Guidelines for Proof Test Analysis

NASA Technical Reports Server (NTRS)

Chell, G. G.; McClung, R. C.; Kuhlman, C. J.; Russell, D. A.; Garr, K.; Donnelly, B.

1999-01-01

These guidelines integrate state-of-the-art elastic-plastic fracture mechanics (EPFM) and proof test implementation issues into a comprehensive proof test analysis procedure in the form of a road map which identifies the types of data, fracture mechanics based parameters, and calculations needed to perform flaw screening and minimum proof load analyses of fracture critical components. Worked examples are presented to illustrate the application of the road map to proof test analysis. The state-of-the art fracture technology employed in these guidelines is based on the EPFM parameter, J, and a pictorial representation of a J fracture analysis, called the failure assessment diagram (FAD) approach. The recommended fracture technology is validated using finite element J results, and laboratory and hardware fracture test results on the nickel-based superalloy Inconel 718, the aluminum alloy 2024-T3511, and ferritic pressure vessel steels. In all cases the laboratory specimens and hardware failed by ductile mechanisms. Advanced proof test analyses involving probability analysis and multiple-cycle proof testing (MCPT) are addressed. Finally, recommendations are provided on how to account for the effects of the proof test overload on subsequent service fatigue and fracture behaviors.

Regional Evaluation and Research Center for Head Start. Southern University, Annual Report, November 28, 1969. Final Report.

ERIC Educational Resources Information Center

Southern Univ. and Agricultural and Mechanical Coll., Baton Rouge, LA.

This final report of the third year of the Southern University-Tulane University Regional Head Start Evaluation and Research Center is a statement of activities engaged in since September 1968. Chapter I includes an introduction and description of the centers; Chapter II, evaluation guidelines, test battery, quality control, evaluation design and…

Safety assessment of a novel active ingredient, acetyl aspartic acid, according to the EU Cosmetics Regulation and the Scientific Committee on Consumer Safety guidelines.

PubMed

Daly, P; Moran, G

2015-10-01

Acetyl aspartic acid (A-A-A) was proposed as a new novel active ingredient for use in cosmetics. The safety of A-A-A was assessed by following an in-house-developed 'New Ingredient Testing Strategy', which was designed in accordance with the Scientific Committee on Consumer Safety (SCCS) notes of guidance and the requirements of Annex I of the EU Cosmetics Regulation. The aim of the project was to determine whether A-A-A was safe for use in cosmetics and to determine a maximum permitted safe level in the formulations. A literature review was conducted, consulting over 40 different information sources. This highlighted a number of gaps which required testing data. A-A-A was tested for phototoxicity according to OECD test guideline 432, skin irritation according to OECD test guideline 439 and eye irritation according to OECD test guideline 437. Dermal absorption of A-A-A was measured according to OECD test guideline 428 and was used to calculate the margin of safety (MoS). Finally, A-A-A was tested in a human repeat insult patch test (HRIPT) and a 14-day in-use tolerance study. A-A-A was non-phototoxic and was non-irritating to skin and eyes in in vitro testing. Dermal absorption was calculated to be 5%. The MoS for A-A-A was 351, at a level of 5%, for all cosmetic product types, indicating no systemic safety toxicity concern. A-A-A at 5% under occlusive patch on a panel of 50 adult volunteers induced no skin irritation or allergic reaction in the HRIPT study. Finally, repeated application of A-A-A to the periocular area, twice per day for 14 days, in 21 female volunteers, demonstrated that 1% A-A-A was well tolerated following dermatological and ophthalmological assessment in a cosmetic formulation. A-A-A was assessed as safe by the cosmetic safety assessor for use in cosmetics at a level of 5% in all cosmetic product types, in line with the requirements of the EU Cosmetics Regulation and in accordance with the SCCS notes of guidance. © 2015 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

European Respiratory Society guidelines for the diagnosis of primary ciliary dyskinesia.

PubMed

Lucas, Jane S; Barbato, Angelo; Collins, Samuel A; Goutaki, Myrofora; Behan, Laura; Caudri, Daan; Dell, Sharon; Eber, Ernst; Escudier, Estelle; Hirst, Robert A; Hogg, Claire; Jorissen, Mark; Latzin, Philipp; Legendre, Marie; Leigh, Margaret W; Midulla, Fabio; Nielsen, Kim G; Omran, Heymut; Papon, Jean-Francois; Pohunek, Petr; Redfern, Beatrice; Rigau, David; Rindlisbacher, Bernhard; Santamaria, Francesca; Shoemark, Amelia; Snijders, Deborah; Tonia, Thomy; Titieni, Andrea; Walker, Woolf T; Werner, Claudius; Bush, Andrew; Kuehni, Claudia E

2017-01-01

The diagnosis of primary ciliary dyskinesia is often confirmed with standard, albeit complex and expensive, tests. In many cases, however, the diagnosis remains difficult despite the array of sophisticated diagnostic tests. There is no "gold standard" reference test. Hence, a Task Force supported by the European Respiratory Society has developed this guideline to provide evidence-based recommendations on diagnostic testing, especially in light of new developments in such tests, and the need for robust diagnoses of patients who might enter randomised controlled trials of treatments. The guideline is based on pre-defined questions relevant for clinical care, a systematic review of the literature, and assessment of the evidence using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach. It focuses on clinical presentation, nasal nitric oxide, analysis of ciliary beat frequency and pattern by high-speed video-microscopy analysis, transmission electron microscopy, genotyping and immunofluorescence. It then used a modified Delphi survey to develop an algorithm for the use of diagnostic tests to definitively confirm and exclude the diagnosis of primary ciliary dyskinesia; and to provide advice when the diagnosis was not conclusive. Finally, this guideline proposes a set of quality criteria for future research on the validity of diagnostic methods for primary ciliary dyskinesia. Copyright ©ERS 2017.

Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project.

PubMed

2003-02-01

International interest in clinical practice guidelines has never been greater but many published guidelines do not meet the basic quality requirements. There have been renewed calls for validated criteria to assess the quality of guidelines. To develop and validate an international instrument for assessing the quality of the process and reporting of clinical practice guideline development. The instrument was developed through a multi-staged process of item generation, selection and scaling, field testing, and refinement procedures. 100 guidelines selected from 11 participating countries were evaluated independently by 194 appraisers with the instrument. Following refinement the instrument was further field tested on three guidelines per country by a new set of 70 appraisers. The final version of the instrument contained 23 items grouped into six quality domains with a 4 point Likert scale to score each item (scope and purpose, stakeholder involvement, rigour of development, clarity and presentation, applicability, editorial independence). 95% of appraisers found the instrument useful for assessing guidelines. Reliability was acceptable for most domains (Cronbach's alpha 0.64-0.88). Guidelines produced as part of an established guideline programme had significantly higher scores on editorial independence and, after the publication of a national policy, had significantly higher quality scores on rigour of development (p<0.005). Guidelines with technical documentation had higher scores on that domain (p<0.0001). This is the first time an appraisal instrument for clinical practice guidelines has been developed and tested internationally. The instrument is sensitive to differences in important aspects of guidelines and can be used consistently and easily by a wide range of professionals from different backgrounds. The adoption of common standards should improve the consistency and quality of the reporting of guideline development worldwide and provide a framework to encourage international comparison of clinical practice guidelines.

Korean guidelines for the diagnosis and management of dry eye: development and validation of clinical efficacy.

PubMed

Hyon, Joon Young; Kim, Hyo-Myung; Lee, Doh; Chung, Eui-Sang; Song, Jong-Suk; Choi, Chul Young; Lee, Jungbok

2014-06-01

To evaluate the clinical efficacy of newly developed guidelines for the diagnosis and management of dry eye. This retrospective, multi-center, non-randomized, observational study included a total of 1,612 patients with dry eye disease who initially visited the clinics from March 2010 to August 2010. Korean guidelines for the diagnosis and management of dry eye were newly developed from concise, expert-consensus recommendations. Severity levels at initial and final visits were determined using the guidelines in patients with 90 ± 7 days of follow-up visits (n = 526). Groups with different clinical outcomes were compared with respect to clinical parameters, treatment modalities, and guideline compliance. Main outcome measures were ocular and visual symptoms, ocular surface disease index, global assessment by patient and physician, tear film break-up time, Schirmer-1 test score, ocular surface staining score at initial and final visits, clinical outcome after three months of treatment, and guideline compliance. Severity level was reduced in 47.37% of patients treated as recommended by the guidelines. Younger age (odd ratio [OR], 0.984; p = 0.044), higher severity level at initial visit, compliance to treatment recommendation (OR, 1.832; p = 0.047), and use of topical cyclosporine (OR, 1.838; p = 0.011) were significantly associated with improved clinical outcomes. Korean guidelines for the diagnosis and management of dry eye can be used as a valid and effective tool for the treatment of dry eye disease.

77 FR 38280 - Final Test Guidelines; 810 Series 2000 Product Performance; Notice of Availability

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-27

... available either electronically through http://www.regulations.gov or in hard copy at the OPP Docket in the...) and revised based on comments received from industry. In addition, formatting changes to incorporate...

75 FR 33759 - Announcement of the Availability of the Final Report of the Dietary Guidelines Advisory Committee...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-15

... HUMAN SERVICES Announcement of the Availability of the Final Report of the Dietary Guidelines Advisory... Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010 (Report); (b) solicit... Dietary Guidelines Advisory Committee (the Committee) will be available on June 15, 2010; (2) Written...

EMQN best practice guidelines for the molecular genetic testing and reporting of chromosome 11p15 imprinting disorders: Silver–Russell and Beckwith–Wiedemann syndrome

PubMed Central

Eggermann, Katja; Bliek, Jet; Brioude, Frédéric; Algar, Elizabeth; Buiting, Karin; Russo, Silvia; Tümer, Zeynep; Monk, David; Moore, Gudrun; Antoniadi, Thalia; Macdonald, Fiona; Netchine, Irène; Lombardi, Paolo; Soellner, Lukas; Begemann, Matthias; Prawitt, Dirk; Maher, Eamonn R; Mannens, Marcel; Riccio, Andrea; Weksberg, Rosanna; Lapunzina, Pablo; Grønskov, Karen; Mackay, Deborah JG; Eggermann, Thomas

2016-01-01

Molecular genetic testing for the 11p15-associated imprinting disorders Silver–Russell and Beckwith–Wiedemann syndrome (SRS, BWS) is challenging because of the molecular heterogeneity and complexity of the affected imprinted regions. With the growing knowledge on the molecular basis of these disorders and the demand for molecular testing, it turned out that there is an urgent need for a standardized molecular diagnostic testing and reporting strategy. Based on the results from the first external pilot quality assessment schemes organized by the European Molecular Quality Network (EMQN) in 2014 and in context with activities of the European Network of Imprinting Disorders (EUCID.net) towards a consensus in diagnostics and management of SRS and BWS, best practice guidelines have now been developed. Members of institutions working in the field of SRS and BWS diagnostics were invited to comment, and in the light of their feedback amendments were made. The final document was ratified in the course of an EMQN best practice guideline meeting and is in accordance with the general SRS and BWS consensus guidelines, which are in preparation. These guidelines are based on the knowledge acquired from peer-reviewed and published data, as well as observations of the authors in their practice. However, these guidelines can only provide a snapshot of current knowledge at the time of manuscript submission and readers are advised to keep up with the literature. PMID:27165005

NASA Contractor Report: Guidelines for Proof Test Analysis

NASA Technical Reports Server (NTRS)

Chell, G. G.; McClung, R. C.; Kuhlman, C. J.; Russell, D. A.; Garr, K.; Donnelly, B.

1997-01-01

These Guidelines integrate state-of-the-art Elastic-Plastic Fracture Mechanics (EPFM) and proof test implementation issues into a comprehensive proof test analysis procedure in the form of a Road Map which identifies the types of data, fracture mechanics based parameters, and calculations needed to perform flaw screening and minimum proof load analyses of fracture critical components. Worked examples are presented to illustrate the application of the Road Map to proof test analysis. The state-of-the-art fracture technology employed in these Guidelines is based on the EPFM parameter, J, and a pictorial representation of a J fracture analysis, called the Failure Assessment Diagram (FAD) approach. The recommended fracture technology is validated using finite element J results, and laboratory and hardware fracture test results on the nickel-based superalloy IN-718, the aluminum alloy 2024-T351 1, and ferritic pressure vessel steels. In all cases the laboratory specimens and hardware failed by ductile mechanisms. Advanced proof test analyses involving probability analysis and Multiple Cycle Proof Testing (MCPT) are addressed. Finally, recommendations are provided on to how to account for the effects of the proof test overload on subsequent service fatigue and fracture behaviors.

Best practice guidelines for molecular genetic diagnosis of cystic fibrosis and CFTR-related disorders--updated European recommendations.

PubMed

Dequeker, Els; Stuhrmann, Manfred; Morris, Michael A; Casals, Teresa; Castellani, Carlo; Claustres, Mireille; Cuppens, Harry; des Georges, Marie; Ferec, Claude; Macek, Milan; Pignatti, Pier-Franco; Scheffer, Hans; Schwartz, Marianne; Witt, Michal; Schwarz, Martin; Girodon, Emmanuelle

2009-01-01

The increasing number of laboratories offering molecular genetic analysis of the CFTR gene and the growing use of commercial kits strengthen the need for an update of previous best practice guidelines (published in 2000). The importance of organizing regional or national laboratory networks, to provide both primary and comprehensive CFTR mutation screening, is stressed. Current guidelines focus on strategies for dealing with increasingly complex situations of CFTR testing. Diagnostic flow charts now include testing in CFTR-related disorders and in fetal bowel anomalies. Emphasis is also placed on the need to consider ethnic or geographic origins of patients and individuals, on basic principles of risk calculation and on the importance of providing accurate laboratory reports. Finally, classification of CFTR mutations is reviewed, with regard to their relevance to pathogenicity and to genetic counselling.

Examining Changes in Prevention Guidelines in Maternal and Child Health: Development of a Teaching Activity.

PubMed

Thompson, Erika L; Vamos, Cheryl A; Windsor-Hardy, Amber; Griner, Stacey B; Daley, Ellen M

2018-06-26

Purpose Recent changes in preventive guidelines (e.g., pap testing, mammography) have resulted in confusion for both providers and patients. These changes have occurred either because new research has been introduced or because evidence for the practice is not established. Public health has the responsibility to promote the dissemination and implementation of changing guidelines into practice to improve the public's health. Health literacy may facilitate this process. The purpose of this study is to describe a teaching tool applying principles of health literacy to changes in prevention guidelines. The objectives of the teaching activity were to: (1) understand the development of evidence-informed prevention guidelines; and (2) use health literacy to evaluate the target population's perspectives on the guideline change using a health literacy approach. Description An interactive lecture and a practice-based assignment were created; the assignment was pilot-tested in graduate Women's Health classes. Multiple final products were developed in order to facilitate the lecture and assignment: (1) lesson plan; (2) slide presentation; (3) health literacy interview guide worksheet; and (4) grading rubric. After the presentation, students interviewed women from the guideline target population using health literacy constructs and synthesized their findings to create an overall assessment report. Assessment Feedback from the pilot test informed the revision of the teaching activity. Conclusions This teaching tool can be applied in a wide variety of settings in higher education, such as courses in public health, nursing, or medicine. As health literacy continues to be an important determinant of health status, integrating this determinant into the dissemination and communication of preventive guideline changes is needed.

A Retrospective Performance Assessment of the Developmental Neurotoxicity Study in Support of OECD Test Guideline 426

PubMed Central

Makris, Susan L.; Raffaele, Kathleen; Allen, Sandra; Bowers, Wayne J.; Hass, Ulla; Alleva, Enrico; Calamandrei, Gemma; Sheets, Larry; Amcoff, Patric; Delrue, Nathalie; Crofton, Kevin M.

2009-01-01

Objective We conducted a review of the history and performance of developmental neurotoxicity (DNT) testing in support of the finalization and implementation of Organisation of Economic Co-operation and Development (OECD) DNT test guideline 426 (TG 426). Information sources and analysis In this review we summarize extensive scientific efforts that form the foundation for this testing paradigm, including basic neurotoxicology research, interlaboratory collaborative studies, expert workshops, and validation studies, and we address the relevance, applicability, and use of the DNT study in risk assessment. Conclusions The OECD DNT guideline represents the best available science for assessing the potential for DNT in human health risk assessment, and data generated with this protocol are relevant and reliable for the assessment of these end points. The test methods used have been subjected to an extensive history of international validation, peer review, and evaluation, which is contained in the public record. The reproducibility, reliability, and sensitivity of these methods have been demonstrated, using a wide variety of test substances, in accordance with OECD guidance on the validation and international acceptance of new or updated test methods for hazard characterization. Multiple independent, expert scientific peer reviews affirm these conclusions. PMID:19165382

Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies: The PRISMA-DTA Statement.

PubMed

McInnes, Matthew D F; Moher, David; Thombs, Brett D; McGrath, Trevor A; Bossuyt, Patrick M; Clifford, Tammy; Cohen, Jérémie F; Deeks, Jonathan J; Gatsonis, Constantine; Hooft, Lotty; Hunt, Harriet A; Hyde, Christopher J; Korevaar, Daniël A; Leeflang, Mariska M G; Macaskill, Petra; Reitsma, Johannes B; Rodin, Rachel; Rutjes, Anne W S; Salameh, Jean-Paul; Stevens, Adrienne; Takwoingi, Yemisi; Tonelli, Marcello; Weeks, Laura; Whiting, Penny; Willis, Brian H

2018-01-23

Systematic reviews of diagnostic test accuracy synthesize data from primary diagnostic studies that have evaluated the accuracy of 1 or more index tests against a reference standard, provide estimates of test performance, allow comparisons of the accuracy of different tests, and facilitate the identification of sources of variability in test accuracy. To develop the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) diagnostic test accuracy guideline as a stand-alone extension of the PRISMA statement. Modifications to the PRISMA statement reflect the specific requirements for reporting of systematic reviews and meta-analyses of diagnostic test accuracy studies and the abstracts for these reviews. Established standards from the Enhancing the Quality and Transparency of Health Research (EQUATOR) Network were followed for the development of the guideline. The original PRISMA statement was used as a framework on which to modify and add items. A group of 24 multidisciplinary experts used a systematic review of articles on existing reporting guidelines and methods, a 3-round Delphi process, a consensus meeting, pilot testing, and iterative refinement to develop the PRISMA diagnostic test accuracy guideline. The final version of the PRISMA diagnostic test accuracy guideline checklist was approved by the group. The systematic review (produced 64 items) and the Delphi process (provided feedback on 7 proposed items; 1 item was later split into 2 items) identified 71 potentially relevant items for consideration. The Delphi process reduced these to 60 items that were discussed at the consensus meeting. Following the meeting, pilot testing and iterative feedback were used to generate the 27-item PRISMA diagnostic test accuracy checklist. To reflect specific or optimal contemporary systematic review methods for diagnostic test accuracy, 8 of the 27 original PRISMA items were left unchanged, 17 were modified, 2 were added, and 2 were omitted. The 27-item PRISMA diagnostic test accuracy checklist provides specific guidance for reporting of systematic reviews. The PRISMA diagnostic test accuracy guideline can facilitate the transparent reporting of reviews, and may assist in the evaluation of validity and applicability, enhance replicability of reviews, and make the results from systematic reviews of diagnostic test accuracy studies more useful.

Development of a novel, multilayered presentation format for clinical practice guidelines.

PubMed

Kristiansen, Annette; Brandt, Linn; Alonso-Coello, Pablo; Agoritsas, Thomas; Akl, Elie A; Conboy, Tara; Elbarbary, Mahmoud; Ferwana, Mazen; Medani, Wedad; Murad, Mohammad Hassan; Rigau, David; Rosenbaum, Sarah; Spencer, Frederick A; Treweek, Shaun; Guyatt, Gordon; Vandvik, Per Olav

2015-03-01

Bridging the gap between clinical research and everyday health-care practice requires effective communication strategies. To address current shortcomings in conveying practice recommendations and supporting evidence, we are creating and testing presentation formats for clinical practice guidelines (CPGs). We carried out multiple cycles of brainstorming and sketching, developing a prototype. Physicians participating in the user testing viewed CPG formats linked to clinical scenarios and engaged in semistructured interviews applying a think-aloud method for exploring important aspects of user experience. We developed a multilayered presentation format that allows clinicians to successively view more in-depth information. Starting with the recommendations, clinicians can, on demand, access a rationale and a key information section containing statements on quality of the evidence, balance between desirable and undesirable consequences, values and preferences, and resource considerations. We collected feedback from 27 stakeholders and performed user testing with 47 practicing physicians from six countries. Advisory group feedback and user testing of the first version revealed problems with conceptual understanding of underlying CPG methodology, as well as difficulties with the complexity of the layout and content. Extensive revisions made before the second round of user testing resulted in most participants expressing overall satisfaction with the final presentation format. We have developed an electronic, multilayered, CPG format that enhances the usability of CPGs for frontline clinicians. We have implemented the format in electronic guideline tools that guideline organizations can now use when authoring and publishing their guidelines.

How to Write Effective Procedure Manuals.

ERIC Educational Resources Information Center

Wold, Geoffrey H.

1987-01-01

Describes six key guidelines for developing usable procedure manuals, including defining the audience; designing a standard format; preparing an outline; using a clear, concise writing style; testing the procedures; and "finalizing" the product with indices, glossaries, appendices, and section tabs. Well-written manuals can increase…

COS-STAR: a reporting guideline for studies developing core outcome sets (protocol).

PubMed

Kirkham, Jamie J; Gorst, Sarah; Altman, Douglas G; Blazeby, Jane; Clarke, Mike; Devane, Declan; Gargon, Elizabeth; Williamson, Paula R

2015-08-22

Core outcome sets can increase the efficiency and value of research and, as a result, there are an increasing number of studies looking to develop core outcome sets (COS). However, the credibility of a COS depends on both the use of sound methodology in its development and clear and transparent reporting of the processes adopted. To date there is no reporting guideline for reporting COS studies. The aim of this programme of research is to develop a reporting guideline for studies developing COS and to highlight some of the important methodological considerations in the process. The study will include a reporting guideline item generation stage which will then be used in a Delphi study. The Delphi study is anticipated to include two rounds. The first round will ask stakeholders to score the items listed and to add any new items they think are relevant. In the second round of the process, participants will be shown the distribution of scores for all stakeholder groups separately and asked to re-score. A final consensus meeting will be held with an expert panel and stakeholder representatives to review the guideline item list. Following the consensus meeting, a reporting guideline will be drafted and review and testing will be undertaken until the guideline is finalised. The final outcome will be the COS-STAR (Core Outcome Set-STAndards for Reporting) guideline for studies developing COS and a supporting explanatory document. To assess the credibility and usefulness of a COS, readers of a COS development report need complete, clear and transparent information on its methodology and proposed core set of outcomes. The COS-STAR guideline will potentially benefit all stakeholders in COS development: COS developers, COS users, e.g. trialists and systematic reviewers, journal editors, policy-makers and patient groups.

ESGE-ESGENA technical specification for process validation and routine testing of endoscope reprocessing in washer-disinfectors according to EN ISO 15883, parts 1, 4, and ISO/TS 15883-5.

PubMed

Beilenhoff, Ulrike; Biering, Holger; Blum, Reinhard; Brljak, Jadranka; Cimbro, Monica; Dumonceau, Jean-Marc; Hassan, Cesare; Jung, Michael; Neumann, Christiane; Pietsch, Michael; Pineau, Lionel; Ponchon, Thierry; Rejchrt, Stanislav; Rey, Jean-François; Schmidt, Verona; Tillett, Jayne; van Hooft, Jeanin

2017-12-01

1 Prerequisites. The clinical service provider should obtain confirmation from the endoscope washer-disinfector (EWD) manufacturer that all endoscopes intended to be used can be reprocessed in the EWD. 2 Installation qualification. This can be performed by different parties but national guidelines should define who has the responsibilities, taking into account legal requirements. 3 Operational qualification. This should include parametric tests to verify that the EWD is working according to its specifications. 4 Performance qualification. Testing of cleaning performance, microbiological testing of routinely used endoscopes, and the quality of the final rinse water should be considered in all local guidelines. The extent of these tests depends on local requirements. According to the results of type testing performed during EWD development, other parameters can be tested if local regulatory authorities accept this. Chemical residues on endoscope surfaces should be searched for, if acceptable test methods are available. 5 Routine inspections. National guidelines should consider both technical and performance criteria. Individual risk analyses performed in the validation and requalification processes are helpful for defining appropriate test frequencies for routine inspections. © Georg Thieme Verlag KG Stuttgart · New York.

40 CFR 721.537 - Organosilane ester.

Code of Federal Regulations, 2010 CFR

2010-07-01

... the substance beyond the aggregate production volume limit, unless that person conducts this study on.... Scientific valid means that the study was conducted according to: (1) The test guidelines specified in... weeks prior to exceeding the applicable production volume limit. The final report shall contain the...

Effect of soil properties on the toxicity of Pb: assessment of the appropriateness of guideline values.

PubMed

Romero-Freire, A; Martin Peinado, F J; van Gestel, C A M

2015-05-30

Soil contamination with lead is a worldwide problem. Pb can cause adverse effects, but its mobility and availability in the terrestrial environment are strongly controlled by soil properties. The present study investigated the influence of different soil properties on the solubility of lead in laboratory spiked soils, and its toxicity in three bioassays, including Lactuca sativa root elongation and Vibrio fischeri illumination tests applied to aqueous extracts and basal soil respiration assays. Final aim was to compare soil-dependent toxicity with guideline values. The L. sativa bioassay proved to be more sensitive to Pb toxicity than the V. fischeri and soil respiration tests. Toxicity was significantly correlated with soil properties, with soil pH, carbonate and organic carbon content being the most important factors. Therefore, these variables should be considered when defining guideline values. Copyright © 2015 Elsevier B.V. All rights reserved.

Publication guidelines for quality improvement in health care: evolution of the SQUIRE project

PubMed Central

Davidoff, F; Batalden, P; Stevens, D; Ogrinc, G; Mooney, S

2008-01-01

In 2005, draft guidelines were published for reporting studies of quality improvement interventions as the initial step in a consensus process for development of a more definitive version. This article contains the full revised version of the guidelines, which the authors refer to as SQUIRE (Standards for QUality Improvement Reporting Excellence). This paper also describes the consensus process, which included informal feedback from authors, editors and peer reviewers who used the guidelines; formal written commentaries; input from a group of publication guideline developers; ongoing review of the literature on the epistemology of improvement and methods for evaluating complex social programmes; a two-day meeting of stakeholders for critical discussion and debate of the guidelines’ content and wording; and commentary on sequential versions of the guidelines from an expert consultant group. Finally, the authors consider the major differences between SQUIRE and the initial draft guidelines; limitations of and unresolved questions about SQUIRE; ancillary supporting documents and alternative versions that are under development; and plans for dissemination, testing and further development of SQUIRE. PMID:18836063

Publishing web-based guidelines using interactive decision models.

PubMed

Sanders, G D; Nease, R F; Owens, D K

2001-05-01

Commonly used methods for guideline development and dissemination do not enable developers to tailor guidelines systematically to specific patient populations and update guidelines easily. We developed a web-based system, ALCHEMIST, that uses decision models and automatically creates evidence-based guidelines that can be disseminated, tailored and updated over the web. Our objective was to demonstrate the use of this system with clinical scenarios that provide challenges for guideline development. We used the ALCHEMIST system to develop guidelines for three clinical scenarios: (1) Chlamydia screening for adolescent women, (2) antiarrhythmic therapy for the prevention of sudden cardiac death; and (3) genetic testing for the BRCA breast-cancer mutation. ALCHEMIST uses information extracted directly from the decision model, combined with the additional information from the author of the decision model, to generate global guidelines. ALCHEMIST generated electronic web-based guidelines for each of the three scenarios. Using ALCHEMIST, we demonstrate that tailoring a guideline for a population at high-risk for Chlamydia changes the recommended policy for control of Chlamydia from contact tracing of reported cases to a population-based screening programme. We used ALCHEMIST to incorporate new evidence about the effectiveness of implantable cardioverter defibrillators (ICD) and demonstrate that the cost-effectiveness of use of ICDs improves from $74 400 per quality-adjusted life year (QALY) gained to $34 500 per QALY gained. Finally, we demonstrate how a clinician could use ALCHEMIST to incorporate a woman's utilities for relevant health states and thereby develop patient-specific recommendations for BRCA testing; the patient-specific recommendation improved quality-adjusted life expectancy by 37 days. The ALCHEMIST system enables guideline developers to publish both a guideline and an interactive decision model on the web. This web-based tool enables guideline developers to tailor guidelines systematically, to update guidelines easily, and to make the underlying evidence and analysis transparent for users.

78 FR 52085 - VA Veteran-Owned Small Business Verification Guidelines

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-22

... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 74 RIN 2900-AO49 VA Veteran-Owned Small Business Verification Guidelines AGENCY: Department of Veterans Affairs. ACTION: Final rule. SUMMARY: This document... Domestic Assistance This final rule affects the verification guidelines of veteran- owned small businesses...

Guidelines for producing training films and videos.

PubMed

Harper, P B

1991-01-01

Drawing from experience in producing a film on the surgical procedure of female sterilization, 4 guidelines to technical film production for training purposes are presented and discussed in this paper. In order of presentation in the text, the paper 1st encourages identifying and securing a technical expert, then clearly identifying steps of the technical procedure, involving trainees and trainers in the production process, and working with experienced producers, scriptwriters, and crew members. Returning to the 1st guideline, the technical advisor will have a central presence during all photography and editing, and ideally should not have any personal investment in the procedure being shown. Prior to script finalization and sorting, research is urged to ensure concrete procedural steps. Printed materials, slides, interviews of experienced clinicians, procedure observation, and test videotape shooting may be called upon and employed as parts of the research phase. Trainees should participate during preliminary research, script development, and pretesting of early film versions, their suggestions for change incorporated where appropriate in the final version. On the final point of securing experienced workers, country nationals sensitive to relevant cultural and background dynamics should be included in the team. The special concerns of airport security regulation and customs requirements knowledge are essential, as well as their attention to assuring adequate on-site electricity for camera equipment.

How to translate therapeutic recommendations in clinical practice guidelines into rules for critiquing physician prescriptions? Methods and application to five guidelines

PubMed Central

2010-01-01

Background Clinical practice guidelines give recommendations about what to do in various medical situations, including therapeutical recommendations for drug prescription. An effective way to computerize these recommendations is to design critiquing decision support systems, i.e. systems that criticize the physician's prescription when it does not conform to the guidelines. These systems are commonly based on a list of "if conditions then criticism" rules. However, writing these rules from the guidelines is not a trivial task. The objective of this article is to propose methods that (1) simplify the implementation of guidelines' therapeutical recommendations in critiquing systems by automatically translating structured therapeutical recommendations into a list of "if conditions then criticize" rules, and (2) can generate an appropriate textual label to explain to the physician why his/her prescription is not recommended. Methods We worked on the therapeutic recommendations in five clinical practice guidelines concerning chronic diseases related to the management of cardiovascular risk. We evaluated the system using a test base of more than 2000 cases. Results Algorithms for automatically translating therapeutical recommendations into "if conditions then criticize" rules are presented. Eight generic recommendations are also proposed; they are guideline-independent, and can be used as default behaviour for handling various situations that are usually implicit in the guidelines, such as decreasing the dose of a poorly tolerated drug. Finally, we provide models and methods for generating a human-readable textual critique. The system was successfully evaluated on the test base. Conclusion We show that it is possible to criticize physicians' prescriptions starting from a structured clinical guideline, and to provide clear explanations. We are now planning a randomized clinical trial to evaluate the impact of the system on practices. PMID:20509903

Development document for final best conventional technology effluent limitations guidelines for the pharmaceutical manufacturing point source category. Final report

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

O'Farrell, T.; Hund, F.

1986-12-01

The document presents the technical rationale for best conventional technology (BCI) effluent limitations guidelines for the pharmaceutical manufacturing point-source category as required by the Clean Water Act of 1977 (P.L. 95-217, the Act). The document describes the technologies considered as the bases for BCT limitations. Section II of this document summarizes the rulemaking process. Sections III through V describe the technical data and engineering analyses used to develop the regulatory technology options. The costs and removals associated with each technology option for each plant and the application of the BCT cost test methodology are presented in Section VI. BCI limitationsmore » bases on the best conventional pollutant control technology are to be achieved by existing direct-discharging facilities.« less

ADAAG Review Federal Advisory Committee Recommendations for a New ADAAG. Final Report.

ERIC Educational Resources Information Center

Architectural and Transportation Barriers Compliance Board, Washington, DC.

This report presents the final recommendations, in the form of a new set of guidelines, of a federal advisory committee concerning revisions to the Americans with Disabilities Act Accessibility Guidelines (ADAAG). The guidelines provide scoping and technical requirements for the design, construction, and alteration of sites, facilities, buildings,…

The Potential of Environmental Sensors for Improving the Mobility Performance of Mainstream Blind Students. Final Report.

ERIC Educational Resources Information Center

Weisgerber, Robert A.; deHaas, Carla

The report describes an effort to develop and test instructional materials, techniques and procedures - ESSETS (environmental sensing, selection, evaluation and training system) - for teaching functionally blind young adults to use electronic travel aids (ETAs). Considered are development of training guidelines, field site selection and instructor…

75 FR 47592 - Final Test Guideline; Product Performance of Skin-applied Insect Repellents of Insect and Other...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-06

... considerations affecting the design and conduct of repellent studies when human subjects are involved. Any... recommendations for the design and execution of studies to evaluate the performance of pesticide products intended... recommends appropriate study designs and methods for selecting subjects, statistical analysis, and reporting...

Consensus guidelines: improving the delivery of clinical preventive services.

PubMed

Ayres, Cynthia G; Griffith, Hurdis M

2008-01-01

Medical directors from the largest competing health plans in the state came together in a noncompetitive way to collaborate on improving the delivery of clinical preventive service (CPS) among their provider base. They identified one consistent set of CPS guidelines based on U.S. Preventive Services Task Force recommendations, the health plan consensus guidelines (HPCG), that they could endorse as priority for guideline implementation. The purposes of this study were to assess clinicians' knowledge and use of CPS recommendations as a guide to delivering preventive care services to their patients and, most importantly, to test the effectiveness of providing the HPCG to clinicians in an effort to increase knowledge and use of CPS guidelines. Within-subjects repeated-measures design was used. We hypothesized an increase in clinician's knowledge and use of CPS after the provision of the HPCG. Survey methodology, including two surveys that assessed clinicians' knowledge and use of CPS in practice, was used. Health plan clinician databases were obtained from the health plans that participated in the development of the HPCG. Health plan clinicians directly involved in delivering preventive services were invited to participate in the study. Final sample included 163 clinicians. Spearman's rho correlation coefficients were determined to examine the relationships between clinician's knowledge and clinician's use of CPS guidelines. Differences between knowledge and use of CPS before and after HPCG were examined by t tests. No difference was found in the familiarity with U.S. Preventive Services Task Force guidelines before and after receipt of HPCG. However, clinician's use increased significantly. A consistent set of CPS guidelines provided by competing health plans can improve the delivery of CPS among contracted health plan clinicians. This approach provides a template for competing health plans nationwide to come to consensus on guidelines that support clinicians in the delivery of CPS ().

Antibiotic prescribing for endodontic therapies: a comparative survey between general dental practitioners and final year Bachelor of Dental Surgery students in Cardiff, UK.

PubMed

Al Masan, A A; Dummer, P M H; Farnell, D J J; Vianna, M E

2018-07-01

To evaluate the views of final year dental surgery students (BDS; G1) at Cardiff University and general dental practitioners (GDPs; G2) within the geographic area of Cardiff, Wales, on antibiotic prescribing for endodontic conditions, and investigate the potential differences between the two groups. A cross-sectional online questionnaire-based survey of 12 qualitative and quantitative questions was distributed to 76 final year BDS Cardiff University students and 55 dental practices within Cardiff, UK. Six questions recorded general information, and the remaining questions included a series of hypothetical clinical scenarios, where the participants were asked to state whether they would or would not prescribe antibiotics. The data were analysed using spss version 23 to produce descriptive statistics, contingency tables and to run chi-square (χ²) tests, Fisher's exact tests and relative risk calculations. The response rate was 60% (n = 79). All G1 participants were aware of the consequences of antibiotic overuse. Approximately 60% of responders were aware of guidelines for antibiotic use in endodontic therapies, and 83% would only use antibiotics for a limited selection of patients (e.g. patients with systemic complications). G1 responses to clinical scenarios indicated overall that they were comparable to the ideal answers except for acute apical abscess (64% believed that antibiotics were indicated). The majority of G2 were aware of the consequences of antibiotic overuse. Only 28% of G2 were aware of guidelines for antibiotic use in endodontic therapies. Overall responses revealed that antibiotics would be prescribed for: systemic complications (78%), acute apical abscess (72%) and symptomatic apical periodontitis (28%). The clinical scenarios revealed G1 were more likely to prescribe antibiotics compared to G2 for cases of necrotic pulp with symptomatic apical periodontitis without systemic complications (incorrect answer) and less likely to other clinical scenarios such as necrotic pulp and asymptomatic apical periodontitis for patients with a history of rheumatic fever (ideal answers), symptomatic irreversible/reversible pulpitis, failure to achieve anaesthesia, chronic apical abscess for patients with diabetes. The recognition of antibiotic prescription for cases with signs of spreading infection was more evident in G2. Final year undergraduate students were aware of the antibiotic resistance crisis, although a third was not aware of guidelines for use of antibiotics in endodontic conditions; their responses to clinical scenario were generally compatible with the guidelines. General dentists were less aware of the implications of overuse of antibiotics and the existence of guidelines, and their responses were occasionally incompatible with antibiotic guidelines for endodontic therapies. © 2018 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Experimental Observations for Determining the Maximum Torque Values to Apply to Composite Components Mechanically Joined With Fasteners (MSFC Center Director's Discretionary Fund Final Report, Proj. 03-13}

NASA Technical Reports Server (NTRS)

Thomas, F. P.

2006-01-01

Aerospace structures utilize innovative, lightweight composite materials for exploration activities. These structural components, due to various reasons including size limitations, manufacturing facilities, contractual obligations, or particular design requirements, will have to be joined. The common methodologies for joining composite components are the adhesively bonded and mechanically fastened joints and, in certain instances, both methods are simultaneously incorporated into the design. Guidelines and recommendations exist for engineers to develop design criteria and analyze and test composites. However, there are no guidelines or recommendations based on analysis or test data to specify a torque or torque range to apply to metallic mechanical fasteners used to join composite components. Utilizing the torque tension machine at NASA s Marshall Space Flight Center, an initial series of tests were conducted to determine the maximum torque that could be applied to a composite specimen. Acoustic emissions were used to nondestructively assess the specimens during the tests and thermographic imaging after the tests.

Study to develop improved fire resistant aircraft passenger seat materials

NASA Technical Reports Server (NTRS)

Duskin, F. E.; Schutter, K. J.; Sieth, H. H.; Trabold, E. L.

1980-01-01

The Phase 3 study of the NASA 'Improved Fire Resistant Aircraft Seat Materials' involved fire tests of improved materials in multilayered combinations representative of cushion configurations. Tests were conducted to determine their thermal, smoke, and fire resistance characteristics. Additionally, a 'Design Guideline' for Fire Resistant Passenger Seats was written outlining general seat design considerations. Finally, a three-abreast 'Tourist Class' passenger seat assembly fabricated from the most advanced fire-resistant materials was delivered.

Sewage Sludge Incinerators: Final Standards of Performance for New Stationary Sources and Emission Guidelines for Existing Sources Final Rule Fact Sheets

EPA Pesticide Factsheets

This page contains a February 2011 fact sheet with information regarding the final NSPS and Emission Guidelines for Existing Sources for Sewage Sludge Incinerators (SSI). This document provides a summary of the information for these regulations.

The NASA/industry Design Analysis Methods for Vibrations (DAMVIBS) program: McDonnell-Douglas Helicopter Company achievements

NASA Technical Reports Server (NTRS)

Toossi, Mostafa; Weisenburger, Richard; Hashemi-Kia, Mostafa

1993-01-01

This paper presents a summary of some of the work performed by McDonnell Douglas Helicopter Company under NASA Langley-sponsored rotorcraft structural dynamics program known as DAMVIBS (Design Analysis Methods for VIBrationS). A set of guidelines which is applicable to dynamic modeling, analysis, testing, and correlation of both helicopter airframes and a large variety of structural finite element models is presented. Utilization of these guidelines and the key features of their applications to vibration modeling of helicopter airframes are discussed. Correlation studies with the test data, together with the development and applications of a set of efficient finite element model checkout procedures, are demonstrated on a large helicopter airframe finite element model. Finally, the lessons learned and the benefits resulting from this program are summarized.

Physician Assessment of Pretest Probability of Malignancy and Adherence With Guidelines for Pulmonary Nodule Evaluation.

PubMed

Tanner, Nichole T; Porter, Alexander; Gould, Michael K; Li, Xiao-Jun; Vachani, Anil; Silvestri, Gerard A

2017-08-01

The annual incidence of pulmonary nodules is estimated at 1.57 million. Guidelines recommend using an initial assessment of nodule probability of malignancy (pCA). A previous study found that despite this recommendation, physicians did not follow guidelines. Physician assessments (N = 337) and two previously validated risk model assessments of pretest probability of cancer were evaluated for performance in 337 patients with pulmonary nodules based on final diagnosis and compared. Physician-assessed pCA was categorized into low, intermediate, and high risk, and the next test ordered was evaluated. The prevalence of malignancy was 47% (n = 158) at 1 year. Physician-assessed pCA performed better than nodule prediction calculators (area under the curve, 0.85 vs 0.75; P < .001 and .78; P = .0001). Physicians did not follow indicated guidelines when selecting the next test in 61% of cases (n = 205). Despite recommendations for serial CT imaging in those with low pCA, 52% (n = 13) were managed more aggressively with PET imaging or biopsy; 12% (n = 3) underwent biopsy procedures for benign disease. Alternatively, in the high-risk category, the majority (n = 103 [75%]) were managed more conservatively. Stratified by diagnosis, 92% (n = 22) with benign disease underwent more conservative management with CT imaging (20%), PET scanning (15%), or biopsy (8%), although three had surgery (8%). Physician assessment as a means for predicting malignancy in pulmonary nodules is more accurate than previously validated nodule prediction calculators. Despite the accuracy of clinical intuition, physicians did not follow guideline-based recommendations when selecting the next diagnostic test. To provide optimal patient care, focus in the areas of guideline refinement, implementation, and dissemination is needed. Published by Elsevier Inc.

40 CFR 799.9130 - TSCA acute inhalation toxicity.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., final guideline). These sources are available at the address in paragraph (g) of this section. (c... settling velocity as the particle in question, whatever its size, shape, and density. It is used to predict... between groups used in a test should not exceed ±20% of the mean weight of each sex. (C) Number of animals...

40 CFR 799.9130 - TSCA acute inhalation toxicity.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., final guideline). These sources are available at the address in paragraph (g) of this section. (c... settling velocity as the particle in question, whatever its size, shape, and density. It is used to predict... between groups used in a test should not exceed ±20% of the mean weight of each sex. (C) Number of animals...

A fall prevention guideline for older adults living in long-term care facilities.

PubMed

Jung, D; Shin, S; Kim, H

2014-12-01

Falls are among the most frequent critical health problems for older adults over 65 years of age and often result in consequential injuries. This study developed a guideline covering risk factors and interventions for falls in order to prevent them from occurring in long-term care facilities. This study was grounded in the methodological approach of the Scottish Intercollegiate Guideline Network for establishing evidence-based guidelines: (1) establishment of the target population and scope of the guideline, (2) systematic literature review and critical analysis, (3) determination of the recommendation grade, (4) development of a draft nursing intervention guideline and algorithm, (5) expert evaluation of the draft nursing intervention guideline, and (6) confirmation of the final intervention guideline and completion of the algorithm. The resulting evidence-based fall prevention guideline consists of a three-step factor assessment and a three-step intervention approach. The resulting guideline was based on the literature and clinical experts. Further research is required to test the guideline's feasibility in across long term care facilities. This guideline can be used by nurses to screen patients who are at a high risk of falling to provide patient interventions to help prevent falls. Considering the high rate of falls at long-term care facilities and the absence of evidence-based guidelines to prevent them, additional studies on falls at long-term care facilities are necessary. Meanwhile, given prior research that indicates the importance of human resources in the application of such guidelines, continuous investigations are needed as to whether the research outcomes are actually conveyed to nurses. © 2014 International Council of Nurses.

Overview of MSFC AMSD Integrated Modeling and Analysis

NASA Technical Reports Server (NTRS)

Cummings, Ramona; Russell, Kevin (Technical Monitor)

2002-01-01

Structural, thermal, dynamic, and optical models of the NGST AMSD mirror assemblies are being finalized and integrated for predicting cryogenic vacuum test performance of the developing designs. Analyzers in use by the MSFC Modeling and Analysis Team are identified, with overview of approach to integrate simulated effects. Guidelines to verify the individual models and calibration cases for comparison with the vendors' analyses are presented. In addition, baseline and proposed additional scenarios for the cryogenic vacuum testing are briefly described.

Apollo experience report: Very high frequency ranging system

NASA Technical Reports Server (NTRS)

Panter, W. C.; Shores, P. W.

1972-01-01

The history of the Apollo very-high-frequency ranging system development program is presented from the program-planning stage through the final-test and flight-evaluation stages. Block diagrams of the equipment are presented, and a description of the theory of operation is outlined. A sample of the distribution of errors measured in the aircraft-flight test program is included. The report is concluded with guidelines or recommendations for the management of development programs having the same general constraints.

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

Medicare program; Medicare depreciation, useful life guidelines--HCFA. Final rule.

PubMed

1983-08-18

These final rules amend Medicare regulations to clarify which useful life guidelines may be used by providers of health care services to determine the useful life of a depreciable asset for Medicare reimbursement purposes. Current regulations state that providers must utilize the Departmental useful life guidelines or, if none have been published by the Department, either the American Hospital Association (AHA) useful life guidelines of 1973 of IRS guidelines. We are eliminating the reference to IRS guidelines because these are now outdated for Medicare purposes since they have been rendered obsolete either by the IRS or by statutory change. We are also deleting the specific reference to the 1973 AHA guidelines since these guidelines are updated by the AHA periodically. In addition, we are clarifying that certain tax legislation on accelerated depreciation, passed by Congress, does not apply to the Medicare program.

Selecting relevant and feasible measurement instruments for the revised Dutch clinical practice guideline for physical therapy in patients after stroke.

PubMed

Otterman, Nicoline; Veerbeek, Janne; Schiemanck, Sven; van der Wees, Philip; Nollet, Frans; Kwakkel, Gert

2017-07-01

To select relevant and feasible instruments for the revision of the Dutch clinical practice guideline for physical therapy in patients with stroke. In this implementation study a comprehensive proposal for ICF categories and matching instruments was developed, based on reliability and validity. Relevant instruments were then selected in a consensus round by 11 knowledge brokers who were responsible for the implementation of the selected instruments. The feasibility of the selected instruments was tested by 36 physical therapists at different work settings within stroke services. Finally, instruments that were deemed relevant and feasible were included in the revised guideline. A total of 28 instruments were recommended for inclusion in the revised guideline. Nineteen instruments were retained from the previous guideline. Ten new instruments were tested in clinical practice, seven of which were found feasible. Two more instruments were added after critical appraisal of the set of the measurement instruments. The revised guideline contains 28 relevant and feasible instrument selected and tested in clinical practice by physical therapists. Further education and implementation is needed to integrate instruments in clinical practice. Further research is proposed for developing and implementing a core set of measurement instruments to be used at fixed time points to establish data registries that allow for continuous improvement of rehabilitation for stroke patients. Implications for Rehabilitation The revised Dutch Stroke Physical Therapy Guideline recommends a total of 28 instruments, that are relevant and feasible for clinical practice of physical therapist in the different settings of stroke rehabilitation. The selection of instrument in daily practice should be part of the clinical reasoning process of PTs and be tailored to individual patients' needs and the degree of priority of the affected ICF category. Suggested education strategies for further integration of instruments in of the daily practice of PTs in Stroke Rehabilitation are: 'Training on the job' and 'peer assessment in clinical situations'.

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

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

Czarnecki, R M

1987-05-01

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

The influence of providing a clinical practice guideline on dental students' decision making.

PubMed

van der Sanden, Wil J M; Mettes, Dirk G; Plasschaert, Alphons J M; Mulder, Jan; Verdonschot, Emiel H

2004-02-01

The aim of this study was to assess the effect of the provision of a clinical practice guideline (CPG) on dental students' decisions to remove asymptomatic, impacted lower third molars. All dental students, who in 2001 were in the 3rd, 4th or 5th (final) year of their study at the Nijmegen College of Dental Sciences, were invited to participate. A pre-test-post-test control group design was used. Given 36 patient cases, all dental students were asked to assess the need for removal of asymptomatic, impacted lower third molars. All pre-test respondents were randomly allocated to the control or intervention group. After the provision of a CPG to the intervention group, both groups were asked to assess the same cases again. Frequencies of decisions to remove the third molars were calculated. Chi-square tests and anova were used to test the influence of study year and gender on the drop-out rate and on the effect of the provision of a CPG on students' treatment decisions. The decrease in indications to remove third molars by the intervention group was statistically significant (P < 0.05). In the control group, no significant decrease was observed. It was concluded that the provision of a CPG significantly influences dental students' decision making about treatment in a third-molar decision task. Students who used the CPG showed more guideline-conformed decision making.

Diagnosis and management of hymenoptera venom allergy: British Society for Allergy and Clinical Immunology (BSACI) guidelines.

PubMed

Krishna, M T; Ewan, P W; Diwakar, L; Durham, S R; Frew, A J; Leech, S C; Nasser, S M

2011-09-01

This guidance for the management of patients with hymenoptera venom allergy has been prepared by the Standards of Care Committee (SOCC) of the British Society for Allergy and Clinical Immunology (BSACI). The guideline is based on evidence as well as on expert opinion and is for use by both adult physicians and pediatricians practising allergy. During the development of these guidelines, all BSACI members were included in the consultation process using a web-based system. Their comments and suggestions were carefully considered by the SOCC. Where evidence was lacking, consensus was reached by the experts on the committee. Included in this guideline are epidemiology, risk factors, clinical features, diagnostic tests, natural history of hymenoptera venom allergy and guidance on undertaking venom immunotherapy (VIT). There are also separate sections on children, elevated baseline tryptase and mastocytosis and mechanisms underlying VIT. Finally, we have made recommendations for potential areas of future research. © 2011 Blackwell Publishing Ltd.

Belgian methodological guidelines for pharmacoeconomic evaluations: toward standardization of drug reimbursement requests.

PubMed

Cleemput, Irina; van Wilder, Philippe; Huybrechts, Michel; Vrijens, France

2009-06-01

To develop methodological guidelines for pharmacoeconomic evaluation (PE) submitted to the Belgian Drug Reimbursement Committee as part of a drug reimbursement request. In 2006, preliminary pharmacoeconomic guidelines were developed by a multidisciplinary research team. Their feasibility was tested and discussed with all stakeholders. The guidelines were adapted and finalized in 2008. The literature review should be transparent and reproducible. PE should be performed from the perspective of the health-care payer, including the governmental payer and the patient. The target population should reflect the population identified for routine use. The comparator to be considered in the evaluation is the treatment most likely to be replaced. Cost-effectiveness and cost-utility analyses are accepted as reference case techniques, under specific conditions. A final end point-as opposed to a surrogate end point-should be used in the incremental cost-effectiveness ratio (ICER). For the calculation of quality-adjusted life-years (QALYs), a generic quality-of-life measure should be used. PE should in principle apply a lifetime horizon. Application of shorter time horizons requires appropriate justification. Uncertainty around the ICER should always be assessed. Costs and outcomes should be discounted at 3% and 1.5%, respectively. The current guidelines are the result of a constructive collaboration between the Belgian Health Care Knowledge Centre, the National Institute for Health and Disability Insurance and the pharmaceutical industry. A point of special attention is the accessibility of existing Belgian resource use data for PE. As PE should serve Belgian health-care policy, they should preferably be based on the best available data.

Development of Guidelines and Resource Materials on Latin America for Use in Grades 1-12. Final Report.

ERIC Educational Resources Information Center

Gill, Clark C.; Conroy, William B.

The Latin America Project (1966-69) consisted of two phases: (1) completion of background studies and (2) preparation, field testing, and evaluation of instructional materials. Five background bulletins were prepared and distributed (See ED 012 832, ED 012 833, ED 012 365, ED 013 342, ED 022 781) and instructional materials organized around…

European guidelines for the diagnosis and treatment of pelvic girdle pain

PubMed Central

Albert, Hanne B.; Östgaard, Hans Christian; Sturesson, Bengt; Stuge, Britt

2008-01-01

A guideline on pelvic girdle pain (PGP) was developed by “Working Group 4” within the framework of the COST ACTION B13 “Low back pain: guidelines for its management”, issued by the European Commission, Research Directorate-General, Department of Policy, Coordination and Strategy. To ensure an evidence-based approach, three subgroups were formed to explore: (a) basic information, (b) diagnostics and epidemiology, and (c) therapeutical interventions. The progress of the subgroups was discussed at each meeting and the final report is based on group consensus. A grading system was used to denote the strength of the evidence, based on the AHCPR Guidelines (1994) and levels of evidence recommended in the method guidelines of the Cochrane Back Review group. It is concluded that PGP is a specific form of low back pain (LBP) that can occur separately or in conjunction with LBP. PGP generally arises in relation to pregnancy, trauma, arthritis and/or osteoarthritis. Uniform definitions are proposed for PGP as well as for joint stability. The point prevalence of pregnant women suffering from PGP is about 20%. Risk factors for developing PGP during pregnancy are most probably a history of previous LBP, and previous trauma to the pelvis. There is agreement that non risk factors are: contraceptive pills, time interval since last pregnancy, height, weight, smoking, and most probably age. PGP can be diagnosed by pain provocation tests (P4/thigh thrust, Patrick’s Faber, Gaenslen’s test, and modified Trendelenburg’s test) and pain palpation tests (long dorsal ligament test and palpation of the symphysis). As a functional test, the active straight leg raise (ASLR) test is recommended. Mobility (palpation) tests, X-rays, CT, scintigraphy, diagnostic injections and diagnostic external pelvic fixation are not recommended. MRI may be used to exclude ankylosing spondylitis and in the case of positive red flags. The recommended treatment includes adequate information and reassurance of the patient, individualized exercises for pregnant women and an individualized multifactorial treatment program for other patients. We recommend medication (excluding pregnant women), if necessary, for pain relief. Recommendations are made for future research on PGP. PMID:18259783

75 FR 62500 - Shoshone Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-12

... Committee Act. The purpose of the meeting is to finalize the Committee's operating guidelines and develop...., Eastern Standard Time, Monday through Friday. SUPPLEMENTARY INFORMATION: The meeting is open to the public. The following business will be conducted: (1) Finalize the Committee's Operating Guidelines, (2...

Personalizing guidelines for diabetes management: twilight or dawn of the expert?

PubMed

Paschou, Stavroula A; Leslie, Richard David

2013-07-10

This opinion article on the management of type 2 diabetes considers the old and new format of guidelines and critical changes in the character of such guidelines. We highlight limitations of the guidelines and make recommendations for how treatment can be more personalised. Published guidelines for the management of adult-onset non-insulin requiring diabetes have adopted a formulaic approach to patient management that can be overseen centrally and delivered by personnel with limited training. Recently, guidelines have taken a patient-centered, multiple risk-factor approach. Importantly, local funding issues are considered, but drive the final action and not the decision-making process. The nature of the disease can be determined by laboratory tests, including screening for diabetes-associated autoantibodies. The strategy remains step-up, with intensification of drug or insulin dose. As with past guidelines, there is an assumption that in each patient with type 2 diabetes, metformin is used initially, but targets and therapies then veer in different directions to create a matrix of options based on the features and responses of each individual. Factors to consider include: (A)ge, (B)ody weight, (C)omplications and co-morbidities, Diabetes (D)uration and (E)xpense, but also patient preference and patient response. Guidelines for the management of type 2 diabetes have important limitations and a patient-centered, multiple target, multiple therapy approach is proposed.

The CARE guidelines: consensus-based clinical case report guideline development.

PubMed

Gagnier, Joel J; Kienle, Gunver; Altman, Douglas G; Moher, David; Sox, Harold; Riley, David

2014-01-01

A case report is a narrative that describes, for medical, scientific, or educational purposes, a medical problem experienced by one or more patients. Case reports written without guidance from reporting standards are insufficiently rigorous to guide clinical practice or to inform clinical study design. Develop, disseminate, and implement systematic reporting guidelines for case reports. We used a three-phase consensus process consisting of (1) pre-meeting literature review and interviews to generate items for the reporting guidelines, (2) a face-to-face consensus meeting to draft the reporting guidelines, and (3) post-meeting feedback, review, and pilot testing, followed by finalization of the case report guidelines. This consensus process involved 27 participants and resulted in a 13-item checklist-a reporting guideline for case reports. The primary items of the checklist are title, key words, abstract, introduction, patient information, clinical findings, timeline, diagnostic assessment, therapeutic interventions, follow-up and outcomes, discussion, patient perspective, and informed consent. We believe the implementation of the CARE (CAse REport) guidelines by medical journals will improve the completeness and transparency of published case reports and that the systematic aggregation of information from case reports will inform clinical study design, provide early signals of effectiveness and harms, and improve healthcare delivery. Copyright © 2014 Reproduced with permission of Global Advances in Health and Medicine. Published by Elsevier Inc. All rights reserved.

Nurses' knowledge of evidence-based guidelines for prevention of ventilator-associated pneumonia in critical care areas: a pre and post test design.

PubMed

Meherali, Salima Moez; Parpio, Yasmin; Ali, Tazeen S; Javed, Fawad

2011-01-01

Ventilator associated pneumonia (VAP) is a common hospital acquired pneumonia in ventilated patients. VAP is associated with increased morbidity, mortality duration of hospitalization and cost of treatment. Critical care nurses are usually unaware of evidence based preventive guidelines for VAP, resulting in negative impact on all aspects of patient care. This study investigated the impact of a 5-hour teaching module on nurses' knowledge to practice evidence based guidelines for the prevention of VAP. This study was conducted at a private tertiary care teaching hospital in Karachi, Pakistan. Single group pre-test design was used. Forty nurses were included in the study. The knowledge of nurses was assessed before, immediately after and 4 weeks after the intervention. The final sample (n=40) was selected on the basis of the set inclusion criteria. The demographic data sheet was used to collect relevant information about the participants. Knowledge was assessed through a self-developed validated tool, consisting of multiple choice questions. The difference in knowledge was analysed through repeated measures of analysis of variance. The mean scores at 3 time points were compared using the Tukey's multiple comparison procedure. Knowledge scores of participants increased significantly after the educational intervention in the first post-test; however, there was a decline in the score in post-test 2. the 5-hour teaching module significantly enhanced nurses' knowledge towards evidence based guidelines for the prevention of VAP. Further research is needed to assess the impact of training on nursing practice and to explore factors affecting attitudinal change.

Physiotherapy in rheumatoid arthritis: development of a practice guideline.

PubMed

Hurkmans, E J; van der Giesen, F J; Bloo, H; Boonman, D C; van der Esch, M; Fluit, M; Hilberdink, W K; Peter, W F; van der Stegen, H P; Veerman, E A; Verhoef, J; Vermeulen, H M; Hendriks, H M; Schoones, J W; Vliet Vlieland, T P

2011-01-01

To improve the quality of the physiotherapy management in patients with rheumatoid arthritis (RA) a Dutch practice guideline, based on current scientific evidence and best practice, was developed. This guideline comprised all elements of a structured approach (assessment, treatment and evaluation) and was based on the Internatio-nal Classification of Functioning, disability and Health (ICF) and the ICF core sets for RA. A guideline steering committee, comprising 10 expert physiotherapists, selected topics concerning the guideline chapters initial assessment, treatment and evaluation. With respect to treatment a systematic literature search was performed using various databases, and the evidence was graded (1-4). For the initial assessment and evaluation mainly review papers and textbooks were used. Based on evidence and expert opinion, recommendations were formulated. A first draft of the guideline was reviewed by 10 experts from different professional backgrounds resulting in the final guideline. In total 7 topics were selected. For the initial assessment, three recommendations were made. Based on the ICF core sets for RA a list of health problems relevant for the physiotherapist was made and completed with red flags and points of attention. Concerning treatment, three recommendations were formulated; both exercise therapy and education on physiotherapy were recommended, whereas passive interventions (delivery of heat or cold, mechanical, electric and electromagnetic energy, massage, passive mobilization/manipulation and balneotherapy) were neither recommended nor discouraged. For treatment evaluation at the level of activities and participation, the Health Assessment Questionnaire was recommended. For evaluating specific body structures and functions the handheld dynamometer, 6-minute walk test or Ästrand bicycle test (including Borg-scale for rating the perceived exertion), Escola Paulista de Medicina Range of Motion Scale and a Visual Analog Scale for pain and morning stiffness were recommended. This physiotherapy practice guideline for RA included seven recommendations on the initial assessment, treatment and evaluation, which were all based on the ICF and the ICF Core Set for RA. The implementation of the guideline in clinical practice needs further evaluation.

Americans With Disabilities Act (ADA) Accessibility Guidelines for Transportation Vehicles. Final rule.

PubMed

2016-12-14

The Architectural and Transportation Barriers Compliance Board (Access Board or Board) is issuing a final rule that revises its existing accessibility guidelines for non-rail vehicles--namely, buses, over-the-road buses, and vans--acquired or remanufactured by entities covered by the Americans with Disabilities Act. The revised guidelines ensure that such vehicles are readily accessible to, and usable by, individuals with disabilities. The U.S. Department of Transportation (DOT) is required to revise its accessibility standards for transportation vehicles acquired or remanufactured by entities covered by the Americans with Disabilities Act (ADA) to be consistent with the final rule.

SELECTIVE DISSEMINATION OF INFORMATION (SDI). VOLUME II, IMPLEMENTATION MANUAL. FINAL REPORT. ARMY TECHNICAL LIBRARY IMPROVEMENT STUDIES (ATLIS), REPORT NO. 16.

ERIC Educational Resources Information Center

BIVONA, WILLIAM A.

A SET OF GUIDELINES FOR IMPLEMENTING AND OPERATING A REPLICA OF A PROTOTYPE SELECTIVE DISSEMINATION OF INFORMATION (SDI) SYSTEM TESTED AT U.S. ARMY NATICK LABORATORIES, AND REPORTED IN LI 000 273, IS GIVEN IN THIS MANUAL. INFORMATION IS SUPPLIED WHICH IS USEFUL IN THE INITIAL STAGES OF IMPLEMENTATION. THE APPLICATION OF SPECIFIC CRITERIA FOR…

Publication Guidelines for Quality Improvement Studies in Health Care: Evolution of the SQUIRE Project

PubMed Central

Batalden, Paul; Stevens, David; Ogrinc, Greg; Mooney, Susan

2008-01-01

In 2005 we published draft guidelines for reporting studies of quality improvement interventions as the initial step in a consensus process for development of a more definitive version. The current article contains the revised version, which we refer to as SQUIRE (Standards for QUality Improvement Reporting Excellence). We describe the consensus process, which included informal feedback, formal written commentaries, input from publication guideline developers, review of the literature on the epistemology of improvement and on methods for evaluating complex social programs, and a meeting of stakeholders for critical review of the guidelines’ content and wording, followed by commentary on sequential versions from an expert consultant group. Finally, we examine major differences between SQUIRE and the initial draft, and consider limitations of and unresolved questions about SQUIRE; we also describe ancillary supporting documents and alternative versions under development, and plans for dissemination, testing, and further development of SQUIRE. PMID:18830766

[How to screen for pheochromocytoma, primary aldosteronism and Cushing's syndrome].

PubMed

Meyer, Patrick

2009-01-07

Pheochromocytoma, primary aldosteronism and Cushing's syndrome are uncommon disorders and are difficult to diagnose because laboratory tests lack validation and specificity. Despite these limitations, practice guidelines are proposed to standardize the screening procedure. The most reliable method to diagnose pheochromocytoma is the measurement of plasmatic and/or urinary metanephrines and normetanephrines depending on the pre-test probability of the disease. The approach for detection of primary aldosteronism is based on the aldosterone-renin ratio under standard conditions. Finally, three tests are available to establish the diagnosis of Cushing's syndrome: 24-h urinary free cortisol excretion, low-dose dexamethasone suppression test and the recent and promising late evening salivary cortisol.

Noise from high speed maglev systems: Noise sources, noise criteria, preliminary design guidelines for noise control, recommendations for acoustical test facility for maglev research. Final report, July 1991-October 1992

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

Hanson, C.E.; Abbot, P.; Dyer, I.

1993-01-01

Noise levels from magnetically-levitated trains (maglev) at very high speed may be high enough to cause environmental noise impact in residential areas. Aeroacoustic sources dominate the sound at high speeds and guideway vibrations generate noticeable sound at low speed. In addition to high noise levels, the startle effect as a result of sudden onset of sound from a rapidly moving nearby maglev vehicle may lead to increased annoyance to neighbors of a maglev system. The report provides a base for determining the noise consequences and potential mitigation for a high speed maglev system in populated areas of the United States.more » Four areas are included in the study: (1) definition of noise sources; (2) development of noise criteria; (3) development of design guidelines; and (4) recommendations for a noise testing facility.« less

Textual analysis of sugar industry influence on the World Health Organization's 2015 sugars intake guideline.

PubMed

Stuckler, David; Reeves, Aaron; Loopstra, Rachel; McKee, Martin

2016-08-01

To determine whether sugar industry-related organizations influenced textual changes between the draft and final versions of the World Health Organization's (WHO's) 2015 guideline Sugars intake for adults and children. Stakeholder consultation submissions on the draft guideline from seven sugar industry-related and 10 public health organizations were assessed using the Wordscores program. Document scores were rescaled using the Martin-Vanberg transformation to improve comparability. Draft and final guidelines were compared to identify changes influenced by the sugar industry and public health organizations. There was a small shift in transformed Wordscores score between the draft and final guidelines, from 0.25 to 0.24, towards the industry position. The change was linked to increased use of the word "low" to describe the quality of the evidence, consistent with industry arguments. There was also a shift from use of the word "consumption" to "intake", irrespective of policy position. Scores for World Sugar Research Organisation and Sugar Nutrition UK submissions ( 0.11 and 0.18, respectively) represented strong pro-industry positions and scores for European Public Health Alliance and Wemos submissions (1.00 and 0.88, respectively) represented the strongest public health positions. Industry tactics included challenging the quality of the evidence, distinguishing between different types of sugar and advocating harm reduction. There was little change between draft and final versions of the WHO sugars intake guideline 2015, following industry consultation. The main change was linked to emphasizing the low quality of the evidence on sugar's adverse effects. Guideline development appeared relatively resistant to industry influence at the stakeholder consultation stage.

Cardiological Society of India Practice Guidelines for Angiography in Patients with Renal Dysfunction

PubMed Central

Bhandari, S.; Seth, A.; Sethi, K.K.; Tyagi, S.; Gupta, R.; Tiwari, S.C.; Mehrotra, S.; Seth, Ashok; Guha, Santanu; Deb, P.K.; Dasbiswas, Arup; Mohanan, P.P.; Venugopal, K.; Sinha, Nakul; Pinto, Brian; Banerjee, Amal; Sengottuvelu, G.; Mehran, Roxana; Collough, Peter Mc

2012-01-01

Preamble The potential risk of contrast-induced acute kidney injury (CI-AKI) has made utilization of coronary angiography in the work-up for the diagnosis of coronary artery disease in CKD quite low.1 This is in contrast to increasing prevalence and severity of CAD as the serum creatinine rises.2 In fact most CKD patients will succumb to CAD and not to ESRD.3 Thus the judicious use of CAG/PCI in this setting is of prime importance but underused. The CSI began to develop guidelines for Indian context as most guidelines are those developed by ACC/AHA or ESC. The aim was to assist the physicians in selecting the best management strategy for an individual patient under his care based on an expert committee who would review the current data and write the guidelines with relevance to the Indian context. The guidelines were developed initially in June 2010 as an initiative of Delhi CSI. Three interventional cardiologist (SB, AS, KKS), one nephrologist (SCT) and two clinical cardiologists (ST, RG) along with Dr. Roxana Mehran (New York) and Dr. Peter McCullough (Missouri), U.S.A.; were involved in a three-way teleconference to discuss/debate the data. This was presented by SB, and over the next two hours each data subset was debated/agreed/deleted and this resulted in the “Guidelines for CAG in Renal Dysfunction Patients”. These were then written and re- circulated to all for final comments. Further, these guidelines were updated and additional Task Force Members nominated by Central CSI were involved in the formation of the final CSI Guidelines. Both (Roxana Mehran and Peter McCullough) reviewed these updated Guidelines in October 2012 and after incorporating the views of all the Task Force members—the final format is as it is presented in this final document. PMID:23186627

Guidelines for evaluation and treatment of lead poisoning of wild raptors

USGS Publications Warehouse

Fallon, Jesse A.; Redig, Patrick; Miller, Tricia A.; Lanzone, Michael J.; Katzner, Todd

2017-01-01

Lead poisoning is a threat to birds, particularly scavenging birds of prey. With the availability of portable lead-testing kits, an increasing number of field researchers are testing wild-caught birds, in situ, for lead poisoning. We describe guidelines for evaluation of lead toxicity in wild raptors by outlining field testing of blood-lead concentrations, presenting criteria for removing a lead-poisoned bird from the wild for treatment, and suggesting strategies for effective treatment of lead intoxicated raptors. Field testing of birds is most commonly accomplished via portable electrochemical analysis of blood; visual observation of condition alone may provide insufficient evidence upon which to make a decision about lead poisoning. Our intended audience is not only the avian research community, but also rehabilitation facilities that may receive apparently uninjured birds. Best practices suggest that birds whose blood-lead levels are <40 μg/dL be released back to the wild as soon as possible after capture. The decision to release or treat birds with blood-lead levels between 40 μg/dL and 60 μg/dL should be made based on the presence of clinical signs of poisoning and relevant biological characteristics (e.g., breeding status). Finally, birds with blood-lead levels >60 μg/dL are potentially lethally poisoned and best served if removed from the wild for appropriate treatment at a licensed rehabilitation facility and later released. We present guidelines for decision-making when treating lead poisoning of wild raptors. Future work based on experimental studies will clarify the role of lead poisoning for specific species and be important to refine these guidelines to improve effectiveness.

75 FR 20556 - Announcement of the Sixth and Final Dietary Guidelines Advisory Committee Meeting and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-20

... Economics (REE); and U.S. Department of Health and Human Services (HHS), Office of Public Health and Science... DEPARTMENT OF AGRICULTURE DEPARTMENT OF HEALTH AND HUMAN SERVICES Announcement of the Sixth and... Human Services (HHS) (a) provide notice of the sixth and final meeting of the Dietary Guidelines...

Agreement between student dietitians' identification of refeeding syndrome risk with refeeding guidelines, electrolytes and other dietitians: a pilot study.

PubMed

Matthews, K; Owers, E; Palmer, M

2015-12-01

Limited research exists concerning how consistently and accurately student and newly-graduated dietitians are identifying refeeding syndrome risk in hospitalised patients. The present study aimed to determine the consistency of students' and newly-graduated dietitians' classification of refeeding syndrome risk, as well as agreement with the application of comparison tools such as the National Institute for Health and Care Excellence guidelines, patients' electrolytes and supplementation, and clinical dietitians previously surveyed. Recently-graduated and final-year Griffith University dietetics students were invited to complete an online survey. The survey questioned demographics and asked respondents to classify the level of refeeding syndrome risk (i.e. none, some, high, unsure) in 13 case studies. Electrolytes and supplementation data were sourced from electronic patient records. Chi-squared tests, t-tests and linear regression analyses were conducted. Fifty-three eligible people responded [n = 53 of 112, mean (SD) age 26 (4) years, 89% female, 34% graduates]. Respondents' answers were generally more consistent and more likely to agree with comparison tools when two tools showed the same level of refeeding syndrome risk (49-98%, β = 0.626-1.0994, P < 0.001) than when they differed (11-49%). Respondents' level of agreement with refeeding identification guidelines, electrolyte levels, supplementation and dietitians previously surveyed did not differ by graduate status, degree level, clinical placement status or having read refeeding syndrome guidelines recently (P > 0.05). Students' and new graduates' identification of refeeding syndrome risk improved when there was consistency between guidelines, electrolytes and dietitians' responses. More research is needed to improve the evidence behind refeeding guidelines, with the aim of enhancing the accuracy and consistency of assessment. © 2014 The British Dietetic Association Ltd.

Bone Marrow Synoptic Reporting for Hematologic Neoplasms: Guideline From the College of American Pathologists Pathology and Laboratory Quality Center.

PubMed

Sever, Cordelia; Abbott, Charles L; de Baca, Monica E; Khoury, Joseph D; Perkins, Sherrie L; Reichard, Kaaren Kemp; Taylor, Ann; Terebelo, Howard R; Colasacco, Carol; Rumble, R Bryan; Thomas, Nicole E

2016-09-01

-There is ample evidence from the solid tumor literature that synoptic reporting improves accuracy and completeness of relevant data. No evidence-based guidelines currently exist for synoptic reporting for bone marrow samples. -To develop evidence-based recommendations to standardize the basic components of a synoptic report template for bone marrow samples. -The College of American Pathologists Pathology and Laboratory Quality Center convened a panel of experts in hematopathology to develop recommendations. A systematic evidence review was conducted to address 5 key questions. Recommendations were derived from strength of evidence, open comment feedback, and expert panel consensus. -Nine guideline statements were established to provide pathology laboratories with a framework by which to develop synoptic reporting templates for bone marrow samples. The guideline calls for specific data groups in the synoptic section of the pathology report; provides a list of evidence-based parameters for key, pertinent elements; and addresses ancillary testing. -A framework for bone marrow synoptic reporting will improve completeness of the final report in a manner that is clear, succinct, and consistent among institutions.

TRICARE: changes included in the National Defense Authorization Act for Fiscal Year 2007; improvements to descriptions of cancer screening for women. Final rule.

PubMed

2010-08-06

The Department is publishing this final rule to implement section 703 of the National Defense Authorization Act (NDAA) for Fiscal Year 2007 (FY07), Public Law 109-364. Specifically, that legislation authorizes breast cancer screening and cervical cancer screening for female beneficiaries of the Military Health System, instead of constraining such testing to mammograms and Papanicolaou smears. The rule allows coverage for "breast cancer screening" and "cervical cancer screening" for female beneficiaries of the Military Health System, instead of constraining such testing to mammograms and Papanicolaou tests. This rule ensures new breast and cervical cancer screening procedures can be added to the TRICARE benefit as such procedures are proven to be a safe, effective, and nationally accepted medical practice. This amends the cancer specific recommendations for breast and cervical cancer screenings to be brought in line with the processes for updating other cancer screening recommendations. In response to public comment on the proposed rule, this final rule includes a clarification that the benefit encompasses screening based on Health and Human Services guidelines.

76 FR 30308 - National Standard 10 Guidelines; Public Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-25

... Standard 10 Guidelines; Public Meetings AGENCY: National Marine Fisheries Service (NMFS), National Oceanic... to the National Standard 10 (NS10) Guidelines and announced a public meeting to be held on May 19... practicable, promote the safety of human life at sea.'' NMFS published final guidelines for NS10 in 1998 (63...

The European Respiratory Society and European Society of Thoracic Surgeons clinical guidelines for evaluating fitness for radical treatment (surgery and chemoradiotherapy) in patients with lung cancer.

PubMed

Brunelli, Alessandro; Charloux, Anne; Bolliger, Chris T; Rocco, Gaetano; Sculier, Jean-Paul; Varela, Gonzalo; Licker, Marc; Ferguson, Mark K; Faivre-Finn, Corinne; Huber, Rudolf Maria; Clini, Enrico M; Win, Thida; De Ruysscher, Dirk; Goldman, Lee

2009-07-01

The European Respiratory Society (ERS) and the European Society of Thoracic Surgeons (ESTS) established a joint task force with the purpose to develop clinical evidence-based guidelines on evaluation of fitness for radical therapy in patients with lung cancer. The following topics were discussed, and are summarized in the final report along with graded recommendations: Cardiologic evaluation before lung resection; lung function tests and exercise tests (limitations of ppoFEV1; DLCO: systematic or selective?; split function studies; exercise tests: systematic; low-tech exercise tests; cardiopulmonary (high tech) exercise tests); future trends in preoperative work-up; physiotherapy/rehabilitation and smoking cessation; scoring systems; advanced care management (ICU/HDU); quality of life in patients submitted to radical treatment; combined cancer surgery and lung volume reduction surgery; compromised parenchymal sparing resections and minimally invasive techniques: the balance between oncological radicality and functional reserve; neoadjuvant chemotherapy and complications; definitive chemo and radiotherapy: functional selection criteria and definition of risk; should surgical criteria be re-calibrated for radiotherapy?; the patient at prohibitive surgical risk: alternatives to surgery; who should treat thoracic patients and where these patients should be treated?

Textual analysis of sugar industry influence on the World Health Organization’s 2015 sugars intake guideline

PubMed Central

Reeves, Aaron; Loopstra, Rachel; McKee, Martin

2016-01-01

Abstract Objective To determine whether sugar industry-related organizations influenced textual changes between the draft and final versions of the World Health Organization’s (WHO’s) 2015 guideline Sugars intake for adults and children. Methods Stakeholder consultation submissions on the draft guideline from seven sugar industry-related and 10 public health organizations were assessed using the Wordscores program. Document scores were rescaled using the Martin–Vanberg transformation to improve comparability. Draft and final guidelines were compared to identify changes influenced by the sugar industry and public health organizations. Findings There was a small shift in transformed Wordscores score between the draft and final guidelines, from 0.25 to 0.24, towards the industry position. The change was linked to increased use of the word “low” to describe the quality of the evidence, consistent with industry arguments. There was also a shift from use of the word “consumption” to “intake”, irrespective of policy position. Scores for World Sugar Research Organisation and Sugar Nutrition UK submissions ( 0.11 and 0.18, respectively) represented strong pro-industry positions and scores for European Public Health Alliance and Wemos submissions (1.00 and 0.88, respectively) represented the strongest public health positions. Industry tactics included challenging the quality of the evidence, distinguishing between different types of sugar and advocating harm reduction. Conclusion There was little change between draft and final versions of the WHO sugars intake guideline 2015, following industry consultation. The main change was linked to emphasizing the low quality of the evidence on sugar’s adverse effects. Guideline development appeared relatively resistant to industry influence at the stakeholder consultation stage. PMID:27516634

76 FR 23871 - Guidelines for the Supervisory Review Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-29

... NATIONAL CREDIT UNION ADMINISTRATION 12 CFR Chapter VII [IRPS 11-1] Guidelines for the Supervisory Review Committee AGENCY: National Credit Union Administration (NCUA). ACTION: Final Interpretative Ruling.... 2160 (1994), the NCUA Board (Board) adopted guidelines that established an independent appellate...

Gastroesophageal reflux disease management according to contemporary international guidelines: a translational study.

PubMed

Pace, Fabio; Riegler, Gabriele; de Leone, Annalisa; Dominici, Patrizia; Grossi, Enzo

2011-03-07

To test the Genval recommendations and the usefulness of a short trial of proton pump inhibitor (PPI) in the initial management and maintenance treatment of gastroesophageal reflux disease (GERD) patients. Five hundred and seventy seven patients with heartburn were recruited. After completing a psychometric tool to assess quality of life (PGWBI) and a previously validated GERD symptom questionnaire (QUID), patients were grouped into those with esophagitis (EE, n = 306) or without mucosal damage (NERD, n = 271) according to endoscopy results. The study started with a 2-wk period of high dose omeprazole (omeprazole test); patients responding to this PPI test entered an acute phase (3 mo) of treatment with any PPI at the standard dose. Finally, those patients with a favorable response to the standard PPI dose were maintained on a half PPI dose for a further 3-mo period. The test was positive in 519 (89.9%) patients, with a greater response in EE patients (96.4%) compared with NERD patients (82.6%) (P = 0.011). Both the percentage of completely asymptomatic patients, at 3 and 6 mo, and the reduction in heartburn intensity were significantly higher in the EE compared with NERD patients (P < 0.01). Finally, the mean PGWBI score was significantly decreased before and increased after therapy in both subgroups when compared with the mean value in a reference Italian population. Our study confirms the validity of the Genval guidelines in the management of GERD patients. In addition, we observed that the overall response to PPI therapy is lower in NERD compared to EE patients.

76 FR 1630 - Supplemental Guidelines for Sex Offender Registration and Notification

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-11

...] RIN 1105-AB36 Supplemental Guidelines for Sex Offender Registration and Notification AGENCY: Department of Justice. ACTION: Final guidelines. SUMMARY: The Sex Offender Registration and Notification Act (SORNA), establishes minimum national standards for sex offender registration and notification. The...

Diagnostic Imaging Guidelines Implementation Study for Spinal Disorders

PubMed Central

Bussières, André E.; Laurencelle, Louis; Peterson, Cynthia

2010-01-01

Purpose: Implementation strategies of imaging guidelines can assist in reducing the number of radiographic examinations. This study aimed to compare the perceived need for diagnostic imaging before and after an educational intervention strategy. Methods: One hundred sixty Swiss chiropractors attending a conference were randomized to either receive a radiology workshop, reviewing appropriate indications for diagnostic imaging for adult spine disorders (n = 80), or be in a control group (CG). One group of 40 individuals dropped out from the CG due to logistic reasons. Participants in the intervention group were randomly assigned to three subgroups to evaluate the effect of an online reminder at midpoint. All participants underwent a pretest and a final test at 14–16 weeks. A posttest was administered to two subgroups at 8–10 weeks. Results: There was no difference between baseline scores, and overall scores for the pretest and the final tests for all four groups were not significantly different. However, the subgroup provided with access to a reminder performed significantly better than the subgroup with whom they were compared (F = 4.486; df = 1 and 30; p = .043). Guideline adherence was 50.5% (95% CI, 39.1–61.8) for the intervention group and 43.7% (95% CI, 23.7–63.6) for the CG at baseline. Adherence at follow-up was lower, but mean group differences remained insignificant. Conclusions: Online access to specific recommendations while making a clinical decision may favorably influence the intention to either order or not order imaging studies. However, a didactic presentation alone did not appear to change the perception for the need of diagnostic imaging studies. PMID:20480010

Automotive advertising copy test. Final report

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

Not Available

In order to better understand consumer perceptions and use of the mileage estimates as presented in print advertising, the Department of Energy, in conjunction with the Federal Trade Commission and the EPA, initiated a research project. Purpose was to: measure recall/recognition of EPA Estimated MPG/highway mileage estimates in print ads; determine consumer expectations and believability of advertised mileage guidelines; measure recall/comprehension of mileage disclaimers; and determine how consumers utilize published mileage estimates.

European guidelines for workplace drug and alcohol testing in hair.

PubMed

Salomone, A; Tsanaclis, L; Agius, R; Kintz, P; Baumgartner, M R

2016-10-01

Guidelines for Legally Defensible Workplace Drug Testing have been prepared and updated by the European Workplace Drug Testing Society (EWDTS). They are based on the 2010 version published by Pascal Kintz and Ronald Agius (Guidelines for European workplace drug and alcohol testing in hair. Drug Test. Anal. 2010, 2, 367) and in concordance with the Society of Hair Testing guidelines (Society of Hair Testing guidelines for drug testing in hair. Forensic Sci. Int. 2012, 218, 20-24). The European Guidelines are designed to establish best practice procedures whilst allowing individual countries to operate within the requirements of national customs and legislation. The EWDTS recommends that all European laboratories that undertake legally defensible workplace drug testing use these guidelines as a template for accreditation. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Detection of Endotoxin Contamination of Graphene Based Materials Using the TNF-α Expression Test and Guidelines for Endotoxin-Free Graphene Oxide Production

PubMed Central

Del Rio-Castillo, Antonio E.; Newman, Leon; Vázquez, Ester; Kostarelos, Kostas; Wick, Peter; Fadeel, Bengt

2016-01-01

Nanomaterials may be contaminated with bacterial endotoxin during production and handling, which may confound toxicological testing of these materials, not least when assessing for immunotoxicity. In the present study, we evaluated the conventional Limulus amebocyte lysate (LAL) assay for endotoxin detection in graphene based material (GBM) samples, including graphene oxide (GO) and few-layered graphene (FLG). Our results showed that some GO samples interfered with various formats of the LAL assay. To overcome this problem, we developed a TNF-α expression test (TET) using primary human monocyte-derived macrophages incubated in the presence or absence of the endotoxin inhibitor, polymyxin B sulfate, and found that this assay, performed with non-cytotoxic doses of the GBM samples, enabled unequivocal detection of endotoxin with a sensitivity that is comparable to the LAL assay. FLG also triggered TNF-α production in the presence of the LPS inhibitor, pointing to an intrinsic pro-inflammatory effect. Finally, we present guidelines for the preparation of endotoxin-free GO, validated by using the TET. PMID:27880838

Detection of Endotoxin Contamination of Graphene Based Materials Using the TNF-α Expression Test and Guidelines for Endotoxin-Free Graphene Oxide Production.

PubMed

Mukherjee, Sourav P; Lozano, Neus; Kucki, Melanie; Del Rio-Castillo, Antonio E; Newman, Leon; Vázquez, Ester; Kostarelos, Kostas; Wick, Peter; Fadeel, Bengt

2016-01-01

Nanomaterials may be contaminated with bacterial endotoxin during production and handling, which may confound toxicological testing of these materials, not least when assessing for immunotoxicity. In the present study, we evaluated the conventional Limulus amebocyte lysate (LAL) assay for endotoxin detection in graphene based material (GBM) samples, including graphene oxide (GO) and few-layered graphene (FLG). Our results showed that some GO samples interfered with various formats of the LAL assay. To overcome this problem, we developed a TNF-α expression test (TET) using primary human monocyte-derived macrophages incubated in the presence or absence of the endotoxin inhibitor, polymyxin B sulfate, and found that this assay, performed with non-cytotoxic doses of the GBM samples, enabled unequivocal detection of endotoxin with a sensitivity that is comparable to the LAL assay. FLG also triggered TNF-α production in the presence of the LPS inhibitor, pointing to an intrinsic pro-inflammatory effect. Finally, we present guidelines for the preparation of endotoxin-free GO, validated by using the TET.

International Guidelines on Computer-Based and Internet-Delivered Testing

ERIC Educational Resources Information Center

International Journal of Testing, 2006

2006-01-01

Developed by the International Test Commission, the International Guidelines on Computer-Based and Internet-Delivered Testing are a set of guidelines specifically developed to highlight good practice issues in relation to computer/Internet tests and testing. These guidelines have been developed from an international perspective and are directed at…

[Guidelines for the sociomedical assessment of performance in patients suffering from chronic non-malignant diseases of the liver and the bile ducts--for the Medical Assessment Services of the German Pension Fund].

PubMed

Horn, S; Irle, H; Knorr, I; Pottins, I; Rohwetter, M; Schuhknecht, P; Timner, K; Becker, E

2009-06-01

The following guidelines were developed for the medical assessment services of the German pension fund. Starting from day-to-day practice, criteria and attributes to guide decisions for a systematisation of the sociomedical assessment of performance in diseases of the liver and the bile ducts were compiled. The guidelines aim at standardising the sociomedical assessment of performance and help to make the decision-making process more transparent, e. g., for the assessment of applications for decreased earning capacity benefits. The guidelines summarise the typical manifestations of diseases of the liver and the bile ducts and describe the necessary medical information for the sociomedical assessment of performance. Relevant assessment criteria for the medical history, clinical examination, and for diagnostic tests are illustrated. The assessment of the individual's capacity is outlined, taking occupational factors into account. Following the determination of dysfunctions, the remaining abilities and disabilities, respectively, are deduced and compared with occupational demands. Finally, inferences are drawn regarding the occupational capacity of the individual. The guidelines followed from an extended procedure to attain a wide consensus in the setting of the German Pension Fund and an upgraded evidence base.

78 FR 24817 - Visual-Manual NHTSA Driver Distraction Guidelines for In-Vehicle Electronic Devices

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-26

...The National Highway Traffic Safety Administration (NHTSA) is concerned about the effects of distraction on motor vehicle safety due to drivers' use of electronic devices. Consequently, NHTSA is issuing nonbinding, voluntary Driver Distraction Guidelines (NHTSA Guidelines) to promote safety by discouraging the introduction of excessively distracting devices in vehicles. This notice announces the issuance of the final version of the first phase of the NHTSA Guidelines. This first phase applies to original equipment (OE) in-vehicle electronic devices used by the driver to perform secondary tasks (communications, entertainment, information gathering, navigation tasks, etc. are considered secondary tasks) through visual-manual means (i.e., the driver looks at a device, manipulates a device-related control with his or her hand, and/or watches for visual feedback). The NHTSA Guidelines list certain secondary tasks believed by the agency to interfere inherently with a driver's ability to safely control the vehicle. The NHTSA Guidelines recommend that in-vehicle devices be designed so that they cannot be used by the driver to perform these inherently distracting secondary tasks while driving. For all other visual-manual secondary tasks, the NHTSA Guidelines specify a test method for measuring eye glance behavior during those tasks. Eye glance metrics are compared to acceptance criteria to evaluate whether a task interferes too much with driver attention, rendering it unsuitable for a driver to perform while driving. If a task does not meet the acceptance criteria, the NHTSA Guidelines recommend that the task be made inaccessible for performance by the driver while driving. In addition, the NHTSA Guidelines contain several recommendations to limit and reduce the potential for distraction associated with the use of OE in-vehicle electronic devices.

Effect of test concentration in the ready biodegradability test for chemical substances: Improvement of OECD test guideline 301C.

PubMed

Nabeoka, Ryosuke; Taruki, Masanori; Kayashima, Takakazu; Yoshida, Tomohiko; Kameya, Takashi

2016-01-01

In Japan, understanding the environmental persistence of chemicals is very important for risk assessment, and ready biodegradability tests are mainly conducted according to the Organisation for Economic Co-operation and Development test guideline 301C. However, the highest test concentration specified in test guideline 301C, 100 mg/L, may cause microbial toxicity and incomplete biodegradation. The authors performed test guideline 301C tests at test concentrations of 30 mg/L for 13 substances that were readily biodegradable in ready biodegradability tests but not in test guideline 301C tests. Of the 5 substances with potential to cause microbial toxicity at 100 mg/L, the percentage of biodegradation of sodium dimethyldithiocarbamate, 4-chloro-3-cresol (CC), thymol (THY), and p-tert-butyl-α-methylbenzenepropionaldehyde measured by biochemical oxygen demand (BOD) increased in the test guideline 301C test at 30 mg/L, suggesting a reduction in toxicity effects. Furthermore, CC and THY met the criteria for ready biodegradability, which are more than 60% of biodegradation by BOD and a 10-d window. Of the 8 substances with a low potential for causing microbial toxicity at 100 mg/L, the percentage of biodegradation of only 2-(diethylamino)ethanol increased in the test guideline 301C test at 30 mg/L. Employing a lower test concentration in the standard test guideline 301C test will contribute to improvement of consistency between results of a test guideline 301C test and other ready biodegradability tests. © 2015 SETAC.

40 CFR 799.11 - Availability of test guidelines.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Availability of test guidelines. 799.11... General Provisions § 799.11 Availability of test guidelines. (a) The TSCA and FIFRA guidelines for the...-487-4650). (b) The OECD guidelines for the various study plans are available from the following...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-28

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

Void Growth and Coalescence Simulations

DTIC Science & Technology

2013-08-01

distortion and damage, minimum time step, and appropriate material model parameters. Further, a temporal and spatial convergence study was used to...estimate errors, thus, this study helps to provide guidelines for modeling of materials with voids. Finally, we use a Gurson model with Johnson-Cook...spatial convergence study was used to estimate errors, thus, this study helps to provide guidelines for modeling of materials with voids. Finally, we

Nondiscrimination on the basis of handicap; procedures and guidelines relating to health care for handicapped infants--HHS. Final rules.

PubMed

1984-01-12

These are final rules on procedures and guidelines relating to nondiscrimination on the basis of handicap in connection with health care for handicapped infants. These rules are issued under the authority of section 504 of the Rehabilitation Act of 1973, which prohibits discrimination on the basis of handicap in programs and activities receiving Federal financial assistance.

10 CFR 960.3-2-2-5 - Formal site nomination.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-2-2-5 Formal site nomination. After the final..., consideration of the available evidence, evaluations, and the resultant findings for the guidelines of subparts...

10 CFR 960.3-2-2-5 - Formal site nomination.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-2-2-5 Formal site nomination. After the final..., consideration of the available evidence, evaluations, and the resultant findings for the guidelines of subparts...

10 CFR 960.3-2-2-5 - Formal site nomination.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-2-2-5 Formal site nomination. After the final..., consideration of the available evidence, evaluations, and the resultant findings for the guidelines of subparts...

10 CFR 960.3-2-2-5 - Formal site nomination.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-2-2-5 Formal site nomination. After the final..., consideration of the available evidence, evaluations, and the resultant findings for the guidelines of subparts...

76 FR 47353 - Final Directives for Forest Service Wind Energy Special Use Authorizations, Forest Service Manual...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-04

... siting wind energy turbines, evaluating a variety of resource interests, and addressing issues... power guidelines produced by the Wind Energy Turbines Guidelines Advisory Committee, which consists of... recognizes that recommendations from the Wind Energy Turbines Guidelines Advisory Committee will be used to...

European guidelines for workplace drug testing in oral fluid.

PubMed

Brcak, Michaela; Beck, Olof; Bosch, Tessa; Carmichael, Duncan; Fucci, Nadia; George, Claire; Piper, Mark; Salomone, Alberto; Schielen, Wim; Steinmeyer, Stefan; Taskinen, Sanna; Weinmann, Wolfgang

2018-03-01

These guidelines for Legally Defensible Workplace Drug Testing have been prepared and updated by the European Workplace Drug Testing Society (EWDTS). The European Guidelines are designed to establish best practice procedures whilst allowing individual countries to operate within the requirements of national customs and legislation. The EWDTS recommends that all European laboratories that undertake legally defensible workplace drug testing should use these guidelines as a template for accreditation. These guidelines are relevant to laboratory-based testing only. These guidelines follow current best practices and are constantly under review. Copyright © 2017 John Wiley & Sons, Ltd.

Qualitative and Semiquantitative Elastography for the Diagnosis of Intermediate Suspicious Thyroid Nodules Based on the 2015 American Thyroid Association Guidelines.

PubMed

Yang, Bo Ra; Kim, Eun-Kyung; Moon, Hee Jung; Yoon, Jung Hyun; Park, Vivian Y; Kwak, Jin Young

2018-04-01

To evaluate qualitative and semiquantitative elastography for the diagnosis of intermediate suspicious thyroid nodules based on the 2015 American Thyroid Association (ATA) guidelines. Through a retrospective search of our institutional database, 746 solid thyroid nodules found on grayscale ultrasonography, strain elastography, and ultrasound-guided fine-needle aspiration between June and November 2009 were collected. Among them, 80 nodules from 80 patients with an intermediate suspicion of malignancy based on the 2015 ATA guidelines that were 10 mm or larger were recruited as the final study nodules. Elastographic findings were categorized according to the criteria of Rago et al (J Clin Endocrinol Metab 2007; 92:2917-2922) and Asteria et al (Thyroid 2008; 18:523-531), and strain ratio values were calculated and recorded. The independent 2-sample t test and χ 2 test (or Fisher exact test) were used to evaluate differences in clinical parameters between benign and malignant thyroid nodules. All variables were compared by univariate and multivariate logistic regression analyses, and odds ratios with 95% confidence intervals were calculated. Of the 80 nodules, 6 (7.5%) were malignant, and 74 (92.5%) were benign. No significant differences were observed in age, sex, nodule size, elasticity score, and strain ratio between benign and malignant nodules. No variables significantly predicted thyroid malignancy on the univariate analysis. On the multivariate logistic regression analysis, there were no independent variables associated with thyroid malignancy, including the elasticity score and strain ratio (all P > .05). Elastographic analysis using the elasticity score and strain ratio has limited ability to characterize the benignity or malignancy of thyroid nodules with an intermediate suspicion of malignancy based on the 2015 ATA guidelines. © 2017 by the American Institute of Ultrasound in Medicine.

European guidelines for workplace drug testing in urine.

PubMed

Taskinen, Sanna; Beck, Olof; Bosch, Tessa; Brcak, Michaela; Carmichael, Duncan; Fucci, Nadia; George, Claire; Piper, Mark; Salomone, Alberto; Schielen, Wim; Steinmeyer, Stefan; Weinmann, Wolfgang

2017-06-01

These European Guidelines for Workplace Drug Testing in Urine have been prepared and updated by the European Workplace Drug Testing Society (EWDTS). The first version of these urine guidelines was published in 2002. Since then, the guidelines have been followed by many laboratories in different European countries and their role has been essential particularly in countries lacking legislation for workplace drug testing. In 2014, the EWDTS started a guidelines updating project and published a new version of the urine guidelines in 2015. Here we represent this updated version of the urine guidelines. The European Guidelines are designed to establish best practice procedures whilst allowing individual countries to operate within the requirements of national customs and legislation. The EWDTS recommends that all European laboratories that undertake legally defensible workplace drug testing should use these guidelines as a template for accreditation. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Implementation of surveillance of invasive mosquitoes in Belgium according to the ECDC guidelines

PubMed Central

2014-01-01

Background In 2012, the new guidelines for the surveillance of IMS in Europe, produced by the European Centre for Disease Prevention and Control (ECDC), were tested in Belgium. This study aimed at (1) testing the usefulness and applicability in the field of the ECDC guidelines for the surveillance of IMS in Europe and (2) surveying IMS throughout Belgium. Methods First, the scenarios, which Belgium is facing, were identified according to the ECDC guidelines. Second, the surveillance strategy and the methods were identified based on the guidelines and adjusted to the Belgium context. Two areas colonised by IMS and 20 potential points of entry (PoE) were selected. Mosquito Magnet Liberty Plus (CO2-baited) traps (23) and oviposition traps (147) were set-up, and larval sampling was performed monthly or bi-monthly from July till October 2012. Finally, the costs and workload of the surveillance activities were compared to the estimates provided by the ECDC guidelines. Results Surveillance at 20 potential PoE (complying with scenario 1) revealed that no new IMS were established in Belgium. Surveillance at two sites colonised by IMS (scenario 2) indicated that although control measures have drastically reduced the Ae. j. japonicus population this species is still present. Furthermore, Ae. koreicus is permanently established. For both scenarios, the problems encountered are discussed and recommendations are given. In addition, the actual workload was lower than the estimated workload, while the actual costs were higher than the estimated ones. Conclusions The ECDC guidelines are helpful, applicable and efficient to implement surveillance of IMS in Belgium. Recommendations were customised to the local context (political demands, salary and investment costs, and existing expertise). The workload and costs related to the preparatory phase (i.e., planning, contacts with the PoE, writing a protocol) were found to be missing in the cost evaluation suggested in the guidelines. Updates on the occurrence of IMS in Belgium and the related risk for disease agents they can transmit will only be available once a structured and permanent surveillance system is implemented. PMID:24766783

Final Supplemental Environmental Assessment: Joint Land Attack Cruise Missile Defense Elevated Netted Sensor System (JLENS), U.S. Army Dugway Proving Ground, Dugway, Utah

DTIC Science & Technology

2009-09-01

evaluate specific system equipment func- tions, performance, operations, and safety in the field environment. The planned test procedures require free space...emission of radiofrequency (RF) electromagnetic energy within a limited spectral region and controlled power spec- tral density. There would be...for personnel. The applicable DoD standard that provides required guidelines for permissible exposure limits of DoD personnel is DoD Instruction

The EFPA Test-Review Model: When Good Intentions Meet a Methodological Thought Disorder

PubMed Central

2017-01-01

The European Federation of Psychologists’ Associations (EFPA) has issued sets of test standards and guidelines for psychometric test reviews without any attempt to address the critical content of many substantive publications by measurement experts such as Joel Michell. For example, he has argued that the psychometric test-theory which underpins classical and modern IRT psychometrics is “pathological”, with the entire profession of psychometricians suffering from a methodological thought disorder. With the advent of new kinds of assessment now being created by the “Next Generation” of psychologists which no longer conform to the item-based, statistical test theory generated last century, a new framework is set out for constructing evidence-bases suitable for these “Next Generation” of assessments, which avoids the illusory beliefs of equal-interval or quantitatively structured psychological attributes. Finally, with no systematic or substantive refutations of the logic, axioms, and evidence set out by Michell and others; it is concluded psychologists and their professional associations remain in denial. As with the eventual demise of a similar attempt to maintain the status quo of professional beliefs within forensic clinical psychology and psychiatry during the last century, those following certain EFPA guidelines might now find themselves required to justify their professional beliefs in legal rather than academic environments. PMID:29403661

ICH S7B draft guideline on the non-clinical strategy for testing delayed cardiac repolarisation risk of drugs: a critical analysis.

PubMed

Cavero, Icilio; Crumb, William

2005-05-01

The International Conference on Harmonization (ICH) stems from the initiative of three major world partners (Japan, USA, European Community) who composed a mutually accepted body of regulations concerning the safety, quality and efficacy requirements that new medicines have to meet in order to receive market approval. Documents on non-clinical safety pharmacology already composed by this organisation include two guidelines: the S7A adopted in 2000 and, its companion, the S7B guideline, in a draft form since 2001. The S7A guideline deals with general principles and recommendations on safety pharmacology studies designed to protect healthy volunteers and patients from potential drug-induced adverse reactions. The S7B recommends a general non-clinical testing strategy for determining the propensity of non-cardiovascular pharmaceuticals to delay ventricular repolarisation, an effect that at times progresses into life-threatening ventricular arrhythmia. In the most recent version of this document (June 2004), the strategy proposes experimental assays and a critical examination of other pertinent information for applying an 'evidence of risk' label to a compound. Regrettably, the guideline fails to deal satisfactorily with a number of crucial issues such as scoring the evidence of risk and the clinical consequences of such scoring. However, in the latter case, the S7B relies on the new ICH guideline E14 which is currently in preparation. E14 is the clinical counterpart of the S7B guideline which states that non-clinical data are a poor predictor of drug-induced repolarisation delay in humans. The present contribution summarises and assesses salient aspects of the S7A guideline as its founding principles are also applicable to the S7B guideline. The differences in strategies proposed by the various existing drafts of the latter document are critically examined together with some unresolved, crucial problems. The need for extending the objective of the S7B document to characterise the full electrophysiological profile of new pharmaceuticals is argued as this approach would more extensively assess the non-clinical cardiac safety of a drug. Finally, in order to overcome present difficulties in arriving at the definitive version of the S7B guideline, the Expert Working Group could reflect on the introduction of the S7B guideline recommendations in the S7A document, as originally intended, or on postponing the adoption of an harmonized text until the availability of novel scientific data allows solving presently contentious aspects of this and the E14 guidelines.

Draft Test Guideline: Daphnid Chronic Toxicity Test

EPA Pesticide Factsheets

The following draft test guideline is part of a series of test guidelines that have been developed by EPA for use in the testing of pesticides and toxic substances, and the development of test data for submission to the Agency for review.

Draft Test Guideline: Gammarid Acute Toxicity Test

EPA Pesticide Factsheets

The following draft test guideline is part of a series of test guidelines that have been developed by EPA for use in the testing of pesticides and toxic substances, and the development of test data for submission to the Agency for review.

Draft Test Guideline: Chironomid Sediment Toxicity Test

EPA Pesticide Factsheets

The following draft test guideline is part of a series of test guidelines that have been developed by EPA for use in the testing of pesticides and toxic substances, and the development of test data for submission to the Agency for review.

Draft Test Guideline: Mysid Acute Toxicity Test

EPA Pesticide Factsheets

The following draft test guideline is part of a series of test guidelines that have been developed by EPA for use in the testing of pesticides and toxic substances, and the development of test data for submission to the Agency for review.

Draft Test Guideline: Penaeid Acute Toxicity Test

EPA Pesticide Factsheets

The following draft test guideline is part of a series of test guidelines that have been developed by EPA for use in the testing of pesticides and toxic substances, and the development of test data for submission to the Agency for review.

Draft Test Guideline: Mysid Chronic Toxicity Test

EPA Pesticide Factsheets

The following draft test guideline is part of a series of test guidelines that have been developed by EPA for use in the testing of pesticides and toxic substances, and the development of test data for submission to the Agency for review.

[Ethical guidelines on genetic testing and gene therapy].

PubMed

Fukushima, Yoshimitsu

2005-03-01

According to the recent and rapid advances in molecular genetics research, genetic testing and gene therapy have a potential of giving unexpected influence to the human beings. To prevent and to solve various ethical, legal and social implementations (ELSI) of genetic testing and gene therapy, several guidelines have been established. In Japan, all researchers and all clinicians have to know and keep the following three guidelines on genetic testing and a guideline on gene therapy: 1) "Guidelines for Researches on Human Genome and Gene (2001)" by the three Ministries (Education, Health and Economy), 2) "Guidelines for Genetic Testing (2001)" by the Genetic--medicine--related 10 societies, 3) "Ethical Principles on Entrusted Genetic Testing (2001)" by the Japan Registered Clinical Laboratories Association, and 4) "Guidelines for Clinical Research on Gene Therapy (2002)" by the two Ministries (Health and Education).

A comprehensive literature review of guidelines facilitating transition of newly graduated nurses to professional nurses.

PubMed

van Rooyen, Dalena R M; Jordan, Portia J; Ten Ham-Baloyi, Wilma; Caka, Ernestina M

2018-05-01

Literature shows that successful transition of newly graduate nurses to professional nurses is imperative but does not always take place, resulting in difficulty in performance, cognizance or behaviour of a role as a nurse, affecting the quality of patient care negatively. No integrative literature review could be found to summarize available guidelines facilitating transition of final year nursing students to professional nurses. An extensive search of the literature by means of an integrative literature review was conducted in 2014 and updated in June 2017, following a five-step process. All relevant studies were subsequently appraised for rigour and quality using the AGREE II tool by two independent reviewers. Eight (n = 8) guidelines on transitions were independently extracted. After thematic analysis was done, three factors to facilitate transition of final year nursing students to professional nurses were found: 1) support for new graduates, 2) the graduate's need for socialization and belonging, and 3) a positive clinical learning environment. The availability and implementation of guidelines on transition of final year nursing students by educational institutions and healthcare facilities could ease the transition from being final year nursing students to becoming professional nurses as well as improve retention of newly qualified professional nurses. Copyright © 2018. Published by Elsevier Ltd.

Guidelines for research on drugged driving

PubMed Central

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

2009-01-01

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

Draft Test Guideline: Tadpole/Sediment Subchronic Toxicity Test

EPA Pesticide Factsheets

The following draft test guideline is part of a series of test guidelines that have been developed by EPA for use in the testing of pesticides and toxic substances, and the development of test data for submission to the Agency for review.

Draft Test Guideline: Bivalve Acute Toxicity Test (Embryo Larval)

EPA Pesticide Factsheets

The following draft test guideline is part of a series of test guidelines that have been developed by EPA for use in the testing of pesticides and toxic substances, and the development of test data for submission to the Agency for review.

Draft Test Guideline: Field Testing For Aquatic Organisms

EPA Pesticide Factsheets

The following draft test guideline is part of a series of test guidelines that have been developed by EPA for use in the testing of pesticides and toxic substances, and the development of test data for submission to the Agency for review.

Draft Test Guideline: Oyster Acute Toxicity Test (Shell Deposition)

EPA Pesticide Factsheets

The following draft test guideline is part of a series of test guidelines that have been developed by EPA for use in the testing of pesticides and toxic substances, and the development of test data for submission to the Agency for review.

Draft Test Guideline: Site-Specific Aquatic Microcosm Test, Laboratory

EPA Pesticide Factsheets

The following draft test guideline is part of a series of test guidelines that have been developed by EPA for use in the testing of pesticides and toxic substances, and the development of test data for submission to the Agency for review.

Draft Test Guideline: Generic Freshwater Microcosm Test, Laboratory

EPA Pesticide Factsheets

The following draft test guideline is part of a series of test guidelines that have been developed by EPA for use in the testing of pesticides and toxic substances, and the development of test data for submission to the Agency for review.

Draft Test Guideline: Fish Early-Life Stage Toxicity Test

EPA Pesticide Factsheets

The following draft test guideline is part of a series of test guidelines that have been developed by EPA for use in the testing of pesticides and toxic substances, and the development of test data for submission to the Agency for review.

Comparison of biodegradation performance of OECD test guideline 301C with that of other ready biodegradability tests.

PubMed

Kayashima, Takakazu; Taruki, Masanori; Katagiri, Kazuomi; Nabeoka, Ryosuke; Yoshida, Tomohiko; Tsuji, Toshiaki

2014-02-01

The Organisation for Economic Co-operatoin and development (OECD) Guidelines for the Testing of Chemicals list 7 types of tests for determining the ready biodegradability of chemical compounds (301A-F and 310). The present study compares the biodegradation performance of test guideline 301C, which is applied in Japan's Chemical Substances Control Law, with the performance of the other 6 ready biodegradability tests (RBTs) listed in the guidelines. Test guideline 301C specifies use of activated sludge precultured with synthetic sewage containing glucose and peptone (301C sludge) as a test inoculum; in the other RBTs, however, activated sludge from wastewater treatment plants (WWTP sludge) is frequently employed. Analysis based on percentage of biodegradation and pass levels revealed that the biodegradation intensity of test guideline 301C is relatively weak compared with the intensities of RBTs using WWTP sludge, and the following chemical compounds are probably not biodegraded under test guideline 301C conditions: phosphorus compounds; secondary, tertiary, and quaternary amines; and branched quaternary carbon compounds. The relatively weak biodegradation intensity of test guideline 301C may be related to the markedly different activities of the 301C and WWTP sludges. These findings will be valuable for evaluating RBT data in relation to Japan's Chemical Substances Control Law. © 2013 SETAC.

Mutual interferences and design principles for mechatronic devices in magnetic resonance imaging.

PubMed

Yu, Ningbo; Gassert, Roger; Riener, Robert

2011-07-01

Robotic and mechatronic devices that work compatibly with magnetic resonance imaging (MRI) are applied in diagnostic MRI, image-guided surgery, neurorehabilitation and neuroscience. MRI-compatible mechatronic systems must address the challenges imposed by the scanner's electromagnetic fields. We have developed objective quantitative evaluation criteria for device characteristics needed to formulate design guidelines that ensure MRI-compatibility based on safety, device functionality and image quality. The mutual interferences between an MRI system and mechatronic devices working in its vicinity are modeled and tested. For each interference, the involved components are listed, and a numerical measure for "MRI-compatibility" is proposed. These interferences are categorized into an MRI-compatibility matrix, with each element representing possible interactions between one part of the mechatronic system and one component of the electromagnetic fields. Based on this formulation, design principles for MRI-compatible mechatronic systems are proposed. Furthermore, test methods are developed to examine whether a mechatronic device indeed works without interferences within an MRI system. Finally, the proposed MRI-compatibility criteria and design guidelines have been applied to an actual design process that has been validated by the test procedures. Objective and quantitative MRI-compatibility measures for mechatronic and robotic devices have been established. Applying the proposed design principles, potential problems in safety, device functionality and image quality can be considered in the design phase to ensure that the mechatronic system will fulfill the MRI-compatibility criteria. New guidelines and test procedures for MRI instrument compatibility provide a rational basis for design and evaluation of mechatronic devices in various MRI applications. Designers can apply these criteria and use the tests, so that MRI-compatibility results can accrue to build an experiential database.

Draft Test Guideline: Aquatic Invetebrate Acute Toxicity, Test, Freshwater Daphnids

EPA Pesticide Factsheets

The following draft test guideline is part of a series of test guidelines that have been developed by EPA for use in the testing of pesticides and toxic substances, and the development of test data for submission to the Agency for review.

Draft Test Guideline: Fish Acute Toxicity Test, Freshwater And Marine

EPA Pesticide Factsheets

The following draft test guideline is part of a series of test guidelines that have been developed by EPA for use in the testing of pesticides and toxic substances, and the development of test data for submission to the Agency for review.

40 CFR 62.11620 - Identification of plan-negative declaration.

Code of Federal Regulations, 2011 CFR

2011-07-01

... POLLUTANTS Virginia Fluoride Emissions from Existing Primary Aluminum Plants § 62.11620 Identification of... emission guidelines set forth in the Final Guideline Document for the Control of Fluoride Emissions from...

40 CFR 62.11620 - Identification of plan-negative declaration.

Code of Federal Regulations, 2010 CFR

2010-07-01

... POLLUTANTS Virginia Fluoride Emissions from Existing Primary Aluminum Plants § 62.11620 Identification of... emission guidelines set forth in the Final Guideline Document for the Control of Fluoride Emissions from...

Draft Test Guideline: Fish Bioconcentration Factor (BCF)

EPA Pesticide Factsheets

The following draft test guideline is part of a series of test guidelines that have been developed by EPA for use in the testing of pesticides and toxic substances, and the development of test data for submission to the Agency for review.

Draft Test Guideline: Oyster Bioconcentration Factor (BCF)

EPA Pesticide Factsheets

The following draft test guideline is part of a series of test guidelines that have been developed by EPA for use in the testing of pesticides and toxic substances, and the development of test data for submission to the Agency for review.

Draft Test Guideline: Fish Life Cycle Toxicity

EPA Pesticide Factsheets

The following draft test guideline is part of a series of test guidelines that have been developed by EPA for use in the testing of pesticides and toxic substances, and the development of test data for submission to the Agency for review.

Draft Test Guideline: Aquatic Food Chain Transfer

EPA Pesticide Factsheets

The following draft test guideline is part of a series of test guidelines that have been developed by EPA for use in the testing of pesticides and toxic substances, and the development of test data for submission to the Agency for review.

Revision of the OECD Genetox Test Guidelines

EPA Science Inventory

The OECD Test Guidelines (TG) on genetic toxicology were initially prepared and adopted between 1981 and 1986. In 1997 the most commonly used guidelines were updated, and the in vivo UDS test (TG 486) was added. More recently, in 2010 and 2011, two new guidelines were adopted: th...

Japanese Society of Medical Oncology Clinical Guidelines: Molecular Testing for Colorectal Cancer Treatment, Third Edition.

PubMed

Yamazaki, Kentaro; Taniguchi, Hiroya; Yoshino, Takayuki; Akagi, Kiwamu; Ishida, Hideyuki; Ebi, Hiromichi; Nakatani, Kaname; Muro, Kei; Yatabe, Yasushi; Yamaguchi, Kensei; Tsuchihara, Katsuya

2018-06-01

The Japanese Society of Medical Oncology (JSMO) previously published 2 editions of the clinical guidelines: "Japanese guidelines for testing of KRAS gene mutation in colorectal cancer" in 2008 and "Japanese Society of Medical Oncology Clinical Guidelines: RAS (KRAS/NRAS) mutation testing in colorectal cancer patients" in 2014. These guidelines have contributed to the proper use of KRAS and RAS mutation testing, respectively. Recently, clinical utility, particularly for colorectal cancer (CRC) patients with BRAF V600E mutation or DNA mismatch-repair (MMR) deficiency, has been established. Therefore, the guideline members decided these genetic alterations should also be involved. The aim of this revision is to properly carry out testing for BRAF V600E mutation and MMR deficiency in addition to RAS mutation. The revised guidelines include the basic requirements for testing for these genetic alterations based on recent scientific evidence. Furthermore, because clinical utility of comprehensive genetic testing using next-generation sequencing and somatic gene testing of analyzing circulating tumor DNA has increasingly evolved with recent advancements in testing technology, we noted the current situation and prospects for these testing technologies and their clinical implementation in the revised guidelines. © 2018 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.

Draft Test Guideline: Whole Sediment Acute Toxicity Invertebrates, Freshwater

EPA Pesticide Factsheets

The following draft test guideline is part of a series of test guidelines that have been developed by EPA for use in the testing of pesticides and toxic substances, and the development of test data for submission to the Agency for review.

Draft Test Guideline: Whole Sediment Acute Toxicity Invertebrates, Marine

EPA Pesticide Factsheets

The following draft test guideline is part of a series of test guidelines that have been developed by EPA for use in the testing of pesticides and toxic substances, and the development of test data for submission to the Agency for review.

Guidelines for testing and release procedures

NASA Technical Reports Server (NTRS)

Molari, R.; Conway, M.

1984-01-01

Guidelines and procedures are recommended for the testing and release of the types of computer software efforts commonly performed at NASA/Ames Research Center. All recommendations are based on the premise that testing and release activities must be specifically selected for the environment, size, and purpose of each individual software project. Guidelines are presented for building a Test Plan and using formal Test Plan and Test Care Inspections on it. Frequent references are made to NASA/Ames Guidelines for Software Inspections. Guidelines are presented for selecting an Overall Test Approach and for each of the four main phases of testing: (1) Unit Testing of Components, (2) Integration Testing of Components, (3) System Integration Testing, and (4) Acceptance Testing. Tools used for testing are listed, including those available from operating systems used at Ames, specialized tools which can be developed, unit test drivers, stub module generators, and the use of format test reporting schemes.

Fifteen hundred guidelines and growing: the UK database of clinical guidelines.

PubMed

van Loo, John; Leonard, Niamh

2006-06-01

The National Library for Health offers a comprehensive searchable database of nationally approved clinical guidelines, called the Guidelines Finder. This resource, commissioned in 2002, is managed and developed by the University of Sheffield Health Sciences Library. The authors introduce the historical and political dimension of guidelines and the nature of guidelines as a mechanism to ensure clinical effectiveness in practice. The article then outlines the maintenance and organisation of the Guidelines Finder database itself, the criteria for selection, who publishes guidelines and guideline formats, usage of the Guidelines Finder service and finally looks at some lessons learnt from a local library offering a national service. Clinical guidelines are central to effective clinical practice at the national, organisational and individual level. The Guidelines Finder is one of the most visited resources within the National Library for Health and is successful in answering information needs related to specific patient care, clinical research, guideline development and education.

Implementation of a guideline for local health policy making by regional health services: exploring determinants of use by a web survey.

PubMed

Kuunders, Theo J M; Jacobs, Monique A M; Goor, Ien A M van de; Bon-Martens, Marja J H van; Oers, Hans A M van; Paulussen, Theo G W M

2017-08-15

Previous evaluation showed insufficient use of a national guideline for integrated local health policy by Regional Health Services (RHS) in the Netherlands. The guideline focuses on five health topics and includes five checklists to support integrated municipal health policies. This study explores the determinants of guideline use by regional Dutch health professionals. A web survey was send to 304 RHS health professionals. The questionnaire was based on a theory- and research-based framework of determinants of public health innovations. Main outcomes were guideline use and completeness of use, defined as the number of health topics and checklists used. Associations between determinants and (completeness of) guideline use were explored by multivariate regression models. The survey was started by 120 professionals (39%). Finally, results from 73 respondents (24%) were eligible for analyses. All 28 Dutch RHS organizations were represented in the final dataset. About half of the respondents (48%) used the guideline. The average score for completeness of use (potential range 1-10) was 2.37 (sd = 1.78; range 1-7). Knowledge, perceived task responsibility and usability were significantly related to guideline use in univariate analyses. Only usability remained significant in the multivariate model on guideline use. Only self-efficacy accounted for significant proportions of variance in completeness of use. The results imply that strategies to improve guideline use by RHSs should primarily target perceived usability. Self-efficacy appeared the primary target for improving completeness of guideline use. Methods for targeting these determinants in RHSs are discussed.

Choosing Wisely: The Top-5 Recommendations from the Italian Panel of the National Guidelines for the Management of Acute Pharyngitis in Children.

PubMed

Chiappini, Elena; Bortone, Barbara; Di Mauro, Giuseppe; Esposito, Susanna; Galli, Luisa; Landi, Massimo; Novelli, Andrea; Marchisio, Paola; Marseglia, Gian Luigi; Principi, Nicola; de Martino, Maurizio

2017-03-01

With the aim to reduce waste in the health care system and avoid risks associated with unnecessary treatment, the Italian Panel of the National Guidelines for the Management of Acute Pharyngitis in Children joined the Choosing Wisely initiative. An ad hoc Choosing Wisely task force was selected to develop a candidate list of items for the top-5 list on pharyngitis medicine. Through a process of literature review and consensus, the final list of 5 items was chosen. Drafted recommendations were formulated and then reviewed by the task force members until a final consensus was reached. The 5 recommendations approved are: blood exams should not be performed; antibiotics should not be administrated unless microbiologic confirmation of streptococcal infection has been carried out; if a throat culture is performed, susceptibility tests on isolates should not be executed; antibiotic course should not be shortened; because penicillin V is not available in Italy, amoxicillin (50 mg/kg/d in 2-3 doses orally) for 10 days is the first choice treatment; and steroids should not be administered for the risk of masking possible underlying severe condition. This top-5 list can be a novel tool to spread the key messages of guidelines and to avoid unnecessary diagnostic procedures, and to promote a rational use of antibiotics in children. Copyright © 2017 Elsevier HS Journals, Inc. All rights reserved.

Draft Test Guideline: Fish Acute Toxicity Mitigated By Humic Acid

EPA Pesticide Factsheets

The following draft test guideline is part of a series of test guidelines that have been developed by EPA for use in the testing of pesticides and toxic substances, and the development of test data for submission to the Agency for review.

Draft Test Guideline: Special Considerations for Conducting Aquatic Laboratory Studies

EPA Pesticide Factsheets

The following draft test guideline is part of a series of test guidelines that have been developed by EPA for use in the testing of pesticides and toxic substances, and the development of test data for submission to the Agency for review.

Title VII Sexual Harassment Guidelines and Educational Employment [and] What Can Students Do About Sex Discrimination?

ERIC Educational Resources Information Center

Howard, Susan; And Others

Guidelines concerning sexual harassment of employees at educational institutions under Title VII of the Civil Rights Act of 1964 are considered. November 1980 final interpretive guidelines issued by the Equal Employment Opportunity Commission state that Title VII prohibits sexual harassment of employees, that employers are responsible for the…

Instructor/Operator Station Design Handbook for Aircrew Training Devices. Final Technical Report for Period March 1982-December 1986.

ERIC Educational Resources Information Center

Warner, H. D.

Human engineering guidelines for the design of instructor/operator stations (IOSs) for aircrew training devices are provided in this handbook. These guidelines specify the preferred configuration of IOS equipment across the range of the anticipated user sizes and performance capabilities. The guidelines are consolidated from various human…

Six simple guidelines for introducing new genera of fungi

Treesearch

Else C. Vellinga; Thomas W. Kuyper; Joe Ammirati; Dennis E. Desjardin; Roy E. Halling; Alfredo Justo; Thomas Læssøe; D. Jean Lodge; P. Brandon Matheny; Andrew S. Methven; Pierre-Arthur Moreau; Gregory M. Mueller; Michael E. Noordeloos; Jorinde Nuytinck; Clark L. Ovrebo; Annemieke Verbeken

2015-01-01

We formulate five guidelines for introducing new genera, plus one recommendation how to publish the results of scientific research. We recommend that reviewers and editors adhere to these guidelines. We propose that the underlying research is solid, and that the results and the final solutions are properly discussed. The six criteria are: (1) all genera that are...

Models and Procedures for Improving the Planning, Management, and Evaluation of Cooperative Education Programs. Final Report. Volume I.

ERIC Educational Resources Information Center

Blaschke, Charles L.; Steiger, JoAnn

This report of a project to design a set of training guidelines for planning, managing, and evaluating cooperative education programs describes briefly the procedures used in developing the guidelines and model; discusses the various components of the planning, management, and evaluation process; and presents guidelines and criteria for designing…

Review of achievements of the OECD Working Party on Manufactured Nanomaterials' Testing and Assessment Programme. From exploratory testing to test guidelines.

PubMed

Rasmussen, Kirsten; González, Mar; Kearns, Peter; Sintes, Juan Riego; Rossi, François; Sayre, Phil

2016-02-01

This paper charts the almost ten years of history of OECD's work on nanosafety, during which the programme of the OECD on the Testing and Assessment of Manufactured Nanomaterials covered the testing of eleven nanomaterials for about 59 end-points addressing physical-chemical properties, mammalian and environmental toxicity, environmental fate and material safety. An overview of the materials tested, the test methods applied and the discussions regarding the applicability of the OECD test guidelines, which are recognised methods for regulatory testing of chemicals, are given. The results indicate that many existing OECD test guidelines are suitable for nanomaterials and consequently, hazard data collected using such guidelines will fall under OECD's system of Mutual Acceptance of Data (MAD) which is a legally binding instrument to facilitate the international acceptance of information for the regulatory safety assessment of chemicals. At the same time, some OECD test guidelines and guidance documents need to be adapted to address nanomaterials while new test guidelines and guidance documents may be needed to address endpoints that are more relevant to nanomaterials. This paper presents examples of areas where test guidelines or guidance for nanomaterials are under development. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

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

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

Czarnecki, R M

1987-05-01

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

Perspectives on the Use of Clinical Pathways in Oncology Care.

PubMed

Chiang, Anne C; Ellis, Peter; Zon, Robin

2017-01-01

Pathways and guidelines are valuable tools to provide evidence-based care in oncology. Pathways may be more restrictive than guidelines because they attempt (where possible) to reduce cost, add efficiency, and remove unwarranted variability. Pathways offer an opportunity to measure, report, and improve quality of care; they can drive to evidence-based targeted therapy where appropriate; they can enhance efficiency through standardization; and, finally, they can be a vehicle to enhance participation in clinical trials. Pathway implementation requires understanding and commitment on the part of the physician and leadership as they may initially disrupt workflow, but ultimately have the ability to enhance patient care. ASCO criteria have been published for the development and implementation of high-quality oncology pathway programs. Future challenges for pathways include incorporation of molecular testing and appropriate targeted care in a real-time precision oncology approach.

Derivation of guideline values for gold (III) ion toxicity limits to protect aquatic ecosystems.

PubMed

Nam, Sun-Hwa; Lee, Woo-Mi; Shin, Yu-Jin; Yoon, Sung-Ji; Kim, Shin Woong; Kwak, Jin Il; An, Youn-Joo

2014-01-01

This study focused on estimating the toxicity values of various aquatic organisms exposed to gold (III) ion (Au(3+)), and to propose maximum guideline values for Au(3+) toxicity that protect the aquatic ecosystem. A comparative assessment of methods developed in Australia and New Zealand versus the European Community (EC) was conducted. The test species used in this study included two bacteria (Escherichia coli and Bacillus subtilis), one alga (Pseudokirchneriella subcapitata), one euglena (Euglena gracilis), three cladocerans (Daphnia magna, Moina macrocopa, and Simocephalus mixtus), and two fish (Danio rerio and Oryzias latipes). Au(3+) induced growth inhibition, mortality, immobilization, and/or developmental malformations in all test species, with responses being concentration-dependent. According to the moderate reliability method of Australia and New Zealand, 0.006 and 0.075 mg/L of guideline values for Au(3+) were obtained by dividing 0.33 and 4.46 mg/L of HC5 and HC50 species sensitivity distributions (SSD) with an FACR (Final Acute to Chronic Ratio) of 59.09. In contrast, the EC method uses an assessment factor (AF), with the 0.0006 mg/L guideline value for Au(3+) being divided with the 48-h EC50 value for 0.60 mg/L (the lowest toxicity value obtained from short term results) by an AF of 1000. The Au(3+) guideline value derived using an AF was more stringent than the SSD. We recommend that more toxicity data using various bioassays are required to develop more accurate ecological risk assessments. More chronic/long-term exposure studies on sensitive endpoints using additional fish species and invertebrates not included in the current dataset will be needed to use other derivation methods (e.g., US EPA and Canadian Type A) or the "High Reliability Method" from Australia/New Zealand. Such research would facilitate the establishment of guideline values for various pollutants that reflect the universal effects of various pollutants in aquatic ecosystems. To the best of our knowledge, this is the first study to suggest guideline values for Au(3+) levels permitted to enter freshwater environments. Copyright © 2013 Elsevier Ltd. All rights reserved.

Experimental analysis of the sheet metal forming behavior of newly developed press hardening steels

NASA Astrophysics Data System (ADS)

Meza-García, Enrique; Kräusel, Verena; Landgrebe, Dirk

2018-05-01

The aim of this work was the characterization of the newly developed press hardening sheet alloys 1800 PHS and 2000 PHS developed by SSAB with regard to their hot forming behavior on the basis of the experimental determination of relevant mechanical and technological properties. For this purpose conventional and non-conventional sheet metal testing methods were used. To determine the friction coefficient, the strip drawing test was applied, while the deep drawing cup test was used to determine the maximum draw depth. Finally, a V-bending test was carried out to evaluate the springback behavior of the investigated alloys by varying the blank temperature and quenching media. This work provides a technological guideline for the production of press hardened sheet parts made of these investigated sheet metals.

Characteristics of knowledge content in a curated online evidence library.

PubMed

Varada, Sowmya; Lacson, Ronilda; Raja, Ali S; Ip, Ivan K; Schneider, Louise; Osterbur, David; Bain, Paul; Vetrano, Nicole; Cellini, Jacqueline; Mita, Carol; Coletti, Margaret; Whelan, Julia; Khorasani, Ramin

2018-05-01

To describe types of recommendations represented in a curated online evidence library, report on the quality of evidence-based recommendations pertaining to diagnostic imaging exams, and assess underlying knowledge representation. The evidence library is populated with clinical decision rules, professional society guidelines, and locally developed best practice guidelines. Individual recommendations were graded based on a standard methodology and compared using chi-square test. Strength of evidence ranged from grade 1 (systematic review) through grade 5 (recommendations based on expert opinion). Finally, variations in the underlying representation of these recommendations were identified. The library contains 546 individual imaging-related recommendations. Only 15% (16/106) of recommendations from clinical decision rules were grade 5 vs 83% (526/636) from professional society practice guidelines and local best practice guidelines that cited grade 5 studies (P < .0001). Minor head trauma, pulmonary embolism, and appendicitis were topic areas supported by the highest quality of evidence. Three main variations in underlying representations of recommendations were "single-decision," "branching," and "score-based." Most recommendations were grade 5, largely because studies to test and validate many recommendations were absent. Recommendation types vary in amount and complexity and, accordingly, the structure and syntax of statements they generate. However, they can be represented in single-decision, branching, and score-based representations. In a curated evidence library with graded imaging-based recommendations, evidence quality varied widely, with decision rules providing the highest-quality recommendations. The library may be helpful in highlighting evidence gaps, comparing recommendations from varied sources on similar clinical topics, and prioritizing imaging recommendations to inform clinical decision support implementation.

2014 Consensus conference on viscoelastic test-based transfusion guidelines for early trauma resuscitation: Report of the panel.

PubMed

Inaba, Kenji; Rizoli, Sandro; Veigas, Precilla V; Callum, Jeannie; Davenport, Ross; Hess, John; Maegele, Marc

2015-06-01

There has been an increased interest in the use of viscoelastic testing to guide blood product replacement during the acute resuscitation of the injured patient. Currently, no uniformly accepted guidelines exist for how this technology should be integrated into clinical care. In September 2014, an international multidisciplinary group of leaders in the field of trauma coagulopathy and resuscitation was assembled for a 2-day consensus conference in Philadelphia, Pennsylvania. This panel included trauma surgeons, hematologists, blood bank specialists, anesthesiologists, and the lay public.Nine questions regarding the impact of viscoelastic testing in the early resuscitation of trauma patients were developed before the conference by panel consensus. Early use was defined as baseline viscoelastic test result thresholds obtained within the first minutes of hospital arrival-when conventional laboratory results are not available. The available data for each question were then reviewed in person using standardized presentations by the expert panel. A consensus summary document was then developed and reviewed by the panel in an open forum. Finally, a two-round Delphi poll was administered to the panel of experts regarding viscoelastic thresholds for triggering the initiation of specific treatments including fibrinogen, platelets, plasma, and prothrombin complex concentrates. This report summarizes the findings and recommendations of this consensus conference.

Site characterization methodology for aquifers in support of bioreclamation activities. Volume 2: Borehole flowmeter technique, tracer tests, geostatistics and geology. Final report, August 1987-September 1989

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

Young, S.C.

1993-08-01

This report discusses a field demonstration of a methodology for characterizing an aquifer's geohydrology in the detail required to design an optimum network of wells and/or infiltration galleries for bioreclamation systems. The project work was conducted on a 1-hectare test site at Columbus AFB, Mississippi. The technical report is divided into two volumes. Volume I describes the test site and the well network, the assumptions, and the application of equations that define groundwater flow to a well, the results of three large-scale aquifer tests, and the results of 160 single-pump tests. Volume II describes the bore hole flowmeter tests, themore » tracer tests, the geological investigations, the geostatistical analysis and the guidelines for using groundwater models to design bioreclamation systems. Site characterization, Hydraulic conductivity, Groundwater flow, Geostatistics, Geohydrology, Monitoring wells.« less

Findings from a novel approach to publication guideline revision: user road testing of a draft version of SQUIRE 2.0.

PubMed

Davies, Louise; Donnelly, Kyla Z; Goodman, Daisy J; Ogrinc, Greg

2016-04-01

The Standards for Quality Improvement Reporting Excellence (SQUIRE) Guideline was published in 2008 (SQUIRE 1.0) and was the first publication guideline specifically designed to advance the science of healthcare improvement. Advances in the discipline of improvement prompted us to revise it. We adopted a novel approach to the revision by asking end-users to 'road test' a draft version of SQUIRE 2.0. The aim was to determine whether they understood and implemented the guidelines as intended by the developers. Forty-four participants were assigned a manuscript section (ie, introduction, methods, results, discussion) and asked to use the draft Guidelines to guide their writing process. They indicated the text that corresponded to each SQUIRE item used and submitted it along with a confidential survey. The survey examined usability of the Guidelines using Likert-scaled questions and participants' interpretation of key concepts in SQUIRE using open-ended questions. On the submitted text, we evaluated concordance between participants' item usage/interpretation and the developers' intended application. For the survey, the Likert-scaled responses were summarised using descriptive statistics and the open-ended questions were analysed by content analysis. Consistent with the SQUIRE Guidelines' recommendation that not every item be included, less than one-third (n=14) of participants applied every item in their section in full. Of the 85 instances when an item was partially used or was omitted, only 7 (8.2%) of these instances were due to participants not understanding the item. Usage of Guideline items was highest for items most similar to standard scientific reporting (ie, 'Specific aim of the improvement' (introduction), 'Description of the improvement' (methods) and 'Implications for further studies' (discussion)) and lowest (<20% of the time) for those unique to healthcare improvement (ie, 'Assessment methods for context factors that contributed to success or failure' and 'Costs and strategic trade-offs'). Items unique to healthcare improvement, specifically 'Evolution of the improvement', 'Context elements that influenced the improvement', 'The logic on which the improvement was based', 'Process and outcome measures', demonstrated poor concordance between participants' interpretation and developers' intended application. User testing of a draft version of SQUIRE 2.0 revealed which items have poor concordance between developer intent and author usage, which will inform final editing of the Guideline and development of supporting supplementary materials. It also identified the items that require special attention when teaching about scholarly writing in healthcare improvement. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Traffic Data Quality Measurement : Final Report

DOT National Transportation Integrated Search

2004-09-15

One of the foremost recommendations from the FHWA sponsored workshops on Traffic Data Quality (TDQ) in 2003 was a call for "guidelines and standards for calculating data quality measures." These guidelines and standards are expected to contain method...

A Study to Formulate Quantitative Guidelines for the Audio-Visual Communications Field. Final Report.

ERIC Educational Resources Information Center

Faris, Gene; Sherman, Mendel

Quantitative guidelines for use in determining the audiovisual (AV) needs of educational institutions were developed by the Octobe r 14-16, 1965 Seminar of the NDEA (National Defense Education Act), Faris-Sherman study. The guidelines that emerged were based in part on a review of past efforts and existing standards but primarily reflected the…

Consensus-based guidelines for Video EEG monitoring in the pre-surgical evaluation of children with epilepsy in the UK.

PubMed

Pressler, Ronit M; Seri, Stefano; Kane, Nick; Martland, Tim; Goyal, Sushma; Iyer, Anand; Warren, Elliott; Notghi, Lesley; Bill, Peter; Thornton, Rachel; Appleton, Richard; Doyle, Sarah; Rushton, Sarah; Worley, Alan; Boyd, Stewart G

2017-08-01

Paediatric Epilepsy surgery in the UK has recently been centralised in order to improve expertise and quality of service available to children. Video EEG monitoring or telemetry is a highly specialised and a crucial component of the pre-surgical evaluation. Although many Epilepsy Monitoring Units work to certain standards, there is no national or international guideline for paediatric video telemetry. Due to lack of evidence we used a modified Delphi process utilizing the clinical and academic expertise of the clinical neurophysiology sub-specialty group of Children's Epilepsy Surgical Service (CESS) centres in England and Wales. This process consisted of the following stages I: Identification of the consensus working group, II: Identification of key areas for guidelines, III: Consensus practice points and IV: Final review. Statements that gained consensus (median score of either 4 or 5 using a five-point Likerttype scale) were included in the guideline. Two rounds of feedback and amendments were undertaken. The consensus guidelines includes the following topics: referral pathways, neurophysiological equipment standards, standards of recording techniques, with specific emphasis on safety of video EEG monitoring both with and without drug withdrawal, a protocol for testing patient's behaviours, data storage and guidelines for writing factual reports and conclusions. All statements developed received a median score of 5 and were adopted by the group. Using a modified Delphi process we were able to develop universally-accepted video EEG guidelines for the UK CESS. Although these recommendations have been specifically developed for the pre-surgical evaluation of children with epilepsy, it is assumed that most components are transferable to any paediatric video EEG monitoring setting. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

76 FR 74063 - Mandatory Guidelines for Federal Workplace Drug Testing Programs

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-30

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Mandatory Guidelines for Federal Workplace Drug Testing... Federal Workplace Drug Testing Programs (Mandatory Guidelines), effective on October 1, 2010, addresses... for physicians performing a review of Federal employee drug testing results that seek approval by the...

Adherence to multiple cancer screening tests among women living in Appalachia Ohio

PubMed Central

Katz, Mira L.; Reiter, Paul L.; Young, Gregory S.; Pennell, Michael L.; Tatum, Cathy M.; Paskett, Electra D.

2015-01-01

Background There is a lack of information about the correlates of completing all three cancer screening tests among women living in Appalachia. Methods Cross-sectional telephone interviews were conducted (April-September 2013) among women (n=637) ages 51-75 from 12 Appalachia Ohio counties. Outcomes of within screening guidelines were verified by medical record. Multivariable logistic regression models identified correlates of being within guidelines for all three cancer screening tests. Results Screening rates were: mammography (32.1%), Pap test (36.1%), and a colorectal cancer test (30.1%). Only 8.6% of women were within guidelines for all tests. Having had a check-up in the past two years and having received a screening recommendation were significantly related to being within guidelines for all three tests (p<0.01). Participants with higher annual household incomes ($60,000+; OR=3.53, 95% CI: 1.49, 8.33) and conditions requiring regular medical visits (OR=3.16, 95% CI: 1.29, 7.74) were more likely to be within guidelines for all three screening tests. Conclusion Less than 10% of women had completed screening within guidelines for all three screening tests. Regular contact with the healthcare system and higher incomes were significant predictors of being within guidelines. Impact Within guidelines rates for the three recommended cancer screening tests is low among women in Appalachia Ohio. This finding illustrates the need for innovative interventions to improve rates of multiple cancer screening tests. PMID:26282630

Evidence-informed recommendations for constructing and disseminating messages supplementing the new Canadian Physical Activity Guidelines

PubMed Central

2013-01-01

Background Few validated guidelines exist for developing messages in health promotion practice. In clinical practice, the Appraisal of Guidelines, Research, and Evaluation II (AGREE II) Instrument is the international gold standard for guideline assessment, development, and reporting. In a case study format, this paper describes the application of the AGREE II principles to guide the development of health promotion guidelines for constructing messages to supplement the new Canadian Physical Activity Guidelines (CPAG) released in 2011. Methods The AGREE II items were modified to suit the objectives of developing messages that (1) clarify key components of the new CPAG and (2) motivate Canadians to meet the CPAG. The adapted AGREE II Instrument was used as a systematic guide for the recommendation development process. Over a two-day meeting, five workgroups (one for each CPAG – child, youth, adult, older adult – and one overarching group) of five to six experts (including behavior change, messaging, and exercise physiology researchers, key stakeholders, and end users) reviewed and discussed evidence for creating and targeting messages to supplement the new CPAG. Recommendations were summarized and reviewed by workgroup experts. The recommendations were pilot tested among end users and then finalized by the workgroup. Results The AGREE II was a useful tool in guiding the development of evidence-based specific recommendations for constructing and disseminating messages that supplement and increase awareness of the new CPAG (child, youth, adults, and older adults). The process also led to the development of sample messages and provision of a rationale alongside the recommendations. Conclusions To our knowledge, these are the first set of evidence-informed recommendations for constructing and disseminating messages supplementing physical activity guidelines. This project also represents the first application of international standards for guideline development (i.e., AGREE II) to the creation of practical recommendations specifically aimed to inform health promotion and public health practice. The messaging recommendations have the potential to increase the public health impact of evidence-based guidelines. PMID:23634998

Improved fire protection system for underground fueling areas. Volume II. Final report Sep 77-Oct 81

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

McDonald, L.; Kennedy, D.; Reid, G.

1981-10-01

The objectives of this investigation were to (1) develop safe practice guidelines that will minimize the chance of fires in underground fueling areas and (2) to develop a low-cost, reliable, automatic fire control system (AFCS) for underground fueling areas. Volume I of the report covered the period from June 21, 1976, to September 30, 1977, and included (1) the preparation of safe practice guidelines for underground fueling areas; (2) preparation of recommended AFCS design concepts for underground fueling areas; and (3) the design, fabrication, and in-mine fire test of an AFCS at Pine Creek Mine, Bishop, Calif. Volume II ofmore » the report covers the period from September 30, 1977, to September 30, 1981, and includes (1) a long-term validation test of the AFCS in the Pine Creek Mine, (2) a study of the environmental effects of aqueous film-forming foam, (3) the design and installation of a system at AMAX Buick Mine, Boss, Mo., (4) the design of a system for enclosed fuel areas, and (5) the design of a system for semipermanent fueling areas.« less

Use of Management Pathways or Algorithms in Children With Chronic Cough: CHEST Guideline and Expert Panel Report.

PubMed

Chang, Anne B; Oppenheimer, John J; Weinberger, Miles M; Rubin, Bruce K; Weir, Kelly; Grant, Cameron C; Irwin, Richard S

2017-04-01

Using management algorithms or pathways potentially improves clinical outcomes. We undertook systematic reviews to examine various aspects in the generic approach (use of cough algorithms and tests) to the management of chronic cough in children (aged ≤ 14 years) based on key questions (KQs) using the Population, Intervention, Comparison, Outcome format. We used the CHEST Expert Cough Panel's protocol for the systematic reviews and the American College of Chest Physicians (CHEST) methodological guidelines and Grading of Recommendations Assessment, Development and Evaluation framework. Data from the systematic reviews in conjunction with patients' values and preferences and the clinical context were used to form recommendations. Delphi methodology was used to obtain the final grading. Combining data from systematic reviews addressing five KQs, we found high-quality evidence that a systematic approach to the management of chronic cough improves clinical outcomes. Although there was evidence from several pathways, the highest evidence was from the use of the CHEST approach. However, there was no or little evidence to address some of the KQs posed. Compared with the 2006 Cough Guidelines, there is now high-quality evidence that in children aged ≤ 14 years with chronic cough (> 4 weeks' duration), the use of cough management protocols (or algorithms) improves clinical outcomes, and cough management or testing algorithms should differ depending on the associated characteristics of the cough and clinical history. A chest radiograph and, when age appropriate, spirometry (pre- and post-β 2 agonist) should be undertaken. Other tests should not be routinely performed and undertaken in accordance with the clinical setting and the child's clinical symptoms and signs (eg, tests for tuberculosis when the child has been exposed). Copyright © 2017 American College of Chest Physicians. All rights reserved.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-15

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

Updates on human papillomavirus and genital warts and counseling messages from the 2010 Sexually Transmitted Diseases Treatment Guidelines.

PubMed

Dunne, Eileen F; Friedman, Allison; Datta, S Deblina; Markowitz, Lauri E; Workowski, Kimberly A

2011-12-01

In April 2009, experts on sexually transmitted diseases (STDs) were convened to review updates on STD prevention and treatment in preparation for the revision of the Centers for Disease Control and Prevention (CDC) STD Treatment Guidelines. At this meeting, there was a discussion of important updates on human papillomavirus (HPV), genital warts, and cervical cancer screening. Key questions were identified with assistance from an expert panel, and systematic reviews of the literature were conducted searching the English-language literature of the PubMed computerized database (US National Library of Medicine). The available evidence was reviewed, and new information was incorporated in the 2010 CDC STD Treatment Guidelines. Two HPV vaccines are now available, the quadrivalent HPV vaccine and the bivalent HPV vaccine; either vaccine is recommended routinely for girls aged 11 or 12 years. The quadrivalent HPV vaccine may be given to boys and men aged 9-26 years. A new patient-applied treatment option for genital warts, sinecatechins 15% ointment, is available and recommended for treatment of external genital warts. This product is a mixture of active ingredients (catechins) from green tea. Finally, updated counseling guidelines and messages about HPV, genital warts, and cervical cancer are included. This manuscript highlights updates to the 2010 CDC STD Treatment Guidelines for HPV and genital warts. Important additions to the 2010 STD Treatment Guidelines include information on prophylactic HPV vaccine recommendations, new patient-applied treatment options for genital warts, and counseling messages for patients on HPV, genital warts, cervical cancer screening, and HPV tests.

78 FR 2675 - Mandatory Guidelines for Federal Workplace Drug Testing Programs

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-14

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Mandatory Guidelines for Federal Workplace Drug Testing... Federal Workplace Drug Testing Programs (Mandatory Guidelines), effective on October 1, 2010, addresses... performing a review of Federal employee drug testing results that seek approval by the Secretary must submit...

75 FR 76478 - Mandatory Guidelines for Federal Workplace Drug Testing Programs

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Mandatory Guidelines for Federal Workplace Drug Testing... Drug Testing Programs (Mandatory Guidelines) which took effect on October 1, 2010 address the role and... Federal employee drug testing results that seek approval by the Secretary must submit their qualifications...

Decision making about healthcare-related tests and diagnostic test strategies. Paper 4: International guidelines show variability in their approaches.

PubMed

Mustafa, Reem A; Wiercioch, Wojtek; Arevalo-Rodriguez, Ingrid; Cheung, Adrienne; Prediger, Barbara; Ivanova, Liudmila; Ventresca, Matthew; Brozek, Jan; Santesso, Nancy; Bossuyt, Patrick; Garg, Amit X; Lloyd, Nancy; Lelgemann, Monika; Bühler, Diedrich; Schünemann, Holger J

2017-12-01

The objective of the study was to describe and compare current practices in developing guidelines about the use of healthcare-related tests and diagnostic strategies (HCTDS). We sampled 37 public health and clinical practice guidelines about HCTDS from various sources without language restrictions. Detailed descriptions of the systems used to assess the quality of evidence and develop recommendations were challenging to find within guidelines. We observed much variability among and within organizations with respect to how they develop recommendations about HCTDS. Twenty-four percent of the guidelines did not consider health benefits and harms but based decisions solely on test accuracy. We did not identify guidelines that described the main potential care pathways involving tests for a healthcare problem. In addition, we did not identify guidelines that systematically assessed, described, and referenced the evidence that linked test accuracy and patient-important outcomes. There is considerable variability among the processes used and factors considered in developing recommendations about the use of tests. This variability may be the cause for the disagreement we observed in recommendations about testing for the same condition. Copyright © 2017 Elsevier Inc. All rights reserved.

Singapore Paediatric Resuscitation Guidelines 2016.

PubMed

Ong, Gene Yong Kwang; Chan, Irene Lai Yeen; Ng, Agnes Suah Bwee; Chew, Su Yah; Mok, Yee Hui; Chan, Yoke Hwee; Ong, Jacqueline Soo May; Ganapathy, Sashikumar; Ng, Kee Chong

2017-07-01

We present the revised 2016 Singapore paediatric resuscitation guidelines. The International Liaison Committee on Resuscitation's Pediatric Taskforce Consensus Statements on Science and Treatment Recommendations, as well as the updated resuscitation guidelines from the American Heart Association and European Resuscitation Council released in October 2015, were debated and discussed by the workgroup. The final recommendations for the Singapore Paediatric Resuscitation Guidelines 2016 were derived after carefully reviewing the current available evidence in the literature and balancing it with local clinical practice. Copyright: © Singapore Medical Association.

Thermal Analysis of Small Re-Entry Probe

NASA Technical Reports Server (NTRS)

Agrawal, Parul; Prabhu, Dinesh K.; Chen, Y. K.

2012-01-01

The Small Probe Reentry Investigation for TPS Engineering (SPRITE) concept was developed at NASA Ames Research Center to facilitate arc-jet testing of a fully instrumented prototype probe at flight scale. Besides demonstrating the feasibility of testing a flight-scale model and the capability of an on-board data acquisition system, another objective for this project was to investigate the capability of simulation tools to predict thermal environments of the probe/test article and its interior. This paper focuses on finite-element thermal analyses of the SPRITE probe during the arcjet tests. Several iterations were performed during the early design phase to provide critical design parameters and guidelines for testing. The thermal effects of ablation and pyrolysis were incorporated into the final higher-fidelity modeling approach by coupling the finite-element analyses with a two-dimensional thermal protection materials response code. Model predictions show good agreement with thermocouple data obtained during the arcjet test.

75 FR 4380 - Draft Test Guidelines; Notice of Availability and Request for Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-27

... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-OPP-2009-0681; FRL-8437-2] Draft Test Guidelines; Notice...: Notice. SUMMARY: EPA is announcing the availability of four draft test guidelines for Product Performance... holidays. The Docket Facility telephone number is (703) 305-5805. Electronic access to the OPPTS Test...

APA's Guidelines for Test User Qualifications: An Executive Summary.

ERIC Educational Resources Information Center

Turner, Samuel M.; DeMers, Stephen T.; Fox, Heather Roberts; Reed, Geoffrey M.

2001-01-01

Describes the American Psychological Association's (APA's) development of the Task Force on Test User Qualifications, explaining the APA's purpose in developing guidelines for the use of psychological tests. Highlights the historical background, the scope of the guidelines, generic knowledge and skills considered important for good test use, and…

75 FR 22809 - Mandatory Guidelines for Federal Workplace Drug Testing Programs

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-30

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Mandatory Guidelines for Federal Workplace Drug Testing... for Federal Workplace Drug Testing Programs (Mandatory Guidelines) from May 1, 2010, to October 1... drug testing programs as soon as possible that they will not be expected to implement the revisions to...

Practical guidelines for feminist research in nursing.

PubMed

Im, Eun-Ok

2013-01-01

With increasing interests in oppressed groups, the number of feminist studies in nursing has steadily increased. Despite the increasing number of feminist studies, very few articles have been written to provide practical guidelines for feminist research in nursing. In this article, guidelines for feminist research in nursing are proposed on the basis of 3 previous feminist studies. First, characteristics of feminist research are concisely described. Then, the 3 studies that are the basis for the guidelines are described. Finally, practical guidelines for feminist nursing research are proposed on the basis of 10 idea categories related to issues/concerns from the 3 studies.

From evidence to action

PubMed Central

Verheyen, Cees CPM; Kerkhoffs, Gino M; Bhandari, Mohit; Schünemann, Holger J

2009-01-01

ABSTRACT Good guidelines will help us to take evidence into practice. In a survey among Dutch orthopedic surgeons, development and use of evidence-based guidelines was perceived as one of the best ways of moving from opinion-based to evidence-based orthopedic practice. The increasing number of guidelines means that knowing how to make a critical appraisal of guidelines is now a key part of every surgeon’s life. This is particularly true because guidelines use varying systems to judge the quality of evidence and the strength of recommendations. In this manuscript we discuss what a guideline is, where we can find guidelines, how to evaluate the quality of guidelines, and finally provide an example on the different steps of guideline development. Thus, we show that good guidelines are a summary of the best available evidence and that they provide a graded recommendation to help surgeons in evidence-based practice. PMID:19234892

Diagnosis of Cystic Fibrosis in Screened Populations.

PubMed

Farrell, Philip M; White, Terry B; Howenstine, Michelle S; Munck, Anne; Parad, Richard B; Rosenfeld, Margaret; Sommerburg, Olaf; Accurso, Frank J; Davies, Jane C; Rock, Michael J; Sanders, Don B; Wilschanski, Michael; Sermet-Gaudelus, Isabelle; Blau, Hannah; Gartner, Silvia; McColley, Susanna A

2017-02-01

Cystic fibrosis (CF) can be difficult to diagnose, even when newborn screening (NBS) tests yield positive results. This challenge is exacerbated by the multitude of NBS protocols, misunderstandings about screening vs diagnostic tests, and the lack of guidelines for presumptive diagnoses. There is also confusion regarding the designation of age at diagnosis. To improve diagnosis and achieve standardization in definitions worldwide, the CF Foundation convened a committee of 32 experts with a mission to develop clear and actionable consensus guidelines on diagnosis of CF with an emphasis on screened populations, especially the newborn population. A comprehensive literature review was performed with emphasis on relevant articles published during the past decade. After reviewing the common screening protocols and outcome scenarios, 14 of 27 consensus statements were drafted that apply to screened populations. These were approved by 80% or more of the participants. It is recommended that all diagnoses be established by demonstrating dysfunction of the CF transmembrane conductance regulator (CFTR) channel, initially with a sweat chloride test and, when needed, potentially with newer methods assessing membrane transport directly, such as intestinal current measurements. Even in babies with 2 CF-causing mutations detected via NBS, diagnosis must be confirmed by demonstrating CFTR dysfunction. The committee also recommends that the latest classifications identified in the Clinical and Functional Translation of CFTR project [http://www.cftr2.org/index.php] should be used to aid with CF diagnosis. Finally, to avoid delays in treatment, we provide guidelines for presumptive diagnoses and recommend how to determine the age of diagnosis. Copyright © 2016. Published by Elsevier Inc.

MYSID TWO-GENERATION TEST GUIDELINE

EPA Science Inventory

McKenney, Charles L., Jr. In press. Mysid Two-Generation Test Guideline. OECD Expert Group on Invertebrate Testing for Endocrine Disruptors, Organisation for Economic Co-operation and Development, Paris, France. 17 p. (ERL,GB 1215).

This guideline describes a two-generati...

Simplified lipid guidelines: Prevention and management of cardiovascular disease in primary care.

PubMed

Allan, G Michael; Lindblad, Adrienne J; Comeau, Ann; Coppola, John; Hudson, Brianne; Mannarino, Marco; McMinis, Cindy; Padwal, Raj; Schelstraete, Christine; Zarnke, Kelly; Garrison, Scott; Cotton, Candra; Korownyk, Christina; McCormack, James; Nickel, Sharon; Kolber, Michael R

2015-10-01

To develop clinical practice guidelines for a simplified approach to primary prevention of cardiovascular disease (CVD), concentrating on CVD risk estimation and lipid management for primary care clinicians and their teams; we sought increased contribution from primary care professionals with little or no conflict of interest and focused on the highest level of evidence available. Nine health professionals (4 family physicians, 2 internal medicine specialists, 1 nurse practitioner, 1 registered nurse, and 1 pharmacist) and 1 nonvoting member (pharmacist project manager) comprised the overarching Lipid Pathway Committee (LPC). Member selection was based on profession, practice setting, and location, and members disclosed any actual or potential conflicts of interest. The guideline process was iterative through online posting, detailed evidence review, and telephone and online meetings. The LPC identified 12 priority questions to be addressed. The Evidence Review Group answered these questions. After review of the answers, key recommendations were derived through consensus of the LPC. The guidelines were drafted, refined, and distributed to a group of clinicians (family physicians, other specialists, pharmacists, nurses, and nurse practitioners) and patients for feedback, then refined again and finalized by the LPC. Recommendations are provided on screening and testing, risk assessments, interventions, follow-up, and the role of acetylsalicylic acid in primary prevention. These simplified lipid guidelines provide practical recommendations for prevention and treatment of CVD for primary care practitioners. All recommendations are intended to assist with, not dictate, decision making in conjunction with patients. Copyright© the College of Family Physicians of Canada.

Simplified lipid guidelines

PubMed Central

Allan, G. Michael; Lindblad, Adrienne J.; Comeau, Ann; Coppola, John; Hudson, Brianne; Mannarino, Marco; McMinis, Cindy; Padwal, Raj; Schelstraete, Christine; Zarnke, Kelly; Garrison, Scott; Cotton, Candra; Korownyk, Christina; McCormack, James; Nickel, Sharon; Kolber, Michael R.

2015-01-01

Abstract Objective To develop clinical practice guidelines for a simplified approach to primary prevention of cardiovascular disease (CVD), concentrating on CVD risk estimation and lipid management for primary care clinicians and their teams; we sought increased contribution from primary care professionals with little or no conflict of interest and focused on the highest level of evidence available. Methods Nine health professionals (4 family physicians, 2 internal medicine specialists, 1 nurse practitioner, 1 registered nurse, and 1 pharmacist) and 1 nonvoting member (pharmacist project manager) comprised the overarching Lipid Pathway Committee (LPC). Member selection was based on profession, practice setting, and location, and members disclosed any actual or potential conflicts of interest. The guideline process was iterative through online posting, detailed evidence review, and telephone and online meetings. The LPC identified 12 priority questions to be addressed. The Evidence Review Group answered these questions. After review of the answers, key recommendations were derived through consensus of the LPC. The guidelines were drafted, refined, and distributed to a group of clinicians (family physicians, other specialists, pharmacists, nurses, and nurse practitioners) and patients for feedback, then refined again and finalized by the LPC. Recommendations Recommendations are provided on screening and testing, risk assessments, interventions, follow-up, and the role of acetylsalicylic acid in primary prevention. Conclusion These simplified lipid guidelines provide practical recommendations for prevention and treatment of CVD for primary care practitioners. All recommendations are intended to assist with, not dictate, decision making in conjunction with patients. PMID:26472792

Human Papillomavirus Testing in Head and Neck Carcinomas: Guideline From the College of American Pathologists.

PubMed

Lewis, James S; Beadle, Beth; Bishop, Justin A; Chernock, Rebecca D; Colasacco, Carol; Lacchetti, Christina; Moncur, Joel Todd; Rocco, James W; Schwartz, Mary R; Seethala, Raja R; Thomas, Nicole E; Westra, William H; Faquin, William C

2018-05-01

Context Human papillomavirus (HPV) is a major cause of oropharyngeal squamous cell carcinomas, and HPV (and/or surrogate marker p16) status has emerged as a prognostic marker that significantly impacts clinical management. There is no current consensus on when to test oropharyngeal squamous cell carcinomas for HPV/p16 or on which tests to choose. Objective To develop evidence-based recommendations for the testing, application, interpretation, and reporting of HPV and surrogate marker tests in head and neck carcinomas. Design The College of American Pathologists convened a panel of experts in head and neck and molecular pathology, as well as surgical, medical, and radiation oncology, to develop recommendations. A systematic review of the literature was conducted to address 6 key questions. Final recommendations were derived from strength of evidence, open comment period feedback, and expert panel consensus. Results The major recommendations include (1) testing newly diagnosed oropharyngeal squamous cell carcinoma patients for high-risk HPV, either from the primary tumor or from cervical nodal metastases, using p16 immunohistochemistry with a 70% nuclear and cytoplasmic staining cutoff, and (2) not routinely testing nonsquamous oropharyngeal carcinomas or nonoropharyngeal carcinomas for HPV. Pathologists are to report tumors as HPV positive or p16 positive. Guidelines are provided for testing cytologic samples and handling of locoregional and distant recurrence specimens. Conclusions Based on the systematic review and on expert panel consensus, high-risk HPV testing is recommended for all new oropharyngeal squamous cell carcinoma patients, but not routinely recommended for other head and neck carcinomas.

The New US Preventive Services Task Force "C" Draft Recommendation for Prostate Cancer Screening.

PubMed

Cooperberg, Matthew R

2017-09-01

The US Preventive Services Task Force has issued a new draft guideline, with a "C" recommendation that men aged 55-69 yr should be informed about the benefits and harms of screening for prostate cancer, and offered prostate-specific antigen testing if they choose it. For men aged ≥70 yr, the recommendation remains "D", or "do not screen." This draft represents substantial progress in the right direction towards offering men a fair opportunity to discuss the risks and benefits of screening with their primary care providers. However, the evidence review underlying the draft remains fundamentally inadequate, leading to biased presentations of both benefits and harms of screening. The final guideline and future revisions should reflect formal engagement with subject matter experts to optimize the advise given to men and their physicians. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Drug Development Pipeline

MedlinePlus

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

Canadian sedentary behaviour guidelines for children and youth.

PubMed

Tremblay, Mark S; Leblanc, Allana G; Janssen, Ian; Kho, Michelle E; Hicks, Audrey; Murumets, Kelly; Colley, Rachel C; Duggan, Mary

2011-02-01

The Canadian Society for Exercise Physiology (CSEP), in partnership with the Healthy Active Living and Obesity Research Group (HALO) at the Children's Hospital of Eastern Ontario Research Institute, and in collaboration with ParticipACTION, and others, has developed the Canadian Sedentary Behaviour Guidelines for Children (aged 5-11 years) and Youth (aged 12-17 years). The guidelines include a preamble to provide context, followed by the specific recommendations for sedentary behaviour. The entire development process was guided by the Appraisal of Guidelines for Research Evaluation (AGREE) II instrument, which is the international standard for clinical practice guideline development. Thus, the guidelines have gone through a rigorous and transparent developmental process and the recommendations are based on evidence from a systematic review and interpretation of the research evidence. The final guidelines benefitted from an extensive online consultation process with 230 domestic and international stakeholders and key informants. The final guideline recommendations state that for health benefits, children (aged 5-11 years) and youth (aged 12-17 years) should minimize the time that they spend being sedentary each day. This may be achieved by (i) limiting recreational screen time to no more than 2 h per day - lower levels are associated with additional health benefits; and (ii) limiting sedentary (motorized) transport, extended sitting time, and time spent indoors throughout the day. These are the first evidence-based Canadian Sedentary Behaviour Guidelines for Children and Youth and provide important and timely recommendations for the advancement of public health based on a systematic synthesis, interpretation, and application of the current scientific evidence.

75 FR 75485 - Current List of Laboratories Which Meet Minimum Standards To Engage in Urine Drug Testing for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-03

... Current List of Laboratories Which Meet Minimum Standards To Engage in Urine Drug Testing for Federal... Guidelines for Federal Workplace Drug Testing Programs (Mandatory Guidelines). The Mandatory Guidelines were... Laboratories and Instrumented Initial Testing Facilities (IITF) must meet in order to conduct drug and specimen...

Drug Testing Guidelines and Practices for Juvenile Probation and Parole Agencies.

ERIC Educational Resources Information Center

American Probation and Parole Association, Lexington, KY.

This document, intended as a resource manual, provides guidelines on drug testing. These topics are covered: (1) National Institute on Drug Abuse guidelines applicability; (2) introduction to legal issues, drug testing in juvenile probation and parole, and juvenile law; (3) mission of a juvenile parole agency; (4) purpose of testing; (5) drug…

75 FR 62842 - Current List of Laboratories Which Meet Minimum Standards To Engage in Urine Drug Testing for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-13

... Current List of Laboratories Which Meet Minimum Standards To Engage in Urine Drug Testing for Federal... Guidelines for Federal Workplace Drug Testing Programs (Mandatory Guidelines). The Mandatory Guidelines were... and Instrumented Initial Testing Facilities (IITF) must meet in order to conduct drug and specimen...

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

ERIC Educational Resources Information Center

Allalouf, Avi

2014-01-01

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

Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline

PubMed Central

Kapur, Vishesh K.; Auckley, Dennis H.; Chowdhuri, Susmita; Kuhlmann, David C.; Mehra, Reena; Ramar, Kannan; Harrod, Christopher G.

2017-01-01

Introduction: This guideline establishes clinical practice recommendations for the diagnosis of obstructive sleep apnea (OSA) in adults and is intended for use in conjunction with other American Academy of Sleep Medicine (AASM) guidelines on the evaluation and treatment of sleep-disordered breathing in adults. Methods: The AASM commissioned a task force of experts in sleep medicine. A systematic review was conducted to identify studies, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process was used to assess the evidence. The task force developed recommendations and assigned strengths based on the quality of evidence, the balance of benefits and harms, patient values and preferences, and resource use. In addition, the task force adopted foundational recommendations from prior guidelines as “good practice statements”, that establish the basis for appropriate and effective diagnosis of OSA. The AASM Board of Directors approved the final recommendations. Recommendations: The following recommendations are intended as a guide for clinicians diagnosing OSA in adults. Under GRADE, a STRONG recommendation is one that clinicians should follow under most circumstances. A WEAK recommendation reflects a lower degree of certainty regarding the outcome and appropriateness of the patient-care strategy for all patients. The ultimate judgment regarding propriety of any specific care must be made by the clinician in light of the individual circumstances presented by the patient, available diagnostic tools, accessible treatment options, and resources. Good Practice Statements: Diagnostic testing for OSA should be performed in conjunction with a comprehensive sleep evaluation and adequate follow-up. Polysomnography is the standard diagnostic test for the diagnosis of OSA in adult patients in whom there is a concern for OSA based on a comprehensive sleep evaluation. Recommendations: We recommend that clinical tools, questionnaires and prediction algorithms not be used to diagnose OSA in adults, in the absence of polysomnography or home sleep apnea testing. (STRONG)We recommend that polysomnography, or home sleep apnea testing with a technically adequate device, be used for the diagnosis of OSA in uncomplicated adult patients presenting with signs and symptoms that indicate an increased risk of moderate to severe OSA. (STRONG)We recommend that if a single home sleep apnea test is negative, inconclusive, or technically inadequate, polysomnography be performed for the diagnosis of OSA. (STRONG)We recommend that polysomnography, rather than home sleep apnea testing, be used for the diagnosis of OSA in patients with significant cardiorespiratory disease, potential respiratory muscle weakness due to neuromuscular condition, awake hypoventilation or suspicion of sleep related hypoventilation, chronic opioid medication use, history of stroke or severe insomnia. (STRONG)We suggest that, if clinically appropriate, a split-night diagnostic protocol, rather than a full-night diagnostic protocol for polysomnography be used for the diagnosis of OSA. (WEAK)We suggest that when the initial polysomnogram is negative and clinical suspicion for OSA remains, a second polysomnogram be considered for the diagnosis of OSA. (WEAK) Citation: Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K, Harrod CG. Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2017;13(3):479–504. PMID:28162150

Laser ignition application in a space experiment

NASA Technical Reports Server (NTRS)

Liou, Larry C.; Culley, Dennis E.

1993-01-01

A laser ignition system is proposed for the Combustion Experiment Module on an orbiting spacecraft. The results of a design study are given using the scheduled 'Flame Ball Experiment' as the design guidelines. Three laser ignition mechanisms and wavelengths are evaluated. A prototype laser is chosen and its specifications are given, followed by consideration of the beam optical arrangement, the ignition power requirement, the laser ignition system weight, size, reliability, and laser cooling and power consumption. Electromagnetic interference to the onboard electronics caused by the laser ignition process is discussed. Finally, ground tests are suggested.

HIV pre-test information, discussion or counselling? A review of guidance relevant to the WHO European Region.

PubMed

Bell, Stephen A; Delpech, Valerie; Raben, Dorthe; Casabona, Jordi; Tsereteli, Nino; de Wit, John

2016-02-01

In the context of a shift from exceptionalism to normalisation, this study examines recommendations/evidence in current pan-European/global guidelines regarding pre-test HIV testing and counselling practices in health care settings. It also reviews new research not yet included in guidelines. There is consensus that verbal informed consent must be gained prior to testing, individually, in private, confidentially, in the presence of a health care provider. All guidelines recommend pre-test information/discussion delivered verbally or via other methods (information sheet). There is agreement about a minimum standard of information to be provided before a test, but guidelines differ regarding discussion about issues encouraging patients to think about implications of the result. There is heavy reliance on expert consultation in guideline development. Referenced scientific evidence is often more than ten years old and based on US/UK research. Eight new papers are reviewed. Current HIV testing and counselling guidelines have inconsistencies regarding the extent and type of information that is recommended during pre-test discussions. The lack of new research underscores a need for new evidence from a range of European settings to support the process of expert consultation in guideline development. © The Author(s) 2015.

Bridge maintenance Program for the City of Columbia, Missouri : final report.

DOT National Transportation Integrated Search

2017-09-22

The goal of this project was to extend the service lives of bridges located in Columbia, Missouri. The objective of the project was to develop guidelines for bridge maintenance and preservation. The guidelines developed are focused on practical and i...

Developing Guidelines for HIV Antibody Testing among Victims of Pediatric Sexual Abuse.

ERIC Educational Resources Information Center

Gellert, George A.; And Others

1990-01-01

An interim set of human immunodeficiency virus (HIV) testing guidelines for victims of pediatric sexual abuse (PSA) is proposed. Guidelines are based on responses of 63 practitioners of PSA assessment to 7 hypothetical clinical profiles with 12 testing criteria. (Author/DB)

Mars Science Laboratory CHIMRA: A Device for Processing Powdered Martian Samples

NASA Technical Reports Server (NTRS)

Sunshine, Daniel

2010-01-01

The CHIMRA is an extraterrestrial sample acquisition and processing device for the Mars Science Laboratory that emphasizes robustness and adaptability through design configuration. This work reviews the guidelines utilized to invent the initial CHIMRA and the strategy employed in advancing the design; these principles will be discussed in relation to both the final CHIMRA design and similar future devices. The computational synthesis necessary to mature a boxed-in impact-generating mechanism will be presented alongside a detailed mechanism description. Results from the development testing required to advance the design for a highly-loaded, long-life and high-speed bearing application will be presented. Lessons learned during the assembly and testing of this subsystem as well as results and lessons from the sample-handling development test program will be reviewed.

[Practical guidelines for genetic testing in cardiovascular diseases].

PubMed

Reinhard, W; Trenkwalder, T; Schunkert, H

2017-08-01

In the last decade, genetic testing for cardiovascular disorders has become more and more relevant. Progress in molecular genetics has led to new opportunities for diagnostics, improved risk prediction and could lead to novel therapeutic approaches. Genetic diagnostic testing is relevant for both confirming a diagnosis as well as deciding on therapeutic consequences, if applicable. Furthermore, predictive testing in family members for specific cardiovascular diseases is now a standard procedure in holistic patient management. The process of genetic testing as well as documentation requirements and discussion of test results with patients are subject to legal regulations. These regulations might be confusing for clinical practitioners/cardiologists. The aim of this article is to provide a clinical framework for genetic testing. First, we explain the legal and ethical background. Second, we illustrate the process of genetic testing step by step and present updates on remuneration. Finally, we discuss the significance of genetic testing and specific disease indications in cardiology.

Item-Writing Guidelines for Physics

ERIC Educational Resources Information Center

Regan, Tom

2015-01-01

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

Control of communicable disease; foreign--requirements for importers of nonhuman primates (NHP). Final rule.

PubMed

2013-02-15

The Centers for Disease Control and Prevention (CDC), located within the Department of Health and Human Services (HHS), is amending regulations for the importation of live nonhuman primates (NHPs) by extending existing requirements for the importation of Macaca fascicularis (cynomolgus), Chlorocebus aethiops (African green), and Macaca mulatta (rhesus) monkeys to all NHPs with the exception of the filovirus testing requirement. Filovirus testing will only be required for Old World NHPs in quarantine that have illness consistent with filovirus infection or that die for any reason other than trauma during quarantine. HHS/CDC is also finalizing a provision to reduce the frequency at which importers of cynomolgus, African green, and rhesus monkeys are required to renew their special permits (from every 180 days to every 2 years). HHS/CDC is incorporating existing guidelines into the regulations and adding new provisions to address the following: NHPs imported as part of an animal act; NHPs imported or transferred by zoological societies; the transfer of NHPs from approved laboratories; and non-live imported NHP products. Finally, HHS/CDC is also requiring that all NHPs be imported only through ports of entry where a HHS/CDC quarantine station is located.

28 CFR 63.8 - Implementation.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Implementation. 63.8 Section 63.8... PROCEDURES § 63.8 Implementation. Agencies and divisions within the Department of Justice shall amend... these guidelines. Such amendments will be made within 6 months of final publication of these guidelines. ...

28 CFR 63.8 - Implementation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Implementation. 63.8 Section 63.8... PROCEDURES § 63.8 Implementation. Agencies and divisions within the Department of Justice shall amend... these guidelines. Such amendments will be made within 6 months of final publication of these guidelines. ...

28 CFR 63.8 - Implementation.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Implementation. 63.8 Section 63.8... PROCEDURES § 63.8 Implementation. Agencies and divisions within the Department of Justice shall amend... these guidelines. Such amendments will be made within 6 months of final publication of these guidelines. ...

28 CFR 63.8 - Implementation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Implementation. 63.8 Section 63.8... PROCEDURES § 63.8 Implementation. Agencies and divisions within the Department of Justice shall amend... these guidelines. Such amendments will be made within 6 months of final publication of these guidelines. ...

28 CFR 63.8 - Implementation.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Implementation. 63.8 Section 63.8... PROCEDURES § 63.8 Implementation. Agencies and divisions within the Department of Justice shall amend... these guidelines. Such amendments will be made within 6 months of final publication of these guidelines. ...

Field verification of geogrid properties for base course reinforcement applications : final report.

DOT National Transportation Integrated Search

2013-11-01

The proposed field study is a continuation of a recently concluded, ODOT-funded project titled: Development of ODOT Guidelines for the Use of Geogrids in Aggregate Bases, which is aimed at addressing the need for improved guidelines for base reinforc...

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

EPA Science Inventory

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

The development of a guideline implementability tool (GUIDE-IT): a qualitative study of family physician perspectives

PubMed Central

2014-01-01

Background The potential of clinical practice guidelines has not been realized due to inconsistent adoption in clinical practice. Optimising intrinsic characteristics of guidelines (e.g., its wording and format) that are associated with uptake (as perceived by their end users) may have potential. Using findings from a realist review on guideline uptake and consultation with experts in guideline development, we designed a conceptual version of a future tool called Guideline Implementability Tool (GUIDE-IT). The tool will aim to involve family physicians in the guideline development process by providing a process to assess draft guideline recommendations. This feedback will then be given back to developers to consider when finalizing the recommendations. As guideline characteristics are best assessed by end-users, the objectives of the current study were to explore how family physicians perceive guideline implementability, and to determine what components should comprise the final GUIDE-IT prototype. Methods We conducted a qualitative study with family physicians inToronto, Ontario. Two experienced investigators conducted one-hour interviews with family physicians using a semi-structured interview guide to 1) elicit feedback on perceptions on guideline implementability; 2) to generate a discussion in response to three draft recommendations; and 3) to provide feedback on the conceptual GUIDE-IT. Sessions were audio taped and transcribed verbatim. Data collection and analysis were guided by content analyses. Results 20 family physicians participated. They perceived guideline uptake according to facilitators and barriers across 6 categories of guideline implementability (format, content, language, usability, development, and the practice environment). Participants’ feedback on 3 draft guideline recommendations were grouped according to guideline perception, cognition, and agreement. When asked to comment on GUIDE-IT, most respondents believed that the tool would be useful, but urged to involve “regular” or community family physicians in the process, and suggested that an online system would be the most efficient way to deliver it. Conclusions Our study identified facilitators and barriers of guideline implementability from the perspective of community and academic family physicians that will be used to build our GUIDE-IT prototype. Our findings build on current knowledge by showing that family physicians perceive guideline uptake mostly according to factors that are in the control of guideline developers. PMID:24476491

Unconventional Oil and Gas Extraction Effluent Guidelines

EPA Pesticide Factsheets

Overview and documents for the Unconventional Oil and Gas Extraction Pretreatment Standards final rule (6/28/2016), direct final rule (Sept. 2016) and proposed rule (Sept. 2016). 40 CFR Part 435, Subpart C.

21 CFR 350.60 - Guidelines for effectiveness testing of antiperspirant drug products.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 5 2011-04-01 2011-04-01 false Guidelines for effectiveness testing of antiperspirant drug products. 350.60 Section 350.60 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Drug Administration is providing guidelines that manufacturers may use in testing for effectiveness...

21 CFR 350.60 - Guidelines for effectiveness testing of antiperspirant drug products.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 5 2014-04-01 2014-04-01 false Guidelines for effectiveness testing of antiperspirant drug products. 350.60 Section 350.60 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Drug Administration is providing guidelines that manufacturers may use in testing for effectiveness...

21 CFR 350.60 - Guidelines for effectiveness testing of antiperspirant drug products.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 5 2012-04-01 2012-04-01 false Guidelines for effectiveness testing of antiperspirant drug products. 350.60 Section 350.60 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Drug Administration is providing guidelines that manufacturers may use in testing for effectiveness...

21 CFR 350.60 - Guidelines for effectiveness testing of antiperspirant drug products.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 5 2013-04-01 2013-04-01 false Guidelines for effectiveness testing of antiperspirant drug products. 350.60 Section 350.60 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Drug Administration is providing guidelines that manufacturers may use in testing for effectiveness...

Comments from the Behavioral Teratology Committee of the Japanese Teratology Society on OECD guideline for the testing of chemicals, proposal for a new guideline 426, developmental neurotoxicity study, draft document (September 2003).

PubMed

Fukui, Yoshihiro; Ema, Makoto; Fujiwara, Michio; Higuchi, Hashihiro; Inouye, Minoru; Iwase, Takayuki; Kihara, Takahide; Nishimura, Tatsuya; Oi, Akihide; Ooshima, Yojiro; Otani, Hiroki; Shinomiya, Mitsuhiro; Sugioka, Kozo; Yamano, Tsunekazu; Yamashita, Keisuke H; Tanimura, Takashi

2004-09-01

In September 2003, a new revision of the draft guideline (Organization for Economic Co-operation and Development [OECD] Guideline for the Testing of Chemicals, Proposal for a New Guideline 426, Developmental Neurotoxicity Study) was distributed. The draft guideline consists of 51 paragraphs and an appendix. The National Coordinators were requested to arrange national expert reviews of the guideline proposal in their member countries. The member of the Behavioral Teratology (BT) Committee of the Japanese Teratology Society (JTS) reviewed, discussed and commented on the draft Test Guideline proposal. The BT Committee of the JTS also commented that the International Collaborative Study to validate this protocol should be definitely performed. These comments were sent to the OECD Secretariat. The BT Committee of the JTS expects that the comments are useful for further discussion.

Tumorigenicity assessment of human cell-processed therapeutic products.

PubMed

Yasuda, Satoshi; Sato, Yoji

2015-09-01

Human pluripotent stem cells (hPSCs) are expected to be sources of various cell types used for cell therapy, although hPSCs are intrinsically tumorigenic and form teratomas in immunodeficient animals after transplant. Despite the urgent need, no detailed guideline for the assessment of tumorigenicity of human cell-processed therapeutic products (hCTPs) has been issued. Here we describe our consideration on tumorigenicity and related tests of hCTPs. The purposes of those tests for hPSC-based products are classified into three categories: 1) quality control of raw materials; 2) quality control of intermediate/final products; and 3) safety assessment of final products. Appropriate types of tests need to be selected, taking the purpose(s) into consideration. In contrast, human somatic (and somatic stem) cells are believed to have little tumorigenicity. Therefore, GMP-compliant quality control is essential to avoid contamination of somatic cell-derived products with tumorigenic cells. Compared with in vivo tumorigenicity tests, in vitro cell proliferation assays may be more useful and reasonable for detecting immortalized cells that have a growth advantage in somatic cell-based products. The results obtained from tumorigenicity and related tests for hCTPs should meet the criteria for decisions on product development, manufacturing processes, and clinical applications. Copyright © 2015.

Impact of a clinical guideline for prescribing antibiotics to inpatients reporting penicillin or cephalosporin allergy.

PubMed

Blumenthal, Kimberly G; Shenoy, Erica S; Varughese, Christy A; Hurwitz, Shelley; Hooper, David C; Banerji, Aleena

2015-10-01

Self-reported penicillin allergy infrequently reflects an inability to tolerate penicillins. Inpatients reporting penicillin allergy receive alternative antibiotics that might be broader spectrum, more toxic, or less effective. To develop and assess a clinical guideline for the general inpatient provider that directs taking a history and prescribing antibiotics for patients with penicillin or cephalosporin allergy. A guideline was implemented to assist providers with assessing allergy history and prescribing antibiotics for patients with reported penicillin or cephalosporin allergy. The guideline used a standard 2-step graded challenge or test dose. A quasi-experimental study was performed to assess safety, feasibility, and impact on antibiotic use by comparing treatment 21 months before guideline implementation with 12 months after guideline implementation. Significantly more test doses to β-lactam antibiotics were performed monthly after vs before guideline implementation (median 14.5, interquartile range 13-16.25, vs 2, interquartile range 1-3.25, P < .001). Seven adverse drug reactions occurred during guideline-driven test doses, with no significant difference in rate (3.9% vs 6.1%, P = .44) or severity (P > .5) between periods. Guideline-driven test doses decreased alternative antimicrobial therapy after the test dose, including vancomycin (68.3% vs 37.2%, P < .001), aztreonam (11.5% vs 0.5%, P < .001), aminoglycosides (6.0% vs 1.1%, P = .004), and fluoro quinolones (15.3% vs 3.3%, P < .001). The implementation of an inpatient antibiotic prescribing guideline for patients with penicillin or cephalosporin allergy was associated with an almost 7-fold increase in the number of test doses to β-lactams without increased adverse drug reactions. Patients assessed with guideline-driven test doses were observed to have significantly decreased alternative antibiotic exposure. Copyright © 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

New Approaches in International Guidelines for Genetic Toxicology Assays: Latest Updates on OECD Guidelines

EPA Science Inventory

In March 2010, the 22nd meeting of the Working Group of National Coordinators of the OECD Test Guidelines Programme (WNT) approved a project for updating the Test Guidelines on genotoxicity, with Canada, the Netherlands, France and the USA identified as lead countries for this wo...

Associations between schools' guidelines and pupils' smoking and sweet consumption.

PubMed

Kankaanpää, R; Tolvanen, M; Anttila, J; Lahti, S

2014-12-01

The aims were to find out if schools' sweet-selling was associated with pupils' sweet consumption, and whether the school's guideline about leaving the school area was associated with pupils' tobacco and sweet consumption. Two independently collected datasets from all Finnish upper secondary schools (N = 988) were linked together. The first dataset on schools' sweet-selling (yes/no) and guideline about leaving school area (yes/no) was collected via school principals in 2007 using an Internet questionnaire with a response rate of 49%, n = 480. The second dataset on pupils' self-reported: weekly school-time (0, never; 1, less than once; 2, 1-2 times; 3, 3-5 times), overall sweet consumption frequencies (1, never; 2, 1-2 times; 3, 3-5 times; 4, 6-7 times) and smoking and snuff-using frequencies (1, never; 2, every now and then; 3 = every day) was collected in 2006-2007 in the School Health Promotion Study from pupils. An average was calculated for the school-level with a response rate 80%, n = 790. The total response rate of the linked final data was 42%, n = 414. Mean values of self-reported sweet and tobacco consumption frequencies between sweet-selling and non-sweet-selling schools and between schools with different guidelines were compared using Mann-Whitney test. Pupils in sweet-selling schools and in schools without a guideline about leaving the school area, more frequently used sweet products and tobacco products than their peers in other schools. Schools may need help in building permanent guidelines to stop sweet-selling in school and to prevent leaving the school area to decrease pupils' sweet consumption and smoking.

[The German Program for Disease Management Guidelines: COPD Guideline 2006. Short review].

PubMed

Ollenschläger, Günter; Kopp, Ina; Lelgemann, Monika

2007-01-15

In Germany, the first national consensus on evidence-based recommendations for COPD prevention and disease management was reached in spring 2006. After a development period of 9 months, the National Disease Management Guideline COPD was finalized by nominal group process under the authorship of the scientific societies for pneumology (DGP and Atemwegsliga), general internal medicine (DGIM), family medicine (DEGAM), and the Drug Commission of the German Medical Association (AKDAE). The recommendations' main sources are the NICE COPD Guideline 2004, the GOLD Recommendations as well as existing German guidelines and reviews of recent scientific evidence. The article gives an overview on authors, sources, and key recommendations of the German National Disease Management Guideline COPD 2006 (www.copd.versorgungsleitlinien.de).

76 FR 52917 - Approval and Promulgation of Air Quality Implementation Plans; Pennsylvania; Adoption of Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-24

... Large Appliance and Metal Furniture Coatings AGENCY: Environmental Protection Agency (EPA). ACTION... Techniques Guidelines (CTG) standards for large appliance and metal furniture coatings. In the Final Rules...; Pennsylvania; Adoption of Control Techniques Guidelines for Large Appliance and Metal Furniture Coatings...

Genetic Testing for Minors: Comparison between Italian and British Guidelines

PubMed Central

Tozzo, Pamela; Caenazzo, Luciana; Rodriguez, Daniele

2012-01-01

Genetic testing in children raises many important ethical, legal, and social issues. One of the main concerns is the ethically inappropriate genetic testing of minors. Various European countries established professional guidelines which reflect the different countries perspectives regarding the main ethical issues involved. In this paper, we analyze the Italian and the British guidelines by highlighting differences and similarities. We discuss presymptomatic, predictive, and carrier testing because we consider them to be the more ethically problematic types of genetic testing in minors. In our opinion, national guidelines should take into account the different needs in clinical practice. At the same time, in the case of genetic testing the national and supranational protection of minors could be strengthened by approving guidelines based on a common framework of principles and values. We suggest that the Oviedo Convention could represent an example of such a common framework or, at least, it could lead to articulate it. PMID:22567400

Singapore Neonatal Resuscitation Guidelines 2016

PubMed Central

Yeo, Cheo Lian; Biswas, Agnihotri; Ee, Teong Tai Kenny; Chinnadurai, Amutha; Baral, Vijayendra Ranjan; Chang, Alvin Shang Ming; Ereno, Imelda Lustestica; Ho, Kah Ying Selina; Poon, Woei Bing; Shah, Varsha Atul; Quek, Bin Huey

2017-01-01

We present the revised Neonatal Resuscitation Guidelines for Singapore. The 2015 International Liaison Committee on Resuscitation Neonatal Task Force’s consensus on science and treatment recommendations (2015), and guidelines from the American Heart Association and European Resuscitation Council were debated and discussed. The final recommendations of the National Resuscitation Council, Singapore, were derived after the task force had carefully reviewed the current available evidence in the literature and addressed their relevance to local clinical practice. PMID:28741001

Infection control in cystic fibrosis: barriers to implementation and ideas for improvement.

PubMed

Saiman, Lisa; Garber, Elizabeth

2009-11-01

This review will focus on recent research documenting baseline adherence to infection control recommendations and barriers to their implementation as experienced by multidisciplinary cystic fibrosis (CF) care providers. In addition, controversies regarding optimal infection control will be discussed. Finally, suggestions to improve infection control in CF will be proposed. Compliance with recent guidelines was assessed for clinical microbiology laboratories and for infection control policies at CF care centers in the United States. Unlike earlier reports, the vast majority of laboratories used selective media for Burkholderia cepacia complex and identified all species of nonlactose fermenting Gram-negative bacilli. Fewer used selective media for Staphylococcus aureus or used agar-based susceptibility testing assays for Pseudomonas aeruginosa. Only 103 (65%) of 158 CF care centers provided written infection control policies for review and these were more likely to address inpatient than outpatient settings. Surveys of healthcare professionals showed that access to a copy of the CF infection control guidelines reduced barriers to adherence to selected infection control practices. These data suggest that access to national infection control guidelines and written local policies are critically important to improving infection control for CF.

Guidelines for the management of Helicobacter pylori infection in Italy: The III Working Group Consensus Report 2015.

PubMed

Zagari, Rocco Maurizio; Romano, Marco; Ojetti, Veronica; Stockbrugger, Reinhold; Gullini, Sergio; Annibale, Bruno; Farinati, Fabio; Ierardi, Enzo; Maconi, Giovanni; Rugge, Massimo; Calabrese, Carlo; Di Mario, Francesco; Luzza, Francesco; Pretolani, Stefano; Savio, Antonella; Gasbarrini, Giovanni; Caselli, Michele

2015-11-01

Knowledge on the role of Helicobacter pylori (HP) infection is continually evolving, and treatment is becoming more challenging due to increasing bacterial resistance. Since the management of HP infection is changing, an update of the national Italian guidelines delivered in 2007 was needed. In the III Working Group Consensus Report 2015, a panel of 17 experts from several Italian regions reviewed current evidence on different topics relating to HP infection. Four working groups examined the following topics: (1) "open questions" on HP diagnosis and treatment (focusing on dyspepsia, gastro-oesophageal reflux disease, non-steroidal anti-inflammatory drugs or aspirin use and extra-gastric diseases); (2) non-invasive and invasive diagnostic tests; (3) treatment of HP infection; (4) role of HP in the prevention of gastric cancer. Statements and recommendations were discussed and a consensus reached in a final plenary session held in February 2015 in Bologna. Recommendations are based on the best current evidence to help physicians manage HP infection in Italy. The guidelines have been endorsed by the Italian Society of Gastroenterology and the Italian Society of Digestive Endoscopy. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

[After ACC/AHA and ESC Guidelines: Pre-operative cardiological evaluation in non-cardiac surgery: certainties, controversial areas and opportunities for a team approach].

PubMed

Urbinati, Stefano; Faggiano, Pompilio; Colivicchi, Furio; Riccio, Carmine; Abrignani, Maurizio Giuseppe; Genovesi-Ebert, Alberto; Fattirolli, Francesco; De Feo, Stefania; Gambetti, Simona; Uguccioni, Massimo

2011-09-01

A standardized and evidence-based approach to the cardiological management of patients undergoing noncardiac surgery has been recently defined by Task Forces of the American Heart Association (AHA), American College of Cardiology (ACC) and the European Society of Cardiology (ESC) that published their guidelines in 2007 and 2009, respectively. Both the recommendations moved from risk indices to a practical, stepwise approach of the patient, which integrates clinical risk factors and test results with the estimated stress of the planned surgical procedure. In the present paper the main topics of the guidelines are discussed, and moreover, emphasis is placed on four controversial issues such as the use of prophylactic coronary revascularization in patients with myocardial ischemia, the perioperative management of patients with congestive heart failure, the routine use of betablockers and statins, and, finally, the management of antiplatelet therapies in patients with coronary stents. In addition to promoting an improvement of immediate perioperative care, the preoperative cardiological evaluation should be a challenge for identifying subjects with enhanced risk of cardiovascular events, who should be treated and monitored during a long-term follow-up.

The Parenting to Reduce Adolescent Depression and Anxiety Scale: Assessing parental concordance with parenting guidelines for the prevention of adolescent depression and anxiety disorders

PubMed Central

Cardamone-Breen, Mairead C.; Jorm, Anthony F.; Lawrence, Katherine A.; Mackinnon, Andrew J.

2017-01-01

Background Despite substantial evidence demonstrating numerous parental risk and protective factors for the development of adolescent depression and anxiety disorders, there is currently no single measure that assesses these parenting factors. To address this gap, we developed the Parenting to Reduce Adolescent Depression and Anxiety Scale (PRADAS) as a criterion-referenced measure of parental concordance with a set of evidence-based parenting guidelines for the prevention of adolescent depression and anxiety disorders. In this paper, we used a sample of Australian parents of adolescents to: (1) validate the PRADAS as a criterion-referenced measure; (2) examine parental concordance with the guidelines in the sample; and (3) examine correlates of parental concordance with the guidelines. Methods Seven hundred eleven parents completed the PRADAS, as well as two established parenting measures, and parent-report measures of adolescent depression and anxiety symptoms. Six hundred sixty adolescent participants (aged 12–15) also completed the symptom measures. Concordance with the guidelines was assessed via nine subscale scores and a total score. Reliability of the scores was assessed with an estimate of the agreement coefficient, as well as 1-month test-retest reliability. Convergent validity was examined via correlations between the scale and two established parenting measures. Results One proposed subscale was removed from the final version of the scale, resulting in a total of eight subscales. Reliability was high for the total score, and acceptable to high for seven of the eight subscales. One-month test-retest reliability was acceptable to high for the total score. Convergent validity was supported by moderate to high correlations with two established measures of parenting. Overall, rates of parental concordance with the guidelines were low in our sample. Higher scores were associated with being female and higher levels of parental education. Greater parental concordance with the guidelines was associated with fewer symptoms of depression and anxiety in adolescent participants. Discussion This initial validation study provides preliminary support for the reliability and validity of the PRADAS. The scale has potential for use in both clinical and research settings. It may be used to identify parents’ strengths and potential targets for intervention, and as an outcome measure in studies of preventive parenting interventions. PMID:28951815

Clinical Practice Guideline for the Treatment of Obstructive Sleep Apnea and Snoring with Oral Appliance Therapy: An Update for 2015

PubMed Central

Ramar, Kannan; Dort, Leslie C.; Katz, Sheri G.; Lettieri, Christopher J.; Harrod, Christopher G.; Thomas, Sherene M.; Chervin, Ronald D.

2015-01-01

Introduction: Since the previous parameter and review paper publication on oral appliances (OAs) in 2006, the relevant scientific literature has grown considerably, particularly in relation to clinical outcomes. The purpose of this new guideline is to replace the previous and update recommendations for the use of OAs in the treatment of obstructive sleep apnea (OSA) and snoring. Methods: The American Academy of Sleep Medicine (AASM) and American Academy of Dental Sleep Medicine (AADSM) commissioned a seven-member task force. A systematic review of the literature was performed and a modified Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process was used to assess the quality of evidence. The task force developed recommendations and assigned strengths based on the quality of the evidence counterbalanced by an assessment of the relative benefit of the treatment versus the potential harms. The AASM and AADSM Board of Directors approved the final guideline recommendations. Recommendations: We recommend that sleep physicians prescribe oral appliances, rather than no therapy, for adult patients who request treatment of primary snoring (without obstructive sleep apnea). (STANDARD) When oral appliance therapy is prescribed by a sleep physician for an adult patient with obstructive sleep apnea, we suggest that a qualified dentist use a custom, titratable appliance over non-custom oral devices. (GUIDELINE) We recommend that sleep physicians consider prescription of oral appliances, rather than no treatment, for adult patients with obstructive sleep apnea who are intolerant of CPAP therapy or prefer alternate therapy. (STANDARD) We suggest that qualified dentists provide oversight— rather than no follow-up—of oral appliance therapy in adult patients with obstructive sleep apnea, to survey for dental-related side effects or occlusal changes and reduce their incidence. (GUIDELINE) We suggest that sleep physicians conduct follow-up sleep testing to improve or confirm treatment efficacy, rather than conduct follow-up without sleep testing, for patients fitted with oral appliances. (GUIDELINE) We suggest that sleep physicians and qualified dentists instruct adult patients treated with oral appliances for obstructive sleep apnea to return for periodic office visits— as opposed to no follow-up—with a qualified dentist and a sleep physician. (GUIDELINE) Conclusions: The AASM and AADSM expect these guidelines to have a positive impact on professional behavior, patient outcomes, and, possibly, health care costs. This guideline reflects the state of knowledge at the time of publication and will require updates if new evidence warrants significant changes to the current recommendations. Citation: Ramar K, Dort LC, Katz SG, Lettieri CJ, Harrod CG, Thomas SM, Chervin RD. Clinical practice guideline for the treatment of obstructive sleep apnea and snoring with oral appliance therapy: an update for 2015. J Clin Sleep Med 2015;11(7):773–827. PMID:26094920

The Prestige oil spill: a laboratory study about the toxicity of the water-soluble fraction of the fuel oil.

PubMed

Navas, José M; Babín, Mar; Casado, Susana; Fernández, Carlos; Tarazona, José V

2006-07-01

The Prestige oil spill caused severe effects on the coastal fauna and flora due to direct contact of organisms with the fuel oil. However, the water soluble fraction (WSF) of the fuel oil can also provoke deleterious effects in the long term and even in regions not directly affected by the spill. Our objective was to determine the toxicity of the WSF using a battery of laboratory toxicity tests. To obtain a WSF in the laboratory, a sample of the spilled fuel was mixed with adequate medium, sonicated, agitated and filtered. No cytotoxic effects were detected in RTG-2 cells exposed to the WSF. In an algae growth inhibition test (OECD test guideline 201) the WSF did not affect the growth of Chlorella vulgaris. Furthermore, acute and reproductive toxicity tests (OECD test guideline 202) carried out using Daphnia magna did not indicate any deleterious effect of the WSF. In a bioassay designed in our laboratory, D. magna were fed with algae previously exposed to the fuel, but no toxic effects were detected. However, the WSF was able to induce a dose-dependent increase of ethoxyresorufin-O-deethylase activity in RTG-2 cells, indicating the presence of chemicals that could cause sub-lethal effects to organisms. After chemical analyses it was established that the final total quantity of polyaromatic hydrocarbons dissolved in medium was approximately 70 ng/ml. These low concentrations explain the observed lack of toxicity.

32 CFR 199.10 - Appeal and hearing procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... issues shall be bound by policy manuals, instructions, procedures, and other guidelines issued by the ASD..., procedures, instructions or guidelines by the ASD(HA), or a designee, when the final decision is issued in... Department of Defense in the administration of CHAMPUS. (ii) Referral for review by ASD(HA). The Director...

GUIDELINES FOR TRAINING SITUATION ANALYSIS (TSA). FINAL REPORT.

ERIC Educational Resources Information Center

CHENZOFF, ANDREW P.; FOLLEY, JOHN D., JR.

THESE GUIDELINES REPRESENT A TEXTBOOK FOR INSTRUCTION IN THREE PHASES OF TRAINING SITUATION ANALYSIS (TSA), A STANDARDIZED PROCEDURE DEVELOPED BY THE NAVAL TRAINING DEVICE CENTER FOR SYSTEMATICALLY GATHERING AND INTERPRETING THE INFORMATION RELEVANT TO THE PLANNING OF TRAINING AND TRAINING DEVICES. THREE PHASES OF TSA ARE DESCRIBED IN…

Guidelines for dynamic data acquisition and analysis

NASA Technical Reports Server (NTRS)

Piersol, Allan G.

1992-01-01

The recommendations concerning pyroshock data presented in the final draft of a proposed military handbook on Guidelines for Dynamic Data Acquisition and Analysis are reviewed. The structural responses produced by pyroshocks are considered to be one of the most difficult types of dynamic data to accurately measure and analyze.

Development of guidelines for permitted left-turn phasing using flashing yellow arrows : final report.

DOT National Transportation Integrated Search

2015-06-01

The objective of this project was to develop guidelines for time-of-day use of permitted left-turn phasing, : which can then be implemented using flashing yellow arrows (FYA). This required determining how the risk : for left-turn crashes varied as t...

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

PubMed

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

2017-09-01

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

Development of a design basis tornado and structural design criteria for the Nevada Test Site, Nevada. Final report

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

McDonald, J.R.; Minor, J.E.; Mehta, K.C.

1975-06-01

In order to evaluate the ability of critical facilities at the Nevada Test Site to withstand the possible damaging effects of extreme winds and tornadoes, parameters for the effects of tornadoes and extreme winds and structural design criteria for the design and evaluation of structures were developed. The meteorological investigations conducted are summarized, and techniques used for developing the combined tornado and extreme wind risk model are discussed. The guidelines for structural design include methods for calculating pressure distributions on walls and roofs of structures and methods for accommodating impact loads from wind-driven missiles. Calculations for determining the design loadsmore » for an example structure are included. (LCL)« less

Identification of individuals at risk for Lynch syndrome using targeted evaluations and genetic testing: National Society of Genetic Counselors and the Collaborative Group of the Americas on Inherited Colorectal Cancer joint practice guideline.

PubMed

Weissman, Scott M; Burt, Randall; Church, James; Erdman, Steve; Hampel, Heather; Holter, Spring; Jasperson, Kory; Kalady, Matt F; Haidle, Joy Larsen; Lynch, Henry T; Palaniappan, Selvi; Wise, Paul E; Senter, Leigha

2012-08-01

Identifying individuals who have Lynch syndrome (LS) involves a complex diagnostic work up that includes taking a detailed family history and a combination of various genetic and immunohistochemical tests. The National Society of Genetic Counselors (NSGC) and the Collaborative Group of the Americas on Inherited Colorectal Cancer (CGA-ICC) have come together to publish this clinical practice testing guideline for the evaluation of LS. The purpose of this practice guideline is to provide guidance and a testing algorithm for LS as well as recommendations on when to offer testing. This guideline does not replace a consultation with a genetics professional. This guideline includes explanations in support of this and a summary of background data. While this guideline is not intended to serve as a review of LS, it includes a discussion of background information on LS, and cites a number of key publications which should be reviewed for a more in-depth understanding of LS. These guidelines are intended for genetic counselors, geneticists, gastroenterologists, surgeons, medical oncologists, obstetricians and gynecologists, nurses and other healthcare providers who evaluate patients for LS.

Towards a standardised approach for evaluating guidelines and guidance documents on palliative sedation: study protocol

PubMed Central

2014-01-01

Background Sedation in palliative care has received growing attention in recent years; and so have guidelines, position statements, and related literature that provide recommendations for its practice. Yet little is known collectively about the content, scope and methodological quality of these materials. According to research, there are large variations in palliative sedation practice, depending on the definition and methodology used. However, a standardised approach to comparing and contrasting related documents, across countries, associations and governmental bodies is lacking. This paper reports on a protocol designed to enable thorough and systematic comparison of guidelines and guidance documents on palliative sedation. Methods and design A multidisciplinary and international group of palliative care researchers, identified themes and clinical issues on palliative sedation based on expert consultations and evidence drawn from the EAPC (European Association of Palliative Care) framework for palliative sedation and AGREE II (Appraisal Guideline Research and Evaluation) instrument for guideline assessment. The most relevant themes were selected and built into a comprehensive checklist. This was tested on people working closely with practitioners and patients, for user-friendliness and comprehensibility, and modified where necessary. Next, a systematic search was conducted for guidelines in English, Dutch, Flemish, or Italian. The search was performed in multiple databases (PubMed, CancerLit, CNAHL, Cochrane Library, NHS Evidence and Google Scholar), and via other Internet resources. Hereafter, the final version of the checklist will be used to extract data from selected literature, and the same will be compiled, entered into SPSS, cleaned and analysed systematically for publication. Discussion We have together developed a comprehensive checklist in a scientifically rigorous manner to allow standardised and systematic comparison. The protocol is applicable to all guidelines on palliative sedation, and the approach will contribute to rigorous and systematic comparison of international guidelines on any challenging topic such as this. Results from the study will provide valuable insights into common core elements and differences between the selected guidelines, and the extent to which recommendations are derived from, or match those in the EAPC framework. The outcomes of the study will be disseminated via peer-reviewed journals and directly to appropriate audiences. PMID:25028571

Towards a standardised approach for evaluating guidelines and guidance documents on palliative sedation: study protocol.

PubMed

Abarshi, Ebun; Rietjens, Judith; Caraceni, Augusto; Payne, Sheila; Deliens, Luc; Van Den Block, Lieve

2014-01-01

Sedation in palliative care has received growing attention in recent years; and so have guidelines, position statements, and related literature that provide recommendations for its practice. Yet little is known collectively about the content, scope and methodological quality of these materials. According to research, there are large variations in palliative sedation practice, depending on the definition and methodology used. However, a standardised approach to comparing and contrasting related documents, across countries, associations and governmental bodies is lacking. This paper reports on a protocol designed to enable thorough and systematic comparison of guidelines and guidance documents on palliative sedation. A multidisciplinary and international group of palliative care researchers, identified themes and clinical issues on palliative sedation based on expert consultations and evidence drawn from the EAPC (European Association of Palliative Care) framework for palliative sedation and AGREE II (Appraisal Guideline Research and Evaluation) instrument for guideline assessment. The most relevant themes were selected and built into a comprehensive checklist. This was tested on people working closely with practitioners and patients, for user-friendliness and comprehensibility, and modified where necessary. Next, a systematic search was conducted for guidelines in English, Dutch, Flemish, or Italian. The search was performed in multiple databases (PubMed, CancerLit, CNAHL, Cochrane Library, NHS Evidence and Google Scholar), and via other Internet resources. Hereafter, the final version of the checklist will be used to extract data from selected literature, and the same will be compiled, entered into SPSS, cleaned and analysed systematically for publication. We have together developed a comprehensive checklist in a scientifically rigorous manner to allow standardised and systematic comparison. The protocol is applicable to all guidelines on palliative sedation, and the approach will contribute to rigorous and systematic comparison of international guidelines on any challenging topic such as this. Results from the study will provide valuable insights into common core elements and differences between the selected guidelines, and the extent to which recommendations are derived from, or match those in the EAPC framework. The outcomes of the study will be disseminated via peer-reviewed journals and directly to appropriate audiences.

The Instrument for Measuring the Implementation Situation of Traditional Chinese Medicine Guideline: Evaluation and Application

PubMed Central

Wang, Yangyang; Chen, Yaolong; Wang, Xiaoyun; Deng, Jingwen

2017-01-01

Clinical practice guidelines play an important role in reducing the variations in clinical practices and improving the quality of care. To assess the real effect, measuring its implementation situation is needed. The implementation situation can be reflected by testing the consistency between the actual clinical practice and the guideline. We constructed an instrument to measure the implementation situation of Traditional Chinese Medicine (TCM) guideline through consistency testing. The main objectives of our study were to validate the instrument and evaluate the implementation situation of menopause syndrome guideline of TCM, using the data from the consistency test of comparing the medical records with the guideline. A total of 621 cases were included for data analysis. Cronbach's Alpha coefficient is 0.73. The model fit of 7 items in four dimensions was good (SRMR = 0.04; GFI = 0.97; NFI = 0.97; TLI = 0.96; CFI = 0.98; AGFI = 0.90). This instrument is of good reliability and validity. It can help the guideline developers to measure the implementation situation, find the reasons affecting the implementation, and revise the guideline. The method of using consistency test to measure the implementation situation may provide a sample for evaluating the guideline implementation in other fields. PMID:29234379

Findings from a novel approach to publication guideline revision: user road testing of a draft version of SQUIRE 2.0

PubMed Central

Davies, Louise; Donnelly, Kyla Z; Goodman, Daisy J; Ogrinc, Greg

2016-01-01

Background The Standards for Quality Improvement Reporting Excellence (SQUIRE) Guideline was published in 2008 (SQUIRE 1.0) and was the first publication guideline specifically designed to advance the science of healthcare improvement. Advances in the discipline of improvement prompted us to revise it. We adopted a novel approach to the revision by asking end-users to ‘road test’ a draft version of SQUIRE 2.0. The aim was to determine whether they understood and implemented the guidelines as intended by the developers. Methods Forty-four participants were assigned a manuscript section (ie, introduction, methods, results, discussion) and asked to use the draft Guidelines to guide their writing process. They indicated the text that corresponded to each SQUIRE item used and submitted it along with a confidential survey. The survey examined usability of the Guidelines using Likert-scaled questions and participants’ interpretation of key concepts in SQUIRE using open-ended questions. On the submitted text, we evaluated concordance between participants’ item usage/interpretation and the developers’ intended application. For the survey, the Likert-scaled responses were summarised using descriptive statistics and the open-ended questions were analysed by content analysis. Results Consistent with the SQUIRE Guidelines’ recommendation that not every item be included, less than one-third (n=14) of participants applied every item in their section in full. Of the 85 instances when an item was partially used or was omitted, only 7 (8.2%) of these instances were due to participants not understanding the item. Usage of Guideline items was highest for items most similar to standard scientific reporting (ie, ‘Specific aim of the improvement’ (introduction), ‘Description of the improvement’ (methods) and ‘Implications for further studies’ (discussion)) and lowest (<20% of the time) for those unique to healthcare improvement (ie, ‘Assessment methods for context factors that contributed to success or failure’ and ‘Costs and strategic trade-offs’). Items unique to healthcare improvement, specifically ‘Evolution of the improvement’, ‘Context elements that influenced the improvement’, ‘The logic on which the improvement was based’, ‘Process and outcome measures’, demonstrated poor concordance between participants’ interpretation and developers’ intended application. Conclusions User testing of a draft version of SQUIRE 2.0 revealed which items have poor concordance between developer intent and author usage, which will inform final editing of the Guideline and development of supporting supplementary materials. It also identified the items that require special attention when teaching about scholarly writing in healthcare improvement. PMID:26263916

Coauthorship in Pathology, a Comparison With Physics and a Survey-Generated and Member-Preferred Authorship Guideline

PubMed Central

Cohen, Michael B; Tarnow, Eugen; De Young, Barry R

2004-01-01

In a large and detailed survey of scientific coauthorship in pathology, 3500 members of the US and Canadian Academy of Pathology (USCAP) were surveyed via the Internet with a final response rate of 22.5%. The results were compared with a previous survey of members of the American Physical Society (APS). The fields are found to be very similar. For example, there is no well-defined way to determine coauthorship: the byline is arrived at without the use of public coauthorship standards according to 90% of respondents (92% in physics). A substantial amount of inappropriate authorship is present in both fields using a variety of authorship guidelines. For example, using the guideline of the International Committee of Medical Journal Editors (the "Uniform Requirements for Manuscripts Submitted to Biomedical Journals" [ICMJE]), the average number of coauthors judged to be inappropriate in pathology on papers with 4 coauthors is 1.0 (1.2 in physics), and using the guideline requiring "direct contributions to scientific discovery or invention," we find 1.6 (1.5 in physics). Finally, it is suggested that authorship guidelines should be constructed by public surveys rather than closed-door committees: an authorship guideline constructed from previous survey feedback (from APS members) was found to be preferable to USCAP members (it received 40% of the vote, the ICMJE received 24% of the vote). PMID:15520623

Coauthorship in pathology, a comparison with physics and a survery-generated and member-preferred authorship guideline.

PubMed

Tarnow, Eugen; De Young, Barry R; Cohen, Michael B

2004-07-22

In a large and detailed survey of scientific coauthorship in pathology, 3500 members of the US and Canadian Academy of Pathology (USCAP) were surveyed via the Internet with a final response rate of 22.5%. The results were compared with a previous survey of members of the American Physical Society (APS). The fields are found to be very similar. For example, there is no well-defined way to determine coauthorship: the byline is arrived at without the use of public coauthorship standards according to 90% of respondents (92% in physics). A substantial amount of inappropriate authorship is present in both fields using a variety of authorship guidelines. For example, using the guideline of the International Committee of Medical Journal Editors (the "Uniform Requirements for Manuscripts Submitted to Biomedical Journals" [ICMJE]), the average number of coauthors judged to be inappropriate in pathology on papers with 4 coauthors is 1.0 (1.2 in physics), and using the guideline requiring "direct contributions to scientific discovery or invention," we find 1.6 (1.5 in physics). Finally, it is suggested that authorship guidelines should be constructed by public surveys rather than closed-door committees: an authorship guideline constructed from previous survey feedback (from APS members) was found to be preferable to USCAP members (it received 40% of the vote, the ICMJE received 24% of the vote).

[The German Program for Disease Management Guidelines: CHD Guideline 2006. Short review].

PubMed

Ollenschläger, Günter; Lelgemann, Monika; Kopp, Ina

2006-12-15

In Germany, the first national consensus on evidence-based recommendations for disease management in patients with chronic coronary heart disease was reached in summer 2006. After a development period of 4 years, the National Disease Management Guideline Chronic Coronary Heart Disease was finalized by nominal group process under the authorship of the scientific associations for cardiac rehabilitation (DGPR), cardiac surgery (DGTHG), cardiology (DGK), general internal medicine (DGIM), family medicine (DEGAM), and the Drug Commission of the German Medical Association (AKDAE). The recommendations' main sources are the ACC/AHA guidelines 2002 updates as well as existing German guidelines and reviews of recent scientific evidence. The article gives an overview on authors, sources, and key recommendations of the German National Disease Management Guideline Chronic Coronary Heart Disease 2006 (www.khk.versorgungsleitlinie.de).

Saudi lung cancer management guidelines 2017

PubMed Central

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

2017-01-01

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

Saudi lung cancer management guidelines 2017.

PubMed

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

2017-01-01

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

32 CFR 767.9 - Content of permit holder's final report.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 5 2014-07-01 2014-07-01 false Content of permit holder's final report. 767.9 Section 767.9 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY MISCELLANEOUS... JURISDICATION OF THE DEPARTMENT OF THE NAVY Permit Guidelines § 767.9 Content of permit holder's final report...

32 CFR 767.9 - Content of permit holder's final report.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 5 2013-07-01 2013-07-01 false Content of permit holder's final report. 767.9 Section 767.9 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY MISCELLANEOUS... JURISDICATION OF THE DEPARTMENT OF THE NAVY Permit Guidelines § 767.9 Content of permit holder's final report...

Technical standards and guidelines: molecular genetic testing for ultra-rare disorders.

PubMed

Maddalena, Anne; Bale, Sherri; Das, Soma; Grody, Wayne; Richards, Sue

2005-10-01

These standards and guidelines are designed primarily as an educational resource for clinical laboratory geneticists to help them provide quality clinical laboratory genetic services. Adherence to these standards and guidelines does not necessarily ensure a successful medical outcome. These standards and guidelines should not be considered inclusive of all proper procedures and tests or exclusive of other procedures and tests that are reasonably directed to obtaining the same results. In determining the propriety of any specific procedure or test, the clinical molecular geneticist should apply his or her own professional judgment to the specific clinical circumstances presented by the individual patient or specimen. It may be prudent, however, to document in the laboratory record the rationale for any significant deviation from these standards and guidelines.

Creating the Action Model for High Risk Infant Follow Up Program in Iran.

PubMed

Heidarzadeh, Mohammad; Jodiery, Behzad; Mirnia, Kayvan; Akrami, Forouzan; Hosseini, Mohammad Bagher; Heidarabadi, Seifollah; HabibeLahi, Abbas

2013-11-01

Intervention in early childhood development as one of the social determinants of health, is important for reducing social gap and inequity. In spite of increasingly developing intensive neonatal care wards and decreasing neonatal mortality rate, there is no follow up program in Iran. This study was carreid out to design high risk infants follow up care program with the practical aim of creating an model action for whole country, in 2012. This qualitative study has been done by the Neonatal Department of the Deputy of Public Health in cooperation with Pediatrics Health Research Center of Tabriz University of Medical Sciences, Iran. After study of international documents, consensus agreement about adapted program for Iran has been accomplished by focus group discussion and attended Delphi agreement technique. After compiling primary draft included evidence based guidelines and executive plan, 14 sessions including expert panels were hold to finalize the program. After finalizing the program, high risk infants follow up care service package has been designed in 3 chapters: Evidence based clinical guidelines; eighteen main clinical guidelines and thirteen subsidiaries clinical guidelines, executive plan; 6 general, 6 following up and 5 backup processes. Education program including general and especial courses for care givers and follow up team, and family education processes. We designed and finalized high risk infants follow up care service package. It seems to open a way to extend it to whole country.

Development of a diagnostic test set to assess agreement in breast pathology: practical application of the Guidelines for Reporting Reliability and Agreement Studies (GRRAS).

PubMed

Oster, Natalia V; Carney, Patricia A; Allison, Kimberly H; Weaver, Donald L; Reisch, Lisa M; Longton, Gary; Onega, Tracy; Pepe, Margaret; Geller, Berta M; Nelson, Heidi D; Ross, Tyler R; Tosteson, Aanna N A; Elmore, Joann G

2013-02-05

Diagnostic test sets are a valuable research tool that contributes importantly to the validity and reliability of studies that assess agreement in breast pathology. In order to fully understand the strengths and weaknesses of any agreement and reliability study, however, the methods should be fully reported. In this paper we provide a step-by-step description of the methods used to create four complex test sets for a study of diagnostic agreement among pathologists interpreting breast biopsy specimens. We use the newly developed Guidelines for Reporting Reliability and Agreement Studies (GRRAS) as a basis to report these methods. Breast tissue biopsies were selected from the National Cancer Institute-funded Breast Cancer Surveillance Consortium sites. We used a random sampling stratified according to woman's age (40-49 vs. ≥50), parenchymal breast density (low vs. high) and interpretation of the original pathologist. A 3-member panel of expert breast pathologists first independently interpreted each case using five primary diagnostic categories (non-proliferative changes, proliferative changes without atypia, atypical ductal hyperplasia, ductal carcinoma in situ, and invasive carcinoma). When the experts did not unanimously agree on a case diagnosis a modified Delphi method was used to determine the reference standard consensus diagnosis. The final test cases were stratified and randomly assigned into one of four unique test sets. We found GRRAS recommendations to be very useful in reporting diagnostic test set development and recommend inclusion of two additional criteria: 1) characterizing the study population and 2) describing the methods for reference diagnosis, when applicable.

Teaching about genetic testing issues in the undergraduate classroom: a case study.

PubMed

Rogers, Jill Cellars; Taylor, Ann T S

2011-06-01

Educating undergraduates about current genetic testing and genomics can involve novel and creative teaching practices. The higher education literature describes numerous pedagogical approaches in the laboratory designed to engage science and liberal arts students. Often these experiences involve students analyzing their own genes for various polymorphisms, some of which are associated with disease states such as an increased risk for developing cancer. While the literature acknowledges possible ethical ramifications of such laboratory exercises, authors do not present recommendations or rubrics for evaluating whether or not the testing is, in fact, ethical. In response, we developed a laboratory investigation and discussion which allowed undergraduate science students to explore current DNA manipulation techniques to isolate their p53 gene, followed by a dialogue probing the ethical implications of examining their sample for various polymorphisms. Students never conducted genotyping on their samples because of ethical concerns, so the discussion served to replace actual genetic testing in the class. A basic scientist led the laboratory portion of the assignment. A genetic counselor facilitated the discussion, which centered around existing ethical guidelines for clinical genetic testing and possible challenges of human genotyping outside the medical setting. In their final papers, students demonstrated an understanding of the practice guidelines established by the genetics community and acknowledged the ethical considerations inherent in p53 genotyping. Given the burgeoning market for personalized medicine, teaching undergraduates about the psychosocial and ethical dimensions of human gene testing seems important and timely, and introduces an additional role genetic counselors can play in educating consumers about genomics.

The ethical implications of genetic testing in the classroom.

PubMed

Taylor, Ann T S; Rogers, Jill Cellars

2011-07-01

The development of classroom experiments where students examine their own DNA is frequently described as an innovative teaching practice. Often these experiences involve students analyzing their genes for various polymorphisms associated with disease states, like an increased risk for developing cancer. Such experiments can muddy the distinction between classroom investigation and medical testing. Although the goals and issues surrounding classroom genotyping do not directly align with those of clinical testing, instructors can use the guidelines and standards established by the medical genetics community when evaluating the ethics of human genotyping. We developed a laboratory investigation and discussion which allowed undergraduate science students to explore current DNA manipulation techniques to isolate their p53 gene, followed by a dialogue probing the ethical implications of examining their sample for various polymorphisms. Students never conducted genotyping on their samples because of the ethical concerns presented in this paper, so the discussion replaced the actual genetic testing in the class. A science faculty member led the laboratory portion, while a genetic counselor facilitated the discussion of the ethical concepts underlying genetic counseling: autonomy, beneficence, confidentiality, and justice. In their final papers, students demonstrated an understanding of the practice guidelines established by the genetics community and acknowledged the ethical considerations inherent in p53 genotyping. Given the burgeoning market for personalized medicine, teaching undergraduates about the psychosocial and ethical dimensions of human genetic testing is important and timely. Moreover, incorporating a genetic counselor in the classroom discussion provided a rich and dynamic discussion of human genetic testing. Copyright © 2011 Wiley Periodicals, Inc.

Guidelines for determining probability of causation under the Energy Employees Occupational Illness Compensation Program Act of 2000; revision of guidelines on non-radiogenic cancers. Final rule.

PubMed

2012-02-06

In a notice of proposed rulemaking published in the Federal Register on March 21, 2011, the Department of Health and Human Services (HHS) proposed to treat chronic lymphocytic leukemia (CLL) as a radiogenic cancer under the Energy Employees Occupational Illness Compensation Program Act of 2000 (EEOICPA) (76 FR 15268). Under this final rule, CLL will be treated as being potentially caused by radiation and hence as potentially compensable under EEOICPA. HHS reverses its decision to exclude CLL from such treatment.

Medicare program; standards for quality of water used in dialysis and revised guidelines on reuse of hemodialysis filters for end-stage renal disease (ESRD) patients--HCFA. Final rule.

PubMed

1995-09-18

This final rule revises the Medicare conditions for coverage of suppliers of end-stage renal disease services. The revisions remove general language in the regulations regarding water quality; incorporate by reference standards for monitoring the quality of water used in dialysis as published by the Association for the Advancement of Medical Instrumentation (AAMI) in its document, "Hemodialysis Systems" (second edition); and update existing regulations to incorporate by reference the second edition of AAMI's voluntary guidelines on "Reuse of Hemodialyzers."

Developing and testing lay literature about breast cancer screening for African American women.

PubMed

Coleman, Elizabeth Ann; Coon, Sharon; Mohrmann, Carolyn; Hardin, Susan; Stewart, Beth; Gibson, Regina Shoate; Cantrell, Mary; Lord, Janet; Heard, Jeanne

2003-01-01

Written materials about breast cancer screening for African American women with low literacy skills are needed. Available materials were not at or below third-grade reading levels, were not culturally sensitive, and were not accurate in illustrating correct breast self-examination (BSE) techniques. Focus groups representing the target population helped the authors design a pamphlet describing how to perform BSE and a motivational picture book to help women overcome barriers to screening. The authors chose a food theme for the cover of the pamphlet written at a third-grade level and suggested a photographic version. In the motivational book, two women address barriers to screening and replace myths and fears with facts and actions. Data from 162 women showed that they learned from both the photographic and illustrated versions. Women in the photographic group found significantly more lumps in the silicone models, so the authors chose that version to use in final testing. Finally, nurses pretested a group of patients before they reviewed the materials and post-tested another group after they reviewed them. The group who had reviewed the materials had greater knowledge of and intent to follow the guidelines and received higher scores on BSE techniques.

Threatened and Endangered Species Habitat Management Plan for Los Alamos National Laboratory

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

Hathcock, Charles Dean; Keller, David Charles; Thompson, Brent E.

Los Alamos National Laboratory’s (LANL) Threatened and Endangered Species Habitat Management Plan (HMP) fulfills a commitment made to the U.S. Department of Energy (DOE) in the “Final Environmental Impact Statement for the Dual-Axis Radiographic Hydrodynamic Test Facility Mitigation Action Plan” (DOE 1996). The HMP received concurrence from the U.S. Fish and Wildlife Service (USFWS) in 1999 (USFWS consultation numbers 2-22-98-I-336 and 2-22-95-I-108). This 2017 update retains the management guidelines from the 1999 HMP for listed species, and updates some descriptive information.

Reading, readability, and legibility research: implications for notification letters.

PubMed

Zimmerman, D E

1993-01-01

This article defines communication science and then briefly describes three research areas relevant to worker notifications: (1) receiving of notification messages, (2) reading and understanding of notification messages, and (3) influences or effects of notification messages on workers. Next, the article focuses on the reading and legibility research relevant to worker notifications and then provides 16 guidelines for drafting worker notifications. Finally, the article suggests evaluating draft notifications by using one or more of the following: skilled editorial reviews, readability scoring, Cloze techniques, signal stopping techniques, in-depth personal interviews, focus groups, and usability testing.

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

EPA Science Inventory

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

Osteoarthritis guidelines: Barriers to implementation and solutions.

PubMed

Ferreira de Meneses, Sarah; Rannou, Francois; Hunter, David J

2016-06-01

Osteoarthritis (OA) is a leading cause of disability worldwide. Clinical practice guidelines (CPGs) have been developed to facilitate improved OA management. Scientific communities worldwide have proposed CPGs for OA treatment. Despite the number of highly prominent guidelines available and their remarkable consistency, their uptake has been suboptimal. Possibly because of the multitude of barriers related to the implementation of CPGs. For example, different guidelines show contradictions, some lack evidence, and they lack a hierarchy or tools to facilitate their translation and application. Also, the guidelines do not acknowledge the effect of comorbidities on choosing the treatments. Finally, poor integration of multidisciplinary services within and across healthcare settings is a major barrier to the effective implementation of management guidelines. Here we describe the main problems related to the OA guidelines and some solutions so as to offer some guidance on the elaboration of future CPGs and their implementation in primary care. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

[Guidelines 2.0: systematic development of a comprehensive checklist for a successful guideline enterprise].

PubMed

Morgano, Gian Paolo; Davoli, Marina; Moja, Lorenzo; Amato, Laura; Ferroni, Eliana; Tirani, Marcello

2015-06-01

Guideline developers worldwide are struggling with the lack of guidance for the practical steps in the guideline enterprise. Our objective was to systematically compile a comprehensive checklist of items linked to relevant resources and tools that guideline developers would consider for development and support of implementation. Data sources included manuals of international guideline developers, literature on guidelines for guidelines with a focus on international and national guideline agencies, professional societies, and recent systematic guidance articles. We reviewed these sources in duplicate, extracted items using a sensitive approach and developed overarching topics that are relevant to guidelines. In an iterative process, we reviewed items for duplication and omissions and involved experts in guideline development for revisions. We developed a checklist with 18 topics and 146 items and a webpage to facilitate its use by guideline developers (http://cebgrade.mcmaster.ca/guidecheck.html). The topics and items included cover all stages of the guideline enterprise, from planning to formulating recommendations, to dissemination and evaluation. The final itemized guideline development checklist (GDC) includes links to training material and resources for methodology. The GDC will serve as a resource for those involved in guideline development and we will use crowdsourcing to keep the checklist up to date and enhance it.

Canadian Sedentary Behaviour Guidelines for the Early Years (aged 0-4 years).

PubMed

Tremblay, Mark S; Leblanc, Allana G; Carson, Valerie; Choquette, Louise; Connor Gorber, Sarah; Dillman, Carrie; Duggan, Mary; Gordon, Mary Jane; Hicks, Audrey; Janssen, Ian; Kho, Michelle E; Latimer-Cheung, Amy E; Leblanc, Claire; Murumets, Kelly; Okely, Anthony D; Reilly, John J; Stearns, Jodie A; Timmons, Brian W; Spence, John C

2012-04-01

The Canadian Society for Exercise Physiology (CSEP), with assistance from multiple partners, stakeholders, and researchers, developed the first Canadian Sedentary Behaviour Guidelines for the Early Years (aged 0-4 years). These national guidelines are in response to a call from health and health care professionals, child care providers, and fitness practitioners for guidance on sedentary behaviour in the early years. The guideline development process followed the Appraisal of Guidelines for Research Evaluation (AGREE) II framework. The recommendations are informed by evidence from a systematic review that examined the relationships between sedentary behaviour (predominantly screen time) and health indicators (healthy body weight, bone and skeletal health, motor skill development, psychosocial health, cognitive development, and cardio-metabolic disease risk factors) for three age groups (infants aged <1 year; toddlers aged 1-2 years; preschoolers aged 3-4 years). Evidence from the review was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The new guidelines include a preamble to provide context, followed by the specific recommendations. The final guidelines benefitted from extensive on-line consultations with input from >900 domestic and international stakeholders, end-users, and key informants. The final guidelines state: for healthy growth and development, caregivers should minimize the time infants (aged <1 year), toddlers (aged 1-2 years), and preschoolers (aged 3-4 years) spend being sedentary during waking hours. This includes prolonged sitting or being restrained (e.g., stroller, high chair) for more than 1 h at a time. For those under 2 years, screen time (e.g., TV, computer, electronic games) is not recommended. For children 2-4 years, screen time should be limited to under 1 h per day; less is better.

Prevention Activities in Professional Psychology: A Reaction to the Prevention Guidelines

ERIC Educational Resources Information Center

Rivera-Mosquera, Evelyn; Dowd, E. Thomas; Mitchell-Blanks, Marsha

2007-01-01

In this reaction article, the authors provide a historical context for prevention activities and their place in psychological practice. They then discuss the prevention guidelines in the Major Contribution authored by S. M. Hage et al. (2007 [this issue]) and provide their critique. Finally, the authors offer ideas for the future specific…

Budgeting for Quality and Survival in the 21st Century--Guidelines for Directors.

ERIC Educational Resources Information Center

Whitehead, R. Ann

2003-01-01

Offers practical guidelines for directors of child care centers on creating a budget and managing the center's finances. Suggests ways to establish priorities, establish a tuition rate, compute projected monthly enrollment and income, budget variable and fixed expenses, create the final budget, and monitor financial statements. (JPB)

Other Solid Waste Incineration (OSWI) Units Standards of Performance for New Stationary Sources and Emission Guidelines for Existing Sources Fact Sheets

EPA Pesticide Factsheets

This page contains a November 2005, and and November 2006 fact sheet with information regarding the final and proposed NSPS and Emission Guidelines for Existing Sources for OSWI. This document provides a summary of the information for this regulation

Scalable Asset Discovery, Vulnerability Scanning, and Penetration Testing for Remote Sites and Wireless Spectrums Utilizing an Embedded Linux Plug - PwniPlug and the Raspberry Pi B+ as a Sample Pen Test

NASA Technical Reports Server (NTRS)

Ganzy, Ethan G.

2014-01-01

All devices attached to the NASA KSC network are subject to security vulnerability scanning and/or penetration testing. In today's changing environment, vulnerable and/or unprotected systems can easily be overlooked. Systems that are not properly managed can become a potential threat to the operational integrity of our systems and networks. This includes all NASA (internal and external) information systems within NASA KSC Internet Protocol (IP) address space, and NASA KSC facilities. The Office of the Chief Information Officer (OCIO) recommends that all NASA Centers and information systems be subject to penetration testing on a regular interval in accordance with the guidelines identified by the National Institute of Standards and Technology (NIST). (ITS-HBK-2810.04-02A) Protecting information and equipment at NASA is an area of increasing concern. In addition to the CPU's on the network; Supervisory, Control and Data Acquisition (SCADA) systems are especially vulnerable because these systems have lacked standards, use embedded controllers with little computational power and informal software, are connected to physical processes, have few operators, and are increasingly also being connected to corporate networks. The scope of work is comprised of several individual components which together build upon previous work by Drew Branch, NASA KSC Intern. The Pwn Plug is the selected COTS (Commercial-Off-The-Shelf) device chosen to test simplification of mandatory IT Security tasks. The device will be utilized to provide services to NASA KSC and enable an assessment of infrastructure soundness and regulatory compliance in an efficient, economical, and business responsive manner. The Pwn Plug is designed as a pen testing appliance which provides a hardware platform that can support commercial penetration testing efforts at significantly reduced costs. The expected outcomes are: 1) External Penetration Testing, 2) Social Engineering, 3) Procedural Documentation, 4) Recommended Remediation Action Plan, 5) System Retest & Remediation Attestation and 6) Final Reports, out briefing and Presentation. Due to physical and material constraints beyond intern and mentor control, the project was redefined as a working pen-test scenario. Limitations of lab availability and tools dictated an academic exercise. This report was developed within the scenario guidelines suggested by the project mentor. The guidelines were to be creative in developing a Pen Test program for a client.

An Examination of Existing Guidelines for Programs for the Preservice and Inservice Education of Teachers in Metric Education and the Modification of These and the Development of New Ones if Deemed Necessary. Final Report of Objective No. 3.

ERIC Educational Resources Information Center

Granito, Dolores

These guidelines for in-service and preservice teacher education related to the conversion to the metric system were developed from a survey of published materials, university faculty, and mathematics supervisors. The eleven guidelines fall into three major categories: (1) design of teacher training programs, (2) teacher training, and (3)…

ASVCP quality assurance guidelines: external quality assessment and comparative testing for reference and in-clinic laboratories.

PubMed

Camus, Melinda S; Flatland, Bente; Freeman, Kathleen P; Cruz Cardona, Janice A

2015-12-01

The purpose of this document is to educate providers of veterinary laboratory diagnostic testing in any setting about comparative testing. These guidelines will define, explain, and illustrate the importance of a multi-faceted laboratory quality management program which includes comparative testing. The guidelines will provide suggestions for implementation of such testing, including which samples should be tested, frequency of testing, and recommendations for result interpretation. Examples and a list of vendors and manufacturers supplying control materials and services to veterinary laboratories are also included. © 2015 American Society for Veterinary Clinical Pathology.

Management of severe perioperative bleeding: guidelines from the European Society of Anaesthesiology: First update 2016.

PubMed

Kozek-Langenecker, Sibylle A; Ahmed, Aamer B; Afshari, Arash; Albaladejo, Pierre; Aldecoa, Cesar; Barauskas, Guidrius; De Robertis, Edoardo; Faraoni, David; Filipescu, Daniela C; Fries, Dietmar; Haas, Thorsten; Jacob, Matthias; Lancé, Marcus D; Pitarch, Juan V L; Mallett, Susan; Meier, Jens; Molnar, Zsolt L; Rahe-Meyer, Niels; Samama, Charles M; Stensballe, Jakob; Van der Linden, Philippe J F; Wikkelsø, Anne J; Wouters, Patrick; Wyffels, Piet; Zacharowski, Kai

2017-06-01

: The management of perioperative bleeding involves multiple assessments and strategies to ensure appropriate patient care. Initially, it is important to identify those patients with an increased risk of perioperative bleeding. Next, strategies should be employed to correct preoperative anaemia and to stabilise macrocirculation and microcirculation to optimise the patient's tolerance to bleeding. Finally, targeted interventions should be used to reduce intraoperative and postoperative bleeding, and so prevent subsequent morbidity and mortality. The objective of these updated guidelines is to provide healthcare professionals with an overview of the most recent evidence to help ensure improved clinical management of patients. For this update, electronic databases were searched without language restrictions from 2011 or 2012 (depending on the search) until 2015. These searches produced 18 334 articles. All articles were assessed and the existing 2013 guidelines were revised to take account of new evidence. This update includes revisions to existing recommendations with respect to the wording, or changes in the grade of recommendation, and also the addition of new recommendations. The final draft guideline was posted on the European Society of Anaesthesiology website for four weeks for review. All comments were collated and the guidelines were amended as appropriate. This publication reflects the output of this work.

Could accreditation bodies facilitate the implementation of medical guidelines in laboratories?

PubMed

Aakre, Kristin M; Oosterhuis, Wytze P; Misra, Shivani; Langlois, Michel R; Joseph, Watine; Twomey, Patrick J; Barth, Julian H

2017-05-01

Several studies have shown that recommendations related to how laboratory testing should be performed and results interpreted are limited in medical guidelines and that the uptake and implementation of the recommendations that are available need improvement. The EFLM/UEMS Working Group on Guidelines conducted a survey amongst the national societies for clinical chemistry in Europe regarding development of laboratory-related guidelines. The results showed that most countries have guidelines that are specifically related to laboratory testing; however, not all countries have a formal procedure for accepting such guidelines and few countries have guideline committees. Based on this, the EFLM/UEMS Working Group on Guidelines conclude that there is still room for improvement regarding these processes in Europe and raise the question if the accreditation bodies could be a facilitator for an improvement.

Evidence-based guidelines for wise use of electronic games by children.

PubMed

Straker, Leon; Abbott, Rebecca; Collins, Rachel; Campbell, Amity

2014-01-01

Electronic games (e-games) are widely used by children, often for substantial durations, yet to date there are no evidence-based guidelines regarding their use. The aim of this paper is to present guidelines for the wise use of e-games by children based on a narrative review of the research. This paper proposes a model of factors that influence child-e-games interaction. It summarises the evidence on positive and negative effects of use of e-games on physical activity and sedentary behaviour, cardio-metabolic health, musculoskeletal health, motor coordination, vision, cognitive development and psychosocial health. Available guidelines and the role of guidelines are discussed. Finally, this information is compiled into a clear set of evidence-based guidelines, about wise use of e-games by children, targeting children, parents, professionals and the e-game industry. These guidelines provide an accessible synthesis of available knowledge and pragmatic guidelines based on e-game specific evidence and related research.

75 FR 42820 - Notice of Availability of a Final Environmental Assessment (Final EA) and a Finding of No...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-22

... evaluated the construction and operation of a new 20,000-square-foot standard design Terminal Radar Approach Control Facility/Base Building conforming to the guidelines of the Terminal Facilities Design Standards... Airport Layout Plan. The Final EA has been prepared in accordance with the National Environmental Policy...

Meta-cognitive student reflections

NASA Astrophysics Data System (ADS)

Barquist, Britt; Stewart, Jim

2009-05-01

We have recently concluded a project testing the effectiveness of a weekly assignment designed to encourage awareness and improvement of meta-cognitive skills. The project is based on the idea that successful problem solvers implement a meta-cognitive process in which they identify the specific concept they are struggling with, and then identify what they understand, what they don't understand, and what they need to know in order to resolve their problem. The assignment required the students to write an email assessing the level of completion of a weekly workbook assignment and to examine in detail their experiences regarding a specific topic they struggled with. The assignment guidelines were designed to coach them through this meta-cognitive process. We responded to most emails with advice for next week's assignment. Our data follow 12 students through a quarter consisting of 11 email assignments which were scored using a rubric based on the assignment guidelines. We found no correlation between rubric scores and final grades. We do have anecdotal evidence that the assignment was beneficial.

Guidelines and standard procedures for continuous water-quality monitors: Site selection, field operation, calibration, record computation, and reporting

USGS Publications Warehouse

Wagner, Richard J.; Mattraw, Harold C.; Ritz, George F.; Smith, Brett A.

2000-01-01

The U.S. Geological Survey uses continuous water-quality monitors to assess variations in the quality of the Nation's surface water. A common system configuration for data collection is the four-parameter water-quality monitoring system, which collects temperature, specific conductance, dissolved oxygen, and pH data, although systems can be configured to measure other properties such as turbidity or chlorophyll. The sensors that are used to measure these water properties require careful field observation, cleaning, and calibration procedures, as well as thorough procedures for the computation and publication of final records. Data from sensors can be used in conjunction with collected samples and chemical analyses to estimate chemical loads. This report provides guidelines for site-selection considerations, sensor test methods, field procedures, error correction, data computation, and review and publication processes. These procedures have evolved over the past three decades, and the process continues to evolve with newer technologies.

[First Argentine consensus guidelines for in vitro antimicrobial susceptibility testing of clinically relevant anaerobic bacteria in humans/ Anaerobic Subcommittee of the Asociación Argentina de Microbiología].

PubMed

Legaria, María C; Bianchini, Hebe M; Castello, Liliana; Carloni, Graciela; Di Martino, Ana; Fernández Canigia, Liliana; Litterio, Mirta; Rollet, Raquel; Rossetti, Adelaida; Predari, Silvia C

2011-01-01

Through time, anaerobic bacteria have shown good susceptibility to clinically useful antianaerobic agents. Nevertheless, the antimicrobial resistance profile of most of the anaerobic species related to severe infections in humans has been modified in the last years and different kinds of resistance to the most active agents have emerged, making their effectiveness less predictable. With the aim of finding an answer and for the purpose of facilitating the detection of anaerobic antimicrobial resistance, the Anaerobic Subcommittee of the Asociación Argentina de Microbiología developed the First Argentine consensus guidelines for in vitro antimicrobial susceptibility testing of clinically relevant anaerobic bacteria in humans. This document resulted from the compatibilization of the Clinical and Laboratory Standards Institute recommendations, the international literature and the work and experience of the Subcommittee. The Consensus document provides a brief taxonomy review, and exposes why and when anaerobic antimicrobial susceptibility tests should be conducted, and which antimicrobial agents can be used according to the species involved. The recommendations on how to perform, read and interpret in vitro anaerobic antimicrobial susceptibility tests with each method are exposed. Finally, the antibiotic susceptibility profile, the classification of antibiotics according to their in vitro activities, the natural and acquired mechanisms of resistance, the emerging resistance and the regional antibiotic resistance profile of clinically relevant anaerobic species are shown.

Low Risk of Cervical Cancer/Precancer Among Most Women Under Surveillance Postcolposcopy.

PubMed

Demarco, Maria; Cheung, Li C; Kinney, Walter K; Wentzensen, Nicolas; Lorey, Thomas S; Fetterman, Barbara; Poitras, Nancy E; Befano, Brian; Castle, Philip E; Schiffman, Mark

2018-04-01

To inform impending postcolposcopy guidelines, this analysis examined the subsequent risk of CIN 3+ among women with a grade lower than CIN 2 (< CIN 2) colposcopy results, taking into account the referring results that brought them to colposcopy and cotest results postcolposcopy. We analyzed 107,005 women from 25 to 65 years old, recommended for colposcopy at Kaiser Permanente Northern California. We estimated absolute risks of CIN 3+ among women: (1) recommended for colposcopy (precolposcopy), (2) following colposcopy and with histology results < CIN 2 (postcolposcopy), and (3) with cotest results 12 months after a < CIN 2 colposcopy (return cotest). After colposcopy showing < CIN 2 (n = 69,790; 87% of the women at colposcopy), the 1-year risk of CIN 3+ was 1.2%, compared with 6.3% at the time of colposcopy recommendation. Negative cotest results 1 year after colposcopy identified a large group (37.1%) of women whose risk of CIN 3+ (i.e., <0.2% at 3 years after postcolposcopy cotest) was comparable with women with normal cytology in the screening population. These risks are consistent with current guidelines recommending repeat cotesting 12 months after colposcopy < CIN 2 and a 3-year return for women with a negative postcolposcopy cotest. Most women are at low risk of subsequent CIN 3+ after a colposcopy showing < CIN 2, especially those who are human papillomavirus-negative postcolposcopy, consistent with current management guidelines for repeat testing intervals. Before the finalizing the upcoming guidelines, we will consider additional rounds of postcolposcopy cotesting.

Catch-up validation study of an in vitro skin irritation test method based on an open source reconstructed epidermis (phase II).

PubMed

Groeber, F; Schober, L; Schmid, F F; Traube, A; Kolbus-Hernandez, S; Daton, K; Hoffmann, S; Petersohn, D; Schäfer-Korting, M; Walles, H; Mewes, K R

2016-10-01

To replace the Draize skin irritation assay (OECD guideline 404) several test methods based on reconstructed human epidermis (RHE) have been developed and were adopted in the OECD test guideline 439. However, all validated test methods in the guideline are linked to RHE provided by only three companies. Thus, the availability of these test models is dependent on the commercial interest of the producer. To overcome this limitation and thus to increase the accessibility of in vitro skin irritation testing, an open source reconstructed epidermis (OS-REp) was introduced. To demonstrate the capacity of the OS-REp in regulatory risk assessment, a catch-up validation study was performed. The participating laboratories used in-house generated OS-REp to assess the set of 20 reference substances according to the performance standards amending the OECD test guideline 439. Testing was performed under blinded conditions. The within-laboratory reproducibility of 87% and the inter-laboratory reproducibility of 85% prove a high reliability of irritancy testing using the OS-REp protocol. In addition, the prediction capacity was with an accuracy of 80% comparable to previous published RHE based test protocols. Taken together the results indicate that the OS-REp test method can be used as a standalone alternative skin irritation test replacing the OECD test guideline 404. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Test blueprints for psychiatry residency in-training written examinations in Riyadh, Saudi Arabia

PubMed Central

Gaffas, Eisha M; Sequeira, Reginald P; Namla, Riyadh A Al; Al-Harbi, Khalid S

2012-01-01

Background The postgraduate training program in psychiatry in Saudi Arabia, which was established in 1997, is a 4-year residency program. Written exams comprising of multiple choice questions (MCQs) are used as a summative assessment of residents in order to determine their eligibility for promotion from one year to the next. Test blueprints are not used in preparing examinations. Objective To develop test blueprints for the written examinations used in the psychiatry residency program. Methods Based on the guidelines of four professional bodies, documentary analysis was used to develop global and detailed test blueprints for each year of the residency program. An expert panel participated during piloting and final modification of the test blueprints. Their opinion about the content, weightage for each content domain, and proportion of test items to be sampled in each cognitive category as defined by modified Bloom’s taxonomy were elicited. Results Eight global and detailed test blueprints, two for each year of the psychiatry residency program, were developed. The global test blueprints were reviewed by experts and piloted. Six experts participated in the final modification of test blueprints. Based on expert consensus, the content, total weightage for each content domain, and proportion of test items to be included in each cognitive category were determined for each global test blueprint. Experts also suggested progressively decreasing the weightage for recall test items and increasing problem solving test items in examinations, from year 1 to year 4 of the psychiatry residence program. Conclusion A systematic approach using a documentary and content analysis technique was used to develop test blueprints with additional input from an expert panel as appropriate. Test blueprinting is an important step to ensure the test validity in all residency programs. PMID:23762000

Test blueprints for psychiatry residency in-training written examinations in Riyadh, Saudi Arabia.

PubMed

Gaffas, Eisha M; Sequeira, Reginald P; Namla, Riyadh A Al; Al-Harbi, Khalid S

2012-01-01

The postgraduate training program in psychiatry in Saudi Arabia, which was established in 1997, is a 4-year residency program. Written exams comprising of multiple choice questions (MCQs) are used as a summative assessment of residents in order to determine their eligibility for promotion from one year to the next. Test blueprints are not used in preparing examinations. To develop test blueprints for the written examinations used in the psychiatry residency program. Based on the guidelines of four professional bodies, documentary analysis was used to develop global and detailed test blueprints for each year of the residency program. An expert panel participated during piloting and final modification of the test blueprints. Their opinion about the content, weightage for each content domain, and proportion of test items to be sampled in each cognitive category as defined by modified Bloom's taxonomy were elicited. Eight global and detailed test blueprints, two for each year of the psychiatry residency program, were developed. The global test blueprints were reviewed by experts and piloted. Six experts participated in the final modification of test blueprints. Based on expert consensus, the content, total weightage for each content domain, and proportion of test items to be included in each cognitive category were determined for each global test blueprint. Experts also suggested progressively decreasing the weightage for recall test items and increasing problem solving test items in examinations, from year 1 to year 4 of the psychiatry residence program. A systematic approach using a documentary and content analysis technique was used to develop test blueprints with additional input from an expert panel as appropriate. Test blueprinting is an important step to ensure the test validity in all residency programs.

Guidelines of the Design of Electropyrotechnic Firing Circuit for Unmanned Flight and Ground Test Projects

NASA Technical Reports Server (NTRS)

Gonzalez, Guillermo A.; Lucy, Melvin H.; Massie, Jeffrey J.

2013-01-01

The NASA Langley Research Center, Engineering Directorate, Electronic System Branch, is responsible for providing pyrotechnic support capabilities to Langley Research Center unmanned flight and ground test projects. These capabilities include device selection, procurement, testing, problem solving, firing system design, fabrication and testing; ground support equipment design, fabrication and testing; checkout procedures and procedure?s training to pyro technicians. This technical memorandum will serve as a guideline for the design, fabrication and testing of electropyrotechnic firing systems. The guidelines will discuss the entire process beginning with requirements definition and ending with development and execution.

Standardized reporting guidelines for emergency department syncope risk-stratification research.

PubMed

Sun, Benjamin C; Thiruganasambandamoorthy, Venkatesh; Cruz, Jeffrey Dela

2012-06-01

There is increasing research interest in the risk stratification of emergency department (ED) syncope patients. A major barrier to comparing and synthesizing existing research is wide variation in the conduct and reporting of studies. The authors wanted to create standardized reporting guidelines for ED syncope risk-stratification research using an expert consensus process. In that pursuit, a panel of syncope researchers was convened and a literature review was performed to identify candidate reporting guideline elements. Candidate elements were grouped into four sections: eligibility criteria, outcomes, electrocardiogram (ECG) findings, and predictors. A two-round, modified Delphi consensus process was conducted using an Internet-based survey application. In the first round, candidate elements were rated on a five-point Likert scale. In the second round, panelists rerated items after receiving information about group ratings from the first round. Items that were rated by >80% of the panelists at the two highest levels of the Likert scale were included in the final guidelines. There were 24 panelists from eight countries who represented five clinical specialties. The panel identified an initial set of 183 candidate elements. After two survey rounds, the final reporting guidelines included 92 items that achieved >80% consensus. These included 10 items for study eligibility, 23 items for outcomes, nine items for ECG abnormalities, and 50 items for candidate predictors. Adherence to these guidelines should facilitate comparison of future research in this area. © 2012 by the Society for Academic Emergency Medicine.

Third Santorini conference pharmacogenomics workshop report: "Pharmacogenomics at the crossroads: what else than good science will be needed for the field to become part of Personalized Medicine?".

PubMed

Llerena, Adrián; Michel, Gerd; Jeannesson, Elise; Wong, Steven; Manolopoulos, Vangelis G; Hockett, Richard Dean; Boubekeur, Karima; Siest, Gérard; Beaune, Philippe; Haefliger, Carolina; Arnold, Hans Peter; Junien, Claudine; Petrovic, Nenad; Molloy, Roisin; Bekers, Otto; Donnelly, Claudine; Arens, Hans-Juergen; Kaput, Jim; McComb, Joel

2007-01-01

This workshop discussed the use of pharmacogenomics knowledge in clinical practice. It was organized in three sections: educational needs, definition of industry as a potential trigger, and regulatory aspects. Regarding pharmacogenomics education, it appears that this is truly lacking, except for patients, who are becoming increasingly educated thanks to the media. Regarding administrators, education is mainly a problem of cost. Indeed, even if cost-effective for society on the whole, pharmacogenomic tests will be expensive for hospitals. Physicians are facing an overabundance of information. They must be helped to bridge the gap between knowledge/research and clinical application. Collaboration between the pharmaceutical industry and the diagnostics industry could be one of the triggers. Moreover, there is a lack of qualification of this information, even though some guidelines are being produced. The Food and Drug Administration organizes workshops that often lead to publications on pharmacogenomic education, genomic data aims and development concepts, which can finally be translated into guidelines. Industry can contribute to pharmacogenomic development, not only through research, but also through marketing activities, which would promote the use of pharmacogenomics by physicians. Legal aspects were also considered in terms of the problem of availability and the degree of qualification of commercial drug tests on the market. The Innovative Medicine Initiative was also presented, which is a public-private partnership to create a biomedical research and development leader to benefit patients and society. Finally, a technical report from the Institute for Prospective Technological Studies on the socioeconomic impact of pharmacogenomics in the EU was presented.

SPSP Phase III Recruiting, Selecting, and Developing Secure Power Systems Professionals: Behavioral Interview Guidelines by Job Roles

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

O'Neil, Lori Ross; Conway, T. J.; Tobey, D. H.

The Secure Power Systems Professional Phase III final report was released last year which an appendix of Behavioral Interview Guidelines by Job Roles. This new report is that appendix broken out as a standalone document to assist utilities in recruiting and developing Secure Power Systems Professionals at their site.

76 FR 22342 - National Standard 10 Guidelines

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-21

... safety of human life at sea.'' NMFS published final guidelines for NS10 in 1998 (63 FR 24212; May 1, 1998... of human life at sea, including whether and to what extent such measures may affect the safety of...; and an explanation that the phrase ``safety of human life at sea'' refers to both the safety of a...

SPSP Phase III Recruiting, Selecting, and Developing Secure Power Systems Professionals. Individual and Team Performance Guidelines

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

O'Neil, Lori Ross; Conway, T. J.; Tobey, D. H.

The Secure Power Systems Professional Phase III final report was released last year which an appendix of Individual and Team Performance Guidelines. This new report is that appendix broken out as a standalone document to assist utilities in recruiting and developing Secure Power Systems Professionals at their site.

Predicting outcome of Morris water maze test in vascular dementia mouse model with deep learning

PubMed Central

Mogi, Masaki; Iwanami, Jun; Min, Li-Juan; Bai, Hui-Yu; Shan, Bao-Shuai; Kukida, Masayoshi; Kan-no, Harumi; Ikeda, Shuntaro; Higaki, Jitsuo; Horiuchi, Masatsugu

2018-01-01

The Morris water maze test (MWM) is one of the most popular and established behavioral tests to evaluate rodents’ spatial learning ability. The conventional training period is around 5 days, but there is no clear evidence or guidelines about the appropriate duration. In many cases, the final outcome of the MWM seems predicable from previous data and their trend. So, we assumed that if we can predict the final result with high accuracy, the experimental period could be shortened and the burden on testers reduced. An artificial neural network (ANN) is a useful modeling method for datasets that enables us to obtain an accurate mathematical model. Therefore, we constructed an ANN system to estimate the final outcome in MWM from the previously obtained 4 days of data in both normal mice and vascular dementia model mice. Ten-week-old male C57B1/6 mice (wild type, WT) were subjected to bilateral common carotid artery stenosis (WT-BCAS) or sham-operation (WT-sham). At 6 weeks after surgery, we evaluated their cognitive function with MWM. Mean escape latency was significantly longer in WT-BCAS than in WT-sham. All data were collected and used as training data and test data for the ANN system. We defined a multiple layer perceptron (MLP) as a prediction model using an open source framework for deep learning, Chainer. After a certain number of updates, we compared the predicted values and actual measured values with test data. A significant correlation coefficient was derived form the updated ANN model in both WT-sham and WT-BCAS. Next, we analyzed the predictive capability of human testers with the same datasets. There was no significant difference in the prediction accuracy between human testers and ANN models in both WT-sham and WT-BCAS. In conclusion, deep learning method with ANN could predict the final outcome in MWM from 4 days of data with high predictive accuracy in a vascular dementia model. PMID:29415035

Predicting outcome of Morris water maze test in vascular dementia mouse model with deep learning.

PubMed

Higaki, Akinori; Mogi, Masaki; Iwanami, Jun; Min, Li-Juan; Bai, Hui-Yu; Shan, Bao-Shuai; Kukida, Masayoshi; Kan-No, Harumi; Ikeda, Shuntaro; Higaki, Jitsuo; Horiuchi, Masatsugu

2018-01-01

The Morris water maze test (MWM) is one of the most popular and established behavioral tests to evaluate rodents' spatial learning ability. The conventional training period is around 5 days, but there is no clear evidence or guidelines about the appropriate duration. In many cases, the final outcome of the MWM seems predicable from previous data and their trend. So, we assumed that if we can predict the final result with high accuracy, the experimental period could be shortened and the burden on testers reduced. An artificial neural network (ANN) is a useful modeling method for datasets that enables us to obtain an accurate mathematical model. Therefore, we constructed an ANN system to estimate the final outcome in MWM from the previously obtained 4 days of data in both normal mice and vascular dementia model mice. Ten-week-old male C57B1/6 mice (wild type, WT) were subjected to bilateral common carotid artery stenosis (WT-BCAS) or sham-operation (WT-sham). At 6 weeks after surgery, we evaluated their cognitive function with MWM. Mean escape latency was significantly longer in WT-BCAS than in WT-sham. All data were collected and used as training data and test data for the ANN system. We defined a multiple layer perceptron (MLP) as a prediction model using an open source framework for deep learning, Chainer. After a certain number of updates, we compared the predicted values and actual measured values with test data. A significant correlation coefficient was derived form the updated ANN model in both WT-sham and WT-BCAS. Next, we analyzed the predictive capability of human testers with the same datasets. There was no significant difference in the prediction accuracy between human testers and ANN models in both WT-sham and WT-BCAS. In conclusion, deep learning method with ANN could predict the final outcome in MWM from 4 days of data with high predictive accuracy in a vascular dementia model.

Performance of small water treatment plants: The case study of Mutshedzi Water Treatment Plant

NASA Astrophysics Data System (ADS)

Makungo, R.; Odiyo, J. O.; Tshidzumba, N.

The performance of small water treatment plants (SWTPs) was evaluated using Mutshedzi WTP as a case study. The majority of SWTPs in South Africa (SA) that supply water to rural villages face problems of cost recovery, water wastages, limited size and semi-skilled labour. The raw and final water quality analyses and their compliance were used to assess the performance of the Mutshedzi WTP. Electrical conductivity (EC), pН and turbidity were measured in the field using a portable multimeter and a turbidity meter respectively. Atomic Absorption Spectrometry and Ion Chromatography were used to analyse metals and non-metals respectively. The results were compared with the Department of Water Affairs (DWA) guidelines for domestic use. The turbidity levels partially exceeded the recommended guidelines for domestic water use of 1 NTU. The concentrations of chemical parameters in final water were within the DWA guidelines for domestic water use except for fluoride, which exceeded the maximum allowable guideline of 1.5 mg/L in August 2009. Mutshedzi WTP had computed compliance for raw and final water analyses ranging from 79% to 93% and 86% to 93% throughout the sampling period, respectively. The results from earlier studies showed that the microbiological quality of final water in Mutshedzi WTP complied with the recommended guidelines, eliminating the slight chance of adverse aesthetic effects and infectious disease transmission associated with the turbidity values between 1 and 5 NTU. The study concluded that Mutshedzi WTP, though moving towards compliance, is still not producing adequate quality of water. Other studies also indicated that the quantity of water produced from Mutshedzi WTP was inadequate. The findings of the study indicate that lack of monitoring of quantity of water supplied to each village, dosage of treatment chemicals, the treatment capacity of the WTP and monitoring the quality of water treated are some of the factors that limit the performance of Mutshedzi WTP. These have been confirmed in literature to be widespread in similar WTPs in SA. It is recommended that water meters be provided and the community be advised to subsidise the cost of water supply. The study recommended that the treatments of turbidity and fluoride should form critical functions of the plant to ensure that final water for domestic use is always safe from any harmful substances or disease causing pathogens. The study concluded that the WTP only needs minor improvement to boost its efficiency with regard to the treatment of raw water. This will also ensure that the plant achieves 100% compliance for final water.

40 CFR 797.1050 - Algal acute toxicity test.

Code of Federal Regulations, 2010 CFR

2010-07-01

... seq.). This guideline prescribes test procedures and conditions using freshwater and marine algae to... definitions also apply to this guideline: (1) Algicidal means having the property of killing algae. (2... volumes of nutrient medium and/or test solution. Start the test by introducing algae into the test and...

40 CFR 797.1050 - Algal acute toxicity test.

Code of Federal Regulations, 2012 CFR

2012-07-01

... seq.). This guideline prescribes test procedures and conditions using freshwater and marine algae to... definitions also apply to this guideline: (1) Algicidal means having the property of killing algae. (2... volumes of nutrient medium and/or test solution. Start the test by introducing algae into the test and...

40 CFR 797.1050 - Algal acute toxicity test.

Code of Federal Regulations, 2013 CFR

2013-07-01

... seq.). This guideline prescribes test procedures and conditions using freshwater and marine algae to... definitions also apply to this guideline: (1) Algicidal means having the property of killing algae. (2... volumes of nutrient medium and/or test solution. Start the test by introducing algae into the test and...

40 CFR 797.1050 - Algal acute toxicity test.

Code of Federal Regulations, 2014 CFR

2014-07-01

... seq.). This guideline prescribes test procedures and conditions using freshwater and marine algae to... definitions also apply to this guideline: (1) Algicidal means having the property of killing algae. (2... volumes of nutrient medium and/or test solution. Start the test by introducing algae into the test and...

40 CFR 797.1050 - Algal acute toxicity test.

Code of Federal Regulations, 2011 CFR

2011-07-01

... seq.). This guideline prescribes test procedures and conditions using freshwater and marine algae to... definitions also apply to this guideline: (1) Algicidal means having the property of killing algae. (2... volumes of nutrient medium and/or test solution. Start the test by introducing algae into the test and...

Effects of Direct-to-Consumer Advertising and Clinical Guidelines on Appropriate Use of Human Papillomavirus DNA Tests

PubMed Central

2011-01-01

Background Both clinical guidelines and direct-to-consumer (DTC) advertising influence use of new health care technologies, but little is known about their relative effects. The introduction of a cervical cancer screening test in 2000 offered a unique opportunity to assess the two strategies. Objective To evaluate the effects of clinical guidelines and a targeted DTC advertising campaign on overall and appropriate use of human papillomavirus (HPV) DNA tests. Research Design Quasi-experimental study using difference-in-differences analysis. Data were MarketScan private insurance claims for 500,000 women ages 21 to 64 enrolled at least 12 consecutive months from January 2001 through December 2005. Results Both clinical guidelines and DTC advertising were associated with increases in overall HPV DNA test use. DTC advertising was associated with a statistically significant increase in HPV DNA test use in two groups of DTC cities (+5.57 percent, p<0.0001; +2.54 percent, p<0.0001). DTC advertising was associated with comparable increases in the probability of appropriate and inappropriate use of the HPV DNA test in primary screening. Clinical guideline releases from the American College of Obstetricians and Gynecologists, and by a co-sponsored panel, were associated with greater increases in HPV DNA tests for appropriate primary screening than for inappropriate primary screening (β=0.3347, p<0.05 and β=0.4175, p<0.01). Conclusions DTC advertising was associated with increased overall use of a cervical cancer screening test, while clinical guidelines were differentially associated with increased appropriate use. These findings suggest distinct influences of consumer marketing and professional guidelines on the use of health care products and services. PMID:21150798

Effects of direct-to-consumer advertising and clinical guidelines on appropriate use of human papillomavirus DNA tests.

PubMed

Price, Rebecca Anhang; Frank, Richard G; Cleary, Paul D; Goldie, Sue J

2011-02-01

Both clinical guidelines and direct-to-consumer (DTC) advertising influence the use of new health care technologies, but little is known about their relative effects. The introduction of a cervical cancer screening test in 2000 offered a unique opportunity to assess the 2 strategies. To evaluate the effects of clinical guidelines and a targeted DTC advertising campaign on overall and appropriate use of human papillomavirus (HPV) DNA tests. Quasi-experimental study using difference-in-differences analysis. Data were MarketScan private insurance claims for 500,000 women aged 21 to 64 enrolled at least 12 consecutive months from January 2001 through December 2005. Both clinical guidelines and DTC advertising were associated with increases in overall HPV DNA test use. DTC advertising was associated with a statistically significant increase in HPV DNA test use in 2 groups of DTC cities (+5.57%, P < 0.0001; +2.54%, P < 0.0001). DTC advertising was associated with comparable increases in the probability of appropriate and inappropriate use of the HPV DNA test in primary screening. Clinical guideline releases from the American College of Obstetricians and Gynecologists, and by a cosponsored panel, were associated with greater increases in HPV DNA tests for appropriate primary screening than for inappropriate primary screening (β = 0.3347, P < 0.05 and β = 0.4175, P < 0.01). DTC advertising was associated with increased overall use of a cervical cancer screening test, whereas clinical guidelines were differentially associated with increased appropriate use. These findings suggest distinct influences of consumer marketing and professional guidelines on the use of health care products and services.

Clinical reasoning in the real world is mediated by bounded rationality: implications for diagnostic clinical practice guidelines.

PubMed

Bonilauri Ferreira, Ana Paula Ribeiro; Ferreira, Rodrigo Fernando; Rajgor, Dimple; Shah, Jatin; Menezes, Andrea; Pietrobon, Ricardo

2010-04-20

Little is known about the reasoning mechanisms used by physicians in decision-making and how this compares to diagnostic clinical practice guidelines. We explored the clinical reasoning process in a real life environment. This is a qualitative study evaluating transcriptions of sixteen physicians' reasoning during appointments with patients, clinical discussions between specialists, and personal interviews with physicians affiliated to a hospital in Brazil. FOUR MAIN THEMES WERE IDENTIFIED: simple and robust heuristics, extensive use of social environment rationality, attempts to prove diagnostic and therapeutic hypothesis while refuting potential contradictions using positive test strategy, and reaching the saturation point. Physicians constantly attempted to prove their initial hypothesis while trying to refute any contradictions. While social environment rationality was the main factor in the determination of all steps of the clinical reasoning process, factors such as referral letters and number of contradictions associated with the initial hypothesis had influence on physicians' confidence and determination of the threshold to reach a final decision. Physicians rely on simple heuristics associated with environmental factors. This model allows for robustness, simplicity, and cognitive energy saving. Since this model does not fit into current diagnostic clinical practice guidelines, we make some propositions to help its integration.

Clinical Reasoning in the Real World Is Mediated by Bounded Rationality: Implications for Diagnostic Clinical Practice Guidelines

PubMed Central

Bonilauri Ferreira, Ana Paula Ribeiro; Ferreira, Rodrigo Fernando; Rajgor, Dimple; Shah, Jatin; Menezes, Andrea; Pietrobon, Ricardo

2010-01-01

Background Little is known about the reasoning mechanisms used by physicians in decision-making and how this compares to diagnostic clinical practice guidelines. We explored the clinical reasoning process in a real life environment. Method This is a qualitative study evaluating transcriptions of sixteen physicians' reasoning during appointments with patients, clinical discussions between specialists, and personal interviews with physicians affiliated to a hospital in Brazil. Results Four main themes were identified: simple and robust heuristics, extensive use of social environment rationality, attempts to prove diagnostic and therapeutic hypothesis while refuting potential contradictions using positive test strategy, and reaching the saturation point. Physicians constantly attempted to prove their initial hypothesis while trying to refute any contradictions. While social environment rationality was the main factor in the determination of all steps of the clinical reasoning process, factors such as referral letters and number of contradictions associated with the initial hypothesis had influence on physicians' confidence and determination of the threshold to reach a final decision. Discussion Physicians rely on simple heuristics associated with environmental factors. This model allows for robustness, simplicity, and cognitive energy saving. Since this model does not fit into current diagnostic clinical practice guidelines, we make some propositions to help its integration. PMID:20421920

Towards European urinalysis guidelines. Introduction of a project under European Confederation of Laboratory Medicine.

PubMed

Kouri, T T; Gant, V A; Fogazzi, G B; Hofmann, W; Hallander, H O; Guder, W G

2000-07-01

Improved standardized performance is needed because urinalysis continues to be one of the most frequently requested laboratory tests. Since 1997, the European Confederation of Laboratory Medicine (ECLM) has been supporting an interdisciplinary project aiming to produce European urinalysis guidelines. More than seventy clinical chemists, microbiologists and ward-based clinicians, as well as representatives of manufacturers are taking part. These guidelines aim to improve the quality and consistency of chemical urinalysis, particle counting and bacterial culture by suggesting optimal investigative processes that could be applied in Europe. The approach is based on medical needs for urinalysis. The importance of the pre-analytical stage for total quality is stressed by detailed illustrative advice for specimen collection. Attention is also given to emerging automated technology. For cost containment reasons, both optimum (ideal) procedures and minimum analytical approaches are suggested. Since urinalysis mostly lacks genuine reference methods (primary reference measurement procedures; Level 4), a novel classification of the methods is proposed: comparison measurement procedures (Level 3), quantitative routine procedures (Level 2), and ordinal scale examinations (Level 1). Stepwise strategies are suggested to save costs, applying different rules for general and specific patient populations. New analytical quality specifications have been created. After a consultation period, the final written text will be published in full as a separate document.

An extended field test of the WHO severe malnutrition guidelines in hospitals in developing countries: preliminary observations.

PubMed

Deen, J L; Weber, M; Qazi, S; Fontaine, O

2003-01-01

The WHO has published guidelines for the inpatient management of severe malnutrition. A qualitative study in hospitals in developing countries is being conducted to document the re-organisation of the clinical ward and support services required to implement these guidelines and to gain an impression of the feasibility and sustainability of such a re-organisation. Following a postal survey of experts in the management of malnutrition in children in developing countries, hospitals were contacted and asked if they were interested to participate in the study. If so, they were requested to submit background information about admission patterns, the frequency of malnutrition, and current practice. Based on this information, hospitals are selected for a preliminary visit. Following this, and the final selection, a paediatrician conducts three visits to the study hospital over a one-year period to appraise the current practice, assist the health staff in recognising the strengths and shortcomings of their current management, help them find locally appropriate solutions, support the implementation process through a participatory approach and assess the outcome. A structured survey instrument is used to guide the assessment and identification of problems. Results of the first visit, which documents the existing situation, and changes identified by staff and implemented during the second visit are presented.

Creating the Action Model for High Risk Infant Follow Up Program in Iran

PubMed Central

Heidarzadeh, Mohammad; Jodiery, Behzad; Mirnia, Kayvan; Akrami, Forouzan; Hosseini, Mohammad Bagher; Heidarabadi, Seifollah; HabibeLahi, Abbas

2013-01-01

Abstract Background Intervention in early childhood development as one of the social determinants of health, is important for reducing social gap and inequity. In spite of increasingly developing intensive neonatal care wards and decreasing neonatal mortality rate, there is no follow up program in Iran. This study was carreid out to design high risk infants follow up care program with the practical aim of creating an model action for whole country, in 2012. Methods This qualitative study has been done by the Neonatal Department of the Deputy of Public Health in cooperation with Pediatrics Health Research Center of Tabriz University of Medical Sciences, Iran. After study of international documents, consensus agreement about adapted program for Iran has been accomplished by focus group discussion and attended Delphi agreement technique. After compiling primary draft included evidence based guidelines and executive plan, 14 sessions including expert panels were hold to finalize the program. Results After finalizing the program, high risk infants follow up care service package has been designed in 3 chapters: Evidence based clinical guidelines; eighteen main clinical guidelines and thirteen subsidiaries clinical guidelines, executive plan; 6 general, 6 following up and 5 backup processes. Education program including general and especial courses for care givers and follow up team, and family education processes. Conclusion We designed and finalized high risk infants follow up care service package. It seems to open a way to extend it to whole country. PMID:26171344

Guidelines for Management Information Systems in Canadian Health Care Facilities

PubMed Central

Thompson, Larry E.

1987-01-01

The MIS Guidelines are a comprehensive set of standards for health care facilities for the recording of staffing, financial, workload, patient care and other management information. The Guidelines enable health care facilities to develop management information systems which identify resources, costs and products to more effectively forecast and control costs and utilize resources to their maximum potential as well as provide improved comparability of operations. The MIS Guidelines were produced by the Management Information Systems (MIS) Project, a cooperative effort of the federal and provincial governments, provincial hospital/health associations, under the authority of the Canadian Federal/Provincial Advisory Committee on Institutional and Medical Services. The Guidelines are currently being implemented on a “test” basis in ten health care facilities across Canada and portions integrated in government reporting as finalized.

21 CFR 350.60 - Guidelines for effectiveness testing of antiperspirant drug products.

Code of Federal Regulations, 2010 CFR

2010-04-01

.... These guidelines are on file in the Dockets Management Branch (HFA-305), Food and Drug Administration... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Guidelines for effectiveness testing of antiperspirant drug products. 350.60 Section 350.60 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF...

[The development of clinical guidelines for the diagnosis and treatment of chronic periodontitis in Belgium].

PubMed

Cosyn, Jan; De Bruyn, Hugo

2008-01-01

In many disciplines of medicine guidelines are developed for the diagnosis and treatment of disease. These are essentially intended to standardize care and to optimize communication between the general practitioner and the specialist. Guidelines have already been described in the literature for chronic periodontitis. However, given the unique conditions in Belgium, these may not be appropriate for the average dental practice. In this manuscript the development of Belgian clinical guidelines for the diagnosis and treatment of chronic periodontitis is described. Basically, ten clinical questions were used as a basis for a thorough literature search. Evidence-based clinical guidelines were developed and adapted during three peer review sessions. In the final session Belgian specialists, who had all been invited, participated. This made sure that the scientific input was sufficiently transformed into clinical guidelines which are actually feasible today in Belgium.

The dissemination of clinical practice guidelines over an intranet: an evaluation.

PubMed Central

Stolte, J. J.; Ash, J.; Chin, H.

1999-01-01

This study compares two clinical practice guideline dissemination systems. It was hypothesized that placing guidelines on an intranet would make this information easier to retrieve. Retrieval time, retrieval accuracy, and ease of use were empirically evaluated. Sixteen clinicians from Kaiser Permanente volunteered to complete tasks that measured these variables. Time values were significantly longer for tasks completed with intranet guidelines (Intranet = 6.7 minutes, Paper = 5.7 minutes). Tasks completed with paper guidelines had a significantly higher percentage of perfect scores than those completed with the intranet (Paper = 85%, Intranet = 59%). There was no significant difference in reported ease of use. Simply placing clinical information on an electronic system does not guarantee that the information will be easier to retrieve. Such information needs to be fully integrated into the clinical decision making process. Computerizing guidelines may provide a necessary initial step toward this goal, but it does not represent the final solution. PMID:10566503

Proceedings of the Guidelines for Seismometer Testing Workshop, Albuquerque, New Mexico, 9-10 May 2005 ("GST2")

USGS Publications Warehouse

Hutt, Charles R.; Nigbor, Robert L.; Evans, John R.

2009-01-01

Testing and specification of seismic and earthquake-engineering sensors and recorders has been marked by significant variations in procedures and selected parameters. These variations cause difficulty in comparing such specifications and test results. In July 1989, and again in May 2005, the U.S. Geological Survey hosted international public/private workshops with the goal of defining widely accepted guidelines for the testing of seismological inertial sensors, seismometers, and accelerometers. This document reports the Proceedings of the 2005 workshop and includes as Appendix 6 the report of the 1989 workshop. In a future document, we will attempt to collate and rationalize a single set of formal guidelines for testing and specifying seismic sensors, supplementing Advanced National Seismic System (ANSS) guidelines on instrumentation likely used by ANSS as its standard for verification, acceptance, and intermittent testing, as well as for responses to ANSS instrument requisitions.

Latent trajectory studies: the basics, how to interpret the results, and what to report.

PubMed

van de Schoot, Rens

2015-01-01

In statistics, tools have been developed to estimate individual change over time. Also, the existence of latent trajectories, where individuals are captured by trajectories that are unobserved (latent), can be evaluated (Muthén & Muthén, 2000). The method used to evaluate such trajectories is called Latent Growth Mixture Modeling (LGMM) or Latent Class Growth Modeling (LCGA). The difference between the two models is whether variance within latent classes is allowed for (Jung & Wickrama, 2008). The default approach most often used when estimating such models begins with estimating a single cluster model, where only a single underlying group is presumed. Next, several additional models are estimated with an increasing number of clusters (latent groups or classes). For each of these models, the software is allowed to estimate all parameters without any restrictions. A final model is chosen based on model comparison tools, for example, using the BIC, the bootstrapped chi-square test, or the Lo-Mendell-Rubin test. To ease the use of LGMM/LCGA step by step in this symposium (Van de Schoot, 2015) guidelines are presented which can be used for researchers applying the methods to longitudinal data, for example, the development of posttraumatic stress disorder (PTSD) after trauma (Depaoli, van de Schoot, van Loey, & Sijbrandij, 2015; Galatzer-Levy, 2015). The guidelines include how to use the software Mplus (Muthén & Muthén, 1998-2012) to run the set of models needed to answer the research question: how many latent classes exist in the data? The next step described in the guidelines is how to add covariates/predictors to predict class membership using the three-step approach (Vermunt, 2010). Lastly, it described what essentials to report in the paper. When applying LGMM/LCGA models for the first time, the guidelines presented can be used to guide what models to run and what to report.

Serving our communities better. Guidelines for planning and developing integrated delivery networks.

PubMed

Prybil, L; Golden, P; Ballance, X

1995-04-01

In 1994 the Daughters of Charity National Health System-East Central (DCNHS-East Central) adopted 11 guidelines to help corporate staff and local leaders plan and develop integrated networks. Guideline 1 emphasizes needs-based strategic planning. Guideline 2 focuses on the community-based network planning process, recommending a team approach and ongoing communication with the local ordinary. In guidelines 3 through 5, the DCNHS-East Central Board of Directors spells out key issues that must be covered in proposals ultimately presented for governance action. Guideline 6 presents three core elements that should characterize all CBNs in which DCNHS-East Central institutions participate. Guideline 7 emphasizes that all CBN proposals and agreements must be clear with respect to the Catholic identity of DCNHS-East Central institutions. Guidelines 8 and 9 require that proposed changes to traditional policies and management practices be explicit in CBN proposals. The tenth guideline requires that all CBN proposals indicate an explicit evaluation function. The final guideline underscores that regardless of the strategic fit or how well a CBN is designed, it is unlikely to succeed unless both internal and external relationships are based on a solid foundation of honesty, mutual respect, and trust.

Test Analysis Guidelines

NASA Technical Reports Server (NTRS)

Jeng, Frank F.

2007-01-01

Development of analysis guidelines for Exploration Life Support (ELS) technology tests was completed. The guidelines were developed based on analysis experiences gained from supporting Environmental Control and Life Support System (ECLSS) technology development in air revitalization systems and water recovery systems. Analyses are vital during all three phases of the ELS technology test: pre-test, during test and post test. Pre-test analyses of a test system help define hardware components, predict system and component performances, required test duration, sampling frequencies of operation parameters, etc. Analyses conducted during tests could verify the consistency of all the measurements and the performance of the test system. Post test analyses are an essential part of the test task. Results of post test analyses are an important factor in judging whether the technology development is a successful one. In addition, development of a rigorous model for a test system is an important objective of any new technology development. Test data analyses, especially post test data analyses, serve to verify the model. Test analyses have supported development of many ECLSS technologies. Some test analysis tasks in ECLSS technology development are listed in the Appendix. To have effective analysis support for ECLSS technology tests, analysis guidelines would be a useful tool. These test guidelines were developed based on experiences gained through previous analysis support of various ECLSS technology tests. A comment on analysis from an experienced NASA ECLSS manager (1) follows: "Bad analysis was one that bent the test to prove that the analysis was right to begin with. Good analysis was one that directed where the testing should go and also bridged the gap between the reality of the test facility and what was expected on orbit."

Protocol for Atomic Oxygen Testing of Materials in Ground-Based Facilities. No. 2

NASA Technical Reports Server (NTRS)

Minton, Timothy K.

1995-01-01

A second version of standard guidelines is proposed for improving materials testing in ground-based atomic oxygen environments for the purpose of predicting the durability of the tested materials in low Earth orbit (LEO). Accompanying these guidelines are background information and notes about testing. Both the guidelines and the additional information are intended to aid users who wish to evaluate the potential hazard of atomic oxygen in LEO to a candidate space component without actually flying the component in space, and to provide a framework for more consistent atomic oxygen testing in the future.

[Knowledge management system for laboratory work and clinical decision support].

PubMed

Inada, Masanori; Sato, Mayumi; Yoneyama, Akiko

2011-05-01

This paper discusses a knowledge management system for clinical laboratories. In the clinical laboratory of Toranomon Hospital, we receive about 20 questions relevant to laboratory tests per day from medical doctors or co-medical staff. These questions mostly involve the essence to appropriately accomplish laboratory tests. We have to answer them carefully and suitably because an incorrect answer may cause a medical accident. Up to now, no method has been in place to achieve a rapid response and standardized answers. For this reason, the laboratory staff have responded to various questions based on their individual knowledge. We began to develop a knowledge management system to promote the knowledge of staff working for the laboratory. This system is a type of knowledge base for assisting the work, such as inquiry management, laboratory consultation, process management, and clinical support. It consists of several functions: guiding laboratory test information, managing inquiries from medical staff, reporting results of patient consultation, distributing laboratory staffs notes, and recording guidelines for laboratory medicine. The laboratory test information guide has 2,000 records of medical test information registered in the database with flexible retrieval. The inquiry management tool provides a methos to record all questions, answer easily, and retrieve cases. It helps staff to respond appropriately in a short period of time. The consulting report system treats patients' claims regarding medical tests. The laboratory staffs notes enter a file management system so they can be accessed to aid in clinical support. Knowledge sharing using this function can achieve the transition from individual to organizational learning. Storing guidelines for laboratory medicine will support EBM. Finally, it is expected that this system will support intellectual activity concerning laboratory work and contribute to the practice of knowledge management for clinical work support.

A content validated questionnaire for assessment of self reported venous blood sampling practices

PubMed Central

2012-01-01

Background Venous blood sampling is a common procedure in health care. It is strictly regulated by national and international guidelines. Deviations from guidelines due to human mistakes can cause patient harm. Validated questionnaires for health care personnel can be used to assess preventable "near misses"--i.e. potential errors and nonconformities during venous blood sampling practices that could transform into adverse events. However, no validated questionnaire that assesses nonconformities in venous blood sampling has previously been presented. The aim was to test a recently developed questionnaire in self reported venous blood sampling practices for validity and reliability. Findings We developed a questionnaire to assess deviations from best practices during venous blood sampling. The questionnaire contained questions about patient identification, test request management, test tube labeling, test tube handling, information search procedures and frequencies of error reporting. For content validity, the questionnaire was confirmed by experts on questionnaires and venous blood sampling. For reliability, test-retest statistics were used on the questionnaire answered twice. The final venous blood sampling questionnaire included 19 questions out of which 9 had in total 34 underlying items. It was found to have content validity. The test-retest analysis demonstrated that the items were generally stable. In total, 82% of the items fulfilled the reliability acceptance criteria. Conclusions The questionnaire could be used for assessment of "near miss" practices that could jeopardize patient safety and gives several benefits instead of assessing rare adverse events only. The higher frequencies of "near miss" practices allows for quantitative analysis of the effect of corrective interventions and to benchmark preanalytical quality not only at the laboratory/hospital level but also at the health care unit/hospital ward. PMID:22260505

A content validated questionnaire for assessment of self reported venous blood sampling practices.

PubMed

Bölenius, Karin; Brulin, Christine; Grankvist, Kjell; Lindkvist, Marie; Söderberg, Johan

2012-01-19

Venous blood sampling is a common procedure in health care. It is strictly regulated by national and international guidelines. Deviations from guidelines due to human mistakes can cause patient harm. Validated questionnaires for health care personnel can be used to assess preventable "near misses"--i.e. potential errors and nonconformities during venous blood sampling practices that could transform into adverse events. However, no validated questionnaire that assesses nonconformities in venous blood sampling has previously been presented. The aim was to test a recently developed questionnaire in self reported venous blood sampling practices for validity and reliability. We developed a questionnaire to assess deviations from best practices during venous blood sampling. The questionnaire contained questions about patient identification, test request management, test tube labeling, test tube handling, information search procedures and frequencies of error reporting. For content validity, the questionnaire was confirmed by experts on questionnaires and venous blood sampling. For reliability, test-retest statistics were used on the questionnaire answered twice. The final venous blood sampling questionnaire included 19 questions out of which 9 had in total 34 underlying items. It was found to have content validity. The test-retest analysis demonstrated that the items were generally stable. In total, 82% of the items fulfilled the reliability acceptance criteria. The questionnaire could be used for assessment of "near miss" practices that could jeopardize patient safety and gives several benefits instead of assessing rare adverse events only. The higher frequencies of "near miss" practices allows for quantitative analysis of the effect of corrective interventions and to benchmark preanalytical quality not only at the laboratory/hospital level but also at the health care unit/hospital ward.

Implementing and expanding HIV testing in immigrant populations in Europe: Comparing guideline's recommendations and expert's opinions.

PubMed

Álvarez-Del Arco, Débora; Monge, Susana; Rivero-Montesdeoca, Yaiza; Burns, Fiona; Noori, Teymur; Del Amo, Julia

2017-01-01

Immigrant populations, especially those from endemic countries, living in the European Union (EU) suffer a disproportionate burden of HIV, delayed diagnosis and poorer access to antiretroviral treatment. While International Organisations are developing recommendations aimed at increasing the uptake of HIV testing, the feasibility and real outcomes of these measures remain unexplored. The aim of this review was, firstly to identify the recommendations of the main International Organisations (IO) on HIV testing in immigrants. Secondly, to describe the challenges for implementing and expanding HIV testing and counselling interventions targeting immigrants by interviewing key informants. The importance of HIV testing in immigrants is discussed, along with the appropriateness of universal HIV testing approaches vs most at risk targeted approaches. Also addressed is, pre- and post-HIV test counselling characteristics and community initiatives suitable to reach this population and, finally the legal issues regarding access to treatment for illegal immigrants. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Progress Towards the Development of a Fathead Minnow Embryo Test and Comparison to the Zebrafish Embryo Test for Assessing Acute Fish Toxicity

EPA Science Inventory

The Zebrafish Embryo Test (ZFET) for acute fish toxicity is a well developed method nearing adoption as an OECD Test Guideline. Early drafts of the test guideline (TG) envisioned a suite of potential test species to be covered including zebrafish, fathead minnow, Japanese Medaka...

Guidelines 2.0: systematic development of a comprehensive checklist for a successful guideline enterprise.

PubMed

Schünemann, Holger J; Wiercioch, Wojtek; Etxeandia, Itziar; Falavigna, Maicon; Santesso, Nancy; Mustafa, Reem; Ventresca, Matthew; Brignardello-Petersen, Romina; Laisaar, Kaja-Triin; Kowalski, Sérgio; Baldeh, Tejan; Zhang, Yuan; Raid, Ulla; Neumann, Ignacio; Norris, Susan L; Thornton, Judith; Harbour, Robin; Treweek, Shaun; Guyatt, Gordon; Alonso-Coello, Pablo; Reinap, Marge; Brozek, Jan; Oxman, Andrew; Akl, Elie A

2014-02-18

Although several tools to evaluate the credibility of health care guidelines exist, guidance on practical steps for developing guidelines is lacking. We systematically compiled a comprehensive checklist of items linked to relevant resources and tools that guideline developers could consider, without the expectation that every guideline would address each item. We searched data sources, including manuals of international guideline developers, literature on guidelines for guidelines (with a focus on methodology reports from international and national agencies, and professional societies) and recent articles providing systematic guidance. We reviewed these sources in duplicate, extracted items for the checklist using a sensitive approach and developed overarching topics relevant to guidelines. In an iterative process, we reviewed items for duplication and omissions and involved experts in guideline development for revisions and suggestions for items to be added. We developed a checklist with 18 topics and 146 items and a webpage to facilitate its use by guideline developers. The topics and included items cover all stages of the guideline enterprise, from the planning and formulation of guidelines, to their implementation and evaluation. The final checklist includes links to training materials as well as resources with suggested methodology for applying the items. The checklist will serve as a resource for guideline developers. Consideration of items on the checklist will support the development, implementation and evaluation of guidelines. We will use crowdsourcing to revise the checklist and keep it up to date.

Guidelines 2.0: systematic development of a comprehensive checklist for a successful guideline enterprise

PubMed Central

Schünemann, Holger J.; Wiercioch, Wojtek; Etxeandia, Itziar; Falavigna, Maicon; Santesso, Nancy; Mustafa, Reem; Ventresca, Matthew; Brignardello-Petersen, Romina; Laisaar, Kaja-Triin; Kowalski, Sérgio; Baldeh, Tejan; Zhang, Yuan; Raid, Ulla; Neumann, Ignacio; Norris, Susan L.; Thornton, Judith; Harbour, Robin; Treweek, Shaun; Guyatt, Gordon; Alonso-Coello, Pablo; Reinap, Marge; Brožek, Jan; Oxman, Andrew; Akl, Elie A.

2014-01-01

Background: Although several tools to evaluate the credibility of health care guidelines exist, guidance on practical steps for developing guidelines is lacking. We systematically compiled a comprehensive checklist of items linked to relevant resources and tools that guideline developers could consider, without the expectation that every guideline would address each item. Methods: We searched data sources, including manuals of international guideline developers, literature on guidelines for guidelines (with a focus on methodology reports from international and national agencies, and professional societies) and recent articles providing systematic guidance. We reviewed these sources in duplicate, extracted items for the checklist using a sensitive approach and developed overarching topics relevant to guidelines. In an iterative process, we reviewed items for duplication and omissions and involved experts in guideline development for revisions and suggestions for items to be added. Results: We developed a checklist with 18 topics and 146 items and a webpage to facilitate its use by guideline developers. The topics and included items cover all stages of the guideline enterprise, from the planning and formulation of guidelines, to their implementation and evaluation. The final checklist includes links to training materials as well as resources with suggested methodology for applying the items. Interpretation: The checklist will serve as a resource for guideline developers. Consideration of items on the checklist will support the development, implementation and evaluation of guidelines. We will use crowdsourcing to revise the checklist and keep it up to date. PMID:24344144

Diagnosis and Management of Gaucher Disease in India - Consensus Guidelines of the Gaucher Disease Task Force of the Society for Indian Academy of Medical Genetics and the Indian Academy of Pediatrics.

PubMed

Puri, Ratna Dua; Kapoor, Seema; Kishnani, Priya S; Dalal, Ashwin; Gupta, Neerja; Muranjan, Mamta; Phadke, Shubha R; Sachdeva, Anupam; Verma, Ishwar C; Mistry, Pramod K

2018-02-15

Gaucher disease (GD) is amongst the most frequently occurring lysosomal storage disorder in all ethnicities. The clinical manifestations and natural history of GD is highly heterogeneous with extreme geographic and ethnic variations. The literature on GD has paucity of information and optimal management guidelines for Indian patients. Gaucher Disease Task Force was formed under the auspices of the Society for Indian Academy of Medical Genetics. Invited experts from various specialties formulated guidelines for the management of patients with GD. A writing committee was formed and the draft guidelines were circulated by email to all members for comments and inputs. The guidelines were finalized in December 2016 at the annual meeting of the Indian Academy of Medical Genetics. These guidelines are intended to serve as a standard framework for treating physicians and the health care systems for optimal management of Gaucher disease in India and to define unique needs of this patient population. Manifestations of GD are protean and a high index of suspicion is essential for timely diagnosis. Patients frequently experience diagnostic delays during which severe irreversible complications occur. Leucocyte acid b-glucosidase activity is mandatory for establishing the diagnosis of Gaucher disease; molecular testing can help identify patients at risk of neuronopathic disease. Enzyme replacement therapy for type 1 and type 3 Gaucher disease is the standard of care. Best outcomes are achieved by early initiation of therapy before onset of irreversible complications. However, in setting of progressive neurological symptoms such as seizures and or/ neuroregression, ERT is not recommended, as it cannot cross the blood brain barrier. The recommendations herein are for diagnosis, for initiation of therapy, therapeutic goals, monitoring and follow up of patients. We highlight that prevention of recurrence of the disease through genetic counseling and prenatal diagnosis is essential in India, due to uniformly severe phenotypes encountered in our population.

[Herbal medicines against respiratory diseases--traditional empiricism or pharmacological evidence?].

PubMed

2014-11-01

Sinusitis and bronchitis belong to the most frequent respiratory infections. The relevant guidelines mention the therapy with herbal substances and assign a good activity to cineole and Myrtol as well as to combination preparations with cowslip. There is no final statement of the guidelines' authors concerning the extract of Pelargonium sidoides. Further studies will be necessary to give reliable therapeutic recommendations.

A guideline for heavy ion radiation testing for Single Event Upset (SEU)

NASA Technical Reports Server (NTRS)

Nichols, D. K.; Price, W. E.; Malone, C.

1984-01-01

A guideline for heavy ion radiation testing for single event upset was prepared to assist new experimenters in preparing and directing tests. How to estimate parts vulnerability and select an irradiation facility is described. A broad brush description of JPL equipment is given, certain necessary pre-test procedures are outlined and the roles and testing guidelines for on-site test personnel are indicated. Detailed descriptions of equipment needed to interface with JPL test crew and equipment are not provided, nor does it meet the more generalized and broader requirements of a MIL-STD document. A detailed equipment description is available upon request, and a MIL-STD document is in the early stages of preparation.

Investigation of culvert hydraulics related to juvenile fish passage. Final research report

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

Barber, M.E.; Downs, R.C.

1996-01-01

Culverts often create barriers to the upstream migration of juvenile fish. The objective of this study was to determine hydraulic characteristics of culverts with different flow conditions. Methods of predicting flow profiles were developed by both Chiu and Mountjoy. Two equations were compared to experimental results. An area of flow corresponding to a predetermined allowable velocity can be calculated using Mountjoy equation. This can then be used in the design of culverts as fish passage guidelines. The report contains a summary of background information, experimental methodology, the results of experimental tests, and an analysis of both the Chiu and Mountjoymore » equations.« less

[The role of gender in intersexual experiments in the second half of the 20th century].

PubMed

Klöppel, Ulrike

2006-01-01

This paper shows the formation of the psychological concept of gender from the testing of a new intersex treatment in the 1950s. By analyzing the initial refusal and final success of the new concept and guidelines in the German speaking medical community, it points to the decisive role of treating intersexuals as "experiments of nature" for the clinical research in psychosexual development. This new technology brought the divergent problematizations of "ambiguous sex" in line thus bridging the gap between scientific and clinical approaches and providing the material basis for turning gender into a scientific and practical entity.

Revisiting sweat chloride test results based on recent guidelines for diagnosis of cystic fibrosis.

PubMed

Pagaduan, Jayson V; Ali, Mahesheema; Dowlin, Michael; Suo, Liye; Ward, Tabitha; Ruiz, Fadel; Devaraj, Sridevi

2018-03-01

Recent sweat chloride guidelines published by the Cystic Fibrosis Foundation changed the intermediate sweat chloride concentration range from 40-59 mmol/L to 30-59 mmol/L for age > 6 months. We wanted to know how this new guideline would impact detection of cystic fibrosis among patients who previously had sweat tests done at Texas Children's Hospital. We revisited sweat chloride test results (n = 3012) in the last 5 years at Texas Children's Hospital based on the new guidelines on diagnosis of cystic fibrosis from the Cystic Fibrosis Foundation. We identified 125 patients that would be reclassified in the intermediate sweat chloride value with the new guidelines that were classified as "unlikely to have CF" in the previous guidelines. 8 (32%) patients with CFTR gene testing were positive for CFTR gene mutation(s). 4 (50%) of these patients were identified to have 2 CFTR mutations. One had variant combination that was reported to cause CF but all were diagnosed with CFTR-related metabolic syndrome. Our findings concur with the new CF diagnosis guidelines that changing the intermediate cut-off to 30-59 mmol/L sweat chloride concentration in combination with CFTR genetic analysis enhances the probability of identifying individuals that have risk of developing CF or have CF and enables for earlier therapeutic intervention.

Real time and accelerated stability studies of Tetanus toxoid manufactured in public sector facilities of Pakistan.

PubMed

Parveen, Ghazala; Hussain, Shahzad; Malik, Farnaz; Begum, Anwar; Mahmood, Sidra; Raza, Naeem

2013-11-01

Tetanus is an acute illness represented by comprehensive increased inflexibility and spastic spasms of skeletal muscles. The poor quality tetanus toxoid vaccine can raise the prevalence of neonatal tetanus. WHO has taken numerous steps to assist national regulatory authorities and vaccine manufacturers to ensure its quality and efficacy. It has formulated international principles for stability evaluation of each vaccine, which are available in the form of recommendations and guidelines. The aim of present study was to ensure the stability of tetanus vaccines produced by National Institute of Health, Islamabad, Pakistan by employing standardized methods to ensure constancy of tetanus toxoid at elevated temperature, if during storage/transportation cold chain may not be maintained in hot weather. A total of three batches filled during full-scale production were tested. All Stability studies determination were performed on final products stored at 2-8°C and elevated temperatures in conformance with the ICH Guideline of Stability Testing of Biological Products. These studies gave comparison between real time shelf-life stability and accelerated stability studies. The findings indicate long﷓term thermo stability and prove that this tetanus vaccine can remain efficient under setting of routine use when suggested measures for storage and handling are followed in true spirit.

Physician Nonadherence With a Hepatitis C Screening Program

PubMed Central

Southern, William N.; Drainoni, Mari-Lynn; Smith, Bryce D.; Koppelman, Elisa; McKee, M. Diane; Christiansen, Cindy L.; Gifford, Allen L.; Weinbaum, Cindy M.; Litwin, Alain H.

2017-01-01

Background Testing for patients at risk for hepatitis C virus (HCV) infection is recommended, but it is unclear whether providers adhere to testing guidelines. We aimed to measure adherence to an HCV screening protocol during a multifaceted continuous intervention. Subjects and Methods Prospective cohort design to examine the associations between patient-level, physician-level, and visit-level characteristics and adherence to an HCV screening protocol. Study participants included all patients with a visit to 1 of the 3 study clinics and the physicians who cared for them. Adherence to the HCV screening protocol and patient-level, physician-level, and visit-level predictors of adherence were measured. Results A total of 8981 patients and 154 physicians were examined. Overall protocol adherence rate was 36.1%. In multivariate analysis, patient male sex (odds ratio [OR] = 1.18), new patient (OR = 1.23), morning visit (OR = 1.32), and patients’ preferred language being non-English (OR = 0.87) were significantly associated with screening adherence. There was a wide variation in overall adherence among physicians (range, 0%–92.4%). Screening adherence continuously declined from 59.1% in week 1 of the study to 13.7% in week 15 (final week). When implementing complex clinical practice guidelines, planners should address physician attitudinal barriers as well as gaps in knowledge to maximize adherence. PMID:24368717

Pre-implementation guidelines for infectious disease point-of-care testing in medical institutions.

PubMed

van der Eijk, Annemiek A; Tintu, Andrei N; Hays, John P

2017-01-01

Infectious disease point-of-care test (ID-POCT) devices are becoming widely available, and in this respect, international quality standards and guidelines are available for consultation once ID-POCT has been implemented into medical institutions. However, specific guidelines for consultation during the initial pre-implementation decision-making process are currently lacking. Further, there exist pre-implementation issues specific to ID-POCT. Here we present pre-implementation guidelines for consultation when considering the implementation of ID-POCT in medical institutions.

A Novel Approach to Improving Utilization of Laboratory Testing.

PubMed

Zhou, Yaolin; Procop, Gary W; Riley, Jacquelyn D

2018-02-01

- The incorporation of best practice guidelines into one's institution is a challenging goal of utilization management, and the successful adoption of such guidelines depends on institutional context. Laboratorians who have access to key clinical data are well positioned to understand existing local practices and promote more appropriate laboratory testing. - To apply a novel approach to utilization management by reviewing international clinical guidelines and current institutional practices to create a reliable mechanism to improve detection and reduce unnecessary tests in our patient population. - We targeted a frequently ordered genetic test for HFE-related hereditary hemochromatosis, a disorder of low penetrance. After reviewing international practice guidelines, we evaluated 918 HFE tests and found that all patients with new diagnoses had transferrin saturation levels that were significantly higher than those of patients with nonrisk genotypes (72% versus 42%; P < .001). - Our "one-button" order that restricts HFE genetic tests to patients with transferrin saturation greater than 45% is consistent with published practice guidelines and detected 100% of new patients with HFE-related hereditary hemochromatosis. - Our proposed algorithm differs from previously published approaches in that it incorporates both clinical practice guidelines and local physician practices, yet requires no additional hands-on effort from pathologists or clinicians. This novel approach to utilization management embraces the role of pathologists as leaders in promoting high-quality patient care in local health care systems.

Quality in genetic counselling for presymptomatic testing--clinical guidelines for practice across the range of genetic conditions.

PubMed

Skirton, Heather; Goldsmith, Lesley; Jackson, Leigh; Tibben, Aad

2013-03-01

Presymptomatic testing (PST) is the performance of a genetic test on an asymptomatic individual at risk of a condition to determine whether the person has inherited the disease-causing mutation. Although relevant guidelines exist for specific diseases, there is no overarching protocol that can be adapted to any disorder or clinical setting in which such testing is offered. The objective of this European project was to develop a set of coherent guidelines for PST (for adult-onset monogenic conditions) for use by health professionals working in a range of disciplines, countries or contexts. To ensure the guidelines were appropriate and practice based, we organised a workshop attended by an expert group of practitioners with relevant health professional backgrounds from 11 countries. Models of service for offering PST were presented, the group then discussed different aspects of testing and the standard of care required to ensure that patients were prepared to make decisions and deal with results and consequences. After the workshop, several rounds of consultation were used with a wider group of professionals to refine the guidelines. The guidelines include general principles governing the offer of testing (eg, autonomous choice of the patient), objectives of genetic counselling in this context (eg, facilitation of decision making), logistical considerations (eg, use of trained staff) and topics to be included during counselling discussion with the patient (eg, consequences of both positive and negative outcomes). We recommend the adoption of these guidelines to provide an equitable structure for those seeking PST in any country.

Best practice guidelines for the molecular genetic diagnosis of Type 1 (HFE-related) hereditary haemochromatosis

PubMed Central

King, Caitriona; Barton, David E

2006-01-01

Background Hereditary haemochromatosis (HH) is a recessively-inherited disorder of iron over-absorption prevalent in Caucasian populations. Affected individuals for Type 1 HH are usually either homozygous for a cysteine to tyrosine amino acid substitution at position 282 (C282Y) of the HFE gene, or compound heterozygotes for C282Y and for a histidine to aspartic acid change at position 63 (H63D). Molecular genetic testing for these two mutations has become widespread in recent years. With diverse testing methods and reporting practices in use, there was a clear need for agreed guidelines for haemochromatosis genetic testing. The UK Clinical Molecular Genetics Society has elaborated a consensus process for the development of disease-specific best practice guidelines for genetic testing. Methods A survey of current practice in the molecular diagnosis of haemochromatosis was conducted. Based on the results of this survey, draft guidelines were prepared using the template developed by UK Clinical Molecular Genetics Society. A workshop was held to develop the draft into a consensus document. The consensus document was then posted on the Clinical Molecular Genetics Society website for broader consultation and amendment. Results Consensus or near-consensus was achieved on all points in the draft guidelines. The consensus and consultation processes worked well, and outstanding issues were documented in an appendix to the guidelines. Conclusion An agreed set of best practice guidelines were developed for diagnostic, predictive and carrier testing for hereditary haemochromatosis and for reporting the results of such testing. PMID:17134494

40 CFR 797.1330 - Daphnid chronic toxicity test.

Code of Federal Regulations, 2010 CFR

2010-07-01

... an extended period of time. In this test guideline, mortality and reproduction (and optionally... exposure over a specified period of time. In this guideline, the effect measured is immobilization. (4..., wet weight) to the volume (liters) of test solution in a test chamber at a point in time or passing...

78 FR 59946 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-30

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... 503 of Public Law 100-71. The ``Mandatory Guidelines for Federal Workplace Drug Testing Programs,'' as...

76 FR 161 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-03

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... ``Mandatory Guidelines for Federal Workplace Drug Testing Programs'', as amended in the revisions listed above...

77 FR 54597 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-05

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... ``Mandatory Guidelines for Federal Workplace Drug Testing Programs'', as amended in the revisions listed above...

76 FR 24501 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-02

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... 100-71. The ``Mandatory Guidelines for Federal Workplace Drug Testing Programs'', as amended in the...

77 FR 20832 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-06

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... ``Mandatory Guidelines for Federal Workplace Drug Testing Programs,'' as amended in the revisions listed above...

77 FR 45645 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-01

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... 100-71. The ``Mandatory Guidelines for Federal Workplace Drug Testing Programs,'' as amended in the...

76 FR 68201 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-03

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... ``Mandatory Guidelines for Federal Workplace Drug Testing Programs'', as amended in the revisions listed above...

78 FR 72684 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-03

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... 503 of Publicc Law 100-71. The ``Mandatory Guidelines for Federal Workplace Drug Testing Programs...

76 FR 31969 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-02

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... ``Mandatory Guidelines for Federal Workplace Drug Testing Programs'', as amended in the revisions listed above...

78 FR 314 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-03

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... ``Mandatory Guidelines for Federal Workplace Drug Testing Programs'', as amended in the revisions listed above...

75 FR 67749 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-03

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... 100-71. The ``Mandatory Guidelines for Federal Workplace Drug Testing Programs,'' as amended in the...

78 FR 14100 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-04

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... ``Mandatory Guidelines for Federal Workplace Drug Testing Programs'', as amended in the revisions listed above...

77 FR 69642 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-20

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... ``Mandatory Guidelines for Federal Workplace Drug Testing Programs'', as amended in the revisions listed above...

78 FR 66034 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-04

... Engage in Urine Drug Testing For Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... 503 of Public Law 100-71. The ``Mandatory Guidelines for Federal Workplace Drug Testing Programs,'' as...

77 FR 5037 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-01

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... ``Mandatory Guidelines for Federal Workplace Drug Testing Programs'', as amended in the revisions listed above...

76 FR 75889 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-05

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... ``Mandatory Guidelines for Federal Workplace Drug Testing Programs'', as amended in the revisions listed above...

77 FR 60449 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-03

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... ``Mandatory Guidelines for Federal Workplace Drug Testing Programs'', as amended in the revisions listed above...

77 FR 26022 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-02

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... ``Mandatory Guidelines for Federal Workplace Drug Testing Programs'', as amended in the revisions listed above...

76 FR 61110 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-03

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... ``Mandatory Guidelines for Federal Workplace Drug Testing Programs,'' as amended in the revisions listed above...

77 FR 32653 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-01

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... 100-71. The ``Mandatory Guidelines for Federal Workplace Drug Testing Programs'', as amended in the...

78 FR 54903 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-06

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... 503 of Public Law 100-71. The ``Mandatory Guidelines for Federal Workplace Drug Testing Programs,'' as...

76 FR 18770 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-05

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... ``Mandatory Guidelines for Federal Workplace Drug Testing Programs,'' as amended in the revisions listed above...

76 FR 40924 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-12

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... ``Mandatory Guidelines for Federal Workplace Drug Testing Programs'', as amended in the revisions listed above...

76 FR 54477 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-01

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... ``Mandatory Guidelines for Federal Workplace Drug Testing Programs'', as amended in the revisions listed above...

78 FR 19500 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-01

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... ``Mandatory Guidelines for Federal Workplace Drug Testing Programs'', as amended in the revisions listed above...

76 FR 46309 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-02

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... ``Mandatory Guidelines for Federal Workplace Drug Testing Programs'', as amended in the revisions listed above...

76 FR 6147 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-03

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... ``Mandatory Guidelines for Federal Workplace Drug Testing Programs'', as amended in the revisions listed above...

76 FR 11802 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-03

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... ``Mandatory Guidelines for Federal Workplace Drug Testing Programs'', as amended in the revisions listed above...

77 FR 71605 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-03

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... 100-71. The ``Mandatory Guidelines for Federal Workplace Drug Testing Programs'', as amended in the...

77 FR 39501 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-03

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... ``Mandatory Guidelines for Federal Workplace Drug Testing Programs'', as amended in the revisions listed above...

78 FR 33429 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-04

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... ``Mandatory Guidelines for Federal Workplace Drug Testing Programs'', as amended in the revisions listed above...

78 FR 25461 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-01

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... ``Mandatory Guidelines for Federal Workplace Drug Testing Programs'', as amended in the revisions listed above...

77 FR 12862 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-02

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... ``Mandatory Guidelines for Federal Workplace Drug Testing Programs'', as amended in the revisions listed above...

78 FR 7795 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-04

... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs (Mandatory... Public Law 100-71. The ``Mandatory Guidelines for Federal Workplace Drug Testing Programs'', as amended...

40 CFR 797.1330 - Daphnid chronic toxicity test.

Code of Federal Regulations, 2013 CFR

2013-07-01

... an extended period of time. In this test guideline, mortality and reproduction (and optionally... exposure over a specified period of time. In this guideline, the effect measured is immobilization. (4..., wet weight) to the volume (liters) of test solution in a test chamber at a point in time or passing...

40 CFR 797.1330 - Daphnid chronic toxicity test.

Code of Federal Regulations, 2014 CFR

2014-07-01

... an extended period of time. In this test guideline, mortality and reproduction (and optionally... exposure over a specified period of time. In this guideline, the effect measured is immobilization. (4..., wet weight) to the volume (liters) of test solution in a test chamber at a point in time or passing...

40 CFR 797.1330 - Daphnid chronic toxicity test.

Code of Federal Regulations, 2011 CFR

2011-07-01

... an extended period of time. In this test guideline, mortality and reproduction (and optionally... exposure over a specified period of time. In this guideline, the effect measured is immobilization. (4..., wet weight) to the volume (liters) of test solution in a test chamber at a point in time or passing...

40 CFR 797.1330 - Daphnid chronic toxicity test.

Code of Federal Regulations, 2012 CFR

2012-07-01

... an extended period of time. In this test guideline, mortality and reproduction (and optionally... exposure over a specified period of time. In this guideline, the effect measured is immobilization. (4..., wet weight) to the volume (liters) of test solution in a test chamber at a point in time or passing...

Translation and cross-cultural adaptation of the Sexual Function Questionnaire (SFQ) into Brazilian Portuguese.

PubMed

Lapa, Clara de Oliveira; Rocha, Gibsi Possapp; Marques, Tiago Reis; Howes, Oliver; Smith, Shubulade; Monteiro, Ricardo Tavares; Zorzetti, Roberta; Spanemberg, Lucas

2017-01-01

Sexual dysfunction is common in patients with psychotic illness. This article describes the translation and cross-cultural adaptation of the Sexual Function Questionnaire (SFQ) into Brazilian Portuguese. The translation and cross-cultural adaptation followed the guidelines for adapting self-report instruments proposed by the Task Force of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Briefly, ISPOR steps include: preparation, forward translation, reconciliation, back-translation, back-translation review, harmonization, cognitive debriefing, review of cognitive debriefing and finalization, before proofreading and final version. The original authors authorized the translation and participated in the study. There was good agreement between translations and between the back-translation and the original English version of the SFQ. The final version was prepared with certificated evaluators in the original language and in Portuguese. Few changes were necessary to the new version in Portuguese. The translated and adapted Brazilian Portuguese version of the SFQ is reliable and semantically equivalent to the original version. Studies on psychotropic-related sexual dysfunction may now test the validity of the instrument and can investigate sexual dysfunction in Portuguese-speaking patients.

Missed connections: Unintended consequences of updated cervical cancer screening guidelines on screening rates for sexually transmitted infections.

PubMed

Bogler, Tali; Farber, Allison; Stall, Nathan; Wijayasinghe, Sheila; Slater, Morgan; Guiang, Charlie; Glazier, Richard H

2015-10-01

To examine the effects of the updated 2012 cervical cancer screening guidelines on the rates of sexually transmitted infection (STI) screening in primary care. Retrospective chart review. Five academic family practice units at St Michael's Hospital in Toronto, Ont. Female patients, aged 19 to 25, who had at least 1 visit with a physician at 1 of the 5 academic family practice units during a 12-month period before (May 1, 2011, to April 30, 2012) or after (November 1, 2012, to October 31, 2013) the release of the updated guidelines. Number of women who received Papanicolaou tests or underwent STI screening; rates of STI screening performed during a Pap test or a periodic health examination; screening rates for HIV, syphilis, and hepatitis C; and the methods used for STI screening before and after the release of the updated guidelines. Results Before the release of the 2012 guidelines, 42 of 100 women had Pap tests and 40 of 100 women underwent STI screening. After the release of the guidelines, 17 of 100 women had Pap tests and 20 of 100 women received STI screening. Female patients were less likely to undergo STI screening under the 2012 guidelines compared with the 2005 guidelines (odds ratio 0.38, 95% CI 0.19 to 0.74; P = .003). Implementation of the 2012 cervical cancer screening guidelines was associated with lower rates of STI screening in the primary care setting. Primary care physicians should screen at-risk women for STIs at any clinically appropriate encounter and consider using noninvasive self-sampling methods.

The international WAO/EAACI guideline for the management of hereditary angioedema-The 2017 revision and update.

PubMed

Maurer, M; Magerl, M; Ansotegui, I; Aygören-Pürsün, E; Betschel, S; Bork, K; Bowen, T; Balle Boysen, H; Farkas, H; Grumach, A S; Hide, M; Katelaris, C; Lockey, R; Longhurst, H; Lumry, W R; Martinez-Saguer, I; Moldovan, D; Nast, A; Pawankar, R; Potter, P; Riedl, M; Ritchie, B; Rosenwasser, L; Sánchez-Borges, M; Zhi, Y; Zuraw, B; Craig, T

2018-01-10

Hereditary Angioedema (HAE) is a rare and disabling disease. Early diagnosis and appropriate therapy are essential. This update and revision of the global guideline for HAE provides up-to-date consensus recommendations for the management of HAE. In the development of this update and revision of the guideline, an international expert panel reviewed the existing evidence and developed 20 recommendations that were discussed, finalized and consented during the guideline consensus conference in June 2016 in Vienna. The final version of this update and revision of the guideline incorporates the contributions of a board of expert reviewers and the endorsing societies. The goal of this guideline update and revision is to provide clinicians and their patients with guidance that will assist them in making rational decisions in the management of HAE with deficient C1-inhibitor (type 1) and HAE with dysfunctional C1-inhibitor (type 2). The key clinical questions covered by these recommendations are: (1) How should HAE-1/2 be defined and classified?, (2) How should HAE-1/2 be diagnosed?, (3) Should HAE-1/2 patients receive prophylactic and/or on-demand treatment and what treatment options should be used?, (4) Should HAE-1/2 management be different for special HAE-1/2 patient groups such as pregnant/lactating women or children?, and (5) Should HAE-1/2 management incorporate self-administration of therapies and patient support measures? © 2018 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

A Review of the Centers for Disease Control and Prevention's Guidelines for the Clinical Laboratory Diagnosis of Lyme Disease.

PubMed

Miraglia, Caterina M

2016-12-01

The purpose of this paper is to review information regarding the current guidelines for the clinical laboratory diagnosis of Lyme disease as set forth by the Centers for Disease Control and Prevention (CDC) to chiropractic physicians and to discuss the clinical utility of this testing. The CDC's website was reviewed to determine what their current recommendations are for the clinical laboratory testing of Lyme disease. The CDC's established guidelines recommend the use of a 2-tiered serologic testing algorithm for the evaluation of patients with suspected Lyme disease. This review provides doctors of chiropractic with information to remain current with the CDC's recommended guidelines for Lyme disease testing because patients may present to their office with the associated signs and symptoms of Lyme disease.

Developmental Neurotoxicology: History and Outline of ...

EPA Pesticide Factsheets

The present work provides a brief review of basic concepts in developmental neurotoxicology, as well as current representative testing guidelines for evaluating developmental neurotoxicity (DNT) of xenobiotics. Historically, DNT was initially recognized as a “functional” teratogenicity: the main concern was that prenatal and/or early postnatal exposures to chemicals during critical periods of central nervous system (CNS) development would cause later functional abnormalities of the brain. Current internationally harmonized DNT study guidelines are thus intended to predict adverse effects of test compounds on the developing CNS by observing such postnatal parameters as motor activity, startle response, and learning and memory, as well as neropathological alterations. The reliability of current DNT study guidelines and sensitivity of testing methodologies recommended in these guidelines have been confirmed by retrospective evaluations of the many international and domestic collaborative validation studies in developed nations including Japan. Invited review with brief review of basic concepts in developmental neurotoxicology, as well as current representative testing guidelines for evaluating developmental neurotoxicity (DNT) of xenobiotics.

Revision of the ICH guideline on detection of toxicity to reproduction for medicinal products: SWOT analysis.

PubMed

Barrow, Paul

2016-09-01

SWOT analysis was used to gain insights and perspectives into the revision of the ICH S5(R2) guideline on detection of toxicity to reproduction for medicinal products. The current ICH guideline was rapidly adopted worldwide and has an excellent safety record for more than 20 years. The revised guideline should aim to further improve reproductive and developmental (DART) safety testing for new drugs. Alternative methods to animal experiments should be used whenever possible. Modern technology should be used to obtain high quality data from fewer animals. Additions to the guideline should include considerations on the following: limit dose setting, maternal toxicity, biopharmaceuticals, vaccines, testing strategies by indication, developmental immunotoxicity, and male-mediated developmental toxicity. Emerging issues, such as epigenetics and the microbiome, will most likely pose challenges to DART testing in the future. It is hoped that the new guideline will be adopted even outside the ICH regions. Copyright © 2016 Elsevier Inc. All rights reserved.

Systematic review of colorectal cancer screening guidelines for average-risk adults: Summarizing the current global recommendations.

PubMed

Bénard, Florence; Barkun, Alan N; Martel, Myriam; von Renteln, Daniel

2018-01-07

To summarize and compare worldwide colorectal cancer (CRC) screening recommendations in order to identify similarities and disparities. A systematic literature search was performed using MEDLINE, EMBASE, Scopus, CENTRAL and ISI Web of knowledge identifying all average-risk CRC screening guideline publications within the last ten years and/or position statements published in the last 2 years. In addition, a hand-search of the webpages of National Gastroenterology Society websites, the National Guideline Clearinghouse, the BMJ Clinical Evidence website, Google and Google Scholar was performed. Fifteen guidelines were identified. Six guidelines were published in North America, four in Europe, four in Asia and one from the World Gastroenterology Organization. The majority of guidelines recommend screening average-risk individuals between ages 50 and 75 using colonoscopy (every 10 years), or flexible sigmoidoscopy (FS, every 5 years) or fecal occult blood test (FOBT, mainly the Fecal Immunochemical Test, annually or biennially). Disparities throughout the different guidelines are found relating to the use of colonoscopy, rank order between test, screening intervals and optimal age ranges for screening. Average risk individuals between 50 and 75 years should undergo CRC screening. Recommendations for optimal surveillance intervals, preferred tests/test cascade as well as the optimal timing when to start and stop screening differ regionally and should be considered for clinical decision making. Furthermore, local resource availability and patient preferences are important to increase CRC screening uptake, as any screening is better than none.

Taking Ownership of the ITC's Guidelines for Computer-Based and Internet-Delivered Testing: A South African Application

ERIC Educational Resources Information Center

Foxcroft, Cheryl D.; Davies, Caroline

2006-01-01

The increased use of computer-based and Internet-delivered testing has raised a number of ethical and legal issues. The International Test Commission's (this issue) Guidelines for Computer-Based and Internet-Delivered Testing represent the most recent attempt to provide test users, publishers, and developers with guidance regarding the appropriate…

Implementing clinical guidelines for chronic obstructive pulmonary disease: barriers and solutions

PubMed Central

Overington, Jeff D.; Huang, Yao C.; Abramson, Michael J.; Brown, Juliet L.; Goddard, John R.; Bowman, Rayleen V.; Fong, Kwun M.

2014-01-01

Chronic obstructive pulmonary disease (COPD) is a complex chronic lung disease characterised by progressive fixed airflow limitation and acute exacerbations that frequently require hospitalisation. Evidence-based clinical guidelines for the diagnosis and management of COPD are now widely available. However, the uptake of these COPD guidelines in clinical practice is highly variable, as is the case for many other chronic disease guidelines. Studies have identified many barriers to implementation of COPD and other guidelines, including factors such as lack of familiarity with guidelines amongst clinicians and inadequate implementation programs. Several methods for enhancing adherence to clinical practice guidelines have been evaluated, including distribution methods, professional education sessions, electronic health records (EHR), point of care reminders and computer decision support systems (CDSS). Results of these studies are mixed to date, and the most effective ways to implement clinical practice guidelines remain unclear. Given the significant resources dedicated to evidence-based medicine, effective dissemination and implementation of best practice at the patient level is an important final step in the process of guideline development. Future efforts should focus on identifying optimal methods for translating the evidence into everyday clinical practice to ensure that patients receive the best care. PMID:25478199

Consumer involvement in topic and outcome selection in the development of clinical practice guidelines.

PubMed

Tong, Allison; Lopez-Vargas, Pamela; Howell, Martin; Phoon, Richard; Johnson, David; Campbell, Denise; Walker, Rowan G; Craig, Jonathan C

2012-12-01

Consumer involvement in guideline development is advocated, but minimal participation, such as a nominated consumer representative on a guideline working group, can inhibit their decision-making power and contribution. Little is known about how to involve consumers more effectively in guideline development. To describe a targeted approach for involving consumers actively in guideline development, by focusing on topic and outcome selection, and to discuss the impact on content and structure of the final guideline. Descriptive study. Patients and carers (n = 24) from a tertiary hospital in Sydney attended three structured peer-facilitated workshops to complete group-based exercises on topic and outcome selection for guidelines for early stage chronic kidney disease. These workshops were run in parallel with the guideline-writing group. For each exercise, participants formed small groups and facilitated their own discussion, recorded their responses and presented them to the wider group. The topics and outcomes identified were fed back to the guideline writers. The participants actively engaged in the workshop discussions and articulated topics and outcomes they perceived should be included in clinical guidelines. Four main changes to guideline-related outputs were observed. A new guideline subtopic was introduced, guidelines were consumer-endorsed, guideline recommendations and suggestions for clinical care were augmented with consumer-focused issues, and plain English guidelines were developed. Consumer workshops in parallel and feeding into guideline development can be a feasible and effective approach for active consumer contribution. This process can inform the development of both consumer-focused guidelines for clinicians and specific versions for consumers. © 2011 Blackwell Publishing Ltd.

75 FR 16813 - Current List of Laboratories Which Meet Minimum Standards To Engage in Urine Drug Testing for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-02

... Current List of Laboratories Which Meet Minimum Standards To Engage in Urine Drug Testing for Federal... Drug Testing Programs (Mandatory Guidelines). The Mandatory Guidelines were first published in the... of [[Page 16814

Current and potential cyber attacks on medical journals; guidelines for improving security.

PubMed

Dadkhah, Mehdi; Seno, Seyed Amin Hosseini; Borchardt, Glenn

2017-03-01

At the moment, scholarly publishing is faced with much academic misconduct and threats such as predatory journals, hijacked journals, phishing, and other scams. In response, we have been discussing this misconduct and trying to increase the awareness of researchers, but it seems that there is a lack of research that presents guidelines for editors to help them protect themselves against these threats. It seems that information security is missing in some parts of scholarly publishing that particularly involves medical journals. In this paper, we explain different types of cyber-attacks that especially threaten editors and academic journals. We then explain the details involved in each type of attack. Finally, we present general guidelines for detection and prevention of the attacks. In some cases, we use small experiments to show that our claim is true. Finally, we conclude the paper with a prioritization of these attacks. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Psychiatry and online social media: potential, pitfalls and ethical guidelines for psychiatrists and trainees.

PubMed

Frankish, Katherine; Ryan, Christopher; Harris, Anthony

2012-06-01

This paper proposes ethical guidelines for psychiatrists and psychiatry trainees when interacting with social media. A three-stage process was followed in the development of these guidelines. A literature review provided situations and possible broad rules as to how social media could be ethically engaged. A roundtable discussion by a panel of invited psychiatrists, psychiatry trainees, psychologists, e-health practitioners, lawyers and consumers was held to discuss the situations and to better formulate the ethical principles upon which psychiatrists could act. These vignettes and principles were then broadly discussed at a seminar held at the 2011 RANZCP Congress. Finally, this paper was circulated to the original invitees for final comment. A set of recommendations for working with social media were developed. The new social media provides important avenues for communication, education and treatment. These avenues pose ethical and practical dilemmas that can be resolved by the application of established ethical principles. Practical recommendations for navigating social media are proposed.

40 CFR 797.1950 - Mysid shrimp chronic toxicity test.

Code of Federal Regulations, 2011 CFR

2011-07-01

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

40 CFR 797.1950 - Mysid shrimp chronic toxicity test.

Code of Federal Regulations, 2012 CFR

2012-07-01

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

40 CFR 797.1950 - Mysid shrimp chronic toxicity test.

Code of Federal Regulations, 2013 CFR

2013-07-01

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

40 CFR 797.1950 - Mysid shrimp chronic toxicity test.

Code of Federal Regulations, 2014 CFR

2014-07-01

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

Receipt of Glucose Testing and Performance of Two US Diabetes Screening Guidelines, 2007–2012

PubMed Central

Bullard, Kai McKeever; Ali, Mohammed K.; Imperatore, Giuseppina; Geiss, Linda S.; Saydah, Sharon H.; Albu, Jeanine B.; Cowie, Catherine C.; Sohler, Nancy; Albright, Ann; Gregg, Edward W.

2015-01-01

Background Screening guidelines are used to help identify prediabetes and diabetes before implementing evidence-based prevention and treatment interventions. We examined screening practices benchmarking against two US guidelines, and the capacity of each guideline to identify dysglycemia. Methods Using 2007–2012 National Health and Nutrition Examination Surveys, we analyzed nationally-representative, cross-sectional data from 5,813 fasting non-pregnant adults aged ≥20 years without self-reported diabetes. We examined proportions of adults eligible for diagnostic glucose testing and those who self-reported receiving testing in the past three years, as recommended by the American Diabetes Association (ADA) and the US Preventive Services Task Force (USPSTF-2008) guidelines. For each screening guideline, we also assessed sensitivity, specificity, and positive (PPV) and negative predictive values in identifying dysglycemia (defined as fasting plasma glucose ≥100 mg/dl or hemoglobin A1c ≥5.7%). Results In 2007–2012, 73.0% and 23.7% of US adults without diagnosed diabetes met ADA and USPSTF-2008 criteria for screening, respectively; and 91.5% had at least one major risk factor for diabetes. Of those ADA- or USPSTF-eligible adults, about 51% reported being tested within the past three years. Eligible individuals not tested were more likely to be lower educated, poorer, uninsured, or have no usual place of care compared to tested eligible adults. Among adults with ≥1 major risk factor, 45.7% reported being tested, and dysglycemia yields (i.e., PPV) ranged from 45.8% (high-risk ethnicity) to 72.6% (self-reported prediabetes). ADA criteria and having any risk factor were more sensitive than the USPSTF-2008 guideline (88.8–97.7% vs. 31.0%) but less specific (13.5–39.7% vs. 82.1%) in recommending glucose testing, resulting in lower PPVs (47.7–54.4% vs. 58.4%). Conclusion Diverging recommendations and variable performance of different guidelines may be impeding national diabetes prevention and treatment efforts. Efforts to align screening recommendations may result in earlier identification of adults at high risk for prediabetes and diabetes. PMID:25928306

77 FR 126 - Current List of Laboratories and Instrumented Initial Testing Facilities Which Meet Minimum...

Federal Register 2010, 2011, 2012, 2013, 2014

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... Engage in Urine Drug Testing for Federal Agencies AGENCY: Substance Abuse and Mental Health Services... certified to meet the standards of the Mandatory Guidelines for Federal Workplace Drug Testing Programs... ``Mandatory Guidelines for Federal Workplace Drug Testing Programs'', as amended in the revisions listed above...

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Research on and Guidelines for Effective Use of Assessment Instruments and Strategies for Adult Learners Enrolled in Adult Basic and Literacy Education Programs. Final Report.

ERIC Educational Resources Information Center

Pennsylvania State Univ., University Park. Inst. for the Study of Adult Literacy.

The goal of this research project was to create a guide on the effective use of assessment instruments and methodologies, related resources, and guidelines for measuring adult learners' attainment of basic skills and competencies to document educational gains and demonstrate program quality. The project focused on confirming current use of…

Integrated Data Collection Analysis (IDCA) Program - Final Review September 12, 2012 at DHS

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

Sandstrom, Mary M.; Brown, Geoffrey W.; Warner, Kirstin F.

The Integrated Data Collection Analysis (IDCA) program conducted a final program review at the Department of Homeland Security on September 12, 2012. The review was focused on the results of the program over the complete performance period. A summary presentation delineating the accomplished tasks started the meeting, followed by technical presentations on various issues that arose during the performance period. The presentations were completed with a statistical evaluation of the testing results from all the participants in the IDCA Proficiency Test study. The meeting closed with a discussion of potential sources of funding for continuing work to resolve some ofmore » these technical issues. This effort, funded by the Department of Homeland Security (DHS), put the issues of safe handling of these materials in perspective with standard military explosives. The study added Small-Scale Safety and Thermal (SSST) testing results for a broad suite of different HMEs to the literature, and suggested new guidelines and methods to develop safe handling practices for HMEs. Each participating testing laboratory used identical test materials and preparation methods wherever possible. Note, however, the test procedures differ among the laboratories. The results were compared among the laboratories and then compared to historical data from various sources. The testing performers involved were Lawrence Livermore National Laboratory (LLNL), Los Alamos National Laboratory (LANL), Naval Surface Warfare Center, Indian Head Division (NSWC IHD), Sandia National Laboratories (SNL), and Air Force Research Laboratory, Tyndall AFB (AFRL/RXQL). These tests were conducted as a proficiency study in order to establish some consistency in test protocols, procedures, and experiments and to compare results when these testing variables cannot be made consistent.« less

Differences in lupus anticoagulant final conclusion through clotting time or Rosner index for mixing test interpretation.

PubMed

Depreter, Barbara; Devreese, Katrien M J

2016-09-01

Lupus anticoagulant (LAC) testing includes a screening, mixing and confirmation step. Although recently published guidelines on LAC testing are a useful step towards standardization, a lack of consensus remains whether to express mixing tests in clotting time (CT) or index of circulating anticoagulant (ICA). The influence of anticoagulant therapy, e.g. vitamin K antagonists (VKA) or direct oral anticoagulants (DOAC) on both methods of interpretation remains to be investigated. The objective of this study was to contribute to a simplification and standardization of the LAC three-step interpretation on the level of the mixing test. Samples from 148 consecutive patients with LAC request and prolonged screening step, and 77 samples from patients non-suspicious for LAC treated with VKA (n=37) or DOAC (n=30) were retrospectively evaluated. An activated partial thromboplastin time (aPTT) and dilute Russell's viper venom time (dRVVT) were used for routine LAC testing. The supplemental anticoagulant samples were tested with dRVVT only. We focused on the interpretation differences for mixing tests expressed as CT or ICA and compared the final LAC conclusion within each distinct group of concordant and discordant mixing test results. Mixing test interpretation by CT resulted in 10 (dRVVT) and 16 (aPTT) more LAC positive patients compared to interpretation with ICA. Isolated prolonged dRVVT screen mix ICA results were exclusively observed in samples from VKA-treated patients without suspicion for LAC. We recommend using CT in respect to the 99th percentile cut-off for interpretation of mixing steps in order to reach the highest sensitivity and specificity in LAC detection.

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

Robb, Kevin R.; Jain, Prashant K.; Hazelwood, Thomas J.

Fluoride salt cooled high-temperature reactor (FHR) concepts include pumps for forced circulation of the primary and secondary coolants. As part of a cooperative research and development agreement between the Shanghai Institute of Applied Physics and the Oak Ridge National Laboratory (ORNL), a research project was initiated to aid in the development of pumps for high-temperature salts. The objectives of the task included characterization of the behavior of an existing ORNL LSTL pump; design and test a modified impeller and volute for improved pump characteristics; and finally, provide lessons learned, recommendations, and guidelines for salt pump development and design. The pumpmore » included on the liquid salt test loop (LSTL) at ORNL served as a case study. This report summarizes the progress to date. The report is organized as follows. First, there is a review, focused on pumps, of the significant amount of work on salts at ORNL during the 1950s 1970s. The existing pump on the LSTL is then described. Plans for hot and cold testing of the pump are then discussed, including the design for a cold shakedown test stand and the required LSTL modifications for hot testing. Initial hydraulic and vibration modeling of the LSTL pump is documented. Later, test data from the LSTL will be used to validate the modeling approaches, which could then be used for future pump design efforts. Some initial insights and test data from the pump are then provided. Finally, some preliminary design goals and requirements for a future LSTL pump are provided as examples of salt pump design considerations.« less

Revision of OECD Guidelines for Genotoxicity Testing: Current Status and Next Steps

EPA Science Inventory

Over the past 30 years, assays have been developed to evaluate chemical genotoxicity. OECD Genotoxicity Test Guidelines (TG) describe assay procedures for regulatory safety testing. Since the last OECD TG revision (1997), there has been tremendous scientific and technological pro...

Fever without source: evaluation of a guideline.

PubMed

Machado, Beatriz Marcondes; Cardoso, Débora Morais; de Paulis, Milena; Escobar, Ana Maria de Ulhôa; Gilio, Alfredo Elias

2009-01-01

To evaluate the applicability of a standardized guideline for children up to 36 months of age with fever without source (FWS). Prospective cohort study involving children with FWS treated at the emergency department of Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil, from June 2006 to May 2007. The guideline classifies the risk of serious bacterial infection (SBI) according to the presence or absence of toxemia, age, and temperature. Laboratory screening was based on risk assessment: complete blood count, blood culture, urinalysis, urine culture, and, if necessary, chest radiography, cerebrospinal fluid, and coproculture. We studied 251 children and, of these, 215 were followed up until the final diagnosis. Toxemia was found in 20 children, and 195 were well-appearing (30 up to 3 months old and 165 from 3 to 36 months old). Among those children from 3 to 36 months without toxemia, 95 had axillary temperature > 39 degrees C. In 107 (49.8%) children, there was spontaneous resolution of fever; in 88 (40.9%), benign self-limited disease was identified; and in 20 (9.3%), there was SBI. Among the cases of SBI, we identified 16 urinary tract infections, three cases of pneumonia and one occult bacteremia. Of the 215 children, 129 (60%) received no antibiotics, and 86 received antibiotics at some point (45 empirically). Empirical antibiotic treatment was maintained for an average of 72 hours. The guideline was shown to be appropriate to follow up these children using simple laboratory tests that can be carried out at most health facilities. The most frequent SBI in this sample was urinary tract infection.

Low Risk of Cervical Cancer/Precancer Among Most Women Under Surveillance Postcolposcopy

PubMed Central

Demarco, Maria; Cheung, Li C.; Kinney, Walter K.; Wentzensen, Nicolas; Lorey, Thomas S.; Fetterman, Barbara; Poitras, Nancy E.; Befano, Brian; Castle, Philip E.; Schiffman, Mark

2018-01-01

Objective To inform impending postcolposcopy guidelines, this analysis examined the subsequent risk of CIN 3+ among women with a grade lower than CIN 2 (< CIN 2) colposcopy results, taking into account the referring results that brought them to colposcopy and cotest results postcolposcopy. Methods We analyzed 107,005 women from 25 to 65 years old, recommended for colposcopy at Kaiser Permanente Northern California. We estimated absolute risks of CIN 3+ among women: (1) recommended for colposcopy (precolposcopy), (2) following colposcopy and with histology results < CIN 2 (postcolposcopy), and (3) with cotest results 12 months after a < CIN 2 colposcopy (return cotest). Results After colposcopy showing < CIN 2 (n = 69,790; 87% of the women at colposcopy), the 1-year risk of CIN 3+ was 1.2%, compared with 6.3% at the time of colposcopy recommendation. Negative cotest results 1 year after colposcopy identified a large group (37.1%) of women whose risk of CIN 3+ (i.e., <0.2% at 3 years after postcolposcopy cotest) was comparable with women with normal cytology in the screening population. These risks are consistent with current guidelines recommending repeat cotesting 12 months after colposcopy < CIN 2 and a 3-year return for women with a negative postcolposcopy cotest. Conclusions Most women are at low risk of subsequent CIN 3+ after a colposcopy showing < CIN 2, especially those who are human papillomavirus–negative postcolposcopy, consistent with current management guidelines for repeat testing intervals. Before the finalizing the upcoming guidelines, we will consider additional rounds of postcolposcopy cotesting. PMID:29570564

Do the Guideline Violations Influence Test Difficulty of High-Stake Test?: An Investigation on University Entrance Examination in Turkey

ERIC Educational Resources Information Center

Atalmis, Erkan Hasan

2016-01-01

Multiple-choice (MC) items are commonly used in high-stake tests. Thus, each item of such tests should be meticulously constructed to increase the accuracy of decisions based on test results. Haladyna and his colleagues (2002) addressed the valid item-writing guidelines to construct high quality MC items in order to increase test reliability and…

Clinical practice guidelines for the management of pregnancy in women with autoimmune rheumatic diseases of the Mexican College of Rheumatology. Part I.

PubMed

Saavedra Salinas, Miguel Ángel; Barrera Cruz, Antonio; Cabral Castañeda, Antonio Rafael; Jara Quezada, Luis Javier; Arce-Salinas, C Alejandro; Álvarez Nemegyei, José; Fraga Mouret, Antonio; Orozco Alcalá, Javier; Salazar Páramo, Mario; Cruz Reyes, Claudia Verónica; Andrade Ortega, Lilia; Vera Lastra, Olga Lidia; Mendoza Pinto, Claudia; Sánchez González, Antonio; Cruz Cruz, Polita Del Rocío; Morales Hernández, Sara; Portela Hernández, Margarita; Pérez Cristóbal, Mario; Medina García, Gabriela; Hernández Romero, Noé; Velarde Ochoa, María Del Carmen; Navarro Zarza, José Eduardo; Portillo Díaz, Verónica; Vargas Guerrero, Angélica; Goycochea Robles, María Victoria; García Figueroa, José Luis; Barreira Mercado, Eduardo; Amigo Castañeda, Mary Carmen

2015-01-01

Pregnancy in women with autoimmune rheumatic diseases is associated with several maternal and fetal complications. The development of clinical practice guidelines with the best available scientific evidence may help standardize the care of these patients. To provide recommendations regarding prenatal care, treatment, and a more effective monitoring of pregnancy in women with lupus erythematosus (SLE), rheumatoid arthritis (RA) and antiphospholipid antibody syndrome (APS). Nominal panels were formed for consensus, systematic search of information, development of clinical questions, processing and grading of recommendations, internal validation by peers, and external validation of the final document. The quality criteria of the AGREE II instrument were followed. The various panels answered the 37 questions related to maternal and fetal care in SLE, RA, and APS, as well as to the use of antirheumatic drugs during pregnancy and lactation. The recommendations were discussed and integrated into a final manuscript. Finally, the corresponding algorithms were developed. We present the recommendations for pregnant women with SLE in this first part. We believe that the Mexican clinical practice guidelines for the management of pregnancy in women with SLE integrate the best available evidence for the treatment and follow-up of patients with these conditions. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Operability test report for the in SITU vapor sampling

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

Corbett, J.E., Westinghouse Hanford

1996-05-31

This report documents the successful completion of testing for the In Situ Vapor Sampling (ISVS) system. The report includes the test procedure (WHC-SD-WM-OTP-196, Rev OA), data sheets, exception resolutions, and a test report summary. This report conforms to the guidelines established in WHC-IP-1026, `Engineering Practice Guidelines,` Appendix L, `Operability Test Procedures and Reports.`

Genetics of pulmonary hypertension in the clinic.

PubMed

Girerd, Barbara; Lau, Edmund; Montani, David; Humbert, Marc

2017-09-01

Heritable pulmonary arterial hypertension (PAH) is an autosomal dominant disease with incomplete penetrance because of mutations in bone morphogenetic protein receptor-II (BMPR2), activin A receptor type II-like kinase 1, endoglin, caveolin-1, potassium channel subfamily K, member 3, and T-box gene 4 genes. Heritable pulmonary veno-occlusive disease and/or pulmonary capillary hemangiomatosis (PVOD/PCH) is an autosomal recessive disease because of biallelic mutations in the eukaryotic translation initiation factor 2 alpha kinase 4 gene. The 2015 european society of cardiology (ESC) and european respiratory society (ERS) pulmonary hypertension guidelines recommend genetic counselling and testing to adults and children with PAH or PVOD/PCH as well as in adult relatives at risk of carrying a predisposing mutation. In France, genetic counseling and testing are offered to all patients displaying sporadic or familial form of PAH or PVOD/PCH and to their relatives at high risk of carrying a predisposing mutation. Patients with a heritable form of PAH are younger at diagnosis with a worse hemodynamic and a dismal prognosis. Patients with a heritable form of PVOD/PCH are younger at diagnosis with a worse response to specific PAH therapies. A program to detect PAH in an early phase was offered to all asymptomatic BMPR2 mutation carriers, according to the 2015 ESC/ERS guidelines. Finally, preimplantation genetic diagnosis has been performed in families with a history of BMPR2 mutations. Genetic counseling and testing has to be implemented in pulmonary hypertension centers.

Against the principle that the individual shall have priority over science.

PubMed

Helgesson, G; Eriksson, S

2008-01-01

This paper highlights a feature common to many ethical guidelines--namely, the idea that the interests of the individual shall always prevail over the interests of science and society. The paper presents how some major ethical guidelines treat the balancing of research interests against those of research subjects and spells out the difficulties in interpreting the principle of the primacy of the individual in a way that can be action-guiding. It suggests various alternative interpretations of the primacy of the individual and argues that they do not hold. Finally, the implications of this analysis for ethical guidelines are discussed.

Laboratory diagnosis of creatine deficiency syndromes: a technical standard and guideline of the American College of Medical Genetics and Genomics.

PubMed

Sharer, J Daniel; Bodamer, Olaf; Longo, Nicola; Tortorelli, Silvia; Wamelink, Mirjam M C; Young, Sarah

2017-02-01

Disclaimer: These ACMG Standards and Guidelines are intended as an educational resource for clinical laboratory geneticists to help them provide quality clinical laboratory genetic services. Adherence to these standards and guidelines is voluntary and does not necessarily assure a successful medical outcome. These Standards and Guidelines should not be considered inclusive of all proper procedures and tests or exclusive of others that are reasonably directed to obtaining the same results. In determining the propriety of any specific procedure or test, clinical laboratory geneticists should apply their professional judgment to the specific circumstances presented by the patient or specimen. Clinical laboratory geneticists are encouraged to document in the patient's record the rationale for the use of a particular procedure or test, whether or not it is in conformance with these Standards and Guidelines. They also are advised to take notice of the date any particular guideline was adopted, and to consider other relevant medical and scientific information that becomes available after that date. It also would be prudent to consider whether intellectual property interests may restrict the performance of certain tests and other procedures.Cerebral creatine deficiency syndromes are neurometabolic conditions characterized by intellectual disability, seizures, speech delay, and behavioral abnormalities. Several laboratory methods are available for preliminary and confirmatory diagnosis of these conditions, including measurement of creatine and related metabolites in biofluids using liquid chromatography-tandem mass spectrometry or gas chromatography-mass spectrometry, enzyme activity assays in cultured cells, and DNA sequence analysis. These guidelines are intended to standardize these procedures to help optimize the diagnosis of creatine deficiency syndromes. While biochemical methods are emphasized, considerations for confirmatory molecular testing are also discussed, along with variables that influence test results and interpretation.Genet Med 19 2, 256-263.

The Impact of 2013 Updated ASCO/CAP HER2 Guidelines on the Diagnosis and Management of Invasive Breast Cancer: A Single-Center Study of 1739 Cases.

PubMed

Zhang, Xiaofei; Bleiweiss, Ira; Jaffer, Shabnam; Nayak, Anupma

2017-10-01

The purpose of this study was to determine the impact of revised ASCO/CAP 2013 HER2 guidelines on the clinical practice of pathologists and oncologists. Retrospective analysis of 1739 patients with invasive breast carcinoma who underwent reflex HER2 (fluorescence in situ hybridization [FISH]) testing, using both 2007 and 2013 guidelines (2007-2014). Using 2013 guidelines, 255 (15%; 95% confidence interval [CI], 13%-16%) cases were classified as HER2 + as opposed to 186 (11%; 95% CI, 9%-12%) by 2007 guidelines (odds ratio [OR] 1.4; 95% CI, 1.2-1.8; P = .0005). Sixty-nine cases equivocal by 2007 guidelines (12% of all equivocal cases) were converted to HER2 + by 2013 guidelines. Sixty-two of these 69 cases shifted from HER2 equivocal to positive due to change in FISH ratio cutoff from 2.2 to 2.0. Six cases had FISH ratio < 2.0 but immunohistochemistry (IHC) score 3+ in 10% to 30% of tumor cells. One case had FISH ratio of 2.0 and IHC score 3+ in 10% to 30% of tumor cells. FISH and IHC test results were discordant in 5% (95% CI, 4%-6%) of cases using 2013 guidelines. No increase in HER2 FISH equivocal cases was observed. Reflex FISH testing of all IHC 1+ cases at our institution additionally detected 58 patients (5%; 95% CI, 4%-6%) with HER2 amplification. The 2013 guidelines increase the detection of HER2 + cases, without introducing significant difference in discordance rate of the IHC and FISH assays. Inclusion of HER2 copy number criterion does not increase the number of FISH equivocal cases in our cohort. We recommend IHC 1+ cases should be offered reflex FISH testing because failure to test them will miss a small number (5%) of potentially treatable cases. Copyright © 2017 Elsevier Inc. All rights reserved.

Economic analysis of the final effluent limitations, new source performance standards and pretreatment standards for the steam electric power industry

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

Not Available

This report presents the economic analysis of final effluent limitation guidelines, New Source Performance Standards, and pretreatment standards being promulgated for the steam-electric power plant point source category. It describes the costs of the final regulations, assesses the effects of these costs on the electric utility industry, and examines the cost-effectiveness of the regulations.

Syncope Best Practices: A Syncope Clinical Practice Guideline to Improve Quality.

PubMed

Phelps, Heather M; Sachdeva, Ritu; Mahle, William T; McCracken, Courtney E; Kelleman, Michael; McConnell, Michael; Fischbach, Peter S; Cardis, Brian M; Campbell, Robert M; Oster, Matthew E

2016-05-01

To determine whether implementation of a standardized clinical practice guideline (CPG) for the evaluation of syncope would decrease practice variability and resource utilization. A retrospective review of medical records of patients presenting to our practice for outpatient evaluation of syncope before and after implementation of the CPG. The guideline included elements of history, physical exam, electrocardiogram, and "red flags" for further testing. Outpatient pediatric cardiology offices of a large pediatric cardiology practice. All new patients between 3 and 21 years old, who presented to cardiology clinic with a chief complaint of syncope. The CPG for the evaluation of pediatric syncope was presented to the providers. Resource utilization was determined by the tests ordered by individual physicians before and after initiation of the CPG. Patient final diagnoses were recorded and the medical records were subsequently reviewed to determine if any patients, who presented again to the system, were ultimately diagnosed with cardiac disease. Of the 1496 patients with an initial visit for syncope, there was no significant difference in the diagnosis of cardiac disease before or after initiation of the CPG: (0.6% vs. 0.4%, P = .55). Electrocardiography provides the highest yield in the evaluation of pediatric syncope. Despite high compliance (86.9%), there were no overall changes in costs ($346.31 vs. $348.53, P = .85) or in resource utilization. There was, however, a decrease in the variability of ordering of echocardiograms among physicians, particularly among those at the extremes of utilization. Although the CPG did not decrease already low costs, it did decrease the wide variability in echo utilization. Evaluation beyond detailed history, physical exam, and electrocardiography provides no additional benefit in the evaluations of pediatric patients presenting with syncope. © 2015 Wiley Periodicals, Inc.

Reliability of physical functioning tests in patients with low back pain: a systematic review.

PubMed

Denteneer, Lenie; Van Daele, Ulrike; Truijen, Steven; De Hertogh, Willem; Meirte, Jill; Stassijns, Gaetane

2018-01-01

The aim of this study was to provide a comprehensive overview of physical functioning tests in patients with low back pain (LBP) and to investigate their reliability. A systematic computerized search was finalized in four different databases on June 24, 2017: PubMed, Web of Science, Embase, and MEDLINE. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed during all stages of this review. Clinical studies that investigate the reliability of physical functioning tests in patients with LBP were eligible. The methodological quality of the included studies was assessed with the use of the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist. To come to final conclusions on the reliability of the identified clinical tests, the current review assessed three factors, namely, outcome assessment, methodological quality, and consistency of description. A total of 20 studies were found eligible and 38 clinical tests were identified. Good overall test-retest reliability was concluded for the extensor endurance test (intraclass correlation coefficient [ICC]=0.93-0.97), the flexor endurance test (ICC=0.90-0.97), the 5-minute walking test (ICC=0.89-0.99), the 50-ft walking test (ICC=0.76-0.96), the shuttle walk test (ICC=0.92-0.99), the sit-to-stand test (ICC=0.91-0.99), and the loaded forward reach test (ICC=0.74-0.98). For inter-rater reliability, only one test, namely, the Biering-Sörensen test (ICC=0.88-0.99), could be concluded to have an overall good inter-rater reliability. None of the identified clinical tests could be concluded to have a good intrarater reliability. Further investigation should focus on a better overall study methodology and the use of identical protocols for the description of clinical tests. The assessment of reliability is only a first step in the recommendation process for the use of clinical tests. In future research, the identified clinical tests in the current review should be further investigated for validity. Only when these clinimetric properties of a clinical test have been thoroughly investigated can a final conclusion regarding the clinical and scientific use of the identified tests be made. Copyright © 2017 Elsevier Inc. All rights reserved.

78 FR 25282 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-30

... Project: Mandatory Guidelines for Federal Workplace Drug Testing Programs (OMB No. 0930-0158)--Revision SAMHSA's Mandatory Guidelines for Federal Workplace Drug Testing Programs will request OMB approval for the Federal Drug Testing Custody and Control Form for federal agency and federally regulated drug...

Improvement in safety monitoring of biologic response modifiers after the implementation of clinical care guidelines by a specialty.

PubMed

Hanson, Rebekah L; Gannon, Michael J; Khamo, Nehrin; Sodhi, Monsheel; Orr, Alexander M; Stubbings, JoAnn

2013-01-01

Tumor necrosis factor (TNF)-alpha inhibitors and other biologic response modifiers (BRMs) are frequently used to treat a variety of inflammatory diseases. Use of these agents may increase risk of serious infections, malignancies, and other complications such as worsening symptoms of heart failure or demyelinating disease. Because of these risks, a baseline assessment and routine monitoring have been recommended, but standardized guidelines for monitoring have yet to be established. To measure the compliance with the recommended safety monitoring in the Clinical Care Guidelines for BRMs at the University of Illinois Hospitals and Health Sciences System (UI Health). The Clinical Care Guidelines for BRMs was developed by a committee of pharmacists, nurses, and physicians based on an assessment of published literature and medication labeling. The guidelines included recommendations for safety monitoring prior to BRM therapy, such as the tuberculosis (TB) test, Hepatitis B surface Antigen (HBsAg) test, liver function test (LFT), complete blood count (CBC), up-to-date vaccinations, risk assessment for cancer, pregnancy testing, monitoring for contraindications with concomitant medications, concomitant disease state risk assessment, and patient education. The guidelines were introduced to UI Health in February 2012 by a systemwide email and by in-services given by the health system's Specialty Pharmacy Service. In-services were given in the clinics known to generate large numbers of BRM orders (e.g., gastroenterology and rheumatology) and at the outpatient center for infused therapies. The purpose of the in-services was to introduce providers to the guidelines and encourage their compliance. To ensure that guideline requirements were met when BRMs were ordered, a process was established to identify BRM orders, assess the orders for compliance with 4 of the safety monitoring tests from the guidelines (TB, HBsAg, LFT, and CBC), and make interventions. When necessary, Specialty Pharmacy Services coordinated with the pharmacists and other providers in the clinic to order lab tests and ensure they were completed prior to the start of therapy. Feedback was provided during the study to proactively improve compliance with the guidelines. After completion of the study, a report containing outpatient prescription orders for BRMs (abatacept, adalimumab, certolizumab, etanercept, golimumab, infliximab, and tocilizumab) from August 2011 through July 2012 was generated from the electronic medical record. Retrospective analyses of completion of safety monitoring were conducted for patients administered BRM treatment. Completion rates were compared before and after implementation of guidelines in February 2012. Completion was considered to have occurred when all 4 safety monitoring tests had been conducted -TB (unless known to be positive from a previous test), HBsAg, LFT, and CBC. Completion data from August 2011 through January 2012 were before the guidelines were implemented, and data from February 2012 through July 2012 were after the guidelines. Chi square analyses were performed on completion frequencies in the patients before and after the guidelines were implemented. Of the 320 unique patient BRM orders evaluated in this study, 195 (61%) were generated in the Rheumatology clinic, 99 (31%) in the Gastroenterology clinic, 21 (6.5%) in the Dermatology clinic, and 5 (1.5%) in the Transplant clinic. Before the guidelines were implemented, 54 ( 31%) of 173 patient orders complied with the safety monitoring by having all 4 clinical tests performed at the appropriate time points. After guideline implementation, 88 (60%) of 147 patient orders were compliant and had all 4 clinical tests conducted, which represents a statistically significant improvement in the rate of compliance (Pearson chi square = 26.43, degrees of freedom (df) = 1, P  less than  0.0001). This significant improvement in compliance rates after guideline implementation was observed in both the new patient group and the patients with continuing prescription orders/treatment changes. There was also an improvement in patients whose prescriptions were dispensed by UI Health and to a lesser degree those whose prescriptions were dispensed by an outside pharmacy. When the new patient group was analyzed separately (n = 92), 50 patients were treated before the guidelines were implemented, and 42 patients were treated after the guidelines were implemented. Compliance rates with safety monitoring in these 2 groups were 52% pre-implementation and 83% post-implementation, which represented a statistically significant improvement in compliance (Pearson chi square = 10.03, df=1, P = 0.0015). Similar results were observed in the second patient subgroup with continuing prescription orders/treatment change (n = 228). A total of 123 patients were treated before the guidelines were implemented, and 105 were treated after the guidelines were implemented. Compliance rates were 23% pre-implementation compared with 50% post-implementation, which represented a statistically significant improvement in compliance (Pearson chi square = 18.99, df = 1, P  less than  0.0001). Given the widespread and long-term use of BRMs, safety monitoring and management should be an important part of a comprehensive medication management program for their use. A coordinated effort may have a significant impact on compliance with safety monitoring guidelines.

EANM procedural guidelines for radionuclide myocardial perfusion imaging with SPECT and SPECT/CT: 2015 revision.

PubMed

Verberne, Hein J; Acampa, Wanda; Anagnostopoulos, Constantinos; Ballinger, Jim; Bengel, Frank; De Bondt, Pieter; Buechel, Ronny R; Cuocolo, Alberto; van Eck-Smit, Berthe L F; Flotats, Albert; Hacker, Marcus; Hindorf, Cecilia; Kaufmann, Philip A; Lindner, Oliver; Ljungberg, Michael; Lonsdale, Markus; Manrique, Alain; Minarik, David; Scholte, Arthur J H A; Slart, Riemer H J A; Trägårdh, Elin; de Wit, Tim C; Hesse, Birger

2015-11-01

Since the publication of the European Association of Nuclear Medicine (EANM) procedural guidelines for radionuclide myocardial perfusion imaging (MPI) in 2005, many small and some larger steps of progress have been made, improving MPI procedures. In this paper, the major changes from the updated 2015 procedural guidelines are highlighted, focusing on the important changes related to new instrumentation with improved image information and the possibility to reduce radiation exposure, which is further discussed in relation to the recent developments of new International Commission on Radiological Protection (ICRP) models. Introduction of the selective coronary vasodilator regadenoson and the use of coronary CT-contrast agents for hybrid imaging with SPECT/CT angiography are other important areas for nuclear cardiology that were not included in the previous guidelines. A large number of minor changes have been described in more detail in the fully revised version available at the EANM home page: http://eanm.org/publications/guidelines/2015_07_EANM_FINAL_myocardial_perfusion_guideline.pdf .

Clinical Practice Guidelines for Gastric Cancer in Korea: An Evidence-Based Approach

PubMed Central

Lee, Jun Haeng; Jung, Hye-Kyung; Kim, Jung Hoon; Jeong, Woo Kyoung; Jeon, Tae Joo; Kim, Joon Mee; Kim, Young Il; Ryu, Keun Won; Kong, Seong-Ho; Kim, Hyoung-Il; Jung, Hwoon-Yong; Kim, Yong Sik; Zang, Dae Young; Cho, Jae Yong; Park, Joon Oh; Lim, Do Hoon; Jung, Eun Sun; Ahn, Hyeong Sik; Kim, Hyun Jung

2014-01-01

Although gastric cancer is quite common in Korea, the treatment outcome is relatively favorable compared to those in western countries. However, there are currently no Korean multidisciplinary guidelines for gastric cancer. Experts from related societies developed guidelines de novo to meet Korean circumstances and requirements, including 23 recommendation statements for diagnosis (n=9) and treatment (n=14) based on relevant key questions. The quality of the evidence was rated according to the GRADE evidence evaluation framework: the evidence levels were based on a systematic review of the literature, and the recommendation grades were classified as either strong or weak. The applicability of the guidelines was considered to meet patients' view and preferences in the context of Korea. The topics of the guidelines cover diagnostic modalities (endoscopy, endoscopic ultrasound, and radiologic diagnosis), treatment modalities (surgery, therapeutic endoscopy, chemotherapy, and radiotherapy), and pathologic evaluation. An external review of the guidelines was conducted during the finalization phase. PMID:25061536

Guideline for the utilization of commercial grade items in nuclear safety related applications: Final report. [Contains Glossary

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

Tulay, M.P.; Yurich, F.J.; Schremser, F.M. Jr.

1988-06-01

This guideline provides direction for the procurement and use of Commercial Grade Items (CGI)in safety-related applications. It is divided into five major sections. A glossary of terms and definitions, an acronym listing, and seven appendices have been included. The glossary defines terms used in this guideline. In certain instances, the definitions may be unique to this guideline. Identification of acronyms utilized in this guideline is also provided. Section 1 provides a background of the commercial grade item issues facing the nuclear industry. It provides a historical perspective of commercial grade item issues. Section 2 discusses the generic process for themore » acceptance of a commercial grade item for safety-related use. Section 3 defines the four distinct methods used to accept commercial grade items for safety-related applications. Section 4 lists specific references that are identified in this guideline. Section 5 is a bibliography of documents that were considered in developed this guideline, but were not directly referenced in the document.« less

78 FR 11521 - Control of Communicable Disease; Foreign-Requirements for Importers of Nonhuman Primates (NHP)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-15

...The Centers for Disease Control and Prevention (CDC), located within the Department of Health and Human Services (HHS), is amending regulations for the importation of live nonhuman primates (NHPs) by extending existing requirements for the importation of Macaca fascicularis (cynomolgus), Chlorocebus aethiops (African green), and Macaca mulatta (rhesus) monkeys to all NHPs with the exception of the filovirus testing requirement. Filovirus testing will only be required for Old World NHPs in quarantine that have illness consistent with filovirus infection or that die for any reason other than trauma during quarantine. HHS/CDC is also finalizing a provision to reduce the frequency at which importers of cynomolgus, African green, and rhesus monkeys are required to renew their special permits (from every 180 days to every 2 years). HHS/CDC is incorporating existing guidelines into the regulations and adding new provisions to address the following: NHPs imported as part of an animal act; NHPs imported or transferred by zoological societies; the transfer of NHPs from approved laboratories; and non-live imported NHP products. Finally, HHS/CDC is also requiring that all NHPs be imported only through ports of entry where a HHS/CDC quarantine station is located.

Diagnosis of Acute Gout: A Clinical Practice Guideline From the American College of Physicians.

PubMed

Qaseem, Amir; McLean, Robert M; Starkey, Melissa; Forciea, Mary Ann

2017-01-03

The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on the diagnosis of gout. This guideline is based on a systematic review of published studies on gout diagnosis, identified using several databases, from database inception to February 2016. Evaluated outcomes included the accuracy of the test results; intermediate outcomes (results of laboratory and radiographic tests, such as serum urate and synovial fluid crystal analysis and radiographic or ultrasonography changes); clinical decision making (additional testing and pharmacologic or dietary management); short-term clinical (patient-centered) outcomes, such as pain and joint swelling and tenderness; and adverse effects of the tests. This guideline grades the evidence and recommendations by using the ACP grading system, which is based on the GRADE (Grading of Recommendations Assessment, Development and Evaluation) method. The target audience for this guideline includes all clinicians, and the target patient population includes adults with joint inflammation suspected to be gout. ACP recommends that clinicians use synovial fluid analysis when clinical judgment indicates that diagnostic testing is necessary in patients with possible acute gout. (Grade: weak recommendation, low-quality evidence).

Guidelines for Standardized Testing of Broadband Seismometers and Accelerometers

USGS Publications Warehouse

Hutt, Charles R.; Evans, John R.; Followill, Fred; Nigbor, Robert L.; Wielandt, Erhard

2010-01-01

Testing and specification of seismic and earthquake-engineering sensors and recorders has been marked by significant variations in procedures and selected parameters. These variations cause difficulty in comparing such specifications and test results. In July 1989, and again in May 2005, the U.S. Geological Survey hosted international pub-lic/private workshops with the goal of defining widely accepted guidelines for the testing of seismological inertial sensors, seismometers, and accelerometers. The Proceedings of the 2005 workshop have been published and include as appendix 6 the report of the 1989 workshop. This document represents a collation and rationalization of a single set of formal guidelines for testing and specifying broadband seismometers and accelerometers.

Exploring the Airways for Adult Education. Section 310, Final Report.

ERIC Educational Resources Information Center

Morris, Betty

Intended to enable an individual to converse with satellite antenna dealers and to select a dealer and acquire an antenna to suit his/her needs at the lowest cost, this edited version of a final project report provides detailed guidelines for purchasing of communications satellites distance education delivery systems and specific technical…

78 FR 25762 - Notice of Availability of the Final Trail Management Plan/Final Environmental Impact Statement...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-02

... DEPARTMENT OF THE INTERIOR National Park Service [NPS-MWR-CUVA-12176; PPMWMWROW2/PPMPSAS1Y.YP0000... Cuyahoga Valley National Park, Ohio AGENCY: National Park Service, Interior. ACTION: Notice of availability... design for new trails and trail facilities, and maintenance and best management practices. The Guidelines...

48 CFR 1852.235-73 - Final Scientific and Technical Reports.

Code of Federal Regulations, 2012 CFR

2012-10-01

... regarding appropriate electronic formats for final reports is available at http://www.sti.nasa.gov under....nasa.gov under the “Get Help” link. (e) In accordance with paragraph (d) of the Rights in Data—General... contained in NPR 2200.2, Guidelines for Documentation, Approval, and Dissemination of NASA Scientific and...

48 CFR 1852.235-73 - Final Scientific and Technical Reports.

Code of Federal Regulations, 2013 CFR

2013-10-01

... regarding appropriate electronic formats for final reports is available at http://www.sti.nasa.gov under....nasa.gov under the “Get Help” link. (e) In accordance with paragraph (d) of the Rights in Data—General... contained in NPR 2200.2, Guidelines for Documentation, Approval, and Dissemination of NASA Scientific and...

48 CFR 1852.235-73 - Final Scientific and Technical Reports.

Code of Federal Regulations, 2011 CFR

2011-10-01

... regarding appropriate electronic formats for final reports is available at http://www.sti.nasa.gov under....nasa.gov under the “Get Help” link. (e) In accordance with paragraph (d) of the Rights in Data—General... contained in NPR 2200.2, Guidelines for Documentation, Approval, and Dissemination of NASA Scientific and...

48 CFR 1852.235-73 - Final Scientific and Technical Reports.

Code of Federal Regulations, 2014 CFR

2014-10-01

... regarding appropriate electronic formats for final reports is available at http://www.sti.nasa.gov under....nasa.gov under the “Get Help” link. (e) In accordance with paragraph (d) of the Rights in Data—General... contained in NPR 2200.2, Guidelines for Documentation, Approval, and Dissemination of NASA Scientific and...

In honor of the Teratology Society's 50th anniversary: The role of Teratology Society members in the development and evolution of in vivo developmental toxicity test guidelines.

PubMed

Tyl, Rochelle W

2010-06-01

Members of the Teratology Society (established in 1960) were involved in the first governmental developmental and reproductive toxicity testing guidelines (1966) by FDA following the thalidomide epidemic, followed by other national and international governmental testing guidelines. The Segment II (developmental toxicity) study design, described in rodents and rabbits, has evolved with additional enhanced endpoints and better descriptions, mechanistic insights, range-finding studies, and toxico/pharmacokinetic ADME information (especially for pharmaceuticals). Society members were also involved in the development of the current screening assays and tests for endocrine disruptors (beginning in 1996) and are now involved with developing new testing guidelines (e.g., the extended one-generation protocol), and evaluating the current test guidelines and new initiatives under ILSI/HESI sponsorship. New initiatives include ToxCast from the U.S. EPA to screen, prioritize, and predict toxic chemicals by high throughput and high-content in vitro assays, bioinformation, and modeling to reduce (or eliminate) in vivo whole animal studies. Our Society and its journal have played vital roles in the scientific and regulatory accomplishments in birth defects research over the past 50 years and will continue to do so in the future. Happy 50th anniversary! (c) 2010 Wiley-Liss, Inc.

Measuring implementation behaviour of menu guidelines in the childcare setting: confirmatory factor analysis of a theoretical domains framework questionnaire (TDFQ).

PubMed

Seward, Kirsty; Wolfenden, Luke; Wiggers, John; Finch, Meghan; Wyse, Rebecca; Oldmeadow, Christopher; Presseau, Justin; Clinton-McHarg, Tara; Yoong, Sze Lin

2017-04-04

While there are number of frameworks which focus on supporting the implementation of evidence based approaches, few psychometrically valid measures exist to assess constructs within these frameworks. This study aimed to develop and psychometrically assess a scale measuring each domain of the Theoretical Domains Framework for use in assessing the implementation of dietary guidelines within a non-health care setting (childcare services). A 75 item 14-domain Theoretical Domains Framework Questionnaire (TDFQ) was developed and administered via telephone interview to 202 centre based childcare service cooks who had a role in planning the service menu. Confirmatory factor analysis (CFA) was undertaken to assess the reliability, discriminant validity and goodness of fit of the 14-domain theoretical domain framework measure. For the CFA, five iterative processes of adjustment were undertaken where 14 items were removed, resulting in a final measure consisting of 14 domains and 61 items. For the final measure: the Chi-Square goodness of fit statistic was 3447.19; the Standardized Root Mean Square Residual (SRMR) was 0.070; the Root Mean Square Error of Approximation (RMSEA) was 0.072; and the Comparative Fit Index (CFI) had a value of 0.78. While only one of the three indices support goodness of fit of the measurement model tested, a 14-domain model with 61 items showed good discriminant validity and internally consistent items. Future research should aim to assess the psychometric properties of the developed TDFQ in other community-based settings.

Metal wastage design guidelines for bubbling fluidized-bed combustors. Final report

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

Lyczkowski, R.W.; Podolski, W.F.; Bouillard, J.X.

These metal wastage design guidelines identify relationships between metal wastage and (1) design parameters (such as tube size, tube spacing and pitch, tube bundle and fluidized-bed height to distributor, and heat exchanger tube material properties) and (2) operating parameters (such as fluidizing velocity, particle size, particle hardness, and angularity). The guidelines are of both a quantitative and qualitative nature. Simplified mechanistic models are described, which account for the essential hydrodynamics and metal wastage processes occurring in bubbling fluidized beds. The empirical correlational approach complements the use of these models in the development of these design guidelines. Data used for modelmore » and guideline validation are summarized and referenced. Sample calculations and recommended design procedures are included. The influences of dependent variables on metal wastage, such as solids velocity, bubble size, and in-bed pressure fluctuations, are discussed.« less

Guidelines for the Design, Fabrication, Testing, Installation and Operation of Srf Cavities

NASA Astrophysics Data System (ADS)

Theilacker, J.; Carter, H.; Foley, M.; Hurh, P.; Klebaner, A.; Krempetz, K.; Nicol, T.; Olis, D.; Page, T.; Peterson, T.; Pfund, P.; Pushka, D.; Schmitt, R.; Wands, R.

2010-04-01

Superconducting Radio-Frequency (SRF) cavities containing cryogens under pressure pose a potential rupture hazard to equipment and personnel. Generally, pressure vessels fall within the scope of the ASME Boiler and Pressure Vessel Code however, the use of niobium as a material for the SRF cavities is beyond the applicability of the Code. Fermilab developed a guideline to ensure sound engineering practices governing the design, fabrication, testing, installation and operation of SRF cavities. The objective of the guideline is to reduce hazards and to achieve an equivalent level of safety afforded by the ASME Code. The guideline addresses concerns specific to SRF cavities in the areas of materials, design and analysis, welding and brazing, pressure relieving requirements, pressure testing and quality control.

[Development and validation of event-specific quantitative PCR method for genetically modified maize LY038].

PubMed

Mano, Junichi; Masubuchi, Tomoko; Hatano, Shuko; Futo, Satoshi; Koiwa, Tomohiro; Minegishi, Yasutaka; Noguchi, Akio; Kondo, Kazunari; Akiyama, Hiroshi; Teshima, Reiko; Kurashima, Takeyo; Takabatake, Reona; Kitta, Kazumi

2013-01-01

In this article, we report a novel real-time PCR-based analytical method for quantitation of the GM maize event LY038. We designed LY038-specific and maize endogenous reference DNA-specific PCR amplifications. After confirming the specificity and linearity of the LY038-specific PCR amplification, we determined the conversion factor required to calculate the weight-based content of GM organism (GMO) in a multilaboratory evaluation. Finally, in order to validate the developed method, an interlaboratory collaborative trial according to the internationally harmonized guidelines was performed with blind DNA samples containing LY038 at the mixing levels of 0, 0.5, 1.0, 5.0 and 10.0%. The precision of the method was evaluated as the RSD of reproducibility (RSDR), and the values obtained were all less than 25%. The limit of quantitation of the method was judged to be 0.5% based on the definition of ISO 24276 guideline. The results from the collaborative trial suggested that the developed quantitative method would be suitable for practical testing of LY038 maize.

Automotive advertising copy test. Final report. [Mileage estimates

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

Not Available

The purpose of this research project was to explore the following issues: (1) mileage recall/recognition of miles per gallon/highway mileage estimates in print ads by advertisement readers; (2) determine consumer expectations and believability of advertised mileage guidelines; (3) measure recall/comprehension of mileage disclaimers; and (4) determine how consumers utilize published mileage estimates. The evidence from this study points to a public which is quite familiar with the EPA mileage estimates, in terms of using them as guidelines and in finding them to be helpful. Most adults also appear to be knowledgeable about factors which can affect car performance and, therefore,more » anticipate that, within certain tolerances, their actual mileage will differ from the EPA estimates. Although the consumer has been educated regarding fuel estimates, there is a very strong suggestion from this research that typical automobile print advertising does a less than an effective job in generating awareness of specific EPA estimates as well as their attendant disclaimer. Copy strategy and execution have a critical impact on recall of the EPA mileage estimates. 18 tables.« less

40 CFR 799.9325 - TSCA 90-day dermal toxicity.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Health Effects Test Guidelines § 799.9325 TSCA 90-day dermal toxicity. (a) Scope. This section is...-observed-effects level (NOEL) and toxic effects associated with continuous or repeated exposure to a test... human exposure. (b) Source. The source material used in developing this TSCA test guideline is the...

40 CFR 799.9325 - TSCA 90-day dermal toxicity.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Health Effects Test Guidelines § 799.9325 TSCA 90-day dermal toxicity. (a) Scope. This section is...-observed-effects level (NOEL) and toxic effects associated with continuous or repeated exposure to a test... human exposure. (b) Source. The source material used in developing this TSCA test guideline is the...

40 CFR 799.9325 - TSCA 90-day dermal toxicity.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Health Effects Test Guidelines § 799.9325 TSCA 90-day dermal toxicity. (a) Scope. This section is...-observed-effects level (NOEL) and toxic effects associated with continuous or repeated exposure to a test... human exposure. (b) Source. The source material used in developing this TSCA test guideline is the...

40 CFR 799.9325 - TSCA 90-day dermal toxicity.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Health Effects Test Guidelines § 799.9325 TSCA 90-day dermal toxicity. (a) Scope. This section is...-observed-effects level (NOEL) and toxic effects associated with continuous or repeated exposure to a test... human exposure. (b) Source. The source material used in developing this TSCA test guideline is the...

40 CFR 799.9325 - TSCA 90-day dermal toxicity.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Health Effects Test Guidelines § 799.9325 TSCA 90-day dermal toxicity. (a) Scope. This section is...-observed-effects level (NOEL) and toxic effects associated with continuous or repeated exposure to a test... human exposure. (b) Source. The source material used in developing this TSCA test guideline is the...

40 CFR 797.1930 - Mysid shrimp acute toxicity test.

Code of Federal Regulations, 2013 CFR

2013-07-01

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

40 CFR 797.1930 - Mysid shrimp acute toxicity test.

Code of Federal Regulations, 2014 CFR

2014-07-01

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

40 CFR 797.1930 - Mysid shrimp acute toxicity test.

Code of Federal Regulations, 2012 CFR

2012-07-01

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

40 CFR 797.1930 - Mysid shrimp acute toxicity test.

Code of Federal Regulations, 2011 CFR

2011-07-01

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

40 CFR 795.228 - Oral/dermal pharmacokinetics.

Code of Federal Regulations, 2010 CFR

2010-07-01

... CONTROL ACT (CONTINUED) PROVISIONAL TEST GUIDELINES Provisional Health Effects Guidelines § 795.228 Oral... laboratory. The animals shall be selected at random for the test groups and any animal showing signs of ill health shall not be used. In all studies, unless otherwise specified, each test group shall contain at...

40 CFR 795.228 - Oral/dermal pharmacokinetics.

Code of Federal Regulations, 2012 CFR

2012-07-01

... CONTROL ACT (CONTINUED) PROVISIONAL TEST GUIDELINES Provisional Health Effects Guidelines § 795.228 Oral... laboratory. The animals shall be selected at random for the test groups and any animal showing signs of ill health shall not be used. In all studies, unless otherwise specified, each test group shall contain at...

40 CFR 795.228 - Oral/dermal pharmacokinetics.

Code of Federal Regulations, 2011 CFR

2011-07-01

... CONTROL ACT (CONTINUED) PROVISIONAL TEST GUIDELINES Provisional Health Effects Guidelines § 795.228 Oral... laboratory. The animals shall be selected at random for the test groups and any animal showing signs of ill health shall not be used. In all studies, unless otherwise specified, each test group shall contain at...

40 CFR 795.228 - Oral/dermal pharmacokinetics.

Code of Federal Regulations, 2013 CFR

2013-07-01

... CONTROL ACT (CONTINUED) PROVISIONAL TEST GUIDELINES Provisional Health Effects Guidelines § 795.228 Oral... laboratory. The animals shall be selected at random for the test groups and any animal showing signs of ill health shall not be used. In all studies, unless otherwise specified, each test group shall contain at...

40 CFR 795.228 - Oral/dermal pharmacokinetics.

Code of Federal Regulations, 2014 CFR

2014-07-01

... CONTROL ACT (CONTINUED) PROVISIONAL TEST GUIDELINES Provisional Health Effects Guidelines § 795.228 Oral... laboratory. The animals shall be selected at random for the test groups and any animal showing signs of ill health shall not be used. In all studies, unless otherwise specified, each test group shall contain at...

75 FR 41488 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-16

.... Project: Mandatory Guidelines for Federal Workplace Drug Testing Programs (OMB No. 0930-0158)--Revision SAMHSA's Mandatory Guidelines for Federal Workplace Drug Testing Programs will request OMB approval for the Federal Drug Testing Custody and Control Form for Federal agency and federally regulated drug...

Guidelines for the development of social marketing programmes for sun protection among adolescents and young adults.

PubMed

Johnson, K M; Jones, S C; Iverson, D

2009-09-01

To formulate 'best practice' guidelines for social marketing programmes for adolescents' and young adults' sun protection. A Delphi consensus process. Eleven experts in sun protection and social marketing participated in a Delphi consensus process, where they were asked to provide up to 10 key points, based on their knowledge and practical experience, which they felt were most important in developing social marketing interventions for the primary prevention of skin cancer among adolescents and young adults. After reaching consensus, the evidence base for each guideline was determined and graded via the Scottish Intercollegiate Guideline Network grading system. Participants were then asked to indicate how strongly they rated the finalized 15 recommendations based on all aspects relating to their knowledge and practical opinion, as well as the research evidence, on a visual analogue scale. The resultant 15 guidelines offer general principles for sun protection interventions utilizing a social marketing approach. This method of guideline development brought the expertise of practitioners to the forefront of guideline development, whilst still utilizing established methods of evidence confirmation. It thus offers a useful method for guideline development in a public health context.

Korean clinical practice guideline for benign prostatic hyperplasia

PubMed Central

Yeo, Jeong Kyun; Choi, Hun; Bae, Jae Hyun; Kim, Jae Heon; Yang, Seong Ok; Oh, Chul Young; Cho, Young Sam; Kim, Kyoung Woo

2016-01-01

In 2014, the Korean Urological Association organized the Benign Prostatic Hyperplasia Guideline Developing Committee composed of experts in the field of benign prostatic hyperplasia (BPH) with the participation of the Korean Academy of Family Medicine and the Korean Continence Society to develop a Korean clinical practice guideline for BPH. The purpose of this clinical practice guideline is to provide current and comprehensive recommendations for the evaluation and treatment of BPH. The committee developed the guideline mainly by adapting existing guidelines and partially by using the de novo method. A comprehensive literature review was carried out primarily from 2009 to 2013 by using medical search engines including data from Korea. Based on the published evidence, recommendations were synthesized, and the level of evidence of the recommendations was determined by using methods adapted from the 2011 Oxford Centre for Evidence-Based Medicine. Meta-analysis was done for one key question and four recommendations. A draft guideline was reviewed by expert peer reviewers and discussed at an expert consensus meeting until final agreement was achieved. This evidence-based guideline for BPH provides recommendations to primary practitioners and urologists for the diagnosis and treatment of BPH in men older than 40 years. PMID:26966724

Belgian guidelines for economic evaluations: second edition.

PubMed

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

2014-12-01

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

Existing reporting guidelines for clinical trials are not completely relevant for implantable medical devices: a systematic review.

PubMed

Motte, Anne-France; Diallo, Stéphanie; van den Brink, Hélène; Châteauvieux, Constance; Serrano, Carole; Naud, Carole; Steelandt, Julie; Alsac, Jean-Marc; Aubry, Pierre; Cour, Florence; Pellerin, Olivier; Pineau, Judith; Prognon, Patrice; Borget, Isabelle; Bonan, Brigitte; Martelli, Nicolas

2017-11-01

The aim of this study was to determine relevant items for reporting clinical trials on implantable medical devices (IMDs) and to identify reporting guidelines which include these items. A panel of experts identified the most relevant items for evaluating IMDs from an initial list based on reference papers. We then conducted a systematic review of articles indexed in MEDLINE. We retrieved reporting guidelines from the EQUATOR network's library for health research reporting. Finally, we screened these reporting guidelines to find those using our set of reporting items. Seven relevant reporting items were selected that related to four topics: randomization, learning curve, surgical setting, and device information. A total of 348 reporting guidelines were identified, among which 26 met our inclusion criteria. However, none of the 26 reporting guidelines presented all seven items together. The most frequently reported item was timing of randomization (65%). On the contrary, device information and learning curve effects were poorly specified. To our knowledge, this study is the first to identify specific items related to IMDs in reporting guidelines for clinical trials. We have shown that no existing reporting guideline is totally suitable for these devices. Copyright © 2017 Elsevier Inc. All rights reserved.

Integration of Evidence into a Detailed Clinical Model-based Electronic Nursing Record System

PubMed Central

Park, Hyeoun-Ae; Jeon, Eunjoo; Chung, Eunja

2012-01-01

Objectives The purpose of this study was to test the feasibility of an electronic nursing record system for perinatal care that is based on detailed clinical models and clinical practice guidelines in perinatal care. Methods This study was carried out in five phases: 1) generating nursing statements using detailed clinical models; 2) identifying the relevant evidence; 3) linking nursing statements with the evidence; 4) developing a prototype electronic nursing record system based on detailed clinical models and clinical practice guidelines; and 5) evaluating the prototype system. Results We first generated 799 nursing statements describing nursing assessments, diagnoses, interventions, and outcomes using entities, attributes, and value sets of detailed clinical models for perinatal care which we developed in a previous study. We then extracted 506 recommendations from nine clinical practice guidelines and created sets of nursing statements to be used for nursing documentation by grouping nursing statements according to these recommendations. Finally, we developed and evaluated a prototype electronic nursing record system that can provide nurses with recommendations for nursing practice and sets of nursing statements based on the recommendations for guiding nursing documentation. Conclusions The prototype system was found to be sufficiently complete, relevant, useful, and applicable in terms of content, and easy to use and useful in terms of system user interface. This study has revealed the feasibility of developing such an ENR system. PMID:22844649

Enhanced UHF RFID tags for drug tracing.

PubMed

Catarinucci, Luca; Colella, Riccardo; De Blasi, Mario; Patrono, Luigi; Tarricone, Luciano

2012-12-01

Radio Frequency Identification (RFID) technology is playing a crucial role for item-level tracing systems in healthcare scenarios. The pharmaceutical supply chain is a fascinating application context, where RFID can guarantee transparency in the drug flow, supporting both suppliers and consumers against the growing counterfeiting problem. In such a context, the choice of the most adequate RFID tag, in terms of shape, frequency, size and reading range, is crucial. The potential presence of items containing materials hostile to the electromagnetic propagation exasperates the problem. In addition, the peculiarities of the different RFID-based checkpoints make even more stringent the requirements for the tag. In this work, the performance of several commercial UHF RFID tags in each step of the pharmaceutical supply chain has been evaluated, confirming the expected criticality. On such basis, a guideline for the electromagnetic design of new high-performance tags capable to overcome such criticalities has been defined. Finally, driven by such guidelines, a new enhanced tag has been designed, realized and tested. Due to patent pending issues, the antenna shape is not shown. Nevertheless, the optimal obtained results do not lose their validity. Indeed, on the one hand they demonstrate that high performance item level tracing systems can actually be implemented also in critical operating conditions. On the other hand, they encourage the tag designer to follow the identified guidelines so to realize enhanced UHF tags.

NASA Electronic Parts and Packaging Field Programmable Gate Array Single Event Effects Test Guideline Update

NASA Technical Reports Server (NTRS)

Berg, Melanie D.; LaBel, Kenneth A.

2018-01-01

The following are updated or new subjects added to the FPGA SEE Test Guidelines manual: academic versus mission specific device evaluation, single event latch-up (SEL) test and analysis, SEE response visibility enhancement during radiation testing, mitigation evaluation (embedded and user-implemented), unreliable design and its affects to SEE Data, testing flushable architectures versus non-flushable architectures, intellectual property core (IP Core) test and evaluation (addresses embedded and user-inserted), heavy-ion energy and linear energy transfer (LET) selection, proton versus heavy-ion testing, fault injection, mean fluence to failure analysis, and mission specific system-level single event upset (SEU) response prediction. Most sections within the guidelines manual provide information regarding best practices for test structure and test system development. The scope of this manual addresses academic versus mission specific device evaluation and visibility enhancement in IP Core testing.

NASA Electronic Parts and Packaging (NEPP) Field Programmable Gate Array (FPGA) Single Event Effects (SEE) Test Guideline Update

NASA Technical Reports Server (NTRS)

Berg, Melanie D.; LaBel, Kenneth A.

2018-01-01

The following are updated or new subjects added to the FPGA SEE Test Guidelines manual: academic versus mission specific device evaluation, single event latch-up (SEL) test and analysis, SEE response visibility enhancement during radiation testing, mitigation evaluation (embedded and user-implemented), unreliable design and its affects to SEE Data, testing flushable architectures versus non-flushable architectures, intellectual property core (IP Core) test and evaluation (addresses embedded and user-inserted), heavy-ion energy and linear energy transfer (LET) selection, proton versus heavy-ion testing, fault injection, mean fluence to failure analysis, and mission specific system-level single event upset (SEU) response prediction. Most sections within the guidelines manual provide information regarding best practices for test structure and test system development. The scope of this manual addresses academic versus mission specific device evaluation and visibility enhancement in IP Core testing.

Mediators and moderators in early intervention research.

PubMed

Breitborde, Nicholas J K; Srihari, Vinod H; Pollard, Jessica M; Addington, Donald N; Woods, Scott W

2010-05-01

The goal of this paper is to provide clarification with regard to the nature of mediator and moderator variables and the statistical methods used to test for the existence of these variables. Particular attention will be devoted to discussing the ways in which the identification of mediator and moderator variables may help to advance the field of early intervention in psychiatry. We completed a literature review of the methodological strategies used to test for mediator and moderator variables. Although several tests for mediator variables are currently available, recent evaluations suggest that tests which directly evaluate the indirect effect are superior. With regard to moderator variables, two approaches ('pick-a-point' and regions of significance) are available, and we provide guidelines with regard to how researchers can determine which approach may be most appropriate to use for their specific study. Finally, we discuss how to evaluate the clinical importance of mediator and moderator relationships as well as the methodology to calculate statistical power for tests of mediation and moderation. Further exploration of mediator and moderator variables may provide valuable information with regard to interventions provided early in the course of a psychiatric illness.

Guidelines of Care for the Management of Atopic Dermatitis Part 4: Prevention of Disease Flares and Use of Adjunctive Therapies and Approaches

PubMed Central

Sidbury, Robert; Tom, Wynnis L.; Bergman, James N.; Cooper, Kevin D.; Silverman, Robert A.; Berger, Timothy G.; Chamlin, Sarah L.; Cohen, David E.; Cordoro, Kelly M.; Davis, Dawn M.; Feldman, Steven R.; Hanifin, Jon M.; Krol, Alfons; Margolis, David J.; Paller, Amy S.; Schwarzenberger, Kathryn; Simpson, Eric L.; Williams, Hywel C.; Elmets, Craig A.; Block, Julie; Harrod, Christopher G.; Begolka, Wendy Smith; Eichenfield, Lawrence F.

2015-01-01

Atopic dermatitis (AD) is a common, chronic inflammatory dermatosis that can affect all age groups. This evidence-based guideline addresses important clinical questions that arise in its management. In this final section, treatments for flare prevention and adjunctive and complementary therapies and approaches are reviewed. Suggestions on utilization are given based on available evidence. PMID:25264237

Proposed reporting model update creates dialogue between FASB and not-for-profits.

PubMed

Mosrie, Norman C

2016-04-01

Seeing a need to refresh the current guidelines, the Financial Accounting Standards Board (FASB) proposed an update to the financial accounting and reporting model for not-for-profit entities. In a response to solicited feedback, the board is now revisiting its proposed update and has set forth a plan to finalize its new guidelines. The FASB continues to solicit and respond to feedback as the process progresses.

Towards a standardization of biomethane potential tests.

PubMed

Holliger, Christof; Alves, Madalena; Andrade, Diana; Angelidaki, Irini; Astals, Sergi; Baier, Urs; Bougrier, Claire; Buffière, Pierre; Carballa, Marta; de Wilde, Vinnie; Ebertseder, Florian; Fernández, Belén; Ficara, Elena; Fotidis, Ioannis; Frigon, Jean-Claude; de Laclos, Hélène Fruteau; Ghasimi, Dara S M; Hack, Gabrielle; Hartel, Mathias; Heerenklage, Joern; Horvath, Ilona Sarvari; Jenicek, Pavel; Koch, Konrad; Krautwald, Judith; Lizasoain, Javier; Liu, Jing; Mosberger, Lona; Nistor, Mihaela; Oechsner, Hans; Oliveira, João Vítor; Paterson, Mark; Pauss, André; Pommier, Sébastien; Porqueddu, Isabella; Raposo, Francisco; Ribeiro, Thierry; Rüsch Pfund, Florian; Strömberg, Sten; Torrijos, Michel; van Eekert, Miriam; van Lier, Jules; Wedwitschka, Harald; Wierinck, Isabella

2016-12-01

Production of biogas from different organic materials is a most interesting source of renewable energy. The biomethane potential (BMP) of these materials has to be determined to get insight in design parameters for anaerobic digesters. Although several norms and guidelines for BMP tests exist, inter-laboratory tests regularly show high variability of BMPs for the same substrate. A workshop was held in June 2015, in Leysin, Switzerland, with over 40 attendees from 30 laboratories around the world, to agree on common solutions to the conundrum of inconsistent BMP test results. This paper presents the consensus of the intense roundtable discussions and cross-comparison of methodologies used in respective laboratories. Compulsory elements for the validation of BMP results were defined. They include the minimal number of replicates, the request to carry out blank and positive control assays, a criterion for the test duration, details on BMP calculation, and last but not least criteria for rejection of the BMP tests. Finally, recommendations on items that strongly influence the outcome of BMP tests such as inoculum characteristics, substrate preparation, test setup, and data analysis are presented to increase the probability of obtaining validated and reproducible results.

Development and use of a content search strategy for retrieving studies on patients' views and preferences.

PubMed

Selva, Anna; Solà, Ivan; Zhang, Yuan; Pardo-Hernandez, Hector; Haynes, R Brian; Martínez García, Laura; Navarro, Tamara; Schünemann, Holger; Alonso-Coello, Pablo

2017-08-30

Identifying scientific literature addressing patients' views and preferences is complex due to the wide range of studies that can be informative and the poor indexing of this evidence. Given the lack of guidance we developed a search strategy to retrieve this type of evidence. We assembled an initial list of terms from several sources, including the revision of the terms and indexing of topic-related studies and, methods research literature, and other relevant projects and systematic reviews. We used the relative recall approach, evaluating the capacity of the designed search strategy for retrieving studies included in relevant systematic reviews for the topic. We implemented in practice the final version of the search strategy for conducting systematic reviews and guidelines, and calculated search's precision and the number of references needed to read (NNR). We assembled an initial version of the search strategy, which had a relative recall of 87.4% (yield of 132/out of 151 studies). We then added some additional terms from the studies not initially identified, and re-tested this improved version against the studies included in a new set of systematic reviews, reaching a relative recall of 85.8% (151/out of 176 studies, 95% CI 79.9 to 90.2). This final version of the strategy includes two sets of terms related with two domains: "Patient Preferences and Decision Making" and "Health State Utilities Values". When we used the search strategy for the development of systematic reviews and clinical guidelines we obtained low precision values (ranging from 2% to 5%), and the NNR from 20 to 50. This search strategy fills an important research gap in this field. It will help systematic reviewers, clinical guideline developers, and policy-makers to retrieve published research on patients' views and preferences. In turn, this will facilitate the inclusion of this critical aspect when formulating heath care decisions, including recommendations.

[The use of systematic review to develop a self-management program for CKD].

PubMed

Lee, Yu-Chin; Wu, Shu-Fang Vivienne; Lee, Mei-Chen; Chen, Fu-An; Yao, Yen-Hong; Wang, Chin-Ling

2014-12-01

Chronic kidney disease (CKD) has become a public health issue of international concern due to its high prevalence. The concept of self-management has been comprehensively applied in education programs that address chronic diseases. In recent years, many studies have used self-management programs in CKD interventions and have investigated the pre- and post-intervention physiological and psychological effectiveness of this approach. However, a complete clinical application program in the self-management model has yet to be developed for use in clinical renal care settings. A systematic review is used to develop a self-management program for CKD. Three implementation steps were used in this study. These steps include: (1) A systematic literature search and review using databases including CEPS (Chinese Electronic Periodical Services) of Airiti, National Digital Library of Theses and Dissertations in Taiwan, CINAHL, Pubmed, Medline, Cochrane Library, and Joanna Briggs Institute. A total of 22 studies were identified as valid and submitted to rigorous analysis. Of these, 4 were systematic literature reviews, 10 were randomized experimental studies, and 8 were non-randomized experimental studies. (2) Empirical evidence then was used to draft relevant guidelines on clinical application. (3) Finally, expert panels tested the validity of the draft to ensure the final version was valid for application in practice. This study designed a self-management program for CKD based on the findings of empirical studies. The content of this program included: design principles, categories, elements, and the intervention measures used in the self-management program. This program and then was assessed using the content validity index (CVI) and a four-point Liker's scale. The content validity score was .98. The guideline of self-management program to CKD was thus developed. This study developed a self-management program applicable to local care of CKD. It is hoped that the guidelines developed in this study offer a reference for clinical caregivers to improve their healthcare practices.

Comparison between diagnosis and treatment of community-acquired pneumonia in children in various medical centres across Europe with the United States, United Kingdom and the World Health Organization guidelines.

PubMed

Usonis, Vytautas; Ivaskevicius, Rimvydas; Diez-Domingo, Javier; Esposito, Susanna; Falup-Pecurariu, Oana G; Finn, Adam; Rodrigues, Fernanda; Spoulou, Vana; Syrogiannopoulos, George A; Greenberg, David

2016-01-01

The aim of this study was to review the current status and usage of guidelines in the diagnosis and treatment of community-acquired pneumonia (CAP) in European countries and to compare to established guidelines in the United States (US), United Kingdom (UK), and the World Health Organization (WHO). A questionnaire was developed and distributed by the Community-Acquired Pneumonia Paediatric Research Initiative (CAP-PRI) working group and distributed to medical centres across Europe. Out of 19 European centres, 6 (31.6 %) used WHO guidelines (3 in combination with other guidelines), 5 (26.3 %) used national guidelines, and 5 (26.3 %) used local guidelines. Chest radiograph and complete blood count were the most common diagnostic examinations, while evaluation of clinical symptoms and laboratory tests varied significantly. Tachypnoea and chest recession were considered criteria for diagnosis in all three guidelines. In US and UK guidelines blood cultures, atypical bacterial and viral detection tests were recommended. In European centres in outpatient settings, amoxicillin was used in 16 (84 %) centers, clarithromycin in 9 (37 %) centers and azithromycin in 7 (47 %) centers, whereas in hospital settings antibiotic treatment varied widely. Amoxicillin is recommended as the first drug of choice for outpatient treatment in all guidelines. Although local variations in clinical criteria, laboratory tests, and antibiotic resistance rates may necessitate some differences in standard empirical antibiotic regimens, there is considerable scope for standardisation across European centres for the diagnosis and treatment of CAP.

Sustainable design guidelines to support the Washington State ferries terminal design manual : design guideline application and refinement.

DOT National Transportation Integrated Search

2013-08-01

The Sustainable Design Guidelines were developed in Phase I of this research program (WA-RD : 816.1). Here we are reporting on the Phase II effort that beta-tested the Phase I Guidelines on : example ferry terminal designs and refinements made ...

Cervical Cancer Screening Guideline Adherence Before and After Guideline Changes in Pennsylvania Medicaid.

PubMed

Parekh, Natasha; Donohue, Julie M; Men, Aiju; Corbelli, Jennifer; Jarlenski, Marian

2017-01-01

To assess changes in cervical cancer screening after the 2009 American College of Obstetricians and Gynecologists' guideline change and to determine predictors associated with underscreening and overscreening among Medicaid-enrolled women. We performed an observational cohort study of Pennsylvania Medicaid claims from 2007 to 2013. We evaluated guideline adherence of 18- to 64-year-old continuously enrolled women before and after the 2009 guideline change. To define adherence, we categorized intervals between Pap tests as longer than (underscreening), within (appropriate screening), or shorter than (overscreening) guideline-recommended intervals (±6-month). We stratified results by age and assessed predictors of underscreening and overscreening through logistic regression. Among 29,650 women, appropriate cervical cancer screening significantly decreased after the guideline change (from 45% [95% confidence interval (CI) 44-46%] to 11% [95% CI 11-12%] among 17,360 younger than 30 year olds and from 27% [95% CI 26-28%] to 6% [95% CI 6-7%] among 12,290 women 30 years old or older). Overscreening significantly increased (from 6% [95% CI 5-6%] to 67% [95% CI 66-68%] in those younger than 30 years old and from 54% [95% CI 52-55%] to 65% [95% CI 64-67%] in those 30 years old or older), whereas underscreening significantly increased only in those 30 years old or older (from 20% [95% CI 19-21%] to 29% [95% CI 27-30%]). Pap tests after guideline change, pregnancy, Managed Care enrollment (in those younger than 30 years old), and black race (in those younger than 30 years old) were associated with underscreening. Pap tests after guideline change, more visits, more sexually transmitted infection testing, and white race (in those 30 years old or older) were associated with overscreening. We observed high rates of cervical cancer overscreening and underscreening and low rates of appropriate screening after the guideline change. Interventions should target both underscreening and overscreening to address these separate yet significant issues.

[Polish guidelines for the prevention and treatment of venous thromboembolism. 2012 update].

PubMed

Zawilska, Krystyna; Bała, Małgorzata M; Błędowski, Piotr; Chmielewski, Dariusz W; Dobrowolski, Zygmunt; Frączek, Mariusz; Frołow, Marzena; Gajewski, Piotr; Guzik, Tomasz; Jaeschke, Roman; Korman, Tomasz; Kotarski, Jan; Kozubski, Wojciech; Krawczyk, Marek; Kruszewski, Wiesław; Kulikowski, Jerzy; Kutaj-Wąsikowska, Halina; Mayzner-Zawadzka, Ewa; Mrozikiewicz, Przemysław M; Musiał, Jacek; Niżankowski, Rafał; Pasierski, Tomasz; Poręba, Ryszard; Tomkowski, Witold; Torbicki, Adam; Undas, Anetta; Urbanek, Tomasz; Wojtukiewicz, Marek Z; Woroń, Jarosław; Wroński, Jacek

2012-01-01

The overall objective of the Polish guidelines for the prevention and treatment of venous thromboembolism is to increase patient benefit and safety by appropriate prevention and treatment of deep vein thrombosis and pulmonary embolism as well as proper management of the complications associated with antithrombotic and thrombolytic therapy. These guidelines apply to adult trauma, cancer, surgical, and medical patients as well as those at increased risk of venous thromboembolism. Specific recommendations have been formulated for pregnant women, patients requiring surgery while receiving long-term oral anticoagulant treatment, and patients undergoing regional anesthesia and/or analgesia. We chose to update the existing Polish guidelines with the use of the most recent high-quality international guidelines that we identified and adjusted the final product to Polish cultural and organizational setting. We based our recommendations primarily on the 9th edition of the American College of Chest Physicians Evidence-Based Clinical Practice Guidelines on Antithrombotic Therapy and Prevention of Thrombosis, the European Society of Cardiology Guidelines on the Diagnosis and Management of Acute Pulmonary Embolism, the 3rd edition of the American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines on Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy, the ACOG practice bulletin on thromboembolism in pregnancy (Number 123), and Guidance from the Scientific and Standardisation Committee of the International Society on Thrombosis and Haemostasis on the Duration of Anticoagulant Therapy after a First Episode of Unprovoked Pulmonary Embolus or Deep Vein Thrombosis, as well as two other Polish practice guidelines on the prophylaxis and treatment of venous thromboembolism and the management of patients treated with oral direct inhibitors of factor X or factor II. To make recommendations regarding specific management issues that had not been addressed in other guidelines, or whenever the panel members felt they needed additional information to reach the decision, we also consulted the authors of guidelines developed by other professional societies and organizations as well as additional sources of evidence. For each adapted recommendation, we explicitly assessed its relevance and applicability in the context of the healthcare system in Poland. When necessary, we explicitly stated the rationale for modification of the previously published recommendations and judgements about the values and preferences we assumed. The information regarding reimbursement of drugs mentioned in the recommendations was added in chapters 6-9 and 13 and approved by the National Health Fund. The final version of the practice guidelines was officially approved by the scientific societies and institutions listed at the beginning of the document.  

Health Information in Bengali (Bangla / বাংলা)

MedlinePlus

... Society Guidelines for the Early Detection of Cancer - English PDF American Cancer Society Guidelines for the Early ... Screening It's a Simple Test - Cervical Cancer Screening - English PDF It's a Simple Test - Cervical Cancer Screening - ...

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

PubMed

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

2015-02-01

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

Cervical cancer screening among women who attend sexually transmitted diseases (STD) clinics: background paper for 2010 STD Treatment Guidelines.

PubMed

Datta, S Deblina; Saraiya, Mona

2011-12-01

In April 2008, experts reviewed updates on sexually transmitted disease (STD) prevention and treatment in preparation for the revision of the Centers for Disease Control and Prevention (CDC) STD Treatment Guidelines. This included a review of cervical cancer screening in the STD clinical setting. Key questions were identified with assistance from an expert panel. Reviews of the literature were conducted using the PubMed computerized database and shared with the panel. Updated information was incorporated in the 2010 CDC STD Treatment Guidelines. We recommend that STD clinics offering cervical screening services screen and treat women according to guidelines by the American College of Obstetrics and Gynecology, the American Cancer Society, the US Preventive Services Task Force, and the American Society for Colposcopists and Cervical Pathologists. New to the 2010 guidelines are higher age for initiating cervical screening (age ≥ 21 years) and less frequent intervals of screening (at least every 3 years). New recommendations include new technologies, such as liquid-based cytology and high-risk human papillomavirus (HPV) DNA tests. Liquid-based technologies are not recommended over conventional testing. HPV DNA tests are recommended as adjunct tests and with new indications for use in cervical screening and management. Stronger recommendations were issued for STD clinics offering cervical screening services to have protocols in place for follow-up of test results and referral (eg, colposcopy). Important additions to the 2010 STD Treatment Guidelines include information on updated algorithms for screening and management of women and recommendations for use of liquid-based cytology and high-risk HPV testing.

[Guidelines for psychology activities in cardiologic rehabilitation and prevention].

PubMed

2003-09-01

The purpose of these guidelines is to provide specific recommendations in regard to psychological activities in cardiac rehabilitation (CR). Based on scientific evidence and clinical experience, the present guidelines are targeted for psychologists working in the field of cardiac rehabilitation and for the core component of CR, as well as for the health care providers, insurers, policy makers and consumers. In the introduction, the framework of Italian cardiac rehabilitation and psychology as well as the methodology used are defined, in accordance with the recommendations of the National Guidelines Programme of the Italian Health Ministry. The first section illustrates the educational training and structural requirements necessary for psychologists intending to work in cardiac rehabilitation, and provides a summary of the principal models of organization. Section two describes the sequence of psychological activities based on the different phases of the process of care. The chapters devoted to selection and admission of cardiac patients define the clinical conditions for which patients should be referred to the psychologist and describe the models for the first "patient-psychologist" contact. The chapter dedicated to evaluation, which aims to identify the care needs of the patient describes the instruments available to the psychologist (interview, screening tests, clinical assessment tests, quality-of-life tests) and the areas of investigation in cardiac diseases patients. The chapter on intervention analyses the different tools including educational interventions, counselling, stress management and psychotherapy evidenced by the literature and common to the different cardiac pathologies. In the chapter on follow-up, are described tools for evaluation of patient satisfaction and for planning long-term care. Section three describes the psychological characterization and the specificity of psychological interventions in different cardiac patients populations: patients with ischemic heart disease, patients after cardiac surgery, patients with chronic heart failure, patients after heart transplantation, patients with chronic peripheral artery disease, patients with pace-maker or implantable cardioverter defibrillator, high risk patients for cardiovascular disease, over 75 years of age and finally end-stage cardiac patients. The last section describes the processes of programme evaluation, audit and patient feedback as the main instruments recommended for continuous improvement of quality of psychological care in cardiac rehabilitation. The appendices contain a flow-chart describing the course of psychological interventions, a summary of recommendations for each cardiac condition and a glossary.

HIV testing in dermatology - a national audit.

PubMed

Esson, Gavin A; Holme, S A

2018-05-01

Forty percent of individuals have late-stage HIV at the time of diagnosis, resulting in increased morbidity. Identifying key diseases which may indicate HIV infection can prompt clinicians to trigger testing, which may result in more timely diagnosis. The British HIV Association has published guidelines on such indicator diseases in dermatology. We audited the practice of HIV testing in UK dermatologists and General Practitioners (GPs) and compared results with the national guidelines. This audit showed that HIV testing in key indicator diseases remains below the standard set out by the national guidelines, and that GPs with special interest in dermatology have a lower likelihood for testing, and lower confidence when compared to consultants, registrars and associate specialists. Large proportions of respondents believed further training in HIV testing would be beneficial.

77 FR 1708 - Center for Substance Abuse Prevention; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-11

... Abuse Prevention (CSAP) Drug Testing Advisory Board (DTAB) will meet on January 31 and February 1, 2012... opioids as potential analytes in the Mandatory Guidelines for Federal Workplace Drug Testing Programs. The... Guidelines for Federal Workplace Drug Testing Programs. This portion of the meeting is closed to the public...

Considerations for a Proton Single Event Effects (SEE) Guideline

NASA Technical Reports Server (NTRS)

LaBel, Kenneth A.

2010-01-01

The intent of this document is to provide guidance on when and what type of -SEE tests should be performed on a device under test (OUT) based on orbit, technology, existing data, and application. It is NOT intended to provide a detailed guideline for how to perform proton SEE radiation tests on electronics.

Applying EALTA Guidelines as Baseline for the Foreign Language Proficiency Test in Turkey: The Case of YDS

ERIC Educational Resources Information Center

Kavakli, Nurdan; Arslan, Sezen

2017-01-01

Within the scope of educational testing and assessment, setting standards and creating guidelines as a code of practice provide more prolific and sustainable outcomes. In this sense, internationally accepted and regionally accredited principles are suggested for standardization in language testing and assessment practices. Herein, ILTA guidelines…

Considerations for a Proton Single Event Effects (SEE) Guideline

NASA Technical Reports Server (NTRS)

LaBel, Kenneth A.

2010-01-01

The intent of this document is to provide guidance on when and what type of SEE tests should be performed on a device under test (DUT) based on orbit, technology, existing data, and application. It is NOT intended to provide a detailed guideline for how to perform proton SEE radiation tests on electronics.

Knowledge of tuberculosis management using directly observed treatment short course therapy among final year medical students in South Western Nigeria.

PubMed

Olakunle, Olarewaju Sunday; Oladimeji, Olanrewaju; Olalekan, Adebimpe Wasiu; Olugbenga-Bello, Adenike; Akinleye, Callistus; Oluwatoyin, Olarewaju Abiodun

2014-01-01

Equipping medical graduates with the competence to manage tuberculosis is not just imperative but also urgent as the diseases have been consistently listed as one of the major causes of morbidity and mortality in Nigeria. However, there were no baseline studies done on knowledge of final year medical students on various aspects of TB diagnosis and management under directly observed treatment short course therapy (DOTS) which forms the basis of this study. A total of 241 final year medical students from three medical colleges in Nigeria were interviewed. The questions assessed their knowledge about various modes of transmission, symptoms and management of tuberculosis under DOTS. More than half of the respondents (i.e. 69%) had poor knowledge on TB disease. Only 33.6% mentioned sputum smear as the best tool of diagnosing TB according to guideline. Poor knowledge was also exhibited when asked of various categories under DOTS treatment regimen, as 46.1% correctly mentioned cat 1 and 2. Minority 18.7% and 6.7% had complete knowledge of 6 months duration for new TB cases and 8 months for re-treatment cases respectively. Less than one tenth, i.e. 4.6% and 2.9% could correctly defined what is called a new TB case and re-treatment cases according to standard guideline. The study reveals gross inadequacies in TB knowledge and management practices among Nigerian final year medical students. There is urgent need for incorporation of National TB guideline into existing undergraduate medical education curriculum as well as students rotation through activities in DOTS clinic.

Evaluation of Internet-Based Clinical Decision Support Systems

PubMed Central

Thomas, Karl W; Dayton, Charles S

1999-01-01

Background Scientifically based clinical guidelines have become increasingly used to educate physicians and improve quality of care. While individual guidelines are potentially useful, repeated studies have shown that guidelines are ineffective in changing physician behavior. The Internet has evolved as a potentially useful tool for guideline education, dissemination, and implementation because of its open standards and its ability to provide concise, relevant clinical information at the location and time of need. Objective Our objective was to develop and test decision support systems (DSS) based on clinical guidelines which could be delivered over the Internet for two disease models: asthma and tuberculosis (TB) preventive therapy. Methods Using open standards of HTML and CGI, we developed an acute asthma severity assessment DSS and a preventative tuberculosis treatment DSS based on content from national guidelines that are recognized as standards of care. Both DSS's are published on the Internet and operate through a decision algorithm developed from the parent guidelines with clinical information provided by the user at the point of clinical care. We tested the effectiveness of each DSS in influencing physician decisions using clinical scenario testing. Results We first validated the asthma algorithm by comparing asthma experts' decisions with the decisions reached by nonpulmonary nurses using the computerized DSS. Using the DSS, nurses scored the same as experts (89% vs. 88%; p = NS). Using the same scenario test instrument, we next compared internal medicine residents using the DSS with residents using a printed version of the National Asthma Education Program-2 guidelines. Residents using the computerized DSS scored significantly better than residents using the paper-based guidelines (92% vs. 84%; p <0.002). We similarly compared residents using the computerized TB DSS to residents using a printed reference card; the residents using the computerized DSS scored significantly better (95.8% vs. 56.6% correct; p<0.001). Conclusions Previous work has shown that guidelines disseminated through traditional educational interventions have minimal impact on physician behavior. Although computerized DSS have been effective in altering physician behavior, many of these systems are not widely available. We have developed two clinical DSS's based on national guidelines and published them on the Internet. Both systems improved physician compliance with national guidelines when tested in clinical scenarios. By providing information that is coupled to relevant activity, we expect that these widely available DSS's will serve as effective educational tools to positively impact physician behavior. PMID:11720915

Managing work-related psychological complaints by general practitioners, in coordination with occupational physicians: a pilot study.

PubMed

Buijs, Peter C; van Dijk, Frank J H; Evers, Marÿe; vd Klink, Jacques J L; Anema, Han

2007-01-01

Increasingly, workers have psychological work-related complaints, endangering their work ability and causing considerable economic losses. Many employees consult their general practitioner (GP). He, however, often pays insufficient attention to work-relatedness or to coordination with occupational physicians (OPs). Appropriate guidelines are missing. Consequently, we developed a GP guideline to handle these problems in coordination with OPs, and tested it in a pilot, using an explorative, evaluative study design. 23 GPs were trained to include employed patients and to test the guideline. Patients received questionnaires after 0, 4, 10 and 30 wk, GPs after 4 and 30 wk. The result was a new guideline, regarding problem orientation, diagnosis and advice, meant to avoid contradictory GP-OP advice and to activate patient responsibility. It included a GP-OP-patient communication form concerning information exchange and harmonization of insight/advice. Implementing GPs concluded that the guideline promotes recovery and work resumption and OP-GP contact benefits patients, prevents conflicting advice and promotes agreement on task division. They judged guideline efficiency and OP commitment less positively. Patients were positive, especially about GP-OP contact. Accordingly, an improved guideline, when tested for its effectiveness in a Randomized Controlled Trial, can help GPs to cope with a growing, complex problem, in collaboration with their occupational colleagues.

Familial Hypercholesterolemia: A Systematic Review of Guidelines on Genetic Testing and Patient Management.

PubMed

Migliara, Giuseppe; Baccolini, Valentina; Rosso, Annalisa; D'Andrea, Elvira; Massimi, Azzurra; Villari, Paolo; De Vito, Corrado

2017-01-01

Familial hypercholesterolemia (FH) is an autosomal-dominant hereditary disorder of lipid metabolism that causes lifelong exposure to increased LDL levels resulting in premature coronary heart disease and, if untreated, death. Recent studies have shown its prevalence to be higher than previously considered, which has important implications for the mortality and morbidity of associated cardiovascular disease (CVD). Several clinical tools are used worldwide to help physicians diagnose FH, but nevertheless most patients remain undetected. This systematic review of guidelines aims to assess the role of genetic testing in the screening, diagnosis, and management of patients affected by heterozygous or homozygous FH and to identify related health-care pathways. We performed a systematic review of the literature; inclusion criteria were English or Italian guidelines focusing on genetic testing. The guidelines were included and evaluated for their content and development process using the Appraisal of Guidelines for Research and Evaluation II instrument. Ten guidelines were considered eligible, and all were judged to be of good quality, with slight differences among them. The most common indications for performing genetic tests were high levels of cholesterol, or physical findings consistent with lipid disorder, in the subject or in the family history. Subsequent screening of family members was indicated when a mutation had been identified in the index patient. Regarding patient management, the various guidelines agreed that intensive treatment with lipid-lowering medications should begin as quickly as possible and that lifestyle modifications should be an integral part of the therapy. Since the early detection of affected patients is beneficial for effective prevention of CVD, genetic testing is particularly useful for identifying family members via cascade screening and for distinguishing between heterozygous and homozygous individuals, the latter of which require more extreme therapeutic intervention.

76 FR 15703 - Standards of Performance for New Stationary Sources and Emission Guidelines for Existing Sources...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-21

...This action promulgates EPA's final response to the 2001 voluntary remand of the December 1, 2000, new source performance standards and emission guidelines for commercial and industrial solid waste incineration units and the vacatur and remand of several definitions by the District of Columbia Circuit Court of Appeals in 2007. In addition, this action includes the 5-year technology review of the new source performance standards and emission guidelines required under section 129 of the Clean Air Act. This action also promulgates other amendments that EPA believes are necessary to address air emissions from commercial and industrial solid waste incineration units.

Reconciling the clinical practice guidelines on Bell's palsy from the AAO-HNSF and the AAN.

PubMed

Schwartz, Seth R; Jones, Stephanie L; Getchius, Thomas S D; Gronseth, Gary S

2014-05-01

Bell's palsy, named after the Scottish anatomist, Sir Charles Bell, is the most common acute mononeuropathy, or disorder affecting a single nerve, and is the most common diagnosis associated with facial nerve weakness/paralysis. In the past 2 years, both the American Academy of Neurology (AAN) and the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) have published clinical practice guidelines aimed to improve the quality of care and outcomes for patients diagnosed with Bell's palsy. This commentary aims to address the similarities and differences in the scope and final recommendations made by each guideline development group.

Information and Communication Technology (ICT) Standards and Guidelines. Final rule.

PubMed

2017-01-18

We, the Architectural and Transportation Barriers Compliance Board (Access Board or Board), are revising and updating, in a single rulemaking, our standards for electronic and information technology developed, procured, maintained, or used by Federal agencies covered by section 508 of the Rehabilitation Act of 1973, as well as our guidelines for telecommunications equipment and customer premises equipment covered by Section 255 of the Communications Act of 1934. The revisions and updates to the section 508-based standards and section 255-based guidelines are intended to ensure that information and communication technology covered by the respective statutes is accessible to and usable by individuals with disabilities.

Guidelines for European workplace drug testing in oral fluid.

PubMed

Cooper, Gail; Moore, Christine; George, Claire; Pichini, Simona

2011-05-01

Over the past decade, oral fluid has established itself as a robust testing matrix for monitoring drug use or misuse. Commercially available collection devices provide opportunities to collect and test oral fluid by the roadside and near-patient testing with both clinical and criminal justice applications. One of the main advantages of oral fluid relates to the collection of the matrix which is non-invasive, simple, and can be carried out under direct observation making it ideal for workplace drug testing. Laboratories offering legally defensible oral fluid workplace drug testing must adhere to national and international quality standards (ISO/IEC 17025); however, these standards do not address issues specific to oral fluid testing. The European Workplace Drug Testing Society (EWDTS) recognizes the importance of providing best practice guidelines to organizations offering testing and those choosing to use oral fluid drug testing to test their employees. The aim of this paper is to present the EWDTS guidelines for oral fluid workplace drug testing. Copyright © 2011 John Wiley & Sons, Ltd.

National Health Guidelines in I.R of Iran, an Innovative Approach for Developing Countries

PubMed Central

Esmaeil Akbari, Mohammad; Mohammadi, Gohar; Vosoogh-Moghaddam, Abbas; Rabanikhah, Fahimeh; Javadi, Hamideh; Rostami-Gooran, Narges; Safaei, Asal; Akbari, Atieh

2015-01-01

Background Guidelines have produced and used in complex environment of health care system with its ethical, economical, legal and other aspects; that should be taken into account in any country. Modifying the format and content of guidelines might facilitate their usage and lead to improved quality of care and cost containment. We have produced this tool for explained above purpose. Methods A coordinating national team has settled at the office of minster of health and medical education, supported by a guideline review committee. An innovative and appropriate approach for adapting national health guidelines has consisted of eight steps, have defined For preparing the draft of each guideline a technical team which, including main author, her/his co-workers have nominated. The authors of each topic have systematically searched databases of the proposed Twenty-two International Sites, and then have selected at least five sources of them that were more relevant. The final recommendations have proposed by agreement of technical team and Guideline Review Committee. Results In less than 5 months, more than 500 authors in whole country have selected to prepare guidelines and, approximately 150 guidelines have provided in three volumes of the published and distributed book. Each guideline had a national ID number, constant forever; all topics should be reviewed every 3-5 years. Conclusion National health guideline(s) would be essential means for policy making in health system and increased the cost containment and quality of care. Ministry of Health and Medical Education should provide and distribute the guidelines based on its accountability to legal responsibility. PMID:25960845

National health guidelines in I.R of iran, an innovative approach for developing countries.

PubMed

Esmaeil Akbari, Mohammad; Mohammadi, Gohar; Vosoogh-Moghaddam, Abbas; Rabanikhah, Fahimeh; Javadi, Hamideh; Rostami-Gooran, Narges; Safaei, Asal; Akbari, Atieh

2015-01-01

Guidelines have produced and used in complex environment of health care system with its ethical, economical, legal and other aspects; that should be taken into account in any country. Modifying the format and content of guidelines might facilitate their usage and lead to improved quality of care and cost containment. We have produced this tool for explained above purpose. A coordinating national team has settled at the office of minster of health and medical education, supported by a guideline review committee. An innovative and appropriate approach for adapting national health guidelines has consisted of eight steps, have defined For preparing the draft of each guideline a technical team which, including main author, her/his co-workers have nominated. The authors of each topic have systematically searched databases of the proposed Twenty-two International Sites, and then have selected at least five sources of them that were more relevant. The final recommendations have proposed by agreement of technical team and Guideline Review Committee. In less than 5 months, more than 500 authors in whole country have selected to prepare guidelines and, approximately 150 guidelines have provided in three volumes of the published and distributed book. Each guideline had a national ID number, constant forever; all topics should be reviewed every 3-5 years. National health guideline(s) would be essential means for policy making in health system and increased the cost containment and quality of care. Ministry of Health and Medical Education should provide and distribute the guidelines based on its accountability to legal responsibility.

Current status of accreditation for drug testing in hair.

PubMed

Cooper, Gail; Moeller, Manfred; Kronstrand, Robert

2008-03-21

At the annual meeting of the Society of Hair Testing in Vadstena, Sweden in 2006, a committee was appointed to address the issue of guidelines for hair testing and to assess the current status of accreditation amongst laboratories offering drug testing in hair. A short questionnaire was circulated amongst the membership and interested parties. Fifty-two responses were received from hair testing laboratories providing details on the amount and type of hair tests they offered and the status of accreditation within their facilities. Although the vast majority of laboratories follow current guidelines (83%), only nine laboratories were accredited to ISO/IEC 17025 for hair testing. A significant number of laboratories reporting that they were in the process of developing quality systems with a view to accrediting their methods within 2-3 years. This study provides an insight into the status of accreditation in hair testing laboratories and supports the need for guidelines to encourage best practice.

Affordable Development and Qualification Strategy for Nuclear Thermal Propulsion

NASA Technical Reports Server (NTRS)

Gerrish, Harold P., Jr.; Doughty, Glen E.; Bhattacharyya, Samit K.

2013-01-01

Nuclear Thermal Propulsion (NTP) is a concept which uses a nuclear reactor to heat a propellant to high temperatures without combustion and can achieve significantly greater specific impulse than chemical engines. NTP has been considered many times for human and cargo missions beyond low earth orbit. A lot of development and technical maturation of NTP components took place during the Rover/NERVA program of the 60's and early 70's. Other NTP programs and studies followed attempting to further mature the NTP concept and identify a champion customer willing to devote the funds and support the development schedule to a demonstration mission. Budgetary constraints require the use of an affordable development and qualification strategy that takes into account all the previous work performed on NTP to construct an existing database, and include lessons learned and past guidelines followed. Current guidelines and standards NASA uses for human rating chemical rocket engines is referenced. The long lead items for NTP development involve the fuel elements of the reactor and ground testing the engine system, subsystem, and components. Other considerations which greatly impact the development plans includes the National Space Policy, National Environmental Policy Act, Presidential Directive/National Security Council Memorandum #25 (Scientific or Technological Experiments with Possible Large-Scale Adverse Environmental Effects and Launch of Nuclear Systems into Space), and Safeguards and Security. Ground testing will utilize non-nuclear test capabilities to help down select components and subsystems before testing in a nuclear environment to save time and cost. Existing test facilities with minor modifications will be considered to the maximum extent practical. New facilities will be designed to meet minimum requirements. Engine and test facility requirements are based on the driving mission requirements with added factors of safety for better assurance and reliability. Emphasis will be placed on small engines, since the smaller the NTP engine, the easier it is to transport, assemble/disassemble, and filter the exhaust during tests. A new ground test concept using underground bore holes (modeled after the underground nuclear test program) to filter the NTP engine exhaust is being considered. The NTP engine system design, development, test, and evaluation plan includes many engine components and subsystems, which are very similar to those used in chemical engines, and can be developed in conjunction with them Other less mature NTP engine components and subsystems (e.g., reactor) will be thoroughly analyzed and tested to acceptable levels recommended by the referenced standards and guidelines. The affordable development strategy also considers a prototype flight test, as a final step in the development process. Preliminary development schedule estimates show that an aggressive development schedule (without much margin) will be required to be flight ready for a 2033 human mission to Mars.

Evidence-based practice guideline: wheelchair biking for the treatment of depression.

PubMed

Fitzsimmons, Suzanne; Schoenfelder, Deborah Perry

2011-07-01

Depression is a problem that will continue to burden older adults and challenge health care providers. Failing to recognize and effectively treat depression in institutionalized older adults is sanctioning these members of society to live their final years in despair and emotional suffering. The wheelchair biking program described in this evidence-based practice guideline provides a refreshing, safe, innovative tool to address depression and improve quality of life in older adults.

Revised Bethesda Guidelines for Hereditary Nonpolyposis Colorectal Cancer (Lynch Syndrome) and Microsatellite Instability

PubMed Central

Umar, Asad; Boland, C. Richard; Terdiman, Jonathan P.; Syngal, Sapna; de la Chapelle, Albert; Rüschoff, Josef; Fishel, Richard; Lindor, Noralane M.; Burgart, Lawrence J.; Hamelin, Richard; Hamilton, Stanley R.; Hiatt, Robert A.; Jass, Jeremy; Lindblom, Annika; Lynch, Henry T.; Peltomaki, Païvi; Ramsey, Scott D.; Rodriguez-Bigas, Miguel A.; Vasen, Hans F. A.; Hawk, Ernest T.; Barrett, J. Carl; Freedman, Andrew N.; Srivastava, Sudhir

2010-01-01

Hereditary nonpolyposis colorectal cancer (HNPCC), also known as Lynch syndrome, is a common autosomal dominant syndrome characterized by early age at onset, neoplastic lesions, and microsatellite instability (MSI). Because cancers with MSI account for approximately 15% of all colorectal cancers and because of the need for a better understanding of the clinical and histologic manifestations of HNPCC, the National Cancer Institute hosted an international workshop on HNPCC in 1996, which led to the development of the Bethesda Guidelines for the identification of individuals with HNPCC who should be tested for MSI. To consider revision and improvement of the Bethesda Guidelines, another HNPCC workshop was held at the National Cancer Institute in Bethesda, MD, in 2002. In this commentary, we summarize the Workshop presentations on HNPCC and MSI testing; present the issues relating to the performance, sensitivity, and specificity of the Bethesda Guidelines; outline the revised Bethesda Guidelines for identifying individuals at risk for HNPCC; and recommend criteria for MSI testing. PMID:14970275

Determinants of Practice Patterns and Quality Gaps in Lung Cancer Staging and Diagnosis

PubMed Central

Niu, Jiangong; Elting, Linda S.; Buchholz, Thomas A.; Giordano, Sharon H.

2014-01-01

Background: Guidelines recommend mediastinal lymph node sampling as the first invasive diagnostic procedure in patients with suspected lung cancer with mediastinal lymphadenopathy without distant metastases. Methods: Patients were a retrospective cohort of 15,316 patients with lung cancer with regional spread without metastatic disease in the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) or Texas Cancer Registry Medicare-linked databases. Patients were categorized based on the sequencing of invasive diagnostic tests performed: (1) evaluation consistent with guidelines, mediastinal sampling done first; (2) evaluation inconsistent with guidelines, non-small cell lung cancer (NSCLC) present, mediastinal sampling performed but not as part of the first invasive test; (3) evaluation inconsistent with guidelines, NSCLC present, mediastinal sampling never done; and (4) evaluation inconsistent with guidelines, small cell lung cancer. The primary outcome was whether guideline-consistent care was delivered. Secondary outcomes included whether patients with NSCLC ever had mediastinal sampling and use of transbronchial needle aspiration (TBNA) among pulmonologists. Results: Only 21% of patients had a diagnostic evaluation consistent with guidelines. Only 56% of patients with NSCLC had mediastinal sampling prior to treatment. There was significant regional variability in guideline-consistent care (range, 12%-29%). Guideline-consistent care was associated with lower patient age, metropolitan areas, and if the physician ordering or performing the test was male, trained in the United States, had seen more patients with lung cancer, and was a pulmonologist or thoracic surgeon who had graduated more recently. More recent pulmonary graduates were also more likely to perform TBNA (P < .001). Conclusions: Guideline-consistent care varied regionally and was associated with physician-level factors, suggesting that a lack of effective physician training may be contributing to the quality gaps observed. PMID:24202651

Guidelines for cone penetration test : performance and design

DOT National Transportation Integrated Search

1978-07-01

This manual presents procedures and guidelines applicable to the use of the cone penetration test. Dr. Schmertmann prepared this manual in February 1977 and made minor additions in May 1978. It represents his interpretation of the state-of-the-art in...

Guidelines for Guidelines: Are They Up to the Task? A Comparative Assessment of Clinical Practice Guideline Development Handbooks

PubMed Central

Ansari, Shabnam; Rashidian, Arash

2012-01-01

Objectives We conducted a comparative review of clinical practice guideline development handbooks. We aimed to identify the main guideline development tasks, assign weights to the importance of each task using expert opinions and identify the handbooks that provided a comprehensive coverage of the tasks. Methods We systematically searched and included handbooks published (in English language) by national, international or professional bodies responsible for evidenced-based guideline development. We reviewed the handbooks to identify the main guideline development tasks and scored each handbook for each task from 0 (the handbook did not mention the task) to 2 (the task suitably addressed and explained), and calculated a weighted score for each handbook. The tasks included in over 75% of the handbooks were considered as ‘necessary’ tasks. Result Nineteen guideline development handbooks and twenty seven main tasks were identified. The guideline handbooks’ weighted scores ranged from 100 to 220. Four handbooks scored over 80% of the maximum possible score, developed by the National Institute for Health and Clinical Excellence, Swiss Centre for International Health, Scottish Intercollegiate Guidelines Network and World Health Organization. Necessary tasks were: selecting the guideline topic, determining the guideline scope, identifying relevant existing guidelines, involving the consumers, forming guideline development group,, developing clinical questions, systematic search for evidence, selecting relevant evidence, appraising identifies research evidence, making group decision, grading available evidence, creating recommendations, final stakeholder consultation, guideline implementation strategies, updating recommendations and correcting potential errors. Discussion Adequate details for evidence based development of guidelines were still lacking from many handbooks. The tasks relevant to ethical issues and piloting were missing in most handbooks. The findings help decision makers in identifying the necessary tasks for guideline development, provide an updated comparative list of guideline development handbooks, and provide a checklist to assess the comprehensiveness of guideline development processes. PMID:23189167

Quality of clinical practice guidelines in delirium: a systematic appraisal

PubMed Central

Marchington, Katie L; Agar, Meera; Davis, Daniel H J; Sikora, Lindsey; Tsang, Tammy W Y

2017-01-01

Objective To determine the accessibility and currency of delirium guidelines, guideline summary papers and evaluation studies, and critically appraise guideline quality. Design Systematic literature search for formal guidelines (in English or French) with focus on delirium assessment and/or management in adults (≥18 years), guideline summary papers and evaluation studies. Full appraisal of delirium guidelines published between 2008 and 2013 and obtaining a ‘Rigour of Development’ domain screening score cut-off of >40% using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. Data sources Multiple bibliographic databases, guideline organisation databases, complemented by a grey literature search. Results 3327 database citations and 83 grey literature links were identified. A total of 118 retrieved delirium guidelines and related documents underwent full-text screening. A final 21 delirium guidelines (with 10 being >5 years old), 12 guideline summary papers and 3 evaluation studies were included. For 11 delirium guidelines published between 2008 and 2013, the screening AGREE II ‘Rigour’ scores ranged from 3% to 91%, with seven meeting the cut-off score of >40%. Overall, the highest rating AGREE II domains were ‘Scope and Purpose’ (mean 80.1%, range 64–100%) and ‘Clarity and Presentation’ (mean 76.7%, range 38–97%). The lowest rating domains were ‘Applicability’ (mean 48.7%, range 8–81%) and ‘Editorial Independence’ (mean 53%, range 2–90%). The three highest rating guidelines in the ‘Applicability’ domain incorporated monitoring criteria or audit and costing templates, and/or implementation strategies. Conclusions Delirium guidelines are best sourced by a systematic grey literature search. Delirium guideline quality varied across all six AGREE II domains, demonstrating the importance of using a formal appraisal tool prior to guideline adaptation and implementation into clinical settings. Adding more knowledge translation resources to guidelines may improve their practical application and effective monitoring. More delirium guideline evaluation studies are needed to determine their effect on clinical practice. PMID:28283488

Dutch translation and cross-cultural validation of the Adult Social Care Outcomes Toolkit (ASCOT).

PubMed

van Leeuwen, Karen M; Bosmans, Judith E; Jansen, Aaltje Pd; Rand, Stacey E; Towers, Ann-Marie; Smith, Nick; Razik, Kamilla; Trukeschitz, Birgit; van Tulder, Maurits W; van der Horst, Henriette E; Ostelo, Raymond W

2015-05-13

The Adult Social Care Outcomes Toolkit was developed to measure outcomes of social care in England. In this study, we translated the four level self-completion version (SCT-4) of the ASCOT for use in the Netherlands and performed a cross-cultural validation. The ASCOT SCT-4 was translated into Dutch following international guidelines, including two forward and back translations. The resulting version was pilot tested among frail older adults using think-aloud interviews. Furthermore, using a subsample of the Dutch ACT-study, we investigated test-retest reliability and construct validity and compared response distributions with data from a comparable English study. The pilot tests showed that translated items were in general understood as intended, that most items were reliable, and that the response distributions of the Dutch translation and associations with other measures were comparable to the original English version. Based on the results of the pilot tests, some small modifications and a revision of the Dignity items were proposed for the final translation, which were approved by the ASCOT development team. The complete original English version and the final Dutch translation can be obtained after registration on the ASCOT website ( http://www.pssru.ac.uk/ascot ). This study provides preliminary evidence that the Dutch translation of the ASCOT is valid, reliable and comparable to the original English version. We recommend further research to confirm the validity of the modified Dutch ASCOT translation.

Clinical practice guidelines for the management of pregnancy in women with autoimmune rheumatic diseases of the Mexican College of Rheumatology. Part II.

PubMed

Saavedra Salinas, Miguel Ángel; Barrera Cruz, Antonio; Cabral Castañeda, Antonio Rafael; Jara Quezada, Luis Javier; Arce-Salinas, C Alejandro; Álvarez Nemegyei, José; Fraga Mouret, Antonio; Orozco Alcalá, Javier; Salazar Páramo, Mario; Cruz Reyes, Claudia Verónica; Andrade Ortega, Lilia; Vera Lastra, Olga Lidia; Mendoza Pinto, Claudia; Sánchez González, Antonio; Cruz Cruz, Polita Del Rocío; Morales Hernández, Sara; Portela Hernández, Margarita; Pérez Cristóbal, Mario; Medina García, Gabriela; Hernández Romero, Noé; Velarde Ochoa, María Del Carmen; Navarro Zarza, José Eduardo; Portillo Díaz, Verónica; Vargas Guerrero, Angélica; Goycochea Robles, María Victoria; García Figueroa, José Luis; Barreira Mercado, Eduardo; Amigo Castañeda, Mary Carmen

2015-01-01

Pregnancy in women with autoimmune rheumatic diseases is associated with several maternal and fetal complications. The development of clinical practice guidelines with the best available scientific evidence may help standardize the care of these patients. To provide recommendations regarding prenatal care, treatment, and a more effective monitoring of pregnancy in women with lupus erythematosus, rheumatoid arthritis (RA) and antiphospholipid syndrome (APS). Nominal panels were formed for consensus, systematic search of information, development of clinical questions, processing and staging of recommendations, internal validation by peers and external validation of the final document. The quality criteria of the AGREE II instrument were followed. The panels answered 37 questions related to maternal and fetal care in lupus erythematosus, RA and APS, as well as for use of antirheumatic drugs during pregnancy and lactation. The recommendations were discussed and integrated into a final manuscript. Finally, the corresponding algorithms were developed. In this second part, the recommendations for pregnant women with RA, APS and the use of antirheumatic drugs during pregnancy and lactation are presented. We believe that the Mexican clinical practice guidelines for the management of pregnancy in women with RA and APS integrate the best available evidence for the treatment and follow-up of patients with these conditions. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Methods for Evaluating the Content, Usability, and Efficacy of Commercial Mobile Health Apps

PubMed Central

Silfee, Valerie J; Waring, Molly E; Boudreaux, Edwin D; Sadasivam, Rajani S; Mullen, Sean P; Carey, Jennifer L; Hayes, Rashelle B; Ding, Eric Y; Bennett, Gary G; Pagoto, Sherry L

2017-01-01

Commercial mobile apps for health behavior change are flourishing in the marketplace, but little evidence exists to support their use. This paper summarizes methods for evaluating the content, usability, and efficacy of commercially available health apps. Content analyses can be used to compare app features with clinical guidelines, evidence-based protocols, and behavior change techniques. Usability testing can establish how well an app functions and serves its intended purpose for a target population. Observational studies can explore the association between use and clinical and behavioral outcomes. Finally, efficacy testing can establish whether a commercial app impacts an outcome of interest via a variety of study designs, including randomized trials, multiphase optimization studies, and N-of-1 studies. Evidence in all these forms would increase adoption of commercial apps in clinical practice, inform the development of the next generation of apps, and ultimately increase the impact of commercial apps. PMID:29254914