Sample records for guidelines casefinding lists
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Ronaldson, Sarah; Adamson, Joy; Dyson, Lisa; Torgerson, David
2014-10-01
Randomized controlled trials (RCTs) are widely used in health care research to provide high-quality evidence of effectiveness of an intervention. However, sometimes a study does not require an RCT in order to answer its primary objective; a case-finding design may be more appropriate. The aim of this paper was to introduce a new study design that nests a waiting list RCT within a case-finding study. An example of the new study design is the DOC Study, which primarily aims to determine the diagnostic accuracy of lung function tests for chronic obstructive pulmonary disease. It also investigates the impact of lung function tests on smoking behaviour through use of a waiting list design. The first step of the study design is to obtain participants' consent. Individuals are then randomized to one of two groups; either the 'intervention now' group or the 'intervention later' group, that is, participants are placed on a waiting list. All participants receive the same intervention; the only difference between the groups is the timing of the intervention. The design addresses patient preference issues and recruitment issues that can arise in other trial designs. Potential limitations include differential attrition between study groups and potential demoralization for the 'intervention later' group. The 'waiting list case-finding trial' design is a valuable method that could be applied to case-finding studies; the design enables the case-finding component of a study to be maintained while simultaneously exploring additional hypotheses through conducting a trial. © 2014 John Wiley & Sons, Ltd.
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Summers, Rachael H; Sharmeen, Taniya; Lippiett, Kate; Gillett, Kate; Astles, Carla; Vu, Linh; Stafford-Watson, Mark; Bruton, Anne; Thomas, Mike; Wilkinson, Tom
2017-08-29
'Finding the missing millions' with chronic obstructive pulmonary disease became part of the Department of Health strategy for England in 2010. Targeted case-finding within primary care is one potential pro-active strategy, but currently little is known about the views of healthcare professionals on this approach. In this study, 36 healthcare professionals (12 GPs, 14 nurses, and 10 practice managers) from 34 UK practices participated in semi-structured telephone interviews about targeted case-finding. Interviews followed an interview guide, were audio-recorded, transcribed verbatim, coded and analysed using 'Framework Approach'. Most of those interviewed practiced opportunistic case-finding. The main perceived barriers to wider case-finding programmes were the resource implications associated with running such programmes and identifying more chronic obstructive pulmonary disease patients. Financial incentives, support from specialist clinicians, and comprehensive guidance were viewed as facilitators. While targeted case-finding is conceptually accepted by primary care staff, scepticism surrounding (1) the value of identifying those with mild disease and (2) the availability of effective targeted case-finding methods, may lead some to favour an opportunistic approach. Key concerns were a lack of unequivocal evidence for the relative benefits vs. disadvantages of diagnosing patients earlier, and resource constraints in an already over-burdened system. Barriers to practical implementation of case-finding studies may be addressed with financial, human and educational resources, such as additional staff to undertake searches and perform spirometry tests, and practical and educational support from specialist teams. SUPPORT NEEDED TO IDENTIFY THOSE UNDIAGNOSED: Additional staff and resources would facilitate targeted searches for patients showing symptoms of early-stage chronic lung disease. Chronic obstructive pulmonary disease (COPD) costs the UK economy billions of pounds each year, yet disparate symptoms mean patients aren't always diagnosed in the early, treatable stages of the disease. Recent guidelines suggest introducing 'targeted case-finding', where symptomatic patients with known risk factors are identified and approached for testing by doctors. Rachael Summers and colleagues at the University of Southampton analyzed the opinions of healthcare professionals on implementing targeted case-finding in primary care. While most of the 36 professionals interviewed agreed that diagnosing COPD earlier had clear benefits, concerns were raised regarding negative patient responses and increased stress for patients, alongside the added strain on already stretched resources. Employing independent staff and enhancing resources may facilitate such a program.
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Usefulness of symptoms to screen for celiac disease.
Rosén, Anna; Sandström, Olof; Carlsson, Annelie; Högberg, Lotta; Olén, Ola; Stenlund, Hans; Ivarsson, Anneli
2014-02-01
To describe the frequency of symptoms and associated conditions among screening-detected celiac disease (CD) cases and non-CD children and to evaluate questionnaire-based case-finding targeting the general population. In a population-based CD screening of 12-year-olds, children and their parents completed questionnaires on CD-associated symptoms and conditions before knowledge of CD status. Questionnaire data for those who had their CD detected in the screening (n = 153) were compared with those of children with normal levels of CD markers (n = 7016). Hypothetical case-finding strategies were also evaluated. Questionnaires were returned by 7054 (98%) of the children and by 6294 (88%) of their parents. Symptoms were as common among screening-detected CD cases as among non-CD children. The frequency of children with screening-detected CD was similar when comparing the groups with and without any CD-related symptoms (2.1% vs 2.1%; P = .930) or CD-associated conditions (3.6% vs 2.1%; P = .07). Case-finding by asking for CD-associated symptoms and/or conditions would have identified 52 cases (38% of all cases) at a cost of analyzing blood samples for 2282 children (37%) in the study population. The current recommended guidelines for finding undiagnosed CD cases, so-called active case-finding, fail to identify the majority of previously undiagnosed cases if applied in the general population of Swedish 12-year-olds. Our results warrant further studies on the effectiveness of CD case-finding in the pediatric population, both at the clinical and population-based levels.
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Owora, Arthur H; Carabin, Hélène; Reese, Jessica; Garwe, Tabitha
2016-09-01
Growing recognition of the interrelated negative outcomes associated with major depression disorder (MDD) among mothers and their children has led to renewed public health interest in the early identification and treatment of maternal MDD. Healthcare providers, however, remain unsure of the validity of existing case-finding instruments. We conducted a systematic review to identify the most valid maternal MDD case-finding instrument used in the United States. We identified articles reporting the sensitivity and specificity of MDD case-finding instruments based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) by systematically searching through three electronic bibliographic databases, PubMed, PsycINFO, and EMBASE, from 1994 to 2014. Study eligibility and quality were evaluated using the Standards for the Reporting of Diagnostic Accuracy studies and Quality Assessment of Diagnostic Accuracy Studies guidelines respectively. Overall, we retrieved 996 unduplicated articles and selected 74 for full-text review. Of these, 14 articles examining 21 different instruments were included in the systematic review. The 10 item Edinburgh Postnatal Depression Scale and Postpartum Depression Screening Scale had the most stable (lowest variation) and highest diagnostic performance during the antepartum and postpartum periods (sensitivity range: 0.63-0.94 and 0.67-0.95; specificity range: 0.83-0.98 and 0.68-0.97 respectively). Greater variation in diagnostic performance was observed among studies with higher MDD prevalence. Factors that explain greater variation in instrument diagnostic performance in study populations with higher MDD prevalence were not examined. Findings suggest that the diagnostic performance of maternal MDD case-finding instruments is peripartum period-specific. Published by Elsevier B.V.
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Burns, Risa B; Bates, Carol K; Hartzband, Pamela; Smetana, Gerald W
2016-06-07
In May 2015, the U.S. Preventive Services Task Force issued a guideline on screening for thyroid disease that included a systematic evidence review and an update of its 2004 recommendations. The review assessed the effect of treating screen-detected subclinical thyroid dysfunction on health outcomes. It found adequate evidence that treating subclinical hypothyroidism does not provide clinically meaningful improvements in blood pressure, body mass index, bone mineral density, lipid levels, or quality-of-life measures. The review also concluded that evidence was inadequate to determine whether screening for thyroid dysfunction reduced cardiovascular disease or related morbidity and mortality. In separate guidelines, the American Association of Clinical Endocrinologists and American Thyroid Association advocated aggressive case-finding and recommended screening persons with certain clinical conditions or characteristics rather than the general population. These societies argue that subclinical hypothyroidism adversely affects cardiovascular outcomes and thus merits case-finding. Here, 2 experts discuss their perspectives on whether treating subclinical hypothyroidism reduces morbidity and mortality, whether there are harms of treatment, and how they would balance the benefits and harms of treatment both in general and for a specific patient.
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Public Health Practice of Population-Based Birth Defects Surveillance Programs in the United States.
Mai, Cara T; Kirby, Russell S; Correa, Adolfo; Rosenberg, Deborah; Petros, Michael; Fagen, Michael C
2016-01-01
Birth defects remain a leading cause of infant mortality in the United States and contribute substantially to health care costs and lifelong disabilities. State population-based surveillance systems have been established to monitor birth defects, yet no recent systematic examination of their efforts in the United States has been conducted. To understand the current population-based birth defects surveillance practices in the United States. The National Birth Defects Prevention Network conducted a survey of US population-based birth defects activities that included questions about operational status, case ascertainment methodology, program infrastructure, data collection and utilization, as well as priorities and challenges for surveillance programs. Birth defects contacts in the United States, including District of Columbia and Puerto Rico, received the survey via e-mail; follow-up reminders via e-mails and telephone were used to ensure a 100% response rate. Forty-three states perform population-based surveillance for birth defects, covering approximately 80% of the live births in the United States. Seventeen primarily use an active case-finding approach and 26 use a passive case-finding approach. These programs all monitor major structural malformations; however, passive case-finding programs more often monitor a broader list of conditions, including developmental conditions and newborn screening conditions. Active case-finding programs more often use clinical reviewers, cover broader pregnancy outcomes, and collect more extensive information, such as family history. More than half of the programs (24 of 43) reported an ability to conduct follow-up studies of children with birth defects. The breadth and depth of information collected at a population level by birth defects surveillance programs in the United States serve as an important data source to guide public health action. Collaborative efforts at the state and national levels can help harmonize data collection and increase utility of birth defects programs.
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Martín, V; Domínguez, A; Alcaide, J
1997-01-01
In spanish prisons, tuberculosis is a serious problem of public health and health authorities don't take it seriously. To prove the efficiency of pulmonary tuberculosis case-finding on arrival at prison in order to get location resources in this activity. Cost-benefit analysis of a case-finding program compared with to wait for diagnostic to illness. The sensitivity of test was fixed in 80% and the specificity in 99.99%. The cost was based on market prices. Sensitivity analysis was done in every variables as well as tridimensional analysis in those one of more influence. The case-finding was efficient on prevalences of tuberculosis over 5 per mil. Its efficiency was hardly affected by discount social rates or the sensitivity of diagnostic tests. The prevalence of illness, the cost of diagnostic activities as well as the success of treatment and the specificity of diagnostic tests used had as influence on the efficiency model. The tridimensional analysis proved that the case-finding of pulmonary tuberculosis has efficiency on low prevalences (1 per thousand), provided the number of people cured is a 5% higher than the alternative one and the costs of case-finding less than 1,000 pesetas per subject. The case-finding pulmonary tuberculosis on arrival at prisons is of high efficiency. In a cost-opportunity situation (location of available resources, penitentiary and extrapenitentiary) the program is very efficacious taking into account the fact of higher prevalence of pulmonary tuberculosis in this people.
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Ronaldson, Sarah J; Dyson, Lisa; Clark, Laura; Hewitt, Catherine E; Torgerson, David J; Cooper, Brendan G; Kearney, Matt; Laughey, William; Raghunath, Raghu; Steele, Lisa; Rhodes, Rebecca; Adamson, Joy
2018-06-01
Early identification of chronic obstructive pulmonary disease (COPD) results in patients receiving appropriate management for their condition at an earlier stage in their disease. The determining the optimal approach to identifying individuals with chronic obstructive pulmonary disease (DOC) study was a case-finding study to enhance early identification of COPD in primary care, which evaluated the diagnostic accuracy of a series of simple lung function tests and symptom-based case-finding questionnaires. Current smokers aged 35 or more were invited to undertake a series of case-finding tools, which comprised lung function tests (specifically, spirometry, microspirometry, peak flow meter, and WheezoMeter) and several case-finding questionnaires. The effectiveness of these tests, individually or in combination, to identify small airways obstruction was evaluated against the gold standard of spirometry, with the quality of spirometry tests assessed by independent overreaders. The study was conducted with general practices in the Yorkshire and Humberside area, in the UK. Six hundred eighty-one individuals met the inclusion criteria, with 444 participants completing their study appointments. A total of 216 (49%) with good-quality spirometry readings were included in the analysis. The most effective case-finding tools were found to be the peak flow meter alone, the peak flow meter plus WheezoMeter, and microspirometry alone. In addition to the main analysis, where the severity of airflow obstruction was based on fixed ratios and percent of predicted values, sensitivity analyses were conducted by using lower limit of normal values. This research informs the choice of test for COPD identification; case-finding by use of the peak flow meter or microspirometer could be used routinely in primary care for suspected COPD patients. Only those testing positive to these tests would move on to full spirometry, thereby reducing unnecessary spirometric testing. © 2018 John Wiley & Sons, Ltd.
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Child health in complex emergencies.
Moss, William J.; Ramakrishnan, Meenakshi; Storms, Dory; Henderson Siegle, Anne; Weiss, William M.; Lejnev, Ivan; Muhe, Lulu
2006-01-01
Coordinated and effective interventions are critical for relief efforts to be successful in addressing the health needs of children in situations of armed conflict, population displacement, and/or food insecurity. We reviewed published literature and surveyed international relief organizations engaged in child health activities in complex emergencies. Our aim was to identify research needs and improve guidelines for the care of children. Much of the literature details the burden of disease and the causes of morbidity and mortality; few interventional studies have been published. Surveys of international relief organizations showed that most use World Health Organization (WHO), United Nations Children's Fund (UNICEF), and ministry of health guidelines designed for use in stable situations. Organizations were least likely to have formal guidelines on the management of asphyxia, prematurity, and infection in neonates; diagnosis and management of children with human immunodeficiency virus (HIV) infection; active case-finding and treatment of tuberculosis; paediatric trauma; and the diagnosis and management of mental-health problems in children. Guidelines often are not adapted to the different types of health-care workers who provide care in complex emergencies. Evidence-based, locally adapted guidelines for the care of children in complex emergencies should be adopted by ministries of health, supported by WHO and UNICEF, and disseminated to international relief organizations to ensure appropriate, effective, and uniform care. PMID:16501716
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Nishikiori, Nobuyuki; Van Weezenbeek, Catharina
2013-02-02
Despite the progress made in the past decade, tuberculosis (TB) control still faces significant challenges. In many countries with declining TB incidence, the disease tends to concentrate in vulnerable populations that often have limited access to health care. In light of the limitations of the current case-finding approach and the global urgency to improve case detection, active case-finding (ACF) has been suggested as an important complementary strategy to accelerate tuberculosis control especially among high-risk populations. The present exercise aims to develop a model that can be used for county-level project planning. A simple deterministic model was developed to calculate the number of estimated TB cases diagnosed and the associated costs of diagnosis. The model was designed to compare cost-effectiveness parameters, such as the cost per case detected, for different diagnostic algorithms when they are applied to different risk populations. The model was transformed into a web-based tool that can support national TB programmes and civil society partners in designing ACF activities. According to the model output, tuberculosis active case-finding can be a costly endeavor, depending on the target population and the diagnostic strategy. The analysis suggests the following: (1) Active case-finding activities are cost-effective only if the tuberculosis prevalence among the target population is high. (2) Extensive diagnostic methods (e.g. X-ray screening for the entire group, use of sputum culture or molecular diagnostics) can be applied only to very high-risk groups such as TB contacts, prisoners or people living with human immunodeficiency virus (HIV) infection. (3) Basic diagnostic approaches such as TB symptom screening are always applicable although the diagnostic yield is very limited. The cost-effectiveness parameter was sensitive to local diagnostic costs and the tuberculosis prevalence of target populations. The prioritization of appropriate target populations and careful selection of cost-effective diagnostic strategies are critical prerequisites for rational active case-finding activities. A decision to conduct such activities should be based on the setting-specific cost-effectiveness analysis and programmatic assessment. A web-based tool was developed and is available to support national tuberculosis programmes and partners in the formulation of cost-effective active case-finding activities at the national and subnational levels.
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Review of systems, physical examination, and routine tests for case-finding in ambulatory patients.
Boland, B J; Wollan, P C; Silverstein, M D
1995-04-01
The screening value of the comprehensive review of systems and the complete physical examination in detecting unsuspected diseases for which therapeutic interventions are initiated has not been formally studied in ambulatory patients. The medical records of 100 randomly selected adult patients who had an ambulatory general medical evaluation at the Mayo Clinic in 1990-1991 were surveyed to compare review of systems and physical examination with routine laboratory tests, chest radiography, and electrocardiography as case-finding maneuvers. The main outcome measure was the therapeutic yield of each case-finding maneuver, defined as the proportion of maneuvers leading to a new therapy for a new clinically important diagnosis. The utilization rate of routine tests in the 100 patients (mean age: 59 +/- 16 years; 58% women) was high, ranging from 77 to 98%. Overall, the case-finding maneuvers led to 36 unsuspected clinically important diagnoses and resulted in 25 new therapeutic interventions. Higher therapeutic yield was observed for review of systems (7%), physical examination (5%), and lipid screening (9.2%) than for chemistry group (2.2%), complete blood count (1.8%), thyroid tests (1.5%), urinalysis (1.1%), electrocardiography (0%), or chest radiography (0%). The number of therapeutic interventions was not associated with patient's age (P = 0.55), sex (P = 0.88), comorbidity (P = 0.30) or with the time interval since the last general medical evaluation (P = 0.12). Based on therapeutic yield, these data suggest that review of systems and physical examination are valuable case-finding maneuvers in the periodic medical evaluation of ambulatory patients.
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Taylor, Jennifer A; Gerwin, Daniel; Morlock, Laura; Miller, Marlene R
2011-12-01
To evaluate the need for triangulating case-finding tools in patient safety surveillance. This study applied four case-finding tools to error-associated patient safety events to identify and characterise the spectrum of events captured by these tools, using puncture or laceration as an example for in-depth analysis. Retrospective hospital discharge data were collected for calendar year 2005 (n=48,418) from a large, urban medical centre in the USA. The study design was cross-sectional and used data linkage to identify the cases captured by each of four case-finding tools. Three case-finding tools (International Classification of Diseases external (E) and nature (N) of injury codes, Patient Safety Indicators (PSI)) were applied to the administrative discharge data to identify potential patient safety events. The fourth tool was Patient Safety Net, a web-based voluntary patient safety event reporting system. The degree of mutual exclusion among detection methods was substantial. For example, when linking puncture or laceration on unique identifiers, out of 447 potential events, 118 were identical between PSI and E-codes, 152 were identical between N-codes and E-codes and 188 were identical between PSI and N-codes. Only 100 events that were identified by PSI, E-codes and N-codes were identical. Triangulation of multiple tools through data linkage captures potential patient safety events most comprehensively. Existing detection tools target patient safety domains differently, and consequently capture different occurrences, necessitating the integration of data from a combination of tools to fully estimate the total burden.
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[CBO guideline 'Osteoporosis' (second revision].
Pols, H A P; Wittenberg, J
2002-07-20
Risk factors for osteoporotic fractures that can be used for case-finding according to the recent guidelines from the Dutch Institute for Health Care Improvement (CBO) include: a vertebral fracture, a fracture past the age of 50, a positive family history, low body weight, severe immobility and the use of corticosteroids. Measurement of bone mineral density (BMD) is only recommended for case-finding and not for population screening. Measurement of the BMD is advised in women > or = 50 years of age with a fracture, women with a vertebral fracture regardless of age, women > or = 60 years of age with three of the following risk factors, and women > or = 70 years of age with two of the following risk factors: positive family history, low body weight and severe immobility. Persons with less than 1000-1200 mg calcium in their daily food who are using corticosteroids, persons with osteoporotic fractures and persons who are being treated with drugs for osteoporosis are eligible for calcium supplementation. Vitamin D supplementation is recommended for persons who do not come outdoors. For the drug treatment of osteoporosis in the first years after menopause, oestrogens, tibolone and raloxifene may be used. It is recommended that postmenopausal women with one or more osteoporotic vertebral fractures or an increased risk and a T-score below -2.5 be treated with a bisphosphonate. Patients who are expected to be treated with > or = 15 mg prednisolone equivalent per day for more than 3 months and postmenopausal women and older men (> or = 70) who will be treated with > or = 7.5 mg prednisolone equivalent per day should be started on a bisphosphonate as soon as possible. Other patients who will be treated with > or = 7.5 mg prednisolone equivalent per day should take a bisphosphonate if their Z-score is below -1 or their T-score is below -2.5.
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Harvey, Nicholas C.W.; McCloskey, Eugene V.; Mitchell, Paul J.; Dawson-Hughes, Bess; Pierroz, Dominique D.; Reginster, Jean-Yves; Rizzoli, René; Cooper, Cyrus; Kanis, John A.
2017-01-01
Introduction This narrative review considers the key challenges facing healthcare professionals and policymakers responsible for providing care to populations in relation to bone health. These challenges broadly fall into 4 distinct themes: Case-finding and management of individuals at high risk of fracturePublic awareness of osteoporosis and fragility fracturesReimbursement and health system policyEpidemiology of fracture in the developing world Methods Findings from cohort studies, randomised controlled trials, systematic reviews and meta-analyses, in addition to current clinical guidelines, position papers and national and international audits are summarised, with the intention of providing a prioritised approach to delivery of optimal bone health for all. Results Systematic approaches to case-finding individuals who are at high risk of sustaining fragility fractures are described. These include strategies and models of care intended to improve case-finding for individuals who have sustained fragility fractures, those undergoing treatment with medicines which have an adverse effect on bone health, and people who have diseases whereby bone loss and, consequently, fragility fractures are a common comorbidity. Approaches to deliver primary fracture prevention in a clinically effective and cost-effective manner are also explored. Public awareness of osteoporosis is low worldwide. If older people are to be more pro-active in the management of their bone health, that needs to change. Effective disease awareness campaigns have been implemented in some countries, but need to be undertaken in many more. A major need exists to improve awareness of the risk that osteoporosis poses to individuals who have initiated treatment, with the intention of improving adherence in the long-term. A multisector effort is also required to support patients and their clinicians to have meaningful discussions concerning the risk-benefit ratio of osteoporosis treatment. With regard to prioritisation of fragility fracture prevention in national policy, there is much to be done. In the developing world, robust epidemiological estimates of fracture incidence are required to inform policy development. Conclusion As the aging of the Baby Boomer generation is upon us, this review provides a comprehensive analysis of how bone health can be improved worldwide for all. PMID:28175979
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Screening and case-finding instruments for depression: a meta-analysis
Gilbody, Simon; Sheldon, Trevor; House, Allan
2008-01-01
Background Screening and case-finding has been proposed as a simple, quick and cheap method to improve the quality of care for depression. We sought to establish the effectiveness of screening in improving the recognition of depression, the management of depression and the outcomes of patients with depression. Methods We performed a Cochrane systematic review of randomized controlled trials conducted in nonmental health settings that included case-finding or screening instruments for depression. We conducted a meta-analysis and explored heterogeneity using meta-regression techniques. Results Sixteen studies with 7576 patients met our inclusion criteria. We found that the use of screening or case-finding instruments were associated with a modest increase in the recognition of depression by clinicians (relative risk [RR] 1.27, 95% confidence interval [CI] 1.02 to 1.59). Questionnaires, when administered to all patients and the results given to clinicians irrespective of baseline score, had no impact on recognition (RR 1.03, 95% CI 0.85 to 1.24). Screening or case finding increased the use of any intervention by a relative risk of 1.30 (95% CI 0.97 to 1.76). There was no evidence of influence on the prescription of antidepressant medications (RR 1.20, 95% CI 0.87 to 1.66). Seven studies provided data on outcomes of depression, and no evidence of an effect was found (standardized mean difference –0.02, 95% CI –0.25 to 0.20). Interpretation If used alone, case-finding or screening questionnaires for depression appear to have little or no impact on the detection and management of depression by clinicians. Recommendations to adopt screening strategies using standardized questionnaires without organizational enhancements are not justified. PMID:18390942
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Horvath, Karl; Semlitsch, Thomas; Jeitler, Klaus; Abuzahra, Muna E; Posch, Nicole; Domke, Andreas; Siebenhofer, Andrea
2016-01-01
Objectives Identification of sufficiently trustworthy top 5 list recommendations from the US Choosing Wisely campaign. Setting Not applicable. Participants All top 5 list recommendations available from the American Board of Internal Medicine Foundation website. Main outcome measures/interventions Compilation of US top 5 lists and search for current German highly trustworthy (S3) guidelines. Extraction of guideline recommendations, including grade of recommendation (GoR), for suggestions comparable to top 5 list recommendations. For recommendations without guideline equivalents, the methodological quality of the top 5 list development process was assessed using criteria similar to that used to judge guidelines, and relevant meta-literature was identified in cited references. Judgement of sufficient trustworthiness of top 5 list recommendations was based either on an ‘A’ GoR of guideline equivalents or on high methodological quality and citation of relevant meta-literature. Results 412 top 5 list recommendations were identified. For 75 (18%), equivalents were found in current German S3 guidelines. 44 of these recommendations were associated with an ‘A’ GoR, or a strong recommendation based on strong evidence, and 26 had a ‘B’ or a ‘C’ GoR. No GoR was provided for 5 recommendations. 337 recommendations had no equivalent in the German S3 guidelines. The methodological quality of the development process was high and relevant meta-literature was cited for 87 top 5 list recommendations. For a further 36, either the methodological quality was high without any meta-literature citations or meta-literature citations existed but the methodological quality was lacking. For the remaining 214 recommendations, either the methodological quality was lacking and no literature was cited or the methodological quality was generally unsatisfactory. Conclusions 131 of current US top 5 list recommendations were found to be sufficiently trustworthy. For a substantial number of current US top 5 list recommendations, their trustworthiness remains unclear. Methodological requirements for developing top 5 lists are recommended. PMID:27855098
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Pelletier, Alexandra; Sunthara, Gajen; Gujral, Nitin; Mittal, Vandna; Bourgeois, Fabienne C
2016-01-01
Background Hospitals today are introducing new mobile apps to improve patient care and workflow processes. Mobile device adoption by hospitals fits with present day technology behavior; however, requires a deeper look into hospital device policies and the impact on patients, staff, and technology development. Should hospitals spend thousands to millions of dollars to equip all personnel with a mobile device that is only used in a hospital environment? Allowing health care professionals to use personal mobile devices at work, known as bring-your-own-device (BYOD), has the potential to support both the hospital and its employees to deliver effective and efficient care. Objective The objectives of this research were to create a mobile app development guideline for a BYOD hospital environment, apply the guideline to the development of an in-house mobile app called TaskList, pilot the TaskList app within Boston Children’s Hospital (BCH), and refine the guideline based on the app pilot. TaskList is an Apple operating system (iOS)-based app designed for medical residents to monitor, create, capture, and share daily collaborative tasks associated with patients. Methods To create the BYOD guidelines, we developed TaskList that required the use of mobile devices among medical resident. The TaskList app was designed in four phases: (1) mobile app guideline development, (2) requirements gathering and developing of TaskList fitting the guideline, (3) deployment of TaskList using BYOD with end-users, and (4) refinement of the guideline based on the TaskList pilot. Phase 1 included understanding the existing hospital BYOD policies and conducting Web searches to find best practices in software development for a BYOD environment. Phase 1 also included gathering subject matter input from the Information Services Department (ISD) at BCH. Phase 2 involved the collaboration between the Innovation Acceleration Program at BCH, the ISD Department and the TaskList Clinical team in understanding what features should be built into the app. Phase 3 involved deployment of TaskList on a clinical floor at BCH. Lastly, Phase 4 gathered the lessons learned from the pilot to refine the guideline. Results Fourteen practical recommendations were identified to create the BCH Mobile Application Development Guideline to safeguard custom applications in hospital BYOD settings. The recommendations were grouped into four categories: (1) authentication and authorization, (2) data management, (3) safeguarding app environment, and (4) remote enforcement. Following the guideline, the TaskList app was developed and then was piloted with an inpatient ward team. Conclusions The Mobile Application Development guideline was created and used in the development of TaskList. The guideline is intended for use by developers when addressing integration with hospital information systems, deploying apps in BYOD health care settings, and meeting compliance standards, such as Health Insurance Portability and Accountability Act (HIPAA) regulations. PMID:27169345
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Al Ayubi, Soleh U; Pelletier, Alexandra; Sunthara, Gajen; Gujral, Nitin; Mittal, Vandna; Bourgeois, Fabienne C
2016-05-11
Hospitals today are introducing new mobile apps to improve patient care and workflow processes. Mobile device adoption by hospitals fits with present day technology behavior; however, requires a deeper look into hospital device policies and the impact on patients, staff, and technology development. Should hospitals spend thousands to millions of dollars to equip all personnel with a mobile device that is only used in a hospital environment? Allowing health care professionals to use personal mobile devices at work, known as bring-your-own-device (BYOD), has the potential to support both the hospital and its employees to deliver effective and efficient care. The objectives of this research were to create a mobile app development guideline for a BYOD hospital environment, apply the guideline to the development of an in-house mobile app called TaskList, pilot the TaskList app within Boston Children's Hospital (BCH), and refine the guideline based on the app pilot. TaskList is an Apple operating system (iOS)-based app designed for medical residents to monitor, create, capture, and share daily collaborative tasks associated with patients. To create the BYOD guidelines, we developed TaskList that required the use of mobile devices among medical resident. The TaskList app was designed in four phases: (1) mobile app guideline development, (2) requirements gathering and developing of TaskList fitting the guideline, (3) deployment of TaskList using BYOD with end-users, and (4) refinement of the guideline based on the TaskList pilot. Phase 1 included understanding the existing hospital BYOD policies and conducting Web searches to find best practices in software development for a BYOD environment. Phase 1 also included gathering subject matter input from the Information Services Department (ISD) at BCH. Phase 2 involved the collaboration between the Innovation Acceleration Program at BCH, the ISD Department and the TaskList Clinical team in understanding what features should be built into the app. Phase 3 involved deployment of TaskList on a clinical floor at BCH. Lastly, Phase 4 gathered the lessons learned from the pilot to refine the guideline. Fourteen practical recommendations were identified to create the BCH Mobile Application Development Guideline to safeguard custom applications in hospital BYOD settings. The recommendations were grouped into four categories: (1) authentication and authorization, (2) data management, (3) safeguarding app environment, and (4) remote enforcement. Following the guideline, the TaskList app was developed and then was piloted with an inpatient ward team. The Mobile Application Development guideline was created and used in the development of TaskList. The guideline is intended for use by developers when addressing integration with hospital information systems, deploying apps in BYOD health care settings, and meeting compliance standards, such as Health Insurance Portability and Accountability Act (HIPAA) regulations.
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Coeliac disease screening is suboptimal in a tertiary gastroenterology setting.
Iskandar, Heba; Gray, Darrell M; Vu, Hongha; Mirza, Faiz; Rude, Mary Katherine; Regan, Kara; Abdalla, Adil; Gaddam, Srinivas; Almaskeen, Sami; Mello, Michael; Marquez, Evelyn; Meyer, Claire; Bolkhir, Ahmed; Kanuri, Navya; Sayuk, Gregory; Gyawali, C Prakash
2017-08-01
Coeliac disease (CD) is widely prevalent in North America, but case-finding techniques currently used may not be adequate for patient identification. We aimed to determine the adequacy of CD screening in an academic gastroenterology (GI) practice. Consecutive initial visits to a tertiary academic GI practice were surveyed over a 3-month period as a fellow-initiated quality improvement project. All electronic records were reviewed to look for indications for CD screening according to published guidelines. The timing of screening was noted (before or after referral), as well as the screening method (serology or biopsy). Data were analysed to compare CD screening practices across subspecialty clinics. 616 consecutive patients (49±0.6 years, range 16-87 years, 58.5% females, 94% Caucasian) fulfilled inclusion criteria. CD testing was indicated in 336 (54.5%), but performed in only 145 (43.2%). The need for CD screening was highest in luminal GI and inflammatory bowel disease clinics, followed by biliary and hepatology clinics (p<0.0001); CD screening rate was highest in the luminal GI clinic (p=0.002). Of 145 patients screened, 4 patients (2.4%) had serology consistent with CD, of which 2 were proven by duodenal biopsy. Using this proportion, an additional 5 patients might have been diagnosed in 191 untested patients with indications for CD screening. More than 50% of patients in a tertiary GI clinic have indications for CD screening, but <50% of indicated cases are screened. Case-finding techniques therefore are suboptimal, constituting a gap in patient care and an important target for future quality improvement initiatives. 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/.
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Sreih, Antoine G; Annapureddy, Narender; Springer, Jason; Casey, George; Byram, Kevin; Cruz, Andy; Estephan, Maya; Frangiosa, Vince; George, Michael D; Liu, Mei; Parker, Adam; Sangani, Sapna; Sharim, Rebecca; Merkel, Peter A
2016-12-01
The aim of this study was to develop and validate case-finding algorithms for granulomatosis with polyangiitis (Wegener's, GPA), microscopic polyangiitis (MPA), and eosinophilic GPA (Churg-Strauss, EGPA). Two hundred fifty patients per disease were randomly selected from two large healthcare systems using the International Classification of Diseases version 9 (ICD9) codes for GPA/EGPA (446.4) and MPA (446.0). Sixteen case-finding algorithms were constructed using a combination of ICD9 code, encounter type (inpatient or outpatient), physician specialty, use of immunosuppressive medications, and the anti-neutrophil cytoplasmic antibody type. Algorithms with the highest average positive predictive value (PPV) were validated in a third healthcare system. An algorithm excluding patients with eosinophilia or asthma and including the encounter type and physician specialty had the highest PPV for GPA (92.4%). An algorithm including patients with eosinophilia and asthma and the physician specialty had the highest PPV for EGPA (100%). An algorithm including patients with one of the diagnoses (alveolar hemorrhage, interstitial lung disease, glomerulonephritis, and acute or chronic kidney disease), encounter type, physician specialty, and immunosuppressive medications had the highest PPV for MPA (76.2%). When validated in a third healthcare system, these algorithms had high PPV (85.9% for GPA, 85.7% for EGPA, and 61.5% for MPA). Adding the anti-neutrophil cytoplasmic antibody type increased the PPV to 94.4%, 100%, and 81.2% for GPA, EGPA, and MPA, respectively. Case-finding algorithms accurately identify patients with GPA, EGPA, and MPA in administrative databases. These algorithms can be used to assemble population-based cohorts and facilitate future research in epidemiology, drug safety, and comparative effectiveness. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
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Sreih, Antoine G.; Annapureddy, Narender; Springer, Jason; Casey, George; Byram, Kevin; Cruz, Andy; Estephan, Maya; Frangiosa, Vince; George, Michael D.; Liu, Mei; Parker, Adam; Sangani, Sapna; Sharim, Rebecca; Merkel, Peter A.
2016-01-01
Purpose To develop and validate case-finding algorithms for granulomatosis with polyangiitis (Wegener’s, GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (Churg-Strauss, EGPA). Methods 250 patients per disease were randomly selected from 2 large healthcare systems using the International Classification of Diseases version 9 (ICD9) codes for GPA/EGPA (446.4) and MPA (446.0). 16 case-finding algorithms were constructed using a combination of ICD9 code, encounter type (inpatient or outpatient), physician specialty, use of immunosuppressive medications, and the anti-neutrophil cytoplasmic antibody (ANCA) type. Algorithms with the highest average positive predictive value (PPV) were validated in a third healthcare system. Results An algorithm excluding patients with eosinophilia or asthma and including the encounter type and physician specialty had the highest PPV for GPA (92.4%). An algorithm including patients with eosinophilia and asthma and the physician specialty had the highest PPV for EGPA (100%). An algorithm including patients with one of the following diagnoses: alveolar hemorrhage, interstitial lung disease, glomerulonephritis, acute or chronic kidney disease, the encounter type, physician specialty, and immunosuppressive medications had the highest PPV for MPA (76.2%). When validated in a third healthcare system, these algorithms had high PPV (85.9% for GPA, 85.7% for EGPA, and 61.5% for MPA). Adding the ANCA type increased the PPV to 94.4%, 100%, and 81.2% for GPA, EGPA, and MPA respectively. Conclusion Case-finding algorithms accurately identify patients with GPA, EGPA, and MPA in administrative databases. These algorithms can be used to assemble population-based cohorts and facilitate future research in epidemiology, drug safety, and comparative effectiveness. PMID:27804171
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Martin, Natasha K; Vickerman, Peter; Brew, Iain F; Williamson, Joan; Miners, Alec; Irving, William L; Saksena, Sushma; Hutchinson, Sharon J; Mandal, Sema; O’Moore, Eamonn; Hickman, Matthew
2016-01-01
Background Prisoners have a high prevalence of Hepatitis C virus (HCV), but case-finding may not have been cost-effective because treatment often exceeded average prison stay combined with a lack of continuity-of-care. We assess the cost-effectiveness of increased HCV case-finding and treatment in UK prisons using short-course therapies. Methods A dynamic HCV transmission model assesses the cost-effectiveness of doubling HCV case-finding (achieved through introducing opt-out HCV testing in UK pilot prisons) and increasing treatment in UK prisons, compared to status-quo voluntary risk-based testing (6% prison entrants/year), using currently recommended therapies (8–24 weeks) or IFN-free DAAs (8–12 weeks, 95% SVR, £3300/wk). Costs (GBP£) and health utilities (quality-adjusted life-years, QALYs) were used to calculate mean incremental cost-effectiveness ratios (ICERs). We assume 56% referral and 2.5%/25% of referred people who inject drugs (PWID)/exPWID treated within 2 months of diagnosis in prison. PWID and ex/nonPWID are in prison an average 4/8 months, respectively. Results Doubling prison testing rates with existing treatments produces a mean ICER of £19,850/QALY gained compared to current testing/treatment, and is 45% likely to be cost-effective under a £20,000 willingness-to-pay (WTP) threshold. Switching to 8–12 week IFN-free DAAs in prisons could increase cost-effectiveness (ICER £15,090/QALY gained). Excluding prevention benefit decreases cost-effectiveness. If >10% referred PWID are treated in prison (2.5% base-case), either treatment could be highly cost-effective (ICER<£13,000). HCV case-finding and IFN-free DAAs could be highly cost-effective if DAA cost is 10% lower or 8 weeks duration. Conclusions Increased HCV testing in UK prisons (such as through opt-out testing) is borderline cost-effective compared to status-quo voluntary risk-based testing under a £20,000 WTP with current treatments, but likely to be cost-effective if short-course IFN-free DAAs are used, and could be highly cost-effective if PWID treatment rates were increased. PMID:26864802
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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...
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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...
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Jordan, Rachel E; Adab, Peymané; Sitch, Alice; Enocson, Alexandra; Blissett, Deirdre; Jowett, Sue; Marsh, Jen; Riley, Richard D; Miller, Martin R; Cooper, Brendan G; Turner, Alice M; Jolly, Kate; Ayres, Jon G; Haroon, Shamil; Stockley, Robert; Greenfield, Sheila; Siebert, Stanley; Daley, Amanda J; Cheng, K K; Fitzmaurice, David
2016-09-01
Many individuals with chronic obstructive pulmonary disease (COPD) remain undiagnosed worldwide. Health-care organisations are implementing case-finding programmes without good evidence of which are the most effective and cost-effective approaches. We assessed the effectiveness and cost-effectiveness of two alternative approaches to targeted case finding for COPD compared with routine practice. In this cluster-randomised controlled trial, participating general practices in the West Midlands, UK, were randomly assigned (1:1), via a computer-generated block randomisation sequence, to either a targeted case-finding group or a routine care group. Eligible patients were ever-smokers aged 40-79 years without a previously recorded diagnosis of COPD. Patients in the targeted case-finding group were further randomly assigned (1:1) via their household to receive either a screening questionnaire at the general practitioner (GP) consultation (opportunistic) or a screening questionnaire at the GP consultation plus a mailed questionnaire (active). Respondents reporting relevant respiratory symptoms were invited for post-bronchodilator spirometry. Patients, clinicians, and investigators were not masked to allocation, but group allocation was concealed from the researchers who performed the spirometry assessments. Primary outcomes were the percentage of the eligible population diagnosed with COPD within 1 year (defined as post-bronchodilator forced expiratory volume in 1 s [FEV1] to forced vital capacity [FVC] ratio <0·7 in patients with symptoms or a new diagnosis on their GP record) and cost per new COPD diagnosis. Multiple logistic and Poisson regression were used to estimate effect sizes. Costs were obtained from the trial. This trial is registered with ISRCTN, number ISRCTN14930255. From Aug 10, 2012, to June 22, 2014, 74 818 eligible patients from 54 diverse general practices were randomly assigned and completed the trial. At 1 year, 1278 (4%) cases of COPD were newly detected in 32 789 eligible patients in the targeted case-finding group compared with 337 (1%) cases in 42 029 patients in the routine care group (adjusted odds ratio [OR] 7·45 [95% CI 4·80-11·55], p<0·0001). The percentage of newly detected COPD cases was higher in the active case-finding group (822 [5%] of 15 378) than in the opportunistic case-finding group (370 [2%] of 15 387; adjusted OR 2·34 [2·06-2·66], p<0·0001; adjusted risk difference 2·9 per 100 patients [95% CI 2·3-3·6], p<0·0001). Active case finding was more cost-effective than opportunistic case finding (£333 vs £376 per case detected, respectively). In this well established primary care system, routine practice identified few new cases of COPD. An active targeted approach to case finding including mailed screening questionnaires before spirometry is a cost-effective way to identify undiagnosed patients and has the potential to improve their health. National Institute for Health Research. Copyright © 2016 Elsevier Ltd. All rights reserved.
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José, Ricardo J P; Roberts, June; Bakerly, Nawar Diar
2010-06-01
To evaluate the effectiveness of a social marketing model on case-finding for COPD in a population with high smoking rates and COPD prevalence. A two-week marketing campaign was conducted using high visibility posters, leaflets distributed with the local newspaper, and the creation of a free automated COPD information line. The primary outcome measure was the number of newly-diagnosed cases of COPD as a result of the campaign. Secondary outcomes measures were: the number of phone calls to the information line up to four weeks after the end of the campaign; the number of individuals who presented to their general practitioner (GP) for spirometry as a result of the campaign; and responses to a questionnaire sent to members of the public to analyse and assess the visibility and impact of the campaign. Ten people came forward to have spirometry performed and all had non-obstructive results. Nine calls were made to the dedicated COPD phone line. 135 out of 400 members of the public (34%) responded to the questionnaire; of these, only 34 (25%) recalled seeing a campaign poster. Posters and leaflets from this campaign were visible but only led to 10 individuals coming forward for spirometry, none of whom had COPD. This form of healthcare marketing was costly and not effective for COPD case-finding in our area.
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Shah, L; Rojas, M; Mori, O; Zamudio, C; Kaufman, J S; Otero, L; Gotuzzo, E; Seas, C; Brewer, T F
2017-04-01
We compared the cost-effectiveness (CE) of an active case-finding (ACF) programme for household contacts of tuberculosis (TB) cases enrolled in first-line treatment to routine passive case-finding (PCF) within an established national TB programme in Peru. Decision analysis was used to model detection of TB in household contacts through: (1) self-report of symptomatic cases for evaluation (PCF), (2) a provider-initiated ACF programme, (3) addition of an Xpert MTB/RIF diagnostic test for a single sputum sample from household contacts, and (4) all strategies combined. CE was calculated as the incremental cost-effectiveness ratio (ICER) in terms of US dollars per disability-adjusted life years (DALYs) averted. Compared to PCF alone, ACF for household contacts resulted in an ICER of $2155 per DALY averted. The addition of the Xpert MTB/RIF diagnostic test resulted in an ICER of $3275 per DALY averted within a PCF programme and $3399 per DALY averted when an ACF programme was included. Provider-initiated ACF of household contacts in an urban setting of Lima, Peru can be highly cost-effective, even including costs to seek out contacts and perform an Xpert/MTB RIF test. ACF including Xpert MTB/RIF was not cost-effective if TB cases detected had high rates of default from treatment or poor outcomes.
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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
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Carter, Matthew
2018-04-12
Treatment with glucocorticoids is the leading cause of drug-induced osteoporosis. National Osteoporosis Guideline Group (NOGG) 2017 guidelines advise a case-finding strategy for patients at risk. The aims of the audit were to evaluate the implementation of the NOGG 2017 guidelines for patients receiving long-term glucocorticoid therapy in a suburban general practice, to instigate changes to ensure 90% of patients are investigated and treated appropriately, and to evaluate impact at a 6-mo re-audit. Reporting Analysis and Intelligence Delivering Results (RAIDR) is a health-care intelligence tool accessing primary care clinical data. Using RAIDR, data on relevant osteoporotic risk factors were combined to produce FRAX scores for patients who had been prescribed glucocorticoids 3 or more times in the past 12 months. FRAX data were displayed in a NOGG guidance graph for major osteoporotic fracture probability. Patients were assessed as high, intermediate, or low risk. High- and intermediate-risk patients above the NOGG threshold were recommended to start bisphosphonates; these patients were sent a prescription for alendronate and a letter of explanation. There were no intermediate patients below the NOGG threshold. Low-risk patients were recommended to have lifestyle advice; a leaflet was produced and sent to these patients. Initial results showed that only 25% of patients recommended to be on bisphosphonates were taking them. Steps were taken to educate the general practitioners in the FRAX tool and NOGG guidelines; the chronic obstructive pulmonary disease annual template was amended to aid adherence by alerting the nurse to the number of glucocorticoid courses prescribed, with additional boxes for prescribing alendronate and printing the lifestyle leaflet; and 2-monthly RAIDR searches by the practice pharmacist were started. A re-audit 6 mo later showed improvement to 92%. This audit showed that education, reminders, and simple computer prompts can greatly improve the implementation of NOGG guidelines for glucocorticoid-induced osteoporosis. Copyright © 2018 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.
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Underreporting of conflicts of interest in clinical practice guidelines: cross sectional study
2013-01-01
Background Conflicts of interest affect recommendations in clinical guidelines and disclosure of such conflicts is important. However, not all conflicts of interest are disclosed. Using a public available disclosure list we determined the prevalence and underreporting of conflicts of interest among authors of clinical guidelines on drug treatments. Methods We included up to five guidelines published from July 2010 to March 2012 from each Danish clinical specialty society. Using the disclosure list of the Danish Health and Medicines Authority, we identified author conflicts of interest and compared them with the disclosures in the guidelines. For each guideline we extracted methodological characteristics of guideline development. Results Forty-five guidelines from 14 specialty societies were included. Of 254 authors, 135 (53%) had conflicts of interest, corresponding to 43 of the 45 guidelines (96%) having one or more authors with a conflict of interest. Only one of the 45 guidelines (2%) disclosed author conflicts of interest. The most common type of conflict of interest (83 of the 135) was being a consultant, an advisory board member or a company employee. Only 10 guidelines (22%) described the methods used for guideline development, 27 (60%) used references in the text and 11 (24%) graded the types of evidence. Conclusions Conflicts of interest were common, but disclosures were very rare. Most guidelines did not describe how they were developed and many did not describe the evidence behind specific recommendations. Publicly available disclosure lists may assist guideline issuing bodies in ensuring that all conflicts are disclosed. PMID:23642105
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-01-03
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-09-05
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-04-06
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-11-03
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2011-06-02
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2012-02-01
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-12-05
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2012-10-03
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-05-02
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-10-03
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2011-04-05
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2011-07-12
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-09-01
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-04-01
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-08-02
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2011-02-03
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2011-03-03
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-07-03
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2013-06-04
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2012-03-02
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20 CFR 404.1569 - Listing of Medical-Vocational Guidelines in appendix 2.
Code of Federal Regulations, 2010 CFR
2010-04-01
... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Listing of Medical-Vocational Guidelines in appendix 2. 404.1569 Section 404.1569 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE... includes information about jobs (classified by their exertional and skill requirements) that exist in the...
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This article provides an executive summary of the recommendations from the Clinical Guideline: Management of the Adult Patient With a Fecal or Urinary Ostomy, published by the Wound, Ostomy and Continence Nurses Society (WOCN Society). It presents an overview of the process used to update and develop the guideline and lists specific recommendations from the guideline. We provide recommendations that include the following topics: stoma construction, preoperative education, stoma site marking, selection of an ostomy pouching system, postoperative education, postoperative management issues, follow-up care after discharge from the acute care setting, health-related quality of life, and stomal and peristomal complications. The intent of the guideline is to provide information that will assist healthcare providers to manage adult patients with ostomies, prevent or decrease complications, and improve patient outcomes. The full text of the published guideline, which includes available evidence supporting the recommendations and a complete reference list, is available in print and as a mobile application from the WOCN Society's online bookstore (http://www.wocn.org). Refer to Supplemental Digital Content 1 (available at: http://links.lww.com/JWOCN/A40) associated with this article for a complete reference list for the guideline.
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2012-01-03
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-07-07
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2010-05-14
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2010-03-01
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-02-01
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-01-04
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-08-02
... 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..., ``Certification of Laboratories Engaged in Urine Drug Testing for Federal Agencies,'' sets strict standards that...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-10
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-09-14
... 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 Laboratories Engaged in Urine Drug Testing for Federal Agencies,'' sets strict standards that...
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Corrosion guidelines : Version 1.0.
DOT National Transportation Integrated Search
2003-09-01
These guidelines outline the corrosion evaluation and recommendation aspects of site investigations for California Department of Transportation (Department) projects. The guidelines list the requirements for field investigations related to corrosion,...
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Wammes, Joost Johan Godert; van den Akker-van Marle, M Elske; Verkerk, Eva W; van Dulmen, Simone A; Westert, Gert P; van Asselt, Antoinette D I; Kool, R B
2016-11-25
The term 'lower value services' concerns healthcare that is of little or no value to the patient and consequently should not be provided routinely, or not be provided at all. De-adoption of lower value care may occur through explicit recommendations in clinical guidelines. The present study aimed to generate a comprehensive list of lower value services for the Netherlands that assesses the type of care and associated medical conditions. The list was compared with the NICE do-not-do list (United Kingdom). Finally, the feasibility of prioritizing the list was studied to identify conditions where de-adoption is warranted. Dutch clinical guidelines (published from 2010 to 2015) were searched for lower value services. The lower value services identified were categorized by type of care (diagnostics, treatment with and without medication), type of lower value service (not routinely provided or not provided at all), and ICD10 codes (international classification of diseases). The list was prioritized per ICD10 code, based on the number of lower value services per ICD10 code, prevalence, and burden of disease. A total of 1366 lower value services were found in the 193 Dutch guidelines included in our study. Of the lower value services, 30% covered diagnostics, 29% related to surgical and medical treatment without drugs primarily, and 39% related to drug treatment. The majority (77%) of all lower value services was on care that should not be offered at all, whereas the other 23% recommended on care that should not be offered routinely. ICD10 chapters that included most lower value services were neoplasms and diseases of the nervous system. Dutch guidelines appear to contain more lower value services than UK guidelines. The prioritization processes revealed several conditions, including back pain, chronic obstructive pulmonary disease, and ischemic heart diseases, where lower value services most likely occur and de-adoption is warranted. In this study, a comprehensive list of lower value services for Dutch hospital care was developed. A feasible method for prioritizing lower value services was established. Identifying and prioritizing lower value services is the first of several necessary steps in reducing them.
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Guidelines for Developing Competency-Based Curriculum.
ERIC Educational Resources Information Center
Goodson, Ludy
1979-01-01
Presents guidelines for the development of competency-based curriculum formulated as a result of an automotive mechanics curriculum workshop. Listed are specific guidelines for content development, writing style, and illustration. (LRA)
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50 CFR 600.747 - Guidelines and procedures for determining new fisheries and gear.
Code of Federal Regulations, 2011 CFR
2011-10-01
... turtles, sea birds, or species listed as endangered or threatened under the ESA. (H) How the gear will be... prepare a list of all fisheries under the authority of each Council, or the Director in the case of Atlantic highly migratory species, and all gear used in such fisheries. This section contains guidelines in...
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50 CFR 600.747 - Guidelines and procedures for determining new fisheries and gear.
Code of Federal Regulations, 2014 CFR
2014-10-01
... turtles, sea birds, or species listed as endangered or threatened under the ESA. (H) How the gear will be... prepare a list of all fisheries under the authority of each Council, or the Director in the case of Atlantic highly migratory species, and all gear used in such fisheries. This section contains guidelines in...
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50 CFR 600.747 - Guidelines and procedures for determining new fisheries and gear.
Code of Federal Regulations, 2013 CFR
2013-10-01
... turtles, sea birds, or species listed as endangered or threatened under the ESA. (H) How the gear will be... prepare a list of all fisheries under the authority of each Council, or the Director in the case of Atlantic highly migratory species, and all gear used in such fisheries. This section contains guidelines in...
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50 CFR 600.747 - Guidelines and procedures for determining new fisheries and gear.
Code of Federal Regulations, 2012 CFR
2012-10-01
... turtles, sea birds, or species listed as endangered or threatened under the ESA. (H) How the gear will be... prepare a list of all fisheries under the authority of each Council, or the Director in the case of Atlantic highly migratory species, and all gear used in such fisheries. This section contains guidelines in...
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Indoor airPLUS Web Linking Guidelines
As an Indoor airPLUS partner, your organization is listed on the EPA Indoor airPLUS Partner List. Your listing can also include a link to your organization's website when you meet the following requirements.
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O'Caoimh, Rónán; Cornally, Nicola; Weathers, Elizabeth; O'Sullivan, Ronan; Fitzgerald, Carol; Orfila, Francesc; Clarnette, Roger; Paúl, Constança; Molloy, D William
2015-09-01
Few case-finding instruments are available to community healthcare professionals. This review aims to identify short, valid instruments that detect older community-dwellers risk of four adverse outcomes: hospitalisation, functional-decline, institutionalisation and death. Data sources included PubMed and the Cochrane library. Data on outcome measures, patient and instrument characteristics, and trial quality (using the Quality In Prognosis Studies [QUIPS] tool), were double-extracted for derivation-validation studies in community-dwelling older adults (>50 years). Forty-six publications, representing 23 unique instruments, were included. Only five were externally validated. Mean patient age range was 64.2-84.6 years. Most instruments n=18, (78%) were derived in North America from secondary analysis of survey data. The majority n=12, (52%), measured more than one outcome with hospitalisation and the Probability of Repeated Admission score the most studied outcome and instrument respectively. All instruments incorporated multiple predictors. Activities of daily living n=16, (70%), was included most often. Accuracy varied according to instruments and outcomes; area under the curve of 0.60-0.73 for hospitalisation, 0.63-0.78 for functional decline, 0.70-0.74 for institutionalisation and 0.56-0.82 for death. The QUIPS tool showed that 5/23 instruments had low potential for bias across all domains. This review highlights the present need to develop short, reliable, valid instruments to case-find older adults at risk in the community. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.
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Sutton, Andrew J; Edmunds, W John; Gill, O Noel
2006-01-01
Background In England and Wales where less than 1% of the population are Injecting drug users (IDUs), 97% of HCV reports are attributed to injecting drug use. As over 60% of the IDU population will have been imprisoned by the age of 30 years, prison may provide a good location in which to offer HCV screening and treatment. The aim of this work is to examine the cost effectiveness of a number of alternative HCV case-finding strategies on prison reception Methods A decision analysis model embedded in a model of the flow of IDUs through prison was used to estimate the cost effectiveness of a number of alternative case-finding strategies. The model estimates the average cost of identifying a new case of HCV from the perspective of the health care provider and how these estimates may evolve over time. Results The results suggest that administering verbal screening for a past positive HCV test and for ever having engaged in illicit drug use prior to the administering of ELISA and PCR tests can have a significant impact on the cost effectiveness of HCV case-finding strategies on prison reception; the discounted cost in 2017 being £2,102 per new HCV case detected compared to £3,107 when no verbal screening is employed. Conclusion The work here demonstrates the importance of targeting those individuals that have ever engaged in illicit drug use for HCV testing in prisons, these individuals can then be targeted for future intervention measures such as treatment or monitored to prevent future transmission. PMID:16803622
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[Thyroid dysfunction during pregnancy].
Díez, Juan J; Iglesias, Pedro; Donnay, Sergio
2015-10-21
Recent clinical practice guidelines on thyroid dysfunction and pregnancy have changed health care provided to pregnant women, although their recommendations are under constant revision. Trimester- and area-specific reference ranges for serum thyroid-stimulating hormone are required for proper diagnosis of hypothyroidism and hyperthyroidism. There is no doubt on the need of therapy for overt hypothyroidism, while therapy for subclinical hypothyroidism is controversial. Further research is needed to settle adverse effects of isolated hypothyroxinemia and thyroid autoimmunity. Differentiation between hyperthyroidism due to Graves' disease and the usually self-limited gestational transient thyrotoxicosis is critical. It is also important to recognize risk factors for postpartum thyroiditis. Supplementation with iodine is recommended to maintain adequate iodine nutrition during pregnancy and avoid serious consequences in offspring. Controversy remains about universal screening for thyroid disease during pregnancy or case-finding in high-risk women. Opinions of some scientific societies and recent cost-benefit studies favour universal screening. Randomized controlled studies currently under development should reduce the uncertainties that still remain in this area. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.
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Ehrensperger, Michael M; Taylor, Kirsten I; Berres, Manfred; Foldi, Nancy S; Dellenbach, Myriam; Bopp, Irene; Gold, Gabriel; von Gunten, Armin; Inglin, Daniel; Müri, René; Rüegger, Brigitte; Kressig, Reto W; Monsch, Andreas U
2014-01-01
Optimal identification of subtle cognitive impairment in the primary care setting requires a very brief tool combining (a) patients' subjective impairments, (b) cognitive testing, and (c) information from informants. The present study developed a new, very quick and easily administered case-finding tool combining these assessments ('BrainCheck') and tested the feasibility and validity of this instrument in two independent studies. We developed a case-finding tool comprised of patient-directed (a) questions about memory and depression and (b) clock drawing, and (c) the informant-directed 7-item version of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Feasibility study: 52 general practitioners rated the feasibility and acceptance of the patient-directed tool. Validation study: An independent group of 288 Memory Clinic patients (mean ± SD age = 76.6 ± 7.9, education = 12.0 ± 2.6; 53.8% female) with diagnoses of mild cognitive impairment (n = 80), probable Alzheimer's disease (n = 185), or major depression (n = 23) and 126 demographically matched, cognitively healthy volunteer participants (age = 75.2 ± 8.8, education = 12.5 ± 2.7; 40% female) partook. All patient and healthy control participants were administered the patient-directed tool, and informants of 113 patient and 70 healthy control participants completed the very short IQCODE. Feasibility study: General practitioners rated the patient-directed tool as highly feasible and acceptable. Validation study: A Classification and Regression Tree analysis generated an algorithm to categorize patient-directed data which resulted in a correct classification rate (CCR) of 81.2% (sensitivity = 83.0%, specificity = 79.4%). Critically, the CCR of the combined patient- and informant-directed instruments (BrainCheck) reached nearly 90% (that is 89.4%; sensitivity = 97.4%, specificity = 81.6%). A new and very brief instrument for general practitioners, 'BrainCheck', combined three sources of information deemed critical for effective case-finding (that is, patients' subject impairments, cognitive testing, informant information) and resulted in a nearly 90% CCR. Thus, it provides a very efficient and valid tool to aid general practitioners in deciding whether patients with suspected cognitive impairments should be further evaluated or not ('watchful waiting').
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28 CFR 2.21 - Reparole consideration guidelines.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Reparole consideration guidelines. 2.21....21 Reparole consideration guidelines. (a)(1) If revocation is based upon administrative violation(s... analogy with listed federal offense behaviors. (b) The guidelines for parole consideration specified at 28...
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Rubin, K H; Rothmann, M J; Holmberg, T; Høiberg, M; Möller, S; Barkmann, R; Glüer, C C; Hermann, A P; Bech, M; Gram, J; Brixen, K
2018-03-01
The Risk-stratified Osteoporosis Strategy Evaluation (ROSE) study investigated the effectiveness of a two-step screening program for osteoporosis in women. We found no overall reduction in fractures from systematic screening compared to the current case-finding strategy. The group of moderate- to high-risk women, who accepted the invitation to DXA, seemed to benefit from the program. The purpose of the ROSE study was to investigate the effectiveness of a two-step population-based osteoporosis screening program using the Fracture Risk Assessment Tool (FRAX) derived from a self-administered questionnaire to select women for DXA scan. After the scanning, standard osteoporosis management according to Danish national guidelines was followed. Participants were randomized to either screening or control group, and randomization was stratified according to age and area of residence. Inclusion took place from February 2010 to November 2011. Participants received a self-administered questionnaire, and women in the screening group with a FRAX score ≥ 15% (major osteoporotic fractures) were invited to a DXA scan. Primary outcome was incident clinical fractures. Intention-to-treat analysis and two per-protocol analyses were performed. A total of 3416 fractures were observed during a median follow-up of 5 years. No significant differences were found in the intention-to-treat analyses with 34,229 women included aged 65-80 years. The per-protocol analyses showed a risk reduction in the group that underwent DXA scanning compared to women in the control group with a FRAX ≥ 15%, in regard to major osteoporotic fractures, hip fractures, and all fractures. The risk reduction was most pronounced for hip fractures (adjusted SHR 0.741, p = 0.007). Compared to an office-based case-finding strategy, the two-step systematic screening strategy had no overall effect on fracture incidence. The two-step strategy seemed, however, to be beneficial in the group of women who were identified by FRAX as moderate- or high-risk patients and complied with DXA.
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Kojima, Taro; Mizukami, Katsuyoshi; Tomita, Naoki; Arai, Hiroyuki; Ohrui, Takashi; Eto, Masato; Takeya, Yasushi; Isaka, Yoshitaka; Rakugi, Hiromi; Sudo, Noriko; Arai, Hidenori; Aoki, Hiroaki; Horie, Shigeo; Ishii, Shinya; Iwasaki, Koh; Takayama, Shin; Suzuki, Yusuke; Matsui, Toshifumi; Mizokami, Fumihiro; Furuta, Katsunori; Toba, Kenji; Akishita, Masahiro
2016-09-01
In 2005, the Japan Geriatrics Society published a list of potentially inappropriate medication that was an extract from the "Guidelines for medical treatment and its safety in the elderly 2005." The 2005 guidelines are due for a revision, and a new comprehensive list of potentially inappropriate medications is required. A total of 15 diseases, conditions and special areas related to their clinical care were selected. We originated clinical questions and keywords for these 15 areas, carried out a systematic review using these search criteria, and formulated guidelines applying the Grading of Recommendations Assessment, Development and Evaluation system advocated by Minds2014. If we did not find good evidence despite the drug being clinically important, we looked for evidence of efficacy and for disease-specific guidelines, and incorporated them into our guidelines. We selected 2098 articles (140 articles per area), and extracted another 186 articles through a manual search. We further added guidelines based on disease entity and made two lists, one of "drugs to be prescribed with special caution" and the other of "drugs to consider starting," primarily considering individuals aged 75 years or older or those who are frail or in need of special care. New lists of potentially inappropriate medications and potential prescribing omissions called "Screening Tool for Older Person's Appropriate Prescriptions for Japanese" were constructed. We anticipate that future studies will highlight more evidence regarding the safety of high-quality drugs, further improving the provision of appropriate medical care for the elderly. Geriatr Gerontol Int 2016: 16: 983-1001. © 2016 Japan Geriatrics Society.
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Automated Tumor Registry for Oncology. A VA-DHCP MUMPS application.
Richie, S
1992-01-01
The VA Automated Tumor Registry for Oncology, Version 2, is a multifaceted, completely automated user-friendly cancer database. Easy to use modules include: Automatic Casefinding; Suspense Files; Abstracting and Printing; Follow-up; Annual Reports; Statistical Reports; Utility Functions.
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Code of Federal Regulations, 2010 CFR
2010-04-01
... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Listing of Medical-Vocational Guidelines in appendix 2 of subpart P of part 404 of this chapter. 416.969 Section 416.969 Employees' Benefits SOCIAL... information about jobs (classified by their exertional and skill requirements) that exist in the national...
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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…
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Automated Tumor Registry for Oncology. A VA-DHCP MUMPS application.
Richie, S.
1992-01-01
The VA Automated Tumor Registry for Oncology, Version 2, is a multifaceted, completely automated user-friendly cancer database. Easy to use modules include: Automatic Casefinding; Suspense Files; Abstracting and Printing; Follow-up; Annual Reports; Statistical Reports; Utility Functions. PMID:1482866
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Al-Darraji, Haider Abdulrazzaq Abed; Altice, Frederick L; Kamarulzaman, Adeeba
2016-08-01
To investigate the prevalence of previously undiagnosed active tuberculosis (TB) cases among prisoners in Malaysia's largest prison using an intensified TB case-finding strategy. From October 2012 to May 2013, prisoners housed in two distinct units (HIV-negative and HIV-positive) were approached to participate in the TB screening study. Consenting prisoners submitted two sputum samples that were examined using GeneXpert MTB/RIF, smear microscopy and liquid culture. Socio-demographic and clinical information was collected and correlates of active TB, defined as having either a positive GeneXpert MTB/RIF or culture results, were assessed using regression analyses. Among the total of 559 prisoners, 442 (79.1%) had complete data; 28.7% were HIV-infected, 80.8% were men and the average age was 36.4 (SD 9.8) years. Overall, 34 (7.7%) had previously undiagnosed active TB, of whom 64.7% were unable to complete their TB treatment in prison due to insufficient time (<6 months) remaining in prison. Previously undiagnosed active TB was independently associated with older age groups (AOR 11.44 and 6.06 for age ≥ 50 and age 40-49 years, respectively) and with higher levels of immunosuppression (CD4 < 200 cells/ml) in HIV-infected prisoners (AOR 3.07, 95% CI 1.03-9.17). The high prevalence of previously undiagnosed active TB in this prison highlights the inadequate performance of internationally recommended case-finding strategies and suggests that passive case-finding policies should be abandoned, especially in prison settings where HIV infection is prevalent. Moreover, partnerships between criminal justice and public health treatment systems are crucial to continue TB treatment after release. © 2016 John Wiley & Sons Ltd.
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40 CFR 161.34 - Flagging of studies for potential adverse effects.
Code of Federal Regulations, 2011 CFR
2011-07-01
... a type listed in paragraph (b) of this section to support an application for new or amended... types and the criteria to be applied to each. Column 1 lists the study types by name. Column 2 lists the associated Pesticide Assessment Guideline number. Column 3 lists the criteria applicable to each type of...
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21 CFR 101.45 - Guidelines for the voluntary nutrition labeling of raw fruits, vegetables, and fish.
Code of Federal Regulations, 2013 CFR
2013-04-01
... 21 Food and Drugs 2 2013-04-01 2013-04-01 false Guidelines for the voluntary nutrition labeling of... Nutrition Labeling Requirements and Guidelines § 101.45 Guidelines for the voluntary nutrition labeling of raw fruits, vegetables, and fish. (a) Nutrition labeling for raw fruits, vegetables, and fish listed...
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21 CFR 101.45 - Guidelines for the voluntary nutrition labeling of raw fruits, vegetables, and fish.
Code of Federal Regulations, 2010 CFR
2010-04-01
... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Guidelines for the voluntary nutrition labeling of... Nutrition Labeling Requirements and Guidelines § 101.45 Guidelines for the voluntary nutrition labeling of raw fruits, vegetables, and fish. (a) Nutrition labeling for raw fruits, vegetables, and fish listed...
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21 CFR 101.45 - Guidelines for the voluntary nutrition labeling of raw fruits, vegetables, and fish.
Code of Federal Regulations, 2014 CFR
2014-04-01
... 21 Food and Drugs 2 2014-04-01 2014-04-01 false Guidelines for the voluntary nutrition labeling of... Nutrition Labeling Requirements and Guidelines § 101.45 Guidelines for the voluntary nutrition labeling of raw fruits, vegetables, and fish. (a) Nutrition labeling for raw fruits, vegetables, and fish listed...
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21 CFR 101.45 - Guidelines for the voluntary nutrition labeling of raw fruits, vegetables, and fish.
Code of Federal Regulations, 2011 CFR
2011-04-01
... 21 Food and Drugs 2 2011-04-01 2011-04-01 false Guidelines for the voluntary nutrition labeling of... Nutrition Labeling Requirements and Guidelines § 101.45 Guidelines for the voluntary nutrition labeling of raw fruits, vegetables, and fish. (a) Nutrition labeling for raw fruits, vegetables, and fish listed...
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21 CFR 101.45 - Guidelines for the voluntary nutrition labeling of raw fruits, vegetables, and fish.
Code of Federal Regulations, 2012 CFR
2012-04-01
... 21 Food and Drugs 2 2012-04-01 2012-04-01 false Guidelines for the voluntary nutrition labeling of... Nutrition Labeling Requirements and Guidelines § 101.45 Guidelines for the voluntary nutrition labeling of raw fruits, vegetables, and fish. (a) Nutrition labeling for raw fruits, vegetables, and fish listed...
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Quality Control Guidelines for SAM Chemical Methods
Learn more about quality control guidelines and recommendations for the analysis of samples using the chemistry methods listed in EPA's Selected Analytical Methods for Environmental Remediation and Recovery (SAM).
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Quality Control Guidelines for SAM Pathogen Methods
Learn more about quality control guidelines and recommendations for the analysis of samples using the biotoxin methods listed in EPA's Selected Analytical Methods for Environmental Remediation and Recovery (SAM).
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Quality Control Guidelines for SAM Radiochemical Methods
Learn more about quality control guidelines and recommendations for the analysis of samples using the radiochemistry methods listed in EPA's Selected Analytical Methods for Environmental Remediation and Recovery (SAM).
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General Quality Control (QC) Guidelines for SAM Methods
Learn more about quality control guidelines and recommendations for the analysis of samples using the methods listed in EPA's Selected Analytical Methods for Environmental Remediation and Recovery (SAM).
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Quality Control Guidelines for SAM Biotoxin Methods
Learn more about quality control guidelines and recommendations for the analysis of samples using the pathogen methods listed in EPA's Selected Analytical Methods for Environmental Remediation and Recovery (SAM).
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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
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CACS: Master Textbook List Helps Solve On-Going Problem.
ERIC Educational Resources Information Center
Anderson, Robert
1979-01-01
The use of a master textbook list developed by the Southern California Association of College Stores (CACS) is described. The three-part program is explained and the information assimilation process, format for revising lists, procedures for implementation, and general guidelines are among areas covered. (PHR)
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Energy Conservation Guidelines for Pennsylvania Schools.
ERIC Educational Resources Information Center
Pennsylvania State Dept. of Education, Harrisburg.
Energy conservation measures that can be effected in the architecture and engineering of new and existing school buildings are listed. Guidelines are also offered for general school operation and maintenance. (MLF)
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DOT National Transportation Integrated Search
1997-01-30
This order lists the location identifiers authorized by the Federal Aviation Administration, Department of the Navy, and Transport Canada. It lists United States airspace fixes and procedure codes. The order also includes guidelines for requesting id...
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Katz, Debra A; Kaplan, Marcia; Stromberg, Sarah E
2012-10-01
A national survey of candidates was conducted to identify motivations for pursuing psychoanalytic training, obstacles that prevent progression or completion, and candidates' ideas on how best to increase interest among potential trainees. In 2009-2010, 40 percent of candidates on the affiliate member e-mail list completed an anonymous web-based survey. Candidates strongly endorsed contact with a personal psychotherapist, psychoanalyst, or supervisor as the most important influence in discovering psychoanalysis and deciding to pursue training. They identified the total cost of analytic training as the greatest obstacle. This was followed by the cost of personal analysis, loss of income for low-fee cases, time away from family, and difficulty finding cases. To enhance training, local institutes should work to improve institute atmosphere and provide assistance with finding cases; national organizations should increase outreach activities and publicize psychoanalysis. Psychoanalytic institutes could recruit future candidates by working to increase personal contact with psychoanalysts, reducing the cost of training, improving institute atmosphere, assisting with case-finding, enhancing outreach activities, and widely publicizing psychoanalysis. Narrative comments from candidates and the implications of these findings regarding engagement of future trainees are discussed.
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School-Based Asthma Case Finding: The Arkansas Experience
ERIC Educational Resources Information Center
Vargas, Perla A.; Magee, James S.; Bushmiaer, Margo; Simpson, Pippa M.; Jones, Craig A.; Feild, Charles R.; Jones, Stacie M.
2006-01-01
This population-based case-finding study sought to determine asthma prevalence and characterize disease severity and burden among school-aged children in the Little Rock School District. Asthma cases were identified by validated algorithm and parental report of asthma diagnosis. The overall response rate was low. Among schools with greater than…
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Prevention of Pica, the Major Cause of Lead Poisoning in Children
ERIC Educational Resources Information Center
de la Burde, Brigitte; Reames, Betty
1973-01-01
Describes a study undertaken to establish a basis for various methods to combat the ingestion of plaster or paint containing lead by children from the lower socio-economic level. Stresses the need for the removal of substandard housing, case-finding, and early treatment of lead poisoning. (Author/SF)
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ERIC Educational Resources Information Center
Sager, Morten; Eriksson, Lena
2015-01-01
In this article we describe and diagnose ailments suffered by the so-called "medical insurance decision-making support tool" that was published in 2007 as part of a major reform of the Swedish social insurance. Through document studies and interviews the guideline is analysed and compared with a reference case, a guideline within…
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Adolescent Dietary Practices: A Consumer Health Perspective.
ERIC Educational Resources Information Center
Petrillo, Jane A.; Meyers, Pamela F.
2002-01-01
Argues that the current and most common eating behaviors of United States youth must be examined to identify effective health promotion and consumer heath strategies regarding the adolescent diet. Presents food selection guidelines for adolescents. Lists guidelines for the school lunch program, grades 7 to 12, guidelines for schools to promote…
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ERIC Educational Resources Information Center
Emergency Librarian, 1992
1992-01-01
This third annual compendium serves up a feast of sources, tips, guidelines, and humor through its many lists. Especially helpful for collection development, it is primarily for teacher librarians who work with teens and children. (EA)
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Joore, Ivo K; Twisk, Denise E; Vanrolleghem, Ann M; de Ridder, Maria; Geerlings, Suzanne E; van Bergen, Jan E A M; van den Broek, Ingrid V
2016-11-17
European guidelines recommend offering an HIV test to individuals who display HIV indicator conditions (ICs). We aimed to investigate the incidence of ICs in primary care reported in medical records prior to HIV diagnosis. We did a cross-sectional search in an electronic general practice database using a matched case-control design to identify which predefined ICs registered by Dutch GPs were most associated with an HIV-positive status prior to the time of diagnosis. We included 224 HIV cases diagnosed from 2009 to 2013, which were matched with 2,193 controls. Almost two thirds (n = 136, 60.7%) of cases were diagnosed with one or more ICs in the period up to five years prior to the index date compared to 18.7% (n = 411) of controls. Cases were more likely to have an IC than controls: in the one year prior to the index date, the odds ratio (OR) for at least one condition was 11.7 (95% CI: 8.3 to 16.4). No significant differences were seen in the strength of the association between HIV diagnosis and ICs when comparing genders, age groups or urbanisation levels. There is no indication that subgroups require a different testing strategy. Our study shows that there are opportunities for IC-guided testing in primary care. We recommend that IC-guided testing be more integrated in GPs' future guidelines and that education strategies be used to facilitate its implementation in daily practice.
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A Sustainable Strategy to Prevent Misuse of Antibiotics for Acute Respiratory Infections
Rattinger, Gail B.; Mullins, C. Daniel; Zuckerman, Ilene H.; Onukwugha, Eberechukwu; Walker, Loreen D.; Gundlapalli, Adi; Samore, Matthew; DeLisle, Sylvain
2012-01-01
Backgrounds Over 50% of antibiotics prescriptions are for outpatients with acute respiratory infections (ARI). Many of them are not needed and thus contribute both avoidable adverse events and pressures toward the development of bacterial resistance. Could a clinical decision support system (CDSS), interposed at the time of electronic prescription, adjust antibiotics utilization toward consensus treatment guidelines for ARI? Methods This is a retrospective comparison of pre- (2002) and post-intervention (2003–2006) periods at two comprehensive health care systems (intervention and control). The intervention was a CDSS that targeted fluoroquinolone and azithromycin; other antibiotics remained unrestricted. 7000 outpatients visits flagged by an ARI case-finding algorithm were reviewed for congruence with the guidelines (antibiotic prescribed-when-warranted or not-prescribed-when-unwarranted). Results 3831 patients satisfied the case definitions for one or more ARI: pneumonia (537), bronchitis (2931), sinusitis (717) and non-specific ARI (145). All patients with pneumonia received antibiotics. The relative risk (RR) of congruent prescribing was 2.57 (95% CI = (1.865 to 3.540) in favor of the intervention site for the antibiotics targeted by the CDSS; congruence did not change for other antibiotics (adjusted RR = 1.18 (95% CI = (0.691 to 2.011)). The proportion of unwarranted prescriptions of the targeted antibiotics decreased from 22% to 3%, pre vs. post-intervention (p<0.0001). Conclusions A CDSS interposed at the time of e-prescription nearly extinguished unwarranted use targeted antibiotics for ARI for four years. This intervention highlights a path toward sustainable antibiotics stewardship for outpatients with ARI. PMID:23251440
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Recipient selection process and listing for lung transplantation
Dupont, Lieven; Yserbyt, Jonas; Schaevers, Veronique; Van Raemdonck, Dirk; Neyrinck, Arne; Vos, Robin
2017-01-01
Lung transplantation remains the ultimate treatment option for selected patients with end-stage (cardio) pulmonary disease. Given the current organ shortage, it is without any doubt that careful selection of potential transplant candidates is essential as this may greatly influence survival after the procedure. In this paper, we will review the current guidelines for referral and listing of lung transplant candidates in general, and in more depth for the specific underlying diseases. Needless to state that these are not absolute guidelines, and that decisions depend upon center’s activity, waiting list, etc. Therefore, every patient should be discussed with the transplant center before any definite decision is made to accept or decline a patient for lung transplantation. PMID:29221322
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A national database for essential drugs in South Africa.
Zweygarth, M; Summers, R S
2000-06-01
In the process of drafting standard treatment guidelines for adults and children at hospital level, the Secretariat of the National Essential Drugs List Committee made use of a database designed with technical support from the School of Pharmacy, MEDUNSA. The database links the current 697 drugs on the Essential Drugs List with Standard Treatment Guidelines for over 400 conditions. It served to streamline the inclusion of different drugs and dosage forms in the various guidelines, and provided concise, updated information to other departments involved in drug procurement. From information on drug prices and morbidity, it can also be used to calculate drug consumption and cost estimates and compare them with actual figures.
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Rector, Thomas S; Wickstrom, Steven L; Shah, Mona; Thomas Greeenlee, N; Rheault, Paula; Rogowski, Jeannette; Freedman, Vicki; Adams, John; Escarce, José J
2004-01-01
Objective To examine the effects of varying diagnostic and pharmaceutical criteria on the performance of claims-based algorithms for identifying beneficiaries with hypertension, heart failure, chronic lung disease, arthritis, glaucoma, and diabetes. Study Setting Secondary 1999–2000 data from two Medicare+Choice health plans. Study Design Retrospective analysis of algorithm specificity and sensitivity. Data Collection Physician, facility, and pharmacy claims data were extracted from electronic records for a sample of 3,633 continuously enrolled beneficiaries who responded to an independent survey that included questions about chronic diseases. Principal Findings Compared to an algorithm that required a single medical claim in a one-year period that listed the diagnosis, either requiring that the diagnosis be listed on two separate claims or that the diagnosis to be listed on one claim for a face-to-face encounter with a health care provider significantly increased specificity for the conditions studied by 0.03 to 0.11. Specificity of algorithms was significantly improved by 0.03 to 0.17 when both a medical claim with a diagnosis and a pharmacy claim for a medication commonly used to treat the condition were required. Sensitivity improved significantly by 0.01 to 0.20 when the algorithm relied on a medical claim with a diagnosis or a pharmacy claim, and by 0.05 to 0.17 when two years rather than one year of claims data were analyzed. Algorithms that had specificity more than 0.95 were found for all six conditions. Sensitivity above 0.90 was not achieved all conditions. Conclusions Varying claims criteria improved the performance of case-finding algorithms for six chronic conditions. Highly specific, and sometimes sensitive, algorithms for identifying members of health plans with several chronic conditions can be developed using claims data. PMID:15533190
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MedlinePlus FAQ: Listing Your Web Site
... medlineplus.gov/faq/criteria.html Question: How do Web sites get listed in MedlinePlus? To use the ... authoritative resources. MedlinePlus uses quality guidelines to evaluate Web sites. We try to ensure that the information ...
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NASA Technical Reports Server (NTRS)
1972-01-01
Safety requirements and guidelines are listed for the sortie module, upper stage vehicle, and space station for the earth orbit operations of the space shuttle program. The requirements and guidelines are for vehicle design, safety devices, warning devices, operational procedures, and residual hazards.
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A review of clinical practice guidelines for lung cancer
Ball, David; Silvestri, Gerard A.
2013-01-01
Clinical practice guidelines are important evidence-based resources to guide complex clinical decision making. However, it is challenging for health professionals to keep abreast available guidelines and to know how and where to access relevant guidelines. This review examines currently available guidelines for lung cancer published in the English language. Important key features are listed for each identified guideline. The methodology, approaches to dissemination and implementation, and associated resources are summarised. General challenges in the area of guideline development are highlighted. The potential to collaborate more widely across lung cancer guideline developers by sharing literature searches and assessments is discussed. PMID:24163752
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Mori, Amani Thomas; Kaale, Eliangiringa Amos; Ngalesoni, Frida; Norheim, Ole Frithjof; Robberstad, Bjarne
2014-01-01
Background Insufficient access to essential medicines is a major health challenge in developing countries. Despite the importance of Standard Treatment Guidelines and National Essential Medicine Lists in facilitating access to medicines, little is known about how they are updated. This study aims to describe the process of updating the Standard Treatment Guidelines and National Essential Medicine List in Tanzania and further examines the criteria and the underlying evidence used in decision-making. Methods This is a qualitative study in which data were collected by in-depth interviews and document reviews. Interviews were conducted with 18 key informants who were involved in updating the Standard Treatment Guidelines and National Essential Medicine List. We used a thematic content approach to analyse the data. Findings The Standard Treatment Guidelines and National Essential Medicine List was updated by committees of experts who were recruited mostly from referral hospitals and the Ministry of Health and Social Welfare. Efficacy, safety, availability and affordability were the most frequently utilised criteria in decision-making, although these were largely based on experience rather than evidence. In addition, recommendations from international guidelines and medicine promotions also influenced decision-making. Cost-effectiveness, despite being an important criterion for formulary decisions, was not utilised. Conclusions Recent decisions about the selection of essential medicines in Tanzania were made by committees of experts who largely used experience and discretionary judgement, leaving evidence with only a limited role in decision-making process. There may be several reasons for the current limited use of evidence in decision-making, but one hypothesis that remains to be explored is whether training experts in evidence-based decision-making would lead to a better and more explicit use of evidence. PMID:24416293
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Mori, Amani Thomas; Kaale, Eliangiringa Amos; Ngalesoni, Frida; Norheim, Ole Frithjof; Robberstad, Bjarne
2014-01-01
Insufficient access to essential medicines is a major health challenge in developing countries. Despite the importance of Standard Treatment Guidelines and National Essential Medicine Lists in facilitating access to medicines, little is known about how they are updated. This study aims to describe the process of updating the Standard Treatment Guidelines and National Essential Medicine List in Tanzania and further examines the criteria and the underlying evidence used in decision-making. This is a qualitative study in which data were collected by in-depth interviews and document reviews. Interviews were conducted with 18 key informants who were involved in updating the Standard Treatment Guidelines and National Essential Medicine List. We used a thematic content approach to analyse the data. The Standard Treatment Guidelines and National Essential Medicine List was updated by committees of experts who were recruited mostly from referral hospitals and the Ministry of Health and Social Welfare. Efficacy, safety, availability and affordability were the most frequently utilised criteria in decision-making, although these were largely based on experience rather than evidence. In addition, recommendations from international guidelines and medicine promotions also influenced decision-making. Cost-effectiveness, despite being an important criterion for formulary decisions, was not utilised. Recent decisions about the selection of essential medicines in Tanzania were made by committees of experts who largely used experience and discretionary judgement, leaving evidence with only a limited role in decision-making process. There may be several reasons for the current limited use of evidence in decision-making, but one hypothesis that remains to be explored is whether training experts in evidence-based decision-making would lead to a better and more explicit use of evidence.
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Rift Valley Fever, Mayotte, 2007–2008
Giry, Claude; Gabrie, Philippe; Tarantola, Arnaud; Pettinelli, François; Collet, Louis; D’Ortenzio, Eric; Renault, Philippe; Pierre, Vincent
2009-01-01
After the 2006–2007 epidemic wave of Rift Valley fever (RVF) in East Africa and its circulation in the Comoros, laboratory case-finding of RVF was conducted in Mayotte from September 2007 through May 2008. Ten recent human RVF cases were detected, which confirms the indigenous transmission of RFV virus in Mayotte. PMID:19331733
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An Overview of Occupational Alcoholism Issues for the 80's.
ERIC Educational Resources Information Center
McClellan, Keith
1982-01-01
Analyzes the past decade as a period of learning and experimentation in occupational alcoholism and employee assistance programming (EAPs). Suggests future EAPs will place less emphasis on supervisory confrontation than on broader types of casefinding; and early identification, prior to a decline in job performance, will take place. (Author/RC)
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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.
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Chatham-Stephens, Kevin; Taylor, Ethel; Chang, Arthur; Peterson, Amy; Daniel, Johnni; Martin, Colleen; Deuster, Patricia; Noe, Rebecca; Kieszak, Stephanie; Schier, Josh; Klontz, Karl; Lewis, Lauren
2017-01-01
In September 2013, the Hawaii Department of Health (HDOH) was notified of seven adults who developed acute hepatitis after taking OxyELITE Pro™, a weight loss and sports dietary supplement. CDC assisted HDOH with their investigation, then conducted case-finding outside of Hawaii with FDA and the Department of Defense (DoD). We defined cases as acute hepatitis of unknown etiology that occurred from April 1, 2013, through December 5, 2013, following exposure to a weight loss or muscle-building dietary supplement, such as OxyELITE Pro™. We conducted case-finding through multiple sources, including data from poison centers (National Poison Data System [NPDS]) and FDA MedWatch. We identified 40 case-patients in 23 states and two military bases with acute hepatitis of unknown etiology and exposure to a weight loss or muscle building dietary supplement. Of 35 case-patients who reported their race, 15 (42.9%) reported white and 9 (25.7%) reported Asian. Commonly reported symptoms included jaundice, fatigue, and dark urine. Twenty-five (62.5%) case-patients reported taking OxyELITE Pro™. Of these 25 patients, 17 of 22 (77.3%) with available data were hospitalized and 1 received a liver transplant. NPDS and FDA MedWatch each captured seven (17.5%) case-patients. Improving the ability to search surveillance systems like NPDS and FDA MedWatch for individual and grouped dietary supplements, as well as coordinating case-finding with DoD, may benefit ongoing surveillance efforts and future outbreak responses involving adverse health effects from dietary supplements. This investigation highlights opportunities and challenges in using multiple sources to identify cases of suspected supplement associated adverse events. Published 2016. This article is a U.S. Government work and is in the public domain in the USA. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.
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Underreporting of congenital rubella in Italy, 2010-2014.
Giambi, Cristina; Bella, Antonino; Filia, Antonietta; Del Manso, Martina; Nacca, Gloria; Declich, Silvia; Rota, Maria Cristina
2017-07-01
In accordance with the goals of the World Health Organization Regional Committee for Europe, the Italian national Measles and Rubella Elimination Plan 2010-2015 aimed to reduce the incidence of congenital rubella cases to <1 case/100,000 live births by 2015. In Italy, a passive national surveillance system for congenital rubella and rubella in pregnancy is active since 2005. We estimated the degree of underreporting of congenital rubella, performing a capture-recapture analysis of cases detected through two independent sources: the national surveillance system and the national hospital discharge database, in the years 2010-2014. We found that 6 out of 11 cases tracked in the retrospective case-finding from hospital registries had not been notified to the surveillance system, and we estimated a degree of underreporting of 53% for the period 2010-2014. This approach showed to be simple to perform, repeatable, and effective. In order to reduce underreporting, some actions aimed at strengthening surveillance procedures are needed. The adoption on a routine basis of the review of hospital discharge registries for case-finding, monthly zero-reporting, and actions to train and sensitize all the specialists involved in the care of pregnant women and the newborns to notification procedures are recommended. What is Known • In Italy, the incidence of congenital rubella was below the WHO target of 1/100,000 live births in 2005-2015, except for two peaks in 2008 and 2012 (5 and 4/100,000, respectively). • Further efforts are required to improve congenital rubella surveillance so that it is more sensitive and specific. The WHO proposes retrospective case-finding from hospital records as an alternative approach to detect infants with congenital rubella. What is New • Underreporting of congenital rubella in Italy was 53% in 2010-2014. • Hospital discharge registries resulted to be an appropriate source to detect congenital rubella cases.
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Koekkoek, P S; Janssen, J; Kooistra, M; Biesbroek, J M; Groeneveld, O; van den Berg, E; Kappelle, L J; Biessels, G J; Rutten, G E H M
2016-06-01
To evaluate two cognitive tests for case-finding for cognitive impairment in older patients with Type 2 diabetes. Of 1243 invited patients with Type 2 diabetes, aged ≥70 years, 228 participated in a prospective cohort study. Exclusion criteria were: diagnosis of dementia; previous investigation at a memory clinic; and inability to write or read. Patients first filled out two self-administered cognitive tests (Test Your Memory and Self-Administered Gerocognitive Examination). Secondly, a general practitioner, blinded to Test Your Memory and Self-Administered Gerocognitive Examination scores, performed a structured evaluation using the Mini-Mental State Examination. Subsequently, patients suspected of cognitive impairment (on either the cognitive tests or general practitioner evaluation) and a random sample of 30% of patients not suspected of cognitive impairment were evaluated at a memory clinic. Diagnostic accuracy and area under the curve were determined for the Test Your Memory, Self-Administered Gerocognitive Examination and general practitioner evaluation compared with a memory clinic evaluation to detect cognitive impairment (mild cognitive impairment or dementia). A total of 44 participants were diagnosed with cognitive impairment. The Test Your Memory and Self-Administered Gerocognitive Examination questionnaires had negative predictive values of 81 and 85%, respectively. Positive predictive values were 39 and 40%, respectively. The general practitioner evaluation had a negative predictive value of 83% and positive predictive value of 64%. The area under the curve was ~0.70 for all tests. Both the tests evaluated in the present study can easily be used in case-finding strategies for cognitive impairment in patients with Type 2 diabetes in primary care. The Self-Administered Gerocognitive Examination had the best diagnostic accuracy and therefore we would have a slight preference for this test. Applying the Self-Administered Gerocognitive Examination would considerably reduce the number of patients in whom the general practitioner needs to evaluate cognitive functioning to tailor diabetes treatment. © 2015 Diabetes UK.
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Sanchez, Alexandra; Massari, Veronique; Gerhardt, Germano; Espinola, Ana Beatriz; Siriwardana, Mahinda; Camacho, Luiz Antonio B; Larouzé, Bernard
2013-10-20
Tuberculosis (TB) is a major issue in prisons of low and middle income countries where TB incidence rates are much higher in prison populations as compared with the general population. In the Rio de Janeiro (RJ) State prison system, the TB control program is limited to passive case-finding and supervised short duration treatment. The aim of this study was to measure the impact of X-ray screening at entry associated with systematic screening on the prevalence and incidence of active TB. We followed up for 2 years a RJ State prison for adult males (1429 inmates at the beginning of the study) and performed, in addition to passive case-finding, 1) two "cross-sectional" X-ray systematic screenings: the first at the beginning of the study period and the second 13 months later; 2) X-ray screening of inmates entering the prison during the 2 year study period. Bacteriological examinations were performed in inmates presenting any pulmonary, pleural or mediastinal X-ray abnormality or spontaneously attending the prison clinic for symptoms suggestive of TB. Overall, 4326 X-rays were performed and 246 TB cases were identified. Prevalence among entering inmates remained similar during 1st and the 2nd year of the study: 2.8% (21/754) and 2.9% (28/954) respectively, whereas prevalence decreased from 6.0% (83/1374) to 2.8% (35/1244) between 1st and 2nd systematic screenings (p < 0.0001). Incidence rates of cases identified by passive case-finding decreased from 42 to 19 per 1000 person-years between the 1st and the 2nd year (p < 0.0001). Cases identified by screenings were less likely to be bacteriologically confirmed as compared with cases identified by passive-case finding. The strategy investigated, which seems highly effective, should be considered in highly endemic confined settings such as prisons.
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36 CFR Appendix E to Part 1191 - List of Figures and Index
Code of Federal Regulations, 2010 CFR
2010-07-01
... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false List of Figures and Index E Appendix E to Part 1191 Parks, Forests, and Public Property ARCHITECTURAL AND TRANSPORTATION BARRIERS...; ARCHITECTURAL BARRIERS ACT (ABA) ACCESSIBILITY GUIDELINES Pt. 1191, App. E Appendix E to Part 1191—List of...
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Siddique, Iqbal; Mohan, Krishna; Hasan, Fuad; Memon, Anjum; Patty, Istvan; Al-Nakib, Basil
2005-11-28
To assess the appropriateness of referrals and to determine the diagnostic yield of colonoscopy according to the 2000 guidelines of the American Society for Gastrointestinal Endoscopy (ASGE). A total of 736 consecutive patients (415 males, 321 females; mean age 43.6+/-16.6 years) undergoing colonoscopy during October 2001-March 2002 were prospectively enrolled in the study. The 2000 ASGE guidelines were used to assess the appropriateness of the indications for the procedure. Diagnostic yield was defined as the ratio between significant findings detected on colonoscopy and the total number of procedures performed for that indication. The large majority (64%) of patients had colonoscopy for an indication that was considered "generally indicated", it was "generally not indicated" for 20%, and it was "not listed" for 16% in the guidelines. The diagnostic yield of colonoscopy was highest for the "generally indicated" (38%) followed by "not listed" (13%) and "generally not indicated" (5%) categories. In the multivariable analysis, the diagnostic yield was independently associated with the appropriateness of indication that was "generally indicated" (odds ratio=12.3) and referrals by gastroenterologist (odds ratio =1.9). There is a high likelihood of inappropriate referrals for colonoscopy in an open-access endoscopy system. The diagnostic yield of the procedure is dependent on the appropriateness of indication and referring physician's specialty. Certain indications "not listed" in the guidelines have an intermediate diagnostic yield and further studies are required to evaluate whether they should be included in future revisions of the ASGE guidelines.
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GSFC preferred parts lists PPL-17
NASA Technical Reports Server (NTRS)
Baldini, B. P. (Editor)
1984-01-01
A listing of preferred parts, part upgrading procedures, part derating guidelines, and part screening procedures to be used in the selection, procurement, and application of parts for Goddard Space Flight Center (GSFC) space systems and ground support equipment is contained.
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Vernooij, Robin W. M.; Alonso-Coello, Pablo; Brouwers, Melissa
2017-01-01
Background Scientific knowledge is in constant development. Consequently, regular review to assure the trustworthiness of clinical guidelines is required. However, there is still a lack of preferred reporting items of the updating process in updated clinical guidelines. The present article describes the development process of the Checklist for the Reporting of Updated Guidelines (CheckUp). Methods and Findings We developed an initial list of items based on an overview of research evidence on clinical guideline updating, the Appraisal of Guidelines for Research and Evaluation (AGREE) II Instrument, and the advice of the CheckUp panel (n = 33 professionals). A multistep process was used to refine this list, including an assessment of ten existing updated clinical guidelines, interviews with key informants (response rate: 54.2%; 13/24), a three-round Delphi consensus survey with the CheckUp panel (33 participants), and an external review with clinical guideline methodologists (response rate: 90%; 53/59) and users (response rate: 55.6%; 10/18). CheckUp includes 16 items that address (1) the presentation of an updated guideline, (2) editorial independence, and (3) the methodology of the updating process. In this article, we present the methodology to develop CheckUp and include as a supplementary file an explanation and elaboration document. Conclusions CheckUp can be used to evaluate the completeness of reporting in updated guidelines and as a tool to inform guideline developers about reporting requirements. Editors may request its completion from guideline authors when submitting updated guidelines for publication. Adherence to CheckUp will likely enhance the comprehensiveness and transparency of clinical guideline updating for the benefit of patients and the public, health care professionals, and other relevant stakeholders. PMID:28072838
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Better Reading Materials for the Content Areas
ERIC Educational Resources Information Center
Peters, Nathaniel A.; Peters, Juanita I.
1974-01-01
The annotated bibliography (an addendum to the Fall 1973 series of listings published in the Volta Review) lists 16 resource materials and classroom textbooks beneficial for use with deaf students, and guidelines for self-evaluation of practices in teaching reading. (LS)
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40 CFR 461.44 - Pretreatment standards for existing sources (PSES).
Code of Federal Regulations, 2012 CFR
2012-07-01
...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Leclanche... for existing sources listed below: (1) Subpart D—Foliar Battery Miscellaneous Wash—PSES. Pollutant or... battery manufacturing operation other than those battery manufacturing operations listed above. [49 FR...
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40 CFR 461.44 - Pretreatment standards for existing sources (PSES).
Code of Federal Regulations, 2013 CFR
2013-07-01
...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Leclanche... for existing sources listed below: (1) Subpart D—Foliar Battery Miscellaneous Wash—PSES. Pollutant or... battery manufacturing operation other than those battery manufacturing operations listed above. [49 FR...
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40 CFR 461.44 - Pretreatment standards for existing sources (PSES).
Code of Federal Regulations, 2014 CFR
2014-07-01
...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Leclanche... for existing sources listed below: (1) Subpart D—Foliar Battery Miscellaneous Wash—PSES. Pollutant or... battery manufacturing operation other than those battery manufacturing operations listed above. [49 FR...
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ERIC Educational Resources Information Center
Bailey, Constance
1975-01-01
Presented are curriculum guidelines for teaching severely and profoundly retarded students, including students with physical handicaps. In addition to a listing of aims and objectives (such as that the student should analyze the need for space for himself and others), guidelines are provided for the following areas: awareness (of such stimuli as…
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Chalmers, J; MacMahon, S; Mancia, G; Whitworth, J; Beilin, L; Hansson, L; Neal, B; Rodgers, A; Ni Mhurchu, C; Clark, T
1999-01-01
The present Guidelines were prepared by the Guidelines Sub-Committee of the World Health Organization-International Society of Hypertension (WHO-ISH) Mild Hypertension Liaison Committee, the members of which are listed at the end of the text. These guidelines represent the fourth revision of the WHO-ISH Guidelines and were finalised after presentation and discussion at the 7th WHO-ISH Meeting on Hypertension, Fukuoka, Japan, 29th Sept-1st Oct, 1998. Previous versions of the Guidelines were published in Bull WHO 1993, 71:503-517 and J Hypertens 1993, 11:905-918.
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Wibulpolprasert, Suwit
2008-06-01
Since 2004, the Subcommittee for Development of the National List of Essential Drugs (NLED) has embarked upon an historical evolution of applying evidence to the revision, inclusion and exclusion of medicines into and from the list. Then, the revision of the 2008 NLED was the first time in Thai history where the drug selection process in Thailand formally incorporated pharmacoeconomics. At present, the lack of a standard methodology for conducting economic evaluation is a major barrier that diminishes the potential use of economic evidence. The development of national economic evaluation guidelines by a group of national experts was subsequently endorsed by members in the Subcommittee as useful tools for future NLED revision. They emphasize that these guidelines should be applied not only to those evaluations conducted by public institutions but also by private pharmaceutical companies that often use this evidence for their marketing, or even for future requirements of economic information from industry, as complementary evidence for inclusion of health technology.
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Integrated Nutrition Education: Senior High.
ERIC Educational Resources Information Center
Illinois State Board of Education, Springfield.
Designed for implementation across the school year in existing curriculum areas, 18 nutrition activity units for high school students are provided. Each activity unit consists of a list of coordinated curriculum areas, a statement of objectives, guidelines for teachers, a list of learning activities, and bibliographic citations. Various…
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ERIC Educational Resources Information Center
Brown, Marion, Comp.; And Others
This document presents guidelines for handling disruptive behavior in the Schenectady County Public Library (New York). Specific responses are listed for dealing with questions about library selection policy and sudden patron illness or injury. Also listed are responses to problem situations involving angry or irate patrons, assault or physically…
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2012-01-01
Background Among the working population, unemployed and temporary agency workers with psychological problems are a particularly vulnerable group, at risk for sickness absence and prolonged work disability. There is a need for the development of a new protocol for this group, because the existing return to work (RTW) interventions, including practice guidelines, do not address the situation when there is no workplace to return to. The purpose of this study was to (1) describe the adaptations needed in the practice guideline for employed workers to enable its use by insurance physicians (IPs) for counselling of sick-listed unemployed and temporary agency workers with minor psychological problems; and (2) evaluate the experiences of IPs when using the new guidance document for minor psychological problems (MPP guidance document). Methods The MPP guidance document for unemployed and temporary agency workers was developed through discussions with nine IPs and with the help of an expert. Semi-structured interviews with five IPs were then held to evaluate the IPs’ field experience using the MPP guidance document, in terms of (a) feasibility and (b) perceived usefulness of the MPP guidance document. Results The main adaptation introduced in the guideline is that interaction with the workplace, which is absent in this population, needed to be established in an alternative way, i.e., through the involvement of vocational rehabilitation agencies and labour experts. Overall, the guideline required minimal changes. In total, nineteen sick-listed workers were counselled using the MPP guidance document. The overall experience of the IPs was that the MPP guidance document was feasible and useful for the IP, while they had mixed responses on its usefulness for the sick-listed worker, in part due to the follow-up period of this study. Conclusions An existing practice guideline for employed workers was adapted for use as a guidance document for unemployed and temporary agency workers with minor psychological problems. IPs were positive about applying the MPP guidance document. The guidance document provides opportunities for RTW counselling for unemployed and temporary agency workers with minor psychological problems. PMID:23014258
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Kishore, Sandeep P; Blank, Evan; Heller, David J; Patel, Amisha; Peters, Alexander; Price, Matthew; Vidula, Mahesh; Fuster, Valentin; Onuma, Oyere; Huffman, Mark D; Vedanthan, Rajesh
2018-02-06
The World Health Organization (WHO) Model List of Essential Medicines (EML) is a key tool for improving global access to medicines for all conditions, including cardiovascular diseases (CVDs). The WHO EML is used by member states to determine their national essential medicine lists and policies and to guide procurement of medicines in the public sector. Here, we describe our efforts to modernize the EML for global CVD prevention and control. We review the recent history of applications to add, delete, and change indications for CVD medicines, with the aim of aligning the list with contemporary clinical practice guidelines. We have identified 4 issues that affect decisions for the EML and may strengthen future applications: 1) cost and cost-effectiveness; 2) presence in clinical practice guidelines; 3) feedback loops; and 4) community engagement. We share our lessons to stimulate others in the global CVD community to embark on similar efforts. Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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WHO expert committee on specifications for pharmaceutical preparations. Fortieth report.
2006-01-01
This report presents the recommendations of an international group of experts convened by the World Health Organization to consider matters concerning the quality assurance of pharmaceuticals and specifications for drug substances and dosage forms. The report is complemented by a number of annexes. These include: a list of available International Chemical Reference Substances and International Infrared Spectra; supplementary guidelines on good manufacturing practices for heating, ventilation and air-conditioning systems for non-sterile pharmaceutical dosage forms; updated supplementary guidelines on good manufacturing practices for the manufacture of herbal medicines; supplementary guidelines on good manufacturing practices for validation; good distribution practices for pharmaceutical products; a model quality assurance system for procurement agencies (recommendations for quality assurance systems focusing on prequalification of products and manufacturers, purchasing, storage and distribution of pharmaceutical products); multisource (generic) pharmaceutical products: guidelines on registration requirements to establish interchangeability; a proposal to waive in vivo bioequivalence requirements for WHO Model List of Essential Medicines immediate-release, solid oral dosage forms; and additional guidance for organizations performing in vivo bioequivalence studies.
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Injuries to rescue workers following the Oklahoma City bombing.
Dellinger, A M; Waxweiler, R J; Mallonee, S
1997-06-01
The objective of this study was to identify and describe physical injuries to rescue workers in the aftermath of the Oklahoma City bombing. Data were obtained from medical records from 16 hospital emergency departments and specialty clinics in the Oklahoma City area, and reported visits to medical providers at the bombing site. Participants were rescue personnel from the Oklahoma City Fire Department, the mutual aid fire stations in the Oklahoma City area, the Federal Emergency Management Agency's Urban Search and Rescue teams, and military personnel stationed near Oklahoma City. All participants were involved in the rescue and recovery operation. The two main outcome measures were (1) the number, types, and rates of injuries; and (2) comparisons of case-finding methods, including medical chart review and telephone interview. The most common injuries were strains and sprains (21.4%), foreign bodies in eyes (14.5%), and laceration/crush/puncture wounds (18.4%). Of the four case-finding mechanisms, telephone interviews following the event identified the largest number of cases (84.5%). Most injuries were minor; some injuries such as chemical burns were preventable. The potential utility of other data collection mechanisms is considered.
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Poor continuity of care for TB diagnosis and treatment in Zambian Prisons: a situation analysis.
Hatwiinda, S; Topp, S M; Siyambango, M; Harris, J B; Maggard, K R; Chileshe, C; Kapata, N; Reid, S E; Henostroza, G
2018-02-01
Prisons act as infectious disease reservoirs. We aimed to explore the challenges of TB control and continuity of care in prisons in Zambia. We evaluated treatment outcomes for a cohort of inmates diagnosed with TB during a TB REACH funded screening programme initiated by the Zambia Prisons Service and the Centre for Infectious Disease Research in Zambia. Between October 2010 and September 2011, 6282 inmates from six prisons were screened for TB, of whom 374 (6.0%) were diagnosed. TB treatment was initiated in 345 of 374 (92%) inmates. Of those, 66% were cured or completed treatment, 5% died and 29% were lost to follow-up. Among those lost to follow-up, 11% were released into the community and 13% were transferred to other prisons. Weak health systems within the Zambian prison service currently undermines continuity of care, despite intensive TB screening and case-finding interventions. To prevent TB transmission and the development of drug resistance, we need sufficient numbers of competent staff for health care, reliable health information systems including electronic record keeping for prison facilities, and standard operating procedures to guide surveillance, case-finding and timely treatment initiation and completion. © 2017 John Wiley & Sons Ltd.
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Schindler's List: A Viewer's Guide.
ERIC Educational Resources Information Center
Hulkower, Benjamin; And Others
This guide aids in understanding the film, "Schindlers List," and how to present it for classroom use. The guide contains: (1) an historical overview of Krakow (Poland); (2) guidelines for viewing; (3) preparation for viewing; (4) topics for discussion after viewing; (5) activities after viewing; and (6) classroom enrichment activities…
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Proyecto Leer Bulletin, Number 9.
ERIC Educational Resources Information Center
Benson, Susan Shattuck
This bulletin lists addresses of publishers and distributors of audiovisual instructional materials in Spanish in the United States and Latin America. Sources are listed in four categories: (1) federal sources of materials, information on materials, names of resource people, programs, and proposal guidelines concerning the Spanish speaking; (2)…
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Evaluating Math Drill and Practice Programs.
ERIC Educational Resources Information Center
Schnorr, Janice M.; Semmel, Dorothy S.
1986-01-01
General guidelines for a process evaluation of software for a specific subject and grade include: (1) Specify instructional objectives and list desired software program characteristics; (2) Access and review descriptions of programs (information sources for math programs are listed); (3) Preview software; and (4) Compare and make purchase…
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Nutrition: An Anti-Cancer Diet?
ERIC Educational Resources Information Center
Grady, Denise; Siwolop, Sana
1984-01-01
Presents seven dietary guidelines on ways to reduce the risk of contracting cancer, discussing scientific evidence supporting the guidelines. Includes a list of foods indicating possible role in cancer, sources, recommendations related to amount/frequency of intake, and hazards of megadoses. Foods cited include fats, vitamins, alcohol, caffeine,…
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Interim Guidelines Growing Longleaf Seedlings in Containers
James P. Barnett; Mark J. Hainds; George A. Hernandez
2002-01-01
These interim guidelines are designed for producers and users of longleaf pine container stock. They are not meant to exclude any container product. The seedling specifications listed in the preferred category are attainable by the grower and will result in excellent field sur vival and early height growth.
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Planning for Emergencies: A Guide for People with Chronic Kidney Disease
... 3. Continue to limit calcium and high-phosphorus products and maintain phosphate binder regimen. If you are unable to perform as many exchanges as usual, then follow the basic guidelines as listed in this emergency guideline, including limiting fluid and ... there anything else I ...
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Helou, A; Ollenschläger, G
1998-06-01
Recently a German appraisal instrument for clinical guidelines was published that could be used by various parties in formal evaluation of guidelines. An user's guide to the appraisal instrument was designed that contains a detailed explanation for each question to ensure that the instrument is interpreted consistently. This paper describes the purposes, format and contents of the user's guide, and reviews the key factors influencing the validity of guidelines. Taking into account international experiences, the purposes, chances and methodological limitations of a prospective assessment of clinical practice guidelines are discussed.
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-04-03
... Products Requiring Federal Contractor Certification as to Forced or Indentured Child Labor Pursuant to... (``Prohibition of Acquisition of Products Produced by Forced or Indentured Child Labor''), in accordance with the ``Procedural Guidelines for the Maintenance of the List of Products Requiring Federal Contractor Certification...
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Awareness List of Principal Documents and Publications of the General Information Programme.
ERIC Educational Resources Information Center
Lermyte, Catherine; Philippon, Brigitte
This bibliography lists and provides abstracts for the principal documents and publications of the General Information Programme and UNISIST, including guidelines, studies, manuals, directories, and materials from international conferences that are concerned with various aspects of information science, librarianship, and archive science. The list…
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Power Pack Your Center Brochure--Keys To Developing an Effective Marketing Tool.
ERIC Educational Resources Information Center
Wassom, Julie
2000-01-01
Suggests that a center's informational brochure can be either a valuable marketing tool or an expensive elimination incentive. Provides a list of five questions center directors should address before beginning the design and development of the center brochure. Lists seven guidelines for brochure development. (SD)
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Consumer Economics Education Guidelines.
ERIC Educational Resources Information Center
VanPatten, Muriel; And Others
These guidelines are designed to assist school districts in the development and implementation of new programs or in strengthening existing programs in consumer economics education at all levels. A variety of resources are included. The need for consumer economics education is discussed and a definition is provided. Goals are listed. Objectives,…
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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...
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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...
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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...
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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...
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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...
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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...
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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...
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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...
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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...
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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...
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Health Services for the School-Age Child: Suggested Guidelines for School Districts.
ERIC Educational Resources Information Center
Oregon State Dept. of Education, Salem.
Organized around eight topics, this document provides guidelines for Oregon school district health services programs for students in preschool/kindergarten through grade twelve. A list of principles related to health program development, a summary of related health legislation, and a checklist for assessing compliance with Oregon administration…
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Guidelines for Nonsexist Use of Language
ERIC Educational Resources Information Center
School Counselor, 1976
1976-01-01
An APA task force, after critically analyzing graduate level psychology textbooks, found sex bias in the style of these books as well as in reporting more studies by males than by females. To avoid future bias, the task force has issued certain guidelines and principles which are listed in this article. (SE)
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Guidelines for Communication Arts: K-12.
ERIC Educational Resources Information Center
1971
These guidelines are part of a total curricular program K-12 developed for use in the elementary and secondary schools of the Diocese of Cleveland. Objectives for the study of the communication arts in these grades are listed as follows: (1) Listening with attention, discrimination, and empathy, (2) Viewing with perception, discrimination, and…
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Wils, Julien; Fonfrède, Michèle; Augereau, Christine; Watine, Joseph
2014-01-01
Several tools are available to help evaluate the quality of clinical practice guidelines (CPG). The AGREE instrument (Appraisal of guidelines for research & evaluation) is the most consensual tool but it has been designed to assess CPG methodology only. The European federation of laboratory medicine (EFLM) recently designed a check-list dedicated to laboratory medicine which is supposed to be comprehensive and which therefore makes it possible to evaluate more thoroughly the quality of CPG in laboratory medicine. In the present work we test the comprehensiveness of this check-list on a sample of CPG written in French and published in Annales de biologie clinique (ABC). Thus we show that some work remains to be achieved before a truly comprehensive check-list is designed. We also show that there is some room for improvement for the CPG published in ABC, for example regarding the fact that some of these CPG do not provide any information about allowed durations of transport and of storage of biological samples before analysis, or about standards of minimal analytical performance, or about the sensitivities or the specificities of the recommended tests.
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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
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Preparing Students for Computer Aided Drafting (CAD). A Conceptual Approach.
ERIC Educational Resources Information Center
Putnam, A. R.; Duelm, Brian
This presentation outlines guidelines for developing and implementing an introductory course in computer-aided drafting (CAD) that is geared toward secondary-level students. The first section of the paper, which deals with content identification and selection, includes lists of mechanical drawing and CAD competencies and a list of rationales for…
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Solar Cell Efficiency Tables (Version 51)
DOE Office of Scientific and Technical Information (OSTI.GOV)
Levi, Dean H; Green, Martin A.; Hishikawa, Yoshihiro
Consolidated tables showing an extensive listing of the highest independently confirmed efficiencies for solar cells and modules are presented. Guidelines for inclusion of results into these tables are outlined and new entries since July 2017 are reviewed, together with progress over the last 25 years. Appendices are included documenting area definitions and also listing recognised test centres.
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MINIMUM CHECK LIST FOR MECHANICAL PLANS AND SPECIFICATIONS.
ERIC Educational Resources Information Center
PIERCE, J.L.
THIS BULLETIN HAS BEEN PREPARED FOR USE AS A MINIMUM CHECK LIST IN THE DEVELOPMENT AND REVIEW OF MECHANICAL AND ELECTRICAL PLANS AND SPECIFICATIONS BY ENGINEERS, ARCHITECTS, AND SUPERINTENDENTS IN PLANNING PUBLIC SCHOOL FACILITIES. THREE LEVELS OF GUIDELINES ARE MENTIONED--(1) MANDATORY BECAUSE OF LAW, CODE, OR REGULATION, (2) RECOMMENDED AS MOST…
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Foundations that Provide Support for Human Services: A Selected List.
ERIC Educational Resources Information Center
Smith, Bertha, Comp.
Lists of foundations can aid the user in securing funding sources for projects in the areas of health, education, community development and/or social services. The user is cautioned that grantsmanship is a competitive process; grants application procedures vary from one foundation to another. In the absence of any specific guidelines, important…
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Biological Science: An Ecological Approach. BSCS Green Version. Teacher's Edition. Sixth Edition.
ERIC Educational Resources Information Center
Biological Sciences Curriculum Study, Colorado Springs.
This book is the teacher's edition to the 1987 edition of the Biological Sciences Curriculum Study Green Version textbook. It contains directions for teaching with this version, a description of the accompanying materials, teaching strategies by chapters, lists of useful software, safety guidelines, a materials list, chemical safety information,…
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Workplace ESL Literacy Program of the Los Angeles Herald Examiner Newspaper.
ERIC Educational Resources Information Center
Herald Examiner, Los Angeles, CA.
This packet of materials from the Los Angeles Herald Examiner's English-as-a-Second-Language (ESL) workplace literacy program, defunct since the newspaper's closing, contains the following items: an overview of the program; a list of units and subunits; two sample lesson plans; teacher guidelines about evaluation and progress; lists of specific…
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77 FR 12907 - Visual-Manual NHTSA Driver Distraction Guidelines for In-Vehicle Electronic Devices
Federal Register 2010, 2011, 2012, 2013, 2014
2012-03-02
... impact of task performance while driving on driving safety and time-based acceptance criteria for... feedback). The proposed NHTSA Guidelines list certain secondary, non-driving related tasks that, based on... cannot be used by the driver to perform such tasks while the driver is driving. For all other secondary...
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ERIC Educational Resources Information Center
DeBlasi, Robert V.
Guidelines of a four-phase model for conducting leadership conferences are outlined. Phase I focuses on initial conference planning, including (1) identifying need and purpose for the conference; (2) selecting a conference chairperson; (3) forming the conference planning committee, listing suggested committees and their responsibilities (program,…
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ERIC Educational Resources Information Center
Manitoba Dept. of Education, Winnipeg.
This teaching guide contains guidelines for conducting five secondary-level marketing cluster courses--Retailing 102, Promotions 202, Relations in Business 202, Management 302, and Marketing Practicum 302. Covered first are goals and objectives, teachers' notes and suggested activities, lists of suggested materials, and guidelines for correlating…
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Reporting studies on time to diagnosis: proposal of a guideline by an international panel (REST).
Launay, Elise; Cohen, Jérémie F; Bossuyt, Patrick M; Buekens, Pierre; Deeks, Jonathan; Dye, Timothy; Feltbower, Richard; Ferrari, Andrea; Kramer, Michael; Leeflang, Mariska; Moher, David; Moons, Karel G; von Elm, Erik; Ravaud, Philippe; Chalumeau, Martin
2016-09-27
Studies on time to diagnosis are an increasing field of clinical research that may help to plan corrective actions and identify inequities in access to healthcare. Specific features of time to diagnosis studies, such as how participants were selected and how time to diagnosis was defined and measured, are poorly reported. The present study aims to derive a reporting guideline for studies on time to diagnosis. Each item of a list previously used to evaluate the completeness of reporting of studies on time to diagnosis was independently evaluated by a core panel of international experts (n = 11) for relevance and readability before an open electronic discussion allowed consensus to be reached on a refined list. The list was then submitted with an explanatory document to first, last and/or corresponding authors (n = 98) of published systematic reviews on time to diagnosis (n = 45) for relevance and readability, and finally approved by the core expert panel. The refined reporting guideline consists of a 19-item checklist: six items are about the process of participant selection (with a suggested flowchart), six about the definition and measurement of time to diagnosis, and three about optional analyses of associations between time to diagnosis and participant characteristics and health outcomes. Of 24 responding authors of systematic reviews, more than 21 (≥88 %) rated the items as relevant, and more than 17 (≥70 %) as readable; 19 of 22 (86 %) authors stated that they would potentially use the reporting guideline in the future. We propose a reporting guideline (REST) that could help authors, reviewers, and editors of time to diagnosis study reports to improve the completeness and the accuracy of their reporting.
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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.
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COS-STAR: a reporting guideline for studies developing core outcome sets (protocol).
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.
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2014-01-01
Background Spirometry is commonly accepted as the gold standard for the diagnosis of COPD, but the reality remains that quality assured spirometry is not or cannot be provided universally around the globe. Adding PEF measurement to a screening questionnaire may rule out airflow limitation compatible with COPD rationalizing spirometry testing. Methods We conducted a cross-sectional survey in a sample of individuals 40–80 yrs. old in Dubai, UAE. They were invited to answer a short socio-demographic questionnaire including a report on current, past history of smoking, and had PEF measured, then they conducted spirometry to identify airflow limitation compatible with COPD. Results Overall, 525 (91.0%) participants performed PEF and spirometry (68% male, with a mean age of 59 years, 17% UAE Nationals), 24% reported smoking of different sorts. Overall, 68 participants (12.9%, 95% C.I. 10.3% to 16.1%) had airflow limitation compatible with COPD. PEFR alone identified 141participants with airflow limitation compatible with COPD, with specificity of 80% and sensitivity of 73.5%. Conclusions PEFR could be an easy, cheap, and non-biased tool to assist with the case-finding of COPD before confirmation with spirometry. PMID:24739210
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Genetic data and the listing of species under the U.S. Endangered Species Act.
Fallon, Sylvia M
2007-10-01
Genetic information is becoming an influential factor in determining whether species, subspecies, and distinct population segments qualify for protection under the U.S. Endangered Species Act. Nevertheless, there are currently no standards or guidelines that define how genetic information should be used by the federal agencies that administer the act. I examined listing decisions made over a 10-year period (February 1996-February 2006) that relied on genetic information. There was wide variation in the genetic data used to inform listing decisions in terms of which genomes (mitochondrial vs. nuclear) were sampled and the number of markers (or genetic techniques) and loci evaluated. In general, whether the federal agencies identified genetic distinctions between putative taxonomic units or populations depended on the type and amount of genetic data. Studies that relied on multiple genetic markers were more likely to detect distinctions, and those organisms were more likely to receive protection than studies that relied on a single genetic marker. Although the results may, in part, reflect the corresponding availability of genetic techniques over the given time frame, the variable use of genetic information for listing decisions has the potential to misguide conservation actions. Future management policy would benefit from guidelines for the critical evaluation of genetic information to list or delist organisms under the Endangered Species Act.
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48 CFR 514.270-7 - Guidelines for using the price list method.
Code of Federal Regulations, 2010 CFR
2010-10-01
... work anticipated to be performed during normal working hours. (3) List the unit prices for work to be performed during both normal working hours and outside of normal working hours. (4) Define “normal” in terms of hours and days of the week. (5) Advise bidders of the previous year's total expenditures or...
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2 CFR 180.500 - What is the purpose of the Excluded Parties List System (EPLS)?
Code of Federal Regulations, 2010 CFR
2010-01-01
... 2 Grants and Agreements 1 2010-01-01 2010-01-01 false What is the purpose of the Excluded Parties List System (EPLS)? 180.500 Section 180.500 Grants and Agreements OFFICE OF MANAGEMENT AND BUDGET GOVERNMENTWIDE GUIDANCE FOR GRANTS AND AGREEMENTS Reserved OMB GUIDELINES TO AGENCIES ON GOVERNMENTWIDE DEBARMENT...
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Code of Federal Regulations, 2013 CFR
2013-07-01
... meet the requirements of the Pollution Prevention Alternative listed in Table 8 to this part 455 (or received a modification by Best Professional Judgement for modifications not listed in Table 8 of this part... submit to its NPDES permitting authority a periodic certification statement as described in § 455.41(b...
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Code of Federal Regulations, 2014 CFR
2014-07-01
... meet the requirements of the Pollution Prevention Alternative listed in Table 8 to this part 455 (or received a modification by Best Professional Judgement for modifications not listed in Table 8 of this part... submit to its NPDES permitting authority a periodic certification statement as described in § 455.41(b...
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Code of Federal Regulations, 2012 CFR
2012-07-01
... meet the requirements of the Pollution Prevention Alternative listed in Table 8 to this part 455 (or received a modification by Best Professional Judgement for modifications not listed in Table 8 of this part... submit to its NPDES permitting authority a periodic certification statement as described in § 455.41(b...
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ERIC Educational Resources Information Center
Massachusetts Inst. of Tech., Cambridge.
A staff development project to create closer integration and mutual support between specialized science and technology curricula and vocational education courses is described. Project activities are listed, and a statement of underlying assumptions is provided. A list of guidelines for coordinating shop and academic projects follows. Guidelines…
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Cosmetic surgery in the NHS: Applying local and national guidelines.
Breuning, Eleonore E; Oikonomou, Dimitris; Singh, Pritam; Rai, Jagdeep K; Mendonca, Derick Amith
2010-09-01
There is no worldwide consensus, as to how healthcare should be funded, in a modern society. Limited resources in the UK, have led to restrictions on cosmetic surgery in the NHS. Guidelines governing access to cosmetic surgery have been formulated. A retrospective audit has been undertaken, to assess adherence to local and national guidelines, in an NHS trust. Ninety-nine casenotes were reviewed over 1 year. Data on complications were collected. Compliance to local guidelines was 44% and to national guidelines was 22%. Complication rate was 23% in guideline compliant patients and 55% in non-compliant patients (P<0.005). Guidelines are difficult to follow in practice. Total adherence to guidelines would reduce waiting lists and complications, but some needy patients could be denied treatment. In practice, rigid adherence to guidelines is not possible. Copyright 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
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A Review of Best Practices for Intravenous Push Medication Administration.
Lenz, Janelle R; Degnan, Daniel D; Hertig, John B; Stevenson, James G
In 2015, the Institute for Safe Medication Practices (ISMP) released safe practice guidelines for adult intravenous (IV) push medications. ISMP's most recent set of guidelines has added to a growing list of recommendations from professional groups on the safe use of IV medications. These recommendations and guidelines vary with regard to their audience, scope, and terminology. In some ways, these variations may contribute to confusion and delayed adoption of the standards. This report attempts to provide clarity about the rationale and background regarding the need for practice improvement, discussion of various guidelines, and practice mitigation strategies to improve patient safety.
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ERIC Educational Resources Information Center
Dawson, Richard G.
Guidelines and readings for an interdisciplinary course in biology and government adapt as a semester or year course for an entire class, independent study, or for teacher resource materials. An attitude questionnaire, list of suggested projects, and reading and writing assignments constitute the guidelines. The content first considers the…
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49 CFR Appendix A to Part 194 - Guidelines for the Preparation of Response Plans
Code of Federal Regulations, 2010 CFR
2010-10-01
...) Oil spill removal organization field equipment deployment drills conducted yearly. (5) A drill that... PLANS FOR ONSHORE OIL PIPELINES Pt. 194, App. A Appendix A to Part 194—Guidelines for the Preparation of... substantial harm to the environment; (4) A list of line sections contained in the response zone, identified by...
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49 CFR Appendix A to Part 194 - Guidelines for the Preparation of Response Plans
Code of Federal Regulations, 2012 CFR
2012-10-01
...) Oil spill removal organization field equipment deployment drills conducted yearly. (5) A drill that... PLANS FOR ONSHORE OIL PIPELINES Pt. 194, App. A Appendix A to Part 194—Guidelines for the Preparation of... substantial harm to the environment; (4) A list of line sections contained in the response zone, identified by...
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49 CFR Appendix A to Part 194 - Guidelines for the Preparation of Response Plans
Code of Federal Regulations, 2013 CFR
2013-10-01
...) Oil spill removal organization field equipment deployment drills conducted yearly. (5) A drill that... PLANS FOR ONSHORE OIL PIPELINES Pt. 194, App. A Appendix A to Part 194—Guidelines for the Preparation of... substantial harm to the environment; (4) A list of line sections contained in the response zone, identified by...
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49 CFR Appendix A to Part 194 - Guidelines for the Preparation of Response Plans
Code of Federal Regulations, 2014 CFR
2014-10-01
...) Oil spill removal organization field equipment deployment drills conducted yearly. (5) A drill that... PLANS FOR ONSHORE OIL PIPELINES Pt. 194, App. A Appendix A to Part 194—Guidelines for the Preparation of... substantial harm to the environment; (4) A list of line sections contained in the response zone, identified by...
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49 CFR Appendix A to Part 194 - Guidelines for the Preparation of Response Plans
Code of Federal Regulations, 2011 CFR
2011-10-01
...) Oil spill removal organization field equipment deployment drills conducted yearly. (5) A drill that... PLANS FOR ONSHORE OIL PIPELINES Pt. 194, App. A Appendix A to Part 194—Guidelines for the Preparation of... substantial harm to the environment; (4) A list of line sections contained in the response zone, identified by...
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The 1985 U.S. Environmental Protection Agency (EPA) Guidelines for Deriving Aquatic Life Criteria (ALC) require acute and chronic toxicity testing with a fixed list of taxa that cover aquatic organisms from vertebrates, invertebrates, and plants. In considering Guideline revision...
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Guidelines for Keeping the Cornell Farm Account Book. Teacher Manual.
ERIC Educational Resources Information Center
Paterson, Dale J.
This teacher's manual is designed to complement the student manual Guidelines for Keeping Cornell Farm Account Book. The first part of the teacher manual contains lists of concepts that should be taught within each of the fifteen units of instruction. The remainder of the teacher's manual provides the fifteen units of instruction included in the…
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Reducing maternal anxiety and stress in pregnancy: what is the best approach?
Fontein-Kuipers, Yvonne
2015-04-01
To briefly review results of the latest research on approaching antenatal maternal anxiety and stress as distinct constructs within a broad spectrum of maternal antenatal distress and the preventive strategic role of the maternal healthcare practitioner. Maternal antenatal anxiety and stress are predominant contributors to short and long-term ill health and reduction of these psychological constructs is evident. Anxiety and stress belong to a broad spectrum of different psychological constructs. Various psychometric instruments are available to measure different individual constructs of antenatal maternal emotional health. Using multiple measures within antenatal care would imply a one-dimensional approach of individual constructs, resulting in inadequate management of care and inefficient use of knowledge and skills of maternity healthcare practitioners. A case-finding approach with slight emphasis on antenatal anxiety with subsequent selection of at-risk women and women suffering from maternal distress are shown to be effective preventive strategies and are consistent with the update of the National Institute for Health and Care Excellence guideline 'Antenatal and postnatal mental health'. Educational aspects of this approach are related to screening and assessment. A shift in perception and attitude towards a broad theoretical and practical approach of antenatal maternal mental health and well-being is required. Case finding with subsequent selective and indicated preventive strategies during pregnancy would conform to this approach and are evidence based.
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ERIC Educational Resources Information Center
Centro Latinoamericano de Educacion de Adultos, Santiago (Chile).
The bibliography forms part of a project to define guidelines for a method of cultural investigation in the education of adults. A brief introduction is followed by a list of libraries and the plan for the listing of entries in the bibliography. Entries are arranged alphabetically by author under the following general headings: background on the…
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Littlewood, Elizabeth; Ali, Shehzad; Ansell, Pat; Dyson, Lisa; Gascoyne, Samantha; Hewitt, Catherine; Keding, Ada; Mann, Rachel; McMillan, Dean; Morgan, Deborah; Swan, Kelly; Waterhouse, Bev; Gilbody, Simon
2016-06-13
Perinatal depression is well recognised as a mental health condition but <50% of cases are identified by healthcare professionals in routine clinical practice. The Edinburgh Postnatal Depression Scale (EPDS) is often used to detect symptoms of postnatal depression in maternity and child services. The National Institute for Health and Care Excellence (NICE) recommends 2 'ultra-brief' case-finding questions (the Whooley questions) to aid identification of depression during the perinatal period, but this recommendation was made in the absence of any validation studies in a perinatal population. Limited research exists on the acceptability of these depression case-finding instruments and the cost-effectiveness of routine screening for perinatal depression. The diagnostic accuracy of the Whooley questions and the EPDS will be determined against a reference standard (the Client Interview Schedule-Revised) during pregnancy (around 20 weeks) and the early postnatal period (around 3-4 months post partum) in a sample of 379 women. Further outcome measures will assess a range of psychological comorbidities, health-related quality of life and resource utilisation. Women will be followed up 12 months postnatally. The sensitivity, specificity and predictive values of the Whooley questions and the EPDS will be calculated against the reference standard at 20 weeks pregnancy and 3-4 months post partum. Acceptability of the depression case-finding instruments to women and healthcare professionals will involve in-depth qualitative interviews. An existing decision analytic model will be adapted to determine the cost-effectiveness of routine screening for perinatal depression. This study is considered low risk for participants. Robust protocols will deal with cases where risk of depression, self-harm or suicide is identified. The protocol received favourable ethical opinion from the North East-York Research Ethics Committee (reference: 11/NE/0022). The study findings will be published in peer-reviewed journals and presented at relevant conferences. 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/
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[Clinical practice guidelines and knowledge management in healthcare].
Ollenschläger, Günter
2013-10-01
Clinical practice guidelines are key tools for the translation of scientific evidence into everyday patient care. Therefore guidelines can act as cornerstones of evidence based knowledge management in healthcare, if they are trustworthy, and its recommendations are not biased by authors' conflict of interests. Good medical guidelines should be disseminated by means of virtual (digital/electronic) health libraries - together with implementation tools in context, such as guideline based algorithms, check lists, patient information, a.s.f. The article presents evidence based medical knowledge management using the German experiences as an example. It discusses future steps establishing evidence based health care by means of combining patient data, evidence from medical science and patient care routine, together with feedback systems for healthcare providers.
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40 CFR 461.14 - Pretreatment standards for existing sources (PSES).
Code of Federal Regulations, 2014 CFR
2014-07-01
...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Cadmium... pollutants from any battery manufacturing operation other than those battery manufacturing operations listed...
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40 CFR 461.65 - Pretreatment standards for new sources (PSNS).
Code of Federal Regulations, 2013 CFR
2013-07-01
...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Magnesium... pollutants from any battery manufacturing operation other than those battery manufacturing operations listed...
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40 CFR 461.55 - Pretreatment standards for new sources (PSNS).
Code of Federal Regulations, 2014 CFR
2014-07-01
...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Lithium... pollutants from any battery manufacturing operation other than those battery manufacturing operations listed...
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40 CFR 461.73 - New source performance standards. (NSPS).
Code of Federal Regulations, 2014 CFR
2014-07-01
...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Zinc Subcategory... pollutants from any battery manufacturing operation other than those battery manufacturing operations listed...
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40 CFR 461.14 - Pretreatment standards for existing sources (PSES).
Code of Federal Regulations, 2012 CFR
2012-07-01
...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Cadmium... pollutants from any battery manufacturing operation other than those battery manufacturing operations listed...
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40 CFR 461.65 - Pretreatment standards for new sources (PSNS).
Code of Federal Regulations, 2014 CFR
2014-07-01
...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Magnesium... pollutants from any battery manufacturing operation other than those battery manufacturing operations listed...
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40 CFR 461.73 - New source performance standards. (NSPS).
Code of Federal Regulations, 2013 CFR
2013-07-01
...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Zinc Subcategory... pollutants from any battery manufacturing operation other than those battery manufacturing operations listed...
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40 CFR 461.14 - Pretreatment standards for existing sources (PSES).
Code of Federal Regulations, 2013 CFR
2013-07-01
...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Cadmium... pollutants from any battery manufacturing operation other than those battery manufacturing operations listed...
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40 CFR 461.55 - Pretreatment standards for new sources (PSNS).
Code of Federal Regulations, 2013 CFR
2013-07-01
...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Lithium... pollutants from any battery manufacturing operation other than those battery manufacturing operations listed...
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ERIC Educational Resources Information Center
Coombs, W. Timothy
1995-01-01
States that although crisis management has evolved rapidly in the past decade, the symbolic aspect of crisis management has been ignored. Indicates little research has been done to examine the effects of crisis-response strategies to see how they shape public opinion. Presents a list of guidelines for appropriate use of a given strategy (based on…
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ERIC Educational Resources Information Center
Oklahoma State Board of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.
This workbook, comprised of both the teacher and student editions, presents guidelines useful for first-year catfish farmers in Oklahoma using pond or cage cultures to raise channel catfish. The teacher edition is a set of unit guidelines only. Contents include a list of suggested readings, important addresses with types of information available…
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Jurcev Savicević, Anamarija
2009-06-01
High level of tuberculosis (TB) knowledge among physicians is important in order to achieve high case-finding and efficient case-management. Few attempts on how to measure physicians' TB knowledge and understanding of national TB guidelines in middle-TB incidence countries such as Croatia have been reported. Related surveys were carried out mostly in high or low incidence countries. The aim of this study was to investigate TB knowledge among general practitioners (GPs) and paediatricians in Split and Dalmatian County, Croatia and need for TB education through cross-sectional survey based on anonymous questionnaire sent to all of them and completed by 160 (60.8%) subjects. Although the median percentage of correct responses was not low (70.3%), several areas of concern were revealed. Particularly low knowledge about normal breathing as usual physical chest examination finding in pulmonary TB (43.1%), proper drugs combination in initial phase of treatment (35%), and duration of treatment (61.9%) were found. Need for education in TB control was reported in 87.9% of physicians. TB knowledge score was obtained by the number of correct answers to 14 selected questions and it was 8.18 +/- 1.84. Scores according to years of experience, number of treated TB patients and need for education, were not different from each other. Higher score was correlated with paediatricians (p = 0.025) and familiarity with existence of National guidelines (p = 0.002). This study showed gaps in knowledge among physicians being the cornerstone of TB control in Croatia. Given that the most successful intervention in TB control is early detection and early and appropriate treatment, efforts should be done to increase TB knowledge. Majority of participants were willing to take a part in education. This could be a good starting point for organisation of education activities as one of the approaches to reduce tuberculosis burden in middle incidence countries.
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40 CFR 461.63 - New source performance standards (NSPS).
Code of Federal Regulations, 2013 CFR
2013-07-01
... GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Magnesium Subcategory § 461... battery manufacturing operation other than those battery manufacturing operations listed above. [49 FR...
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40 CFR 461.63 - New source performance standards (NSPS).
Code of Federal Regulations, 2014 CFR
2014-07-01
... GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Magnesium Subcategory § 461... battery manufacturing operation other than those battery manufacturing operations listed above. [49 FR...
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Ross, Craig S; Brewer, Robert D; Jernigan, David H
2016-01-01
The purpose of this study was to outline a method to improve alcohol industry compliance with its self-regulatory advertising placement guidelines on television with the goal of reducing youth exposure to noncompliant advertisements. Data were sourced from Nielsen (The Nielsen Company, New York, NY) for all alcohol advertisements on television in the United States for 2005-2012. A "no-buy" list, that is a list of cable television programs and networks to be avoided when purchasing alcohol advertising, was devised using three criteria: avoid placements on programs that were noncompliant in the past (serially noncompliant), avoid placements on networks at times of day when youth make up a high proportion of the audience (high-risk network dayparts), and use a "guardbanded" (or more restrictive) composition guideline when placing ads on low-rated programs (low rated). Youth were exposed to 15.1 billion noncompliant advertising impressions from 2005 to 2012, mostly on cable television. Together, the three no-buy list criteria accounted for 99% of 12.9 billion noncompliant advertising exposures on cable television for youth ages 2-20 years. When we evaluated the no-buy list criteria sequentially and mutually exclusively, serially noncompliant ads accounted for 67% of noncompliant exposure, high-risk network-daypart ads accounted for 26%, and low-rated ads accounted for 7%. These findings suggest that the prospective use of the no-buy list criteria when purchasing alcohol advertising could eliminate most noncompliant advertising exposures and could be incorporated into standard post-audit procedures that are widely used by the alcohol industry in assessing exposure to television advertising.
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40 CFR 461.63 - New source performance standards (NSPS).
Code of Federal Regulations, 2010 CFR
2010-07-01
... GUIDELINES AND STANDARDS BATTERY MANUFACTURING POINT SOURCE CATEGORY Magnesium Subcategory § 461.63 New... battery manufacturing operation other than those battery manufacturing operations listed above. [49 FR...
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40 CFR 461.65 - Pretreatment standards for new sources (PSNS).
Code of Federal Regulations, 2010 CFR
2010-07-01
...) EFFLUENT GUIDELINES AND STANDARDS BATTERY MANUFACTURING POINT SOURCE CATEGORY Magnesium Subcategory § 461... pollutants from any battery manufacturing operation other than those battery manufacturing operations listed...
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Acute oral toxicity test of chemical compounds in silkworms.
Usui, Kimihito; Nishida, Satoshi; Sugita, Takuya; Ueki, Takuro; Matsumoto, Yasuhiko; Okumura, Hidenobu; Sekimizu, Kazuhisa
2016-02-01
This study performed an acute oral toxicity test of 59 compounds in silkworms. These compounds are listed in OECD guidelines as standard substances for a cytotoxicity test, and median lethal dose (LD(50)) werecalculated for each compound. Acute oral LD(50) values in mammals are listed in OECD guidelines and acute oral LD(50) values in silkworms were determined in this study. R(2) for the correlation between LD(50) values in mammals and LD(50) values in silkworms was 0.66. In addition, the acute oral toxicity test in silkworms was performed by two different facilities, and test results from the facilities were highly reproducible. These findings suggest that an acute oral toxicity test in silkworms is a useful way to evaluate the toxicity of compounds in mammals.
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40 CFR 461.13 - New source performance standards (NSPS).
Code of Federal Regulations, 2010 CFR
2010-07-01
... GUIDELINES AND STANDARDS BATTERY MANUFACTURING POINT SOURCE CATEGORY Cadmium Subcategory § 461.13 New source... pollutants from any battery manufacturing operation other than those battery manufacturing operations listed...
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40 CFR 461.53 - New source performance standards (NSPS).
Code of Federal Regulations, 2010 CFR
2010-07-01
... GUIDELINES AND STANDARDS BATTERY MANUFACTURING POINT SOURCE CATEGORY Lithium Subcategory § 461.53 New source... pollutants from any battery manufacturing operation other than those battery manufacturing operations listed...
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40 CFR 461.55 - Pretreatment standards for new sources (PSNS).
Code of Federal Regulations, 2010 CFR
2010-07-01
...) EFFLUENT GUIDELINES AND STANDARDS BATTERY MANUFACTURING POINT SOURCE CATEGORY Lithium Subcategory § 461.55... from any battery manufacturing operation other than those battery manufacturing operations listed above. ...
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40 CFR 455.47 - Pretreatment standards for new sources (PSNS).
Code of Federal Regulations, 2011 CFR
2011-07-01
...) EFFLUENT GUIDELINES AND STANDARDS PESTICIDE CHEMICALS Pesticide Chemicals Formulating and Packaging... Best Engineering Judgement for modifications not listed in Table 8 to this part 455); (2) The...
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40 CFR 455.47 - Pretreatment standards for new sources (PSNS).
Code of Federal Regulations, 2010 CFR
2010-07-01
...) EFFLUENT GUIDELINES AND STANDARDS PESTICIDE CHEMICALS Pesticide Chemicals Formulating and Packaging... Best Engineering Judgement for modifications not listed in Table 8 to this part 455); (2) The...
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40 CFR 461.53 - New source performance standards (NSPS).
Code of Federal Regulations, 2011 CFR
2011-07-01
... GUIDELINES AND STANDARDS BATTERY MANUFACTURING POINT SOURCE CATEGORY Lithium Subcategory § 461.53 New source... pollutants from any battery manufacturing operation other than those battery manufacturing operations listed...
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40 CFR 461.13 - New source performance standards (NSPS).
Code of Federal Regulations, 2011 CFR
2011-07-01
... GUIDELINES AND STANDARDS BATTERY MANUFACTURING POINT SOURCE CATEGORY Cadmium Subcategory § 461.13 New source... pollutants from any battery manufacturing operation other than those battery manufacturing operations listed...
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Project BETA: Biological Education Through Animals.
ERIC Educational Resources Information Center
Abramson, Charles I.; Wallisch, Kristy; Huss, Jeanine M.; Payne, Delissa
1999-01-01
Describes a program in which biology students study animals in pet shops to learn about animal behavior. Lists general guidelines for starting a partnership and presents two sample student activities. (WRM)
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[National and regional prioritisation in Swedish health care: experiences from cardiology].
Carlsson, Jörg
2012-01-01
Prioritisation of medical services in Sweden takes place on two different levels. On the national level, the Swedish priority guidelines ascribe priority values ranging from 1 (high priority) to 10 (low priority) to measures (in terms of condition-treatment pairs) of prevention, diagnosis, treatment and rehabilitation of cardiovascular diseases. In addition, this list contains interventions that should be avoided and those that should only be provided as part of clinical research projects. The government then commissions a multi-professional team under the supervision of the National Board of Health and Welfare "Socialstyelsen" with the development of corresponding guidelines. In addition to the scientific evidence, the priority lists incorporate ethical and economical aspects and are based on the so-called ethics platform consisting of human dignity, needs, solidarity and cost-effectiveness. At the other level of prioritisation there are regional projects aiming at the in- and exclusion of medical measures. The Swedish prioritisation process will be described using the example of priority lists in cardiology. (As supplied by publisher). Copyright © 2012. Published by Elsevier GmbH.
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... Guidelines for Americans and the U.S. Department of Agriculture's MyPlate . Where can I find out more about ... on food sources of folate: U.S. Department of Agriculture's (USDA) National Nutrient Database Nutrient List for folate ( ...
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... Guidelines for Americans and the U.S. Department of Agriculture's MyPlate . Where can I find out more about ... on food sources of selenium: U.S. Department of Agriculture's (USDA) National Nutrient Database Nutrient List for selenium ( ...
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... Guidelines for Americans and the U.S. Department of Agriculture's MyPlate . Where can I find out more about ... on food sources of calcium: U.S. Department of Agriculture's (USDA) National Nutrient Database Nutrient List for calcium ( ...
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... Guidelines for Americans and the U.S. Department of Agriculture's MyPlate . Where can I find out more about ... on food sources of iron: U.S. Department of Agriculture's (USDA) National Nutrient Database Nutrient List for Iron ( ...
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... Guidelines for Americans and the U.S. Department of Agriculture's MyPlate . Where can I find out more about ... on food sources of magnesium: U.S. Department of Agriculture's (USDA) National Nutrient Database Nutrient List for magnesium ( ...
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40 CFR 455.46 - Pretreatment standards for existing sources (PSES).
Code of Federal Regulations, 2014 CFR
2014-07-01
...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) PESTICIDE CHEMICALS Pesticide Chemicals Formulating and... listed in Table 8 to this part 455 (or received a modification by Best Engineering Judgement for...
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40 CFR 455.46 - Pretreatment standards for existing sources (PSES).
Code of Federal Regulations, 2011 CFR
2011-07-01
...) EFFLUENT GUIDELINES AND STANDARDS PESTICIDE CHEMICALS Pesticide Chemicals Formulating and Packaging... listed in Table 8 to this part 455 (or received a modification by Best Engineering Judgement for...
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40 CFR 455.47 - Pretreatment standards for new sources (PSNS).
Code of Federal Regulations, 2012 CFR
2012-07-01
...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) PESTICIDE CHEMICALS Pesticide Chemicals Formulating and... received a modification by Best Engineering Judgement for modifications not listed in Table 8 to this part...
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40 CFR 455.46 - Pretreatment standards for existing sources (PSES).
Code of Federal Regulations, 2012 CFR
2012-07-01
...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) PESTICIDE CHEMICALS Pesticide Chemicals Formulating and... listed in Table 8 to this part 455 (or received a modification by Best Engineering Judgement for...
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40 CFR 455.47 - Pretreatment standards for new sources (PSNS).
Code of Federal Regulations, 2014 CFR
2014-07-01
...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) PESTICIDE CHEMICALS Pesticide Chemicals Formulating and... received a modification by Best Engineering Judgement for modifications not listed in Table 8 to this part...
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40 CFR 455.46 - Pretreatment standards for existing sources (PSES).
Code of Federal Regulations, 2010 CFR
2010-07-01
...) EFFLUENT GUIDELINES AND STANDARDS PESTICIDE CHEMICALS Pesticide Chemicals Formulating and Packaging... listed in Table 8 to this part 455 (or received a modification by Best Engineering Judgement for...
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WHO Expert Committee on Specifications for Pharmaceutical Preparations.
2009-01-01
The Expert Committee on Specifications for Pharmaceutical Preparations works towards clear, independent and practical standards and guidelines for the quality assurance of medicines. Standards are developed by the Committee through worldwide consultation and an international consensus-building process. The following new standards and guidelines were adopted and recommended for use: the current list of available International Chemical Reference Substances and International Infrared Reference Spectra; guidelines on stability testing of active pharmaceutical ingredients and finished pharmaceutical products; procedure for prequalification of pharmaceutical products; and the procedure for assessing the acceptability, in principle, of active pharmaceutical ingredients for use in pharmaceutical products.
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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.
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... Guidelines for Americans and the U.S. Department of Agriculture's MyPlate . Where can I find out more about ... on food sources of zinc: U.S. Department of Agriculture's (USDA’s) National Nutrient Database Nutrient List for zinc ( ...
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... Guidelines for Americans and the U.S. Department of Agriculture's MyPlate . Where can I find out more about ... food sources of vitamin E: U.S. Department of Agriculture's (USDA's) National Nutrient Database Nutrient List for vitamin ...
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... Guidelines for Americans and the U.S. Department of Agriculture's MyPlate . Where can I find out more about ... food sources of vitamin C: U.S. Department of Agriculture's (USDA's) National Nutrient Database Nutrient List for vitamin ...
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... Guidelines for Americans and the U.S. Department of Agriculture's MyPlate . Where can I find out more about ... food sources of vitamin D: U.S. Department of Agriculture's (USDA's) National Nutrient Database Nutrient List for vitamin ...
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... Guidelines for Americans and the U.S. Department of Agriculture's MyPlate . Where can I find out more about ... food sources of vitamin A: U.S. Department of Agriculture's (USDA's) National Nutrient Database Nutrient List for vitamin ...
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40 CFR 461.64 - Pretreatment standards for existing sources (PSES).
Code of Federal Regulations, 2014 CFR
2014-07-01
...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Magnesium... allowance for process wastewater pollutants from any battery manufacturing operation other than those battery manufacturing operations listed above. ...
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40 CFR 461.64 - Pretreatment standards for existing sources (PSES).
Code of Federal Regulations, 2013 CFR
2013-07-01
...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Magnesium... allowance for process wastewater pollutants from any battery manufacturing operation other than those battery manufacturing operations listed above. ...
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... Guidelines for Americans and the U.S. Department of Agriculture’s MyPlate . Where can I find out more about ... on food sources of potassium: U.S. Department of Agriculture’s (USDA) National Nutrient Database Nutrient List for potassium ( ...
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... Guidelines for Americans and the U.S. Department of Agriculture's MyPlate . Where can I find out more about ... food sources of vitamin B6: U.S. Department of Agriculture's (USDA's) National Nutrient Database Nutrient List for vitamin ...
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... Guidelines for Americans and the U.S. Department of Agriculture's MyPlate . Where can I find out more about ... food sources of vitamin B12: U.S. Department of Agriculture's (USDA's) National Nutrient Database Nutrient List for vitamin ...
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Code of Federal Regulations, 2013 CFR
2013-07-01
...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Zinc Subcategory... from any battery manufacturing operation other than those battery manufacturing operations listed above...
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Code of Federal Regulations, 2013 CFR
2013-07-01
...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Cadmium... from any battery manufacturing operation other than those battery manufacturing operations listed above. ...
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Code of Federal Regulations, 2014 CFR
2014-07-01
...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Cadmium... from any battery manufacturing operation other than those battery manufacturing operations listed above. ...
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Code of Federal Regulations, 2014 CFR
2014-07-01
...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Zinc Subcategory... from any battery manufacturing operation other than those battery manufacturing operations listed above...
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Code of Federal Regulations, 2012 CFR
2012-07-01
...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Cadmium... from any battery manufacturing operation other than those battery manufacturing operations listed above. ...
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Development, Validation, and Implementation of a Clinic Nurse Staffing Guideline.
Deeken, Debra Jean; Wakefield, Douglas; Kite, Cora; Linebaugh, Jeanette; Mitchell, Blair; Parkinson, Deidre; Misra, Madhukar
2017-10-01
Ensuring that the level of nurse staffing used to care for patients is appropriate to the setting and service intensity is essential for high-quality and cost-effective care. This article describes the development, validation, and implementation of the clinic technical skills permission list developed specifically to guide nurse staffing decisions in physician clinics of an academic medical center. Results and lessons learned in using this staffing guideline are presented.
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Guidelines for reporting evaluations based on observational methodology.
Portell, Mariona; Anguera, M Teresa; Chacón-Moscoso, Salvador; Sanduvete-Chaves, Susana
2015-01-01
Observational methodology is one of the most suitable research designs for evaluating fidelity of implementation, especially in complex interventions. However, the conduct and reporting of observational studies is hampered by the absence of specific guidelines, such as those that exist for other evaluation designs. This lack of specific guidance poses a threat to the quality and transparency of these studies and also constitutes a considerable publication hurdle. The aim of this study thus was to draw up a set of proposed guidelines for reporting evaluations based on observational methodology. The guidelines were developed by triangulating three sources of information: observational studies performed in different fields by experts in observational methodology, reporting guidelines for general studies and studies with similar designs to observational studies, and proposals from experts in observational methodology at scientific meetings. We produced a list of guidelines grouped into three domains: intervention and expected outcomes, methods, and results. The result is a useful, carefully crafted set of simple guidelines for conducting and reporting observational studies in the field of program evaluation.
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The Potential Impact of a “No-Buy” List on Youth Exposure to Alcohol Advertising on Cable Television
Ross, Craig S.; Brewer, Robert D.; Jernigan, David H.
2016-01-01
Objective: The purpose of this study was to outline a method to improve alcohol industry compliance with its self-regulatory advertising placement guidelines on television with the goal of reducing youth exposure to noncompliant advertisements. Method: Data were sourced from Nielsen (The Nielsen Company, New York, NY) for all alcohol advertisements on television in the United States for 2005–2012. A “no-buy” list, that is a list of cable television programs and networks to be avoided when purchasing alcohol advertising, was devised using three criteria: avoid placements on programs that were noncompliant in the past (serially noncompliant), avoid placements on networks at times of day when youth make up a high proportion of the audience (high-risk network dayparts), and use a “guardbanded” (or more restrictive) composition guideline when placing ads on low-rated programs (low rated). Results: Youth were exposed to 15.1 billion noncompliant advertising impressions from 2005 to 2012, mostly on cable television. Together, the three no-buy list criteria accounted for 99% of 12.9 billion noncompliant advertising exposures on cable television for youth ages 2–20 years. When we evaluated the no-buy list criteria sequentially and mutually exclusively, serially noncompliant ads accounted for 67% of noncompliant exposure, high-risk network-daypart ads accounted for 26%, and low rated ads accounted for 7%. Conclusions: These findings suggest that the prospective use of the no-buy list criteria when purchasing alcohol advertising could eliminate most noncompliant advertising exposures and could be incorporated into standard post-audit procedures that are widely used by the alcohol industry in assessing exposure to television advertising. PMID:26751350
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Kawashita, Futoshi; Taniyama, Yukari; Hwi, Song You; Fujisaki, Takeshi; Kameda, Takashi; Mori, Koji
2005-11-01
Recently, corporate social responsibility (CSR) is becoming widely recognized as an issue for Japanese companies. Corporate responsibility for employees is considered important by various stakeholders, and occupational safety and health is regarded as one of these responsibilities. The present authors examined this issue from the viewpoint of corporate management by analysis of statements found in CSR-related reports. For companies listed on the First Section of the Tokyo Stock Exchange (TSE), we searched for CSR-related reports, and titles and contents, based on two established guidelines: the GRI Sustainability Reporting Guidelines 2002 as the international reference and the Environmental Reporting Guidelines of the Ministry of the Environment, Government of Japan, as the domestic reference. Corporations that published CSR reports were 26.3% (416/1,581) of the total, and large differences were recognized by type of industry. Comparing the numbers of pages for various contents, more concern was shown about the environment than about social activity, indicating the environment to be the main issue of CSR in Japan. In the items included in the guidelines, many matters about occupational accidents were mentioned, but it was found that statements regarding HIV/AIDS, which is not of such strong social concern in Japan, and statements regarding the costs of safety that are difficult to calculate were few. However, statements regarding mental health, which is of high interest socially, were many, even though this issue is not included in the two guidelines used. In revising the guidelines, these matters should be reviewed. In the future, continuance of analysis of CSR-related reports with regard to changes and comparisons with overseas reports will help improve occupational safety and health.
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Peintner, Ursula; Schwarz, Stefanie; Mešić, Armin; Moreau, Pierre-Arthur; Moreno, Gabriel; Saviuc, Philippe
2013-01-01
Mycophiles forage for and pick vast quantities of a wide variety of wild mushroom species. As a result, mushroom intoxications are comparatively frequent in such countries with mycophiles. Thus, national governments are forced to release guidelines or enact legislation in order to ensure the safe commerce of wild mushrooms due to food safety concerns. It is in these guidelines and laws that one can observe whether a country is indeed mycophobic or mycophilic. Furthermore, these laws and guidelines provide valuable information on mushroom preferences and on the consumption habits of each country. As such we were interested in the questions as to whether mushroom consumption behaviour was different within Europe, and if it was possible to discover the typical or distinctive culinary preferences of Slavic or Romanic speaking people, people from special geographical regions or from different zones. This work is based on the analysis of edible mushroom lists available in specific guidelines or legislation related to the consumption and commerce of mushrooms in 27 European countries. The overall diversity of edible mushrooms authorised to be commercialised in Europe is very high. However, only 60 out of a total 268 fungal species can be cultivated. This highlights the importance of guidelines or legislation for the safe commerce of wild mushrooms. The species richness and composition of the mushrooms listed for commerce is very heterogeneous within Europe. The consumption behaviour is not only language-family-related, but is strongly influenced by geographical location and neighbouring countries. Indicator species were detected for different European regions; most of them are widespread fungi, and thus prove culture-specific preferences for these mushrooms. Our results highlight tradition and external input such as trade and cultural exchange as strong factors shaping mushroom consumption behaviour. PMID:23704957
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Peintner, Ursula; Schwarz, Stefanie; Mešić, Armin; Moreau, Pierre-Arthur; Moreno, Gabriel; Saviuc, Philippe
2013-01-01
Mycophiles forage for and pick vast quantities of a wide variety of wild mushroom species. As a result, mushroom intoxications are comparatively frequent in such countries with mycophiles. Thus, national governments are forced to release guidelines or enact legislation in order to ensure the safe commerce of wild mushrooms due to food safety concerns. It is in these guidelines and laws that one can observe whether a country is indeed mycophobic or mycophilic. Furthermore, these laws and guidelines provide valuable information on mushroom preferences and on the consumption habits of each country. As such we were interested in the questions as to whether mushroom consumption behaviour was different within Europe, and if it was possible to discover the typical or distinctive culinary preferences of Slavic or Romanic speaking people, people from special geographical regions or from different zones. This work is based on the analysis of edible mushroom lists available in specific guidelines or legislation related to the consumption and commerce of mushrooms in 27 European countries. The overall diversity of edible mushrooms authorised to be commercialised in Europe is very high. However, only 60 out of a total 268 fungal species can be cultivated. This highlights the importance of guidelines or legislation for the safe commerce of wild mushrooms. The species richness and composition of the mushrooms listed for commerce is very heterogeneous within Europe. The consumption behaviour is not only language-family-related, but is strongly influenced by geographical location and neighbouring countries. Indicator species were detected for different European regions; most of them are widespread fungi, and thus prove culture-specific preferences for these mushrooms. Our results highlight tradition and external input such as trade and cultural exchange as strong factors shaping mushroom consumption behaviour.
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20 CFR 404.1569 - Listing of Medical-Vocational Guidelines in appendix 2.
Code of Federal Regulations, 2011 CFR
2011-04-01
... factors and residual functional capacity is not the same as the corresponding criterion of a rule. In... national economy. Appendix 2 provides rules using this data reflecting major functional and vocational...
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Solar cell efficiency tables (version 50)
DOE Office of Scientific and Technical Information (OSTI.GOV)
Green, Martin A.; Hishikawa, Yoshihiro; Warta, Wilhelm
Consolidated tables showing an extensive listing of the highest independently confirmed efficiencies for solar cells and modules are presented. Guidelines for inclusion of results into these tables are outlined, and new entries since January 2017 are reviewed.
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40 CFR 461.15 - Pretreatment standards for new sources (PSNS).
Code of Federal Regulations, 2010 CFR
2010-07-01
...) EFFLUENT GUIDELINES AND STANDARDS BATTERY MANUFACTURING POINT SOURCE CATEGORY Cadmium Subcategory § 461.15... discharge allowance for process wastewater pollutants from any battery manufacturing operation other than those battery manufacturing operations listed above. ...
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Code of Federal Regulations, 2010 CFR
2010-07-01
...) EFFLUENT GUIDELINES AND STANDARDS BATTERY MANUFACTURING POINT SOURCE CATEGORY Zinc Subcategory § 461.72... battery manufacturing operation other than those battery manufacturing operations listed above. [49 FR...
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40 CFR 461.15 - Pretreatment standards for new sources (PSNS).
Code of Federal Regulations, 2011 CFR
2011-07-01
...) EFFLUENT GUIDELINES AND STANDARDS BATTERY MANUFACTURING POINT SOURCE CATEGORY Cadmium Subcategory § 461.15... discharge allowance for process wastewater pollutants from any battery manufacturing operation other than those battery manufacturing operations listed above. ...
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Code of Federal Regulations, 2010 CFR
2010-07-01
... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS ORGANIC CHEMICALS, PLASTICS, AND SYNTHETIC FIBERS Thermoplastic... concentration listed in the following table. Effluent characteristics BPT Effluent Limitations 1 Maximum for any...
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Code of Federal Regulations, 2010 CFR
2010-07-01
... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS ORGANIC CHEMICALS, PLASTICS, AND SYNTHETIC FIBERS Thermosetting... concentration listed in the following table. Effluent characteristics BPT effluent limitations 1 Maximum for any...
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van Beurden, Karlijn M; Brouwers, Evelien P M; Joosen, Margot C W; Terluin, Berend; van der Klink, Jac J L; van Weeghel, Jaap
2013-03-06
Sickness absence due to common mental disorders (such as depression, anxiety disorder, adjustment disorder) is a problem in many Western countries. Long-term sickness absence leads to substantial societal and financial costs. In workers with common mental disorders, sickness absence costs are much higher than medical costs. In the Netherlands, a practice guideline was developed that promotes an activating approach of the occupational physician to establish faster return-to-work by enhancing the problem-solving capacity of workers, especially in relation to their work environment. Studies on this guideline indicate a promising association between guideline adherence and a shortened sick leave duration, but also minimal adherence to the guideline by occupational physicians. Therefore, this study evaluates the effect of guideline-based care on the full return-to-work of workers who are sick listed due to common mental disorders. This is a two-armed cluster-randomised controlled trial with randomisation at the occupational physician level. During one year, occupational physicians in the intervention group receive innovative training to improve their guideline-based care whereas occupational physicians in the control group provide care as usual. A total of 232 workers, sick listed due to common mental disorders and counselled by participating occupational physicians, will be included. Data are collected via the registration system of the occupational health service, and by questionnaires at baseline and at 3, 6 and 12 months. The primary outcome is time to full return-to-work. Secondary outcomes are partial return-to-work, total number of sick leave days, symptoms, and workability. Personal and work characteristics are the prognostic measures. Additional measures are coping, self-efficacy, remoralization, personal experiences, satisfaction with consultations with the occupational physician and with contact with the supervisor, experiences and behaviour of the supervisor, and the extent of guideline adherence. If the results show that guideline-based care in fact leads to faster and sustainable return-to-work, this study will contribute to lowering personal, societal and financial costs. ISRCTN86605310.
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2013-01-01
Background Sickness absence due to common mental disorders (such as depression, anxiety disorder, adjustment disorder) is a problem in many Western countries. Long-term sickness absence leads to substantial societal and financial costs. In workers with common mental disorders, sickness absence costs are much higher than medical costs. In the Netherlands, a practice guideline was developed that promotes an activating approach of the occupational physician to establish faster return-to-work by enhancing the problem-solving capacity of workers, especially in relation to their work environment. Studies on this guideline indicate a promising association between guideline adherence and a shortened sick leave duration, but also minimal adherence to the guideline by occupational physicians. Therefore, this study evaluates the effect of guideline-based care on the full return-to-work of workers who are sick listed due to common mental disorders. Methods/design This is a two-armed cluster-randomised controlled trial with randomisation at the occupational physician level. During one year, occupational physicians in the intervention group receive innovative training to improve their guideline-based care whereas occupational physicians in the control group provide care as usual. A total of 232 workers, sick listed due to common mental disorders and counselled by participating occupational physicians, will be included. Data are collected via the registration system of the occupational health service, and by questionnaires at baseline and at 3, 6 and 12 months. The primary outcome is time to full return-to-work. Secondary outcomes are partial return-to-work, total number of sick leave days, symptoms, and workability. Personal and work characteristics are the prognostic measures. Additional measures are coping, self-efficacy, remoralization, personal experiences, satisfaction with consultations with the occupational physician and with contact with the supervisor, experiences and behaviour of the supervisor, and the extent of guideline adherence. Discussion If the results show that guideline-based care in fact leads to faster and sustainable return-to-work, this study will contribute to lowering personal, societal and financial costs. Trial registration ISRCTN86605310 PMID:23496948
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Thyroid in pregnancy: From physiology to screening.
Springer, Drahomira; Jiskra, Jan; Limanova, Zdenka; Zima, Tomas; Potlukova, Eliska
2017-03-01
Thyroid hormones are crucial for the growth and maturation of many target tissues, especially the brain and skeleton. During critical periods in the first trimester of pregnancy, maternal thyroxine is essential for fetal development as it supplies thyroid hormone-dependent tissues. The ontogeny of mature thyroid function involves organogenesis, and maturation of the hypothalamus, pituitary and the thyroid gland; and it is almost complete by the 12th-14th gestational week. In case of maternal hypothyroidism, substitution with levothyroxine must be started in early pregnancy. After the 14th gestational week, fetal brain development may already be irreversibly affected by lack of thyroid hormones. The prevalence of manifest hypothyroidism in pregnancy is about 0.3-0.5%. The prevalence of subclinical hypothyroidism varies between 4 and 17%, strongly depending on the definition of the upper TSH cutoff limit. Hyperthyroidism occurs in 0.1-1% of all pregnancies. Positivity for antibodies against thyroid peroxidase (TPOAb) is common in women of childbearing age with an incidence rate of 5.1-12.4%. TPOAb-positivity may be regarded as a manifestation of a general autoimmune state which may alter the fertilization and implantation processes or cause early missed abortions. Women positive for TPOAb are at a significant risk of developing hypothyroidism during pregnancy and postpartum. Laboratory diagnosis of thyroid dysfunction during pregnancy is based upon serum TSH concentration. TSH in pregnancy is physiologically lower than the non-pregnant population. Results of multiple international studies point toward creation of trimester-specific reference intervals for TSH in pregnancy. Screening for hypothyroidism in pregnancy is controversial and its implementation varies from country to country. Currently, the case-finding approach of screening high-risk women is preferred in most countries to universal screening. However, numerous studies have shown that one-third to one-half of women with thyroid disorders escape the case-finding approach. Moreover, the universal screening has been shown to be more cost-effective. Screening for thyroid disorders in pregnancy should include assessment of both TSH and TPOAb, regardless of the screening approach. This review summarizes the current knowledge on physiology of thyroid hormones in pregnancy, causes of maternal thyroid dysfunction and its effects on pregnancy course and fetal development. We discuss the question of case-finding versus universal screening strategies and we display an overview of the analytical methods and their reference intervals in the assessment of thyroid function and thyroid autoimmunity in pregnancy. Finally, we present our results supporting the implementation of universal screening.
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ERIC Educational Resources Information Center
Kirsch, Robert A.; And Others
1989-01-01
The first article discusses CD-ROM pricing and provides a list of databases and magazines available on CD-ROM. The second provides guidelines for purchasing a CD-ROM workstation. The third describes the use of ERIC on CD-ROM as a research tool for high school students. The fourth describes the benefits of using online searching to teach research…
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Simon, Katya; Simon, Valentina; Rosenzweig, Rachel; Barroso, Rebeca; Gillmor-Kahn, Mickey
2018-05-01
Listeria monocytogenes is a foodborne pathogen capable of crossing the placental-fetal barrier; infection with the bacterium causes listeriosis. An exposed fetus may suffer blindness, neurological damage including meningitis, or even death. The adverse consequences of listeriosis place the infection on the federally reportable disease list. Primary prevention relies on women avoiding 6 categories of foods most likely to be contaminated with L monocytogenes, as indicated in guidelines developed by the Centers for Disease Control and Prevention (CDC), adapted by the American College of Obstetricians and Gynecologists (ACOG) in 2014, and reaffirmed without changes by ACOG in 2016. This report contains a critical evaluation of United States listeriosis prevention guidelines. Between 1998 and 2016, there were 876 identified listeriosis events documented in the illness and recall databases maintained by the CDC, Food and Drug Administration (FDA), and United States Department of Agriculture - Food Safety and Inspection Service (USDA-FSIS). Each contaminated food was manually compared to the existing listeriosis avoidance guidelines, placing each event within or outside the guidelines. Trends were analyzed over time. Database analysis demonstrates that prior to the year 2000, abiding by the current guidelines would have prevented all reported listeriosis cases. However, in 2015 and 2016, only 5% of confirmed L monocytogenes infections originated from the 6 food groups listed in the CDC and ACOG guidelines. Similar trends emerged for food processing plant recalls (USDA-FSIS database) and grocery store recalls (FDA database). The total number of listeriosis illnesses in the United States doubled from 2007 to 2014. A gradual shift in detection of L monocytogenes contamination in ready-to-eat meals, frozen foods, and ready-to-eat salads has occurred. Another emerging culprit is pasteurized dairy products. Revision of listeriosis avoidance guidelines by a consensus-seeking, multidisciplinary task force, is needed. © 2018 by the American College of Nurse-Midwives.
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Liquid and gaseous oxygen safety review, volume 2
NASA Technical Reports Server (NTRS)
Lapin, A.
1972-01-01
Guidelines, codes, regulations and special procedures used in the design, installation, fabrication, testing and operations for protection against hazards involved with production, transportation, storage and system handling of oxygen are presented with a list of related references.
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Storyboard Development for Interactive Multimedia Training.
ERIC Educational Resources Information Center
Orr, Kay L.; And Others
1994-01-01
Discusses procedures for storyboard development and provides guidelines for designing interactive multimedia courseware, including interactivity, learner control, feedback, visual elements, motion video, graphics/animation, text, audio, and programming. A topical bibliography that lists 98 items is included. (LRW)
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Solar cell efficiency tables (version 49)
Green, Martin A.; Emery, Keith; Hishikawa, Yoshihiro; ...
2016-11-28
Consolidated tables showing an extensive listing of the highest independently confirmed efficiencies for solar cells and modules are presented. Here, guidelines for inclusion of results into these tables are outlined, and new entries since June 2016 are reviewed.
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Solar cell efficiency tables (version 49)
DOE Office of Scientific and Technical Information (OSTI.GOV)
Green, Martin A.; Emery, Keith; Hishikawa, Yoshihiro
Consolidated tables showing an extensive listing of the highest independently confirmed efficiencies for solar cells and modules are presented. Here, guidelines for inclusion of results into these tables are outlined, and new entries since June 2016 are reviewed.
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Commandant Instructions 3710.5: Aircraft Employment Standards
DOT National Transportation Integrated Search
1997-03-14
Three enclosures provide guidelines for aircraft employment to operational : commanders and planning staffs for derivation of the standards and definitions : of the terms used, listings of standards as they are applied to each Air Station, and gives ...
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A Course on Multimedia Environmental Transport, Exposure, and Risk Assessment.
ERIC Educational Resources Information Center
Cohen, Yoram; And Others
1990-01-01
Included are the general guidelines, outline, a summary of major intermedia transport processes, model features, a discussion of multimedia exposure and health risk, and a list of 50 suggested references for this course. (CW)
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The Picric Acid Episode--An "Isolated Incident" That Wasn't.
ERIC Educational Resources Information Center
McDermott, John J.; Edgar, Irvin T.
1979-01-01
This is an account of the discovery of a potentially dangerous high explosive chemical on storeroom shelves of secondary schools in Pennsylvania. A list of guidelines is given to eliminate problems in the future. (SA)
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Code of Federal Regulations, 2010 CFR
2010-07-01
... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS ORGANIC CHEMICALS, PLASTICS, AND SYNTHETIC FIBERS Other Fibers... concentration listed in the following table. Effluent characteristics BPT effluent limitations 1 Maximum for any...
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Code of Federal Regulations, 2010 CFR
2010-07-01
... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS ORGANIC CHEMICALS, PLASTICS, AND SYNTHETIC FIBERS Rayon Fibers... concentration listed in the following table. Effluent characteristics BPT effluent limitations 1 Maximum for any...
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Hickey, James P.
1996-01-01
This chapter provides a listing of the increasing variety of organic moieties and heteroatom group for which Linear Solvation Energy Relationship (LSER) values are available, and the LSER variable estimation rules. The listings include values for typical nitrogen-, sulfur- and phosphorus-containing moieties, and general organosilicon and organotin groups. The contributions by an ion pair situation to the LSER values are also offered in Table 1, allowing estimation of parameters for salts and zwitterions. The guidelines permit quick estimation of values for the four primary LSER variables Vi/100, π*, Βm, and αm by summing the contribtuions from its components. The use of guidelines and Table 1 significantly simplifies computation of values for the LSER variables for most possible organic comppounds in the environment, including the larger compounds of environmental and biological interest.
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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.
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NASA's Technical Handbook for Avoiding On-Orbit ESD Anomalies Due to Internal Charging Effects
NASA Technical Reports Server (NTRS)
Whittlesey, Albert; Garrett, Henry B.
1996-01-01
This paper describes NASA-HDBK-4002, "Avoiding Problems Caused by Spacecraft On-Orbit Internal Charging Effects". The handbook includes a description of internal charging and why it is of concern to spacecraft designers. It also suggests how to determine when a project needs to consider internal spacecraft charging, it contains an electron penetration depth chart, rationale for a critical electron flux criterion, a worst-case geosynchronous electron plasma spectrum, general design guidelines, quantitative design guidelines, and a typical materials characteristics list. Appendices include a listing of some environment codes, electron transport codes, a discussion of geostationary electron plasma environments, a brief description of electron beam and other materials tests, and transient susceptibility tests. The handbook will be in the web page, hftp://standards.nasa.gov. A prior document, NASA TP2361 "Design Guidelines for Assessing and controlling Spacecraft Charging Effects", 1984, is in use to describe mitigation techniques for the effects of surface charging of satellites in space plasma environments. HDBK-4002 is meant to complement 2361 and together, the pair of documents describe both cause and mitigation designs for problems caused by energetic space plasmas.
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Investing in Obesity Treatment: Kaiser Permanente's Approach to Chronic Disease Management.
Tsai, Adam G; Histon, Trina; Donahoo, W Troy; Hashmi, Shahid; Murali, Sameer; Latare, Peggy; Oliver, Lajune; Slovis, Jennifer; Grall, Sarah; Fisher, David; Solomon, Loel
2016-09-01
Kaiser Permanente, an integrated health care delivery system in the USA, takes a "whole systems" approach to the chronic disease of obesity that begins with efforts to prevent it by modifying the environment in communities and schools. Aggressive case-finding and substantial investment in intensive lifestyle modification programs target individuals at high risk of diabetes and other weight-related conditions. Kaiser Permanente regions are increasingly standardizing their approach when patients with obesity require treatment intensification using medically supervised diets, prescription medication to treat obesity, or weight loss surgery.
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Hodge, Chad M; Narus, Scott P
2018-05-01
Problem list data is a driving force for many beneficial clinical tools, yet these data remain underutilized. We performed a systematic literature review, pulling insights from previous research, aggregating insights into themes, and distilling themes into actionable advice. We sought to learn what changes we could make to existing applications, to the clinical workflow, and to clinicians' perceptions that would improve problem list utilization and increase the prevalence of problems data in the electronic medical record. We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to systematically curate a corpus of pertinent articles. We performed a thematic analysis, looking for interesting excerpts and ideas. By aggregating excerpts from many authors, we gained broader, more inclusive insights into what makes a good problem list and what factors are conducive to its success. Analysis led to a list of 7 benefits of using the problem list, 15 aspects critical to problem list success, and knowledge to help inform policy development, such as consensus on what belongs on the problem list, who should maintain the problem list, and when. A list of suggestions is made on ways in which the problem list can be improved to increase utilization by clinicians. There is also a need for standard measurements of the problem list, so that lists can be measured, compared, and discussed with rigor and a common vocabulary.
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Complex mixtures in industrial workspaces: lessons for indoor air quality evaluations.
Lippy, B E; Turner, R W
1991-11-01
Acceptable occupational exposure levels for hundreds of airborne concentrations of dusts, vapors, fumes, and gases have been set by consensus organizations and regulatory bodies for decades. These levels have established tremendous precedent and are tempting reference values in the relatively new field of indoor air quality evaluations where validated criteria are greatly needed. The American Conference of Government Industrial Hygienists (ACGIH) has been the most visible and productive group setting these guidelines for industrial exposure. The ACGIH Chemical Substances Committee has published an annual list of threshold limit values (TLVs) for more than 40 years. Currently the list covers more than 400 substances. In 1989, the Occupational Safety and Health Administration (OSHA) published updated permissible exposure limits (PELs) for approximately 600 substances. Most PELs before this update were adopted from the 1968 ACGIH list of TLVs and consensus standards of the American Standards Association. This OSHA update has resulted in reductions of 212 PELs and the addition of 164 new levels. The magnitude of the problem of protecting workers can be seen by the small fraction that the OSHA PELs represent of the more than 60,000 entries in the National Institute for Occupational Safety and Health's Registry of Toxic Effects of Chemical Substances. None of these levels, whether guidelines or regulatory requirements, are established based on any possible synergistic effect with other chemicals. The only guidance given by the ACGIH for synergistic effects is that such cases must be determined individually. Clearly, there are major drawbacks in using occupational standards and guidelines for evaluating the health effects of chemical agents that can be found in office settings, often in concentrations orders of magnitude less than what is routinely measured in the workplace. These guidelines are even less valuable when the concern is the complex mixing of chemicals in nonoccupational environments.
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Analysis of on-line clinical laboratory manuals and practical recommendations.
Beckwith, Bruce; Schwartz, Robert; Pantanowitz, Liron
2004-04-01
On-line clinical laboratory manuals are a valuable resource for medical professionals. To our knowledge, no recommendations currently exist for their content or design. To analyze publicly accessible on-line clinical laboratory manuals and to propose guidelines for their content. We conducted an Internet search for clinical laboratory manuals written in English with individual test listings. Four individual test listings in each manual were evaluated for 16 data elements, including sample requirements, test methodology, units of measure, reference range, and critical values. Web sites were also evaluated for supplementary information and search functions. We identified 48 on-line laboratory manuals, including 24 academic or community hospital laboratories and 24 commercial or reference laboratories. All manuals had search engines and/or test indices. No single manual contained all 16 data elements evaluated. An average of 8.9 (56%) elements were present (range, 4-14). Basic sample requirements (specimen and volume needed) were the elements most commonly present (98% of manuals). The frequency of the remaining data elements varied from 10% to 90%. On-line clinical laboratory manuals originate from both hospital and commercial laboratories. While most manuals were user-friendly and contained adequate specimen-collection information, other important elements, such as reference ranges, were frequently absent. To ensure that clinical laboratory manuals are of maximal utility, we propose the following 13 data elements be included in individual test listings: test name, synonyms, test description, test methodology, sample requirements, volume requirements, collection guidelines, transport guidelines, units of measure, reference range, critical values, test availability, and date of latest revision.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Iversen, C.M.; Powell, A.S.; McCormack, M.L.
The second version of the Fine-Root Ecology Database is available for download! Download the full FRED 2.0 data set, user guidance document, map, and list of data sources here. Prior to downloading the data, please read and follow the Data Use Guidelines, and it's worth checking out some tips for using FRED before you begin your analyses. Also, see here for an updating list of corrections to FRED 2.0.
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Methodological Quality of National Guidelines for Pediatric Inpatient Conditions
Hester, Gabrielle; Nelson, Katherine; Mahant, Sanjay; Eresuma, Emily; Keren, Ron; Srivastava, Rajendu
2014-01-01
Background Guidelines help inform standardization of care for quality improvement (QI). The Pediatric Research in Inpatient Settings (PRIS) network published a prioritization list of inpatient conditions with high prevalence, cost, and variation in resource utilization across children’s hospitals. The methodological quality of guidelines for priority conditions is unknown. Objective To rate the methodological quality of national guidelines for 20 priority pediatric inpatient conditions. Design We searched sources including PubMed for national guidelines published 2002–2012. Guidelines specific to one organism, test or treatment, or institution were excluded. Guidelines were rated by two raters using a validated tool (AGREE II) with an overall rating on a 7-point scale (7–highest). Inter-rater reliability was measured with a weighted kappa coefficient. Results 17 guidelines met inclusion criteria for 13 conditions, 7 conditions yielded no relevant national guidelines. The highest methodological quality guidelines were for asthma, tonsillectomy, and bronchiolitis (mean overall rating 7, 6.5 and 6.5 respectively); the lowest were for sickle cell disease (2 guidelines) and dental caries (mean overall rating 4, 3.5, and 3 respectively). The overall weighted kappa was 0.83 (95% confidence interval 0.78–0.87). Conclusions We identified a group of moderate to high methodological quality national guidelines for priority pediatric inpatient conditions. Hospitals should consider these guidelines to inform QI initiatives. PMID:24677729
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Boylan, S; Louie, J C Y; Gill, T P
2012-07-01
Strong evidence linking poor diet and lack of physical activity to risk of obesity and related chronic disease has supported the development and promotion of guidelines to improve population health. Still, obesity continues to escalate as a major health concern, and so the impact of weight-related guidelines on behaviour is unclear. The aim of this review was to examine consumer response to weight-related guidelines. A systematic literature search was performed using Medline, PsycInfo, ProQuest Central and additional searches using Google and reference lists. Of the 1,765 articles identified, 46 relevant titles were included. Most studies examined attitudes towards content, source, tailoring and comprehension of dietary guidelines. Many respondents reported that guidelines were confusing, and that simple, clear, specific, realistic, and in some cases, tailored guidelines are required. Recognition of guidelines did not signify understanding nor did perceived credibility of a source guarantee utilization of guidelines. There was a lack of studies assessing: the impact of guidelines on behaviour; responses to physical activity guidelines; responses among males and studies undertaken in developing countries. Further research is needed, in particular regarding responses to physical activity guidelines and guidelines in different populations. Communication professionals should assist health professionals in the development of accurate and effective weight-related guidelines. © 2012 The Authors. obesity reviews © 2012 International Association for the Study of Obesity.
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Swarm, Robert A.; Abernethy, Amy Pickar; Anghelescu, Doralina L.; Benedetti, Costantino; Buga, Sorin; Cleeland, Charles; deLeon-Casasola, Oscar A.; Eilers, June G.; Ferrell, Betty; Green, Mark; Janjan, Nora A.; Kamdar, Mihir M.; Levy, Michael H.; Lynch, Maureen; McDowell, Rachel M.; Moryl, Natalie; Nesbit, Suzanne A.; Paice, Judith A.; Rabow, Michael W.; Syrjala, Karen L.; Urba, Susan G.; Weinstein, Sharon M.; Dwyer, Mary; Kumar, Rashmi
2018-01-01
Pain is a common symptom associated with cancer and its treatment. Pain management is an important aspect of oncologic care, and unrelieved pain significantly comprises overall quality of life. These NCCN Guidelines list the principles of management and acknowledge the range of complex decisions faced in the management oncologic pain. In addition to pain assessment techniques, these guidelines provide principles of use, dosing, management of adverse effects, and safe handling procedures of pharmacologic therapies and discuss a multidisciplinary approach for the management of cancer pain. PMID:23946177
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-08-02
... 62366:2007. engineering to medical devices. D. General Hospital/General Plastic Surgery: 6-253 Hoists... CLSI H59-A. Thromboembolic Disease; Approved Guideline. F. Nanotechnology: 18-2 Standard Guide for...
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14 CFR 1203.603 - Systematic review for declassification.
Code of Federal Regulations, 2010 CFR
2010-01-01
... INFORMATION SECURITY PROGRAM Declassification and Downgrading § 1203.603 Systematic review for... review guidelines. The Chairperson, NASA Information Security Program Committee, shall develop, in... custodian and referred to the Chairperson, NASA Information Security Program Committee. This listing shall...
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Code of Federal Regulations, 2010 CFR
2010-07-01
... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS BATTERY MANUFACTURING POINT SOURCE CATEGORY Cadmium Subcategory... allowance for process wastewater pollutants from any battery manufacturing operation other than those battery manufacturing operations listed above. ...
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An Update on Football Deaths and Catastrophic Injuries.
ERIC Educational Resources Information Center
Mueller, Frederick O.; Blyth, Carl S.
1986-01-01
The latest figures (1985) indicate a continued decline in football deaths and catastrophic injuries, which is credited to a ban on spearing and to a helmet standard. Guidelines for prevention of fatalities and injuries are listed. (Author/MT)
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Why Hire a Consultant if You Already Know What's Best?
ERIC Educational Resources Information Center
Kaufman, Roger
1996-01-01
Discusses the client-consultant relationship from both sides. Argues that a consulting breakdown can be a chance for both the client and the consultant to grow through negotiation. Lists some basic guidelines for successful consulting relationships. (PEN)
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GASB 8 Compliance; Guidelines to Ease the Pain.
ERIC Educational Resources Information Center
McDougall, Donald B.
1991-01-01
Offers advice to schools and colleges attempting to bring their existing accounting procedures into conformity with "generally accepted accounting principles." Provides data categories for school asset lists and definitions of "cost" most frequently used in fixed asset management. (MLF)
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Code of Federal Regulations, 2013 CFR
2013-07-01
... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Cadmium... allowance for process wastewater pollutants from any battery manufacturing operation other than those battery manufacturing operations listed above. ...
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Code of Federal Regulations, 2014 CFR
2014-07-01
... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Cadmium... allowance for process wastewater pollutants from any battery manufacturing operation other than those battery manufacturing operations listed above. ...
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40 CFR 461.15 - Pretreatment standards for new sources (PSNS).
Code of Federal Regulations, 2012 CFR
2012-07-01
...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Cadmium....16 (b) There shall be no discharge allowance for process wastewater pollutants from any battery manufacturing operation other than those battery manufacturing operations listed above. ...
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40 CFR 461.15 - Pretreatment standards for new sources (PSNS).
Code of Federal Regulations, 2013 CFR
2013-07-01
...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Cadmium....16 (b) There shall be no discharge allowance for process wastewater pollutants from any battery manufacturing operation other than those battery manufacturing operations listed above. ...
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Code of Federal Regulations, 2012 CFR
2012-07-01
... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Cadmium... allowance for process wastewater pollutants from any battery manufacturing operation other than those battery manufacturing operations listed above. ...
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40 CFR 461.15 - Pretreatment standards for new sources (PSNS).
Code of Federal Regulations, 2014 CFR
2014-07-01
...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Cadmium....16 (b) There shall be no discharge allowance for process wastewater pollutants from any battery manufacturing operation other than those battery manufacturing operations listed above. ...
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Code of Federal Regulations, 2011 CFR
2011-07-01
... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS BATTERY MANUFACTURING POINT SOURCE CATEGORY Cadmium Subcategory... allowance for process wastewater pollutants from any battery manufacturing operation other than those battery manufacturing operations listed above. ...
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[Recreation for Youth with Deaf Blindness.
ERIC Educational Resources Information Center
Carr, Theresa, Ed.
1992-01-01
This newsletter special issue focuses on recreational programming for people with deaf blindness. The following individual articles are presented: "Strategies To Promote Community Integrated Recreation: Guidelines for Leisure Coaches" by Joann Enos (which lists seven such strategies); "Assessing Recreation and Leisure…
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World Health Organization and Essential Medicines.
Dugani, Sagar; Wasan, Kishor M; Kissoon, Niranjan
2018-05-01
In June 2017, the World Health Organization released 20th Model List of Essential Medicines for adults and sixth Model List of Essential Medicines for children. In our commentary, we describe the changes to the Essential Medicine list, and identify deficits in excluding medicines for management of diseases with a high burden. In using tracer conditions such as cardiovascular and thromboembolic disease, mental health, and diseases of the musculoskeletal system, we highlight the absence of several medicines, which are incorporated into major clinical practice guidelines. We recommend that the World Health Organization review its process with respect to identifying disease conditions as well as evidence-based therapies. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.
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Reporting Guidelines: Optimal Use in Preventive Medicine and Public Health
Popham, Karyn; Calo, William A.; Carpentier, Melissa Y.; Chen, Naomi E.; Kamrudin, Samira A.; Le, Yen-Chi L.; Skala, Katherine A.; Thornton, Logan R.; Mullen, Patricia Dolan
2012-01-01
Numerous reporting guidelines are available to help authors write higher quality manuscripts more efficiently. Almost 200 are listed on the EQUATOR (Enhancing the Quality and Transparency of Health Research) Network’s website and they vary in authority, usability, and breadth, making it difficult to decide which one(s) to use. This paper provides consistent information about guidelines for preventive medicine and public health and a framework and sequential approach for selecting them. EQUATOR guidelines were reviewed for relevance to target audiences; selected guidelines were classified as “core” (frequently recommended) or specialized, and the latter were grouped by their focus. Core and specialized guidelines were coded for indicators of authority (simultaneous publication in multiple journals, rationale, scientific background supporting each element, expertise of designers, permanent website/named group), usability (presence of checklists and examples of good reporting), and breadth (manuscript sections covered). Discrepancies were resolved by consensus. Selected guidelines are presented in four tables arranged to facilitate selection: core guidelines, all of which pertain to major research designs; guidelines for additional study designs, topical guidelines, and guidelines for particular manuscript sections. A flow diagram provides an overview. The framework and sequential approach will enable authors as well as editors, peer reviewers, researchers, and systematic reviewers to make optimal use of available guidelines to improve the transparency, clarity, and rigor of manuscripts and research protocols and the efficiency of conducing systematic reviews and meta-analyses. PMID:22992369
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Code of Federal Regulations, 2010 CFR
2010-04-01
... EXECUTIVE ORDERS 11988, FLOODPLAIN MANAGEMENT AND 11990, PROTECTION OF WETLANDS Introduction § 725.4... definitions listed in the Glossary of the Council's Floodplain Management Guidelines for Implementing E.O... Council's Principles, Standards and Procedures (P,S,&P), provision of financial assistance for State...
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Solar cell efficiency tables (version 48): Solar cell efficiency tables (version 48)
DOE Office of Scientific and Technical Information (OSTI.GOV)
Green, Martin A.; Emery, Keith; Hishikawa, Yoshihiro
Consolidated tables showing an extensive listing of the highest independently confirmed efficiencies for solar cells and modules are presented. Guidelines for inclusion of results into these tables are outlined, and new entries since January 2016 are reviewed.
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40 CFR 461.73 - New source performance standards. (NSPS).
Code of Federal Regulations, 2010 CFR
2010-07-01
...) EFFLUENT GUIDELINES AND STANDARDS BATTERY MANUFACTURING POINT SOURCE CATEGORY Zinc Subcategory § 461.73 New... times. (b) There shall be no discharge allowance for process wastewater pollutants from any battery manufacturing operation other than those battery manufacturing operations listed above. ...
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40 CFR 401.16 - Conventional pollutants.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 40 Protection of Environment 29 2011-07-01 2009-07-01 true Conventional pollutants. 401.16 Section 401.16 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GENERAL PROVISIONS § 401.16 Conventional pollutants. The following comprise the list of...
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Liquid rocket metal tanks and tank components
NASA Technical Reports Server (NTRS)
Wagner, W. A.; Keller, R. B. (Editor)
1974-01-01
Significant guidelines are presented for the successful design of aerospace tanks and tank components, such as expulsion devices, standpipes, and baffles. The state of the art is reviewed, and the design criteria are presented along with recommended practices. Design monographs are listed.
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What They Should Know About Menstruation.
ERIC Educational Resources Information Center
McNab, Warren L.
1985-01-01
Lists common misconceptions about menstruation and suggests a unit on menstrual education. Activities and guidelines are presented along with unit outline. The outline consists of six major areas: definition and purpose; history; anatomy and reproduction; physiology; protection and discomfort; and related topics. (DH)
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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.
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NASA Video Catalog. Supplement 12
NASA Technical Reports Server (NTRS)
2002-01-01
This report lists 1878 video productions from the NASA STI Database. This issue of the NASA Video Catalog cites video productions listed in the NASA STI Database. The videos listed have been developed by the NASA centers, covering Shuttle mission press conferences; fly-bys of planets; aircraft design, testing and performance; environmental pollution; lunar and planetary exploration; and many other categories related to manned and unmanned space exploration. Each entry in the publication consists of a standard bibliographic citation accompanied by an abstract. The listing of the entries is arranged by STAR categories. A complete Table of Contents describes the scope of each category. For users with specific information, a Title Index is available. A Subject Term Index, based on the NASA Thesaurus, is also included. Guidelines for usage of NASA audio/visual material, ordering information, and order forms are also available.
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Hamer, Mirjam; Biddell, Jasmin; Claus, Nathan; Randall, Kirsten; Alcorn, Dennis; Parker, Gary; Shrime, Mark G
2017-01-01
Over two-thirds of the world’s population lack access to surgical care. Non-governmental organisation’s providing free surgeries may overcome financial barriers, but other barriers to care still exist. This analysis paper discusses two different case-finding strategies in Madagascar that aimed to increase the proportion of poor patients, women and those for whom multiple barriers to care exist. From October 2014 to June 2015, we used a centralised selection strategy, aiming to find 70% of patients from the port city, Toamasina, and 30% from the national capital and two remote cities. From August 2015 to June 2016, a decentralised strategy was used, aiming to find 30% of patients from Toamasina and 70% from 11 remote locations, including the capital. Demographic information and self-reported barriers to care were collected. Wealth quintile was calculated for each patient using a combination of participant responses to asset-related and demographic questions, and publicly available data. A total of 2971 patients were assessed. The change from centralised to decentralised selection resulted in significantly poorer patients undergoing surgery. All reported barriers to prior care, except for lack of transportation, were significantly more likely to be identified in the decentralised group. Patients who identified multiple barriers to prior surgical care were less likely to be from the richest quintile (p=0.037) and more likely to be in the decentralised group (p=0.046). Our country-specific analysis shows that decentralised patient selection strategies may be used to overcome barriers to care and allow patients in greatest need to access surgical care. PMID:29071129
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Case finding of lifestyle and mental health disorders in primary care: validation of the ‘CHAT’ tool
Goodyear-Smith, Felicity; Coupe, Nicole M; Arroll, Bruce; Elley, C Raina; Sullivan, Sean; McGill, Anne-Thea
2008-01-01
Background Primary care is accessible and ideally placed for case finding of patients with lifestyle and mental health risk factors and subsequent intervention. The short self-administered Case-finding and Help Assessment Tool (CHAT) was developed for lifestyle and mental health assessment of adult patients in primary health care. This tool checks for tobacco use, alcohol and other drug misuse, problem gambling, depression, anxiety and stress, abuse, anger problems, inactivity, and eating disorders. It is well accepted by patients, GPs and nurses. Aim To assess criterion-based validity of CHAT against a composite gold standard. Design of study Conducted according to the Standards for Reporting of Diagnostic Accuracy statement for diagnostic tests. Setting Primary care practices in Auckland, New Zealand. Method One thousand consecutive adult patients completed CHAT and a composite gold standard. Sensitivities, specificities, positive and negative predictive values, and likelihood ratios were calculated. Results Response rates for each item ranged from 79.6 to 99.8%. CHAT was sensitive and specific for almost all issues screened, except exercise and eating disorders. Sensitivity ranged from 96% (95% confidence interval [CI] = 87 to 99%) for major depression to 26% (95% CI = 22 to 30%) for exercise. Specificity ranged from 97% (95% CI = 96 to 98%) for problem gambling and problem drug use to 40% (95% CI = 36 to 45%) for exercise. All had high likelihood ratios (3–30), except exercise and eating disorders. Conclusion CHAT is a valid and acceptable case-finding tool for most common lifestyle and mental health conditions. PMID:18186993
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Case-finding for hepatitis C in primary care: a mixed-methods service evaluation
Datta, Shivani; Horwood, Jeremy; Hickman, Matthew; Sharp, Debbie
2014-01-01
Background Hepatitis C is often asymptomatic, presenting with liver failure and cancer decades after infection. People who inject drugs (PWID) and immigrant populations from countries with a moderate-to-high prevalence of hepatitis C virus (HCV) are the main risk groups. Deaths and hospital admissions due to HCV cirrhosis tripled between 1998 and 2010, but the majority of people with chronic HCV are unaware of it. Aim To identify patients at risk of developing hepatitis C using routine GP data, to determine the proportion not tested, and to explore GPs’ views regarding testing. Design and setting Mixed-methods service evaluation (density-based selection of PWID) in six NHS practices in Bristol. Method Patients at risk of HCV were identified. The Health Protection Agency laboratory (now part of Public Health England) provided test results. Semi-structured interviews with 17 GPs were audiorecorded and thematic analyses conducted on anonymised transcripts. Results Of 3765 patients identified as being at risk of developing hepatitis C, 3051 (81%) had no test result, including 53% of PWID and 93% of the ‘ethnicity’ group. All GPs said they usually test PWID. Most GPs test for HIV and hepatitis B in immigrants more often than they test for HCV. Barriers to testing included not questioning patients about risk factors, competing priorities, the chaotic lifestyle of PWID, difficulty extracting information from computerised records, and forgetting to address HCV. Conclusion Computer prompts and GP education on whom to test are warranted. Ensuring that country of origin and drug use is included on the new-patient questionnaire might also aid case-finding for HCV. PMID:24567619
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Case-finding for hepatitis C in primary care: a mixed-methods service evaluation.
Datta, Shivani; Horwood, Jeremy; Hickman, Matthew; Sharp, Debbie
2014-02-01
Hepatitis C is often asymptomatic, presenting with liver failure and cancer decades after infection. People who inject drugs (PWID) and immigrant populations from countries with a moderate-to-high prevalence of hepatitis C virus (HCV) are the main risk groups. Deaths and hospital admissions due to HCV cirrhosis tripled between 1998 and 2010, but the majority of people with chronic HCV are unaware of it. To identify patients at risk of developing hepatitis C using routine GP data, to determine the proportion not tested, and to explore GPs' views regarding testing. Mixed-methods service evaluation (density-based selection of PWID) in six NHS practices in Bristol. Patients at risk of HCV were identified. The Health Protection Agency laboratory (now part of Public Health England) provided test results. Semi-structured interviews with 17 GPs were audiorecorded and thematic analyses conducted on anonymised transcripts. Of 3765 patients identified as being at risk of developing hepatitis C, 3051 (81%) had no test result, including 53% of PWID and 93% of the 'ethnicity' group. All GPs said they usually test PWID. Most GPs test for HIV and hepatitis B in immigrants more often than they test for HCV. Barriers to testing included not questioning patients about risk factors, competing priorities, the chaotic lifestyle of PWID, difficulty extracting information from computerised records, and forgetting to address HCV. Computer prompts and GP education on whom to test are warranted. Ensuring that country of origin and drug use is included on the new-patient questionnaire might also aid case-finding for HCV.
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[Physiotherapy Education in Germany: Ready for Direct Access?
Konrad, R; Konrad, A; Geraedts, M
2017-07-01
Objective: The aim of this study is to investigate whether the curricula for physiotherapy education in Germany conform to standards recommended in the World Confederation for Physical Therapy (WCPT) guideline for physical therapist professional entry-level education, published by the WCPT. This Guideline specifies education standards for physical therapists that are able to act as independent practitioners, without referral from another health care professional. Methods: To assess the German curricula of physical therapist education, a list of assessment dimensions was derived from the WCPT-Guideline by means of content analysis. The content validity of this list was estimated by nine experts using Lawshe's method. The German Training and Examination Regulations for Physiotherapists (PhysTh-AprV) and all available regional curricula were studied. All documents were evaluated by 2 independent coders who rated the conformity of the documents with the assessment dimensions. Results: Based on the Lawshe procedure, the whole test content validity index of the 61 out of 67 examined assessment dimensions was 0,84. Cohen's kappa coefficient for intercoder reliability was 0,71-0,97. The German curricula showed high correlation with the WCPT Guideline on many theoretical basic subjects. Fulfillment of some of the requirements showed heterogeneous results. Autonomous practitioners largely lacked special competencies. Conclusions: None of the German educational standards meets the expectations of the WCPT Guideline in terms of direct access. Considering the deficits of the German educational standards and the release date of some of them, a continuous development of the German education does not appear to be adequate. This issue needs to be addressed in the current debate on health policy. © Georg Thieme Verlag KG Stuttgart · New York.
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Compliance with donor age recommendations in oocyte donor recruitment advertisements in the USA.
Alberta, Hillary B; Berry, Roberta M; Levine, Aaron D
2013-04-01
IVF using donated oocytes offers benefits to many infertile patients, yet the technique also raises a number of ethical concerns, including worries about potential physical and psychological risks to oocyte donors. In the USA, oversight of oocyte donation consists of a combination of federal and state regulations and self-regulatory guidelines promulgated by the American Society for Reproductive Medicine. This study assesses compliance with one of these self-regulatory guidelines - specifically, ASRM's preferred minimum age for donors of 21. To assess compliance, 539 oocyte donor recruitment advertisements from two recruitment channels (Craigslist and college newspapers) were collected and evaluated. Of these, 61% in the Craigslist dataset and 43% in the college newspaper dataset listed minimum ages between 18 and 20, which is inconsistent with ASRM's preferred minimum age recommendation of 21. Advertisements placed by oocyte donor recruitment agencies were more likely than advertisements placed by clinics to specify minimum ages between 18 and 20. These results indicate that ASRM should evaluate and consider revising its donor age guidelines. IVF using donated human eggs can help many patients who have difficulty having children. However, the technique also raises ethical concerns, including concerns about potential physical and psychological harms to egg donors. In the USA, oversight of egg donation relies on a combination of federal and state regulation and professional self-regulation. Governmental regulations address only limited aspects of egg donation, such as the potential spread of infectious diseases and the reporting of success rates, leaving voluntary guidelines developed by an association of medical professionals to address most issues, including ethical concerns raised by the practice. One of these voluntary guidelines recommends that egg donors should be at least 21 years of age. In this article, we analysed 539 egg donor recruitment advertisements published on Craigslist and in college newspapers to see whether fertility clinics and egg donor recruitment agencies follow this recommendation. We found that 61% of advertisements in the Craigslist dataset and 43% of advertisements in the college newspaper dataset listed minimum ages between 18 and 20 and, thus, did not follow the recommendation that egg donors be at least 21 years of age. Advertisements placed by egg donor recruitment agencies were more likely than advertisements placed by fertility clinics to list minimum ages between 18 and 20. These results indicate that the American Society for Reproductive Medicine should evaluate and consider revising its donor age guidelines. Copyright © 2012 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
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Benchmarking of venous thromboembolism prophylaxis practice with ENT.UK guidelines.
Al-Qahtani, Ali S
2017-05-01
The aim of this study was to benchmark our guidelines of prevention of venous thromboembolism (VTE) in ENT surgical population against ENT.UK guidelines, and also to encourage healthcare providers to utilize benchmarking as an effective method of improving performance. The study design is prospective descriptive analysis. The setting of this study is tertiary referral centre (Assir Central Hospital, Abha, Saudi Arabia). In this study, we are benchmarking our practice guidelines of the prevention of VTE in the ENT surgical population against that of ENT.UK guidelines to mitigate any gaps. ENT guidelines 2010 were downloaded from the ENT.UK Website. Our guidelines were compared with the possibilities that either our performance meets or fall short of ENT.UK guidelines. Immediate corrective actions will take place if there is quality chasm between the two guidelines. ENT.UK guidelines are evidence-based and updated which may serve as role-model for adoption and benchmarking. Our guidelines were accordingly amended to contain all factors required in providing a quality service to ENT surgical patients. While not given appropriate attention, benchmarking is a useful tool in improving quality of health care. It allows learning from others' practices and experiences, and works towards closing any quality gaps. In addition, benchmarking clinical outcomes is critical for quality improvement and informing decisions concerning service provision. It is recommended to be included on the list of quality improvement methods of healthcare services.
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Quality Improvement Intervention for Reduction of Redundant Testing.
Ducatman, Alan M; Tacker, Danyel H; Ducatman, Barbara S; Long, Dustin; Perrotta, Peter L; Lawther, Hannah; Pennington, Kelly; Lander, Owen; Warden, Mary; Failinger, Conard; Halbritter, Kevin; Pellegrino, Ronald; Treese, Marney; Stead, Jeffrey A; Glass, Eric; Cianciaruso, Lauren; Nau, Konrad C
2017-01-01
Laboratory data are critical to analyzing and improving clinical quality. In the setting of residual use of creatine kinase M and B isoenzyme testing for myocardial infarction, we assessed disease outcomes of discordant creatine kinase M and B isoenzyme +/troponin I (-) test pairs in order to address anticipated clinician concerns about potential loss of case-finding sensitivity following proposed discontinuation of routine creatine kinase and creatine kinase M and B isoenzyme testing. Time-sequenced interventions were introduced. The main outcome was the percentage of cardiac marker studies performed within guidelines. Nonguideline orders dominated at baseline. Creatine kinase M and B isoenzyme testing in 7496 order sets failed to detect additional myocardial infarctions but was associated with 42 potentially preventable admissions/quarter. Interruptive computerized soft stops improved guideline compliance from 32.3% to 58% ( P < .001) in services not receiving peer leader intervention and to >80% ( P < .001) with peer leadership that featured dashboard feedback about test order performance. This successful experience was recapitulated in interrupted time series within 2 additional services within facility 1 and then in 2 external hospitals (including a critical access facility). Improvements have been sustained postintervention. Laboratory cost savings at the academic facility were estimated to be ≥US$635 000 per year. National collaborative data indicated that facility 1 improved its order patterns from fourth to first quartile compared to peer norms and imply that nonguideline orders persist elsewhere. This example illustrates how pathologists can provide leadership in assisting clinicians in changing laboratory ordering practices. We found that clinicians respond to local laboratory data about their own test performance and that evidence suggesting harm is more compelling to clinicians than evidence of cost savings. Our experience indicates that interventions done at an academic facility can be readily instituted by private practitioners at external facilities. The intervention data also supplement existing literature that electronic order interruptions are more successful when combined with modalities that rely on peer education combined with dashboard feedback about laboratory order performance. The findings may have implications for the role of the pathology laboratory in the ongoing pivot from quantity-based to value-based health care.
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Code of Federal Regulations, 2011 CFR
2011-01-01
... institution or creditor or to a fraudulent Web site. Appropriate responses may include the following: (a... consumer report; or b. The Social Security Number (SSN) has not been issued, or is listed on the Social...
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Statistical Sources for Health Science Librarians.
ERIC Educational Resources Information Center
Weise, Frieda
This continuing education course syllabus presents information on the collection of vital and health statistics, lists of agencies or organizations involved in statistical collection and/or dissemination, annotated bibliographies of statistical sources, and guidelines for accessing statistical information. Topics covered include: (1) the reporting…
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40 CFR 461.14 - Pretreatment standards for existing sources (PSES).
Code of Federal Regulations, 2010 CFR
2010-07-01
...) EFFLUENT GUIDELINES AND STANDARDS BATTERY MANUFACTURING POINT SOURCE CATEGORY Cadmium Subcategory § 461.14... 1.49 (b) There shall be no discharge allowance for process wastewater pollutants from any battery manufacturing operation other than those battery manufacturing operations listed above. ...
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Guidelines for Tailoring DOD-STD-2167A for SDS (Strategic Defense System) Software Development
1988-02-01
UNCLASSIFIED APPENDIX A LIST OF ACRONYMS ABM Anti-Ballistic Missle AP Advanced Prototypes BM/C3 Battle Management/Command, Control, Communications CDRL...32 5.7.5 Configuration management ................................. 32 5.8 Sytem integration and testing ....... ............................. 34 t
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ERIC Educational Resources Information Center
Klein, Regina; And Others
1988-01-01
The first of three articles describes the results of a survey that examined characteristics and responsibilities of help-desk personnel at major database and online services. The second provides guidelines to using such customer services, and the third lists help-desk numbers for online databases and systems. (CLB)
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40 CFR 401.15 - Toxic pollutants.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 40 Protection of Environment 29 2011-07-01 2009-07-01 true Toxic pollutants. 401.15 Section 401.15 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GENERAL PROVISIONS § 401.15 Toxic pollutants. The following comprise the list of toxic pollutants...
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How To Get Your Web Page Noticed.
ERIC Educational Resources Information Center
Schrock, Kathleen
1997-01-01
Presents guidelines for making a Web site noticeable. Discusses submitting the URL to directories, links, and announcement lists, and sending the site over the server via FTP to search engines. Describes how to index the site with "Title,""Heading," and "Meta" tags. (AEF)
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Safety in Academic Chemistry Laboratories. Fourth Edition.
ERIC Educational Resources Information Center
American Chemical Society, Washington, DC.
This booklet provides guidelines for safety in the chemical laboratory. Part I, "Guides for Instructors and Administrators," includes safety rules, safety practices and facilities, preparation for emergencies, safety committees, accident reporting, fire insurance, and listings of some hazardous chemicals. Part II, "Student Guide to…
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Competency-Based Curriculum Guide for Merchandising/Marketing.
ERIC Educational Resources Information Center
Nakamaejo, David T.; And Others
Designed for the curriculum coordinator, this guide provides guidelines for planning postsecondary merchandising/marketing programs. The first section contains competencies identified as essential for occupations in the merchandising/marketing field which are listed by these subject areas: selling, merchandise analysis, wholesaling, marketing,…
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-07-02
... 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... and Instrumented Initial Testing Facilities [[Page 39758
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Computer Bits: Child Care Center Management Software Buying Guide Update.
ERIC Educational Resources Information Center
Neugebauer, Roger
1987-01-01
Compares seven center management programs used for basic financial and data management tasks such as accounting, payroll and attendance records, and mailing lists. Describes three other specialized programs and gives guidelines for selecting the best software for a particular center. (NH)
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ERIC Educational Resources Information Center
Truett, Carol; And Others
1997-01-01
Provides advice for making school Internet-use guidelines. Outlines responsible proactive use of the Internet for educators and librarians, discusses strengths and weaknesses of Internet blocking software and rating systems, and describes acceptable-use policies (AUP). Lists resources for creating your own AUP, Internet filtering software, and…
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Liquid and gaseous oxygen safety review
NASA Technical Reports Server (NTRS)
Lapin, A.
1973-01-01
Materials used in oxygen systems and allowable oxygen environments are specified for each material. Design criteria, cleaning procedures and quality control methods are covered. Guidelines for protection against hazards involved with production, transportation, storage and use of oxygen are presented. Study also lists extensive references.
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40 CFR 461.14 - Pretreatment standards for existing sources (PSES).
Code of Federal Regulations, 2011 CFR
2011-07-01
...) EFFLUENT GUIDELINES AND STANDARDS BATTERY MANUFACTURING POINT SOURCE CATEGORY Cadmium Subcategory § 461.14... 1.49 (b) There shall be no discharge allowance for process wastewater pollutants from any battery manufacturing operation other than those battery manufacturing operations listed above. ...
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Nosadini, Margherita; Mohammad, Shekeeb S; Suppiej, Agnese; Sartori, Stefano; Dale, Russell C
2016-11-01
Intravenous immunoglobulin (IVIG) is an expensive therapy used in immunodeficiency and autoimmune disorders. Increasing demands and consequent shortages result in a need for usage to conform to guidelines. We retrospectively evaluated IVIG use for neuroimmunological indications and adherence to existing guidelines in a major Australian paediatric hospital between 2000 and 2014. One-hundred and ninety-six children (96 male, 100 female; mean age at disease onset 6y 5mo [range 3mo-15y 10mo], mean age at first IVIG dose 7y 2mo [range 3mo-16y 5mo]) received IVIG for neuroimmunological indications during the study period (28.1% had Guillain-Barré syndrome), representing 15.5% of all hospital indications. In total, 1669 IVIG courses were administered (total 57 221g, median 78g/patient, range 12-5748g). The highest median numbers of courses were in chronic inflammatory demyelinating polyneuropathies, opsoclonus-myoclonus ataxia syndrome, suspected immune-mediated epilepsies, and Rasmussen's encephalitis. Adverse reactions occurred in 25.5% of patients, but these were mostly minor. Outcome at follow-up was best in anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis, Guillain-Barré syndrome, and myasthenia gravis, and worst in Rasmussen's encephalitis and epilepsies. The total cost of IVIG was US$2 595 907 (median $3538/patient, range $544-260 766). Of patients receiving IVIG, 45.4% to 57.1% were given the therapy for 'weak' indications or indications 'not listed' in international guidelines. Some entities commonly treated with IVIG in current practice, such as anti-NMDAR encephalitis and transverse myelitis, are not listed in most guidelines. Our study demonstrates that IVIG is generally well tolerated but expensive, and discloses discrepancies between guidelines and clinical practice in paediatric neurology, suggesting both the need for greater adherence to current recommendations, and for recommendations to be updated to accommodate emerging indications. © 2016 Mac Keith Press.
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Clinical Practice Guidelines for Delirium Management: Potential Application in Palliative Care
Bush, Shirley H.; Bruera, Eduardo; Lawlor, Peter G.; Kanji, Salmaan; Davis, Daniel H.J.; Agar, Meera; Wright, David; Hartwick, Michael; Currow, David C.; Gagnon, Bruno; Simon, Jessica; Pereira, José L.
2014-01-01
Context Delirium occurs in patients across a wide array of health care settings. The extent to which formal management guidelines exist or are adaptable to palliative care is unclear. Objectives This review aims to 1) source published delirium management guidelines with potential relevance to palliative care settings, 2) discuss the process of guideline development, 3) appraise their clinical utility, and 4) outline the processes of their implementation and evaluation and make recommendations for future guideline development. Methods We searched PubMed (1990–2013), Scopus, U.S. National Guideline Clearinghouse, Google, and relevant reference lists to identify published guidelines for the management of delirium. This was supplemented with multidisciplinary input from delirium researchers and other relevant stakeholders at an international delirium study planning meeting. Results There is a paucity of high-level evidence for pharmacological and non-pharmacological interventions in the management of delirium in palliative care. However, multiple delirium guidelines for clinical practice have been developed, with recommendations derived from “expert opinion” for areas where research evidence is lacking. In addition to their potential benefits, limitations of clinical guidelines warrant consideration. Guidelines should be appraised and then adapted for use in a particular setting before implementation. Further research is needed on the evaluation of guidelines, as disseminated and implemented in a clinical setting, focusing on measurable outcomes in addition to their impact on quality of care. Conclusion Delirium clinical guidelines are available but the level of evidence is limited. More robust evidence is required for future guideline development. PMID:24766743
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Nsabagasani, Xavier; Ogwal-Okeng, Japer; Hansen, Ebba Holme; Mbonye, Anthony; Muyinda, Herbert; Ssengooba, Freddie
2016-01-01
The Integrated Management of Childhood Illnesses is the main approach for treating children in more than 100 low income countries worldwide. In 2007, the World Health Assembly urged countries to integrate 'better medicines for children' into their essential medicines lists and treatment guidelines. WHO regularly provides generic algorithms for IMCI and publishes the Model Essential Medicines List with child-friendly medicines based on new evidence for member countries to adopt. However, the status of 'better medicines for children' within the Integrated Management of Childhood Illnesses approach in Uganda has not been studied. Qualitative interviews were conducted with: two officials from the ministry of health; two district health officials and, 22 health workers from public health facilities. Interview transcripts were manually analyzed for manifest and latent content. Child-appropriate dosage formulations were not included in the package for the Integrated Management of Childhood Illnesses and ministry officials attributed this to resource constraints and lack of initial guidance from the World Health Organization. Underfunding reportedly undercut efforts to: orient health workers; do support supervision and update treatment guidelines to reflect 'better medicines for children'. Health workers reported difficulties in administering tablets and capsules to under-five children and that's why they preferred liquid oral dosage formulations, suppositories and injections. The IMCI strategy in Uganda was not revised to reflect child-appropriate dosage formulations - a missed opportunity for improving the quality of management of childhood illnesses. Funding was an obstacle to the integration of child-appropriate dosage formulations. Ministry of health should prioritize funding for the Integrated Management of Childhood Illnesses and revising the Essential Medicines and Health Supplies List of Uganda, the Uganda Clinical Guidelines and, the Treatment Charts for the Integrated Management of Childhood Illnesses to reflect child-appropriate dosage formulations.
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Gupta, Veer; Henriksen, Kim; Edwards, Melissa; Jeromin, Andreas; Lista, Simone; Bazenet, Chantal; Soares, Holly; Lovestone, Simon; Hampel, Harald; Montine, Thomas; Blennow, Kaj; Foroud, Tatiana; Carrillo, Maria; Graff-Radford, Neill; Laske, Christoph; Breteler, Monique; Shaw, Leslie; Trojanowski, John Q.; Schupf, Nicole; Rissman, Robert A.; Fagan, Anne M.; Oberoi, Pankaj; Umek, Robert; Weiner, Michael W.; Grammas, Paula; Posner, Holly; Martins, Ralph
2015-01-01
The lack of readily available biomarkers is a significant hindrance towards progressing to effective therapeutic and preventative strategies for Alzheimer’s disease (AD). Blood-based biomarkers have potential to overcome access and cost barriers and greatly facilitate advanced neuroimaging and cerebrospinal fluid biomarker approaches. Despite the fact that preanalytical processing is the largest source of variability in laboratory testing, there are no currently available standardized preanalytical guidelines. The current international working group provides the initial starting point for such guidelines for standardized operating procedures (SOPs). It is anticipated that these guidelines will be updated as additional research findings become available. The statement provides (1) a synopsis of selected preanalytical methods utilized in many international AD cohort studies, (2) initial draft guidelines/SOPs for preanalytical methods, and (3) a list of required methodological information and protocols to be made available for publications in the field in order to foster cross-validation across cohorts and laboratories. PMID:25282381
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COS Target Acquisition Guidelines, Recommendations, and Interpretation
NASA Astrophysics Data System (ADS)
Keyes, Charles (Tony) D.; Penton, Steven V.
2010-06-01
Based upon analysis of SMOV and Cycle 17 observations through April 2010, this ISR expands, updates, and supersedes recommendations and information provided about target acquisitions (TA) in the COS Instrument Handbook version 2. This ISR provides an overview of COS TA, presents general guidelines and recommendations for crafting COS TAs, establishes COS TA centering accuracy requirements to achieve COS photometric, velocity, and resolution objectives, and summarizes the performance of the COS on-board TA modes as compared to these centering requirements. Updated TA strategy recommendations are given where appropriate, a user-oriented table lists where to find important quantities for the analysis and interpretation of COS TAs, and a brief appendix with additional supporting information is included. An overview of COS TA strategies is provided in Section 2 and Table 1; important updates to ACQ/SEARCH requirements and SEARCH-SIZE recommendations as a function of target coordinate accuracy are given in Tables 2 and 3; COS TA performance by mode is described in Section 5; important header keywords that are useful for evaluating the quality of COS TAs are listed in Table 5 along with where to find them; Table 6 gives a summary of COS TA modes, options, and recommended values; Section 7 summarizes updated recommendations and guidelines for COS TA; and Appendix A provides additional useful COS TA information.
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Fire toxicology from the National Academy of Sciences (NAS) point of view
NASA Technical Reports Server (NTRS)
Winter, D. L.
1978-01-01
At the request of NASA the Subcommittee on Fire Toxicology undertook the tasks of evaluating the state-of-knowledge in fire toxicology and recommending guidelines for establishing standard approaches for testing the toxicity of polymeric materials in fires. The recommended guidelines on methodology for evaluation of toxicity of pyrolysis and combustion products are presented. Flow charts reflecting the organizations responsible for the evaluation tasks are presented to show organizational changes which took place between 1977 and 1978. Also listed are the names, phone numbers and companies in attendance at the meeting.
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Hamacher, Michael; Eisenacher, Martin; Tribl, Florian; Stephan, Christian; Marcus, Katrin; Hardt, Tanja; Wiltfang, Jens; Martens, Lennart; Desiderio, Dominic; Gutstein, Howard; Park, Young Mok; Meyer, Helmut E
2008-06-01
The Human Brain Proteome Project (HUPO BPP) aims at advancing knowledge and the understanding of neurodiseases and aging with the purpose of identifying prognostic and diagnostic biomarkers, as well as to push new diagnostic approaches and medications. The participating groups meet in semi-annual workshops to discuss the progress, as well as the needs, within the field of proteomics. The 9(th) HUPO BPP workshop took place in Barbados from 9-10 January, 2008. Discussing the future HUPO BPP Roadmap, the attendees drafted the so called HUPO BPP wish list containing timelines, suggestions and missions. This wish list will be updated regularly and will serve as a guideline for the next phase.
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Physical Chemistry, Science (Experimental): 5318.60.
ERIC Educational Resources Information Center
Mary, Charlotta B.; Feuer, Jerold
Performance objectives are stated for this secondary school instructional unit concerned with aspects of physical chemistry, involving the physical properties of matter, and laws and theories regarding chemical interaction. Lists of films and state-adopted and other texts are presented. Included are enrollment guidelines; an outline summarizing…
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Code of Federal Regulations, 2011 CFR
2011-04-01
... residual functional capacity is not the same as the corresponding criterion of a rule. In these instances... economy. Appendix 2 provides rules using this data reflecting major functional and vocational patterns. We...
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Full Text Journal Subscriptions: An Evolutionary Process.
ERIC Educational Resources Information Center
Luther, Judy
1997-01-01
Provides an overview of companies offering Web accessible subscriptions to full text electronic versions of scientific, technical, and medical journals (Academic Press, Blackwell, EBSCO, Elsevier, Highwire Press, Information Quest, Institute of Physics, Johns Hopkins University Press, OCLC, OVID, Springer, and SWETS). Also lists guidelines for…
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Sharpen Your Skills: Large Type.
ERIC Educational Resources Information Center
Knisely, Phillis; Wickham, Marian
1984-01-01
Three short articles about large type transcribing are provided for braille transcribers and teachers of the visually handicapped. The first article lists general suggestions for simple typewriter maintenance. The second article reviews the guidelines for typing fractions in large type for mathematics exercises. The third article describes a…
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ERIC Educational Resources Information Center
Practical Pointers, 1977
1977-01-01
Described are uses of creative dramatics with handicapped and non-handicapped children and adults. Creative dramatics is seen to involve acting out situations without formal or strict guidelines, with focus on expression of one's feelings and working cooperatively with others. Activities and leadership hints are listed for warm-up games and…
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Motivating Staff, Parents, and Children.
ERIC Educational Resources Information Center
Jones, Cynthia Cavenaugh
Two motivational theories considered particularly useful in administering early childhood programs are discussed, and guidelines for motivating staff, parents, and children are provided. First, the two-factor theory of motivation within organizations, as outlined by Herzberg (1959), is described. Offered in this section are a list of motivators…
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Identifying Depression in Students with Mental Retardation.
ERIC Educational Resources Information Center
Stough, Laura M.; Baker, Lynn
1999-01-01
Offers guidelines to teachers for identifying depression in students with mental retardation. Discusses prevalence and symptoms of depression, causes of depression, difficulty of diagnosis in students with mental retardation, detecting symptoms in the classroom, treatment of depression, and psychological services. Inserts list ideas for helping…
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A Planning Process and the Integration of Institutional Research.
ERIC Educational Resources Information Center
Spencer, R.; And Others
Consisting mainly of charts, graphs, and lists, this publication presents materials used in the Delaware County Community College (DCCC) planning and institutional research processes. Guidelines for establishing DCCC mission, goals, objectives, and management by objectives performance standards relative to planning changes, instructional programs,…
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Exploring Music through Technology.
ERIC Educational Resources Information Center
Willard, Joanne B.
1992-01-01
Describes a high school music technology course that uses a project-oriented approach to teach students about hardware and software tools for sequencing, arranging, multitrack recording, and mixing. Course equipment is listed, and the MIDI (Musical Instrument Digital Interface) is briefly described. Copyright guidelines for educational uses of…
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40 CFR 461.13 - New source performance standards (NSPS).
Code of Federal Regulations, 2013 CFR
2013-07-01
... GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Cadmium Subcategory § 461.13... allowance for process wastewater pollutants from any battery manufacturing operation other than those battery manufacturing operations listed above. [49 FR 9134, Mar. 9, 1984; 49 FR 13879, Apr. 9, 1984] ...
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40 CFR 461.13 - New source performance standards (NSPS).
Code of Federal Regulations, 2012 CFR
2012-07-01
... GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Cadmium Subcategory § 461.13... allowance for process wastewater pollutants from any battery manufacturing operation other than those battery manufacturing operations listed above. [49 FR 9134, Mar. 9, 1984; 49 FR 13879, Apr. 9, 1984] ...
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40 CFR 461.13 - New source performance standards (NSPS).
Code of Federal Regulations, 2014 CFR
2014-07-01
... GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Cadmium Subcategory § 461.13... allowance for process wastewater pollutants from any battery manufacturing operation other than those battery manufacturing operations listed above. [49 FR 9134, Mar. 9, 1984; 49 FR 13879, Apr. 9, 1984] ...
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Observing Community Residences.
ERIC Educational Resources Information Center
Taylor, Steven J.; Bogdan, Robert
The document offers guidelines effectively monitoring the quality of care provided in community residences serving people with disabilities. An initial section offers suggestions on observation and evaluation procedures. The remainder of the document lists possible questions to be asked in 19 areas: location, building and yard, relations with the…
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Basopo, Victor; Mujasi, Paschal N
2017-01-01
Hypertension is the most prevalent cardiovascular disease in Zimbabwe. The prevalence of Hypertension in the country is above 30% regardless of the cut off used. Currently, majority of patients in Zimbabwe seek health care from the private sector due to limited government funding for the public health sector. However, Standard treatment guidelines for hypertension are only available in the public sector and are optional in the private sector. This study assesses compliance of private sector prescribing to Standard Treatment guidelines for hypertension. We reviewed hypertension prescription claims to a private health insurance company in Zimbabwe for the period Jan 1-Dec 31 2015. We used the last prescription claimed in the year on the assumption that it represented the patient's current treatment. Prescription data was analyzed by comparing medicines prescribed to those recommended in the Zimbabwe 7th Essential Medicines List and Standard Treatment Guidelines 2015. We used Microsoft Excel© 2010 to conduct the analysis. A total of 1019 prescriptions were reviewed. Most patients were either on mono or dual therapy (76%). The mostly prescribed class of antihypertensive as first line were Angiotensin Converting Enzyme Inhibitors /Angiotensin Receptor Blockers. Regardless of whether they were being used as first, second or third line this class of antihypertensives emerged as the most prescribed (639 times). Only 358 (35%) prescriptions were compliant with standard treatment guidelines; the rest (661) did not meet several criteria. Areas of non-compliance included use of second line medicines as first line, failure to consider patient characteristics when prescribing, use of contraindicated medicines for certain patients, clinically significant interactions among prescribed medicines and illogical combinations that predispose patients to toxicity. The poor compliance to standard treatment guidelines observed in our study indicates need to improve prescription practices for Hypertension in the private sector in Zimbabwe for its cost-effective management among the covered patients. However, further investigation is needed to understand the drivers of the prescribing habits and the non-compliance to the Essential Medicines List and Standard Treatment guidelines observed. This will enable design of appropriate educational, managerial and economic interventions to improve compliance.
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Clavien, Pierre-Alain; Lesurtel, Mickael; Bossuyt, Patrick M M; Gores, Gregory J; Langer, Bernard; Perrier, Arnaud
2012-01-01
Although liver transplantation is a widely accepted treatment for hepatocellular carcinoma (HCC), much controversy remains and there is no generally accepted set of guidelines. An international consensus conference was held on Dec 2–4, 2010, in Zurich, Switzerland, with the aim of reviewing current practice regarding liver transplantation in patients with HCC and to develop internationally accepted statements and guidelines. The format of the conference was based on the Danish model. 19 working groups of experts prepared evidence-based reviews according to the Oxford classification, and drafted recommendations answering 19 specific questions. An independent jury of nine members was appointed to review these submissions and make final recommendations, after debates with the experts and audience at the conference. This report presents the final 37 statements and recommendations, covering assessment of candidates for liver transplantation, criteria for listing in cirrhotic and non-cirrhotic patients, role of tumour downstaging, management of patients on the waiting list, role of living donation, and post-transplant management. PMID:22047762
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Morisse Pradier, H; Sénéchal, A; Philit, F; Tronc, F; Maury, J-M; Grima, R; Flamens, C; Paulus, S; Neidecker, J; Mornex, J-F
2016-02-01
Lung transplantation (LT) is now considered as an excellent treatment option for selected patients with end-stage pulmonary diseases, such as COPD, cystic fibrosis, idiopathic pulmonary fibrosis, and pulmonary arterial hypertension. The 2 goals of LT are to provide a survival benefit and to improve quality of life. The 3-step decision process leading to LT is discussed in this review. The first step is the selection of candidates, which requires a careful examination in order to check absolute and relative contraindications. The second step is the timing of listing for LT; it requires the knowledge of disease-specific prognostic factors available in international guidelines, and discussed in this paper. The third step is the choice of procedure: indications of heart-lung, single-lung, and bilateral-lung transplantation are described. In conclusion, this document provides guidelines to help pulmonologists in the referral and selection processes of candidates for transplantation in order to optimize the outcome of LT. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
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Guidelines for Feeding Very Low Birth Weight Infants
Dutta, Sourabh; Singh, Balpreet; Chessell, Lorraine; Wilson, Jennifer; Janes, Marianne; McDonald, Kimberley; Shahid, Shaneela; Gardner, Victoria A.; Hjartarson, Aune; Purcha, Margaret; Watson, Jennifer; de Boer, Chris; Gaal, Barbara; Fusch, Christoph
2015-01-01
Despite the fact that feeding a very low birth weight (VLBW) neonate is a fundamental and inevitable part of its management, this is a field which is beset with controversies. Optimal nutrition improves growth and neurological outcomes, and reduces the incidence of sepsis and possibly even retinopathy of prematurity. There is a great deal of heterogeneity of practice among neonatologists and pediatricians regarding feeding VLBW infants. A working group on feeding guidelines for VLBW infants was constituted in McMaster University, Canada. The group listed a number of important questions that had to be answered with respect to feeding VLBW infants, systematically reviewed the literature, critically appraised the level of evidence, and generated a comprehensive set of guidelines. These guidelines form the basis of this state-of-art review. The review touches upon trophic feeding, nutritional feeding, fortification, feeding in special circumstances, assessment of feed tolerance, and management of gastric residuals, gastro-esophageal reflux, and glycerin enemas. PMID:25580815
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Manville, Albert; Hueckel, Greg
2004-09-01
This session at the Wind Energy and Birds/Bats workshop consisted of two presentations followed by a discussion/question and answer period. The two papers were: 'Development and Application of USFWS Guidance for Site Evaluation, Siting, Construction, Operation and Monitoring of Wind Turbines' by Albert Manville and 'Wind Power in Washington State' by Greg Hueckel. The session provided a comparison of wind project guidelines developed by the U.S. Fish and Wildlife Service (USFWS) in May 2003 and the Washington State Department of Fish and Wildlife in August 2003. Questions addressed included: is there a need or desire for uniform national or statemore » criteria; can other states learn from Washington State's example, or from the USFWS voluntary guidelines; should there be uniform requirements/guidelines/check-lists for the siting, operation, monitoring, and mitigation to prevent or minimize avian, bat, and other wildlife impacts.« less
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Van de Velde, S; Heselmans, A; Donceel, P; Vandekerckhove, P; Ramaekers, D; Aertgeerts, B
2011-09-01
OBJECTIVE This study evaluated whether the Appraisal of Guidelines Research and Evaluation (AGREE) rigour of development score of practice guidelines on ice for acute ankle sprains is related to the convergence between recommendations. DESIGN The authors systematically reviewed guidelines on ice for acute ankle sprains. Four appraisers independently used the AGREE instrument to evaluate the rigour of development of selected guidelines. For each guideline, one reviewer listed the cited evidence on ice and calculated a cited evidence score. The authors plotted the recommended durations and numbers of ice applications over the standardised rigour of development score to explore the relationships. DATA SOURCES Three reviewers searched for guidelines in Medline, Embase, Sportdiscus, PEDro, G-I-N Guideline Library, Trip Database, SumSearch, National Guideline Clearinghouse and the Health Technology Assessment database, and conducted a web-based search for guideline development organisations. ELIGIBILITY CRITERIA Eligible guidelines had a development methodology that included a process to search or use results from scientific studies and the participation of an expert group to formulate recommendations. RESULTS The authors identified 21 guidelines, containing clinically significant variations in recommended durations and numbers of ice applications. The median standardised rigour of development score was 57% (IQR 18 to 77). Variations occurred evenly among guidelines with low moderate or high rigour scores. The median evidence citation score in the guidelines was 7% (IQR 0 to 61). CONCLUSIONS There is no relationship between the rigour of development score and the recommendations in guidelines on ice for acute ankle sprains. The guidelines suffered from methodological problems which were not captured by the AGREE instrument.
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Pharmacoeconomic guidelines and their implementation in the positive list system in South Korea.
Bae, Eun Young; Lee, Eui Kyung
2009-01-01
This article reviews the change in the reimbursement and pricing system in South Korea, which was the precursor to the eventual implementation of evidence-based decision-making. There has been pressure on Korea's National Health Insurance system to control its skyrocketing expenditures on drugs. As a result, a series of cost-containment policies have been implemented. The idea of economic evidence-based decision-making was first introduced in Korea in 2001 when the government announced cost-effectiveness as one of the criteria for reimbursement decisions. After this announcement, the Health Insurance Review and Assessment Service (HIRA) developed guidelines, which became the standard for economic evaluations. In 2006, the drug listing system for reimbursement was changed from a negative to a positive system under the drug expenditure rationalization plan. Under this new system, only drugs that are proven economically and clinically valuable can be listed, and applicants have to submit economic evaluation studies to support the cost-effectiveness of their drugs. Once new applications are submitted, HIRA reviews them, and the Drug Reimbursement Evaluation Committee (DREC) decides whether or not to recommend the submitted drugs. In its reimbursement decisions, the DREC considers not only cost-effectiveness but also the availability of therapeutic alternatives, the severity of the condition treated, and the impact on the budget, among other measures. After the introduction of the positive list system, 56% of drugs were determined to be appropriate for reimbursement by the DREC. Despite limited human resources, experience, and quality local data, Korea is continuing to make efforts to establish a system of evidence-based decision-making.
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32 CFR 767.7 - Conditions of permits.
Code of Federal Regulations, 2010 CFR
2010-07-01
... GUIDELINES FOR ARCHEOLOGICAL RESEARCH PERMITS ON SHIP AND AIRCRAFT WRECKS UNDER THE JURISDICATION OF THE... to submit to NHC a working and diving log listing days spent in field research, activities pursued... protect all sensitive information regarding the location and character of the wreck site that could...
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Modern School Shop Planning. Fifth Edition.
ERIC Educational Resources Information Center
1967
Facility planning and the integration of industrial education with total school programs are discussed with regard to safety, health, budgeting, and the effects of environment upon learning and teaching. Standards for equipment selection, purchasing, and usage are given, along with equipment and supplier lists. Facility guidelines and requirements…
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Gun Control: The Debate and Public Policy.
ERIC Educational Resources Information Center
Watkins, Christine
1997-01-01
Provides an overview and background information on the debate over gun control, as well as several teaching ideas. Handouts include a list of related topics drawn from various disciplines (economics, U.S. history), seven arguments for and against gun control, and a set of policy evaluation guidelines. (MJP)
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People and Environment: Understanding Global Relationships.
ERIC Educational Resources Information Center
Clearing: Nature and Learning in the Pacific Northwest, 1984
1984-01-01
Discusses impacts of global resources and environment, focusing on food, fisheries, forests, energy, water, and air. Includes graphs, charts, maps, and tables of the current environmental situation; they are suitable for classroom use. Also includes suggested guidelines for implementing a global studies program and an annotated list of resource…
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ERIC Educational Resources Information Center
Food and Nutrition Service (USDA), Washington, DC.
The 1992 "Best Practices" award winners for exemplary accomplishments in the National School Lunch and School Breakfast Programs are recognized and described in this booklet. The information provided can be used as a tool to implement the dietary guidelines and achieve the Year 2000 nutrition objectives. The programs are listed under the…
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40 CFR 461.44 - Pretreatment standards for existing sources (PSES).
Code of Federal Regulations, 2010 CFR
2010-07-01
...) EFFLUENT GUIDELINES AND STANDARDS BATTERY MANUFACTURING POINT SOURCE CATEGORY Leclanche Subcategory § 461... existing sources listed below: (1) Subpart D—Foliar Battery Miscellaneous Wash—PSES. Pollutant or pollutant... 0.015 (b) There shall be no discharge allowance for process wastewater pollutants from any battery...
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Texas Sustainable School Design Guideline.
ERIC Educational Resources Information Center
Nicklas, Michael; Bailey, Gary; Padia, Harshad D.; Malin, Nadav
This guide offers a detailed listing of the key practices and technologies that can help create a sustainable school. The document includes hundreds of cost-effective recommendations that can improve the energy performance and environmental quality of school designs. Each design and construction phase is addressed, from site selection through…
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Guidelines and Recommendations for New Hampshire Public Elementary Schools, Kindergarten--Grade 6.
ERIC Educational Resources Information Center
New Hampshire State Dept. of Education, Concord.
Sections concerned with facilities deal with library services, equipment and facilities for science and physical education, and the school building. Recommendations for library service include check lists and standards pertaining to objectives, basic equipment and supplies, individual classroom collections, audio visual collections, library…
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Pro: Boards Need Independent, Impartial Experts to Audit Administrative Performance.
ERIC Educational Resources Information Center
Boonin, Tobyann; Neuwirth, Paul
1983-01-01
Argues that school boards should use outside "management auditors" to help assess operational effectiveness, especially in five areas: internal financial auditing, personnel and payroll, purchasing, construction and repairs, and data processing. Suggests guidelines for hiring management auditors and lists 11 firms that perform management…
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GUIDELINES FOR EDUCATING YOUTH UNDER STRESS.
ERIC Educational Resources Information Center
CONWAY, WALTER J.; JOHN, MARY JANE
THIS GUIDE PRESENTS FUNDAMENTAL PRACTICAL CONCEPTS CONCERNING BEHAVIOR, CLASSROOM ENVIRONMENT, AND CURRICULUM FOR THE CHILD UNDER STRESS. THE ANGRY CHILD, THE CONFUSED CHILD, THE DESTRUCTIVE CHILD, AND THE QUIET CHILD ARE DISCUSSED. THE GENERAL GOALS OF CLASSROOM CONTROLS AND EFFECTIVE METHODS OF ACHIEVING THESE GOALS ARE DISCUSSED. LISTS OF…
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Tornado Preparedness Planning.
ERIC Educational Resources Information Center
National Oceanic and Atmospheric Administration (DOC), Rockville, MD. National Weather Service.
This pamphlet contains a set of guidelines for community leaders interested in developing preparedness plans for tornadoes and severe thunderstorms. Included in the guide is a list of the types of officials and agencies which should be involved in planning meetings. A set of suggestions for developing a community communications network and…
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Preparation of Plant Samples for Phytochemical Research and the Study of Their Biological Activities
USDA-ARS?s Scientific Manuscript database
Prior to investigating plant natural products for biologically active constituents, it is necessary to establish guidelines and procedures for carefully collecting, cataloging, and storing specimens. All field collections should begin with detailed records on location, which should include a list o...
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40 CFR 461.44 - Pretreatment standards for existing sources (PSES).
Code of Federal Regulations, 2011 CFR
2011-07-01
...) EFFLUENT GUIDELINES AND STANDARDS BATTERY MANUFACTURING POINT SOURCE CATEGORY Leclanche Subcategory § 461... existing sources listed below: (1) Subpart D—Foliar Battery Miscellaneous Wash—PSES. Pollutant or pollutant... 0.015 (b) There shall be no discharge allowance for process wastewater pollutants from any battery...
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Simple Steps to a Successful Workshop. CSLA Guide.
ERIC Educational Resources Information Center
Lewis, Dorothy G.
This document provides guidelines for workshop planning. The first section, "Getting Started," discusses identifying needs, choosing the workshop format, setting goals, and forming a planning committee. The second section, "Procedure for the Planning Committee," lists seven main tasks. The third section, "Duties of the Personnel," outlines the…
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Kelber, Olaf; Wegener, Tankred; Steinhoff, Barbara; Staiger, Christiane; Wiesner, Jacqueline; Knöss, Werner; Kraft, Karin
2014-01-01
An assessment of genotoxicity is a precondition for marketing authorization respectively registration of herbal medicinal products (HMPs), as well as for inclusion into the 'Community list of herbal substances, preparations and combinations thereof for use in traditional herbal medicinal products' established by the European Commission in accordance with Directive 2001/83/EC as amended, and based on proposals from the Committee on Herbal Medicinal Products (HMPC). In the 'Guideline on the assessment of genotoxicity of herbal substances/preparations' (EMEA/HMPC/107079/2007) HMPC has described a stepwise approach for genotoxicity testing, according to which the Ames test is a sufficient base for the assessment of genotoxicity in case of an unequivocally negative result. For reducing efforts for testing of individual herbal substances/preparations, HMPC has also developed the 'guideline on selection of test materials for genotoxicity testing for traditional herbal medicinal products/herbal medicinal products' (EMEA/HMPC/67644/2009) with the aim to allow testing of a standard range of test materials which could be considered representative of the commonly used preparations from a specific herbal drug according to a 'bracketing/matrixing' approach. The purpose of this paper is to provide data on the practical application of this bracketing and matrixing concept using the example of Valerianae radix, with the intention of facilitating its inclusion in the "Community list". Five extraction solvents, representing the extremes of the polarity range and including also mid-range extraction solvents, were used, covering the entire spectrum of phytochemical constituents of Valerianae radix, thereby including polar and non-polar constituents. Extracts were tested in the Ames test according to all relevant guidelines. Results were unequivocally negative for all extracts. A review of the literature showed that this result is in accordance with the available data, thus demonstrating the lack of a genotoxic potential. In conclusion the two guidelines on genotoxicity provide a practically applicable concept. Valerianae radix has no genotoxic potential, supporting its use in HMPs and its inclusion in the Community list. Copyright © 2014 The Authors. Published by Elsevier GmbH.. All rights reserved.
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Do neonatal hypoglycaemia guidelines in Australia and New Zealand facilitate breast feeding?
Sundercombe, Samantha L; Raynes-Greenow, Camille H; Turner, Robin M; Jeffery, Heather E
2014-12-01
to establish how well postnatal ward neonatal hypoglycaemia guidelines facilitate breast feeding and adhere to UNICEF UK Baby Friendly Initiative (BFI) recommendations, and to compare compliance with different recommendations. an appraisal of guidelines obtained via email survey using a UNICEF UK BFI checklist tool. Information about Baby Friendly Health/Hospital Initiative (BFHI) accreditation status was obtained by email questionnaire. tertiary neonatal centres in Australia and New Zealand. 22 guidelines were returned from 23 centres eligible to participate. guidelines generally scored poorly. On a scale ranging from 31 to 124 of overall guideline quality, the median score was 71. On a scale of 9 to 36 for adherence to recommendations to facilitate breast feeding, the median guideline score was 20. Compliance with the recommendation to promote skin-to-skin contact and early breast feeding was poor across all centres, achieving a score of 59 out of 88. Nine of 22 guidelines mentioned skin-to-skin contact after birth and 14 advised feeding within one hour of birth. The recommendation about discussing artificial milk supplementation with parents received a score of 44 out of 88. Fourteen guidelines listed Large for Gestational Age (LGA) infants to be at risk of hypoglycaemia. Few guidelines included up-to-date references or flowcharts. guidelines need to recommend early skin-to-skin contact and discussion with parents before artificial milk supplementation. Guidelines suggest LGA neonates are being screened unnecessarily. guidelines need constant revision as evidence for best practice expands. The UNICEF UK BFI checklist provides a readily available quality improvement tool. Copyright © 2014 Elsevier Ltd. All rights reserved.
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Clinical practice guidelines for delirium management: potential application in palliative care.
Bush, Shirley H; Bruera, Eduardo; Lawlor, Peter G; Kanji, Salmaan; Davis, Daniel H J; Agar, Meera; Wright, David Kenneth; Hartwick, Michael; Currow, David C; Gagnon, Bruno; Simon, Jessica; Pereira, José L
2014-08-01
Delirium occurs in patients across a wide array of health care settings. The extent to which formal management guidelines exist or are adaptable to palliative care is unclear. This review aims to 1) source published delirium management guidelines with potential relevance to palliative care settings, 2) discuss the process of guideline development, 3) appraise their clinical utility, and 4) outline the processes of their implementation and evaluation and make recommendations for future guideline development. We searched PubMed (1990-2013), Scopus, U.S. National Guideline Clearinghouse, Google, and relevant reference lists to identify published guidelines for the management of delirium. This was supplemented with multidisciplinary input from delirium researchers and other relevant stakeholders at an international delirium study planning meeting. There is a paucity of high-level evidence for pharmacological and non-pharmacological interventions in the management of delirium in palliative care. However, multiple delirium guidelines for clinical practice have been developed, with recommendations derived from "expert opinion" for areas where research evidence is lacking. In addition to their potential benefits, limitations of clinical guidelines warrant consideration. Guidelines should be appraised and then adapted for use in a particular setting before implementation. Further research is needed on the evaluation of guidelines, as disseminated and implemented in a clinical setting, focusing on measurable outcomes in addition to their impact on quality of care. Delirium clinical guidelines are available but the level of evidence is limited. More robust evidence is required for future guideline development. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
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A practical guide to the application of the IUCN Red List of Ecosystems criteria
Rodríguez, Jon Paul; Keith, David A.; Rodríguez-Clark, Kathryn M.; Murray, Nicholas J.; Nicholson, Emily; Regan, Tracey J.; Miller, Rebecca M.; Barrow, Edmund G.; Bland, Lucie M.; Boe, Kaia; Brooks, Thomas M.; Oliveira-Miranda, María A.; Spalding, Mark; Wit, Piet
2015-01-01
The newly developed IUCN Red List of Ecosystems is part of a growing toolbox for assessing risks to biodiversity, which addresses ecosystems and their functioning. The Red List of Ecosystems standard allows systematic assessment of all freshwater, marine, terrestrial and subterranean ecosystem types in terms of their global risk of collapse. In addition, the Red List of Ecosystems categories and criteria provide a technical base for assessments of ecosystem status at the regional, national, or subnational level. While the Red List of Ecosystems criteria were designed to be widely applicable by scientists and practitioners, guidelines are needed to ensure they are implemented in a standardized manner to reduce epistemic uncertainties and allow robust comparisons among ecosystems and over time. We review the intended application of the Red List of Ecosystems assessment process, summarize ‘best-practice’ methods for ecosystem assessments and outline approaches to ensure operational rigour of assessments. The Red List of Ecosystems will inform priority setting for ecosystem types worldwide, and strengthen capacity to report on progress towards the Aichi Targets of the Convention on Biological Diversity. When integrated with other IUCN knowledge products, such as the World Database of Protected Areas/Protected Planet, Key Biodiversity Areas and the IUCN Red List of Threatened Species, the Red List of Ecosystems will contribute to providing the most complete global measure of the status of biodiversity yet achieved. PMID:25561664
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Mitchell, Alex J; Meader, Nick; Davies, Evan; Clover, Kerrie; Carter, Gregory L; Loscalzo, Matthew J; Linden, Wolfgang; Grassi, Luigi; Johansen, Christoffer; Carlson, Linda E; Zabora, James
2012-10-01
To examine the validity of screening and case-finding tools used in the identification of depression as defined by an ICD10/DSM-IV criterion standard. We identified 63 studies involving 19 tools (in 33 publications) designed to help clinicians identify depression in cancer settings. We used a standardized rating system. We excluded 11 tools without at least two independent studies, leaving 8 tools for comparison. Across all cancer stages there were 56 diagnostic validity studies (n=10,009). For case-finding, one stem question, two stem questions and the BDI-II all had level 2 evidence (2a, 2b and 2c respectively) and given their better acceptability we gave the stem questions a grade B recommendation. For screening, two stem questions had level 1b evidence (with high acceptability) and the BDI-II had level 2c evidence. For every 100 people screened in advanced cancer, the two questions would accurately detect 18 cases, while missing only 1 and correctly reassure 74 with 7 falsely identified. For every 100 people screened in non-palliative settings the BDI-II would accurately detect 17 cases, missing 2 and correctly re-assure 70, with 11 falsely identified as cases. The main cautions are the reliance on DSM-IV definitions of major depression, the large number of small studies and the paucity of data for many tools in specific settings. Although no single tool could be offered unqualified support, several tools are likely to improve upon unassisted clinical recognition. In clinical practice, all tools should form part of an integrated approach involving further follow-up, clinical assessment and evidence based therapy. Copyright © 2012 Elsevier B.V. All rights reserved.
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Detection of sleep apnea by case-finding and home monitoring with Somnolter®: a pilot study.
Cattrysse, Fabienne; Peeters, Mathias; Calaerts, Sanne; Ferson, Karen; Degryse, Jean-Marie
2014-09-08
Obstructive sleep apnea and hypopnea syndrome (OSAHS) is a disorder that causes clinical symptoms (e.g. snoring, excessive daytime sleepiness and impaired concentration) that may increase the risk of traffic accidents, cardiovascular disease, type 2 diabetes and reduce the quality of life. A recently developed device (Somnolter®) detects apneas and hypopneas in a home setting, allowing to detect OSAHS in a more comfortable environment compared to the gold standard polysomnography. The aim of our study was to investigate whether the Somnolter® is useful in family practice to identify patients with OSAHS. Questionnaires were offered to patients in five general practitioner (GP) practices.Based on the questionnaire and body mass index, patients with an increased risk of OSAHS were contacted to collaborate in the study. In this convenience sample, 18 patients were successfully tested with the Somnolter® measuring SaO2, mandibular movements, body position, heart rate, nasal air flow and thoracic and abdominal breathing movements. The Somnolter® automatically analyses the data and different parameters to detect OSAHS. Afterwards, the data were manually revised by the researchers. Out of 365 subjects, 31 met the inclusion criteria and 18 were successfully tested at home. Sixteen out of 18 patients had an Apnea Hypopnea Index (AHI) ≥ 5, ten of them had mild OSAHS, 3 were categorized as moderate OSAHS and finally 3 matched the criteria of severe OSAHS. The proposed case-finding strategy still needs optimization, but is considered helpful in selecting patients at high risk of OSAHS. OSAHS was detected in 14 out of 18 patients tested with the Somnolter®. In the future the Somnolter® might be a feasible alternative to diagnose OSAHS.
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Harrold, Leslie R.; Salman, Craig; Shoor, Stanford; Curtis, Jeffrey R.; Asgari, Maryam M.; Gelfand, Joel M.; Wu, Jashin J.; Herrinton, Lisa J.
2017-01-01
Objective Few studies based in well-defined North American populations have examined the occurrence of juvenile idiopathic arthritis (JIA), and none has been based in an ethnically diverse population. We used computerized healthcare information from the Kaiser Permanente Northern California membership to validate JIA diagnoses and estimate the incidence and prevalence of the disease in this well-characterized population. Methods We identified children aged ≤ 15 years with ≥ 1 relevant International Classification of Diseases, 9th edition, diagnosis code of 696.0, 714, or 720 in computerized clinical encounter data during 1996–2009. In a random sample, we then reviewed the medical records to confirm the diagnosis and diagnosis date and to identify the best-performing case-finding algorithms. Finally, we used the case-finding algorithms to estimate the incidence rate and point prevalence of JIA. Results A diagnosis of JIA was confirmed in 69% of individuals with at least 1 relevant code. Forty-five percent were newly diagnosed during the study period. The age- and sex-standardized incidence rate of JIA per 100,000 person-years was 11.9 (95% CI 10.9–12.9). It was 16.4 (95% CI 14.6–18.1) in girls and 7.7 (95% CI 6.5–8.9) in boys. The peak incidence rate occurred in children aged 11–15 years. The prevalence of JIA per 100,000 persons was 44.7 (95% CI 39.1–50.2) on December 31, 2009. Conclusion The incidence rate of JIA observed in the Kaiser Permanente population, 1996–2009, was similar to that reported in Rochester, Minnesota, USA, but 2 to 3 times higher than Canadian estimates. PMID:23588938
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Patterson, Mark E; Miranda, Derick; Schuman, Greg; Eaton, Christopher; Smith, Andrew; Silver, Brad
2016-01-01
Leveraging "big data" as a means of informing cost-effective care holds potential in triaging high-risk heart failure (HF) patients for interventions within hospitals seeking to reduce 30-day readmissions. Explore provider's beliefs and perceptions about using an electronic health record (EHR)-based tool that uses unstructured clinical notes to risk-stratify high-risk heart failure patients. Six providers from an inpatient HF clinic within an urban safety net hospital were recruited to participate in a semistructured focus group. A facilitator led a discussion on the feasibility and value of using an EHR tool driven by unstructured clinical notes to help identify high-risk patients. Data collected from transcripts were analyzed using a thematic analysis that facilitated drawing conclusions clustered around categories and themes. From six categories emerged two themes: (1) challenges of finding valid and accurate results, and (2) strategies used to overcome these challenges. Although employing a tool that uses electronic medical record (EMR) unstructured text as the benchmark by which to identify high-risk patients is efficient, choosing appropriate benchmark groups could be challenging given the multiple causes of readmission. Strategies to mitigate these challenges include establishing clear selection criteria to guide benchmark group composition, and quality outcome goals for the hospital. Prior to implementing into practice an innovative EMR-based case-finder driven by unstructured clinical notes, providers are advised to do the following: (1) define patient quality outcome goals, (2) establish criteria by which to guide benchmark selection, and (3) verify the tool's validity and reliability. Achieving consensus on these issues would be necessary for this innovative EHR-based tool to effectively improve clinical decision-making and in turn, decrease readmissions for high-risk patients.
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Continuum of Major Life Activities "Bank of Basic Skills."
ERIC Educational Resources Information Center
Charlton, Sue; And Others
The manual lists those skills considered critical for independent living of severely handicapped persons from elementary to senior high school. The skills are intended to help serve as guidelines in selecting and developing appropriate curriculum and Individualized Education Program objectives. The skills are grouped according to their general…
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NREN for All: Insurmountable Opportunity.
ERIC Educational Resources Information Center
Polly, Jean Armour
1993-01-01
Discussion of the NREN (National Research and Education Network) and issues of access focuses on the role of the public library. Highlights include current uses of the Internet; resource sharing; guidelines for public library service; availability of the Internet and NREN through public libraries; and a sidebar that lists sources of further…
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Planning and Troubleshooting Guide.
ERIC Educational Resources Information Center
1994
This reference guide serves as an index for an 11-volume series of handbooks that offer guidelines to school administrators on the application and implementation of Total Quality Management (TQM) principles to education--Total Quality Education (TQE). The topics are listed in alphabetical order to show the corresponding volume and page number(s).…
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41 CFR 60-20.4 - Seniority system.
Code of Federal Regulations, 2012 CFR
2012-07-01
... 41 Public Contracts and Property Management 1 2012-07-01 2009-07-01 true Seniority system. 60-20.4 Section 60-20.4 Public Contracts and Property Management Other Provisions Relating to Public Contracts... DISCRIMINATION GUIDELINES § 60-20.4 Seniority system. Where they exist, seniority lines and lists must not be...
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41 CFR 60-20.4 - Seniority system.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 41 Public Contracts and Property Management 1 2011-07-01 2009-07-01 true Seniority system. 60-20.4 Section 60-20.4 Public Contracts and Property Management Other Provisions Relating to Public Contracts... DISCRIMINATION GUIDELINES § 60-20.4 Seniority system. Where they exist, seniority lines and lists must not be...
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Recreation Handbook for State and Local Unit Recreation Committees.
ERIC Educational Resources Information Center
National Association for Retarded Citizens, Arlington, TX.
The recreation handbook provides broad guidelines and lists sources of information for state and local units of the National Association for Retarded Citizens (NARC) to develop recreational programs throughout the nation. Described are the importance of recreation for reasons such as developing good habits of physical fitness, survey results…
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Code of Federal Regulations, 2013 CFR
2013-04-01
... material to that business (e.g., if the business regards an entry he should have the invoice, packing list... Customs business. Examples include: a. A working knowledge of all automated systems in use in the district...
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Code of Federal Regulations, 2014 CFR
2014-04-01
... material to that business (e.g., if the business regards an entry he should have the invoice, packing list... Customs business. Examples include: a. A working knowledge of all automated systems in use in the district...
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Internet Advertising: Ethics and Etiquette.
ERIC Educational Resources Information Center
Machovec, George S.
1994-01-01
Discusses the growth of the Internet and the attitudes of users toward advertising, provides examples of kinds of advertising used on electronic networks, and lists several companies that help advertisers use the Internet. Fifteen guidelines are suggested to help advertisers use the Internet in a reasonable and appropriate way. (Contains 11…
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29 CFR 1604.3 - Separate lines of progression and seniority systems.
Code of Federal Regulations, 2014 CFR
2014-07-01
... GUIDELINES ON DISCRIMINATION BECAUSE OF SEX § 1604.3 Separate lines of progression and seniority systems. (a... lines of progression or separate seniority lists based on sex where this would adversely affect any employee unless sex is a bona fide occupational qualification for that job. Accordingly, employment...
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Culturally Oriented Instruction for Native American Students
ERIC Educational Resources Information Center
Mahan, James Mark; Criger, Mary Kathryn
1977-01-01
A program of the Division of Teacher Education at Indiana University in which a few selected, committed student teachers are placed on Indian reservations in the southwest is described. Teaching assignments are for 17 weeks. The guidelines presented here were taken from lists drawn up by these young teachers. (Author/JM)
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When All Else Fails--KICK! Trouble Shooting, Preventive Maintenance, and Auxiliary Equipment.
ERIC Educational Resources Information Center
Beasley, Augie E.; Palmer, Carolyn G.
The guidelines presented in this manual for the maintenance and repair of media equipment and materials provide information on optical systems, slide projectors, film projectors, overhead projectors, record players, cassette recorders, public address systems, opaque projectors, laminators, motion picture films, and cassette tapes. A list of…
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Laboratory Safety Manual for Alabama Schools. Bulletin 1975. No. 20.
ERIC Educational Resources Information Center
Alabama State Dept. of Education, Montgomery.
This document presents the Alabama State Department of Education guidelines for science laboratory safety, equipment, storage, chemical safety, rocket safety, electrical safety, safety with radioisotopes, and safety with biologicals. Also included is a brief bibliography, a teacher's checklist, a listing of laser facts and regulations, and a…
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Theme Issue: Organizational Communication.
ERIC Educational Resources Information Center
Anapol, Malthon M., Ed.
1978-01-01
The articles in this publication discuss the identity problem of those educated in organizational communication when they face a job market that does not identify specific roles and positions for their specialty. The publication includes an outline for a course in organizational communication and a list of guidelines for the selection of client…
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Vocabulary Development and Maintenance--Identifiers. ERIC Processing Manual, Section VIII (Part 2).
ERIC Educational Resources Information Center
Weller, Carolyn R., Ed.; Houston, Jim, Ed.
Comprehensive rules, guidelines, and examples are provided for use by ERIC indexers and lexicographers in creating and using Identifiers, and in developing and maintaining the ERIC Identifier file via the "Identifier Authority List (IAL)." Identifiers and the IAL are defined/described: Identifiers are highly specific entities, including…
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Preliminary design specifications of a calcium model
NASA Technical Reports Server (NTRS)
1978-01-01
A list of objectives, requirements, and guidelines are given for a calcium model. Existing models are reviewed and evaluated in relation to the stated objectives and requirements. The reviewed models were either too abstract or apparently invalidated. A technical approach to the design of a desirable model is identified.
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Code of Federal Regulations, 2010 CFR
2010-07-01
...) EFFLUENT GUIDELINES AND STANDARDS BATTERY MANUFACTURING POINT SOURCE CATEGORY Cadmium Subcategory § 461.12... 1.49 (b) There shall be no discharge allowance for process wastewater pollutants from any battery manufacturing operation other than those battery manufacturing operations listed above. ...
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Code of Federal Regulations, 2010 CFR
2010-07-01
... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS BATTERY MANUFACTURING POINT SOURCE CATEGORY Zinc Subcategory...) There shall be no discharge allowance for process wastewater pollutants from any battery manufacturing operation other than those battery manufacturing operations listed above. [49 FR 9134, Mar. 9, 1984; 49 FR...
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49 CFR 397.71 - Federal standards.
Code of Federal Regulations, 2011 CFR
2011-10-01
... accordance with this section. (vi) Exposure and other risk factors. States and Indian tribes shall define the exposure and risk factors associated with any NRHM routing designations. The distance to sensitive areas...: (i) The factors listed in paragraph (b)(9) of this section; and (ii) The DOT “Guidelines for Applying...
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Sexual Harassment Identification and Prevention.
ERIC Educational Resources Information Center
Anderson, Patricia L.
1993-01-01
School administrators should develop a clear policy statement prohibiting sexual harassment; create guidelines to implement the policy; and designate a key administrator to oversee and ensure compliance with laws related to sexual harassment. Lists steps for dealing with a claim, what teachers can do to protect themselves from claims, and what a…
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Including "Everyone" in Outdoor Play.
ERIC Educational Resources Information Center
Flynn, Lynda L.; Kieff, Judith
2002-01-01
Presents guidelines for outdoor play that are important when young children have special needs. Details a decision-making process for planning adaptations and practical strategies for making adaptations and interventions to enhance outdoor play for children with special needs. Lists adaptations for a child who is blind, is deaf, has physical…
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Document is intended to provide general guidelines for use byEPA and EPA-contracted laboratories when disposing of samples and associated analytical waste following use of the analytical methods listed in SAM.
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Outdoor Education - A Guide to Site Planning and Implementation of Programs.
ERIC Educational Resources Information Center
Texas Education Agency, Austin. Div. of Curriculum Development.
This booklet presents guidelines for initiating outdoor instructional programs. Initially, the guide lists the objectives of outdoor education: survival, recreation, development of personal health and well-being, career opportunities, and social adjustment. A discussion follows on the three phases of site planning. The first phase is site analysis…
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Computer Assisted Instruction for the Mentally Retarded.
ERIC Educational Resources Information Center
Providence Coll., RI.
Computer Assisted Instruction (CAI) for the mentally retarded is described; the advantages of CAI (which generally follows the pattern of programed instruction) are listed; and the roles of the teacher and the student are summarized. The coursewriter is explained, and its use as an experimental tool discussed. Guidelines are given covering…
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-08-02
... 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... and Instrumented Initial Testing Facilities (IITF) must meet in order to conduct drug and specimen...
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7 CFR 4285.69 - Evaluation and disposition of applications.
Code of Federal Regulations, 2011 CFR
2011-01-01
...-State Research on Cooperatives Program § 4285.69 Evaluation and disposition of applications. (a... will be made for responsiveness to the program solicitation (e.g., relationship of proposal to research topic(s) listed in solicitation). Proposals that do not fall within the guidelines as stated in the...
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7 CFR 4285.69 - Evaluation and disposition of applications.
Code of Federal Regulations, 2010 CFR
2010-01-01
...-State Research on Cooperatives Program § 4285.69 Evaluation and disposition of applications. (a... will be made for responsiveness to the program solicitation (e.g., relationship of proposal to research topic(s) listed in solicitation). Proposals that do not fall within the guidelines as stated in the...
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7 CFR 4285.69 - Evaluation and disposition of applications.
Code of Federal Regulations, 2014 CFR
2014-01-01
...-State Research on Cooperatives Program § 4285.69 Evaluation and disposition of applications. (a... will be made for responsiveness to the program solicitation (e.g., relationship of proposal to research topic(s) listed in solicitation). Proposals that do not fall within the guidelines as stated in the...
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7 CFR 4285.69 - Evaluation and disposition of applications.
Code of Federal Regulations, 2013 CFR
2013-01-01
...-State Research on Cooperatives Program § 4285.69 Evaluation and disposition of applications. (a... will be made for responsiveness to the program solicitation (e.g., relationship of proposal to research topic(s) listed in solicitation). Proposals that do not fall within the guidelines as stated in the...
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7 CFR 4285.69 - Evaluation and disposition of applications.
Code of Federal Regulations, 2012 CFR
2012-01-01
...-State Research on Cooperatives Program § 4285.69 Evaluation and disposition of applications. (a... will be made for responsiveness to the program solicitation (e.g., relationship of proposal to research topic(s) listed in solicitation). Proposals that do not fall within the guidelines as stated in the...
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Looking at Elections through the Cartoonist's Eye. Teaching with Cartoons.
ERIC Educational Resources Information Center
Heitzman, W. Ray
2000-01-01
Provides a taxonomy of subskills needed to interpret political cartoons. Focuses on two of the subskills (caricature and symbolism) in detail. Includes copies of political cartoons that all pertain to the electoral process, guidelines for selecting cartoons for classroom use, and a list of resources. (CMK)
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41 CFR 60-20.4 - Seniority system.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Seniority system. 60-20.4 Section 60-20.4 Public Contracts and Property Management Other Provisions Relating to Public Contracts... DISCRIMINATION GUIDELINES § 60-20.4 Seniority system. Where they exist, seniority lines and lists must not be...
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Recommended Guidelines for PKU Programs.
ERIC Educational Resources Information Center
Children's Bureau (DHEW), Washington, DC.
A discussion of screening tests for phenylketonuria recommends and provides some data on two tests, lists five disadvantages of urine tests, and discusses three new tests. Also considered are the role of the central laboratory facility and seven suggestions for screening different types of infants at different times. Treatment or followup programs…
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Proposal Writing: Reactions of an Evaluator.
ERIC Educational Resources Information Center
Robings, Ed
Because community college proposals have been found inadequate in many cases, suggestions are made for the improvement of future proposals by these colleges. The suggestions are as follows: (1) Meet the Criteria--read carefully the restrictions and guidelines; (2) Present Specific Facts and Plans--list specific classes, forums and seminars…
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Code of Federal Regulations, 2013 CFR
2013-07-01
... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Zinc...) There shall be no discharge allowance for process wastewater pollutants from any battery manufacturing operation other than those battery manufacturing operations listed above. [49 FR 9134, Mar. 9, 1984; 49 FR...
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Code of Federal Regulations, 2014 CFR
2014-07-01
... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) BATTERY MANUFACTURING POINT SOURCE CATEGORY Zinc...) There shall be no discharge allowance for process wastewater pollutants from any battery manufacturing operation other than those battery manufacturing operations listed above. [49 FR 9134, Mar. 9, 1984; 49 FR...
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Code of Federal Regulations, 2011 CFR
2011-07-01
...) EFFLUENT GUIDELINES AND STANDARDS BATTERY MANUFACTURING POINT SOURCE CATEGORY Cadmium Subcategory § 461.12... 1.49 (b) There shall be no discharge allowance for process wastewater pollutants from any battery manufacturing operation other than those battery manufacturing operations listed above. ...
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45 CFR 150.319 - Determining the amount of the penalty-mitigating circumstances.
Code of Federal Regulations, 2010 CFR
2010-10-01
... RELATING TO HEALTH CARE ACCESS CMS ENFORCEMENT IN GROUP AND INDIVIDUAL INSURANCE MARKETS CMS Enforcement... guidelines for taking into account the factors listed in § 150.317, CMS considers the following: (a) Record... noncompliance without notice from CMS and voluntarily reported that noncompliance, provided that the responsible...
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ERIC Educational Resources Information Center
Payne, Annette
1996-01-01
Describes a schoolwide project culminating in a week of activities on the theme of endangered species. However, most of the planning guidelines and many of the activities are easily adaptable to other themes as well. Lists eight tips for getting organized including a brief brainstorming session and how to handle committee meetings. (AIM)
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34 CFR 85.510 - Who maintains the EPLS?
Code of Federal Regulations, 2010 CFR
2010-07-01
... 34 Education 1 2010-07-01 2010-07-01 false Who maintains the EPLS? 85.510 Section 85.510 Education Office of the Secretary, Department of Education GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Excluded Parties List System § 85.510 Who maintains the EPLS? In accordance with the OMB guidelines, the...
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Miller, J.T.
1994-09-01
Guidelines are given for using abbreviations, acronyms, and initialisms (AAIs) in documents prepared by US Department of Energy facilities managed by Martin Marietta Energy Systems, Inc., in Oak Ridge, Tennessee. The more than 10,000 AAIs listed represent only a small portion of those found in recent documents prepared by contributing editors of the Information Management Services organization of Oak Ridge National Laboratory, the Oak Ridge K-25 Site, and the Oak Ridge Y-12 Plant. This document expands on AAIs listed in the Document Preparation Guide and is intended as a companion document
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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
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Consumer product chemical weight fractions from ingredient lists.
Isaacs, Kristin K; Phillips, Katherine A; Biryol, Derya; Dionisio, Kathie L; Price, Paul S
2018-05-01
Assessing human exposures to chemicals in consumer products requires composition information. However, comprehensive composition data for products in commerce are not generally available. Many consumer products have reported ingredient lists that are constructed using specific guidelines. A probabilistic model was developed to estimate quantitative weight fraction (WF) values that are consistent with the rank of an ingredient in the list, the number of reported ingredients, and labeling rules. The model provides the mean, median, and 95% upper and lower confidence limit WFs for ingredients of any rank in lists of any length. WFs predicted by the model compared favorably with those reported on Material Safety Data Sheets. Predictions for chemicals known to provide specific functions in products were also found to reasonably agree with reported WFs. The model was applied to a selection of publicly available ingredient lists, thereby estimating WFs for 1293 unique ingredients in 1123 products in 81 product categories. Predicted WFs, although less precise than reported values, can be estimated for large numbers of product-chemical combinations and thus provide a useful source of data for high-throughput or screening-level exposure assessments.
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Social media use and cybercivility guidelines in U.S. nursing schools: A review of websites.
De Gagne, Jennie C; Yamane, Sandra S; Conklin, Jamie L; Chang, Jianhong; Kang, Hee Sun
This research analyzes to what extent U.S. nursing schools use social media, their policies or guidelines on cybercivility in social media, online classrooms, and email correspondence, and whether these protocols are readily available to students. This website-based study employs a descriptive, cross-sectional, non-experimental search design. Data were collected in nursing schools offering master's programs (n=197) and online graduate programs in master's degree (n=110) listed in the 2017 edition of U.S. News and World Report. School ranking was positively correlated with the total number of social networking sites being used in the schools, but not with the presence of cybercivility guidelines. About a third of the nursing schools in the sample had policies/guidelines concerning social media, while fewer than 10% had policies/guidelines about online classroom conduct (n=14) or email use (n=16). Key features of these protocols were professionalism, expected behaviors, and consequences. Establishing and implementing policies and guidelines regarding cybercivility is a vital step to promote a culture of civility online. It is especially important to do so in nursing schools where standards should reflect the values of the profession. Copyright © 2017 Elsevier Inc. All rights reserved.
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Giardiello, Francis M; Allen, John I; Axilbund, Jennifer E; Boland, C Richard; Burke, Carol A; Burt, Randall W; Church, James M; Dominitz, Jason A; Johnson, David A; Kaltenbach, Tonya; Levin, Theodore R; Lieberman, David A; Robertson, Douglas J; Syngal, Sapna; Rex, Douglas K
2014-08-01
The Multi-Society Task Force, in collaboration with invited experts, developed guidelines to assist health care providers with the appropriate provision of genetic testing and management of patients at risk for and affected with Lynch syndrome as follows: Figure 1 provides a colorectal cancer risk assessment tool to screen individuals in the office or endoscopy setting; Figure 2 illustrates a strategy for universal screening for Lynch syndrome by tumor testing of patients diagnosed with colorectal cancer; Figures 3-6 provide algorithms for genetic evaluation of affected and at-risk family members of pedigrees with Lynch syndrome; Table 10 provides guidelines for screening at-risk and affected persons with Lynch syndrome; and Table 12 lists the guidelines for the management of patients with Lynch syndrome. A detailed explanation of Lynch syndrome and the methodology utilized to derive these guidelines, as well as an explanation of, and supporting literature for, these guidelines are provided. Copyright © 2014 American Gastroenterological Association, American College of Gastroenterology, the American Society of Colon and Rectal Surgeons, and the American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
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Japanese guideline for the management of hyperuricemia and gout: second edition.
Yamanaka, Hisashi
2011-12-01
Gout is a urate deposition disease caused by persistent hyperuricemia. Because gout patients present with a variety of clinical symptoms, it is necessary to have a guideline for the standard management and care of gout and hyperuricemia. The Japanese Society of Gout and Nucleic Acid Metabolism, a scientific society committed to study nucleic acid metabolism and related diseases, established the first edition of the "Guideline for the Management of Hyperuricemia and Gout" in 2002, and published the revised version in January 2010. This second edition is not only evidence based on a search of systemic literature, but also includes consensus levels by a Delphi exercise to determine the strength of the recommendations. A draft version of this guideline was reviewed by internal and external reviewers as well as a patient. In this guideline, key messages from each chapter are listed as statements together with the evidence level, consensus level, and strength of the recommendation. In this proceeding, several selected chapters on the clinical management of gout and hyperuricemia are described. We hope this guideline is appropriately used for the standard management and care of patients with hyperuricemia and gout in daily practice.
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Hoepelman, I M; Sachs, A P; Visser, M R; Lammers, J W
1997-08-16
There are three Anglo-Saxon guidelines for the management of patients with a community-acquired pneumonia: an American, a British and a Canadian one. The guidelines correspond fairly well. There is a subdivision into categories according to whether the patients are treated at home (formerly healthy patients younger than 60 years versus patients with pre-existent disease or aged 60 years and more) or in the hospital (patients not needing intensive care versus those who do need it). For each category the most common causative micro-organisms are listed together with recommended antibiotic treatment. The Canadian guidelines have nursing home patients as a separate category because of slightly different causative organisms due to frequent microaspiration. The guidelines are applicable to the situation in the Netherlands, with a few exceptions: antibiotic resistance is not a major problem in the Netherlands (as yet), and contrary to what the guidelines state an agent with activity against Pseudomonas aeruginosa is not necessary; the same agents as in category III can be prescribed in these patients. A macrolide or azalide antibiotic is advisable for intensive care patients in view of the possibility of infection with Legionella pneumophila or Mycoplasma pneumoniae.
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Tonsillectomy under threat: auditing the indications for performing tonsillectomy.
Silva, S; Ouda, M; Mathanakumara, S; Ridyard, E; Morar, P
2012-06-01
The 2009 McKinsey National Health Service report considered that tonsillectomy was relatively ineffective and often unjustified, and that its frequently could be greatly reduced. ENTUK argued against this, for severe recurrent tonsillitis. This study audited clinical indications for tonsillectomy. CRITERIA AND STANDARDS: Current guidelines state that patients with recurrent tonsillitis must have disabling sore throat episodes five or more times per year, and symptoms for at least a year, to justify tonsillectomy. Seventeen recurrent tonsillitis patients receiving tonsillectomy were audited prospectively. Indications were poorly documented in the referral letter, so surgeons agreed to list specified tonsillectomy criteria when scheduling patients for tonsillectomy. A pro forma reminder was distributed to all clinics, and the next 100 scheduled tonsillectomy patients were audited. In the first audit, all 17 tonsillectomies were justified but only two (11.8 per cent) had documented indications. In the second audit, 85 per cent of patients had all essential criteria, which were documented in the listing letter. Tonsillectomy risks being removed from the UK essential otolaryngological surgical register, risking increased patient morbidity and work absence, despite valid supporting evidence of efficacy for recurrent tonsillitis. All UK otolaryngology units should strictly adhere to the ENTUK and Scottish Intercollegiate Guidelines Network recommendations for tonsillectomy, and should document essential criteria in the listing letter, to strengthen the advocacy argument for tonsillectomy as essential, valid treatment for recurrent tonsillitis.
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[Pharmaceutical product quality control and good manufacturing practices].
Hiyama, Yukio
2010-01-01
This report describes the roles of Good Manufacturing Practices (GMP) in pharmaceutical product quality control. There are three keys to pharmaceutical product quality control. They are specifications, thorough product characterization during development, and adherence to GMP as the ICH Q6A guideline on specifications provides the most important principles in its background section. Impacts of the revised Pharmaceutical Affairs Law (rPAL) which became effective in 2005 on product quality control are discussed. Progress of ICH discussion for Pharmaceutical Development (Q8), Quality Risk Management (Q9) and Pharmaceutical Quality System (Q10) are reviewed. In order to reconstruct GMP guidelines and GMP inspection system in the regulatory agencies under the new paradigm by rPAL and the ICH, a series of Health Science studies were conducted. For GMP guidelines, product GMP guideline, technology transfer guideline, laboratory control guideline and change control system guideline were written. For the GMP inspection system, inspection check list, inspection memo and inspection scenario were proposed also by the Health Science study groups. Because pharmaceutical products and their raw materials are manufactured and distributed internationally, collaborations with other national authorities are highly desired. In order to enhance the international collaborations, consistent establishment of GMP inspection quality system throughout Japan will be essential.
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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.
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Parkhill, Anne; Hill, Kelvin
2009-03-01
The Australian National Stroke Foundation appointed a search specialist to find the best available evidence for the second edition of its Clinical Guidelines for Acute Stroke Management. To identify the relative effectiveness of differing evidence sources for the guideline update. We searched and reviewed references from five valid evidence sources for clinical and economic questions: (i) electronic databases; (ii) reference lists of relevant systematic reviews, guidelines, and/or primary studies; (iii) table of contents of a number of key journals for the last 6 months; (iv) internet/grey literature; and (v) experts. Reference sources were recorded, quantified, and analysed. In the clinical portion of the guidelines document, there was a greater use of previous knowledge and sources other than electronic databases for evidence, while there was a greater use of electronic databases for the economic section. The results confirmed that searchers need to be aware of the context and range of sources for evidence searches. For best available evidence, searchers cannot rely solely on electronic databases and need to encompass many different media and sources.
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[Systemic validation of clinical practice guidelines: the AGREE network].
Hannes, K; Van Royen, P; Aertgeerts, B; Buntinx, F; Ramaekers, D; Chevalier, P
2005-12-01
Over recent decades, the number of available clinical practice guidelines has enormously grown. Guidelines should meet specific quality criteria to ensure good quality. There is a growing need for the developement of a set of criteria to ensure that potential biases inherent in guideline development have been properly addressed and that the recommendations for practice are valid and reliable. The AGREE-collaboration is an international network that developed an instrument to critically appraise the methodological quality of guidelines. AGREE promotes a clear strategy to produce, disseminate and evaluate guidelines of high quality. In the first phase of the international project the AGREE-instrument was tested in 11 different countries. Based on this experience the instrument was refined and optimised. In the second phase it was disseminated, promoted and evaluated in 18 participating countries. Belgium was one of them. The Belgian partner in the AGREE-project developed 3 workshops and established 13 validation committees to validate guidelines from Belgian developer groups. We collected 33 questionnaires from participants of the workshops and the validation committees, in which we asked for primary experiences and information on the usefulness and applicability of the instrument. We were also interested in the shortcomings of the instrument and potential strategies to bridge them. More efforts should be made to train methodological experts to gain certain skills for a critical appraisal of clinical practice guidelines. Promoting the AGREE-instrument will lead to a broader knowledge and use of quality criteria in guideline development and appraisal. The development and dissemination of an international list of criteria to appraise the quality of guidelines will stimulate the development of methodologically sound guidelines. International comparisons between existing guidelines will lead to a better collaboration between guideline developers throughout the world.
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Hampel, Heather; Bennett, Robin L; Buchanan, Adam; Pearlman, Rachel; Wiesner, Georgia L
2015-01-01
The practice guidelines of the American College of Medical Genetics and Genomics (ACMG) and the National Society of Genetic Counselors (NSGC) are developed by members of the ACMG and NSGC to assist medical geneticists, genetic counselors, and other health-care providers in making decisions about appropriate management of genetic concerns, including access to and/or delivery of services. Each practice guideline focuses on a clinical or practice-based issue and is the result of a review and analysis of current professional literature believed to be reliable. As such, information and recommendations within the ACMG and NSGC joint practice guidelines reflect the current scientific and clinical knowledge at the time of publication, are current only as of their publication date, and are subject to change without notice as advances emerge. In addition, variations in practice, which take into account the needs of the individual patient and the resources and limitations unique to the institution or type of practice, may warrant approaches, treatments, and/or procedures that differ from the recommendations outlined in this guideline. Therefore, these recommendations should not be construed as dictating an exclusive course of management, nor does the use of such recommendations guarantee a particular outcome. Genetic counseling practice guidelines are never intended to displace a health-care provider's best medical judgment based on the clinical circumstances of a particular patient or patient population. Practice guidelines are published by the ACMG or the NSGC for educational and informational purposes only, and neither the ACMG nor the NSGC "approve" or "endorse" any specific methods, practices, or sources of information.Cancer genetic consultation is an important aspect of the care of individuals at increased risk of a hereditary cancer syndrome. Yet several patient, clinician, and system-level barriers hinder identification of individuals appropriate for cancer genetics referral. Thus, the purpose of this practice guideline is to present a single set of comprehensive personal and family history criteria to facilitate identification and maximize appropriate referral of at-risk individuals for cancer genetic consultation. To develop this guideline, a literature search for hereditary cancer susceptibility syndromes was conducted using PubMed. In addition, GeneReviews and the National Comprehensive Cancer Network guidelines were reviewed when applicable. When conflicting guidelines were identified, the evidence was ranked as follows: position papers from national and professional organizations ranked highest, followed by consortium guidelines, and then peer-reviewed publications from single institutions. The criteria for cancer genetic consultation referral are provided in two formats: (i) tables that list the tumor type along with the criteria that, if met, would warrant a referral for a cancer genetic consultation and (ii) an alphabetical list of the syndromes, including a brief summary of each and the rationale for the referral criteria that were selected. Consider referral for a cancer genetic consultation if your patient or any of their first-degree relatives meet any of these referral criteria.
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Crosland, Paul; Maconachie, Ross; Buckner, Sara; McGuire, Hugh; Humphries, Steve E; Qureshi, Nadeem
2018-05-17
The cost effectiveness of cascade testing for familial hypercholesterolaemia (FH) is well recognised. Less clear is the cost effectiveness of FH screening when it includes case identification strategies that incorporate routinely available data from primary and secondary care electronic health records. Nine strategies were compared, all using cascade testing in combination with different index case approaches (primary care identification, secondary care identification, and clinical assessment using the Simon Broome (SB) or Dutch Lipid Clinic Network (DLCN) criteria). A decision analytic model was informed by three systematic literature reviews and expert advice provided by a NICE Guideline Committee. The model found that the addition of primary care case identification by database search for patients with recorded total cholesterol >9.3 mmol/L was more cost effective than cascade testing alone. The incremental cost-effectiveness ratio (ICER) of clinical assessment using the DLCN criteria was £3254 per quality-adjusted life year (QALY) compared with case-finding with no genetic testing. The ICER of clinical assessment using the SB criteria was £13,365 per QALY (compared with primary care identification using the DLCN criteria), indicating that the SB criteria was preferred because it achieved additional health benefits at an acceptable cost. Secondary care identification, with either the SB or DLCN criteria, was not cost effective, alone (dominated and dominated respectively) or combined with primary care identification (£63, 514 per QALY, and £82,388 per QALY respectively). Searching primary care databases for people at high risk of FH followed by cascade testing is likely to be cost-effective. Copyright © 2018 Elsevier B.V. All rights reserved.
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The diagnostic accuracy of the MyDiagnostick to detect atrial fibrillation in primary care
2014-01-01
Background Atrial fibrillation is very common in people aged 65 or older. This condition increases the risk of death, congestive heart failure and thromboembolic conditions. Many patients with atrial fibrillation are asymptomatic and a cerebrovascular accident (CVA) is often the first clinical presentation. Guidelines concerning the prevention of CVA recommend monitoring the heart rate in patients aged 65 or older. Recently, the MyDiagnostick (Applied Biomedical Systems BV, Maastricht, The Netherlands) was introduced as a new screening tool which might serve as an alternative for the less accurate pulse palpation. This study was designed to explore the diagnostic accuracy of the MyDiagnostick for the detection of atrial fibrillation. Methods A phase II diagnostic accuracy study in a convenience sample of 191 subjects recruited in primary care. The majority of participants were patients with a known history of atrial fibrillation (n = 161). Readings of the MyDiagnostick were compared with electrocardiographic recordings. Sensitivity and specificity and their 95% confidence interval were calculated using 2x2 tables. Results A prevalence of 54% for an atrial fibrillation rhythm was found in the study population at the moment of the study. A combination of three measurements with the MyDiagnostick for each patient showed a sensitivity of 94% (95% CI 87 – 98) and a specificity of 93% (95% CI 85 – 97). Conclusion The MyDiagnostick is an easy-to-use device that showed a good diagnostic accuracy with a high sensitivity and specificity for atrial fibrillation in a convenience sample in primary care. Future research is needed to determine the place of the MyDiagnostick in possible screening or case-finding strategies for atrial fibrillation. PMID:24913608
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Theunissen, Kevin A T M; Schipper, Pim; Hoebe, Christian J P A; Crutzen, Rik; Kok, Gerjo; Dukers-Muijrers, Nicole H T M
2014-12-20
Partner notification (PN) is an essential case-finding tool in the management of sexually transmitted infections (STIs). Yet, data on the effectiveness and factors impacting implementation of PN in the Netherlands are lacking. With the aim of further exploring and improving the PN process, the current study assessed perceived barriers and facilitators among health care professionals in the STI clinical setting. In particular, we explored the management of PN in young heterosexual patients diagnosed with Chlamydia trachomatis (Ct). We conducted semi-structured interviews among 22 health care professionals (response rate 52%) from 5 of the 8 national STI clinics in the Netherlands. We carried out qualitative content analysis using a framework approach. All participants were nurses, aged mid 20's to late 50's, and all but one were female. All health care professionals felt comfortable discussing PN. Other perceived facilitators for PN included: time, one-on-one consultations, interviewing skills (i.e. Motivational Interviewing) and a proactive helping style. Important barriers were identified as: sub-optimal guidelines, inaccurate sexual history, a lack of feedback regarding the motivational strategies that were used, and the lack of feedback regarding overall PN effectiveness. The health care professionals placed an emphasis on the care and treatment of the individual index patient rather than on discussion of PN, or on motivating and helping patients to engage in PN. Health care professionals identified several barriers that need to be overcome, and facilitators which need to be maintained. Future efforts should concentrate on introducing PN protocols, providing feedback on both the effectiveness of strategies used by health care professionals, and on the PN process as a whole, and educating health care professionals about Motivational Interviewing strategies. Moreover, the possible implementation of an Internet-based PN system should be explored.
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A practical guide to the application of the IUCN Red List of Ecosystems criteria.
Rodríguez, Jon Paul; Keith, David A; Rodríguez-Clark, Kathryn M; Murray, Nicholas J; Nicholson, Emily; Regan, Tracey J; Miller, Rebecca M; Barrow, Edmund G; Bland, Lucie M; Boe, Kaia; Brooks, Thomas M; Oliveira-Miranda, María A; Spalding, Mark; Wit, Piet
2015-02-19
The newly developed IUCN Red List of Ecosystems is part of a growing toolbox for assessing risks to biodiversity, which addresses ecosystems and their functioning. The Red List of Ecosystems standard allows systematic assessment of all freshwater, marine, terrestrial and subterranean ecosystem types in terms of their global risk of collapse. In addition, the Red List of Ecosystems categories and criteria provide a technical base for assessments of ecosystem status at the regional, national, or subnational level. While the Red List of Ecosystems criteria were designed to be widely applicable by scientists and practitioners, guidelines are needed to ensure they are implemented in a standardized manner to reduce epistemic uncertainties and allow robust comparisons among ecosystems and over time. We review the intended application of the Red List of Ecosystems assessment process, summarize 'best-practice' methods for ecosystem assessments and outline approaches to ensure operational rigour of assessments. The Red List of Ecosystems will inform priority setting for ecosystem types worldwide, and strengthen capacity to report on progress towards the Aichi Targets of the Convention on Biological Diversity. When integrated with other IUCN knowledge products, such as the World Database of Protected Areas/Protected Planet, Key Biodiversity Areas and the IUCN Red List of Threatened Species, the Red List of Ecosystems will contribute to providing the most complete global measure of the status of biodiversity yet achieved. © 2015 The Author(s) Published by the Royal Society. All rights reserved.
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-11-29
...On December 9, 2010, the Bureau of Industry and Security (BIS) published an advance notice of proposed rulemaking entitled Commerce Control List: Revising Descriptions of Items and Foreign Availability as part of the President's Export Control Reform (ECR) Initiative. The December 9, 2010 notice sought, among other things, public comments on how descriptions of items controlled on the Commerce Control List (CCL) could be made clearer. This proposed rule would implement changes identified by BIS and the public that would make the CCL clearer. This rule would only implement changes that can be made to the CCL without requiring changes to multilateral export control regime guidelines or lists. However, BIS has identified changes that would require a decision of a multilateral regime to implement. For those changes, the U.S. Government is developing regime change proposals for consideration by members of those multilateral export control regimes. BIS will implement those changes in separate rulemakings, if approved by the respective multilateral export control regimes.
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Politics of Japanese Naming Practice: Language Policy and Character Use
ERIC Educational Resources Information Center
Watanabe, Noriko
2007-01-01
This paper discusses the collision between government guidelines on "kanji" use in public documents and Japanese naming practice that places significance on written forms. The tension between the state's need to control the legibility of its texts through allowable "kanji" character lists collides with people's rights and desires to name their own…
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29 CFR Appendix B to Subpart L of... - National Consensus Standards
Code of Federal Regulations, 2010 CFR
2010-07-01
... 29 Labor 5 2010-07-01 2010-07-01 false National Consensus Standards B Appendix B to Subpart L of... Appendix B to Subpart L of Part 1910—National Consensus Standards The following table contains a cross-reference listing of those current national consensus standards which contains information and guidelines...
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The Interface between ChE and Mathematics: What Do Students Really Need?
ERIC Educational Resources Information Center
Graham, Michael D.; Ganter, Susan L.
2001-01-01
Summarizes the report given to the Committee on the Undergraduate Program in Mathematics of the Mathematical Association of America (MAA) who is developing new guidelines for instruction in mathematics with a chemical engineering group at Clemson University in order to list specific knowledge and skills in mathematics needed by engineering…
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Reference Manual for the Instructional Use of Microcomputers. Volume I (Release II).
ERIC Educational Resources Information Center
Forman, Denyse; And Others
This manual is intended to provide educators with information and guidelines for locating, selecting, and purchasing commercially available courseware for the Apple II microcomputer. A courseware index is provided which lists programs in broad subject areas and grade levels. Information given for each program includes its DOS, language, cost,…
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Costs at U.S. Educational Institutions, 1982/83.
ERIC Educational Resources Information Center
Boyan, Douglas R.
Costs at U.S. educational institutions for 1982-1983 are identified. A listing of monthly maintenance rates (MMR) by institution within each state covers room, board, incidentals, and makes no distinction between on-campus and off-campus living. The MMR data and guidelines for additional expenses are for the foreign student in typical full-time…
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Fire! Fire Prevention and Safety: A Teacher's Handbook.
ERIC Educational Resources Information Center
New York City Board of Education, Brooklyn, NY. Div. of Educational Planning and Support.
In this curriculum guide, guidelines for teaching children about fire safety and related topics and activities representing an interdisciplinary approach to fire safety are outlined. Major fire hazards and methods of dealing with them are described. Possible sites for field trips and films relating to fire are listed. The rules of the New York…
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Testing the Whole Class: What Impact Does It Have?
ERIC Educational Resources Information Center
Rhodes-Kline, Anne K.
Reading Recovery (RR), a one-on-one short-term intervention program for first-grade children at risk for literacy failure, targets the lowest 20% of a first-grade classroom. Currently, program guidelines specify that the kindergarten teacher recommend a list of children to be tested for the program. All recommended children are administered an…
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A Guide to Researching the Criminal Justice/Corrections Field.
ERIC Educational Resources Information Center
Moore, Annie M.
This combination guide and bibliography is designed to assist students enrolled in classes in the criminal justice/corrections field. Step-by-step guidelines for writing a term paper are presented along with a bibliography listing resources dealing with corrections and criminal justice that are available in the Chicago State University library.…
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Guidelines for a Gender-Balanced Curriculum in English, Grades 7-12.
ERIC Educational Resources Information Center
National Council of Teachers of English, Urbana, IL. Women in Literature and Life Assembly.
This booklet presents a book list, activities, and teacher resources to provide teachers a starting place for works of adolescent literature that will initiate conversations and questions about gender roles and the perceptions of appropriate behavior and activities. It is designed to bring teachers' attention to more recent titles in order to…
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The How To of Badminton from Player to Teacher.
ERIC Educational Resources Information Center
Hicks, Virginia
This book is designed to help beginning and advanced students learn to play badminton in physical education classes, and to provide guidelines for the physical education instructor teaching badminton. It includes chapters on how to perform all the basic skills and advanced techniques, and provides a table which lists common errors and suggestions…
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Machine Shop. Module 8: CNC (Computerized Numerical Control). Instructor's Guide.
ERIC Educational Resources Information Center
Crosswhite, Dwight
This document consists of materials for a five-unit course on the following topics: (1) safety guidelines; (2) coordinates and dimensions; (3) numerical control math; (4) programming for numerical control machines; and (5) setting and operating the numerical control machine. The instructor's guide begins with a list of competencies covered in the…
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Softball Guide. January 1974-January 1976.
ERIC Educational Resources Information Center
Dobie, Dorothy, Ed.
This guide, produced by the Division for Girls and Women's Sports (DGWS), is a collection of rules, guidelines, and essays by various authors on the subject of women's softball. The document is divided into four sections. The first section is on the DGWS and contains statements of beliefs and standards and membership listings for various councils…
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ERIC Educational Resources Information Center
Falk, Dennis R.; Carlson, Helen L.
This book is designed to offer an overall paradigm for designing instruction related to multimedia. Each chapter explores the paradigm through literature reviews, lists of pertinent questions, case studies, guidelines, and resource suggestions. The first two parts discuss defining an instructional problem and generating solutions via multimedia…
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Competencies for Teachers Who Instruct Children with Learning Disabilities. Project I.O.U.
ERIC Educational Resources Information Center
Keegan, William
The report lists competencies for teachers in every day interactions with learning disabled students. Developed by a task force, the competencies are intended to serve as general guidelines. Information is presented on the goal, assessment competencies, and instructional competencies for the following areas: classroom management, spoken language,…
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Preparing Food for Preschoolers: A Guide for Food Service Personnel.
ERIC Educational Resources Information Center
Lundin, Janet, Ed.; O'Malley, Edward T., Ed.
Guidelines and suggestions to help food service workers in children's day care centers plan, prepare, and serve a variety of nutritious, tasty, and attractive meals and snacks are presented. The following topics are included (subtopics are listed in parentheses): (1) preparation of food (seasoning foods; preparing meat, fish, vegetables, and…
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Instructional Strategies for Developing Critical Thinking in EFL Classrooms
ERIC Educational Resources Information Center
Zhao, Cairan; Pandian, Ambigapathy; Singh, Manjet Kaur Mehar
2016-01-01
In English as first language contexts, clear requirement for critical thinking (CT) has been listed in teaching guidelines and assessment criteria in higher education. At present, fostering language learners to be critical thinkers is valued in English as a foreign language (EFL) teaching as well; yet how to achieve the objective remains a…
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How to Handle Impasses in Bargaining.
ERIC Educational Resources Information Center
Durrant, Robert E.
Guidelines in an outline format are presented to school board members and administrators on how to handle impasses in bargaining. The following two rules are given: there sometimes may be strikes, but there always will be settlements; and on the way to settlements, there always will be impasses. Suggestions for handling impasses are listed under…
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Evaluating the Buy or Rent Housing Decision.
ERIC Educational Resources Information Center
Davis, Joseph M.
This booklet offers guidelines by which a person can make an informed decision about whether buying or renting a house is the best individual alternative. Advantages and disadvantages of both buying and renting are listed. Cost considerations are discussed and compared along with such considerations as selection of the time to buy and estimation…
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The Handbook of Psychiatric Drug Therapy for Children and Adolescents.
ERIC Educational Resources Information Center
Theesen, Karen A.
A compilation of literature and clinical wisdom, this handbook provides the reader with current information on the safety and efficacy of the psychotropic agents in the pediatric population. It lists information on the pharmacokinetics, adverse effects, dosing, and suggested monitoring guidelines for children and adolescents. The guide may also be…
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The nutritional role of flavored and white milk in the diets of children
USDA-ARS?s Scientific Manuscript database
It has been recognized that milk provides shortfall nutrients to the diets of children. The 2000 Dietary Guidelines Advisory Committee identified calcium and vitamin A as shortfall nutrients; the 2005 DGAC added potassium and magnesium to the list. The goal of this study was to assess the contributi...
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DOT National Transportation Integrated Search
1997-03-01
The goal of the activities documented in this report was to produce a prioritized list of candidate studies and issues that would guide data acquisition in this project. This goal was accomplished in three steps. First, 91 issues were compiled from e...
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Combating Discrimination in the Schools: Legal Remedies and Guidelines.
ERIC Educational Resources Information Center
National Education Association, Washington, DC.
This booklet outlines the Federal laws and regulations prohibiting discrimination in educational institutions and programs. It is not a comprehensive listing of all antidiscrimination laws, but rather a guide to laws and regulations that may be used for individual and group action. The primary emphasis in this pamphlet is on the protection of…
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The Mad, Mad World of Textbook Adoption
ERIC Educational Resources Information Center
Thomas B Fordham Foundation and Institute, 2004
2004-01-01
Textbook Adoption: The process, in place in twenty-one states, of reviewing textbooks according to state guidelines and then mandating specific books that schools must use, or lists of approved textbooks that schools must choose from. It consistently produces second-rate textbooks that replicate the same flaws and failings over and over again.…
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40 CFR 461.75 - Pretreatment standards for new sources (PSNS).
Code of Federal Regulations, 2011 CFR
2011-07-01
...) EFFLUENT GUIDELINES AND STANDARDS BATTERY MANUFACTURING POINT SOURCE CATEGORY Zinc Subcategory § 461.75... and achieve the following pretreatment standards for new sources listed below: (1) Subpart G—Zinc... average Metric units—mg/kg of zinc English units—pounds per 1,000,000 pounds of zinc Chromium 4.55 1.97...
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Just Do It: Resources for Interpretive Planning
ERIC Educational Resources Information Center
Koepler, Jes
2008-01-01
Now that you have finished reading this journal issue and understand what interpretive planning is and when to apply it, how can you get started and just "do" it? This article provides an annotated list of practical handbooks and internet resources that provide guidelines for museum practitioners to engage in interpretive planning at institutions…
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Financial Reporting Practices in Illinois Public Community Colleges.
ERIC Educational Resources Information Center
Skeadas, Gus J.
A study was conducted to determine how well Illinois' 38 community college districts satisfied the needs of board members, creditors, investors, and tax payers for financial information. A list of 38 financial reporting requirements was developed from the requirements of the Illinois Community College Board (ICCB) and guidelines from the Audits of…
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Parenting Workshops on Child Development.
ERIC Educational Resources Information Center
Warren-Newport Public Library, Gurnee, IL.
The parent education materials in this packet are intended for use by professionals, and some paraprofessionals, who work with children from birth through 5 years of age and with their families. Included are guidelines for choosing playthings for children of any age, and lists of suggested toys for children of various ages, and, in particular,…
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-05-09
... requirements. See section 307(b)(2). List of Subjects in 40 CFR Part 52 Environmental protection, Air pollution... Explanation Subchapter 2D Air Pollution Control Requirements * * * * * * * Section .0900 Volatile Organic... Miscellaneous Metal 9/1/2010 5/9/2013 [Insert citation of and Plastic Parts publication]. Coatings. Sect .0968...
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GUIDELINES TO THE AFL-CIO COMMUNITY SERVICES PROGRAM.
ERIC Educational Resources Information Center
BEIRNE, JOSEPH A.
BACKGROUND MATERIALS ON THE AFL-CIO PROGRAM OF COMMUNITY SERVICES OUTLINE THE ORIGINS AND DEVELOPMENT OF THE PROGRAM, PARTICULARLY SINCE THE FORMATION OF THE AFL-CIO IN 1955. IN ADDITION TO LISTING KEY POLICY AND POSITION STATEMENTS STIPULATING THE SCOPE AND THE ADMINISTRATIVE ORGANIZATION OF THE PROGRAM, THIS OUTLINE DESCRIBES SUCH MAJOR…
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ERIC Educational Resources Information Center
Wei, Shiyuan; Zhou, Guangda
1989-01-01
Describes the historical development of educational programs which could enhance the culture and knowledge of minorities in the mountainous regions of China. Identifies current major problems in minority education and lists statistical information for the school population. Provides guidelines for developing a minority education program. (KO)
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Reading Guidance: Death and Grief.
ERIC Educational Resources Information Center
Smith, Alice Gullen
1989-01-01
Gives guidelines for the librarian using reading guidance (similar to bibliotherapy). Provides a nine-item annotated bibliography of novels for children and adolescents on the subject of death and grief. Appends an embryo list of categories suitable for content analysis of any file librarians might wish to keep on books suitable for use in this…
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40 CFR 60.34b - Emission guidelines for municipal waste combustor operating practices.
Code of Federal Regulations, 2010 CFR
2010-07-01
... approval, a State plan shall include emission limits for carbon monoxide at least as protective as the emission limits for carbon monoxide listed in table 3 of this subpart. table 3 provides emission limits for the carbon monoxide concentration level for each type of designated facility. (b) For approval, a...
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Fiscal Year 1999 At-a-Glance. Office of Justice Programs.
ERIC Educational Resources Information Center
Department of Justice, Washington, DC. Office of Justice Programs.
This publication provides brief descriptions of all the funding opportunities of the bureaus and offices of the Office of Justice Programs. Each description lists the amount of funding available, tells who can apply, and gives the status of program regulations, guidelines, reports, and application kits. The citations also contain the name of the…
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Plagiarism: Librarians Help Provide New Solutions to an Old Problem.
ERIC Educational Resources Information Center
Hamilton, Denise
2003-01-01
While technology has made plagiarism easier, it has also made it easier to detect. This article explains how librarians are getting involved in this battle, what can tip off a plagiarized hand, and the software that can turn suspicion into confirmation. A list of online sources of plagiarism guidelines is provided. (AEF)
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ERIC Educational Resources Information Center
Kindig, L. E.; Mrvos, S. R.
Guidelines are offered for the prevention and relief of lower back pain. The structure of the spine is described, and the functions and composition of spinal disks are explained. A list is included of common causes of abnormalities of the spinal column, and injuries which may cause the fracture of the vertebrae are described. Factors causing low…
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Values Strategies for Classroom Teachers.
ERIC Educational Resources Information Center
Lemin, Marion, Ed.; And Others
This document is a reference for teachers to use in incorporating values education into all subject areas through the activities listed in the book. The book contains 16 chapters, of which about half provide guidelines, discussion and activities related to values in general, and half suggest activities specific to individual areas of study. In the…
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Navigating the Legal and Ethical World of Overseas Contracts.
ERIC Educational Resources Information Center
Skinner, Karla Jo
1998-01-01
Referring to Iowa contract law, reviews ethical and legal aspects of overseas employment contracts signed by educators at recruitment fairs. Iowa Department of Education guidelines state the following aspects of a good contract: it is in writing; it states the salary, pay periods, benefits, and dates of employment; it lists special conditions and…
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Code of Federal Regulations, 2010 CFR
2010-10-01
... hazardous materials are only safe for transportation when they are securely sealed in a proper package...) that a container or package for transportation of a hazardous material is safe, certified, or in.... —Listing an unauthorized, incorrect, non-working, or unmonitored (24 hrs. a day) emergency response...
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Occupational Exploration at Ontario Junior High School: 9th Grade.
ERIC Educational Resources Information Center
Bates, Gene; And Others
The document contains 56 activities for Grade 9. The contents include the following areas: questions about the future; job seeking activities and guidelines; career games; a personal interest check list; unit guides for courses in World of Work (55 pages), and Career Educational Planning (40 pages) which include objectives, activities, evaluation,…
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-04-02
... Information Collection: Comment Request Affirmative Fair Housing Marketing (AFHM) Plan AGENCY: Office of the... (marketing efforts) to assure that they meet the Fair Housing guidelines in how the project is marketed to.... This Notice also lists the following information: Title of Proposal: Affirmative Fair Housing Marketing...
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USDA-ARS?s Scientific Manuscript database
Ninety-two American Indian 5th graders from a rural, northern plains reservation community completed Nominal Group Technique (NGT) sessions designed to understand both barriers and facilitators to following DGA. Individually and in small groups, children generated lists of responses to specific que...
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Online Information Services for Secondary School Students. Second Edition.
ERIC Educational Resources Information Center
Aversa, Elizabeth Smith; And Others
This guide addresses the role of online searching in school library media centers. The first section reviews the literature in the area and presents guidelines for planning and implementing online access for students based on the experiences reported. This section lists 44 references. The second section summarizes the results of a 1986 survey of…
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Issues Regarding the Use of Interpreters and Translators in a School Setting.
ERIC Educational Resources Information Center
Medina, Victoria
This paper sets forth guidelines regarding the use of interpreters/translators for use in assessment of students from linguistically and culturally different environments. Training components for such personnel are listed according to general knowledge, cultural knowledge, and specific skills. Limitations of using a third party in the assessment…
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Tokyo Guidelines 2018: antimicrobial therapy for acute cholangitis and cholecystitis.
Gomi, Harumi; Solomkin, Joseph S; Schlossberg, David; Okamoto, Kohji; Takada, Tadahiro; Strasberg, Steven M; Ukai, Tomohiko; Endo, Itaru; Iwashita, Yukio; Hibi, Taizo; Pitt, Henry A; Matsunaga, Naohisa; Takamori, Yoriyuki; Umezawa, Akiko; Asai, Koji; Suzuki, Kenji; Han, Ho-Seong; Hwang, Tsann-Long; Mori, Yasuhisa; Yoon, Yoo-Seok; Huang, Wayne Shih-Wei; Belli, Giulio; Dervenis, Christos; Yokoe, Masamichi; Kiriyama, Seiki; Itoi, Takao; Jagannath, Palepu; Garden, O James; Miura, Fumihiko; de Santibañes, Eduardo; Shikata, Satoru; Noguchi, Yoshinori; Wada, Keita; Honda, Goro; Supe, Avinash Nivritti; Yoshida, Masahiro; Mayumi, Toshihiko; Gouma, Dirk J; Deziel, Daniel J; Liau, Kui-Hin; Chen, Miin-Fu; Liu, Keng-Hao; Su, Cheng-Hsi; Chan, Angus C W; Yoon, Dong-Sup; Choi, In-Seok; Jonas, Eduard; Chen, Xiao-Ping; Fan, Sheung Tat; Ker, Chen-Guo; Giménez, Mariano Eduardo; Kitano, Seigo; Inomata, Masafumi; Mukai, Shuntaro; Higuchi, Ryota; Hirata, Koichi; Inui, Kazuo; Sumiyama, Yoshinobu; Yamamoto, Masakazu
2018-01-01
Antimicrobial therapy is a mainstay of the management for patients with acute cholangitis and/or cholecystitis. The Tokyo Guidelines 2018 (TG18) provides recommendations for the appropriate use of antimicrobials for community-acquired and healthcare-associated infections. The listed agents are for empirical therapy provided before the infecting isolates are identified. Antimicrobial agents are listed by class-definitions and TG18 severity grade I, II, and III subcategorized by clinical settings. In the era of emerging and increasing antimicrobial resistance, monitoring and updating local antibiograms is underscored. Prudent antimicrobial usage and early de-escalation or termination of antimicrobial therapy are now important parts of decision-making. What is new in TG18 is that the duration of antimicrobial therapy for both acute cholangitis and cholecystitis is systematically reviewed. Prophylactic antimicrobial usage for elective endoscopic retrograde cholangiopancreatography is no longer recommended and the section was deleted in TG18. Free full articles and mobile app of TG18 are available at: http://www.jshbps.jp/modules/en/index.php?content_id=47. Related clinical questions and references are also included. © 2018 Japanese Society of Hepato-Biliary-Pancreatic Surgery.
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Wangge, Grace; van der Graaf, Yolanda; van der Heijden, Geert J. M. G.
2016-01-01
Abstract Rationale, aims and objectives Most of the clinical guidelines in low‐resource countries are adaptations from preexisting international guidelines. This adaptation can be problematic when those international guidelines are not based on current evidence or original evidence‐based international guidelines are not followed. This study aims to evaluate the quality of an Indonesian type 2 diabetes mellitus guideline adapted from selected international guidelines. Methods The “Consensus on the Management and Prevention of type 2 Diabetes in Indonesia 2011” is a guideline by the Indonesian Society of Endocrinology (Perkeni). Four parent guidelines identified from its list of references were from the International Diabetes Federation (IDF), American Association of Clinical Endocrinologist (AACE), American Diabetes Association (ADA), and one jointly released by ADA and European Association for the Study of Diabetes (EASD). Two reviewers independently assessed its quality using the Appraisal of Guidelines, Research and Evaluation Collaboration (AGREE II) instrument. Six recommendations were compared: (1) screening for diabetes; (2) diagnosis; (3) control of hyperglycemia; (4) target blood glucose; (5) target blood pressure; and (6) treatment of dyslipidemia. Results Perkeni's guideline satisfied 55% of the AGREE II items, while its parent guidelines satisfied 59% to 74%. Perkeni's shows low score on “rigor of development” and “applicability” and the lowest score in the “scope and purpose” domain. Differences were found in 4 recommendations: the screening of diabetes, control of hyperglycemia, target blood glucose, and treatment of dyslipidemia. In 3 of 4, Perkeni followed the ADA's recommendation. Conclusion Derivation of recommendations from parent guidelines and their adaptation to the context of Indonesian health care lacks transparency. When guidelines are either derived from other guidelines or adapted for use in different context, evidence‐based practice principles should be followed and adhered to. PMID:27592587
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Widyahening, Indah S; Wangge, Grace; van der Graaf, Yolanda; van der Heijden, Geert J M G
2017-02-01
Most of the clinical guidelines in low-resource countries are adaptations from preexisting international guidelines. This adaptation can be problematic when those international guidelines are not based on current evidence or original evidence-based international guidelines are not followed. This study aims to evaluate the quality of an Indonesian type 2 diabetes mellitus guideline adapted from selected international guidelines. The "Consensus on the Management and Prevention of type 2 Diabetes in Indonesia 2011" is a guideline by the Indonesian Society of Endocrinology (Perkeni). Four parent guidelines identified from its list of references were from the International Diabetes Federation (IDF), American Association of Clinical Endocrinologist (AACE), American Diabetes Association (ADA), and one jointly released by ADA and European Association for the Study of Diabetes (EASD). Two reviewers independently assessed its quality using the Appraisal of Guidelines, Research and Evaluation Collaboration (AGREE II) instrument. Six recommendations were compared: (1) screening for diabetes; (2) diagnosis; (3) control of hyperglycemia; (4) target blood glucose; (5) target blood pressure; and (6) treatment of dyslipidemia. Perkeni's guideline satisfied 55% of the AGREE II items, while its parent guidelines satisfied 59% to 74%. Perkeni's shows low score on "rigor of development" and "applicability" and the lowest score in the "scope and purpose" domain. Differences were found in 4 recommendations: the screening of diabetes, control of hyperglycemia, target blood glucose, and treatment of dyslipidemia. In 3 of 4, Perkeni followed the ADA's recommendation. Derivation of recommendations from parent guidelines and their adaptation to the context of Indonesian health care lacks transparency. When guidelines are either derived from other guidelines or adapted for use in different context, evidence-based practice principles should be followed and adhered to. © 2016 The Authors Journal of Evaluation in Clinical Practice Published by John Wiley & Sons Ltd.
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Looking Inward: Philosophical and Methodological Perspectives on Phenomenological Self-Reflection.
Pool, Natalie M
2018-07-01
Engaging in early and ongoing self-reflection during interpretive phenomenological research is critical for ensuring trustworthiness or rigor. However, the lack of guidelines and clarity about the role of self-reflection in this methodology creates both theoretical and procedural confusion. The purpose of this article is to describe key philosophical underpinnings, characteristics, and hallmarks of the process of self-reflection in interpretive phenomenological investigation and to provide a list of guidelines that facilitate this process. Excerpts from an interpretive phenomenological study are used to illustrate characteristics of quality self-reflection. The guidelines are intended to be particularly beneficial for novice researchers who may find self-reflective writing to be daunting and unclear. Facilitating use of self-reflection may strengthen both the interpretive phenomenological body of work as well as that of all qualitative research.
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ESPACOMP Medication Adherence Reporting Guidelines (EMERGE): a reactive-Delphi study protocol
Helmy, R; Zullig, L L; Dunbar-Jacob, J; Hughes, D A; Vrijens, B; Wilson, I B; De Geest, S
2017-01-01
Introduction Medication adherence is fundamental to achieving optimal patient outcomes. Reporting research on medication adherence suffers from some issues—including conceptualisation, measurement and data analysis—that thwart its advancement. Using the ABC taxonomy for medication adherence as the conceptual basis, a steering committee of members of the European Society for Patient Adherence, COMpliance, and Persistence (ESPACOMP) launched an initiative to develop ESPACOMP Medication Adherence Reporting Guidelines (EMERGE). This paper is a protocol for a Delphi study that aims to build consensus among a group of topic experts regarding an item list that will support developing EMERGE. Methods and analysis This study uses a reactive-Delphi design where a group of topic experts will be asked to rate the relevance and clarity of an initial list of items, in addition to suggesting further items and/or modifications of the initial items. The initial item list, generated by the EMERGE steering committee through a structured process, consists of 26 items distributed in 2 sections: 4 items representing the taxonomy-based minimum reporting criteria, and 22 items organised according to the common reporting sections. A purposive sample of experts will be selected from relevant disciplines and diverse geographical locations. Consensus will be achieved through predefined decision rules to keep, delete or modify the items. An iterative process of online survey rounds will be carried out until consensus is reached. Ethics and dissemination An ethics approval was not required for the study according to the Swiss federal act on research involving human beings. The participating experts will be asked to give an informed consent. The results of this Delphi study will feed into EMERGE, which will be disseminated through peer-reviewed publications and presentations at conferences. Additionally, the steering committee will encourage their endorsement by registering the guidelines at the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) network and other relevant organisations. PMID:28188154
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Affirmative Action Compliance Program for Fiscal Year 1980
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
Eleven chapters are used to delineate Lawrence Berkeley Lab's compliance, namely: (1) a description of LBL's facility, history, staff, mission, etc; (2) Affirmative Action policy statement; (3) dissemination (internal and external) per the implementation regulations; (4) identification of Affirmative Action responsibilities; (5) personnel policies; (6) past goal-setting process and accomplishment; (7) work-force array, job groups, availability determinations, identification of underutilization, and goals and timetables; (8) identification of problem areas and action-oriented programs; (9) listing and brief description of specific LBL Affirmative Action programs; (10) compliance with sex-discrimination guidelines; and (11) compliance with guidelines on discrimination because of religion or nationalmore » origin.« less
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Developing a unified list of physicians' reasoning tasks during clinical encounters.
Goldszmidt, Mark; Minda, John Paul; Bordage, Georges
2013-03-01
The clinical reasoning literature focuses on how physicians reason while making decisions, rather than on what they reason about while performing their clinical tasks. In an attempt to provide a common language for discussing, teaching, and researching clinical reasoning, the authors undertook the task of developing a unified list of physicians' reasoning tasks, or what they reason about, during clinical encounters. The authors compiled an initial list of 20 reasoning tasks based on the literature from four content areas--clinical reasoning, communications, medical errors, and clinical guidelines. In the summer and fall of 2010, they surveyed a purposive sample of 46 international experts in clinical reasoning and communications. From the results of the first survey, the authors refined their list of reasoning tasks, then resurveyed 22 of the original participants. From the results of the second survey, they further refined their list and validated the inclusion of the reasoning tasks. Twenty-four of 46 (52%) and 15 of 22 (65%) participants completed the first- and second-round surveys, respectively. Following the second-round survey, the authors' list included 24 reasoning tasks, and a clinical example corresponding to each, that fell into four broad categories: framing the encounter (3), diagnosis (8), management (11), and self-reflection (2). The development of this unified list represents a first step in offering a vocabulary for discussing, reflecting on, teaching, and studying physicians' reasoning tasks during clinical encounters.
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Sakagami, Yuichiro; Tsutani, Kiichiro
2014-01-01
The purpose of this study was to summarize the historical changes in the list of plasma fractionation products (PFP) placed on the Model List of Essential Medicines (EML) issued by the World Health Organization (WHO). PFP such as albumin, blood coagulation factors, and immunoglobulins are derived from blood collected from thousands of people. PFP have been listed since the first edition of the EML (1977). However, the PFP listed on the EML have changed dramatically because EML's selection process has changed from experience-based to evidence-based. For example, albumin, which had been listed since the 2nd edition (1979), was deleted in the 11th edition (2000) because of the uncertainty of its efficacy. Human immunoglobulin normal, which had been deleted from the 13th edition (2003), was relisted in the 15th edition (2007). Moreover, the WHO has issued several resolutions and guidelines regarding PFP production, quality, and safety in order to promote the establishment of blood programmes in every nation. The focus of WHO's EML selection process has changed over 30 years. In the 20th century, WHO mainly focused on PFP efficacy, quality, and safety problems. However, currently the focus is on the problem of PFP accessibility, especially in developing countries. Therefore, it would be important to know how to capitalize on established knowledge and production technology to increase the accessibility of PFP worldwide.
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2014-01-01
Background Wider adoption of reporting guidelines by veterinary journals could improve the quality of published veterinary research. The aims of this study were to assess the knowledge and views of veterinary Editors-in-Chief on reporting guidelines, identify the policies of their journals, and determine their information needs. Editors-in-Chief of 185 journals on the contact list for the International Association of Veterinary Editors (IAVE) were surveyed in April 2012 using an online questionnaire which contained both closed and open questions. Results The response rate was 36.8% (68/185). Thirty-six of 68 editors (52.9%) stated they knew what a reporting guideline was before receiving the questionnaire. Editors said they had found out about reporting guidelines primarily through articles in other journals, via the Internet and through their own journal. Twenty of 57 respondents (35.1%) said their journal referred to reporting guidelines in its instructions to authors. CONSORT, REFLECT, and ARRIVE were the most frequently cited. Forty-four of 68 respondents (68.2%) believed that reporting guidelines should be adopted by all refereed veterinary journals. Qualitative analysis of the open questions revealed that lack of knowledge, fear, resistance to change, and difficulty in implementation were perceived as barriers to the adoption of reporting guidelines by journals. Editors suggested that reporting guidelines be promoted through communication and education of the veterinary community, with roles for the IAVE and universities. Many respondents believed a consensus policy on guideline implementation was needed for veterinary journals. Conclusions Further communication and education about reporting guidelines for editors, authors and reviewers has the potential to increase their adoption by veterinary journals in the future. PMID:24410882
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International Continence Society supported pelvic physiotherapy education guideline.
Bakker, Els; Shelly, Beth; Esch, Fetske H; Frawley, Helena; McClurg, Doreen; Meyers, Peter
2018-02-01
To provide a guideline of desired knowledge, clinical skills and education levels in Pelvic Physiotherapy (PT). Physiotherapy (PT) involves "using knowledge and skills unique to physiotherapists" and, "is the service only provided by, or under the direction and supervision of a physiotherapist." 1 METHODS: The PT Committee, within the body of the International Continence Society (ICS), collected information regarding existing educational levels for pelvic floor PT. Through face to face and on on-line discussion consensus was reached which was summarized in three progressive educational levels based on knowledge and skills and brought together in a guideline. The guideline was submitted to all physiotherapists and the Educational Committee of the ICS, and after approval, submitted to the Executive Board of the ICS. The guideline lists, in a progressive way, knowledge areas and skills to be achieved by education. It is broad and allows for individual interpretation based on local situations regarding education and healthcare possibilities. It is intended to be dynamic and updated on a regular basis. The proposed Pelvic PT education guideline is a dynamic document that allows course creators to plan topics for continuing course work and to recognize educational level of a therapist in the field of Pelvic PT. This education guideline can be used to set minimum worldwide standards resulting in higher skill levels for local pelvic physiotherapists and thereby better patient care outcome. © 2018 Wiley Periodicals, Inc.