshoreman, railroad industry workers, and other occupations with potential exposure to PAH also showed risk of excess prostate cancer. Risk was significantly decreased for blue-collar occupations, including farm workers, commercial fishermen, mechanics and repairers, structural metal workers, mining, printing, winding, dry cleaning, textile machine operators, cooks, bakers, and bartenders. Although we observed excess risks of prostate cancer among some low socioeconomic status (SES) occupations, the overall results suggest that the effects of higher SES cannot be ruled out in associations between occupational factors and the risk of prostate cancer. PMID:9787844

  8. 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…

  9. 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…

  10. 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).

  11. Studying sudden and unexpected infant deaths in a time of changing death certification and investigation practices: evaluating sleep-related risk factors for infant death in New York City.

    PubMed

    Senter, Lindsay; Sackoff, Judith; Landi, Kristen; Boyd, Lorraine

    2011-02-01

    We describe an approach for quantifying and characterizing the extent to which sudden and unexpected infant deaths (SUIDs) result from unsafe sleep environments (e.g., prone position, bedsharing, soft bedding); and present data on sleep-related infant deaths in NYC. Using a combination of vital statistics and medical examiner data, including autopsy and death scene investigation findings, we analyzed any death due to accidental threat to breathing (ATB) (ICD-10 W75 & W84), and deaths of undetermined intent (UND) (Y10-Y34) between 2000 and 2003 in NYC for the presence of sleep-related factors (SRF). Homicide deaths were excluded as were SIDS, since in NYC SIDS is not a certification option if environmental factors were possibly contributors to the death. All 19 ATB and 69 (75%) UND had SRFs as per the OCME investigation. Black infants and infants born to teen mothers had higher SRF death rates for both ATB and UND deaths. Bedsharing was the most common SRF (53%-ATB; 72%-UND deaths); the majority of non-bedsharing infants were found in the prone position (60%-ATB; 78%-UND deaths). We found a high prevalence of SRFs among ATB and UND deaths. This is the first local study to illustrate the importance of knowing how SUIDs are certified in order to ascertain the prevalence of infant deaths with SRFs. Advancing the research requires clarity on the criteria used by local medical examiners to categorize SUIDs. This will help jurisdictions interpret their infant mortality statistics, which in turn will improve education and prevention efforts. PMID:20177757

  12. Certificates.

    PubMed

    Fry, F

    1994-06-01

    The Concise Oxford English Dictionary defines 'dilemma' as "an argument forcing one to choose one of two alternatives both unfavourable to him (or her)". This is situation that frequently confronts the general practitioner. In this article a personal solution to the problem of 'certificates' is presented. Not every one will necessarily agree with the solutions presented and some may find them unacceptable, or have better solutions. The author warmly welcomes correspondence, either personal, or in the form of Letters to the Editor, as this is a subject in which consensus decisions are important. PMID:8053842

  13. Certificates.

    PubMed

    Fry, F

    1994-06-01

    The Concise Oxford English Dictionary defines 'dilemma' as "an argument forcing one to choose one of two alternatives both unfavourable to him (or her)". This is situation that frequently confronts the general practitioner. In this article a personal solution to the problem of 'certificates' is presented. Not every one will necessarily agree with the solutions presented and some may find them unacceptable, or have better solutions. The author warmly welcomes correspondence, either personal, or in the form of Letters to the Editor, as this is a subject in which consensus decisions are important.

  14. 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

  15. Approach to spatial information security based on digital certificate

    NASA Astrophysics Data System (ADS)

    Cong, Shengri; Zhang, Kai; Chen, Baowen

    2005-11-01

    With the development of the online applications of geographic information systems (GIS) and the spatial information services, the spatial information security becomes more important. This work introduced digital certificates and authorization schemes into GIS to protect the crucial spatial information combining the techniques of the role-based access control (RBAC), the public key infrastructure (PKI) and the privilege management infrastructure (PMI). We investigated the spatial information granularity suited for sensitivity marking and digital certificate model that fits the need of GIS security based on the semantics analysis of spatial information. It implements a secure, flexible, fine-grained data access based on public technologies in GIS in the world.

  16. 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.

  17. Death certificate case-control study of cancers of the prostate and colon and employment in the textile industry.

    PubMed

    Hoar, S K; Blair, A

    1984-01-01

    A case-control study was conducted to investigate possible relationships between employment in the textile industry and cancers of the prostate and colon. Death certificate information on occupation and industry was obtained for 1037 male prostatic cancer cases, 820 male and female colon cases, and matched controls who died during 1970-1978 in South Carolina. Black males were the only race-sex group to show an excess risk of prostate or colon cancer among employees of the textile industry. Nonstatistically significant excesses of prostate cancer were seen in dyeing and finishing businesses and broad woven fabric mills. Overall, there was no strong evidence indicating a relationship between the textile industry and either prostate or colon cancer. It is unlikely that limitations of the data masked real risks since previously reported associations with nontextile industries were confirmed.

  18. United States non-Hodgkin's lymphoma surveillance by occupation 1984-1989: a twenty-four state death certificate study.

    PubMed

    Figgs, L W; Dosemeci, M; Blair, A

    1995-06-01

    Death certificates from 23,890 male and female non-Hodgkin's lymphoma (NHL) cases and 119,450 noncancer controls from 24 states for the period 1984-1989 were used to generate hypotheses regarding occupational associations. Cases were frequency matched by age, race, and gender with five controls per case. Odds ratios were calculated for 231 industries and 509 occupations. Significant associations were observed for a variety of white-collar professionals (i.e., real estate agents, secretaries, bookkeepers, teachers, postal employees, business agents, engineers, chemists, and medical professionals) and blue-collar occupations (i.e., firefighters, farm managers, aircraft mechanics, electronic repairers, mining machine operators, and crane and tower operators). PMID:7645576

  19. [Death].

    PubMed

    Ribas, Jordi Domingo

    2003-12-01

    Intercultural factors are essential for reflection. In this article, the authors deals with a more direct vision on the special edition about Grief and Mourning, about the topic which lies in the depths of all of our consciences: death and the question what lies beyond death? The author provides us elements to reflect about concepts, some accepted in various cases, rejected in others, but always polemical, which help us to penetrate farther into the real mystery of life: death and what follows death.

  20. The environmental impact statement: an important addition to the certification of early deaths.

    PubMed

    Pacy, H

    1978-05-20

    An environmental impact statement (EIS) has been made in conjunction with a prospective study of 56 consecutive deaths of persons under 60 years of age in a local population. EIS is the cheapest and the quickest means by which to continually highlight the weaknesses of a national health system.

  1. 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.

  2. 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.

  3. 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

  4. Performance criteria for verbal autopsy-based systems to estimate national causes of death: development and application to the Indian Million Death Study

    PubMed Central

    2014-01-01

    Background Verbal autopsy (VA) has been proposed to determine the cause of death (COD) distributions in settings where most deaths occur without medical attention or certification. We develop performance criteria for VA-based COD systems and apply these to the Registrar General of India’s ongoing, nationally-representative Indian Million Death Study (MDS). Methods Performance criteria include a low ill-defined proportion of deaths before old age; reproducibility, including consistency of COD distributions with independent resampling; differences in COD distribution of hospital, home, urban or rural deaths; age-, sex- and time-specific plausibility of specific diseases; stability and repeatability of dual physician coding; and the ability of the mortality classification system to capture a wide range of conditions. Results The introduction of the MDS in India reduced the proportion of ill-defined deaths before age 70 years from 13% to 4%. The cause-specific mortality fractions (CSMFs) at ages 5 to 69 years for independently resampled deaths and the MDS were very similar across 19 disease categories. By contrast, CSMFs at these ages differed between hospital and home deaths and between urban and rural deaths. Thus, reliance mostly on urban or hospital data can distort national estimates of CODs. Age-, sex- and time-specific patterns for various diseases were plausible. Initial physician agreement on COD occurred about two-thirds of the time. The MDS COD classification system was able to capture more eligible records than alternative classification systems. By these metrics, the Indian MDS performs well for deaths prior to age 70 years. The key implication for low- and middle-income countries where medical certification of death remains uncommon is to implement COD surveys that randomly sample all deaths, use simple but high-quality field work with built-in resampling, and use electronic rather than paper systems to expedite field work and coding. Conclusions Simple

  5. Performance-Based Certification in Georgia. Teaching Field Criterion-Referenced Tests Development. On-the-Job Assessment Development. Schedule for Implementation of Performance-Based Certification.

    ERIC Educational Resources Information Center

    Georgia State Dept. of Education, Atlanta. Office of Planning and Development.

    Performance-based teacher certification in Georgia is centered on: criterion-referenced tests, and on-the-job assessment procedures for student teachers and beginning teachers. A state-funded contract was awarded to develop teacher certification tests, resulting in a 250-item pool and 15 criterion-referenced tests for 32 teaching fields. Cutting…

  6. 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.

  7. Reversal of English trend towards hospital death in dementia: a population-based study of place of death and associated individual and regional factors, 2001–2010

    PubMed Central

    2014-01-01

    Background England has one of the highest rates of hospital death in dementia in Europe. How this has changed over time is unknown. This study aimed to analyse temporal trends in place of death in dementia over a recent ten year period. Methods Population-based study linking Office for National Statistics mortality data with regional variables, in England 2001–2010. Participants were adults aged over 60 with a death certificate mention of dementia. Multivariable Poisson regression was used to determine the proportion ratio (PR) for death in care home (1) and home/hospice (1) compared to hospital (0). Explanatory variables included individual factors (age, gender, marital status, underlying cause of death), and regional variables derived at area level (deprivation, care home bed provision, urbanisation). Results 388,899 deaths were included. Most people died in care homes (55.3%) or hospitals (39.6%). A pattern of increasing hospital deaths reversed in 2006, with a subsequent decrease in hospital deaths (−0.93% per year, 95% CI −1.08 to −0.79 p < 0.001), and an increase in care home deaths (0.60% per year, 95% CI 0.45 to 0.75 p < 0.001). Care home death was more likely with older age (PR 1.11, 1.10 to 1.13), and in areas with greater care home bed provision (PR 1.82, 1.79 to 1.85) and affluence (PR 1.29, 1.26 to 1.31). Few patients died at home (4.8%) or hospice (0.3%). Home/hospice death was more likely in affluent areas (PR 1.23, 1.18 to 1.29), for women (PR 1.61, 1.56 to 1.65), and for those with cancer as underlying cause of death (PR 1.84, 1.77 to 1.91), and less likely in the unmarried (PRs 0.51 to 0.66). Conclusions Two in five people with dementia die in hospital. However, the trend towards increasing hospital deaths has reversed, and care home bed provision is key to sustain this. Home and hospice deaths are rare. Initiatives which aim to support the end of life preferences for people with dementia should be investigated. PMID:24666928

  8. Certificate-based authorization policy in a PKI environment

    SciTech Connect

    Thompson, Mary R.; Essiari, Abdelilah; Mudumbai, Srilekha

    2003-02-15

    The major emphasis of Public Key Infrastructure has been to provide acryptographically secure means of authenticating identities. However, procedures for authorizing the holders of these identities to perform specific actions still need additional research and development. While there are a number of proposed standards for authorization structures and protocols such as KeyNote, SPKI and SAML based on X.509 or other key-based identities, none have been widely adopted. As part of an effort to use X.509 identities to provide authorization in highly distributed environments, we have developed and deployed an authorization service based on X.509 identified users and access policy contained in certificates signed by X.509 identified stakeholders. The major goal of this system, called Akenti, is to produce a usable authorization system for an environment consisting of distributed resources used by geographically and administratively distributed users. Akenti assumes communication between user s and resources over a secure protocol such as Transport Layer Security(TLS) to provide mutual authentication with X.509 certificates. This paper explains the authorization model and policy language used by Akenti, and how we have implemented an Apache authorization module to provide Akenti authorization.

  9. 40 CFR 94.912 - Optional certification to land-based standards for auxiliary marine engines.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Optional certification to land-based... ENGINES Exclusion and Exemption Provisions § 94.912 Optional certification to land-based standards for... land-based engines. See § 94.907 for provisions that apply to propulsion marine engines or...

  10. Factors associated with reporting multiple causes of death

    PubMed Central

    Wall, Melanie M; Huang, Jinzhou; Oswald, John; McCullen, Diane

    2005-01-01

    Background There is analytical potential for multiple cause of death data collected from death certificates. This study examines relationships of multiple causes of death as a function of factors available on the death certificate (demographics of decedent, place of death, type of certifier, disposal method, whether an autopsy was performed, and year of death). Methods Data from 326,332 Minnesota death certificates from 1990–1998 are examined. Underlying and non-underlying causes of death are examined (based on record axis codes) as well as demographic and death-related covariates. Associations between covariates and prevalence of multiple causes of death and conditional probability of underlying compared to non-underlying causes of death are examined. The occurrence of ischemic heart disease or diabetes as underlying causes are specifically examined. Results Both the probability of multiple causes of death and the proportion of underlying cause compared to non-underlying cause of death are associated with demographic characteristics of the deceased and other non-medical conditions related to filing death certificate such as place of death. Conclusions Multiple cause of death data provide a potentially useful way of looking for inaccuracies in reporting of causes of death. Differences across demographics in the proportion of time a cause is selected as underlying compared to non-underlying exist and can potentially provide useful information about the overall impact of causes of death in different populations. PMID:15655070

  11. Statewide Systematic Evaluation of Sudden, Unexpected Infant Death Classification: Results from a National Pilot Project

    PubMed Central

    Kryscio, Richard; Holsinger, James W.; Krous, Henry F.

    2009-01-01

    The Centers for Disease Control and Prevention funded seven states, including Kentucky, to clarify statewide death certification practices in sudden, unexpected infant death and compare state performances with national expectations. Accurate assignment of the cause and manner of death in cases of sudden, unexpected infant death is critical for accurate vital statistics data to direct limited resources to appropriate targets, and to implement optimal and safe risk reduction strategies. The primary objectives are to (1) Compare SUID death certifications recommended by the KY medical examiners with the stated cause of death text field on the hard copy death electronic death certificates and (2) Compare KY and national SUID rates. Causes of death for SUID cases recommended by the medical examiners and those appearing on the hard copy and electronic death certificates in KY were collected retrospectively for 2004 and 2005. Medical examiner recommendations were based upon a classification scheme devised by them in 2003. Coroners hard copy death certificates and the cause of death rates in KY were compared to those occurring nationally. Eleven percent of infants dying suddenly and unexpectedly did not undergo autopsy during the study interval. The KY 2003 classification scheme for SIDS is at variance with the NICHD and San Diego SIDS definitions. Significant differences in causes of death recommended by medical examiners and those appearing on the hard copy and electronic death certificates were identified. SIDS rates increased in KY in contrast to decreasing rates nationally. Nationwide adoption of a widely used SIDS definition, such as that proposed in San Diego in 2004 as well as legislation by states to ensure autopsy in all cases of sudden unexpected infant death are recommended. Medical examiners’ recommendations for cause of death should appear on death certificates. Multidisciplinary pediatric death review teams prospectively evaluating cases before death

  12. 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...-certification (every 3 years, see 40 CFR 745.226(f)(7) for details) Firm $550 $550 Combined Renovation and...

  13. 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...-certification (every 3 years, see 40 CFR 745.226(f)(7) for details) Firm $550 $550 Combined Renovation and...

  14. 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...-certification (every 3 years, see 40 CFR 745.226(f)(7) for details) Firm $550 $550 Combined Renovation and...

  15. 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...-certification (every 3 years, see 40 CFR 745.226(f)(7) for details) Firm $550 $550 Combined Renovation and...

  16. 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.

  17. The Role of Industry-Based Certifications in Career and Technical Education

    ERIC Educational Resources Information Center

    Wilcox, Dave

    2006-01-01

    This article presents a brief summary of statewide applications of industry-based certifications (IBCs). Many state systems and local institutions are developing additional creative ways of using IBCs to support learning and program objectives. The technology of assessment and certification is advancing, so the snapshot of "the current reality"…

  18. 75 FR 27182 - Energy Conservation Program: Web-Based Compliance and Certification Management System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-14

    ... electronic Web-based tool, the Compliance and Certification Management System (CCMS), which will be the... reports to be submitted via e-mail; and updates the address and contact information used to submit compliance statements and certification reports through certified mail to DOE. DATES: Effective Date:...

  19. 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…

  20. 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...

  1. 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...

  2. 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...

  3. 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...

  4. 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...

  5. 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...

  6. 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.

  7. The quality of certification of deaths due to external causes in the city of Fortaleza in the State of Ceará, Brazil.

    PubMed

    Messias, Kelly Leite Maia; Bispo Júnior, José Patrício; Pegado, Maiara Freitas de Queiroz; Oliveira, Lara Carvalho; Peixoto, Thales Gomes; Sales, Madeline Aragão Claudino; Monteiro Filho, Marcelo Praxedes; Ferreira, David Guerreiro; Lage, Markus Paulo Felício; Freitas, Thiago Ponte; Bezerra Filho, José Gomes

    2016-04-01

    The article analyzes the quality of information of deaths from external causes in Fortaleza, in the State of Ceará, Brazil. They analyzed the completeness of the information of the death certificate (DO) and the correlation between the underlying cause of death described in the OF and registered in the Mortality Information System (SIM ).We used all the original statements of deaths from external causes, occurred in 2010, of residents in Fortaleza. The study population was 2109 DO. The statements were individually checked seeking to identify the completion of the fields and the basic cause attested the coding of the underlying cause in this DO and compared with the SIM was held. The fields with the highest completion rates were: name (100%), place of residence (100%), mother's name (99.6%), place of birth (99.1%), and sex (98.8%). The fields with the lowest completion rates were: place of occurrence (55%), race/skin color (38.4%), and schooling (34%). They observed inadequacies in the completion of the underlying cause. In DO are reported injuries found and not the circumstances of the death. There was poor level of concordance between the basic cause of DO and registered on the SIM (kappa 0.07). They suggest awareness strategies and training of medical examiners.

  8. The quality of certification of deaths due to external causes in the city of Fortaleza in the State of Ceará, Brazil.

    PubMed

    Messias, Kelly Leite Maia; Bispo Júnior, José Patrício; Pegado, Maiara Freitas de Queiroz; Oliveira, Lara Carvalho; Peixoto, Thales Gomes; Sales, Madeline Aragão Claudino; Monteiro Filho, Marcelo Praxedes; Ferreira, David Guerreiro; Lage, Markus Paulo Felício; Freitas, Thiago Ponte; Bezerra Filho, José Gomes

    2016-04-01

    The article analyzes the quality of information of deaths from external causes in Fortaleza, in the State of Ceará, Brazil. They analyzed the completeness of the information of the death certificate (DO) and the correlation between the underlying cause of death described in the OF and registered in the Mortality Information System (SIM ).We used all the original statements of deaths from external causes, occurred in 2010, of residents in Fortaleza. The study population was 2109 DO. The statements were individually checked seeking to identify the completion of the fields and the basic cause attested the coding of the underlying cause in this DO and compared with the SIM was held. The fields with the highest completion rates were: name (100%), place of residence (100%), mother's name (99.6%), place of birth (99.1%), and sex (98.8%). The fields with the lowest completion rates were: place of occurrence (55%), race/skin color (38.4%), and schooling (34%). They observed inadequacies in the completion of the underlying cause. In DO are reported injuries found and not the circumstances of the death. There was poor level of concordance between the basic cause of DO and registered on the SIM (kappa 0.07). They suggest awareness strategies and training of medical examiners. PMID:27076024

  9. 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

  10. 29 CFR 1919.50 - Eligibility for accreditation to certificate shore-based material handling devices covered by...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 7 2013-07-01 2013-07-01 false Eligibility for accreditation to certificate shore-based... Shore-Based Equipment § 1919.50 Eligibility for accreditation to certificate shore-based material... examinations and/or testing, as applicable, of vessels or shore-based equipment or gear of the type for...

  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

    ... 29 Labor 7 2010-07-01 2010-07-01 false Eligibility for accreditation to certificate shore-based... Shore-Based Equipment § 1919.50 Eligibility for accreditation to certificate shore-based material... examinations and/or testing, as applicable, of vessels or shore-based equipment or gear of the type for...

  12. Coherent state quantum key distribution based on entanglement sudden death

    NASA Astrophysics Data System (ADS)

    Jaeger, Gregg; Simon, David; Sergienko, Alexander V.

    2016-03-01

    A method for quantum key distribution (QKD) using entangled coherent states is discussed which is designed to provide key distribution rates and transmission distances surpassing those of traditional entangled photon pair QKD by exploiting entanglement sudden death. The method uses entangled electromagnetic signal states of `macroscopic' average photon numbers rather than single photon or entangled photon pairs, which have inherently limited rate and distance performance as bearers of quantum key data. Accordingly, rather than relying specifically on Bell inequalities as do entangled photon pair-based methods, the security of this method is based on entanglement witnesses and related functions.

  13. Death duties

    PubMed Central

    Myers, Kathryn A.; Eden, David

    2007-01-01

    PROBLEM BEING ADDRESSED Family physicians are often called upon to pronounce and certify the deaths of patients. Inadequate knowledge of the Coroners Act (in the province of Ontario) and of the correct process of certifying death can make physicians uncomfortable when confronted with these tasks. OBJECTIVE OF PROGRAM To educate family physicians about how to perform the administrative tasks required of them when patients die. PROGRAM DESCRIPTION The program included an educational video, a tutorial outlining the process of death certification, and discussion with a regional coroner about key features of the Coroners Act. In small groups, participants worked through cases of patient deaths in which they were asked to determine whether a coroner needed to be involved, to determine the manner of death, and to complete a mock death certificate for each case. CONCLUSION All participants reported a high level of satisfaction with the workshop and thought the main objective of the program had been achieved. Results of a test given 3 months after the workshop showed substantial improvement in participants’ knowledge of the coroner’s role and of the process of death certification. PMID:17872782

  14. PVDaCS - A prototype knowledge-based expert system for certification of spacecraft data

    NASA Technical Reports Server (NTRS)

    Wharton, Cathleen; Shiroma, Patricia J.; Simmons, Karen E.

    1989-01-01

    On-line data management techniques to certify spacecraft information are mandated by increasing telemetry rates. Knowledge-based expert systems offer the ability to certify data electronically without the need for time-consuming human interaction. Issues of automatic certification are explored by designing a knowledge-based expert system to certify data from a scientific instrument, the Orbiter Ultraviolet Spectrometer, on an operating NASA planetary spacecraft, Pioneer Venus. The resulting rule-based system, called PVDaCS (Pioneer Venus Data Certification System), is a functional prototype demonstrating the concepts of a larger system design. A key element of the system design is the representation of an expert's knowledge through the usage of well ordered sequences. PVDaCS produces a certification value derived from expert knowledge and an analysis of the instrument's operation. Results of system performance are presented.

  15. 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.

  16. Characteristics of Belgian “life-ending acts without explicit patient request”: a large-scale death certificate survey revisited

    PubMed Central

    Chambaere, Kenneth; Bernheim, Jan L.; Downar, James; Deliens, Luc

    2014-01-01

    Background “Life-ending acts without explicit patient request,” as identified in robust international studies, are central in current debates on physician-assisted dying. Despite their contentiousness, little attention has been paid to their actual characteristics and to what extent they truly represent nonvoluntary termination of life. Methods We analyzed the 66 cases of life-ending acts without explicit patient request identified in a large-scale survey of physicians certifying a representative sample of deaths (n = 6927) in Flanders, Belgium, in 2007. The characteristics we studied included physicians’ labelling of the act, treatment course and doses used, and patient involvement in the decision. Results In most cases (87.9%), physicians labelled their acts in terms of symptom treatment rather than in terms of ending life. By comparing drug combinations and doses of opioids used, we found that the life-ending acts were similar to intensified pain and symptom treatment and were distinct from euthanasia. In 45 cases, there was at least 1 characteristic inconsistent with the common understanding of the practice: either patients had previously expressed a wish for ending life (16/66, 24.4%), physicians reported that the administered doses had not been higher than necessary to relieve suffering (22/66, 33.3%), or both (7/66, 10.6%). Interpretation Most of the cases we studied did not fit the label of “nonvoluntary life-ending” for at least 1 of the following reasons: the drugs were administered with a focus on symptom control; a hastened death was highly unlikely; or the act was taken in accordance with the patient’s previously expressed wishes. Thus, we recommend a more nuanced view of life-ending acts without explicit patient request in the debate on physician-assisted dying. PMID:25485252

  17. 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.

  18. 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...

  19. 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...

  20. Scientifically Based Research in Educational Products: Vendors and Consumers on Filling the Certification Gap

    ERIC Educational Resources Information Center

    Caruthers, Bill J.

    2009-01-01

    The 2002 reauthorization of the Elementary and Secondary Education Act, or No Child Left Behind (NCLB) changed school law in the United States. Public schools can utilize federal funds to purchase only those educational products subject to scientifically based research. No dedicated certification intermediary (CI) exists to determine individual…

  1. 38 CFR 52.20 - Application for recognition based on certification.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Application for recognition based on certification. 52.20 Section 52.20 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Obtaining...

  2. 38 CFR 52.20 - Application for recognition based on certification.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Application for recognition based on certification. 52.20 Section 52.20 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Obtaining...

  3. 38 CFR 52.20 - Application for recognition based on certification.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Application for recognition based on certification. 52.20 Section 52.20 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Obtaining...

  4. 38 CFR 52.20 - Application for recognition based on certification.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Application for recognition based on certification. 52.20 Section 52.20 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Obtaining...

  5. 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...

  6. 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...

  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, 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...

  9. 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...

  10. 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...

  11. A comparison of hospice programs based on Medicare certification status.

    PubMed

    Sontag, M A

    1996-01-01

    This article presents results from a study of 119 hospice programs in the United States. Personal interviews and questionnaires were utilized to collect data about hospice programs, their directors, nurses, social workers, and chaplains. Specifically, this article describes reasons programs sought Medicare certification, and the perceived advantages and disadvantages to being a Medicare certified program. Characteristics of both certified and non-certified programs are presented, and examined for differences. Potential access barriers such as restrictive admission criteria are examined in this article. Finally, perceptions of staff about hospice services in certified and non-certified programs are compared. Results from this study indicate that Medicare certified programs have longer lengths of stays, were more likely to include a nurse on the first visit, and billed patients more frequently than noncertified programs. Volunteer use was lower in the Medicare certified programs. Staff in Medicare certified programs were much more likely to view patients' medical needs as the primary focus of their programs. Results from this study suggest that Medicare certified programs may reflect a more medical model of palliative care.

  12. 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.

  13. ASNT central certification program

    NASA Astrophysics Data System (ADS)

    Spring, Robert W.; Snell, John R., Jr.

    1997-04-01

    The American Society of Nondestructive Testing (ASNT) has recently established a new central certification program. This program will allow individuals who meet the requirements to receive a 'portable' certificate. Augmenting the existing employer-based certification, this program will have significant impact on industries that may ultimately require nondestructive testing (NDT) personnel to have central certification. This paper explains show ASNT has structured central certification and when and how it will effect thermal/infrared thermography (T/IRT) personnel. The paper also discusses the industry specific certification process.

  14. Dynamic frailty models based on compound birth-death processes.

    PubMed

    Putter, Hein; van Houwelingen, Hans C

    2015-07-01

    Frailty models are used in survival analysis to model unobserved heterogeneity. They accommodate such heterogeneity by the inclusion of a random term, the frailty, which is assumed to multiply the hazard of a subject (individual frailty) or the hazards of all subjects in a cluster (shared frailty). Typically, the frailty term is assumed to be constant over time. This is a restrictive assumption and extensions to allow for time-varying or dynamic frailties are of interest. In this paper, we extend the auto-correlated frailty models of Henderson and Shimakura and of Fiocco, Putter and van Houwelingen, developed for longitudinal count data and discrete survival data, to continuous survival data. We present a rigorous construction of the frailty processes in continuous time based on compound birth-death processes. When the frailty processes are used as mixtures in models for survival data, we derive the marginal hazards and survival functions and the marginal bivariate survival functions and cross-ratio function. We derive distributional properties of the processes, conditional on observed data, and show how to obtain the maximum likelihood estimators of the parameters of the model using a (stochastic) expectation-maximization algorithm. The methods are applied to a publicly available data set.

  15. 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

  16. 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…

  17. Ace your certification exam: biofilm-based wound care.

    PubMed

    Shah, Jayesh

    2011-12-01

    Dr Jayesh Shah authors this quarterly column, consisting of 5 questions with explanations, to help you practice for your exam. In this issue, the column focuses on questions about biofilm-based wound care.

  18. 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...

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. 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.

  4. 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.

  5. 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…

  6. [Prognosis of patient with intractable diseases in Wakayama Prefecture--a follow-up study based on medical care certificates].

    PubMed

    Kasamatsu, T; Yoshimura, N; Ueda, A; Morioka, S; Sugita, K; Hashimoto, T

    1994-04-01

    To clarify the prognosis of patients with intractable diseases, a baseline survey of patients who received financial aid for intractable disease treatment between April 1984 and March 1985 was performed in Wakayama Prefecture, followed by a follow-up survey over a period of 8 years. Based on public welfare-subsidized system in Wakayama Prefecture, all patients with intractable diseases were checked up annually their certificates of financial aid for treatment. The results obtained were as follows: Parkinson's disease had the highest rate of discontinuation of medical care at 65%, followed by idiopathic thrombocytopenic purpura (ITP) at 64%, aplastic anemia at 55%, ulcerative colitis (UC) at 54%, and Behcet's disease at 50%. Systemic lupus erythematosus (SLE) had the lowest rate of discontinuation of medical care at 32%. Discontinuation was due to death in approximately 50% of the patients with SLE, scleroderma, dermatomyositis and polymyositis, and aplastic anemia. Of these, the causes of death in more than 50% were directly related to the primary diseases. However, in patients with SLE and aplastic anemia, 25% discontinued care because of cure or alleviation. Some patients remained in remission even though the prognosis for these diseases is not generally considered to be favorable. Transfer of jurisdiction to the Disabled Persons Welfare Act was seen in 28% of patients with Parkinson's disease, 24% with Behcet's disease, and 23% with ossification of posterior longitudinal ligament, diseases which are believed to cause restriction in daily activities of patients in some cases. On the other hand, cure or alleviation was the reason for discontinuation in 60-70% of patients with Buerger's disease, UC and ITP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8025309

  7. 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

  8. 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...

  9. 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....

  10. 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....

  11. 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...

  12. 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...

  13. 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....

  14. 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....

  15. 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....

  16. Drug insight: cancer therapy strategies based on restoration of endogenous cell death mechanisms.

    PubMed

    Reed, John C

    2006-07-01

    Cell death is a normal facet of human physiology, ensuring tissue homeostasis by offsetting cell production with cell demise. Neoplasms arise in part because of defects in physiological cell death mechanisms, contributing to pathological cell expansion. Defects in normal cell death pathways also contribute to cancer progression by permitting progressively aberrant cell behaviors, while also desensitizing tumor cells to immune-mediated attack, radiation, and chemotherapy. Through basic research, much has been learned about the molecular mechanisms responsible for cell turnover and how tumors escape cell death. By exploiting this knowledge base, several innovative strategies for eradicating malignancies have materialized that are based on restoration of natural pathways for cell autodestruction. Some of these strategies have advanced into human clinical trials. Several of the current strategies based on targeting core components of the cell death machinery for cancer therapy are reviewed here, and a summary of progress toward clinical applications is provided. PMID:16826219

  17. 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)

  18. Blended roles: preparing the advanced practice nurse educator/clinician with a Web-based nurse educator certificate program.

    PubMed

    Bonnel, Wanda B; Starling, Carol K; Wambach, Karen A; Tarnow, Karen

    2003-01-01

    Changing demographics, a nursing shortage, and various societal changes underscore the need for nurse educators and new nurse educator programs. This article describes a Web-based nurse educator program designed to prepare advanced practice nurses for faculty roles while simultaneously preparing them as clinicians. Guided by adult education theory and self-directed learning theory, the Web-based Nurse Educator Certificate (four Web-based nurse educator courses including a teaching practicum) has been developed and offered to clinical master's and postmaster's students. This article also describes student work with mentors, interactive Web-based teaching strategies, portfolios, graduate competencies, and initial evaluative data. In the first two years of the program, 48 students have taken at least one course in the Nurse Educator Certificate program and eight students have completed it. A Web-based nurse educator certificate program, as part of a clinical master's or postmaster's program, has the potential to help meet the faculty shortage.

  19. 40 CFR 745.238 - Fees for accreditation and certification of lead-based paint activities.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...-certification (every 3 years, see 40 CFR 745.226(f)(7) for details) Firm $550 $550 Combined Renovation and Lead..., see 40 CFR 745.225(f)(1) for details) Initial CourseInspector Risk assessor Supervisor Worker Project... Activities—Individual Certification Re-certification (every 3 years, see 40 CFR 745.226(e)(1) for...

  20. 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…

  1. Improving maternity care in Ethiopia through facility based review of maternal deaths and near misses.

    PubMed

    Gebrehiwot, Yirgu; Tewolde, Birukkidus T

    2014-10-01

    The present study aimed to initiate facility based review of maternal deaths and near misses as part of the Ethiopian effort to reduce maternal mortality and achieve United Nations Millennium Development Goals 4 and 5. An in-depth review of all maternal deaths and near misses among women who visited 10 hospitals in four regions of Ethiopia was conducted between May 2011 and October 2012 as part of the FIGO LOGIC initiative. During the study period, a total of 2774 cases (206 deaths and 2568 near misses) were reviewed. The ratio of maternal deaths to near misses was 1:12 and the overall maternal death rate was 728 per 100 000 live births. Socioeconomic factors associated with maternal mortality included illiteracy 1672 (60.3%) and lack of employment outside the home 2098 (75.6%). In all, 1946 (70.2%) women arrived at hospital after they had developed serious complications owing to issues such as lack of transportation. Only 1223 (44.1%) women received prenatal follow-up and 157 (76.2%) deaths were attributed to direct obstetric causes. Based on the findings, facilities adopted a number of quality improvement measures such as providing 24-hour services, and making ambulances available. Integrating review of maternal deaths and near misses into regular practice provides accurate information on causes of maternal deaths and near misses and also improves quality of care in facilities.

  2. 28 CFR 26.23 - Certification process.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Certification process. 26.23 Section 26.23 Judicial Administration DEPARTMENT OF JUSTICE DEATH SENTENCES PROCEDURES Certification Process for State Capital Counsel Systems § 26.23 Certification process. (a) An appropriate state official...

  3. A necropsy-based descriptive study of dairy cow deaths on a Colorado dairy.

    PubMed

    McConnel, C S; Garry, F B; Lombard, J E; Kidd, J A; Hill, A E; Gould, D H

    2009-05-01

    Increasing levels of dairy cow mortality pose a challenge to the US dairy industry. The industry's current understanding of dairy cow mortality is reliant upon descriptions largely based on producer or veterinary assumptions regarding cause of death without the benefit of detailed postmortem evaluations. A thorough necropsy is a superior tool for establishing a cause of death, except for cases involving euthanasia for traumatic accidents or severe locomotor disorders. Information provided from a necropsy examination would be most valuable if it were categorized and combined with cow health information in a complete postmortem evaluation designed to guide future management decisions. The objective of this study was to describe dairy cow deaths on a Colorado dairy over a 1-yr period and explore classification systems for necropsy findings that might inform management actions aimed at reducing dairy cow mortality. Throughout the study period a thorough necropsy examination was performed on every cow that died. Based upon this examination each death was characterized by a proximate cause (i.e., the most likely immediate cause of the death). Each proximate cause of death was then categorized using 3 alternate schemes founded on generalized etiologic principles and influenced by previous clinical history and treatments. These schemes included the broad categories commonly used for classifying findings within a review of literature related to dairy cow mortality, a diagnostic scheme used within the problem-oriented veterinary medical record, and an analysis focusing on the primary physiologic system derangement for each death. A total of 2,067 cows were enrolled during the study period of which 1,468 cows freshened, 507 cows were sold, and 94 cows died, resulting in a mortality risk of 6.4 deaths per 100 lactations at risk. The distribution of deaths by parity was significantly different from the herd distribution at the end of study with the largest percentage of death

  4. Possible Prevention of Neonatal Death: A Regional Population-Based Study in Japan

    PubMed Central

    Yanagi, Takahide; Ono, Tetsuo; Tsuji, Shunichiro; Takahashi, Kentaro

    2016-01-01

    Purpose The neonatal mortality rate in Japan has currently been at the lowest level in the world. However, it is unclear whether there are still some potentially preventable neonatal deaths. We, therefore, aimed to examine the backgrounds of neonatal death and the possibilities of prevention in a region of Japan. Materials and Methods This is a population-based study of neonatal death in Shiga Prefecture of Japan. Results The 103 neonatal deaths in our prefecture between 2007 and 2011 were included. After reviewing by a peer-review team, we classified the backgrounds of these neonatal deaths and analyzed end-of-life care approaches associated with prenatal diagnosis. Furthermore, we evaluated the possibilities of preventable neonatal death, suggesting specific recommendations for its prevention. We analyzed 102 (99%) of the neonatal deaths. Congenital malformations and extreme prematurity were the first and the second most common causes of death, respectively. More than half of the congenital abnormalities (59%) including malformations and chromosome abnormality had been diagnosed before births. We had 22 neonates with non-intensive care including eighteen cases with congenital abnormality and four with extreme prematurity. Twenty three cases were judged to have had some possibility of prevention with one having had a strong possibility of prevention. Among specific recommendations of preventable neonatal death, more than half of them were for obstetricians. Conclusion There is room to reduce neonatal deaths in Japan. Prevention of neonatal death requires grater prenatal care by obstetricians before birth rather than improved neonatal care by neonatologists after birth. PMID:26847296

  5. [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.

  6. 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

  7. 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.

  8. [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.

  9. [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. PMID:21987332

  10. PRESENT CONDITION OF FOOD WASTE RECYCLING LOOP BASED ON RECYCLING PROJECT CERTIFICATION OF THE FOOD WASTE RECYCLING LAW

    NASA Astrophysics Data System (ADS)

    Kita, Tomoko; Kanaya, Ken

    Purpose of this research is to clear present condition of food waste recycling loops based on recycling project certification of the Food Waste Recycling Law. Method of this research is questionnaire survey to companies constituting the loops. Findings of this research are as follows: 1. Proponents of the loop is most often the recycling companies. 2. Food waste recycling rate is 61% for the food retailing industry and 81% for the food service industry. These values are higher than the national average in 2006. The effect of the revision of recycling project certification is suggested.

  11. Test Security and Item Exposure Control for Computer-Based Examinations: Performance of a Computerized Classification Test for Professional Certification.

    ERIC Educational Resources Information Center

    Kalohn, John C.; Spray, Judith A.

    A client of American College Testing, Inc. (ACT) decided to implement a computer-based testing program to replace their paper-pencil format for professional certification. This paper reports on the results of the developed test after 1 year's use, especially as the results relate to test security issues. ACT research shows that a variable length…

  12. Metallomics insights into the programmed cell death induced by metal-based anticancer compounds.

    PubMed

    Tan, Cai-Ping; Lu, Yi-Ying; Ji, Liang-Nian; Mao, Zong-Wan

    2014-05-01

    Since the discovery of cisplatin more than 40 years ago, enormous research efforts have been dedicated to developing metal-based anticancer agents and to elucidating the mechanisms involved in the action of these compounds. Abnormal metabolism and the evasion of apoptosis are important hallmarks of malignant transformation, and the induction of apoptotic cell death has been considered to be a main pathway by which cytotoxic metal complexes combat cancer. However, many cancers have cellular defects involving the apoptotic machinery, which results in an acquired resistance to apoptotic cell death and therefore reduced chemotherapeutic effectiveness. Over the past decade, it has been revealed that a growing number of cell death pathways induced by metal complexes are not dependent on apoptosis. Metal complexes specifically triggering these alternative cell death pathways have been identified and explored as novel cancer treatment options. In this review, we discuss recent examples of metallomics studies on the different types of cell death induced by metal-based anticancer drugs, especially on the three major forms of programmed cell death (PCD) in mammalian cells: apoptosis, autophagy and regulated necrosis, also called necroptosis.

  13. Physician-assisted deaths under the euthanasia law in Belgium: a population-based survey

    PubMed Central

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

    2010-01-01

    Background Legalization of euthanasia and physician-assisted suicide has been heavily debated in many countries. To help inform this debate, we describe the practices of euthanasia and assisted suicide, and the use of life-ending drugs without an explicit request from the patient, in Flanders, Belgium, where euthanasia is legal. Methods We mailed a questionnaire regarding the use of life-ending drugs with or without explicit patient request to physicians who certified a representative sample (n = 6927) of death certificates of patients who died in Flanders between June and November 2007. Results The response rate was 58.4%. Overall, 208 deaths involving the use of life-ending drugs were reported: 142 (weighted prevalence 2.0%) were with an explicit patient request (euthanasia or assisted suicide) and 66 (weighted prevalence 1.8%) were without an explicit request. Euthanasia and assisted suicide mostly involved patients less than 80 years of age, those with cancer and those dying at home. Use of life-ending drugs without an explicit request mostly involved patients 80 years of older, those with a disease other than cancer and those in hospital. Of the deaths without an explicit request, the decision was not discussed with the patient in 77.9% of cases. Compared with assisted deaths with the patient’s explicit request, those without an explicit request were more likely to have a shorter length of treatment of the terminal illness, to have cure as a goal of treatment in the last week, to have a shorter estimated time by which life was shortened and to involve the administration of opioids. Interpretation Physician-assisted deaths with an explicit patient request (euthanasia and assisted suicide) and without an explicit request occurred in different patient groups and under different circumstances. Cases without an explicit request often involved patients whose diseases had unpredictable end-of-life trajectories. Although opioids were used in most of these cases

  14. 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…

  15. 40 CFR 94.912 - Optional certification to land-based standards for auxiliary marine engines.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... certified to the requirements that apply to compression-ignition engines under 40 CFR part 89 or 1039 for... certificate issued under 40 CFR part 86 or 1039 for each engine to also be a valid certificate of conformity... applicable requirements from 40 CFR part 89 or 1039. This paragraph (c) applies to engine manufacturers,...

  16. 40 CFR 94.912 - Optional certification to land-based standards for auxiliary marine engines.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... certified to the requirements that apply to compression-ignition engines under 40 CFR part 89 or 1039 for... certificate issued under 40 CFR part 86 or 1039 for each engine to also be a valid certificate of conformity... applicable requirements from 40 CFR part 89 or 1039. This paragraph (c) applies to engine manufacturers,...

  17. 40 CFR 94.912 - Optional certification to land-based standards for auxiliary marine engines.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... certified to the requirements that apply to compression-ignition engines under 40 CFR part 89 or 1039 for... certificate issued under 40 CFR part 86 or 1039 for each engine to also be a valid certificate of conformity... applicable requirements from 40 CFR part 89 or 1039. This paragraph (c) applies to engine manufacturers,...

  18. 40 CFR 94.912 - Optional certification to land-based standards for auxiliary marine engines.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... without making any changes that could increase its certified emission levels, as described in 40 CFR 94... certified to the requirements that apply to compression-ignition engines under 40 CFR part 89 or 1039 for... certificate issued under 40 CFR part 86 or 1039 for each engine to also be a valid certificate of...

  19. Influence of measurement errors on temperature-based death time determination.

    PubMed

    Hubig, Michael; Muggenthaler, Holger; Mall, Gita

    2011-07-01

    Temperature-based methods represent essential tools in forensic death time determination. Empirical double exponential models have gained wide acceptance because they are highly flexible and simple to handle. The most established model commonly used in forensic practice was developed by Henssge. It contains three independent variables: the body mass, the environmental temperature, and the initial body core temperature. The present study investigates the influence of variations in the input data (environmental temperature, initial body core temperature, core temperature, time) on the standard deviation of the model-based estimates of the time since death. Two different approaches were used for calculating the standard deviation: the law of error propagation and the Monte Carlo method. Errors in environmental temperature measurements as well as deviations of the initial rectal temperature were identified as major sources of inaccuracies in model based death time estimation.

  20. 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…

  1. 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.

  2. Combined Prediction Model of Death Toll for Road Traffic Accidents Based on Independent and Dependent Variables

    PubMed Central

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

    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. PMID:25610454

  3. 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

  4. 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…

  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. The Determinants of Place of Death: An Evidence-Based Analysis

    PubMed Central

    Costa, V

    2014-01-01

    Background According to a conceptual model described in this analysis, place of death is determined by an interplay of factors associated with the illness, the individual, and the environment. Objectives Our objective was to evaluate the determinants of place of death for adult patients who have been diagnosed with an advanced, life-limiting condition and are not expected to stabilize or improve. Data Sources A literature search was performed using Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid Embase, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), and EBM Reviews, for studies published from January 1, 2004, to September 24, 2013. Review Methods Different places of death are considered in this analysis—home, nursing home, inpatient hospice, and inpatient palliative care unit, compared with hospital. We selected factors to evaluate from a list of possible predictors—i.e., determinants—of death. We extracted the adjusted odds ratios and 95% confidence intervals of each determinant, performed a meta-analysis if appropriate, and conducted a stratified analysis if substantial heterogeneity was observed. Results From a literature search yielding 5,899 citations, we included 2 systematic reviews and 29 observational studies. Factors that increased the likelihood of home death included multidisciplinary home palliative care, patient preference, having an informal caregiver, and the caregiver's ability to cope. Factors increasing the likelihood of a nursing home death included the availability of palliative care in the nursing home and the existence of advance directives. A cancer diagnosis and the involvement of home care services increased the likelihood of dying in an inpatient palliative care unit. A cancer diagnosis and a longer time between referral to palliative care and death increased the likelihood of inpatient hospice death. The quality of the evidence was considered low. Limitations Our results are based

  7. Burden of Severe Pneumonia, Pneumococcal Pneumonia and Pneumonia Deaths in Indian States: Modelling Based Estimates

    PubMed Central

    Farooqui, Habib; Jit, Mark; Heymann, David L.; Zodpey, Sanjay

    2015-01-01

    The burden of severe pneumonia in terms of morbidity and mortality is unknown in India especially at sub-national level. In this context, we aimed to estimate the number of severe pneumonia episodes, pneumococcal pneumonia episodes and pneumonia deaths in children younger than 5 years in 2010. We adapted and parameterized a mathematical model based on the epidemiological concept of potential impact fraction developed CHERG for this analysis. The key parameters that determine the distribution of severe pneumonia episode across Indian states were state-specific under-5 population, state-specific prevalence of selected definite pneumonia risk factors and meta-estimates of relative risks for each of these risk factors. We applied the incidence estimates and attributable fraction of risk factors to population estimates for 2010 of each Indian state. We then estimated the number of pneumococcal pneumonia cases by applying the vaccine probe methodology to an existing trial. We estimated mortality due to severe pneumonia and pneumococcal pneumonia by combining incidence estimates with case fatality ratios from multi-centric hospital-based studies. Our results suggest that in 2010, 3.6 million (3.3–3.9 million) episodes of severe pneumonia and 0.35 million (0.31–0.40 million) all cause pneumonia deaths occurred in children younger than 5 years in India. The states that merit special mention include Uttar Pradesh where 18.1% children reside but contribute 24% of pneumonia cases and 26% pneumonia deaths, Bihar (11.3% children, 16% cases, 22% deaths) Madhya Pradesh (6.6% children, 9% cases, 12% deaths), and Rajasthan (6.6% children, 8% cases, 11% deaths). Further, we estimated that 0.56 million (0.49–0.64 million) severe episodes of pneumococcal pneumonia and 105 thousand (92–119 thousand) pneumococcal deaths occurred in India. The top contributors to India’s pneumococcal pneumonia burden were Uttar Pradesh, Bihar, Madhya Pradesh and Rajasthan in that order. Our

  8. Burden of Severe Pneumonia, Pneumococcal Pneumonia and Pneumonia Deaths in Indian States: Modelling Based Estimates.

    PubMed

    Farooqui, Habib; Jit, Mark; Heymann, David L; Zodpey, Sanjay

    2015-01-01

    The burden of severe pneumonia in terms of morbidity and mortality is unknown in India especially at sub-national level. In this context, we aimed to estimate the number of severe pneumonia episodes, pneumococcal pneumonia episodes and pneumonia deaths in children younger than 5 years in 2010. We adapted and parameterized a mathematical model based on the epidemiological concept of potential impact fraction developed CHERG for this analysis. The key parameters that determine the distribution of severe pneumonia episode across Indian states were state-specific under-5 population, state-specific prevalence of selected definite pneumonia risk factors and meta-estimates of relative risks for each of these risk factors. We applied the incidence estimates and attributable fraction of risk factors to population estimates for 2010 of each Indian state. We then estimated the number of pneumococcal pneumonia cases by applying the vaccine probe methodology to an existing trial. We estimated mortality due to severe pneumonia and pneumococcal pneumonia by combining incidence estimates with case fatality ratios from multi-centric hospital-based studies. Our results suggest that in 2010, 3.6 million (3.3-3.9 million) episodes of severe pneumonia and 0.35 million (0.31-0.40 million) all cause pneumonia deaths occurred in children younger than 5 years in India. The states that merit special mention include Uttar Pradesh where 18.1% children reside but contribute 24% of pneumonia cases and 26% pneumonia deaths, Bihar (11.3% children, 16% cases, 22% deaths) Madhya Pradesh (6.6% children, 9% cases, 12% deaths), and Rajasthan (6.6% children, 8% cases, 11% deaths). Further, we estimated that 0.56 million (0.49-0.64 million) severe episodes of pneumococcal pneumonia and 105 thousand (92-119 thousand) pneumococcal deaths occurred in India. The top contributors to India's pneumococcal pneumonia burden were Uttar Pradesh, Bihar, Madhya Pradesh and Rajasthan in that order. Our results

  9. The effect of a community-based police surveillance program on snowmobile injuries and deaths.

    PubMed

    Rowe, B H; Therrien, S A; Bretzlaff, J A; Sahai, V S; Nagarajan, K V; Bota, G W

    1998-01-01

    Serious snowmobile injuries are preventable and associated with late-night travel, alcohol use, and speed. We studied the effectiveness of a community-based policing (STOP) program in the prevention of serious injuries related to snowmobile trauma in Sudbury, Ontario. Volunteers were trained in police protocol and were appointed special constables to increase policing on snowmobile trails from 1993-95. Snowmobile admissions and deaths in Sudbury were examined; the pre- (1990-1992) and post- (1993-1995) STOP seasons were compared. In the pre-STOP period, 102 injuries, 87 admissions, and 15 deaths occurred compared to 57 injuries (p = 0.0004), 53 admissions (p = 0.00001) and 4 deaths (p = 0.13) in the post-STOP period. All other event and demographic features of the crashes remained similar. Significant economic savings were realized from this intervention; acute care costs savings exceeded $70,000/year and costs from death decreased by $5 million. An intervention involving enforcement on snowmobile trails can reduce the incidence of injuries from snowmobile-related trauma.

  10. Does Marital Status Predict the Odds of Suicidal Death in Taiwan? A Seven-Year Population-Based Study

    ERIC Educational Resources Information Center

    Yeh, Jui-Yuan; Xirasagar, Sudha; Liu, Tsai-Ching; Li, Chong-Yi; Lin, Herng-Ching

    2008-01-01

    Using nationwide, 7-year population-based data for 1997-2003, we examined marital status to see if it predicted suicide among the ethnic Chinese population of Taiwan. Using cause of death data, with a case-control design, two groups--total adult suicide deaths, n = 17,850, the study group, and adult deaths other than suicide, n = 71,400 (randomly…

  11. Getting Started on Assessment: Developing a Voluntary System of Assessment and Certification Based on Skill Standards.

    ERIC Educational Resources Information Center

    National Skill Standards Board (DOL/ETA), Washington, DC.

    This manual provides practical advice for voluntary partnerships that, since 1994, are part of the effort to build a voluntary national system of skill standards, assessment, and certification. Intended to be used with guidance from the National Skill Standards Board, it is designed for the voluntary partnerships that have completed the standards…

  12. 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…

  13. 21 CFR 1311.40 - Renewal of CSOS digital certificates.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... obtain a new CSOS digital certificate when the registrant's DEA registration expires or whenever the... certificate will expire on the date on which the DEA registration on which the certificate is based...

  14. 21 CFR 1311.40 - Renewal of CSOS digital certificates.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... obtain a new CSOS digital certificate when the registrant's DEA registration expires or whenever the... certificate will expire on the date on which the DEA registration on which the certificate is based...

  15. 21 CFR 1311.40 - Renewal of CSOS digital certificates.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... obtain a new CSOS digital certificate when the registrant's DEA registration expires or whenever the... certificate will expire on the date on which the DEA registration on which the certificate is based...

  16. Deaths due to Unknown Foodborne Agents

    PubMed Central

    2004-01-01

    This study reviews the available evidence on unknown pathogenic agents transmitted in food and examines the methods that have been used to estimate that such agents cause 3,400 deaths per year in the United States. The estimate of deaths was derived from hospital discharge and death certificate data on deaths attributed to gastroenteritis of unknown cause. Fatal illnesses due to unknown foodborne agents do not always involve gastroenteritis, and gastroenteritis may not be accurately diagnosed or reported on hospital charts or death certificates. The death estimate consequently omitted deaths from unknown foodborne agents that do not cause gastroenteritis and likely overstated the number of deaths from agents that cause gastroenteritis. Although the number of deaths from unknown foodborne agents is uncertain, the possible economic cost of these deaths is so large that increased efforts to identify the causal agents are warranted. PMID:15498153

  17. Involvement of sphingoid bases in mediating reactive oxygen intermediate production and programmed cell death in Arabidopsis.

    PubMed

    Shi, Lihua; Bielawski, Jacek; Mu, Jinye; Dong, Haili; Teng, Chong; Zhang, Jian; Yang, Xiaohui; Tomishige, Nario; Hanada, Kentaro; Hannun, Yusuf A; Zuo, Jianru

    2007-12-01

    Sphingolipids have been suggested to act as second messengers for an array of cellular signaling activities in plant cells, including stress responses and programmed cell death (PCD). However, the mechanisms underpinning these processes are not well understood. Here, we report that an Arabidopsis mutant, fumonisin B1 resistant 11-1 (fbr 11-1), which fails to generate reactive oxygen intermediates (ROIs), is incapable of initiating PCD when the mutant is challenged by fumonisin B(1) (FB(1)), a specific inhibitor of ceramide synthase. Molecular analysis indicated that FBR11 encodes a long-chain base 1 (LCB1) subunit of serine palmitoyltransferase (SPT), which catalyzes the first rate-limiting step of de novo sphingolipid synthesis. Mass spectrometric analysis of the sphingolipid concentrations revealed that whereas the fbr 11-1 mutation did not affect basal levels of sphingoid bases, the mutant showed attenuated formation of sphingoid bases in response to FB(1). By a direct feeding experiment, we show that the free sphingoid bases dihydrosphingosine, phytosphingosine and sphingosine efficiently induce ROI generation followed by cell death. Conversely, ROI generation and cell death induced by dihydrosphingosine were specifically blocked by its phosphorylated form dihydrosphingosine-1-phosphate in a dose-dependent manner, suggesting that the maintenance of homeostasis between a free sphingoid base and its phosphorylated derivative is critical to determining the cell fate. Because alterations of the sphingolipid level occur prior to the ROI production, we propose that the free sphingoid bases are involved in the control of PCD in Arabidopsis, presumably through the regulation of the ROI level upon receiving different developmental or environmental cues.

  18. Cell death following BNCT: a theoretical approach based on Monte Carlo simulations.

    PubMed

    Ballarini, F; Bakeine, J; Bortolussi, S; Bruschi, P; Cansolino, L; Clerici, A M; Ferrari, C; Protti, N; Stella, S; Zonta, A; Zonta, C; Altieri, S

    2011-12-01

    In parallel to boron measurements and animal studies, investigations on radiation-induced cell death are also in progress in Pavia, with the aim of better characterisation of the effects of a BNCT treatment down to the cellular level. Such studies are being carried out not only experimentally but also theoretically, based on a mechanistic model and a Monte Carlo code. Such model assumes that: (1) only clustered DNA strand breaks can lead to chromosome aberrations; (2) only chromosome fragments within a certain threshold distance can undergo misrejoining; (3) the so-called "lethal aberrations" (dicentrics, rings and large deletions) lead to cell death. After applying the model to normal cells exposed to monochromatic fields of different radiation types, the irradiation section of the code was purposely extended to mimic the cell exposure to a mixed radiation field produced by the (10)B(n,α) (7)Li reaction, which gives rise to alpha particles and Li ions of short range and high biological effectiveness, and by the (14)N(n,p)(14)C reaction, which produces 0.58 MeV protons. Very good agreement between model predictions and literature data was found for human and animal cells exposed to X- or gamma-rays, protons and alpha particles, thus allowing to validate the model for cell death induced by monochromatic radiation fields. The model predictions showed good agreement also with experimental data obtained by our group exposing DHD cells to thermal neutrons in the TRIGA Mark II reactor of the University of Pavia; this allowed to validate the model also for a BNCT exposure scenario, providing a useful predictive tool to bridge the gap between irradiation and cell death. PMID:21481595

  19. 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.

  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. 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

  2. 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…

  3. 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.

  4. Mortality in Cambodia: an 18-month prospective community-based surveillance of all-age deaths using verbal autopsies.

    PubMed

    Goyet, Sophie; Rammaert, Blandine; McCarron, Margaret; Khieu, Virak; Fournier, Isabelle; Kitsutani, Paul; Ly, Sowath; Mounts, Anthony; Letson, William G; Buchy, Philippe; Vong, Sirenda

    2015-03-01

    To estimate the 2009-2010 death rates, causes, and patterns of mortality in rural Cambodia, we conducted active, population-based death surveillance in 25 rural villages of Cambodia from March 2009 to August 2010. Among the population of 28,053 under surveillance, 280 deaths were reported and explored by physician-certified verbal autopsies, using the International Classification of Diseases 10, yielding an overall mortality rate (MR) of 6.7/1000 persons-year (95% CI 5.74-7.68). The MR was 39.1/1000 live births for those younger than 5 years old. Infants accounted for 5.4% of all deaths. In children younger than 5 years, infectious and parasitic diseases were the leading causes of death. In children 5 to 14 years, 3 out of 4 deaths were due to injuries. Adult deaths were mainly attributed to noncommunicable diseases (52%). We conclude that this rural population is facing a substantial burden of noncommunicable diseases while still struggling with infectious diseases, respiratory diseases in particular.

  5. Certification Reform.

    ERIC Educational Resources Information Center

    Klagholz, Leo; Cooperman, Saul

    Two major problems of state certification of teachers are decline in the quality of teacher candidates and the inability of qualified applicants to be certified without majoring in education. With improved knowledge about how good teachers teach and what is essential for beginning teachers to know, teacher education programs are likely to remain…

  6. 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.

  7. 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. PMID:20018990

  8. [Methodological bases for the training of a therapist in cardiology in light of physician certification].

    PubMed

    Selivonenko, V G; Medvedeva, V N; Porada, L V

    1996-01-01

    In the course of theoretical education, one of the most important forms is that of lectures, particularly generalizing and problem-solving ones. Practical education (two thirds of the working time) will include the following: keeping patients under observation; practical studies; clinical and clinicoanatomical conferences; professor's rounds; going on duty by departments; participation in conducting and mastering the instrumental methods of investigation. The role of the audience at the lectures is an active one, that of the teacher is to direct and correct. Special attention is payed to individual work of a physician. All of the aforementioned kinds of work will, we believe, help the physician in making progress, upgrading his clinical mentality, attaining knowledge, skills, deontological principles in work. Use of test questions in cardiology approved by Ministry of Health of Ukraine as a national programme for certification of physicians together with the traditional methods of teaching will improve the quality of physician training.

  9. 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...

  10. 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...

  11. 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...

  12. 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...

  13. 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.

  14. 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

  15. Death imagery and death anxiety.

    PubMed

    McDonald, R T; Hilgendorf, W A

    1986-01-01

    This study investigated the relationship between positive/negative death imagery and death anxiety. Subjects were 179 undergraduate students at a large, private, midwestern university. Results reveal that on five measures of death anxiety the subjects with low death anxiety scores had significantly more positive death images than did those with high death anxiety scores. The few subjects who imagined death to be young (N = 14) had a significantly more positive image of death than those who perceived it to be an old person. Death was seen as male by 92% of the male respondents and 74% of the female respondents. Significant differences in death imagery and death anxiety were found between subjects enrolled in an introductory psychology course and those enrolled in a thanatology course. No sex differences in death anxiety or positive/negative death imagery were found.

  16. 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

    ... work, or construction); or (3) Certification as an industrial hygienist, professional engineer, registered architect and/or certification in a related engineering/health/environmental field (e.g., safety...) Bachelor's degree in engineering, architecture, or a related profession, and 1 year of experience...

  17. Iowa record-linkage study: death rates in psychiatric patients.

    PubMed

    Black, D W

    1998-09-01

    The Iowa record-linkage study was developed to investigate death rates in psychiatric patients, and involved computer matching of death certificates with a roster of patients. A list of all patients admitted to our hospital from 1972 through 1981 was obtained and after removing duplicate entries the list was pared to 5412 names. The record included multiple identifiers (e.g., name, gender, date-of-birth, hospital number). This information was then linked by computer with all Iowa death certificates for the same period; a total of 331 deaths were identified. Patients were assigned to a single psychiatric diagnostic category based on a computer program that reviewed each patient's clinical diagnoses and picked the one with the highest priority in a hierarchy we had created. Age and sex adjusted mortality tables were constructed, allowing us to compute expected numbers of deaths. Relative risk for premature death was greatest among women, and those under 20 years. Risk was associated with all psychiatric diagnoses and was significantly higher among patients of either gender with an organic mental disorder or schizophrenia; women with acute schizophrenia, depressive neuroses, alcoholism, drug abuse, and psychophysiological disorders; and men with neuroses. Death from natural causes, especially from heart disease, was significantly excessive among women, while death from accidents and suicides was excessive for both men and women. The overall SMR was 1.65 (P < 0.001). Most importantly, we found that the greatest excess of mortality occurred within the first 2 years following hospital discharge. Thus, we were able to demonstrate that risk of mortality in general, and of suicide specifically, differed according to age, gender, diagnosis, and portion of the follow-up. We have subsequently used this method to investigate specific risk factors associated with mortality in mood disorders, schizophrenia, and antisocial personality disorder. Findings from these studies are

  18. 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

  19. Development of a cell death-based method for the screening of nuclear factor-kappaB inhibitors.

    PubMed

    Chopra, Puneet; Bajpai, Malini; Dastidar, Sunanda G; Ray, Abhijit

    2008-06-01

    Nuclear factor kappa B (NF-kappaB) plays a significant role in immunity and inflammation and represents a first choice as pharmacological target for anti-inflammatory therapy. However, research in this field has been hampered by the fact that no convenient assay suitable for large-scale screening procedures is available. The present study provides a cell death-based assay method for screening of nuclear factor-kappaB inhibitors. In this study, we observed that four distinct pharmacologic inhibitors of NF-kappaB, pyrrolidine dithiocarbamate (PDTC), N-tosyl-L-lysyl chloromethyl ketone (TPCK), genistein and BAY11-7082, resulted in the cell death of murine macrophages, J774A.1. DNA-binding experiments showed that lethal doses were consistent with those required for NF-kappaB inhibition. DNA fragmentation analysis showed that cell death is apoptotic in nature. Further studies suggested that NF-kappaB inhibitors induced apoptosis is independent of the involvement of other markers of cell death such as caspases and p38 MAP (Mitogen activated protein) kinase. From this study, we conclude that NF-kappaB activation may represent an important survival mechanism in macrophages. This study also provides a new cell-based screening method, as any compound that will inhibit NF-kappaB activity will result in the death of macrophages.

  20. 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. PMID:21266002

  1. 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

  2. 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.

  3. 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. PMID:25636651

  4. 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.

  5. Does marital status predict the odds of suicidal death in taiwan? A seven-year population-based study.

    PubMed

    Yeh, Jui-Yuan; Xirasagar, Sudha; Liu, Tsai-Ching; Li, Chong-Yi; Lin, Herng-Ching

    2008-06-01

    Using nationwide, 7-year population-based data for 1997-2003, we examined marital status to see if it predicted suicide among the ethnic Chinese population of Taiwan. Using cause of death data, with a case-control design, two groups-total adult suicide deaths, n = 17,850, the study group, and adult deaths other than suicide, n = 71,400 (randomly selected from age, sex, and geographic region matched controls, four per suicide)-were studied. Using multiple logistic regression analysis including age-marital status interaction, adjusted estimates show divorced status to be the most detrimental for suicide propensity, with males showing stronger effect size. Females never married, aged below 35 and 65-plus, and widowed 65-plus had lower suicide odds. PMID:18611128

  6. 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

    ... professional, environmental scientist); or (4) A high school diploma (or equivalent), and at least 3 years of... receive certification in the future. (iv) The opportunity and method for requesting a hearing prior...

  7. Emergency referral transport for maternal complication: lessons from the community based maternal death audits in Unnao district, Uttar Pradesh, India

    PubMed Central

    Raj, Sunil Saksena; Manthri, Suneedh; Sahoo, Pratap Kumar

    2015-01-01

    Background: An effective emergency referral transport system is the link between the home of the pregnant woman and a health facility providing basic or comprehensive emergency obstetric care. This study attempts to explore the role of emergency transport associated with maternal deaths in Unnao district, Uttar Pradesh (UP). Methods: A descriptive study was carried out to assess the causes of and factors leading to maternal deaths in Unnao district, UP, through community based Maternal Death Review (MDR) using verbal autopsy, in a sample of 57 maternal deaths conducted between June 1, 2009, and May 31, 2010. A facility review was also conducted in 15 of the 16 block level and district health facilities to collect information on preparedness of the facilities for treating obstetric complications including referral transportation. A descriptive analysis was carried out using ratios and percentages to analyze the availability of basic facilities which may lead to maternal deaths. Results: It was found that there were only 10 ambulances available at 15 facilities against 19 required as per Indian Public Health Standards (IPHS). About 47% of the deaths took place in a facility, 30% enroute to a health facility and 23% at home. Twenty five percent of women were taken to one facility, 32% were taken to two facilities, and 25% were taken to three facilities while 19% were not taken to any facility before their death. Sixteen percent of the pregnant women could not arrange transportation to reach any facility. The mean time to make arrangements for travel from home to facility-1 and facility-2 to facility-3 was 3.1 hours; whereas from facility-1 to facility-2 was 9.9 hours. The mean travel time from home to facility-1 was 1 hour, from facility-1 to facility-2 was 1.4 hours and facility-2 to facility-3 was 1.6 hours. Conclusion: The public health facility review and MDR, clearly indicates that the inter-facility transfers appropriateness and timeliness of referral are major

  8. 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.

  9. Comparative risk of death in older adults treated with antipsychotics: A population-based cohort study.

    PubMed

    Schmedt, Niklas; Kollhorst, Bianca; Enders, Dirk; Jobski, Kathrin; Krappweis, Jutta; Garbe, Edeltraut; Schink, Tania

    2016-09-01

    Although the use of antipsychotics has been associated with an increased risk of death, data on the safety of individual substances is scarce. We thus aimed to compare the risk of death in new users of individual antipsychotics aged =>65 years and conducted a cohort study in the German Pharmacoepidemiological Research Database between 2005 and 2011. Patients were followed from initiation of treatment until death, 90 days after cohort entry, end of insurance or the end of the study period. Multivariable cox regression was used to estimate confounder adjusted hazard ratios (aHR) of death for 14 individual antipsychotics compared to risperidone. In sensitivity analyses, we also applied high-dimensional propensity score (HDPS) methods to explore possible unmeasured confounding. In a cohort of 137,713 new users of antipsychotics, a higher risk of death was found for haloperidol (aHR: 1.45; 95% confidence interval: 1.35-1.55), levomepromazine (aHR: 1.34; 1.16-1.54), zuclopenthixol (aHR: 1.32; 1.02-1.72) and to a lesser extent for melperone (aHR: 1.13; 1.07-1.19) compared to risperidone. Lower risks were observed for quetiapine, prothipendyl, olanzapine, tiapride, clozapine, perazine and flupentixol. In subgroup analyses, levomepromazine and chlorprothixene were only associated with a higher risk of death in patients aged =>80 years and with dementia. The application of HDPS methods did not substantially change the results. In conclusion, our study suggests that initiation of haloperidol, levomepromazine, zuclopenthixol and chlorprothixene treatment is associated with an increased risk of death compared to risperidone and should be avoided in older patients except in palliative care when treatment alternatives are available. PMID:27475994

  10. [Determination of the time of death based on simultaneous measurement of brain and rectal temperatures].

    PubMed

    Henssge, C; Frekers, R; Reinhardt; Beckmann, E R

    1984-01-01

    Analysis of the data on 21 corpses (brain and rectal temperatures which had been recorded simultaneously) yielded the following results and conclusions with regard to separate or combined computations of time of death: In the range of a standardized brain temperature (QH) 0.5 less than or equal to QH less than 1.0 (approx. up to 6.5 hpm), the most precise computations of time of death are achieved by exclusive application of brain temperature (standard deviation around dt = 0 "s0" = +/- 0.75; variation: 3.3 h). In the range of 0.3 less than or equal to QH less than 0.5 (approx. 6.5-10.5 hpm), combined computation of time of death balanced in the ratio of 6:4 (brain/rectum) is comparatively the most precise one (s0 = +/- 1.18; variation: 5 h). In the range of 0.07 less than or equal to QH less than 0.03 (beyond 10.5 hpm), the most precise computation of time of death (s0 = +/- 1.62; variation: 6.6 h) is achieved by exclusive application of rectal temperature. An "integrated" approach composed of both computation formulae, and thus possibly eliminating temperature in the occurrence of death, seems to be appropriate in the range of about 0.5 less than or equal to QH greater than 1.0 to avoid major errors in computing times of death, e.g., in cases involving fever in the occurrence of death (s0 = +/- 0.69; variation: 2.7 h).

  11. 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.

  12. 20 CFR 655.204 - Determinations based on temporary labor certification applications.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... the bases of the OFLC Administrator's determination in accordance with the DHS regulation at 8 CFR 214... for Logging Employment and Non-H-2A Agricultural Employment § 655.204 Determinations based...

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

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 3 2012-10-01 2012-10-01 false Internet-based TRS provider and TRS program... Services and Related Customer Premises Equipment for Persons With Disabilities § 64.606 Internet-based TRS... including notification in the Federal Register. (2) Internet-based TRS provider. Any entity desiring...

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

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 3 2013-10-01 2013-10-01 false Internet-based TRS provider and TRS program... Services and Related Customer Premises Equipment for Persons With Disabilities § 64.606 Internet-based TRS... including notification in the Federal Register. (2) Internet-based TRS provider. Any entity desiring...

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

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 3 2014-10-01 2014-10-01 false Internet-based TRS provider and TRS program... Services and Related Customer Premises Equipment for Persons With Disabilities § 64.606 Internet-based TRS... including notification in the Federal Register. (2) Internet-based TRS provider. Any entity desiring...

  16. 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.

  17. 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

  18. Certification and maintenance of certification in surgery.

    PubMed

    Rhodes, Robert S; Biester, Thomas W

    2007-08-01

    The processes that lead to certification by the American Board of Surgery (ABS) emphasize surgeons' training and qualifications. Moreover, the need for periodic recertification appears to provide strong motivation for surgeons to remain current. Such certification is regarded as having great value among patients, but concerns about quality and safety have increased pressure to assess what surgeons actually do in practice. As a result, the American Board of Medical Specialties (ABMS) member boards have recently initiated Maintenance of Certification (MOC) programs that add a requirement for assessment of practice performance to the elements of traditional certification. This article describes the current ABS certification process and the ABS MOC program in greater detail.

  19. 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

  20. 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)

  1. Postmortem CT is more accurate than clinical diagnosis for identifying the immediate cause of death in hospitalized patients: a prospective autopsy-based study.

    PubMed

    Inai, Kunihiro; Noriki, Sakon; Kinoshita, Kazuyuki; Sakai, Toyohiko; Kimura, Hirohiko; Nishijima, Akihiko; Iwasaki, Hiromichi; Naiki, Hironobu

    2016-07-01

    Despite 75 to 90 % physician accuracy in determining the underlying cause of death, precision of determination of the immediate cause of death is approximately 40 %. In contrast, two thirds of immediate causes of death in hospitalized patients are correctly diagnosed by postmortem computed tomography (CT). Postmortem CT might provide an alternative approach to verifying the immediate cause of death. To evaluate the effectiveness of postmortem CT as an alternative method to determine the immediate cause of death in hospitalized patients, an autopsy-based prospective study was performed. Of 563 deaths from September 2011 to August 2013, 50 consecutive cadavers undergoing hospital autopsies with consent for additional postmortem CT at the University of Fukui were enrolled. The accuracy of determination of the immediate cause of death by postmortem CT was evaluated in these patients. Diagnostic discrepancy was also compared between radiologists and attending physicians. The immediate cause of death was correctly diagnosed in 37 of 50 subjects using postmortem CT (74 %), concerning 29 cases of respiratory failure, 4 of hemorrhage, 3 of liver failure and 1 of septic shock. Six cases of organ failure involving 13 patients were not identified as the cause of death by postmortem CT. Regarding the immediate cause of death, accuracy of clinical diagnosis was significantly lower than that of postmortem CT (46 vs 74 %, P < 0.01). Postmortem CT may be more useful than clinical diagnosis for identifying the immediate cause of death in hospitalized patients not undergoing autopsy. PMID:27085336

  2. 20 CFR 410.679 - Finality of findings with respect to other claims for benefits based on the disability or death...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 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...

  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. 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. 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)

  6. Association of caesarean section and neonatal death: a population-based case-control study in Islamic Republic of Iran.

    PubMed

    Ghaedmohammadi, Z; Anaraki, A; Khajeian, A; Khajehian, M; Ostovar, A

    2015-06-09

    The high caesarean section rate in the Islamic Republic of Iran could be a risk for adverse neonatal outcomes. This population-based, case-control study investigated the association of caesarean section and neonatal death. A total of 146 mothers whose babies had died during 28 days after birth were compared with 549 mothers with live newborns, according to delivery route and reasons for undergoing caesarean section. The crude odds ratio (OR) for the association of caesarean section and neonatal death was 1.97 (1.35-2.87). The adjusted OR was 2.19 (1.48-3.24) controlled for mother's education, parity and age. Adjusted ORs for elective caesarean, previous caesarean and emergency caesarean were 0.65 (0.26-1.62), 2.77 (1.64-4.66) and 2.51 (1.56-4.03) respectively. The ORs for caesarean delivery and neonatal death varied by mother's education, parity and age. The association of caesarean section with neonatal death is complex and is modified by other influencing factors.

  7. Predictors of Place of Death for Those in Receipt of Home-Based Palliative Care Services in Ontario, Canada.

    PubMed

    Guerriere, Denise; Husain, Amna; Marshall, Denise; Zagorski, Brandon; Seow, Hsien; Brazil, Kevin; Kennedy, Julia; McLernon, Robin; Burns, Sheri; Coyte, Peter C

    2015-01-01

    Many cancer patients die in institutional settings despite their preference to die at home. A longitudinal, prospective cohort study was conducted to comprehensively assess the determinants of home death for patients receiving home-based palliative care. Data collected from biweekly telephone interviews with caregivers (n = 302) and program databases were entered into a multivariate logistic model. Patients with high nursing costs (odds ratio [OR]: 4.3; confidence interval [CI]: 1.8-10.2) and patients with high personal support worker costs (OR: 2.3; CI: 1.1-4.5) were more likely to die at home than those with low costs. Patients who lived alone were less likely to die at home than those who cohabitated (OR: 0.4; CI: 0.2-0.8), and those with a high propensity for a home-death preference were more likely to die at home than those with a low propensity (OR: 5.8; CI: 1.1-31.3). An understanding of the predictors of place of death may contribute to the development of effective interventions that support home death.

  8. The value of certification.

    PubMed

    Kaplow, Roberta

    2011-01-01

    Certification is defined in the nursing literature in several ways; no one consistent definition of certification exists. Nursing specialty certification programs are intended for consumer protection. Certification protects the public by enabling consumers to identify competent people more readily. However, benefits for stakeholders other than patients and families are also described in the literature. This article describes the value of specialty certification from the perspective of the patient and family, nurse, and employer.

  9. 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

  10. 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,…

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

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Obtaining Per.... VA will pay per diem to a State for providing adult day health care to eligible veterans in a... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Per diem based...

  12. 38 CFR 52.10 - Per diem based on recognition and certification.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Obtaining Per.... VA will pay per diem to a State for providing adult day health care to eligible veterans in a... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Per diem based...

  13. 38 CFR 52.10 - Per diem based on recognition and certification.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Obtaining Per.... VA will pay per diem to a State for providing adult day health care to eligible veterans in a... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Per diem based...

  14. 38 CFR 52.10 - Per diem based on recognition and certification.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Obtaining Per.... VA will pay per diem to a State for providing adult day health care to eligible veterans in a... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Per diem based...

  15. 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

  16. 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

  17. 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.

  18. Changing Patterns in Place of Cancer Death in England: A Population-Based Study

    PubMed Central

    Gao, Wei; Ho, Yuen K.; Verne, Julia; Glickman, Myer; Higginson, Irene J.

    2013-01-01

    Background Most patients with cancer prefer to die at home or in a hospice, but hospitals remain the most common place of death (PoD).This study aims to explore the changing time trends of PoD and the associated factors, which are essential for end-of-life care improvement. Methods and Findings The study analysed all cancer deaths in England collected by the Office for National Statistics during 1993–2010 (n = 2,281,223). Time trends of age- and gender-standardised proportion of deaths in individual PoDs were evaluated using weighted piecewise linear regression. Variables associated with PoD (home or hospice versus hospital) were determined using proportion ratio (PR) derived from the log-binomial regression, adjusting for clustering effects. Hospital remained the most common PoD throughout the study period (48.0%; 95% CI 47.9%–48.0%), followed by home (24.5%; 95% CI 24.4%–24.5%), and hospice (16.4%; 95% CI 16.3%–16.4%). Home and hospice deaths increased since 2005 (0.87%; 95% CI 0.74%–0.99%/year, 0.24%; 95% CI 0.17%–0.32%/year, respectively, p<0.001), while hospital deaths declined (−1.20%; 95% CI −1.41 to −0.99/year, p<0.001). Patients who died from haematological cancer (PRs 0.46–0.52), who were single, widowed, or divorced (PRs 0.75–0.88), and aged over 75 (PRs 0.81–0.84 for 75–84; 0.66–0.72 for 85+) were less likely to die in home or hospice (p<0.001; reference groups: colorectal cancer, married, age 25–54). There was little improvement in patients with lung cancer of dying in home or hospice (PRs 0.87–0.88). Marital status became the second most important factor associated with PoD, after cancer type. Patients from less deprived areas (higher quintile of the deprivation index) were more likely to die at home or in a hospice than those from more deprived areas (lower quintile of the deprivation index; PRs 1.02–1.12). The analysis is limited by a lack of data on individual patients' preferences for PoD or a clinical

  19. Single base substitution in OsCDC48 is responsible for premature senescence and death phenotype in rice

    PubMed Central

    Huang, Qi‐Na; Shi, Yong‐Feng; Zhang, Xiao‐Bo; Song, Li‐Xin; Feng, Bao‐Hua; Wang, Hui‐Mei; Xu, Xia; Li, Xiao‐Hong; Guo, Dan

    2015-01-01

    Abstract A premature senescence and death 128 (psd128) mutant was isolated from an ethyl methane sulfonate‐induced rice IR64 mutant bank. The premature senescence phenotype appeared at the six‐leaf stage and the plant died at the early heading stage. psd128 exhibited impaired chloroplast development with significantly reduced photosynthetic ability, chlorophyll and carotenoid contents, root vigor, soluble protein content and increased malonaldehyde content. Furthermore, the expression of senescence‐related genes was significantly altered in psd128. The mutant trait was controlled by a single recessive nuclear gene. Using map‐based strategy, the mutation Oryza sativa cell division cycle 48 (OsCDC48) was isolated and predicted to encode a putative AAA‐type ATPase with 809 amino‐acid residuals. A single base substitution at position C2347T in psd128 resulted in a premature stop codon. Functional complementation could rescue the mutant phenotype. In addition, RNA interference resulted in the premature senescence and death phenotype. OsCDC48 was expressed constitutively in the root, stem, leaf and panicle. Subcellular analysis indicated that OsCDC48:YFP fusion proteins were located both in the cytoplasm and nucleus. OsCDC48 was highly conserved with more than 90% identity in the protein levels among plant species. Our results indicated that the impaired function of OsCDC48 was responsible for the premature senescence and death phenotype. PMID:26040493

  20. Dealing with death and dying.

    PubMed

    McFarland, K F; Rollins, E C; Gonzalez, M F; Rhoades, D R

    1994-03-01

    We instituted two thanatology seminars for medical students and residents which emphasized feelings more than objective data. The seminars began with students filling out a death certificate on themselves. Eighty-four per cent predicted that their own probable cause of death would be from an acute illness. Discussion and reflection on this experience helped them realize how difficult it would be to deal with a chronic illness. By answering a question about what they were most grateful for, they became aware that they valued family and friends most highly. We believe that this experience legitimized feelings which form the basis of empathy.

  1. 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.

  2. End-of-life medical decisions in France: a death certificate follow-up survey 5 years after the 2005 act of parliament on patients’ rights and end of life

    PubMed Central

    2012-01-01

    Background The “Patients’ Rights and End of Life Care” Act came into force in France in 2005. It allows withholding/withdrawal of life-support treatment, and intensified use of medications that may hasten death through a double effect, as long as hastening death is not the purpose of the decision. It also specifies the requirements of the decision-making process. This study assesses the situation by examining the frequency of end-of-life decisions by patients’ and physicians’ characteristics, and describes the decision-making processes. Methods We conducted a nationwide retrospective study of a random sample of adult patients who died in December 2009. Questionnaires were mailed to the physicians who certified/attended these deaths. Cases were weighted to adjust for response rate bias. Bivariate analyses and logistic regressions were performed for each decision. Results Of all deaths, 16.9% were sudden deaths with no information about end of life, 12.2% followed a decision to do everything possible to prolong life, and 47.7% followed at least one medical decision that may certainly or probably hasten death: withholding (14.6%) or withdrawal (4.2%) of treatments, intensified use of opioids and/or benzodiazepines (28.1%), use of medications to deliberately hasten death (i.e. not legally authorized) (0.8%), at the patient’s request (0.2%) or not (0.6%). All other variables held constant, cause of death, patient's age, doctor’s age and specialty, and place of death, influenced the frequencies of decisions. When a decision was made, 20% of the persons concerned were considered to be competent. The decision was discussed with the patient if competent in 40% (everything done) to 86% (intensification of alleviation of symptoms) of cases. Legal requirements regarding decision-making for incompetent patients were frequently not complied with. Conclusions This study shows that end-of-life medical decisions are common in France. Most are in compliance with the

  3. 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.)

  4. 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

  5. 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...

  6. 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:…

  7. Work-related deaths in children.

    PubMed

    Suruda, A; Halperin, W

    1991-01-01

    An analysis of OSHA fatality investigations for 1984-1987 found 104 work-related deaths in children. The largest category (30%) involved industrial vehicles and equipment, followed by electrocution (17%) and falls (11%). Forty-three deaths (41%) occurred while engaged in types of work prohibited for children by the Fair Labor Standards Act (FLSA). Three deaths involved work with conveyors, an activity currently permitted for child workers under FLSA. OSHA issued citations for safety violations in 70% of deaths. Since OSHA investigates only some work-related deaths, the actual number of child labor fatalities during the four year period was probably higher. Using information from OSHA and from death certificate data, we estimate that there are at least 100 work-related deaths in the United States in children under 18 each year. Hazardous child labor continues to occur even in industries regulated by OSHA and FLSA.

  8. The national review of asthma deaths: what did we learn and what needs to change?

    PubMed Central

    2015-01-01

    Key points The 2014 UK National Review of Asthma Deaths identified potentially preventable factors in two-thirds of the medical records of cases scrutinised 45% of people who died from asthma did not call for or receive medical assistance in their final fatal attack Overall asthma management, acute and chronic, in primary and secondary care was judged to be good in less than one-fifth of those who died There was a failure by doctors and nurses to identify and act on risk factors for asthma attacks and asthma death The rationale for diagnosing asthma was not evident in a considerable number of cases, and there were inaccuracies related to the completion of medical certificates of the cause of death in over half of the cases considered for the UK National Review of Asthma Deaths Educational aims To increase awareness of some of the findings of the recent UK National Review of Asthma Deaths and previous similar studies To emphasise the need for accurate diagnosis of asthma, and of the requirements for completion of medical certificates of the cause of death To consider areas for improving asthma care and prevention of attacks and avoidable deaths Summary Despite the development and publication of evidence-based asthma guidelines nearly three decades ago, potentially preventable factors are repeatedly identified in studies of the care provided for patients who die from asthma. The UK National Review of Asthma Deaths (NRAD), a confidential enquiry, was no exception: major preventable factors were identified in two-thirds of asthma deaths. Most of these factors, such as inappropriate prescription and failure to provide patients with personal asthma action plans (PAAPs), could possibly have been prevented had asthma guidelines been implemented. NRAD involved in-depth scrutiny by clinicians of the asthma care for 276 people who were classified with asthma as the underlying cause of death in real-life. A striking finding was that a third of these patients did not actually

  9. Apparent disapperance of hypernatraemic dehydration from infant deaths in Sheffield.

    PubMed

    Sunderland, R; Emery, J L

    1979-09-01

    The death certificates and necropsy reports of the 1115 Sheffield infants who died under 2 years of age in 1969-78 were examined. This study showed the apparent disappearance of deaths with hypernatraemia and in particular deaths presenting as cot deaths. The fall in incidence may be as much the result of an intensive local campaign on child care and infant feeding as of the change in the composition of dried milk for baby feeding.

  10. The Certification Advantage

    ERIC Educational Resources Information Center

    Foster, John C.; Pritz, Sandra G.

    2006-01-01

    Certificates have become an important career credential and can give students an advantage when they enter the workplace. However, many types of certificates exist, and the number of people seeking them and organizations offering them are both growing rapidly. In a time of such growth, the authors review some of the basics about certification--the…

  11. Alternative Teacher Certification.

    ERIC Educational Resources Information Center

    Newman, Carol; Thomas, Kay

    This paper examines issues related to alternative teacher certification, discussing teacher certification in Texas and noting that most researchers agree that both traditional and alternative routes to teacher preparation need improvement. For over a decade, alternative certification has become increasingly available in Texas. This paper…

  12. 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.

  13. Network-based survival-associated module biomarker and its crosstalk with cell death genes in ovarian cancer

    PubMed Central

    Jin, Nana; Wu, Hao; Miao, Zhengqiang; Huang, Yan; Hu, Yongfei; Bi, Xiaoman; Wu, Deng; Qian, Kun; Wang, Liqiang; Wang, Changliang; Wang, Hongwei; Li, Kongning; Li, Xia; Wang, Dong

    2015-01-01

    Ovarian cancer remains a dismal disease with diagnosing in the late, metastatic stages, therefore, there is a growing realization of the critical need to develop effective biomarkers for understanding underlying mechanisms. Although existing evidences demonstrate the important role of the single genetic abnormality in pathogenesis, the perturbations of interactors in the complex network are often ignored. Moreover, ovarian cancer diagnosis and treatment still exist a large gap that need to be bridged. In this work, we adopted a network-based survival-associated approach to capture a 12-gene network module based on differential co-expression PPI network in the advanced-stage, high-grade ovarian serous cystadenocarcinoma. Then, regulatory genes (protein-coding genes and non-coding genes) direct interacting with the module were found to be significantly overlapped with cell death genes. More importantly, these overlapping genes tightly clustered together pointing to the module, deciphering the crosstalk between network-based survival-associated module and cell death in ovarian cancer. PMID:26099452

  14. 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)

  15. Neonatal Death

    MedlinePlus

    ... story First Candle Centering Corporation The Compassionate Friends Star Legacy Foundation Last reviewed: November, 2015 Neonatal death ... story First Candle Centering Corporation The Compassionate Friends Star Legacy Foundation Last reviewed: November, 2015 Complications & Loss ...

  16. Using linked birth and infant death files for program planning and evaluation: NIMS workshop lessons.

    PubMed

    Zahniser, C; Halpin, G; Hollinshead, W; Kessel, S; Koontz, A

    1987-01-01

    Health planners should base program decisions on the best information available. Combining information from different sources can be valuable in identifying problems--the essential first step in program planning. To facilitate this process, a workshop was conducted during the National Infant Mortality Surveillance Conference in Atlanta, GA. Maternal and child health directors explored the use of linked birth and infant death data for program planning and evaluation. Linked birth and infant death certificate files permit evaluation of infant mortality by birth weight and other infant and maternal characteristics, thus providing more detailed information than birth or death certificates alone. An assessment of the birth weight distribution of live births, birth weight specific-mortality risks, distribution of deaths by birth weight, and birth weight-specific causes of death can help identify problems in the childbearing population and with the delivery of health services. Once the infant health problems are defined clearly, the selection and delivery of services can be better targeted and evaluated for the reduction of these problems.

  17. Estimation of age at death based on quantitation of the 4977-bp deletion of human mitochondrial DNA in skeletal muscle.

    PubMed

    Meissner, C; von Wurmb, N; Schimansky, B; Oehmichen, M

    1999-11-01

    The 4977-bp deletion in human mitochondrial DNA (mtDNA) is known to accumulate in various tissues with age. Since this deletion in mtDNA correlates closest with age in muscle tissue, iliopsoas muscle tissue was taken at autopsy from 50 persons aged 24-97 years to determine whether age at death can be estimated based on the amount of the 4977-bp deletion in skeletal muscle. Total DNA (nuclear and mtDNA) was extracted from 100 mg tissue and the 4977-bp deletion quantified using a kinetic polymerase chain reaction (PCR) followed by visualization of the products on silver stained polyacrylamide gels. The amount of the 4977-bp deletion of mtDNA ranged from 0.00049% to 0.14% depending on age, with a correlation coefficient of r = 0.83 (P = 0.0001). In forensic practice this method can aid in the estimation of age at death with a relatively wide confidence interval, thus enabling a discrimination between young and elderly persons in the identification of human remains based solely on skeletal muscle.

  18. The value of specialty nursing certification.

    PubMed

    Niebuhr, Bonnie; Biel, Melissa

    2007-01-01

    The American Board of Nursing Specialties (ABNS) undertook a national study to validate nurses' perceptions, values, and behaviors related to certification. A Web-based survey was developed and disseminated to certified nurses, noncertified nurses, and nurse managers. Of the 11,427 respondents, 8,615 (75%) identified themselves as certified nurses, and 2,812 (25%) were noncertified nurses. Of these, 1,608 respondents (14%) held the position of Nurse Manager. Using the Perceived Value of Certification Tool (PVCT), certified and noncertified nurses showed a high level of agreement with the value statements on certified practice. Nurse Managers bolstered these perceptions with their correspondingly high rate of agreement on the certification value statements. Additionally, the study examined barriers and challenges to certification, incentives to certification, the impact of certification on lost workdays and nurse retention. This study took an important step in furthering understanding of nursing certification and the implications for health care organizations, nursing certification boards, and certified and noncertified nurses.

  19. 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.

  20. The changing demographics of inpatient hospice death: Population-based cross-sectional study in England, 1993–2012

    PubMed Central

    Sleeman, Katherine E; Davies, Joanna M; Verne, Julia; Gao, Wei; Higginson, Irene J

    2016-01-01

    Background: Studies in the United Kingdom and elsewhere have suggested inequality of hospice provision with respect to factors such as age, diagnosis and socio-economic position. How this has changed over time is unknown. Aim: To describe the factors associated with inpatient hospice death in England and examine how these have changed over time. Design: Population-based study. Multivariable Poisson regression compared 1998–2002, 2003–2007 and 2008–2012, with 1993–1997. Explanatory variables included individual factors (age, gender, marital status, underlying cause of death) and area-based measures of deprivation. Setting: Adults aged 25 years and over who died in inpatient hospice units in England between 1993 and 2002 (n = 446,615). Results: The annual number of hospice deaths increased from 17,440 in 1993 to 26,032 in 2012, accounting for 3.4% of all deaths in 1993 and 6.0% in 2012. A total of 50.6% of hospice decedents were men; the mean age was 69.9 (standard deviation: 12.4) years. The likelihood of hospice decedents being in the oldest age group (>85 years) increased over time (proportion ratio: 1.43, 95% confidence interval: 1.39 to 1.48 for 2008–2012 compared to 1993–1997). Just 5.2% of all hospice decedents had non-cancer diagnoses, though the likelihood of non-cancer conditions increased over time (proportion ratio: 1.41, 95% confidence interval: 1.37 to 1.46 for 2008–2012 compared to 1993–1997). The likelihood of hospice decedents being resident in the least deprived quintile increased over time (proportion ratio: 1.25, 95% confidence interval: 1.22 to 1.29 for 2008–2012 compared to 1993–1997). Conclusion: The increase in non-cancer conditions among hospice decedents is encouraging although absolute numbers remain very small. Deprivation trends are concerning and require further exploration. PMID:25991729

  1. 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…

  2. 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

  3. Aerosol delivery of programmed cell death protein 4 using polysorbitol-based gene delivery system for lung cancer therapy.

    PubMed

    Kim, You-Kyoung; Xing, Lei; Chen, Bao-An; Xu, Fengguo; Jiang, Hu-Lin; Zhang, Can

    2014-11-01

    The development of a safe and effective gene delivery system is the most challenging obstacle to the broad application of gene therapy in the clinic. In this study, we report the development of a polysorbitol-based gene delivery system as an alternative gene carrier for lung cancer therapy. The copolymer was prepared by a Michael addition reaction between sorbitol diacrylate (SD) and spermine (SPE); the SD-SPE copolymer effectively condenses with DNA on the nanoscale and protects it from nucleases. SD-SPE/DNA complexes showed excellent transfection with low toxicity both in vitro and in vivo, and aerosol delivery of SD-SPE complexes with programmed cell death protein 4 DNA significantly suppressed lung tumorigenesis in K-ras(LA1) lung cancer model mice. These results demonstrate that SD-SPE has great potential as a gene delivery system based on its excellent biocompatibility and high gene delivery efficiency for lung cancer gene therapy. PMID:24983766

  4. 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.

  5. 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

  6. 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

  7. Winning the Race with Death.

    ERIC Educational Resources Information Center

    Goodman, Lisl M.

    The hypothesis of a negative relationship between level of self-actualization and fear of death was based on the assumption that people are not afraid of death per se but of the incompleteness of their lives. Fear of death was furthermore assumed to inhibit orientation toward the future, thereby restricting movement toward achievement and…

  8. Changing Breton Responses to Death.

    ERIC Educational Resources Information Center

    Badone, Ellen

    1988-01-01

    Based on fieldwork conducted in Brittany, France, during 1983 and 1984, discusses changes in Breton responses to death which have accompanied modernization and economic development. Suggests that familiarity with death and acceptance of it are being replaced by the "denial of death" characteristic of contemporary Western culture. Notes parallel…

  9. 5 CFR 1330.404 - Certification criteria.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... PERSONNEL MANAGEMENT HUMAN RESOURCES MANAGEMENT Performance Appraisal Certification for Pay Purposes § 1330... executives or senior professionals must make meaningful distinctions based on relative performance and meet... the performance expectations for individual senior employees derive from, and clearly link to,...

  10. 5 CFR 1330.404 - Certification criteria.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... PERSONNEL MANAGEMENT HUMAN RESOURCES MANAGEMENT Performance Appraisal Certification for Pay Purposes § 1330... executives or senior professionals must make meaningful distinctions based on relative performance and meet... the performance expectations for individual senior employees derive from, and clearly link to,...

  11. 5 CFR 1330.404 - Certification criteria.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... PERSONNEL MANAGEMENT HUMAN RESOURCES MANAGEMENT Performance Appraisal Certification for Pay Purposes § 1330... executives or senior professionals must make meaningful distinctions based on relative performance and meet... the performance expectations for individual senior employees derive from, and clearly link to,...

  12. Contribution of deaths related to alcohol use of socioeconomic variation in mortality: register based follow up study.

    PubMed Central

    Mäkelä, P.; Valkonen, T.; Martelin, T.

    1997-01-01

    OBJECTIVE: To estimate the contribution of excessive alcohol use to socioeconomic variation in mortality among men and women in Finland. DESIGN: Register based follow up study. SUBJECTS: The population covered by the 1985 and 1990 censuses, aged > or = 20 in the follow up period 1987-93. MAIN OUTCOME MEASURES: Total mortality and alcohol related mortality from all causes, from diseases, and from accidents and violence according to socioeconomic position. The excess mortality among other classes compared with upper non-manual employees and differences in life expectancy between the classes were used to measure mortality differentials. RESULTS: Alcohol related mortality constituted 11% of all mortality among men aged > or = 20 and 2% among women and was higher among manual workers than among other classes. It accounted for 14% of the excess all cause mortality among manual workers over upper non-manual employees among men and 4% among women and for 24% and 9% of the differences in life expectancy, respectively. Half of the excess mortality from accidents and violence among male manual workers and 38% among female manual workers was accounted for by alcohol related deaths, whereas in diseases the role of alcohol was modest. The contribution of alcohol related deaths to relative mortality differentials weakened with age. CONCLUSIONS: Class differentials in alcohol related mortality are an important factor in the socioeconomic mortality differentials in Finland, especially among men, among younger age groups, and in mortality from accidents and violence. PMID:9253268

  13. CDC's National Violent Death Reporting System: background and methodology

    PubMed Central

    Paulozzi, L; Mercy, J; Frazier, L; Annest, J

    2004-01-01

    Objectives: This paper describes a new surveillance system called the National Violent Death Reporting System (NVDRS), initiated by the United States Centers for Disease Control and Prevention. NVDRS's mission is the collection of detailed, timely information on all violent deaths. Design: NVDRS is a population based, active surveillance system designed to obtain a complete census of all resident and occurrent violent deaths. Each state collects information on its own deaths from death certificates, medical examiner/coroner files, law enforcement records, and crime laboratories. Deaths occurring in the same incident are linked. Over 270 data elements can be collected on each incident. Setting: The 13 state health departments of Alaska, Colorado, Georgia, Maryland, Massachusetts, New Jersey, North Carolina, Oklahoma, Oregon, Rhode Island, South Carolina, Virginia, and Wisconsin. Subjects: Cases consist of violent deaths from suicide, homicide, undetermined intent, legal intervention, and unintentional firearm injury. Information is collected on suspects as well as victims. Interventions: None. Outcome measures: The quality of surveillance will be measured in terms of its acceptability, accuracy, sensitivity, timeliness, utility, and cost. Results: The system has just been started. There are no results as yet. Conclusions: NVDRS has achieved enough support to begin data collection efforts in selected states. This system will need to overcome the significant barriers to such a large data collection effort. Its success depends on the use of its data to inform and assess violence prevention efforts. If successful, it will open a new chapter in the use of empirical information to guide public policy around violence in the United States. PMID:14760027

  14. Avoiding a fate worse than death: an argument for legalising voluntary physician-based euthanasia.

    PubMed

    Werren, Julia; Yuksel, Necef; Smith, Saxon

    2012-09-01

    The legalisation of voluntary physician-based euthanasia is currently the subject of much political, social and ethical debate and there is evidence in Australia of growing support for its implementation. In addressing many of the issues that surround legalisation, the article looks at some overseas jurisdictions that have legalised euthanasia to determine whether the social, political and ethical concerns prominent in the Australian debate have proved problematic in other jurisdictions. In addition, the article examines the report on the Dying with Dignity Bill 2009 (Tas) which commented extensively on the issues relating to voluntary physician-based euthanasia.

  15. Avoiding a fate worse than death: an argument for legalising voluntary physician-based euthanasia.

    PubMed

    Werren, Julia; Yuksel, Necef; Smith, Saxon

    2012-09-01

    The legalisation of voluntary physician-based euthanasia is currently the subject of much political, social and ethical debate and there is evidence in Australia of growing support for its implementation. In addressing many of the issues that surround legalisation, the article looks at some overseas jurisdictions that have legalised euthanasia to determine whether the social, political and ethical concerns prominent in the Australian debate have proved problematic in other jurisdictions. In addition, the article examines the report on the Dying with Dignity Bill 2009 (Tas) which commented extensively on the issues relating to voluntary physician-based euthanasia. PMID:23156656

  16. 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.

  17. RSES heat pump technician certification

    SciTech Connect

    Zeiner, J.

    1996-06-01

    In 1987 the National Heat Pump certification test was developed by the Refrigeration Service Engineers Society (RSES), and in 1994, the program was more specifically named Heat Pump Service Technician Certification. This report describes the benefits of certification.

  18. 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.

  19. 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.

  20. Epidemiologic characteristics of death by poisoning in 1991-2001 in Korea.

    PubMed

    Shin, Sang Do; Suh, Gil Joon; Rhee, Joong Eui; Sung, Joohon; Kim, Jaiyong

    2004-04-01

    The purpose of this study was to investigate the epidemiologic characteristics of the death by poisoning in Korea. We recoded the Death Certificates Database by injury based on the short version of the International Classification of External Causes of Injuries (ICECI). We evaluated the mortality rate by total injury and poisoning, and analyzed the mortality rate by age, gender, year and month, toxic agent, and intent. Adjusted odds ratios were calculated to evaluate the effects of socioeconomic factors on suicidal poisoning death. The total number of death cases by injury was 346,656. The proportion of death cases by injury decreased from 13.53% of all death cases in 1991 to 11.89% in 2001. However, the mortality rate by poisoning increased rapidly from 1998, and then remained stable. The number of suicidal poisoning deaths has gradually increased, and its mortality rate was 6.41 (per 100,000) in 2001. Major toxic agents were pesticides and herbicides (50.90%) in 2001. Adjusted odds ratios of suicidal poisoning versus other poisonings showed significant differences in education attainment, region, and marital status. In conclusion, the mortality rate by poisoning has increased, and the proportion of suicidal poisoning also has increased compared to that of accidental poisoning.

  1. 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.

  2. Establishing cause of maternal death in Malawi via facility-based review and application of the ICD-MM classification.

    PubMed

    Owolabi, H; Ameh, C A; Bar-Zeev, S; Adaji, S; Kachale, F; van den Broek, N

    2014-09-01

    Maternal death review (MDR) is an accepted process that is implemented across Malawi and 'underlying cause of death' is assigned by healthcare providers using a standard MDR form. Mixed-methods approach. Key informant interviews with eight stakeholders involved in MDR. Secondary analysis of MDR forms for 54 maternal deaths. Comparison of assigned cause of death by healthcare providers conducting MDR at health facility level with cause assigned by researchers using the International Classification of Diseases Maternal Mortality (ICD-MM) classification. MDR teams, analysts and policymakers reported facing challenges in completing the forms, analysing and using information. The concepts of underlying (primary) and contributing (secondary) causes of death are often misunderstood. Healthcare providers using only MDR forms reported cause of death as non-obstetric complications in 39.6% and pregnancy-related infection in 11.3% of cases. For 30.2% of cases, no clear clinical cause of death was recorded. The most commonly assigned underlying cause of death using ICD-MM was obstetric haemorrhage (32.1%), non-obstetric complications (24.5%) and pregnancy-related infection (22.6%). There was poor agreement between cause(s) of maternal death assigned by healthcare providers in the field and trained researchers using the new ICD-MM classification (κ statistic; 0.219). The majority of cases could be reclassified using the ICD-MM and this provided a more specific cause of death. A more structured and user-friendly MDR form is required. Accurate classification of cause of death is important. Dissemination of, and training in the use of the new ICD-MM classification system will be helpful to healthcare providers conducting MDR in Malawi.

  3. Certification for Information Brokers.

    ERIC Educational Resources Information Center

    Sawyer, Deborah C.

    1995-01-01

    The future of the information broker business depends on certification. Some obstacles are lack of commonality, control, a professional title, and time. Core competencies (ethics, professional conduct, and client care) and specialties could determine certification criteria, and a grace period for phasing in established brokers could be initiated.…

  4. 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.

  5. Ending preventable child deaths in South Africa: What role can ward-based outreach teams play?

    PubMed

    Doherty, Tanya; Kroon, Max; Rhoda, Natasha; Sanders, David

    2016-07-01

    South Africa (SA) has emerged from the Millennium Development Goal era with a mixture of success and failure. The successful national scale-up of prevention of mother-to-child transmission of HIV services with increasingly efficacious antiretroviral regimens has reduced the mother-to-child transmission rate dramatically; however, over the same period there appears to have been no progress in coverage of high-impact interventions for pneumonia and diarrhoea, which are now leading causes of under-5 mortality. SA embarked on a strategy to re-engineer the primary healthcare system in 2011, which included the creation of ward-based outreach teams consisting of community health workers (CHWs). In this article we argue that the proposed ratio of CHWs to population is too low for public health impact and that the role and scope of CHWs should be extended beyond giving of health information to include assessment and treatment of childhood illnesses (particularly diarrhoea and suspected pneumonia). Evidence and experience amply demonstrate that CHWs in sufficient density can have a rapid and positive impact on neonatal and young child mortality, especially when they are allowed to treat common acute conditions. SA's mediocre performance in child survival could be dramatically improved if there were more CHWs who were allowed to do more.

  6. 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.

  7. Presence of base excision repair enzymes in the wheat aleurone and their activation in cells undergoing programmed cell death.

    PubMed

    Bissenbaev, Amangeldy K; Ishchenko, Alexander A; Taipakova, Sabira M; Saparbaev, Murat K

    2011-10-01

    Cereal aleurone cells are specialized endosperm cells that produce enzymes to hydrolyze the starchy endosperm during germination. Aleurone cells can undergo programmed cell death (PCD) when incubated in the presence of gibberellic acid (GA) in contrast to abscisic acid (ABA) which inhibits the process. The progression of PCD in aleurone layer cells of wheat grain is accompanied by an increase in deoxyribonuclease (DNase) activities and the internucleosomal degradation of nuclear DNA. Reactive oxygen species (ROS) are increased during PCD in the aleurone cells owing to the β-oxidation of triglycerides and inhibition of the antioxidant enzymes possibly leading to extensive oxidative damage to DNA. ROS generate mainly non-bulky DNA base lesions which are removed in the base excision repair (BER) pathway, initiated by the DNA glycosylases. At present, very little is known about oxidative DNA damage repair in cereals. Here, we study DNA repair in the cell-free extracts of wheat aleurone layer incubated or not with phytohormones. We show, for the first time, the presence of 8-oxoguanine-DNA and ethenoadenine-DNA glycosylase activities in wheat aleurone cells. Interestingly, the DNA glycosylase and AP endonuclease activities are strongly induced in the presence of GA. Based on these data we propose that GA in addition to activation of nuclear DNases also induces the DNA repair activities which remove oxidized DNA bases in the BER pathway. Potential roles of the wheat DNA glycosylases in GA-induced oligonucleosomal fragmentation of DNA and metabolic activation of aleurone layer cells via repair of transcribed regions are discussed.

  8. Infanticide: is its incidence among postneonatal infant deaths increasing?: an 18-year population-based analysis in California.

    PubMed

    Krous, Henry F; Nadeau, Julie M; Silva, Patricia D; Byard, Roger W

    2002-06-01

    The decline in the incidence of sudden infant death syndrome (SIDS) and recent recommendations regarding the differentiation of SIDS and child abuse has generated speculation that some cases of infanticide were misdiagnosed as SIDS. The aims of this study were to determine the change in incidences and proportions of postneonatal deaths from all causes, SIDS, and infanticide in California over an 18-year interval encompassing years before and after the Back to Sleep campaign. Selected postneonatal mortality data from 1981 through 1998 obtained from the California Department of Health Services were analyzed and graphically displayed. The total postneonatal mortality and incidence of SIDS deaths per 100,000 live births decreased 45% and 66%, respectively, during the study interval; the incidence of infanticide remained low. The ratio of infanticide to SIDS increased from 4.3 per 100 in 1981 to 10.2 per 100 in 1998. Infanticide deaths, as a percentage of the total number of postneonatal deaths, increased slightly from the first to the second half of the study interval but never rose above 3.2%. It is concluded that this increased percentage is due to a decrease in SIDS deaths and not to an actual increase in infanticide deaths.

  9. [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.

  10. 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.

  11. Value, Challenges, and Satisfaction of Certification for Multiple Sclerosis Specialists

    PubMed Central

    Halper, June

    2014-01-01

    Background: Specialist certification among interdisciplinary multiple sclerosis (MS) team members provides formal recognition of a specialized body of knowledge felt to be necessary to provide optimal care to individuals and families living with MS. Multiple sclerosis specialist certification (MS Certified Specialist, or MSCS) first became available in 2004 for MS interdisciplinary team members, but prior to the present study had not been evaluated for its perceived value, challenges, and satisfaction. Methods: A sample consisting of 67 currently certified MS specialists and 20 lapsed-certification MS specialists completed the following instruments: Perceived Value of Certification Tool (PVCT), Perceived Challenges and Barriers to Certification Scale (PCBCS), Overall Satisfaction with Certification Scale, and a demographic data form. Results: Satisfactory reliability was shown for the total scale and four factored subscales of the PVCT and for two of the three factored PCBCS subscales. Currently certified MS specialists perceived significantly greater value and satisfaction than lapsed-certification MS specialists in terms of employer and peer recognition, validation of MS knowledge, and empowering MS patients. Lapsed-certification MS specialists reported increased confidence and caring for MS patients using evidence-based practice. Both currently certified and lapsed-certification groups reported dissatisfaction with MSCS recognition and pay/salary rewards. Conclusions: The results of this study can be used in efforts to encourage initial certification and recertification of interdisciplinary MS team members. PMID:25061432

  12. Demographic implications of the New United States certificates.

    PubMed

    Lunde, A S; Grove, R D

    1966-06-01

    To assist in developing uniform reporting of vital events among the fifty states, Puerto Rico, and the Virgin Islands, the United States government prepares standard certificates of birth, fetal death, death, marriage, and divorce. These model forms are revised, with the assistance of the states, approximately every ten years. Revisions are now being prepared by the National Center for Health Statistics which will become effective beginning January 1, 1968. Important new source material for demography will be introduced.Most changes will appear in the Standard Certificate of Live Birth and in the Standard Certificate of Fetal Death. An item on education of father and mother will provide detailed national data on education and fertility. The date of the last live birth to the mother and the date of the last fetal death will provide information on previous pregnancy outcome and on child-spacing. The recording of state file numbers for mates born alive and dead in the same delivery will make it easier to match live birth and fetal death certificates for the preparation of detailed tabulations on multiple births. Several new items related to maternal and child health have also been added. No significent changes were planned for the Standard Certificate of Death.The Standard Certificate of Marriage will include as new items the education of the bride and groom, the date on which the last marriage, if any, ended, and specification of the officiant as a religious or civil official. The Standard Certificate of Divorce or Annulment will obtain information on the education of husband and wife, the approximate date on which the couple separated, the mode of dissolution of the previous marriage, and the total number of living children. It is anticipated that most of the new items will be included in the certificates of all the states. The National Center for Health Statistics will provide detailed tabulations related to these items, beginning with data year 1968.Demographers

  13. 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…

  14. 13 CFR 120.610 - Form and terms of Certificates.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Secondary Market Certificates § 120.610 Form and terms of Certificates. (a) General form and content. Each... based upon an analysis of market conditions and program experience, and will publish any such change in... payments are based on the unpaid principal balance of the portion of the Pool represented by a...

  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. The Debate in Cuba's Scientific Community on Sudden Cardiac Death.

    PubMed

    Vilches, Ernesto; Ochoa, Luis A; Ramos, Lianne

    2015-10-01

    Sudden cardiac death poses a challenge to modern medicine because of its high incidence, the unexpected and dramatic nature of the event, and years of potential life lost. What's more, despite modest decreases in global mortality attributed to cardiovascular diseases, incidence of sudden cardiac death has not declined. Cuba, like most of the Americas, suffers from knowledge gaps that hamper adequate strategies to address sudden cardiac death as a population health problem. We suggest that a generally accepted operational definition of sudden cardiac death be agreed upon, and a national registry developed that recognizes this cause of death on death certificates. These two actions will enable Cuba's public health authorities to assess the extent of the problem and to design intervention strategies for the population with intermediate and lower cardiovascular risk, the group in which most cases occur. KEYWORDS Sudden cardiac death, cardiovascular disease, sudden death, sudden cardiac arrest, risk reduction, prevention and control, Cuba.

  17. 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.

  18. Institutional Review Boards’ Use and Understanding of Certificates of Confidentiality

    PubMed Central

    Beskow, Laura M.; Check, Devon K.; Namey, Emily E.; Dame, Lauren A.; Lin, Li; Cooper, Alexandra; Weinfurt, Kevin P.; Wolf, Leslie E.

    2012-01-01

    Certificates of Confidentiality, issued by agencies of the U.S. government, are regarded as an important tool for meeting ethical and legal obligations to safeguard research participants’ privacy and confidentiality. By shielding against forced disclosure of identifying data, Certificates are intended to facilitate research on sensitive topics critical to the public’s health. Although Certificates are potentially applicable to an extensive array of research, their full legal effect is unclear, and little is known about stakeholders’ views of the protections they provide. To begin addressing this challenge, we conducted a national survey of institutional review board (IRB) chairs, followed by telephone interviews with selected chairs, to learn more about their familiarity with and opinions about Certificates; their institutions’ use of Certificates; policies and practices concerning when Certificates are required or recommended; and the role Certificates play in assessments of research risk. Overall, our results suggest uncertainty about Certificates among IRB chairs. On most objective knowledge questions, most respondents chose the incorrect answer or ‘unsure’. Among chairs who reported more familiarity with Certificates, composite opinion scores calculated based on five survey questions were evenly distributed among positive, neutral/middle, and negative views. Further, respondents expressed a variety of ideas about the appropriate use of Certificates, what they are intended to protect, and their effect on research risk. Nevertheless, chairs who participated in our study commonly viewed Certificates as a potentially valuable tool, frequently describing them as an ‘extra layer’ of protection. These findings lead to several practical observations concerning the need for more stakeholder education about Certificates, consideration of Certificates for a broader range of studies, the importance of remaining vigilant and using all tools available to

  19. [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.

  20. 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)

  1. 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)

  2. 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)

  3. 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.

  4. Certification Exams. Let's Proceed.

    ERIC Educational Resources Information Center

    McKinney, William R.; Pope, Michael S.

    1986-01-01

    The authors discuss why certification examinations for park, recreation, and leisure professionals are needed and highlight specific concerns now being addressed by the Test Development Management Committee of the National Recreation and Park Association. (MT)

  5. 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.

  6. 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

  7. [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.

  8. [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. PMID:24294729

  9. 24 CFR 200.944 - Supplementary specific requirements under the HUD building product standards and certification...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... under the HUD building product standards and certification program for plywood and other performance... product standards and certification program for plywood and other performance rated wood-based structural... building product certification program. In the case of plywood and wood-based structural-use...

  10. 24 CFR 200.944 - Supplementary specific requirements under the HUD building product standards and certification...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... under the HUD building product standards and certification program for plywood and other performance... product standards and certification program for plywood and other performance rated wood-based structural... building product certification program. In the case of plywood and wood-based structural-use...

  11. EDR2 negatively regulates salicylic acid-based defenses and cell death during powdery mildew infections of Arabidopsis thaliana

    PubMed Central

    Vorwerk, Sonja; Schiff, Celine; Santamaria, Marjorie; Koh, Serry; Nishimura, Marc; Vogel, John; Somerville, Chris; Somerville, Shauna

    2007-01-01

    Background The hypersensitive necrosis response (HR) of resistant plants to avirulent pathogens is a form of programmed cell death in which the plant sacrifices a few cells under attack, restricting pathogen growth into adjacent healthy tissues. In spite of the importance of this defense response, relatively little is known about the plant components that execute the cell death program or about its regulation in response to pathogen attack. Results We isolated the edr2-6 mutant, an allele of the previously described edr2 mutants. We found that edr2-6 exhibited an exaggerated chlorosis and necrosis response to attack by three pathogens, two powdery mildew and one downy mildew species, but not in response to abiotic stresses or attack by the bacterial leaf speck pathogen. The chlorosis and necrosis did not spread beyond inoculated sites suggesting that EDR2 limits the initiation of cell death rather than its spread. The pathogen-induced chlorosis and necrosis of edr2-6 was correlated with a stimulation of the salicylic acid defense pathway and was suppressed in mutants deficient in salicylic acid signaling. EDR2 encodes a novel protein with a pleckstrin homology and a StAR transfer (START) domain as well as a plant-specific domain of unknown function, DUF1336. The pleckstrin homology domain binds to phosphatidylinositol-4-phosphate in vitro and an EDR2:HA:GFP protein localizes to endoplasmic reticulum, plasma membrane and endosomes. Conclusion EDR2 acts as a negative regulator of cell death, specifically the cell death elicited by pathogen attack and mediated by the salicylic acid defense pathway. Phosphatidylinositol-4-phosphate may have a role in limiting cell death via its effect on EDR2. This role in cell death may be indirect, by helping to target EDR2 to the appropriate membrane, or it may play a more direct role. PMID:17612410

  12. 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.

  13. [Sudden infant death syndrome].

    PubMed

    Espinosa Morett, A; Shkurovich, M; Carlos Ugartechea, J; Mallet Arelano, A; Salmón Rodríguez, L E

    1976-01-01

    This report is based on a review of the present situation of the sudden infant death syndrome through the presentation of four cases studied at the Unidad de Pediatría, Hospital General de México, S.S.A. All cases were in apparent good health before death. All babies were less than ten months of age. In three cases, necropsy was not performed, and the other one did not show significant abnormalities at the post-mortem examination. A complete review of the literature was made including: historical, epidemiological, genetic, clinical and pathological aspects. Special emphasis is made on the pathophysiology of the syndrome during MOR phase of sleep and muscular hypertrophy of the lungs arteriolae suggesting chronic hypoxia which are the most relevant theories in the sudden infant death syndrome. Psychological aspects and the family management by the physician and detection of possible future victims of the syndrome are finally discussed. PMID:973858

  14. Habitual Sleep Duration and Insomnia and the Risk of Cardiovascular Events and All-cause Death: Report from a Community-Based Cohort

    PubMed Central

    Chien, Kuo-Liong; Chen, Pei-Chung; Hsu, Hsiu-Ching; Su, Ta-Chen; Sung, Fung-Chang; Chen, Ming-Fong; Lee, Yuan-Teh

    2010-01-01

    Study Objectives: To investigate the relationship between sleep duration and insomnia severity and the risk of all-cause death and cardiovascular disease (CVD) events Design: Prospective cohort study Setting: Community-based Participants: A total of 3,430 adults aged 35 years or older Intervention: None Measurements and Results: During a median 15.9 year (interquartile range, 13.1 to 16.9) follow-up period, 420 cases developed cardiovascular disease and 901 cases died. A U-shape association between sleep duration and all-cause death was found: the age and gender-adjusted relative risks (95% confidence interval [CI]) of all-cause death (with 7 h of daily sleep being considered for the reference group) for individuals reporting ≤ 5 h, 6 h, 8 h, and ≥ 9 h were 1.15 (0.91–1.45), 1.02 (0.85–1.25), 1.05 (0.88–1.27), and 1.43 (1.16–1.75); P for trend, 0.019. However, the relationship between sleep duration and risk of CVD were linear. The multivariate-adjusted relative risk (95% CI) for all-cause death (using individuals without insomnia) were 1.02 (0.86–1.20) for occasional insomnia, 1.15 (0.92–1.42) for frequent insomnia, and 1.70 (1.16–2.49) for nearly everyday insomnia (P for trend, 0.028). The multivariate adjusted relative risk (95% CI) was 2.53 (1.71–3.76) for all-cause death and 2.07 (1.11–3.85) for CVD rate in participants sleeping ≥9 h and for those with frequent insomnia. Conclusions: Sleep duration and insomnia severity were associated with all-cause death and CVD events among ethnic Chinese in Taiwan. Our data indicate that an optimal sleep duration (7–8 h) predicted fewer deaths. Citation: Chien K; Chen P; Hsu H; Su T; Sung F; Chen M; Lee Y. Habitual sleep duration and insomnia and the risk of cardiovascular events and all-cause death: report from a community-based cohort. SLEEP 2010;33(2):177–184. PMID:20175401

  15. 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…

  16. [Physicians and the death penalty. Physicians' participation in the death penalty and executions].

    PubMed

    Mertz, J

    1989-06-20

    Doctorss' participation in the death penalty and in executions is described from the literature on the subject. Expert testimonies from psychiatrists during death penalty trials, concerning the mental condition and the possibility of future violent behaviour of the person charged, are of decisive importance for whether the death penalty is imposed or not. By treating prisoners on death row for mental illness the doctor can precipitate the execution. Psychiatrists make fit-for-execution certificates stating whether the condemned is healthy enough to be executed. The doctor monitors the execution and gives advice to the executioner; at an intravenous execution the doctor and medical technique are further involved. It is concluded that doctors should not participate in the death penalty and executions, and that they should discuss ways of achieving such a situation.

  17. 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.

  18. 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).

  19. 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.

  20. Uniformity in brain death criteria.

    PubMed

    Shemie, Sam D; Baker, Andrew

    2015-04-01

    Despite well-described international variabilities in brain death practices, de facto there already exists a minimum international clinical standard for the diagnosis of brain death. This remains rooted in the Harvard criteria and based on the characteristics of a permanently nonfunctioning brain. Medicine is evolving toward a single unified determination of death based on the cessation of brain function subsequent to catastrophic brain injury or circulatory arrest. Clarity in lexicon could be established, including movement toward functional definitions and away from anatomically based terms such as cardiac and brain death that erroneously imply death of the organ. The cessation of clinical functions of the brain that will not resume is determined by the absence of capacity for consciousness, centrally mediated motor responses, brainstem reflexes, and capacity to breathe. A known proximate cause and the absence of confounding or reversible conditions must be confirmed. Regional medical, legal, cultural, religious, or socioeconomic factors may require testing beyond this minimal clinical standard. PMID:25839725

  1. 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

  2. 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.

  3. Computer Certification Updates for Technical Educators.

    ERIC Educational Resources Information Center

    Evans, Candy Duncan; Henry, Janice Schoen

    2000-01-01

    Discusses the importance of providing students with information about certification. Included advantages of certification for employers, employees, and others and discusses certifications sponsored by professional associations. Includes certification resources such as websites, books, and organizations. (JOW)

  4. 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...

  5. 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...

  6. 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...

  7. 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...

  8. 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...

  9. 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.

  10. The Assessment of Alternative Certification Practices. Panel Presentations.

    ERIC Educational Resources Information Center

    Allegro, Annalisa

    This panel discussion focuses on alternative teacher certification. Alternative certification is a way of becoming a bilingual education or English-as-a-Second-Language (ESL) teacher without completing a preservice college program. It has three areas: formal instruction, school-based supervision, and evaluation. It serves the purpose of more…

  11. 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…

  12. Problem Solving Abilities and Perceptions in Alternative Certification Mathematics Teachers

    ERIC Educational Resources Information Center

    Evans, Brian R.

    2012-01-01

    It is important for teacher educators to understand new alternative certification middle and high school teachers' mathematical problem solving abilities and perceptions. Teachers in an alternative certification program in New York were enrolled in a proof-based algebra course. At the beginning and end of a semester participants were given a…

  13. 40 CFR 270.280 - What are the certification requirements?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... compliance with 40 CFR part 267. (a) Your certification must read: I certify under penalty of law that: (1) I... of my facility's compliance status with 40 CFR part 267, which supports this certification. Based on... existing facility complies with all applicable requirements of 40 CFR part 267 and will continue to...

  14. 40 CFR 270.280 - What are the certification requirements?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... compliance with 40 CFR part 267. (a) Your certification must read: I certify under penalty of law that: (1) I... of my facility's compliance status with 40 CFR part 267, which supports this certification. Based on... existing facility complies with all applicable requirements of 40 CFR part 267 and will continue to...

  15. 40 CFR 270.280 - What are the certification requirements?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... compliance with 40 CFR part 267. (a) Your certification must read: I certify under penalty of law that: (1) I... of my facility's compliance status with 40 CFR part 267, which supports this certification. Based on... existing facility complies with all applicable requirements of 40 CFR part 267 and will continue to...

  16. 40 CFR 270.280 - What are the certification requirements?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... compliance with 40 CFR part 267. (a) Your certification must read: I certify under penalty of law that: (1) I... of my facility's compliance status with 40 CFR part 267, which supports this certification. Based on... existing facility complies with all applicable requirements of 40 CFR part 267 and will continue to...

  17. 40 CFR 270.280 - What are the certification requirements?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... compliance with 40 CFR part 267. (a) Your certification must read: I certify under penalty of law that: (1) I... of my facility's compliance status with 40 CFR part 267, which supports this certification. Based on... existing facility complies with all applicable requirements of 40 CFR part 267 and will continue to...

  18. 30 CFR 35.9 - Certificates of approval.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 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...

  19. 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…

  20. A Parallel Universe: Certification in the Information Technology Guild.

    ERIC Educational Resources Information Center

    Adelman, Clifford

    2000-01-01

    Discusses the growing importance of transnational, competency-based training in information technology and considers implications for traditional institutions of higher education. Considers the awarding of certificates rather than degrees; the types of providers offering training; the role of testing companies in the certification process; and the…

  1. 33 CFR 81.9 - Certificate of Alternative Compliance: Contents.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Compliance: Contents. 81.9 Section 81.9 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND... Certificate of Alternative Compliance: Contents. The Chief of the Marine Safety Division issues the Certificate of Alternative Compliance to the vessel based on a determination that it cannot comply fully...

  2. 33 CFR 89.9 - Certificate of Alternative Compliance: Contents.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Compliance: Contents. 89.9 Section 89.9 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND... Compliance § 89.9 Certificate of Alternative Compliance: Contents. The Chief of the Marine Safety Division issues the Certificate of Alternative Compliance to the vessel based on a determination that it...

  3. 33 CFR 89.9 - Certificate of Alternative Compliance: Contents.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Compliance: Contents. 89.9 Section 89.9 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND... Compliance § 89.9 Certificate of Alternative Compliance: Contents. The Chief of the Marine Safety Division issues the Certificate of Alternative Compliance to the vessel based on a determination that it...

  4. 33 CFR 81.9 - Certificate of Alternative Compliance: Contents.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Compliance: Contents. 81.9 Section 81.9 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND... Certificate of Alternative Compliance: Contents. The Chief of the Marine Safety Division issues the Certificate of Alternative Compliance to the vessel based on a determination that it cannot comply fully...

  5. 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... percent of the total production or sales of the Firm during the 12-month period preceding the most recent...-month versus twenty-four month decline. Based upon a comparison of the most recent 12-month period...

  6. 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.

  7. Cervical screening and cervical cancer death among older women: a population-based, case-control study.

    PubMed

    Rustagi, Alison S; Kamineni, Aruna; Weinmann, Sheila; Reed, Susan D; Newcomb, Polly; Weiss, Noel S

    2014-05-01

    Recent research suggests that cervical screening of older women is associated with a considerable decrease in cervical cancer incidence. We sought to quantify the efficacy of cervical cytology screening to reduce death from this disease. Among enrollees of 2 US health plans, we compared Papanicolaou smear screening histories of women aged 55-79 years who died of cervical cancer during 1980-2010 (cases) to those of women at risk of cervical cancer (controls). Controls were matched 2:1 to cases on health plan, age, and enrollment duration. Cytology screening during the detectable preclinical phase, estimated as the 5-7 years before diagnosis during which cervical neoplasia is asymptomatic but cytologically detectable, was ascertained from medical records. A total of 39 cases and 80 controls were eligible. The odds ratio of cervical cancer death associated with screening during the presumed detectable preclinical phase was 0.26 (95% confidence interval: 0.10, 0.63) after adjustment for matching characteristics, smoking, marital status, and race/ethnicity using logistic regression. We estimate that cervical cytology screening of all women aged 55-79 years in the United States could avert 630 deaths annually. These results provide a minimum estimate of the efficacy of human papillomavirus DNA screening-a more sensitive test-to reduce cervical cancer death among older women.

  8. Cervical Screening and Cervical Cancer Death Among Older Women: A Population-Based, Case-Control Study

    PubMed Central

    Rustagi, Alison S.; Kamineni, Aruna; Weinmann, Sheila; Reed, Susan D.; Newcomb, Polly; Weiss, Noel S.

    2014-01-01

    Recent research suggests that cervical screening of older women is associated with a considerable decrease in cervical cancer incidence. We sought to quantify the efficacy of cervical cytology screening to reduce death from this disease. Among enrollees of 2 US health plans, we compared Papanicolaou smear screening histories of women aged 55–79 years who died of cervical cancer during 1980–2010 (cases) to those of women at risk of cervical cancer (controls). Controls were matched 2:1 to cases on health plan, age, and enrollment duration. Cytology screening during the detectable preclinical phase, estimated as the 5–7 years before diagnosis during which cervical neoplasia is asymptomatic but cytologically detectable, was ascertained from medical records. A total of 39 cases and 80 controls were eligible. The odds ratio of cervical cancer death associated with screening during the presumed detectable preclinical phase was 0.26 (95% confidence interval: 0.10, 0.63) after adjustment for matching characteristics, smoking, marital status, and race/ethnicity using logistic regression. We estimate that cervical cytology screening of all women aged 55–79 years in the United States could avert 630 deaths annually. These results provide a minimum estimate of the efficacy of human papillomavirus DNA screening—a more sensitive test—to reduce cervical cancer death among older women. PMID:24685531

  9. 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…

  10. Council on Certification Professional Practice Analysis.

    PubMed

    Zaglaniczny, K L

    1993-06-01

    The CCNA has completed a PPA and will begin implementing its recommendations with the December 1993 certification examination. The results of the PPA provide content validation for the CCNA certification examination. The certification examination is reflective of the knowledge and skill required for entry-level practice. Assessment of this knowledge is accomplished through the use of questions that are based on the areas represented in the content outline. Analysis of the PPA has resulted in changes in the examination content outline and percentages of questions in each area to reflect current entry-level nurse anesthesia practice. The new outline is based on the major domains of knowledge required for nurse anesthesia practice. These changes are justified by the consistency in the responses of the practitioners surveyed. There was overall agreement as to the knowledge and skills related to patient conditions, procedures, agents, techniques, and equipment that an entry-level CRNA must have to practice. Members of the CCNA and Examination Committee will use the revised outline to develop questions for the certification examination. The questions will be focused on the areas identified as requiring high levels of expertise and those that appeared higher in frequency. The PPA survey will be used as a basis for subsequent content validation studies. It will be revised to reflect new knowledge, technology, and techniques related to nurse anesthesia practice. The CCNA has demonstrated its commitment to the certification process through completion of the PPA and implementation of changes in the structure of the examination.

  11. Population-based mammography screening below age 50: balancing radiation-induced vs prevented breast cancer deaths

    PubMed Central

    de Gelder, R; Draisma, G; Heijnsdijk, E A M; de Koning, H J

    2011-01-01

    Introduction: Exposure to ionizing radiation at mammography screening may cause breast cancer. Because the radiation risk increases with lower exposure age, advancing the lower age limit may affect the balance between screening benefits and risks. The present study explores the benefit–risk ratio of screening before age 50. Methods: The benefits of biennial mammography screening, starting at various ages between 40 and 50, and continuing up to age 74 were examined using micro-simulation. In contrast with previous studies that commonly used excess relative risk models, we assessed the radiation risks using the latest BEIR-VII excess absolute rate exposure-risk model. Results: The estimated radiation risk is lower than previously assessed. At a mean glandular dose of 1.3 mGy per view that was recently measured in the Netherlands, biennial mammography screening between age 50 and 74 was predicted to induce 1.6 breast cancer deaths per 100 000 women aged 0–100 (range 1.3–6.3 extra deaths at a glandular dose of 1–5 mGy per view), against 1121 avoided deaths in this population. Advancing the lower age limit for screening to include women aged 40–74 was predicted to induce 3.7 breast cancer deaths per 100 000 women aged 0–100 (range 2.9–14.4) at biennial screening, but would also prevent 1302 deaths. Conclusion: The benefits of mammography screening between age 40 and 74 were predicted to outweigh the radiation risks. PMID:21364575

  12. [The need for death education].

    PubMed

    Deeken, A

    1992-08-01

    "Death Education" is at the same time "Life Education." For many years I have endeavored to create an awareness of the need for death education in Japan. In this paper I would like to stress the necessity of death education for the following three groups. 1. For medical personnel. Three objectives of death education: 1) Learn to understand the fears and anxieties of the patients facing death and try to reduce their excessive fears and anxieties. 2) Familiarize yourself with the ethical issues related to terminal care and try to establish a warm relationship based on trust and continue communication with the dying patient till the end. 2. For patients. 1) Be aware that the time of your life is limited and try to discover the preciousness of the remaining time. Meditate on the uniqueness of your own death. 2) Finish your unfinished business, reevaluate your human relationships and benefit from a life review therapy. 3) Remove the taboo on death, arrange your own funeral and consider the possibility of another life after death. 3. For the patient's family and friends. 1) Continue warm communication with the dying patient till the end. 2) Prepare for your own bereavement and grief. 3) Try to make your own grief process an opportunity for personal growth. When a cure is no longer possible for a dying patient, the focus of our endeavors should be loving care of the person. Death education can help us to provide better terminal care during the final stage of life.

  13. 20 CFR 656.26 - Board of Alien Labor Certification Appeals review of denials of labor certification.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 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...(f), a request for review of the denial, revocation, or debarment may be made to the Board of...

  14. 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...(f), a request for review of the denial, revocation, or debarment may be made to the Board of...

  15. 20 CFR 656.26 - Board of Alien Labor Certification Appeals review of denials of labor certification.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 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...(f), a request for review of the denial, revocation, or debarment may be made to the Board of...

  16. 38 CFR 3.805 - Loan guaranty for surviving spouses; certification.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... surviving spouses; certification. 3.805 Section 3.805 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF... Benefits § 3.805 Loan guaranty for surviving spouses; certification. A certification of loan guaranty benefits may be extended to surviving spouses based on an application filed on or after January 1, 1959,...

  17. 76 FR 59003 - Energy Conservation Program: Compliance Certification for Electric Motors

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-23

    ... proposing to remove the certified mail option to make electronic submissions of Compliance Certification... ``Department'') through an electronic Web-based tool, the Compliance and Certification Management System (CCMS... to submit Compliance Certification information through certified mail to DOE. DATES: Effective...

  18. 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.)

  19. Competency/Performance-Based Certification; The Latest Scientific Management Effluvium? Or the Answer for Which We Have Waited?

    ERIC Educational Resources Information Center

    Vanderpool, J. Alden

    The fatal flaw of competency/performance-based teacher education (C/PBTE) is the lack of empirical knowledge on teacher behavior as it relates to pupil outcomes. Competencies identified have been based on reason, logic, and experience--all insufficient without empirical evidence. It seems that many accusations against C/PBTE are justified, and it…

  20. 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.

  1. 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…

  2. Mandatory Certification Needed in Librarianship.

    ERIC Educational Resources Information Center

    Williams, Benjamin R.

    This report on the need for compulsory, standardized procedures for the certification of librarians (1) provides an historical overview of the subject; (2) identifies three types of certification: compulsory, permissive, and voluntary; (3) outlines current certification practices, requirements, and standards for school librarians; (4) reviews the…

  3. Overview of the DOE packaging certification process

    SciTech Connect

    Liu, Y.Y.; Carlson, R.D.; Carlson, R.W.; Kapoor, A.

    1995-12-31

    This paper gives an overview of the DOE packaging certification process, which is implemented by the Office of Facility Safety Analysis, under the Assistance Secretary for Environment, Safety and Health, for packagings that are not used for weapons and weapons components, nor for naval nuclear propulsion. The overview will emphasize Type B packagings and the Safety Analysis Report for Packaging (SARP) review that parallels the NRC packaging review. Other important elements in the DOE packaging certification program, such as training, methods development, data bases, and technical assistance, are also emphasized, because they have contributed significantly to the improvement of the certification process since DOE consolidated its packaging certification function in 1985. The paper finishes with a discussion of the roles and functions of the DOE Packaging Safety Review Steering Committee, which is chartered to address issues and concerns of interest to the DOE packaging and transportation safety community. Two articles related to DOE packaging certification were published earlier on the SARP review procedures and the DOE Packaging Review Guide. These articles may be consulted for additional information.

  4. Death Education and Death Fear Reduction

    ERIC Educational Resources Information Center

    Mueller, Mary Louise

    1976-01-01

    The study examined the possibility of reducing the fear of death in early adolescents through a 12-lesson unit designed to assist the student to achieve an attitude of integration toward life and death. (NQ)

  5. [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. PMID:22448466

  6. [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.

  7. [The medical history and the death cause of Young-Jo based on the Seungjeongwon Ilgi : royal secretariat logs)].

    PubMed

    Kim, Sun hyung; Kim, Dal Rea

    2010-12-31

    Young-Jo, 83 years old, was the longest lived king of the Chosun Dynasty. Seungjeongwon Ilgi gives more detail about the diseases and prescriptions of Young-Jo. We could close look at what the Annals of the Chosun Dynasty just described that king received medical attention. In inspecting Jung-Jo`s constitution, to examine his medical history is very important. Yong-jo had a weak constitution, but he was always concerned about health care. Youn-jo complained of colic syndrom and heart fire when young; ascris and shoulder pain since middle age; severe fatigue and gait disturbance caused by edema in his latter years. During his last 20 years, he had taken and resorted to Ken-GongTang, the reason was not psychological disposion, but physical disease. Also, Yong-Jo's condition just before death could be assumed in Seungjeongwon Ilgi and Jonhyeongak Ilgi. According to continuous complaints such as edema of the lower limbs, faint(lethargy) and eating disorder caused by abnormal rising of GI (anorexia), we could presume that the cause of death was uremia. In addition, it has significance to correct feasible misconceaption about the cause of death grounded on The Annals of the Chosun Dynasty.

  8. Synthesis and evaluation of indole-based chalcones as inducers of methuosis, a novel type of nonapoptotic cell death.

    PubMed

    Robinson, Michael W; Overmeyer, Jean H; Young, Ashley M; Erhardt, Paul W; Maltese, William A

    2012-03-01

    Methuosis is a novel caspase-independent form of cell death in which massive accumulation of vacuoles derived from macropinosomes ultimately causes cells to detach from the substratum and rupture. We recently described a chalcone-like compound, 3-(2-methyl-1H-indol-3-yl)-1-(4-pyridinyl)-2-propen-1-one (i.e., MIPP), which can induce methuosis in glioblastoma and other types of cancer cells. Herein, we describe the synthesis and structure-activity relationships of a directed library of related compounds, providing insights into the contributions of the two aryl ring systems and highlighting a potent derivative, 3-(5-methoxy, 2-methyl-1H-indol-3-yl)-1-(4-pyridinyl)-2-propen-1-one (i.e., MOMIPP) that can induce methuosis at low micromolar concentrations. We have also generated biologically active azide derivatives that may be useful for future studies aimed at identifying the protein targets of MOMIPP by photoaffinity labeling techniques. The potential significance of these studies is underscored by the finding that MOMIPP effectively reduces the growth and viability of Temozolomide-resistant glioblastoma and doxorubicin-resistant breast cancer cells. Thus, it may serve as a prototype for drugs that could be used to trigger death by methuosis in cancers that are resistant to conventional forms of cell death (e.g., apoptosis).

  9. Acute traumatic death of a 17th century general based on examination of mummified remains found in Korea.

    PubMed

    Lee, In Sun; Lee, Eun-Joo; Park, Jun Bum; Baek, Seung Hee; Oh, Chang Seok; Lee, Soong Deok; Kim, Yi-Suk; Bok, Gi Dae; Hong, Jung Won; Lim, Do-Sun; Shin, Myung Ho; Seo, Min; Shin, Dong Hoon

    2009-06-01

    Recently, we examined one of the most perfectly preserved mummies of the Joseon Dynasty (1392-1910) ever found in Korea. The individual was an elderly man and a high-ranking general who had lived sometime during the 16th or 17th century in Korea. When computerized tomography (CT) radiographs were taken, a fracture line was observed on the left side of the mandible. A post-factum dissection also provided crucial clues to the cause of death. First of all, blood clots were still evident at the fracture site, indicating that the mandibular fracture had occurred just before death. Second, we also found feces exclusively in the sigmoid colon or rectum, but not in the stomach, small intestine or colon. This told us that our subject had not eaten anything during his final 2 days (even though there was no indication that he would have had any difficulty eating during that time). Therefore, we presume that this case might not be one of chronic or wasting disease, but rather a case of sudden death. By virtue of the varied specialties of the researchers involved in this study, we were able to piece together a partly very clear and partly very plausible story for our 17th century mummy subject. Considering the high level of preservation of remains and artifacts found in lime soil mixture barrier (LSMB) tombs, not to mention the rich supplementary information available from historical documents, similarly successful studies are promised in forthcoming days and years. PMID:19345566

  10. 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.

  11. 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.

  12. 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

  13. Consensus recommendations on rater training and certification.

    PubMed

    West, Mark D; Daniel, David G; Opler, Mark; Wise-Rankovic, Alexandria; Kalali, Amir

    2014-01-01

    There is currently no accepted standard for the clinical research industry to follow when selecting and training raters to administer rating scales in clinical neuroscience trials. This article offers guidelines, based on expert recommendations of the CNS Summit Rater Training and Certification Committee, for selecting, training, and evaluating raters. The article also defines terminology and offers recommendations for considering raters with prior training and certification. These guidelines are intended for investigators, pharmaceutical companies, contract research organizations, and other entities involved in clinical neuroscience trials.

  14. 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…

  15. 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. PMID:27541016

  16. 38 CFR 11.84 - Redemption because of veteran's death.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Redemption because of veteran's death. 11.84 Section 11.84 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... Certificates Under Section 502 of the World War Adjusted Compensation Act § 11.84 Redemption because of...

  17. 38 CFR 11.84 - Redemption because of veteran's death.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Redemption because of veteran's death. 11.84 Section 11.84 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... Certificates Under Section 502 of the World War Adjusted Compensation Act § 11.84 Redemption because of...

  18. 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 ...

  19. 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.

  20. 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…

  1. Virginia Career Readiness Certificate

    ERIC Educational Resources Information Center

    DuBois, Glenn; Westerman, Gloria

    2007-01-01

    This article describes how Virginia responded to employer needs and created a blue print for the establishment of a demand driven workforce-credentialing system. This system serves the needs of job seekers and the competency-certification needs of hiring authorities. This is a true quality of life and economic development movement.

  2. Certification/Licensure Dictionary.

    ERIC Educational Resources Information Center

    Ohio State Dept. of Education, Columbus.

    This document helps districts implement the new teacher licensure standards and ensure that staff are assigned to classes they are qualified to teach. It identifies both the existing certification areas and the new licensure areas that are required for teaching specific courses. The areas included are: agriculture; business; career-based…

  3. Pharmacist specialty certification.

    PubMed

    Durfee, Sharon M

    2012-03-01

    Nutrition support is a pharmacy specialty in which pharmacists work with prescribers, conduct order review, and either perform or oversee compounding of these complex parenteral nutrition formulations. Pharmacists should be certified in this specialty, and the options for certification are outlined in this article. PMID:22275326

  4. 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 strategic issues…

  5. Improving professional practice through certification.

    PubMed

    Valente, Sharon M

    2010-01-01

    Certification helps ensure quality of practice and currency of nursing knowledge. We designed certification review courses and evaluated their impact on satisfaction, quality of care, adverse drug events (ADEs), and RN vacancies. Certification correlated with improved patient and nurse satisfaction, quality of care, and increased nurse rates of reporting ADEs, although the ADE total rates are consistent. Certification inversely correlated with nurse vacancies. Certification has helped to enhance nurses' knowledge, productivity, quality of care, and patient and nurse satisfaction, and has decreased RN vacancies. PMID:20885144

  6. 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).

  7. 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...

  8. 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...

  9. 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...

  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, 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...

  12. 78 FR 27343 - Medical Examiner's Certification Integration

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-10

    ... Report MCSIA Motor Carrier Safety Improvement Act MVR Motor Vehicle Record NLETS National Law Enforcement... via CDLIS motor vehicle records (MVRs). Based on the Medical Certification Requirements as Part of the... Employees and Safety of Operations, 54 M.C.C. 337 (1952) and former 49 CFR 191.11 (1952 ed.), 17 FR...

  13. 14 CFR 121.919 - Certification.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... subject to an AQP is eligible to receive a commercial or airline transport pilot, flight engineer, or aircraft dispatcher certificate or appropriate rating based on the successful completion of training and evaluation events accomplished under that program if the following requirements are met: (a) Training...

  14. 14 CFR 121.919 - Certification.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... subject to an AQP is eligible to receive a commercial or airline transport pilot, flight engineer, or aircraft dispatcher certificate or appropriate rating based on the successful completion of training and evaluation events accomplished under that program if the following requirements are met: (a) Training...

  15. 14 CFR 121.919 - Certification.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... subject to an AQP is eligible to receive a commercial or airline transport pilot, flight engineer, or aircraft dispatcher certificate or appropriate rating based on the successful completion of training and evaluation events accomplished under that program if the following requirements are met: (a) Training...

  16. 14 CFR 121.919 - Certification.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... subject to an AQP is eligible to receive a commercial or airline transport pilot, flight engineer, or aircraft dispatcher certificate or appropriate rating based on the successful completion of training and evaluation events accomplished under that program if the following requirements are met: (a) Training...

  17. 14 CFR 121.919 - Certification.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... subject to an AQP is eligible to receive a commercial or airline transport pilot, flight engineer, or aircraft dispatcher certificate or appropriate rating based on the successful completion of training and evaluation events accomplished under that program if the following requirements are met: (a) Training...

  18. 10 CFR 431.36 - Compliance Certification.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

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

  19. 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.

  20. 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

  1. 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

  2. Certification assays for HIV-1-based vectors: frequent passage of gag sequences without evidence of replication-competent viruses.

    PubMed

    Sastry, Lakshmi; Xu, Yi; Johnson, Terry; Desai, Kunal; Rissing, David; Marsh, Jonathan; Cornetta, Kenneth

    2003-11-01

    A principal concern regarding the safety of HIV-1-based vectors is replication-competent lentivirus (RCL). We have developed two PCR assays for detecting RCL; the first detects recombination between gag regions in the transfer vector and the packaging construct (sensitivity of detection approximately 10-100 copies of target sequence). The second assay uses real-time PCR to detect vesicular stomatitis virus glycoprotein (VSVG) envelope DNA (sensitivity approximately 5-50 VSVG sequences). In an attempt to amplify any RCL, test vectors were used to transduce C8166 and 293 cells, which were then screened weekly for 3 weeks. Psi-gag recombinants were routinely detected (20 of 21 analyses) in four transductions using the RRL-CMV-GFP vector. In contrast, VSVG sequences were detected only once in 21 analyses. Interestingly, p24 levels (as measured by ELISA) were occasionally detectable after 3 weeks of culture. To determine if a true RCL was present, 21-day cell-free medium was used to transduce naïve cells. No evidence of psi-gag or VSVG transfer was detected, indicating that the recombination events were insufficient to reconstitute a true RCL. These findings have important implications for the design and safety of HIV-1-based vectors intended for clinical applications. PMID:14599817

  3. Child deaths of unknown cause: review of 7 years' experience.

    PubMed

    Bowen, Kathryn A; Marshall, William N

    2004-01-01

    Using data from the Pima County (Arizona) Child Fatality Review Team, we sought to describe the nature of unknown cause pediatric deaths. Of 1,150 total deaths (1995-2001), 22 were unknown cause and 3 had only a mode of death on the death certificate. There were 15 infants <6 months, 4 children 1-4 years, 2 children 5-9 years, 1 preteen (10-14 years), and 3 aged 15-17 years. Four patterns were seen: those resembling SIDS but with confounding history, autopsy, or scene investigation; sleeping toddlers with respiratory symptoms; children with underlying conditions not expected to cause death; and deaths without complete investigation. PMID:15583775

  4. 45 CFR 170.550 - EHR Module certification.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... TECHNOLOGY STANDARDS, IMPLEMENTATION SPECIFICATIONS, AND CERTIFICATION CRITERIA AND CERTIFICATION PROGRAMS FOR HEALTH INFORMATION TECHNOLOGY ONC HIT Certification Program § 170.550 EHR Module certification....

  5. 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 University of…

  6. 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…

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

    SciTech Connect

    Cross, J.B. ); Koontz, S.L. . Lyndon B. Johnson Space Center); Lan, E.H. )

    1991-01-01

    The effects of atomic oxygen on boron nitride, silicon nitride, solar cell interconnects used on the Intelsat 6 satellite, organic polymers, and MoS{sub 2} and WS{sub 2} dry lubricant have been studied in low Earth orbit (LEO) flight experiments and in our ground-based simulation facility at Los Alamos National Laboratory. Both the in-flight and ground-based experiments employed in situ electrical resistance measurements to detect penetration of atomic oxygen through materials and ESCA analysis to measure chemical composition changes. In the presence of atomic oxygen, silver oxidizes to form silver oxide, which has a much higher electrical resistance than pure silver. Permeation of atomic oxygen through BN overcoated on thin silver was observed. No permeation of atomic oxygen through Si{sub 3}N{sub 4} was observed. Test results on the Intelsat 6 satellite interconnects used on its photovoltaic array indicate that more than 60--80% of the original thickness of silver should remain after completion of the proposed Space Shuttle rescue/reboost mission. Gas phase reaction products produced by the interaction of high kinetic energy atomic oxygen (AO) with Kapton were found to be H{sub 2}, H{sub 2}O, CO, and CO{sub 2} with NO being a possible secondary product. Hydrogen abstraction at high AO kinetic energy is postulated to be the key reaction controlling the erosion rate of Kapton. An Arrhenius-like expression having an activation barrier of 0.4 eV can be fit to the data, which suggests that the rate limiting step in the AO/Kapton reaction mechanism can be overcome by translational energy. Oxidation of MoS{sub 2} and WS{sub 2} dry lubricants in both ground-based and orbital exposures indicated the formation of MoO{sub 3} and WO{sub 3} respectively. A protective oxide layer is formed {approx}30 monolayers thick which has a high initial friction coefficient until the layer is worn off.

  8. Mentor Advice Giving in an Alternative Certification Program for Secondary Science Teaching: Opportunities and Roadblocks in Developing a Knowledge Base for Teaching

    ERIC Educational Resources Information Center

    Bradbury, Leslie Upson; Koballa, Thomas R., Jr.

    2007-01-01

    Mentoring is often an important component of alternative certification programs, yet little is known about what novices learn about science teaching through mentoring relationships. This study investigated the advice given by two mentor science teachers to their proteges. Findings indicate that mentors gave more advice related to general…

  9. 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…

  10. Incidence, causes and severity of injuries in Aquitaine, France: a community-based study of hospital admissions and deaths.

    PubMed Central

    Tiret, L; Garros, B; Maurette, P; Nicaud, V; Thicoipe, M; Hatton, F; Erny, P

    1989-01-01

    This paper reports the results of a study of injuries conducted during a one-year period within a defined geographic population of 2.7 million persons (Aquitaine, France). Cases were defined as unintentional or intentional injuries, either resulting in immediate death before reaching hospital or requiring hospital admission. During the one-year period, 1,181 deaths were registered and 8,190 hospital admissions occurred during the sample periods. The three leading causes of injury were falls (40 per cent), traffic accidents (27 per cent), and poisonings (15 per cent). The overall incidence of injuries was 136 per 10,000 person years. Incidence by sex and age was assessed for the main external causes. The ratios of nonfatal to fatal cases were calculated by sex and age and by external cause. The origin of the injury was suicide in 14 per cent of cases and assault or homicide in 3 per cent. The severity of injuries, assessed using an automatic computation of the Injury Severity Score (ISS), ranged from 1 to 66 with a mean of 6.9. Substantial variations of ISS were observed according to external cause. At the 8th day following admission, 31 per cent of hospital-treated patients were still hospitalized and 0.8 per cent had died in hospital. The outcome correlated well with the ISS. PMID:2916718

  11. 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.

  12. 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

  13. 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

  14. 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…

  15. 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

  16. 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. PMID:1504295

  17. Children and Death.

    ERIC Educational Resources Information Center

    Brennan, Andrew J. J.

    Health professionals and educators should develop their abilities to educate about death and to comfort the bereaved. Due to lower death rates, the lack of philosophical religious views, and distorted perceptions of death contributed by television, death has become a mystery instead of a segment of the common experience. Particularly when a child…

  18. Deaths in World Trade Center terrorist attacks--New York City, 2001.

    PubMed

    2002-09-11

    On September 11, 2001, terrorists flew two hijacked airplanes into the World Trade Center (WTC) in lower Manhattan in New York City (NYC), destroying both towers of the WTC. This report presents preliminary vital statistics on the deaths caused by the terrorist attacks and describes the procedures developed by the New York City Department of Health and Mental Hygiene (NYCDOHMH) to issue death certificates in response to the attacks. These data underscore the need for legal mechanisms to expedite the issuance of death certificates in the absence of human remains and the need for vital registration systems that can be relocated in case of emergency. PMID:12238537

  19. 47 CFR 2.962 - Requirements for Telecommunication Certification Bodies.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...) The certification system shall be based on type testing as identified in sub-clause 1.2(a) of ISO/IEC... regulations for product evaluation. (2) The TCB shall demonstrate expert knowledge of the regulations for...

  20. 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. PMID:24898690

  1. GC/MS-based metabolomics approach to identify biomarkers differentiating survivals from death in crucian carps infected by Edwardsiella tarda.

    PubMed

    Guo, Chang; Huang, Xiao-Yan; Yang, Man-Jun; Wang, Sheng; Ren, Shi-Tong; Li, Hui; Peng, Xuan-Xian

    2014-08-01

    Microbial disease problems constitute the largest single cause of economic losses in aquaculture. An understanding of immune system in aquaculture animals how to function in defense against bacterial infections is especially important to control these diseases and improve food quality and safety. In the present study, we use a crucian carp model to explore which pathways and metabolites are crucial for the defense against infection caused by Edwardsiella tarda EIB202. We establish the metabolic profile of crucian carps and then compare the metabolic difference between survivals and dead fish by self-control. We identify elevating unsaturated fatty acid biosynthesis and decreasing fructose and mannose metabolism as the most key pathways and increasing palmitic acid and decreasing d-mannose as the most crucial metabolites differentiating survivals from death in these fish infected by E. tarda. Our findings highlight the importance of metabolic strategy against bacterial infections.

  2. Facility Death Review of Maternal and Neonatal Deaths in Bangladesh

    PubMed Central

    Biswas, Animesh; Rahman, Fazlur; Eriksson, Charli; Halim, Abdul; Dalal, Koustuv

    2015-01-01

    Objectives To explore the experiences, acceptance, and effects of conducting facility death review (FDR) of maternal and neonatal deaths and stillbirths at or below the district level in Bangladesh. Methods This was a qualitative study with healthcare providers involved in FDRs. Two districts were studied: Thakurgaon district (a pilot district) and Jamalpur district (randomly selected from three follow-on study districts). Data were collected between January and November 2011. Data were collected from focus group discussions, in-depth interviews, and document review. Hospital administrators, obstetrics and gynecology consultants, and pediatric consultants and nurses employed in the same departments of the respective facilities participated in the study. Content and thematic analyses were performed. Results FDR for maternal and neonatal deaths and stillbirths can be performed in upazila health complexes at sub-district and district hospital levels. Senior staff nurses took responsibility for notifying each death and conducting death reviews with the support of doctors. Doctors reviewed the FDRs to assign causes of death. Review meetings with doctors, nurses, and health managers at the upazila and district levels supported the preparation of remedial action plans based on FDR findings, and interventions were planned accordingly. There were excellent examples of improved quality of care at facilities as a result of FDR. FDR also identified gaps and challenges to overcome in the near future to improve maternal and newborn health. Discussion FDR of maternal and neonatal deaths is feasible in district and upazila health facilities. FDR not only identifies the medical causes of a maternal or neonatal death but also explores remediable gaps and challenges in the facility. FDR creates an enabled environment in the facility to explore medical causes of deaths, including the gaps and challenges that influence mortality. FDRs mobilize health managers at upazila and district

  3. Brainstem death: A comprehensive review in Indian perspective.

    PubMed

    Dhanwate, Anant Dattatray

    2014-09-01

    With the advent of cardiopulmonary resuscitation techniques, the cardiopulmonary definition of death lost its significance in favor of brain death. Brain death is a permanent cessation of all functions of the brain in which though individual organs may function but lack of integrating function of the brain, lack of respiratory drive, consciousness, and cognition confirms to the definition that death is an irreversible cessation of functioning of the organism as a whole. In spite of medical and legal acceptance globally, the concept of brain death and brain-stem death is still unclear to many. Brain death is not promptly declared due to lack of awareness and doubts about the legal procedure of certification. Many brain dead patients are kept on life supporting systems needlessly. In this comprehensive review, an attempt has been made to highlight the history and concept of brain death and brain-stem death; the anatomical and physiological basis of brain-stem death, and criteria to diagnose brain-stem death in India.

  4. Certification reporting forms

    SciTech Connect

    Not Available

    1981-02-18

    The required information and formats for the certification report including the cover sheet, compliance statement, and body of the report are given in this document. The body of the reports is different for each product. There are no product-to-product differences in the forms of the other parts of the reports. The products covered in this document include: furnaces, water heaters, refrigerator-freezers, central air conditioners, room air conditioners, and freezers.

  5. TORT certification package

    SciTech Connect

    Frost, R.L.

    1993-10-01

    The TORT code has been certified. TORT is a three-dimensional discrete ordinates transport theory code, than can solve neutron, photon, or coupled neutron/photon problems. The code will be used primarily for shielding and radiation field calculations SRS. As defined in this work, certification dies not imply validation. The code must be validated for a particular type of calculation before it can be used for critical applications.

  6. 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

  7. 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.

  8. 7 CFR 205.404 - Granting certification.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 3 2013-01-01 2013-01-01 false Granting certification. 205.404 Section 205.404... PROVISIONS NATIONAL ORGANIC PROGRAM Certification § 205.404 Granting certification. (a) Within a reasonable... agent shall grant certification. The certification may include requirements for the correction of...

  9. 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

  10. Changes in and Impact of the Death Review Process in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial.

    PubMed

    Miller, Anthony B; Feld, Ronald; Fontana, Robert; Gohagan, John K; Jatoi, Ismail; Lawrence, Walter; Miller, Amy; ProroK, Philip C; Rajput, Ashwani; Sherman, Morris; Welch, Gilbert; Wright, Patrick; Yurgalevitch, Susan; Albertsen, Peter

    2015-01-01

    Death review was conducted for the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial to avoid the biases associated with causes of death entered on death certificates. An algorithm selected deaths for review. Records on diagnosis and terminal illness were perused in the coordinating center and by the chair of the death review committee (DRC). Identifying information and randomization arm was removed. Three reviewers independently determined the cause of death. Disagreement was resolved at a meeting of the DRC. This process was subsequently simplified. The cause of death was determined by one DRC member and compared to the death certificate. With agreement the case was finalized. When discordant, the records were sent to a second DRC member. If the reviewers agreed, the case was finalized. If not, a third member reviewed. If two of the three reviewers agreed, the case was sent back to the discordant reviewer. If the reviewer remained discordant the case was resolved by a conference call. Of the 4728 death reviews that were completed, the DRC confirmed the death certificate underlying cause for over 90%. Between 5% and 13% of the certified deaths were regarded as indirect causes of death, associated with the treatment of the ascertained cancer; differential for prostate cancer, 11% in the intervention arm and 6% in the control. Without review, between 1% and 6% of the deaths that occurred would not have been assigned to the relevant PLCO cancer. The DRC completed 76% of those requiring review before the process ceased.

  11. 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

  12. 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

  13. Body cooling after death.

    PubMed

    Kuehn, L A; Tikuisis, P; Livingstone, S; Limmer, R

    1980-09-01

    In the analyses of cases of death in cold air environments, it is often of interest to determine the time required for the body of the individual to cool to ambient temperature. Usually such determinations have been based on Newton's law of cooling. This paper describes a case history in which this technique was experimentally tested and consequently abandoned in favour of a more complex biophysical model which more accurately described the thermo-physical events inherent in body cooling. This model is recommended for determination of the times required for various body parts to cool to ambient environmental temperatures.

  14. 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.

  15. 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.

  16. 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.

  17. 8 CFR 1212.15 - Certificates for foreign health care workers.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Language (TOEFL), Paper-Based 560, Computer-Based 220; Test of Written English (TWE): 4.5; Test of Spoken... as a registered nurse must obtain the following scores to obtain a certificate: ETS: TOEFL: Paper... issued a certificate: ETS: TOEFL: Paper-Based 530, Computer-Based 197; TWE: 4.0; TSE: 50; MELAB:...

  18. 14 CFR 147.3 - Certificate required.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) SCHOOLS AND OTHER CERTIFICATED AGENCIES AVIATION MAINTENANCE TECHNICIAN SCHOOLS General § 147.3 Certificate required. No person may operate as a certificated aviation maintenance technician school without, or...

  19. 14 CFR 147.3 - Certificate required.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) SCHOOLS AND OTHER CERTIFICATED AGENCIES AVIATION MAINTENANCE TECHNICIAN SCHOOLS General § 147.3 Certificate required. No person may operate as a certificated aviation maintenance technician school without, or...

  20. 14 CFR 147.3 - Certificate required.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) SCHOOLS AND OTHER CERTIFICATED AGENCIES AVIATION MAINTENANCE TECHNICIAN SCHOOLS General § 147.3 Certificate required. No person may operate as a certificated aviation maintenance technician school without, or...

  1. 14 CFR 147.3 - Certificate required.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) SCHOOLS AND OTHER CERTIFICATED AGENCIES AVIATION MAINTENANCE TECHNICIAN SCHOOLS General § 147.3 Certificate required. No person may operate as a certificated aviation maintenance technician school without, or...

  2. 7 CFR 989.107 - Inspection certificate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing... GROWN IN CALIFORNIA Administrative Rules and Regulations Definitions § 989.107 Inspection certificate. Inspection certificate means any written certification, finding, or attestation as to the quality...

  3. 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...

  4. 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...

  5. 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...

  6. 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...

  7. 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...

  8. Stochastic Evolution Dynamic of the Rock-Scissors-Paper Game Based on a Quasi Birth and Death Process.

    PubMed

    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

  9. 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.

  10. Stochastic Evolution Dynamic of the Rock-Scissors-Paper Game Based on a Quasi Birth and Death Process.

    PubMed

    Yu, Qian; Fang, Debin; Zhang, Xiaoling; Jin, Chen; Ren, Qiyu

    2016-06-27

    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.

  11. Role of connexin-based gap junction channels and hemichannels in ischemia-induced cell death in nervous tissue

    PubMed Central

    Contreras, Jorge E.; Sánchez, Helmuth A.; Véliz, Loreto P.; Bukauskas, Feliksas F.; Bennett, Michael V.L.; Sáez, Juan C.

    2013-01-01

    Gap junction channels and hemichannels formed of connexin subunits are found in most cell types in vertebrates. Gap junctions connect cells via channels not open to the extracellular space and permit the passage of ions and molecules of ~1 kDa. Single connexin hemichannels, which are connexin hexamers, are present in the surface membrane before docking with a hemichannel in an apposed membrane. Because of their high conductance and permeability in cell–cell channels, it had been thought that connexin hemichannels remained closed until docking to form a cell–cell channel. Now it is clear that at least some hemichannels can open to allow passage of molecules between the cytoplasm and extracellular space. Here we review evidence that gap junction channels may allow intercellular diffusion of necrotic or apoptotic signals, but may also allow diffusion of ions and substances from healthy to injured cells, thereby contributing to cell survival. Moreover, opening of gap junction hemichannels may exacerbate cell injury or mediate paracrine or autocrine signaling. In addition to the cell specific features of an ischemic insult, propagation of cell damage and death within affected tissues may be affected by expression and regulation of gap junction channels and hemichannels formed by connexins. PMID:15572178

  12. 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

  13. 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

  14. High-dimensional entanglement certification.

    PubMed

    Huang, Zixin; Maccone, Lorenzo; Karim, Akib; Macchiavello, Chiara; Chapman, Robert J; Peruzzo, Alberto

    2016-06-17

    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.

  15. High-dimensional entanglement certification

    NASA Astrophysics Data System (ADS)

    Huang, Zixin; Maccone, Lorenzo; Karim, Akib; Macchiavello, Chiara; Chapman, Robert J.; Peruzzo, Alberto

    2016-06-01

    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.

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. 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

  2. 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. PMID:24392820

  3. 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.

  4. 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.

  5. DORT certification package

    SciTech Connect

    Frost, R.L.

    1994-01-01

    The DORT code has been certified. DORT is a two-dimensional discrete ordinates transport theory code, that can solve neutron, photon, or coupled neutron/photon problems. It is anticipated that DORT will be used for criticality calculations as well as for shielding and radiation field analysis at SRS. In addition to the DORT module itself, 5 utility programs that are useful in certain DORT applications have been certified. These modules are: GIP, DOS, GRTUNCL, BNDRYS, and RTFLUM. As defined in this work, certification does not imply validation. These codes must be validated for a particular type of calculation before they can be used for critical applications.

  6. 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.

  7. 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…

  8. Sudden Infant Death Syndrome

    MedlinePlus

    Sudden infant death syndrome (SIDS) is the sudden, unexplained death of an infant younger than one year old. Some people call ... boys, African Americans, and American Indian/Alaska Native infants have a higher risk of SIDS. Although health ...

  9. 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.…

  10. 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. PMID:27550005

  11. The ABCs of Certification Use

    ERIC Educational Resources Information Center

    Lualhati, Joselito C.

    2006-01-01

    Educators continue to show interest in the topic of certification use, which is not surprising. Certifications provide educators access to "de facto" content standards that define expectations of what students need to know and be able to do; teaching materials and resources that make it easier for educators to teach the knowledge and skills…

  12. Licensure/Certification. NSTEP Bibliography.

    ERIC Educational Resources Information Center

    Mattson, Beverly

    This bibliography on licensure and certification in special education lists 110 references grouped into 82 general references and 28 references on alternative certification (28). References date from 1984 through 1994 and include journal articles, books, conference papers, and government reports. (DB)

  13. Certification of High School Coaches.

    ERIC Educational Resources Information Center

    Maetozo, Matthew G., Ed.

    Approximately one-fourth of all head coaches of junior and senior high school teams have had no professional preparation for such responsibility. Professional groups are urging certification or endorsement requirements beyond present requisites for teaching certification. This publication presents eight professional viewpoints on various aspects…

  14. Ventricular fibrillation and sudden cardiac death during myocardial infarction.

    PubMed

    Jabbari, Reza

    2016-05-01

    In this PhD thesis, we report that VF is still a common complication of STEMI, with an incidence of 11.6% in the population of Danish STEMI patients who survive to reach the hospital. In this STEMI population, we identified several risk factors associated with VF independent of MI. We identified and confirmed findings from several previous studies and found several risk factors, such as younger age, a family history of sudden death, a TIMI flow grade of 0, the absence of angina, anterior infarction (i.e., VF before PPCI), and inferior infarction (i.e., VF during PPCI) that were associated with VF in a Danish cohort. Furthermore, a history of atrial fibrillation and alcohol intake were identified as novel risk factors for VF. To the best of our knowledge, this study contains data on the largest VF cohort with the longest reported follow-up published; we found that VF mortality is significantly higher within the first 30 days for patients who experience VF before and during PPCI compared with STEMI patients without VF. However, the long-term mortality rates of the three groups are the same. Importantly, our results contradict the previous understanding that VF during PPCI is "benign"; the mortality rate within the first 30 days was as high for patients with VF during PPCI as the mortality rate of patients with VF before PPCI. Finally, although it is difficult to draw clinical implications from a descriptive study, due to the comprehensiveness of Danish death certificates, we reported a high incidence of cardiac symptoms and contact with healthcare professionals based on cardiac symptoms in young SCD patients who died due to CAD, although death was not avoided. PMID:27127021

  15. Suicide on death row.

    PubMed

    Lester, David; Tartaro, Christine

    2002-09-01

    The suicide rate on death row for the period 1976 through 1999 was found to be high (113 per 100,000 per year), some five times higher than the suicide rate for the male population of the United States. The death row suicide rate was predicted by features of the death row population (negatively with the population on death row) and by social indicators of the society as a whole (negatively with birth and divorce rates and positively with marriage rates).

  16. No life without death.

    PubMed

    Krammer, Peter H; Kamiński, Marcin; Kiessling, Michael; Gülow, Karsten

    2007-01-01

    Apoptosis-programed cell death-is the most common form of death in the body. Once apoptosis is induced, proper execution of the cell death program requires the coordinated activation and execution of multiple molecular processes. Here, we describe the pathways and the basic components of the death-inducing machinery. Since apoptosis is a key regulator of tissue homeostasis, an imbalance of apoptosis results in severe diseases like cancer, autoimmunity, and AIDS.

  17. 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

  18. Dreams of Death.

    ERIC Educational Resources Information Center

    Barrett, Deirdre

    1989-01-01

    Examined frequency and characteristics of overt dreams of dying among healthy young adults. Dreams of dying were found to be rare but distinctive content category, representing overwhelmingly pleasant dreams. Over one-half of death dreams involved lengthy afterlife sequence, remainder focused on process of death. Death dreams of these healthy…

  19. Religious characteristics and the death penalty.

    PubMed

    Miller, Monica K; Hayward, R David

    2008-04-01

    Using one mock trial scenario, this study investigated whether religious and demographic factors were related to death penalty attitudes and sentencing verdicts. Those who favored the death penalty differed from those who had doubts about the penalty in gender, affiliation, fundamentalism, evangelism, literal Biblical interpretism, beliefs about God's attitudes toward murders, and perceptions of how their religious groups felt about the death penalty. These relationships generally held after mock jurors were death qualified. Gender, fundamentalism, literal interpretism, beliefs about God's death penalty position, and perceptions of how one's religious group felt about the death penalty predicted death penalty sentencing verdicts. Future research could determine whether using peremptory challenges to exclude potential jurors based on religion can help lawyers choose a more favorable jury.

  20. [Medical insurance and forensic aspects of postmortem examination in cases of extra-clinical and accidental death].

    PubMed

    Ebert, B

    1997-12-01

    In general, death of a person--also in cases of a so called "sudden death"--is followed by a certification of death, normally by the physician who attended the patient in his last illness, but doctors in external e.g. extraclinical emergency care systems as well are liable to fill in death certificates concerning these unknown patients whose sudden and in general unexpected cases of death mostly happened under dubious circumstances. Thus, doctors in extraclinical care are highly susceptible to miss cases of homicide, cases with relevant forensic and statistical aspects or claims of relatives concerning insurance premiums of the underwriter. By demonstrating three different case reports of "sudden-death"-incidents, the circumstances of death are illuminated and consequences are shown.