Science.gov

Sample records for imaging guidelines implementation

  1. Guideline implementation: Surgical attire.

    PubMed

    Cowperthwaite, Liz; Holm, Rebecca L

    2015-02-01

    Surgical attire helps protect patients from microorganisms that may be shed from the hair and skin of perioperative personnel. The updated AORN "Guideline for surgical attire" provides guidance on scrub attire, shoes, head coverings, and masks worn in the semirestricted and restricted areas of the perioperative setting, as well as how to handle personal items (eg, jewelry, backpacks, cell phones) that may be taken into the perioperative suite. This article focuses on key points of the guideline to help perioperative personnel adhere to facility policies and regulatory requirements for attire. The key points address the potential benefits of wearing scrub attire made of antimicrobial fabric, covering the arms when in the restricted area of the surgical suite, removing or confining jewelry when wearing scrub attire, disinfecting personal items that will be taken into the perioperative suite, and sending reusable attire to a health care-accredited laundry facility after use. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures.

  2. 10 CFR 960.3 - Implementation guidelines.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Implementation guidelines. 960.3 Section 960.3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3 Implementation guidelines. The guidelines of this...

  3. 10 CFR 960.3 - Implementation guidelines.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Implementation guidelines. 960.3 Section 960.3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3 Implementation guidelines. The guidelines of this...

  4. 10 CFR 960.3 - Implementation guidelines.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Implementation guidelines. 960.3 Section 960.3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3 Implementation guidelines. The guidelines of this...

  5. 10 CFR 960.3 - Implementation guidelines.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Implementation guidelines. 960.3 Section 960.3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3 Implementation guidelines. The guidelines of this...

  6. 10 CFR 960.3 - Implementation guidelines.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Implementation guidelines. 960.3 Section 960.3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3 Implementation guidelines. The guidelines of this...

  7. Guideline Implementation: Processing Flexible Endoscopes.

    PubMed

    Bashaw, Marie A

    2016-09-01

    The updated AORN "Guideline for processing flexible endoscopes" provides guidance to perioperative, endoscopy, and sterile processing personnel for processing all types of reusable flexible endoscopes and accessories in all procedural settings. This article focuses on key points of the guideline to help perioperative personnel safely and effectively process flexible endoscopes to prevent infection transmission. The key points address verification of manual cleaning, mechanical cleaning and processing, storage in a drying cabinet, determination of maximum storage time before reprocessing is needed, and considerations for implementing a microbiologic surveillance program. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures.

  8. Guideline Implementation: Processing Flexible Endoscopes.

    PubMed

    Bashaw, Marie A

    2016-09-01

    The updated AORN "Guideline for processing flexible endoscopes" provides guidance to perioperative, endoscopy, and sterile processing personnel for processing all types of reusable flexible endoscopes and accessories in all procedural settings. This article focuses on key points of the guideline to help perioperative personnel safely and effectively process flexible endoscopes to prevent infection transmission. The key points address verification of manual cleaning, mechanical cleaning and processing, storage in a drying cabinet, determination of maximum storage time before reprocessing is needed, and considerations for implementing a microbiologic surveillance program. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures. PMID:27568535

  9. GOSIP implementation guidelines

    SciTech Connect

    Van Norman, H.J.

    1996-07-01

    GOSIP (Government Open Systems Interconnection Profile) is a subset of ISO`s OSI protocol standards relevant to US Government operations. As a Federal Information Processing Standard (FIPS), GOSIP is required by law for all Federal agencies. Mandatory standards-based communications products are required when purchasing functionality equivalent to what is specified in GOSIP. This unprecedented requirement by the Federal government has caused considerable confusion concerning practical implementation of relatively immature and untested technologies. Many organizations already have substantial investment in one or more proprietary network architectures. This paper examines issues associated with conversion to the GOSIP system.

  10. Guideline implementation: surgical instrument cleaning.

    PubMed

    Cowperthwaite, Liz; Holm, Rebecca L

    2015-05-01

    Cleaning, decontaminating, and handling instructions for instruments vary widely based on the type of instrument and the manufacturer. Processing instruments in accordance with the manufacturer's instructions can help prevent damage and keep devices in good working order. Most importantly, proper cleaning and disinfection may prevent transmission of pathogenic organisms from a contaminated device to a patient or health care worker. The updated AORN "Guideline for cleaning and care of surgical instruments" provides guidance on cleaning, decontaminating, transporting, inspecting, and storing instruments. This article focuses on key points of the guideline to help perioperative personnel implement appropriate instrument care protocols in their practice settings. The key points address timely cleaning and decontamination of instruments after use; appropriate heating, ventilation, and air conditioning parameters for the decontamination area; processing of ophthalmic instruments and laryngoscopes; and precautions to take with instruments used in cases of suspected prion disease. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures. PMID:25946180

  11. Guideline implementation: surgical instrument cleaning.

    PubMed

    Cowperthwaite, Liz; Holm, Rebecca L

    2015-05-01

    Cleaning, decontaminating, and handling instructions for instruments vary widely based on the type of instrument and the manufacturer. Processing instruments in accordance with the manufacturer's instructions can help prevent damage and keep devices in good working order. Most importantly, proper cleaning and disinfection may prevent transmission of pathogenic organisms from a contaminated device to a patient or health care worker. The updated AORN "Guideline for cleaning and care of surgical instruments" provides guidance on cleaning, decontaminating, transporting, inspecting, and storing instruments. This article focuses on key points of the guideline to help perioperative personnel implement appropriate instrument care protocols in their practice settings. The key points address timely cleaning and decontamination of instruments after use; appropriate heating, ventilation, and air conditioning parameters for the decontamination area; processing of ophthalmic instruments and laryngoscopes; and precautions to take with instruments used in cases of suspected prion disease. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures.

  12. Total quality management implementation guidelines

    SciTech Connect

    Not Available

    1993-12-01

    These Guidelines were designed by the Energy Quality Council to help managers and supervisors in the Department of Energy Complex bring Total Quality Management to their organizations. Because the Department is composed of a rich mixture of diverse organizations, each with its own distinctive culture and quality history, these Guidelines are intended to be adapted by users to meet the particular needs of their organizations. For example, for organizations that are well along on their quality journeys and may already have achieved quality results, these Guidelines will provide a consistent methodology and terminology reference to foster their alignment with the overall Energy quality initiative. For organizations that are just beginning their quality journeys, these Guidelines will serve as a startup manual on quality principles applied in the Energy context.

  13. Guidelines for an effective SPDS implementation program

    SciTech Connect

    Blanch, P.M.; Wilkinson, C.D.

    1984-03-01

    Guidelines developed by the Nuclear Utility Task Action Committee for the implementation of a safety parameter display system (SPDS) are summarized. These guidelines reflect the consensus of nuclear utilities on how SPDS requirements, as set up by the Nuclear Regulatory Commission, could be met. This article includes a functional definition of SPDS and discussions of SPDS implementation plans, design bases, purchase specifications, training, integration and documentation, and verification and validation.

  14. Guidelines for Implementing Teletraining Systems.

    ERIC Educational Resources Information Center

    Chute, Alan G.

    Designed to provide change agents with a framework for planning and implementing successful teletraining systems, this paper discusses strategies for the introduction of sophisticated teletraining technology into corporate training programs without adversely affecting a client organization's social environment. Teletraining is defined as an…

  15. Implementation of Job Placement Services Guidelines.

    ERIC Educational Resources Information Center

    McGillicuddy (Shirley) & Associates, Sierra Madre, CA.

    The Implementation of Job Placement Services Guidelines Project was designed to strengthen placement programs and services for California community college vocational students, and for all students needing part-time employment to realize their educational goals. The project was designed to test the validity and relevance of quality indicators…

  16. Guidelines for Implementing Workplace Literacy Programs.

    ERIC Educational Resources Information Center

    Jester, Marie H.

    This document provides guidelines for implementing workplace literacy programs. Project leadership selection, characteristics and skills, education and experience, and roles and responsibilities are reviewed. Community and business involvement, partnership development, and the voluntary advisory council components of a marketing workplace literacy…

  17. Mentally Gifted Minor Program. Guidelines for Implementation.

    ERIC Educational Resources Information Center

    Sunnyvale Elementary School District, CA.

    Information and guidelines are presented for implementing a school district's Mentally Gifted Minor (MGM) Program, which operates within the regular school organization, under the administration of the school principal. Goals for an MGM program listed cover learning skills and cognitive and affective processes. Relevant California legislation on…

  18. Reporting guidelines for implementation and operational research.

    PubMed

    Hales, Simon; Lesher-Trevino, Ana; Ford, Nathan; Maher, Dermot; Ramsay, Andrew; Tran, Nhan

    2016-01-01

    In public health, implementation research is done to improve access to interventions that have been shown to work but have not reached many of the people who could benefit from them. Researchers identify practical problems facing public health programmes and aim to find solutions that improve health outcomes. In operational research, routinely-collected programme data are used to uncover ways of delivering more effective, efficient and equitable health care. As implementation research can address many types of questions, many research designs may be appropriate. Existing reporting guidelines partially cover the methods used in implementation and operational research, so we ran a consultation through the World Health Organization (WHO), the Alliance for Health Policy & Systems Research (AHPSR) and the Special Programme for Research and Training in Tropical Diseases (TDR) and developed guidelines to facilitate the funding, conduct, review and publishing of such studies. Our intention is to provide a practical reference for funders, researchers, policymakers, implementers, reviewers and editors working with implementation and operational research. This is an evolving field, so we plan to monitor the use of these guidelines and develop future versions as required.

  19. Reporting guidelines for implementation and operational research

    PubMed Central

    Lesher-Trevino, Ana; Ford, Nathan; Maher, Dermot; Ramsay, Andrew; Tran, Nhan

    2016-01-01

    Abstract In public health, implementation research is done to improve access to interventions that have been shown to work but have not reached many of the people who could benefit from them. Researchers identify practical problems facing public health programmes and aim to find solutions that improve health outcomes. In operational research, routinely-collected programme data are used to uncover ways of delivering more effective, efficient and equitable health care. As implementation research can address many types of questions, many research designs may be appropriate. Existing reporting guidelines partially cover the methods used in implementation and operational research, so we ran a consultation through the World Health Organization (WHO), the Alliance for Health Policy & Systems Research (AHPSR) and the Special Programme for Research and Training in Tropical Diseases (TDR) and developed guidelines to facilitate the funding, conduct, review and publishing of such studies. Our intention is to provide a practical reference for funders, researchers, policymakers, implementers, reviewers and editors working with implementation and operational research. This is an evolving field, so we plan to monitor the use of these guidelines and develop future versions as required. PMID:26769997

  20. Developing clinical practice guidelines: reviewing, reporting, and publishing guidelines; updating guidelines; and the emerging issues of enhancing guideline implementability and accounting for comorbid conditions in guideline development

    PubMed Central

    2012-01-01

    Clinical practice guidelines are one of the foundations of efforts to improve health care. In 1999, we authored a paper about methods to develop guidelines. Since it was published, the methods of guideline development have progressed both in terms of methods and necessary procedures and the context for guideline development has changed with the emergence of guideline clearing houses and large scale guideline production organisations (such as the UK National Institute for Health and Clinical Excellence). It therefore seems timely to, in a series of three articles, update and extend our earlier paper. In this third paper we discuss the issues of: reviewing, reporting, and publishing guidelines; updating guidelines; and the two emerging issues of enhancing guideline implementability and how guideline developers should approach dealing with the issue of patients who will be the subject of guidelines having co-morbid conditions. PMID:22762242

  1. Guidelines for Implementing Training Effectiveness Evaluation. Final Report.

    ERIC Educational Resources Information Center

    Semple, Clarence A.

    The document presents guidelines for planning, implementing, and documenting training effectiveness evaluations. The guidelines are intended to assist researchers in coping with many of the constraints associated with executing empirical research in operational settings. (NTIS)

  2. Barriers and Strategies in Guideline Implementation-A Scoping Review.

    PubMed

    Fischer, Florian; Lange, Kerstin; Klose, Kristina; Greiner, Wolfgang; Kraemer, Alexander

    2016-01-01

    Research indicates that clinical guidelines are often not applied. The success of their implementation depends on the consideration of a variety of barriers and the use of adequate strategies to overcome them. Therefore, this scoping review aims to describe and categorize the most important barriers to guideline implementation. Furthermore, it provides an overview of different kinds of suitable strategies that are tailored to overcome these barriers. The search algorithm led to the identification of 1659 articles in PubMed. Overall, 69 articles were included in the data synthesis. The content of these articles was analysed by using a qualitative synthesis approach, to extract the most important information on barriers and strategies. The barriers to guideline implementation can be differentiated into personal factors, guideline-related factors, and external factors. The scoping review revealed the following aspects as central elements of successful strategies for guideline implementation: dissemination, education and training, social interaction, decision support systems and standing orders. Available evidence indicates that a structured implementation can improve adherence to guidelines. Therefore, the barriers to guideline implementation and adherence need to be analysed in advance so that strategies that are tailored to the specific setting and target groups can be developed. PMID:27417624

  3. [Perspectives in guideline development and implementation in Germany].

    PubMed

    Kopp, I B

    2010-06-01

    Guidelines are important tools for improving knowledge management, processes and outcomes in health care. They aim to assisst both the clinical and the patient decision-making process, particularly in those areas of health care where considerable variation or potential for improvement exist. However, guidelines are often subject to substantial criticism by practicing clinicians. A prerequisite to improving the acceptance of guidelines is a systematic and methodically sound approach in guideline development. The German instrument for methodological guideline appraisal, DELBI, is intended to assist both guideline developers and users. However, this alone is insufficient. Implementation is a process requiring multifaceted strategies to promote behavior change. These include the provision of assistance for local adaptation and well-defined quality indicators for monitoring guideline adherence and quality of care. Additionally, possible links to existing quality management activities should be taken into account to avoid duplication of efforts.

  4. Digital Imaging and Conservation: Model Guidelines.

    ERIC Educational Resources Information Center

    Dean, John F.

    2003-01-01

    Examines the intersection of conservation and digital imaging based on guidelines at the Cornell University (Ithaca, NY) library. Discusses the digitization of artifacts; assessing the condition prior to scanning; scanning considerations, including temperature and humidity, lighting, and security; stable storage of artifacts after scanning; and…

  5. A case of standardization? Implementing health promotion guidelines in Denmark.

    PubMed

    Rod, Morten Hulvej; Høybye, Mette Terp

    2016-09-01

    Guidelines are increasingly used in an effort to standardize and systematize health practices at the local level and to promote evidence-based practice. The implementation of guidelines frequently faces problems, however, and standardization processes may in general have other outcomes than the ones envisioned by the makers of standards. In 2012, the Danish National Health Authorities introduced a set of health promotion guidelines that were meant to guide the decision making and priority setting of Denmark's 98 local governments. The guidelines provided recommendations for health promotion policies and interventions and were structured according to risk factors such as alcohol, smoking and physical activity. This article examines the process of implementation of the new Danish health promotion guidelines. The article is based on qualitative interviews and participant observation, focusing on the professional practices of health promotion officers in four local governments as well as the field of Danish health promotion more generally. The analysis highlights practices and episodes related to the implementation of the guidelines and takes inspiration from Timmermans and Epstein's sociology of standards and standardization. It remains an open question whether or not the guidelines lead to more standardized policies and interventions, but we suggest that the guidelines promote a risk factor-oriented approach as the dominant frame for knowledge, reasoning, decision making and priority setting in health promotion. We describe this process as a case of epistemic standardization. PMID:25912256

  6. A manual for implementing residual radioactive material guidelines

    SciTech Connect

    Gilbert, T.L.; Yu, C.; Yuan, Y.C.; Zielen, A.J.; Jusko, M.J.; Wallo, A. III

    1989-06-01

    This manual presents information for implementing US Department of Energy (DOE) guidelines for residual radioactive material at sites identified by the Formerly Utilized Sites Remedial Action Program (FUSRAP) and the Surplus Facilities Management Program (SFMP). It describes the analysis and models used to derive site-specific guidelines for allowable residual concentrations of radionuclides in soil and the design and use of the RESRAD computer code for calculating guideline values. It also describes procedures for implementing DOE policy for reducing residual radioactivity to levels that are as low as reasonably achievable. 36 refs., 16 figs, 22 tabs.

  7. Dissemination and implementation of guidelines for the treatment of asthma.

    PubMed

    Tan, W C; Aït-Khaled, N

    2006-07-01

    Asthma remains a serious global health problem that affects people of all ages. Many asthma management guidelines, both national and international, are available, but they are seldom implemented. The implementation of guidelines remains a challenge worldwide, as barriers exist at several levels. These barriers are generic, such as poverty, inadequate resources and poor infrastructure, or specific, such as organisational, health care provider and patient factors. The barriers are, however, potentially correctable, and the goal of guideline implementation is to translate evidence-based asthma management recommendations into real-life practice to improve patient health. This state of the art article reviews the challenges and current status of and strategies for asthma dissemination and implementation globally, and highlights the specific strategies for such improvement in developing countries.

  8. Microcomputers in Schools: Policy and Implementation Guidelines.

    ERIC Educational Resources Information Center

    Commonwealth Secretariat, London (England).

    This report is about information technology in the classroom and is designed to provide information to anyone who might be involved in the planning and implementation of a national program for the introduction of computers into schools. The first of two sections of the report examines the background against which policy decisions can be made,…

  9. State Laws and Guidelines for Implementing RTI

    ERIC Educational Resources Information Center

    Zirkel, Perry A.; Thomas, Lisa B.

    2010-01-01

    The legal source of schools' use of response to intervention (RTI) is a matter of federal and state special education laws, although its implementation is largely a matter of general education practice. The only mention of RTI is in the Individuals With Disabilities Education Act (IDEA), and it is limited to identification of students with…

  10. A practical approach to implementing new CDC GBS guidelines.

    PubMed

    Hill, Shawna M; Bridges, Margie A; Knudsen, Alexis L; Vezeau, Toni M

    2013-01-01

    Group beta streptococcus (GBS) is a well-documented pathogen causing serious maternal and fetal morbidity and mortality. The CDC guidelines for managing clients who test positive for GBS in pregnancy were revised and published in 2010. However, CDC and extant literature provide limited guidance on implementation strategies for these new recommendations. Although several algorithms are included in the CDC (2010) document, none combine the maternal risk factors for practical and consistent implementation from pregnancy to newborn. In response to confusion upon initial education of these guidelines, we developed an algorithm for maternal intrapartum management. In addition, we clarified the CDC (2010) newborn algorithm in response to provider request. Without altering the recommendations, both algorithms provide clarification of the CDC (2010) guidelines. The nursing process provides an organizational structure for the discussion of our efforts to translate the complex guidelines into practice. This article could provide other facilities with tools for dealing with specific aspects of the complex clinical management of perinatal GBS.

  11. [Implementation of Study Results in Guidelines and Adherence to Guidelines in Clinical Practice].

    PubMed

    Waldfahrer, F

    2016-04-01

    Guidelines were introduced in hospital and practice-based otorhinolaryngology in the 1990s, and have been undergoing further development ever since. There are currently 20 guidelines on file at the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. The Society has cooperated in a further 34 guidelines. The quality of the guidelines has been continually improved by concrete specifications put forward by the Association of the Scientific Medical Societies in Germany [Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V.]. Since increasing digitalisation has made access to scientific publications quicker and more simple, relevant study results can be incorporated in guidelines more easily today than in the analogue world. S2e and S3 guidelines must be based on a formal literature search with subsequent evaluation of the evidence. The consensus procedure for S2k guidelines is also regulated. However, the implementation of guidelines in routine medical practice must still be considered inadequate, and there is still a considerable need for improvement in adherence to these guidelines. PMID:27128403

  12. Guideline adaptation and implementation planning: a prospective observational study

    PubMed Central

    2013-01-01

    Background Adaptation of high-quality practice guidelines for local use has been advanced as an efficient means to improve acceptability and applicability of evidence-informed care. In a pan-Canadian study, we examined how cancer care groups adapted pre-existing guidelines to their unique context and began implementation planning. Methods Using a mixed-methods, case-study design, five cases were purposefully sampled from self-identified groups and followed as they used a structured method and resources for guideline adaptation. Cases received the ADAPTE Collaboration toolkit, facilitation, methodological and logistical support, resources and assistance as required. Documentary and primary data collection methods captured individual case experience, including monthly summaries of meeting and field notes, email/telephone correspondence, and project records. Site visits, process audits, interviews, and a final evaluation forum with all cases contributed to a comprehensive account of participant experience. Results Study cases took 12 to >24 months to complete guideline adaptation. Although participants appreciated the structure, most found the ADAPTE method complex and lacking practical aspects. They needed assistance establishing individual guideline mandate and infrastructure, articulating health questions, executing search strategies, appraising evidence, and achieving consensus. Facilitation was described as a multi-faceted process, a team effort, and an essential ingredient for guideline adaptation. While front-line care providers implicitly identified implementation issues during adaptation, they identified a need to add an explicit implementation planning component. Conclusions Guideline adaptation is a positive initial step toward evidence-informed care, but adaptation (vs. ‘de novo’ development) did not meet expectations for reducing time or resource commitments. Undertaking adaptation is as much about the process (engagement and capacity building) as it

  13. Guidelines for Implementing Change: A Case Study

    NASA Astrophysics Data System (ADS)

    Masekela, Belinda; Nienaber, Rita

    To attain and sustain a competitive advantage organizations are continually faced with the need to change their structures, processes and technologies. Converting to new technology and implementing a new information management system in an organization results in inevitable changes in organizational procedures impacting on the people involved. A major problem encountered during this process is resistance to change, which may contribute to total failure of this system. Change management is the process that can be used to negate this impact and assist employees in transitioning to a new way of doing things.

  14. Multisensor image fusion guidelines in remote sensing

    NASA Astrophysics Data System (ADS)

    Pohl, C.

    2016-04-01

    Remote sensing delivers multimodal and -temporal data from the Earth's surface. In order to cope with these multidimensional data sources and to make the most of them, image fusion is a valuable tool. It has developed over the past few decades into a usable image processing technique for extracting information of higher quality and reliability. As more sensors and advanced image fusion techniques have become available, researchers have conducted a vast amount of successful studies using image fusion. However, the definition of an appropriate workflow prior to processing the imagery requires knowledge in all related fields - i.e. remote sensing, image fusion and the desired image exploitation processing. From the findings of this research it can be seen that the choice of the appropriate technique, as well as the fine-tuning of the individual parameters of this technique, is crucial. There is still a lack of strategic guidelines due to the complexity and variability of data selection, processing techniques and applications. This paper gives an overview on the state-of-the-art in remote sensing image fusion including sensors and applications. Putting research results in image fusion from the past 15 years into a context provides a new view on the subject and helps other researchers to build their innovation on these findings. Recommendations of experts help to understand further needs to achieve feasible strategies in remote sensing image fusion.

  15. [On the attractiveness, implementation and evaluation of guidelines].

    PubMed

    Nothacker, Monika; Muche-Borowski, Cathleen; Kopp, Ina; Selbmann, Hans Konrad; Neugebauer, Edmund A M

    2013-01-01

    Principles and conditions for guideline implementation and evaluation were the subject of a workshop organised by the German Association of the Scientific Medical Societies (AWMF) and the German Network for Health Services Research (DNVF). This report reflects contents and discussions and suggests possible future activities. The workshop highlighted the need for conceptual frameworks, theory-driven research and concerted strategies. The reinforcement of strategic partnerships within the health care organisations is an indispensable prerequisite for successful guideline implementation and evaluation.(As supplied by author).

  16. Osteoporosis guideline implementation in family medicine using electronic medical records

    PubMed Central

    Pritchard, Janet; Karampatos, Sarah; Ioannidis, George; Adachi, Jonathan; Thabane, Lehana; Nash, Lynn; Mehan, Upe; Kozak, Joseph; Feldman, Sid; Hirsch, Steve; Jovaisas, Algis V.; Cheung, Angela; Lohfeld, Lynne; Papaioannou, Alexandra

    2016-01-01

    Abstract Objective To identify family physicians’ learning needs related to osteoporosis care; determine family physicians’ preferred modes of learning; and identify barriers to using electronic medical records (EMRs) to implement osteoporosis guidelines in practice. Design Web-based survey. Setting Ontario. Participants Family physicians. Main outcome measures Quantitative and qualitative data about learning needs related to osteoporosis diagnosis and management; preferred mode of learning about guidelines; and barriers to using EMRs to implement guidelines. Results Of the 12 332 family physicians invited to participate in the survey, 8.5% and 7.0% provided partial or fully completed surveys, respectively. More than 80% of respondents agreed that the priority areas for education were as follows: selecting laboratory tests for secondary osteoporosis and interpreting the test results; interpreting bone mineral density results; determining appropriate circumstances for ordering anterior-posterior lumbar spine x-ray scans; and understanding duration, types, and adverse effects of pharmacotherapy. Qualitative analysis revealed that managing moderate-risk patients was a learning need. Continuing medical education was the preferred mode of learning. Approximately 80% of respondents agreed that the scarcity of EMR tools to aid in guideline implementation was a barrier to using guidelines, and 50% of respondents agreed that if EMR-embedded tools were available, time would limit their ability to use them. Conclusion This survey identified key diagnostic- and treatment-related topics in osteoporosis care that should be the focus of future continuing professional development for family physicians. Developers of EMR tools, physicians, and researchers aiming to implement guidelines to improve osteoporosis care should consider the potential barriers indicated in this study.

  17. Chapter 688 Implementation Guidelines and Instructions for Local School Districts.

    ERIC Educational Resources Information Center

    Massachusetts State Executive Office of Human Services, Boston.

    The booklet presents guidelines for implementing Massachusetts Chapter 688, which provides for a 2-year transitional process to plan for habilitative services for severely disabled young adults who will lose their entitlement to special education upon graduation or reaching the age of 22. The law is intended to serve individuals who traditionally…

  18. How to Implement the NCAA Financial Audit Guidelines.

    ERIC Educational Resources Information Center

    Connolly, Lawrence C., Jr.; And Others

    1987-01-01

    Suggestions for implementing new National Collegiate Athletic Association guidelines for intercollegiate athletics program financial audits include forming an internal task force, preparing an organization chart, choosing the type of audit, conducting a survey of booster groups, preparing a schedule of revenues and expenditures, selecting an…

  19. Overcoming the obstacles of implementing infection prevention and control guidelines.

    PubMed

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

    2015-12-01

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

  20. Implementing wound care guidelines: observations and recommendations from the bedside.

    PubMed

    Lloyd-Vossen, Jan

    2009-06-01

    The successful implementation of wound care guidelines requires an appreciation for the frustrations experienced by nurses trying to incorporate these tools into clinical practice. These frustrations or barriers to best wound care practice implementation are examined from the perspective of: 1) the practice environment, which must be understood; 2) the potential adopters, predominantly nurses seeking the best fit between evidence and their clinical practice setting; and 3) the evidence-based innovation created to change wound care practice at the point of care. Barriers identified include lack of available resources, time constraints, prescriptive guidelines that incorrectly assume details of the practice environment, and wound care product confusion. Recommendations to facilitate implementation from the bedside are discussed and include expanding guidelines to incorporate detailed educational content and dissemination strategies that serve to increase relevancy to everyday practice. Additional suggestions include decreasing wound care product confusion by developing standardized, function-based product nomenclature and improving the quality of wound care research to increase nurses' confidence in the evidence and resultant recommendations. Resources currently used to develop guidelines also should be utilized to create accompanying educational material to support the transfer and uptake of knowledge.

  1. A model for practice guideline adaptation and implementation: empowerment of the physician.

    PubMed

    Wise, C G; Billi, J E

    1995-09-01

    The Medical Center model of practice guideline adaptation and implementation uses local clinical leaders to evaluate nationally endorsed guidelines, adapt those guidelines for use in the local setting, work with support staff to develop and apply methods for guideline implementation, and assist the evaluation of clinical practice and outcomes data. The model described here combines the guideline dissemination techniques of clinical leadership, implementation, and data support and feedback. This model overcomes the failures of previous models by incorporating local physician involvement during every step of practice guideline selection, adaptation, implementation, and evaluation, and by supporting the physician leaders with quality data, resources to support guideline implementation, and outcomes assessment and feedback.

  2. Implementation of Anaphylaxis Management Guidelines: A Register-Based Study

    PubMed Central

    Grabenhenrich, Linus; Hompes, Stephanie; Gough, Hannah; Ruëff, Franziska; Scherer, Kathrin; Pföhler, Claudia; Treudler, Regina; Mahler, Vera; Hawranek, Thomas; Nemat, Katja; Koehli, Alice; Keil, Thomas; Worm, Margitta

    2012-01-01

    Background Anaphylaxis management guidelines recommend the use of intramuscular adrenaline in severe reactions, complemented by antihistamines and corticoids; secondary prevention includes allergen avoidance and provision of self-applicable first aid drugs. Gaps between recommendations and their implementation have been reported, but only in confined settings. Hence, we analysed nation-wide data on the management of anaphylaxis, evaluating the implementation of guidelines. Methods Within the anaphylaxis registry, allergy referral centres across Germany, Austria and Switzerland provided data on severe anaphylaxis cases. Based on patient records, details on reaction circumstances, diagnostic workup and treatment were collected via online questionnaire. Report of anaphylaxis through emergency physicians allowed for validation of registry data. Results 2114 severe anaphylaxis patients from 58 centres were included. 8% received adrenaline intravenously, 4% intramuscularly; 50% antihistamines, and 51% corticoids. Validation data indicated moderate underreporting of first aid drugs in the Registry. 20% received specific instructions at the time of the reaction; 81% were provided with prophylactic first aid drugs at any time. Conclusion There is a distinct discrepancy between current anaphylaxis management guidelines and their implementation. To improve patient care, a revised approach for medical education and training on the management of severe anaphylaxis is warranted. PMID:22590513

  3. [General Strategies for Implementation of Clinical Practice Guidelines].

    PubMed

    Valenzuela-Flores, Adriana Abigail; Viniegra-Osorio, Arturo; Torres-Arreola, Laura Laura

    2015-01-01

    The need to use clinical practice guidelines (CPG) arises from the health conditions and problems that public health institutions in the country face. CPG are informative documents that help improve the quality of care processes and patient safety; having among its objectives, to reduce the variability of medical practice. The Instituto Mexicano del Seguro Social designed a strategic plan for the dissemination, implementation, monitoring and control of CPG to establish an applicable model in the medical units in the three levels of care at the Instituto. This paper summarizes some of the strategies of the plan that were made with the knowledge and experience of clinicians and managers, with which they intend to promote the adoption of the key recommendations of the guidelines, to promote a sense of belonging for health personnel, and to encourage changes in organizational culture.

  4. 48 CFR 47.403 - Guidelines for implementation of the Fly America Act.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... implementation of the Fly America Act. 47.403 Section 47.403 Federal Acquisition Regulations System FEDERAL... Guidelines for implementation of the Fly America Act. This section 47.403 is based on the Guidelines for Implementation of the Fly America Act (case number B-138942), issued by the Comptroller General of the...

  5. 48 CFR 47.403 - Guidelines for implementation of the Fly America Act.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... implementation of the Fly America Act. 47.403 Section 47.403 Federal Acquisition Regulations System FEDERAL... Guidelines for implementation of the Fly America Act. This section 47.403 is based on the Guidelines for Implementation of the Fly America Act (case number B-138942), issued by the Comptroller General of the...

  6. 48 CFR 47.403 - Guidelines for implementation of the Fly America Act.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... implementation of the Fly America Act. 47.403 Section 47.403 Federal Acquisition Regulations System FEDERAL... Guidelines for implementation of the Fly America Act. This section 47.403 is based on the Guidelines for Implementation of the Fly America Act (case number B-138942), issued by the Comptroller General of the...

  7. 48 CFR 47.403 - Guidelines for implementation of the Fly America Act.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... implementation of the Fly America Act. 47.403 Section 47.403 Federal Acquisition Regulations System FEDERAL... Guidelines for implementation of the Fly America Act. This section 47.403 is based on the Guidelines for Implementation of the Fly America Act (case number B-138942), issued by the Comptroller General of the...

  8. 48 CFR 47.403 - Guidelines for implementation of the Fly America Act.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... implementation of the Fly America Act. 47.403 Section 47.403 Federal Acquisition Regulations System FEDERAL... Guidelines for implementation of the Fly America Act. This section 47.403 is based on the Guidelines for Implementation of the Fly America Act (case number B-138942), issued by the Comptroller General of the...

  9. Pain, agitation, and delirium guidelines: nurses' involvement in development and implementation.

    PubMed

    Davidson, Judy E; Winkelman, Chris; Gélinas, Céline; Dermenchyan, Anna

    2015-06-01

    The 2013 American College of Critical Care Medicine/Society of Critical Care Medicine clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit serves as a living example of nurses' involvement in the development and implementation of professional guidelines. Nurses who served on this guideline-writing panel describe their experiences. Specific examples from the pain, agitation, and delirium guidelines for care are used to explore the roles of the nurse leader, nurse informaticist, staff nurse, and nurse researcher in relationship to guideline implementation. PMID:26033098

  10. Developing and Implementing Health and Sustainability Guidelines for Institutional Food Service123

    PubMed Central

    Kimmons, Joel; Jones, Sonya; McPeak, Holly H.; Bowden, Brian

    2012-01-01

    Health and sustainability guidelines for institutional food service are directed at improving dietary intake and increasing the ecological benefits of the food system. The development and implementation of institutional food service guidelines, such as the Health and Human Services (HHS) and General Services Administration (GSA) Health and Sustainability Guidelines for Federal Concessions and Vending Operations (HHS/GSA Guidelines), have the potential to improve the health and sustainability of the food system. Institutional guidelines assist staff, managers, and vendors in aligning the food environment at food service venues with healthier and more sustainable choices and practices. Guideline specifics and their effective implementation depend on the size, culture, nature, and management structure of an institution and the individuals affected. They may be applied anywhere food is sold, served, or consumed. Changing institutional food service practice requires comprehensive analysis, engagement, and education of all relevant stakeholders including institutional management, members of the food supply chain, and customers. Current examples of food service guidelines presented here are the HHS and GSA Health and Sustainability Guidelines for Federal Concessions and Vending Operations, which translate evidence-based recommendations on health and sustainability into institutional food service practices and are currently being implemented at the federal level. Developing and implementing guidelines has the potential to improve long-term population health outcomes while simultaneously benefitting the food system. Nutritionists, public health practitioners, and researchers should consider working with institutions to develop, implement, and evaluate food service guidelines for health and sustainability. PMID:22585909

  11. Developing and implementing health and sustainability guidelines for institutional food service.

    PubMed

    Kimmons, Joel; Jones, Sonya; McPeak, Holly H; Bowden, Brian

    2012-05-01

    Health and sustainability guidelines for institutional food service are directed at improving dietary intake and increasing the ecological benefits of the food system. The development and implementation of institutional food service guidelines, such as the Health and Human Services (HHS) and General Services Administration (GSA) Health and Sustainability Guidelines for Federal Concessions and Vending Operations (HHS/GSA Guidelines), have the potential to improve the health and sustainability of the food system. Institutional guidelines assist staff, managers, and vendors in aligning the food environment at food service venues with healthier and more sustainable choices and practices. Guideline specifics and their effective implementation depend on the size, culture, nature, and management structure of an institution and the individuals affected. They may be applied anywhere food is sold, served, or consumed. Changing institutional food service practice requires comprehensive analysis, engagement, and education of all relevant stakeholders including institutional management, members of the food supply chain, and customers. Current examples of food service guidelines presented here are the HHS and GSA Health and Sustainability Guidelines for Federal Concessions and Vending Operations, which translate evidence-based recommendations on health and sustainability into institutional food service practices and are currently being implemented at the federal level. Developing and implementing guidelines has the potential to improve long-term population health outcomes while simultaneously benefitting the food system. Nutritionists, public health practitioners, and researchers should consider working with institutions to develop, implement, and evaluate food service guidelines for health and sustainability. PMID:22585909

  12. Developing and implementing health and sustainability guidelines for institutional food service.

    PubMed

    Kimmons, Joel; Jones, Sonya; McPeak, Holly H; Bowden, Brian

    2012-05-01

    Health and sustainability guidelines for institutional food service are directed at improving dietary intake and increasing the ecological benefits of the food system. The development and implementation of institutional food service guidelines, such as the Health and Human Services (HHS) and General Services Administration (GSA) Health and Sustainability Guidelines for Federal Concessions and Vending Operations (HHS/GSA Guidelines), have the potential to improve the health and sustainability of the food system. Institutional guidelines assist staff, managers, and vendors in aligning the food environment at food service venues with healthier and more sustainable choices and practices. Guideline specifics and their effective implementation depend on the size, culture, nature, and management structure of an institution and the individuals affected. They may be applied anywhere food is sold, served, or consumed. Changing institutional food service practice requires comprehensive analysis, engagement, and education of all relevant stakeholders including institutional management, members of the food supply chain, and customers. Current examples of food service guidelines presented here are the HHS and GSA Health and Sustainability Guidelines for Federal Concessions and Vending Operations, which translate evidence-based recommendations on health and sustainability into institutional food service practices and are currently being implemented at the federal level. Developing and implementing guidelines has the potential to improve long-term population health outcomes while simultaneously benefitting the food system. Nutritionists, public health practitioners, and researchers should consider working with institutions to develop, implement, and evaluate food service guidelines for health and sustainability.

  13. Continuing Education, Guideline Implementation, and the Emerging Transdisciplinary Field of Knowledge Translation

    ERIC Educational Resources Information Center

    Davis, Dave

    2006-01-01

    This article discusses continuing education and the implementation of clinical practice guidelines or best evidence, quality improvement, and patient safety. Continuing education focuses on the perspective of the adult learner and is guided by well-established educational principles. In contrast, guideline implementation and related concepts…

  14. Guidelines for the Scholarly Use of Images.

    PubMed

    Lewis, Petra J

    2016-06-01

    As academic radiologists, we use a variety of images in our educational "products" regularly-whether they are lectures, websites, papers, digital media, or other resources. As the ability to download images from the Internet has proliferated, the need for us to have a basic understanding of copyright laws and how they might be applied to our products has increased. This article aims to provide answers to the most common questions. Please note that this article is for informational purposes and should not be considered legal advice. PMID:27017135

  15. Information technology tools to improve treatment of patients with depression: focus on guidelines implementation.

    PubMed

    Meglic, Matic; Ivanovski, Matic; Marusic, Andrej

    2008-06-01

    Information technology has the potential to improve and support the treatment of depression. Use of clinical guidelines can improve outcome of treatment, but implementation of guidelines is a demanding process and the resulting user compliance is often poor. Electronic health records, clinical decision support systems and other information technology tools seem at first glance to be a preferable way to implement clinical guidelines since they require user's active and problem oriented participation. This article reviews attempts made so far at use of information tools for implementation of clinical guidelines for depression treatment and discusses their effects. It turns out that there are few existing solutions, ambiguous effects and that usage is often limited. In future the factors determining development of successful electronic tools for clinical guidelines implementation will need to be further specified. Further research projects are underway in Slovenia to investigate these issues.

  16. Clinical imaging guidelines part 2: Risks, benefits, barriers, and solutions.

    PubMed

    Malone, James; del Rosario-Perez, Maria; Van Bladel, Lodewijk; Jung, Seung Eun; Holmberg, Ola; Bettmann, Michael A

    2015-02-01

    A recent international meeting was convened by two United Nations bodies to focus on international collaboration on clinical appropriateness/referral guidelines for use in medical imaging. This paper, the second of 4 from this technical meeting, addresses barriers to the successful development/deployment of clinical imaging guidelines and means of overcoming them. It reflects the discussions of the attendees, and the issues identified are treated under 7 headings: ■ Practical Strategy for Development and Deployment of Guidelines; ■ Governance Arrangements and Concerns with Deployment of Guidelines; ■ Finance, Sustainability, Reimbursement, and Related Issues; ■ Identifying Benefits and Radiation Risks from Radiological Examinations; ■ Information Given to Patients and the Public, and Consent Issues; ■ Special Concerns Related to Pregnancy; and ■ The Research Agenda. Examples of topics identified include the observation that guideline development is a global task and there is no case for continuing it as the project of the few professional organizations that have been brave enough to make the long-term commitment required. Advocacy for guidelines should include the expectations that they will facilitate: (1) better health care delivery; (2) lower cost of that delivery; with (3) reduced radiation dose and associated health risks. Radiation protection issues should not be isolated; rather, they should be integrated with the overall health care picture. The type of dose/radiation risk information to be provided with guidelines should include the uncertainty involved and advice on application of the precautionary principle with patients. This principle may be taken as an extension of the well-established medical principle of "first do no harm." PMID:25652302

  17. Operational Earthquake Forecasting: Proposed Guidelines for Implementation (Invited)

    NASA Astrophysics Data System (ADS)

    Jordan, T. H.

    2010-12-01

    The goal of operational earthquake forecasting (OEF) is to provide the public with authoritative information about how seismic hazards are changing with time. During periods of high seismic activity, short-term earthquake forecasts based on empirical statistical models can attain nominal probability gains in excess of 100 relative to the long-term forecasts used in probabilistic seismic hazard analysis (PSHA). Prospective experiments are underway by the Collaboratory for the Study of Earthquake Predictability (CSEP) to evaluate the reliability and skill of these seismicity-based forecasts in a variety of tectonic environments. How such information should be used for civil protection is by no means clear, because even with hundredfold increases, the probabilities of large earthquakes typically remain small, rarely exceeding a few percent over forecasting intervals of days or weeks. Civil protection agencies have been understandably cautious in implementing formal procedures for OEF in this sort of “low-probability environment.” Nevertheless, the need to move more quickly towards OEF has been underscored by recent experiences, such as the 2009 L’Aquila earthquake sequence and other seismic crises in which an anxious public has been confused by informal, inconsistent earthquake forecasts. Whether scientists like it or not, rising public expectations for real-time information, accelerated by the use of social media, will require civil protection agencies to develop sources of authoritative information about the short-term earthquake probabilities. In this presentation, I will discuss guidelines for the implementation of OEF informed by my experience on the California Earthquake Prediction Evaluation Council, convened by CalEMA, and the International Commission on Earthquake Forecasting, convened by the Italian government following the L’Aquila disaster. (a) Public sources of information on short-term probabilities should be authoritative, scientific, open, and

  18. Implementation of an automated guideline monitor for secondary prevention of acute myocardial infarction.

    PubMed Central

    Noirot, Laura A.; Blickensderfer, Amy; Christensen, Erin; Schaiff, Robyn; Kessels, Anthony; Braverman, Alan; Goldberg, Anne; Dunagan, William Claiborne; Bailey, Thomas C.

    2002-01-01

    Clinical practice guidelines can be used to help improve health care quality, but they are often not optimally implemented. Practice enabling and reinforcing techniques, such as clinical reminders and academic detailing are effective methods for translating guidelines into practice. Following a study showing that we could improve adherence to secondary prevention guidelines for acute myocardial infarction (AMI) using computerized alerts and academic detailing, we implemented an automated monitor to accomplish the same goal in a less labor-intensive manner. This paper describes the implementation of this production application. PMID:12463887

  19. Implementing Bright Futures guidelines for well-child care in North Carolina.

    PubMed

    Foy, Jane Meschan

    2013-01-01

    The Bright Futures guidelines published by the American Academy of Pediatrics offer a comprehensive agenda for improving the health of people from birth to age 21 years. The guidelines are the culmination of a century of multidisciplinary, multiorganizational efforts in the United States to prevent illness and promote health in children and adolescents, and, in turn, the adults they become. Regulations interpreting the Patient Protection and Affordable Care Act (ACA) specifically state that group health plans must, at a minimum, provide coverage for the preventive services recommended in the Bright Futures guidelines. Thus the ACA will be an impetus for implementation of the guidelines. This issue brief describes the genesis, history, and development of the guidelines. In addition, it briefly touches on each of the commentaries and other articles contained in this issue of the NCMJ dedicated to the implementation of Bright Futures guidelines.

  20. Snomed CT implementation. Mapping guidelines facilitating reuse of data.

    PubMed

    Randorff Højen, A; Rosenbeck Gøeg, K

    2012-01-01

    Clinical practice as well as research and quality-assurance benefit from unambiguous clinical information resulting from the use of a common terminology like the Systematized Nomenclature of Medicine - Clinical Terms (SNOMED CT). A common terminology is a necessity to enable consistent reuse of data, and supporting semantic interoperability. Managing use of terminology for large cross specialty Electronic Health Record systems (EHR systems) or just beyond the level of single EHR systems requires that mappings are kept consistent. The objective of this study is to provide a clear methodology for SNOMED CT mapping to enhance applicability of SNOMED CT despite incompleteness and redundancy. Such mapping guidelines are presented based on an in depth analysis of 14 different EHR templates retrieved from five Danish and Swedish EHR systems. Each mapping is assessed against defined quality criteria and mapping guidelines are specified. Future work will include guideline validation.

  1. Implementing Thrombosis Guidelines in Cancer Patients: A Review

    PubMed Central

    Farge-Bancel, Dominique; Bounameaux, Henri; Brenner, Benjamin; Büller, Harry R.; Kakkar, Ajay; Pabinger, Ingrid; Streiff, Michael; Debourdeau, Philippe

    2014-01-01

    Venous thromboembolism is a frequent and serious complication in patients with cancer. It is an independent prognostic factor of death in cancer patients and the second leading cause of death, but physicians often underestimate its importance, as well as the need for adequate prevention and treatment. Management of venous thromboembolism in patients with cancer requires the coordinated efforts of a wide range of clinicians, highlighting the importance of a multidisciplinary approach. However, a lack of consensus among various national and international clinical practice guidelines has contributed to knowledge and practice gaps among practitioners, and inconsistent approaches to venous thromboembolism. The 2013 international guidelines for thrombosis in cancer have sought to address these gaps by critically re-evaluating the evidence coming from clinical trials and synthesizing a number of guidelines documents. An individualized approach to prophylaxis is recommended for all patients. PMID:25386357

  2. Randomized Controlled Trial of Education and Feedback for Implementation of Guidelines for Acute Low Back Pain

    PubMed Central

    Schectman, Joel M; Schroth, W Scott; Verme, Dante; Voss, John D

    2003-01-01

    OBJECTIVE The effect of clinical guidelines on resource utilization for complex conditions with substantial barriers to clinician behavior change has not been well studied. We report the impact of a multifaceted guideline implementation intervention on primary care clinician utilization of radiologic and specialty services for the care of acute low back pain. DESIGN Physician groups were randomized to receive guideline education and individual feedback, supporting patient education materials, both, or neither. The impact on guideline adherence and resource utilization was evaluated during the 12-month period before and after implementation. PARTICIPANTS Fourteen physician groups with 120 primary care physician and associate practitioners from 2 group model HMO practices. INTERVENTIONS Guideline implementation utilized an education/audit/feedback model with local peer opinion leaders. The patient education component included written and videotaped materials on the care of low back pain. MAIN RESULTS The clinician intervention was associated with an absolute increase in guideline-consistent behavior of 5.4% in the intervention group versus a decline of 2.7% in the control group (P = .04). The patient education intervention produced no significant change in guideline-consistent behavior, but was poorly adopted. Patient characteristics including duration of pain, prior history of low back pain, and number of visits during the illness episode were strong predictors of service utilization and guideline-consistent behavior. CONCLUSIONS Implementation of an education and feedback-supported acute low back pain care guideline for primary care clinicians was associated with an increase in guideline-consistent behavior. Patient education materials did not enhance guideline effectiveness. Implementation barriers could limit the utility of this approach in usual care setttings. PMID:14521638

  3. 49 CFR Appendix C to Part 224 - Guidelines for Electronic Submission of Reflectorization Implementation Compliance Reports

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Guidelines for Electronic Submission of Reflectorization Implementation Compliance Reports C Appendix C to Part 224 Transportation Other Regulations... REFLECTORIZATION OF RAIL FREIGHT ROLLING STOCK Pt. 224, App. C Appendix C to Part 224—Guidelines for...

  4. 49 CFR Appendix C to Part 224 - Guidelines for Electronic Submission of Reflectorization Implementation Compliance Reports

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Guidelines for Electronic Submission of Reflectorization Implementation Compliance Reports C Appendix C to Part 224 Transportation Other Regulations... REFLECTORIZATION OF RAIL FREIGHT ROLLING STOCK Pt. 224, App. C Appendix C to Part 224—Guidelines for...

  5. 49 CFR Appendix C to Part 224 - Guidelines for Electronic Submission of Reflectorization Implementation Compliance Reports

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Guidelines for Electronic Submission of Reflectorization Implementation Compliance Reports C Appendix C to Part 224 Transportation Other Regulations... REFLECTORIZATION OF RAIL FREIGHT ROLLING STOCK Pt. 224, App. C Appendix C to Part 224—Guidelines for...

  6. Association for Counselor Education and Supervision Guidelines for Research Mentorship: Development and Implementation

    ERIC Educational Resources Information Center

    Borders, L. DiAnne; Wester, Kelly L.; Granello, Darcy Haag; Chang, Catherine Y.; Hays, Danica G.; Pepperell, Jennifer; Spurgeon, Shawn L.

    2012-01-01

    The authors describe guidelines endorsed by the Association for Counselor Education and Supervision for research mentorship, including characteristics of mentors and mentees. Suggestions for implementing the guidelines at the individual, program, institution, and professional levels are focused on enhancing mentoring relationships as well as…

  7. Consumer Education in the Secondary Curriculum: Guidelines for Implementation.

    ERIC Educational Resources Information Center

    Pennsylvania State Dept. of Education, Harrisburg. Bureau of General and Academic Education.

    Guidelines are suggested here for integrating consumer subject matter into existing secondary curricula, developing a team approach, or developing a systems approach that involves the entire school and community rather than offering a separate consumer education course. Any or all of the above suggestions might be utilized within a school…

  8. [Implementation of clinical practice guidelines: how can we close the evidence-practice gap?].

    PubMed

    Muche-Borowski, Cathleen; Nothacker, M; Kopp, I

    2015-01-01

    Guidelines are intended as instruments of knowledge transfer to support decision-making by physicians, other health professionals and patients in clinical practice and thereby contribute to quality improvements in healthcare. To date they are an indispensable tool for healthcare. Their benefit for patients can only be seen in application, i.e. the implementation of guideline recommendations. For successful implementation, implementability and practicability play a crucial role and these characteristics can be influenced and should be promoted by the guideline development group. In addition, a force field analysis to identify barriers against and facilitators for the implementation of specific guideline recommendations from the perspective of physicians and patients is recommended to guide the development of an individual implementation strategy and the selection of appropriate interventions. However, implementation cannot be achieved by the guideline development group alone and a universal implementation strategy does not exist. Therefore, a process using theory, analysis, experience and shared responsibility of stakeholders in healthcare is recommended, with the aim to achieve sustainable behavioral change and improve the quality of care by guideline-oriented behavior.

  9. Implementation of image compression for printers

    NASA Astrophysics Data System (ADS)

    Oka, Kenichiro; Onishi, Masaru

    1992-05-01

    Printers process a large quantity of data when printing. For example, printing on an A3 size (297 mm X 420 mm) at 300 dpi resolution requires 17.4 million pixels, and about 66 Mbytes in a 32-bits/pixel-color image composed of yellow (Y), magenta (M), cyan (C) and black components. Containing such a large capacity of random access memories (RAMs) in a printer causes an increase in both the cost and size of memory circuits. Thus, image compression techniques are examined in this study to cope with these problems. A still-image coding, being standardized by JPEG (Joint Photographic Experts Group), will presumably be utilized for image communications or image data bases. The JPEG scheme can compress natural images efficiently but it is unsuitable for text or computer graphics (CG) images for degradation of restored images. This scheme, therefore, cannot be implemented for printers which require good image quality. We studied codings which are more suitable for printers than the JPEG scheme. Two criteria were considered to select a coding scheme for printers: (1) no visible degradation of input printer images and (2) capability of image edition. Especially in terms of criteria (2), a fixed-length coding was adopted; an arbitrary pixel data code can be easily read out of an image memory. We then implemented an image coding scheme in our new sublimation full-color printer. Input image data are compressed by coding before being written into an image memory.

  10. BARRIERS TO IMPLEMENT THE NATIONAL GUIDELINES ON NEWBORN CARE IN A RURAL MOUNTAINOUS PROVINCE OF VIETNAM

    PubMed Central

    Thi, Le Minh; Ha, BuiThiThu; Hoa, Dinh Thi Phuong

    2016-01-01

    Reducing the disparity in neonatal health among regions to ensure every mother and her newborn receive the health care they need is a priority in Vietnam. This study was conducted to assess the barriers in implementing the National guidelines on newborn care in a rural mountainous province of Vietnam. Qualitative methods were applied with 28 in-depth interviews and 4 focus group discussions in DakNong province. The results showed that there exist many barriers in implementing the national guideline in newborn care services. There is a big gap between health policy development and policy implementation. The Vietnam government had approved a good strategy and guidelines. Efforts now need to focus on implementing the national guideline and improving quality of care. PMID:27516812

  11. A systematic approach to implementing and evaluating clinical guidelines: The results of fifteen years of Preventive Child Health Care guidelines in the Netherlands.

    PubMed

    Fleuren, Margot A H; van Dommelen, Paula; Dunnink, Trudy

    2015-07-01

    Preventive Child Health Care (PCHC) services are delivered to all children in the Netherlands by approximately 5500 doctors, nurses and doctor's assistants. In 1996, The Dutch Ministry of Health, Welfare and Sports asked for the development of evidence-based PCHC guidelines. Since 1998, twenty-five guidelines have been published. Levels of implementation affect outcomes and so implementation and evaluation of the actual use of guidelines are essential. At the outset, there was a national implementation plan with six main activities: a) determinant analysis before the implementation of a guideline, b) innovation strategies tailored to the determinants, c) dissemination to all professionals, d) ongoing evaluation of the awareness and use of the guidelines, e) trained implementation coordinator(s) in each PCHC organization and f) a national help desk. The awareness and use of the guidelines in random samples of doctors, nurses and doctor's assistants were surveyed using questionnaires. The respondents stated (on a 7-point scale) the proportion of all children they had exposed to given core elements in a guideline. The aim is for at least 90% of the professionals to be aware of the guideline and for 80% to perform the core elements for all (or nearly all) children. The six main activities, with the exception of ongoing evaluation, were gradually put into place, albeit only gradually, between 1998 and 2015 for all guidelines. In 2012, the use of individual core elements in all guidelines, dating from before 2012, varied from 28% to 100%. One guideline met both criteria of 90% awareness and 80% use, and three guidelines nearly met these criteria. Looking back on fifteen years of PCHC guidelines, we may conclude that the guidelines produced recently are implemented in accordance with the national implementation plan. Unfortunately, the evaluation of guideline use continues to be a difficulty. PMID:25982867

  12. Evidence-based guidelines: MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis-clinical implementation in the diagnostic process.

    PubMed

    Rovira, Àlex; Wattjes, Mike P; Tintoré, Mar; Tur, Carmen; Yousry, Tarek A; Sormani, Maria P; De Stefano, Nicola; Filippi, Massimo; Auger, Cristina; Rocca, Maria A; Barkhof, Frederik; Fazekas, Franz; Kappos, Ludwig; Polman, Chris; Miller, David; Montalban, Xavier

    2015-08-01

    The clinical use of MRI in patients with multiple sclerosis (MS) has advanced markedly over the past few years. Technical improvements and continuously emerging data from clinical trials and observational studies have contributed to the enhanced performance of this tool for achieving a prompt diagnosis in patients with MS. The aim of this article is to provide guidelines for the implementation of MRI of the brain and spinal cord in the diagnosis of patients who are suspected of having MS. These guidelines are based on an extensive review of the recent literature, as well as on the personal experience of the members of the MAGNIMS (Magnetic Resonance Imaging in MS) network. We address the indications, timing, coverage, reporting and interpretation of MRI studies in patients with suspected MS. Our recommendations are intended to help radiologists and neurologists standardize and optimize the use of MRI in clinical practice for the diagnosis of MS.

  13. Incorporation of Pharmacogenomics into Routine Clinical Practice: the Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline Development Process

    PubMed Central

    Caudle, Kelly E.; Klein, Teri E.; Hoffman, James M.; Müller, Daniel J.; Whirl-Carrillo, Michelle; Gong, Li; McDonagh, Ellen M.; Sangkuhl, Katrin; Thorn, Caroline F.; Schwab, Matthias; Agúndez, José A.G.; Freimuth, Robert R.; Huser, Vojtech; Lee, Ming Ta Michael; Iwuchukwu, Otito F.; Crews, Kristine R.; Scott, Stuart A.; Wadelius, Mia; Swen, Jesse J.; Tyndale, Rachel F.; Stein, C. Michael; Roden, Dan; Relling, Mary V.; Williams, Marc S.; Johnson, Samuel G.

    2014-01-01

    The Clinical Pharmacogenetics Implementation Consortium (CPIC) publishes genotype-based drug guidelines to help clinicians understand how available genetic test results could be used to optimize drug therapy. CPIC has focused initially on well-known examples of pharmacogenomic associations that have been implemented in selected clinical settings, publishing nine to date. Each CPIC guideline adheres to a standardized format and includes a standard system for grading levels of evidence linking genotypes to phenotypes and assigning a level of strength to each prescribing recommendation. CPIC guidelines contain the necessary information to help clinicians translate patient-specific diplotypes for each gene into clinical phenotypes or drug dosing groups. This paper reviews the development process of the CPIC guidelines and compares this process to the Institute of Medicine’s Standards for Developing Trustworthy Clinical Practice Guidelines. PMID:24479687

  14. Incorporation of pharmacogenomics into routine clinical practice: the Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline development process.

    PubMed

    Caudle, Kelly E; Klein, Teri E; Hoffman, James M; Muller, Daniel J; Whirl-Carrillo, Michelle; Gong, Li; McDonagh, Ellen M; Sangkuhl, Katrin; Thorn, Caroline F; Schwab, Matthias; Agundez, Jose A G; Freimuth, Robert R; Huser, Vojtech; Lee, Ming Ta Michael; Iwuchukwu, Otito F; Crews, Kristine R; Scott, Stuart A; Wadelius, Mia; Swen, Jesse J; Tyndale, Rachel F; Stein, C Michael; Roden, Dan; Relling, Mary V; Williams, Marc S; Johnson, Samuel G

    2014-02-01

    The Clinical Pharmacogenetics Implementation Consortium (CPIC) publishes genotype-based drug guidelines to help clinicians understand how available genetic test results could be used to optimize drug therapy. CPIC has focused initially on well-known examples of pharmacogenomic associations that have been implemented in selected clinical settings, publishing nine to date. Each CPIC guideline adheres to a standardized format and includes a standard system for grading levels of evidence linking genotypes to phenotypes and assigning a level of strength to each prescribing recommendation. CPIC guidelines contain the necessary information to help clinicians translate patient-specific diplotypes for each gene into clinical phenotypes or drug dosing groups. This paper reviews the development process of the CPIC guidelines and compares this process to the Institute of Medicine's Standards for Developing Trustworthy Clinical Practice Guidelines.

  15. A national survey of implementation of guidelines for gestational diabetes mellitus.

    PubMed

    O'Higgins, A; Dunne, F; Lee, B; Smith, D; Turner, M J

    2014-09-01

    In 2010, national guidelines for the management of gestational diabetes mellitus (GDM) were published by the Health Service Executive (HSE). In 2012, a questionnaire was distributed to all maternity units to survey implementation of the guidelines. All units screened women for GDM, but used different screening tests with fifteen units (79%) using the recommended 75g OGTT, three units (16%) using a 100g OGTT and one unit (5%) using a 50g glucose challenge test. Optimal outcomes are best achieved through multidisciplinary diabetes-obstetric care and this was available in nine of the units (47%). The prevalence of GDM varied from 2.2 - 7.4%. Insulin usage varied from 15-56%. Six centres (31%) had not implemented the national guidelines in full because of lack of resources. Despite national endorsement of the guideline, significant variations remain in implementation. This may lead to differences in clinical outcomes depending on where a woman attends for obstetric care.

  16. Implementing practice guidelines for anxiety disorders in secondary mental health care: a case study

    PubMed Central

    2012-01-01

    Background Recent years have seen the large-scale development of clinical practice guidelines for mental disorders in several countries. In the Netherlands, more than ten multidisciplinary guidelines for mental health care have been developed since 2003. The first dealt with the treatment of anxiety disorders. An important question was whether it is feasible to implement these guidelines because implementing practice guidelines is often difficult. Although several implementation interventions have proven effective, there seems to be no ready-made strategy that works in all circumstances. Case description The Dutch multidisciplinary guidelines for anxiety disorders were implemented in a community mental health care centre, located in the east of the Netherlands. The centre provides secondary outpatient care. The unit within the centre that specializes in the treatment of anxiety disorders has 16 team members with diverse professional backgrounds. Important steps in the process of implementing the guidelines were analysing the care provided before start of the implementation to determine the goals for improvement, and analysing the context and target group for implementation. Based on these analyses, a tailor-made multifaceted implementation strategy was developed that combined the reorganization of the care process, the development of instruction materials, the organization of educational meetings and the use of continuous quality circles to improve adherence to guidelines. Discussion and evaluation Significant improvements in adherence rates were made in the aspect of care that was targeted for change. An increase was found in the number of patients being provided with recommended forms of psychotherapeutic treatment, ranging from 43% to 54% (p < 0.01). The delivery of adequate pharmacological treatment was not explicitly targeted for change remained constant. Conclusion The case study presented here shows that the implementation of practice guidelines for

  17. Implementing guidelines for the treatment of acute otitis media.

    PubMed

    Barenkamp, Stephen J

    2006-01-01

    The recently published Clinical Practice Guideline for the Diagnosis and Management of Acute Otitis Media represents a sincere effort by the AAP andthe AAFP to provide management guidelines for the practitioner based upon the best scientific evidence available. Despite many years of research and hundreds of clinical studies addressing various aspects of the epidemiology, clinical presentation, and treatment of acute otitis media, important questions remain unaddressed or have been addressed in a less than optimal fashion. These gaps in knowledge and deficiencies in several of the studies that formed the scientific basis for the proposed guidelines are the major reasons behind continued disagreement over certain recommendations. Until more comprehensive and careful analyses can be performed, disagreements are likely to persist. Even so, there is general agreement about most of the recommendations made in these guidelines, and these recommendations will provide a very valuable framework for the practicing physician as he or she cares for children with acute otitis media. To briefly review the major points, first is the critical importance of accurately diagnosing acute otitis media using a combination of clinical findings and observable abnormalities of the tympanic membrane and middle ear space. Particularly important is the differentiation of acute otitis media from otitis media with effusion. Second is the value of treating the pain associated with acute otitis media as a regular component of care, irrespective of any decision concerning antimicrobial treatment. Third is the option, for a select group of older patients with nonsevere disease, of withholding antimicrobial therapy for the first 48 to 72 hours, if close follow-up and active parental involvement can be guaranteed. Fourth is the recommendation that if an antimicrobial agent is used, high-dose amoxicillin (80 to 90 mg/kg/d) is the treatment of choice for most children at the time of initial presentation

  18. Implementation of Spanish adaptation of the European guidelines on cardiovascular disease prevention in primary care

    PubMed Central

    2013-01-01

    Background The successful implementation of cardiovascular disease (CVD) prevention guidelines relies heavily on primary care physicians (PCPs) providing risk factor evaluation, intervention and patient education. The aim of this study was to ascertain the degree of awareness and implementation of the Spanish adaptation of the European guidelines on CVD prevention in clinical practice (CEIPC guidelines) among PCPs. Methods A cross-sectional survey of PCPs was conducted in Spain between January and June 2011. A random sample of 1,390 PCPs was obtained and stratified by region. Data were collected by means of a self-administered questionnaire. Results More than half (58%) the physicians were aware of and knew the recommendations, and 62% of those claimed to use them in clinical practice, with general physicians (without any specialist accreditation) being less likely to so than family doctors. Most PCPs (60%) did not assess cardiovascular risk, with the limited time available in the surgery being cited as the greatest barrier by 81%. The main reason to be sceptical about recommendations, reported by 71% of physicians, was that there are too many guidelines. Almost half the doctors cited the lack of training and skills as the greatest barrier to the implementation of lifestyle and behavioural change recommendations. Conclusions Most PCPs were aware of the Spanish adaptation of the European guidelines on CVD prevention (CEIPC guidelines) and knew their content. However, only one third of PCPs used the guidelines in clinical practice and less than half CVD risk assessment tools. PMID:23506390

  19. SU-D-18C-06: Initial Experience with Implementing MRI Safety Guidelines for Patients with Pacemakers - Medical Physicist Perspective

    SciTech Connect

    James, J; Place, V; Panda, A; Edmonson, H; Felmlee, J; Pooley, R

    2014-06-01

    Purpose: Several institutions have developed MRI guidelines for patients with MR-unsafe or MR-conditional pacemakers. Here we highlight the role of a medical physicist in implementing these guidelines for non-pacemaker dependent patients. Guidelines: Implementing these guidelines requires involvement from several medical specialties and a strong collaboration with the site MRI supervisor to develop a structured workflow. A medical physicist is required to be present during the scan to supervise the MR scanning and to maintain a safety checklist that ensures: 1) uninterrupted patient communication with the technologist, 2) continuous patient physiologic monitoring (e.g. blood pressure and electrocardiography) by a trained nurse, 3) redundant patient vitals monitoring (e.g. pulse oximetry) due to the possibility of in vivo electrocardiography reading fluctuations during image acquisition. A radiologist is strongly recommended to be available to review the images before patients are discharged from the scanner. Pacemaker MRI should be restricted to 1.5T field strength. The MRI sequences should be optimized by the physicist with regards to: a) SAR: limited to <1.5 W/Kg for MR-unsafe pacemakers in normal operating mode, b) RF exposure time: <30 min, c) Coils: use T/R coils but not restricted to such, d) Artifacts: further optimization of sequences whenever image quality is compromised due to the pacemaker. In particular, cardiac, breast and left-shoulder MRIs are most susceptible to these artifacts. Possible strategies to lower the SAR include: a) BW reduction, 2) echo-train-length reduction, 3) increase TR, 4) decrease number of averages, 5) decrease flip angle, 6) reduce slices and/or a combination of all the options. Conclusion: A medical physicist in collaboration with the MR supervisor plays an important role in the supervision/implementation of safe MR scanning of pacemaker patients. Developing and establishing a workflow has enabled our institution to scan over

  20. 32 CFR 2004.11 - Agency Implementing Regulations, Internal Rules, or Guidelines [102(b)(3)].

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Agency Implementing Regulations, Internal Rules, or Guidelines . 2004.11 Section 2004.11 National Defense Other Regulations Relating to National... INDUSTRIAL SECURITY PROGRAM DIRECTIVE NO. 1 Implementation and Oversight § 2004.11 Agency...

  1. Implementation of National Guidelines for Healthy School Meals: The Relationship between Process and Outcome

    ERIC Educational Resources Information Center

    Holthe, Asle; Larsen, Torill; Samdal, Oddrun

    2011-01-01

    The implementation of policy interventions at the school level is often considered an organizational change process. The main goal of the present study was to examine the degree of implementation of Norwegian national guidelines for healthy school meals and how organizational capacity at the school level contributed to the degree of…

  2. Identifying students with learning disabilities: the effect of implementing statewide guidelines.

    PubMed

    McLeskey, J; Waldron, N L

    1991-10-01

    Methods for identifying students with learning disabilities continue to be an area of controversy. The present investigation examined the impact of implementing statewide guidelines for the identification of these students. Data were collected from multidisciplinary team reports on 718 students with learning disabilities who were referred and labeled during the 1983-84 school year (before implementation of statewide learning disability guidelines) and 790 students who were identified during 1987-88 (after implementation of the guidelines). The results of the study revealed that the statewide guidelines significantly changed the characteristics of students who were identified. After the implementation of the guidelines, students with much more severe academic problems were identified. These students were much more likely to have a severe discrepancy and be chronically failing in the regular classroom. However, even with explicit, widely accepted guidelines, approximately one third of all students identified in 1987-88 failed to meet the stated criteria for identification. The implications of these findings for professional practice and future research are discussed. PMID:1940608

  3. Codifying Implementation Guidelines for a Collaborative Improvement Initiative

    ERIC Educational Resources Information Center

    Coughlan, Paul; Coghlan, David

    2008-01-01

    The application of action learning in inter-organizational settings is largely undeveloped. This article presents a description of and reflection on an action learning approach to enabling collaborative improvement in the extended manufacturing enterprise. The article focuses in particular on implementing the action learning approach. However, the…

  4. School-Based Management: Rationale and Implementation Guidelines.

    ERIC Educational Resources Information Center

    Oswald, Lori Jo

    1995-01-01

    School-based management (SBM), the decentralization of decision-making authority to the school site, comes in many variations. However, all forms of SBM require a rethinking of how and where budgeting, curriculum, and personnel decisions are made. This bulletin provides an overview of what SBM is and how it is implemented by summarizing some of…

  5. Asthma Management in Educational Settings: Implementing Guideline-Based Care in Washington State Schools.

    PubMed

    Evans-Agnew, Robin A; Klein, Nicole; Lecce, Sally

    2015-11-01

    Managing asthma in the schools is complex and requires careful planning. This article highlights key steps in implementing guideline-based care for children with asthma in Washington State schools: assessing students, establishing acuity, communicating with parents, and training staff. Advance planning can improve outcomes for students, parents, and school staff in managing this complex and prevalent disease. NASN recently developed asthma management guidelines. Developing state-specific guidelines provides an opportunity to speak specifically to state laws and nurse practice acts while also reinforcing the importance of specialized practice to school nurses, school administrators and teachers, parents, and students. PMID:26515566

  6. DOE-EPRI On-Line Monitoring Implementation Guidelines

    SciTech Connect

    E. Davis, R. Bickford

    2003-01-02

    Industry and EPRI experience at several plants has shown on-line monitoring to be very effective in identifying out-of-calibration instrument channels or indications of equipment-degradation problems. The EPRI implementation project for on-line monitoring has demonstrated the feasability of on-line monitoring at several participating nuclear plants. The results have been very enouraging, and substantial progress is anticipated in the coming years.

  7. Effectiveness of electronic guideline-based implementation systems in ambulatory care settings - a systematic review

    PubMed Central

    2009-01-01

    Background Electronic guideline-based decision support systems have been suggested to successfully deliver the knowledge embedded in clinical practice guidelines. A number of studies have already shown positive findings for decision support systems such as drug-dosing systems and computer-generated reminder systems for preventive care services. Methods A systematic literature search (1990 to December 2008) of the English literature indexed in the Medline database, Embase, the Cochrane Central Register of Controlled Trials, and CRD (DARE, HTA and NHS EED databases) was conducted to identify evaluation studies of electronic multi-step guideline implementation systems in ambulatory care settings. Important inclusion criterions were the multidimensionality of the guideline (the guideline needed to consist of several aspects or steps) and real-time interaction with the system during consultation. Clinical decision support systems such as one-time reminders for preventive care for which positive findings were shown in earlier reviews were excluded. Two comparisons were considered: electronic multidimensional guidelines versus usual care (comparison one) and electronic multidimensional guidelines versus other guideline implementation methods (comparison two). Results Twenty-seven publications were selected for analysis in this systematic review. Most designs were cluster randomized controlled trials investigating process outcomes more than patient outcomes. With success defined as at least 50% of the outcome variables being significant, none of the studies were successful in improving patient outcomes. Only seven of seventeen studies that investigated process outcomes showed improvements in process of care variables compared with the usual care group (comparison one). No incremental effect of the electronic implementation over the distribution of paper versions of the guideline was found, neither for the patient outcomes nor for the process outcomes (comparison two

  8. Do guidelines influence the implementation of health programs? — Uganda’s experience

    PubMed Central

    2012-01-01

    Background A guideline contains processes and procedures intended to guide health service delivery. However, the presence of guidelines may not guarantee their implementation, which may be a result of weaknesses in the development process. This study was undertaken to describe the processes of developing health planning, services management, and clinical guidelines within the health sector in Uganda, with the goal of understanding how these processes facilitate or abate the utility of guidelines. Methods Qualitative and quantitative research methods were used to collect and analyze data. Data collection was undertaken at the levels of the central Ministry of Health, the district, and service delivery. Qualitative methods included review of documents, observations, and key informant interviews, as well as quantitative aspects included counting guidelines. Quantitative data were analyzed with Microsoft Excel, and qualitative data were analyzed using deductive content thematic analysis. Results There were 137 guidelines in the health sector, with programs related to Millennium Development Goals having the highest number (n = 83). The impetus for guideline development was stated in 78% of cases. Several guidelines duplicated content, and some conflicted with each other. The level of consultation varied, and some guidelines did not consider government-wide policies and circumstances at the service delivery level. Booklets were the main format of presentation, which was not tailored to the service delivery level. There was no framework for systematic dissemination, and target users were defined broadly in most cases. Over 60% of guidelines available at the central level were not available at the service delivery level, but there were good examples in isolated cases. There was no framework for systematic monitoring of use, evaluation, and review of guidelines. Suboptimal performance of the supervision framework that would encourage the use of guidelines, assess their

  9. Evidence-Based Imaging Guidelines and Medicare Payment Policy

    PubMed Central

    Sistrom, Christopher L; McKay, Niccie L

    2008-01-01

    Objective This study examines the relationship between evidence-based appropriateness criteria for neurologic imaging procedures and Medicare payment determinations. The primary research question is whether Medicare is more likely to pay for imaging procedures as the level of appropriateness increases. Data Sources The American College of Radiology Appropriateness Criteria (ACRAC) for neurological imaging, ICD-9-CM codes, CPT codes, and payment determinations by the Medicare Part B carrier for Florida and Connecticut. Study Design Cross-sectional study of appropriateness criteria and Medicare Part B payment policy for neurological imaging. In addition to descriptive and bivariate statistics, multivariate logistic regression on payment determination (yes or no) was performed. Data Collection Methods The American College of Radiology Appropriateness Criteria (ACRAC) documents specific to neurological imaging, ICD-9-CM codes, and CPT codes were used to create 2,510 medical condition/imaging procedure combinations, with associated appropriateness scores (coded as low/middle/high). Principal Findings As the level of appropriateness increased, more medical condition/imaging procedure combinations were payable (low = 61 percent, middle = 70 percent, and high = 74 percent). Logistic regression indicated that the odds of a medical condition/imaging procedure combination with a middle level of appropriateness being payable was 48 percent higher than for an otherwise similar combination with a low appropriateness score (95 percent CI on odds ratio=1.19–1.84). The odds ratio for being payable between high and low levels of appropriateness was 2.25 (95 percent CI: 1.66–3.04). Conclusions Medicare could improve its payment determinations by taking advantage of existing clinical guidelines, appropriateness criteria, and other authoritative resources for evidence-based practice. Such an approach would give providers a financial incentive that is aligned with best

  10. [Recommendations of the ESC guidelines regarding cardiovascular imaging].

    PubMed

    Sechtem, U; Greulich, S; Ong, P

    2016-08-01

    Cardiac imaging plays a key role in the diagnosis and risk stratification in the ESC guidelines for the management of patients with stable coronary artery disease. Demonstration of myocardial ischaemia guides the decision which further diagnostic and therapeutic strategy should be followed in these patients. One should, however, not forget that there are no randomised studies supporting this type of management. In patients with a low pretest probability coronary CT angiography is the optimal tool to exclude coronary artery stenoses rapidly and effectively. In the near future, however, better data is needed showing how much cardiac imaging is really necessary and how cost-effective it is in patients with stable coronary artery disease. PMID:27388914

  11. Guidelines for the implementation of an open source information system

    SciTech Connect

    Doak, J.; Howell, J.A.

    1995-08-01

    This work was initially performed for the International Atomic Energy Agency (IAEA) to help with the Open Source Task of the 93 + 2 Initiative; however, the information should be of interest to anyone working with open sources. The authors cover all aspects of an open source information system (OSIS) including, for example, identifying relevant sources, understanding copyright issues, and making information available to analysts. They foresee this document as a reference point that implementors of a system could augment for their particular needs. The primary organization of this document focuses on specific aspects, or components, of an OSIS; they describe each component and often make specific recommendations for its implementation. This document also contains a section discussing the process of collecting open source data and a section containing miscellaneous information. The appendix contains a listing of various providers, producers, and databases that the authors have come across in their research.

  12. Requirements for guidelines systems: implementation challenges and lessons from existing software-engineering efforts

    PubMed Central

    2012-01-01

    Background A large body of work in the clinical guidelines field has identified requirements for guideline systems, but there are formidable challenges in translating such requirements into production-quality systems that can be used in routine patient care. Detailed analysis of requirements from an implementation perspective can be useful in helping define sub-requirements to the point where they are implementable. Further, additional requirements emerge as a result of such analysis. During such an analysis, study of examples of existing, software-engineering efforts in non-biomedical fields can provide useful signposts to the implementer of a clinical guideline system. Methods In addition to requirements described by guideline-system authors, comparative reviews of such systems, and publications discussing information needs for guideline systems and clinical decision support systems in general, we have incorporated additional requirements related to production-system robustness and functionality from publications in the business workflow domain, in addition to drawing on our own experience in the development of the Proteus guideline system (http://proteme.org). Results The sub-requirements are discussed by conveniently grouping them into the categories used by the review of Isern and Moreno 2008. We cite previous work under each category and then provide sub-requirements under each category, and provide example of similar work in software-engineering efforts that have addressed a similar problem in a non-biomedical context. Conclusions When analyzing requirements from the implementation viewpoint, knowledge of successes and failures in related software-engineering efforts can guide implementers in the choice of effective design and development strategies. PMID:22405400

  13. The U.S. prevention of cardiovascular disease guidelines and implications for implementation in LMIC.

    PubMed

    Wong, Nathan D; Moran, Andrew E

    2014-12-01

    The 2013 guidelines for the Prevention of Cardiovascular Disease released by the American College of Cardiology and the American Heart Association included guidelines of assessment of cardiovascular disease (CVD) risk, lifestyle management, management of overweight and obesity, and treatment of blood cholesterol. In addition, there were also 2014 guidelines on hypertension management released by members appointed to the Eighth Joint National Committee. Taken together, these guidelines, though extensively discussed and disseminated in the United States, have not been widely recognized beyond the United States, nor have their implications been considered for lower- and middle-income developing countries. With an estimated 80% of the global burden in CVD occurring in developing countries, it is important to develop strategies to adequately detect those at increased CVD risk and to manage their risk through lifestyle and where appropriate, pharmacologic means. Though certain aspects of each guideline may be suitable for implementation globally, including in developing countries, other recommendations would be unrealistic for many countries based on local epidemiology and resources. CVD prevention priorities can be set using guidance from recently published CVD prevention guidelines if appropriately modified to the context of lower- and middle-income developing countries. Establishment of global CVD prevention standards and rapid adaptation and dissemination of clinical guidelines are of paramount importance if we are to make significant progress into achieving World Health Organization 2025 goals to reduce the burden from CVD and other noncommunicable diseases. PMID:25592799

  14. Implementing guidelines on reporting research using animals (ARRIVE etc.): new requirements for publication in BJP.

    PubMed

    McGrath, John C; Lilley, Elliot

    2015-07-01

    The ARRIVE guidelines have been implemented in BJP for 4 years with the aim of increasing transparency in reporting experiments involving animals. BJP has assessed our success in implementing them and concluded that we could do better. This editorial discusses the issues and explains how we are changing our requirements for authors to report their findings in experiments involving animals. This is one of a series of editorials discussing updates to the BJP Instructions to Authors.

  15. Knowledge translation in emergency medical services: A qualitative survey of barriers to guideline implementation

    PubMed Central

    Bigham, Blair L.; Aufderheide, Tom P.; Davis, Daniel P.; Powell, Judy; Donn, Stuart; Suffoletto, Brian; Nafziger, Sarah; Stouffer, John; Morrison, Laurie J.

    2010-01-01

    Background The American Heart Association (AHA) released guidelines to improve survival rates from out-of-hospital cardiac arrest in 2005. We sought to identify what barriers delayed the implementation of these guidelines in EMS agencies. Methods We surveyed 178 EMS agencies as part of a larger quantitative survey regarding guideline implementation and conducted a single-question semi-structured interview using the Grounded Theory method. We asked “What barriersm if any, delayed implementation of the (2005 AHA) guidelines in your EMS agency?” Data were coded and member validation was employed to verify our findings. Results 176/178 agencies completed the quantitative survey. Qualitative data collection ceased after reaching theoretical saturation with 34 interviews. Ten unique barriers were identified. We categorized these ten barriers into three themes. The theme Instruction Delays (reported by 41% of respondents) included three barriers: booking/training instructors (9%), receiving training materials (15%), and scheduling staff for training (18%). The second theme, Defibrillator Delays (38%), included two barriers; reprogramming defibrillators (24%) and receiving new defibrillators to replace non-upgradeable units (15%). The third theme was Decision-Making (38%) and included five barriers; coordinating with allied agencies (9%), government regulators such as state and provincial health authorities (9%), medical direction and base hospitals (9%), ROC participation (9%), and internal crises (3%). Conclusion Many barriers contributed to delays in the implementation of the 2005 AHA guidelines in EMS agencies. These identified barriers should be proactively addressed prior to the 2010 Guidelines to facilitate rapid translation of science into clinical practice. PMID:20398994

  16. Identification of attributes that promote the adoption and implementation of 2005 Dietary Guidelines for Americans

    Technology Transfer Automated Retrieval System (TEKTRAN)

    As part of a larger study, this research was to identify attributes of the Dietary Guidelines for Americans (DGAs) that would promote their adoption and implementation by participants in a nutrition intervention. Project procedures were guided by the Diffusion of Innovations (DOI) theory. To identif...

  17. Web-Based Social Work Courses: Guidelines for Developing and Implementing an Online Environment

    ERIC Educational Resources Information Center

    Dawson, Beverly Araujo; Fenster, Judy

    2015-01-01

    Although web-based courses in schools of social work have proliferated over the past decade, the literature contains few guidelines on steps that schools can take to develop such courses. Using Knowles's framework, which delineates tasks and themes involved in implementing e-learning in social work education, this article describes the cultivation…

  18. 75 FR 4769 - Availability of Grant Funds and Proposed Implementation Guidelines; Withdrawal of Solicitation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-29

    ... notice entitled ``Availability of Grant Funds for Fiscal Year 2010'' (75 FR 3092). Included in that... Proposed Implementation Guidelines; Withdrawal of Solicitation for the Marine Aquaculture Initiative AGENCY... solicitation of applications for the NOAA Marine Aquaculture Initiative 2010, which was published in the...

  19. Implementing planetary protection guidelines for missions to and from small bodies

    NASA Astrophysics Data System (ADS)

    Stabekis, P.; Rummel, J.

    The increased interest in the exploration of planetary satellites, comets and asteroids prompted NASA to seek advice from the Space Studies Board (SSB) of the National Research Council regarding planetary protection guidelines for missions to and from these "small bodies". Just before and after the SSB's recommendations two missions were launched, a third is in preparation for launch, and a fourth is in the planning stages. Stardust was successfully launched on February 7, 1999 on a NASA mission to encounter with the comet Wild-2 in order to collect non-destructively cometary dust particles and acquire images of the comet nucleus and coma. The cometary samples will be returned to Earth in January 2006. Genesis, also of NASA, was launched on August 8, 2001 on a mission to collect pieces of the Sun, called solar wind, and return them to Earth in 2004. Muses -C is the first sample return mission by Japan's Institute of Space and Astronautical Science (ISAS). It is scheduled for launch in November/December 2002, will encounter the asteroid 1998SF36 in 2005, and will return to Earth in 2007 with a surface sample from the asteroid. This paper will address the process by which PP requirements for these missions were established and implemented. It will also examine the case of misions to and from Europa, now in the planning stages, and offer suggestions regarding their PP requirements, consistent with SSB recommendations to date.

  20. Interprofessional Implementation of a Pain/Sedation Guideline on a Trauma Intensive Care Unit.

    PubMed

    Sacco, Tara L; LaRiccia, Brenton

    2016-01-01

    Trauma patients experience pain and agitation during their hospitalization. Many complications have been noted both in the absence of symptom management and the in presence of oversedation/narcotization. To combat noted untoward effects of pain and sedation management, an interprofessional team convened to develop a pain and sedation guideline for use in a trauma intensive care unit. Guideline development began with a comprehensive review of the literature. With the input of unit stakeholders, a nurse-driven analgosedation guideline was implemented for a 6-month trial. During this time, unit champions were integral to successful trial execution. Outcome measurement included patient and unit outcomes, nursing satisfaction, and a pre- and postimplementation patient comparison. Following implementation, unit length of stay decreased by 4.16% and there was a 17.81% decrease in average time on the ventilator following the initiation of weaning. Patient reports of nurse sensitivity and responsiveness to pain increased from 93.7 to 94.9. Nurses reported satisfaction with the practice change and improvements in care. In comparing pre- and postimplementation patient data, there was a significant decrease in mean analgesic treatment duration and an increase in the use of antipsychotics for delirium management. Following the trial period, this guideline was permanently adopted across the adult critical care service. The development of a nurse-driven analgosedation guideline was noted to be both feasible and successful. PMID:27163223

  1. Implementation of WHO guidelines on management of severe malnutrition in hospitals in Africa.

    PubMed Central

    Deen, Jacqueline L.; Funk, Matthias; Guevara, Victor C.; Saloojee, Haroon; Doe, James Y.; Palmer, Ayo; Weber, Martin W.

    2003-01-01

    OBJECTIVE: To investigate the problems, benefits, feasibility, and sustainability of implementation of WHO guidelines on management of severe malnutrition. METHODS: A postal survey invited staff from 12 African hospitals to participate in the study. Five hospitals were evaluated and two were selected to take part in the study: a district hospital in South Africa and a mission hospital in Ghana. At an initial visit, an experienced paediatrician reviewed the situation in the hospitals and introduced the principles of the guidelines through a participatory approach. During a second visit about six months later, the paediatrician reviewed the feasibility and sustainability of the introduced changes and helped find solutions to problems. At a final visit after one year, the paediatrician reassessed the overall situation. FINDINGS: Malnutrition management practices improved at both hospitals. Measures against hypoglycaemia, hypothermia, and infection were strengthened. Early, frequent feeding was established as a routine practice. Some micronutrients for inclusion in the diet were not locally available and needed to be imported. Problems were encountered with monitoring of weight gain and introducing a rehydration solution for malnutrition. CONCLUSION: Implementation of the main principles of the WHO guidelines on severe malnutrition was feasible, affordable, and sustainable at two African hospitals. The guidelines could be improved by including suggestions on how to adapt specific recommendations to local situations. The guidelines are well supported by experience and published reports, but more information is needed about some components and their impact on mortality. PMID:12764489

  2. Implementation of the SSHAC Guidelines for Level 3 and 4 PSHAs - Experience Gained from Actual Applications

    USGS Publications Warehouse

    Hanks, Thomas C.; Abrahamson, Norm A.; Boore, David M.; Coppersmith, Kevin J.; Knepprath, Nichole E.

    2009-01-01

    In April 1997, after four years of deliberations, the Senior Seismic Hazard Analysis Committee released its report 'Recommendations for Probabilistic Seismic Hazard Analysis: Guidance on Uncertainty and Use of Experts' through the U.S. Nuclear Regulatory Commission as NUREG/CR-6372, hereafter SSHAC (1997). Known informally ever since as the 'SSHAC Guidelines', SSHAC (1997) addresses why and how multiple expert opinions - and the intrinsic uncertainties that attend them - should be used in Probabilistic Seismic Hazard Analyses (PSHA) for critical facilities such as commercial nuclear power plants. Ten years later, in September 2007, the U.S. Geological Survey (USGS) entered into a 13-month agreement with the U.S. Nuclear Regulatory Commission (NRC) titled 'Practical Procedures for Implementation of the SSHAC Guidelines and for Updating PSHAs'. The NRC was interested in understanding and documenting lessons learned from recent PSHAs conducted at the higher SSHAC Levels (3 and 4) and in gaining input from the seismic community for updating PSHAs as new information became available. This study increased in importance in anticipation of new applications for nuclear power facilities at both existing and new sites. The intent of this project was not to replace the SSHAC Guidelines but to supplement them with the experience gained from putting the SSHAC Guidelines to work in practical applications. During the course of this project, we also learned that updating PSHAs for existing nuclear power facilities involves very different issues from the implementation of the SSHAC Guidelines for new facilities. As such, we report our findings and recommendations from this study in two separate documents, this being the first. The SSHAC Guidelines were written without regard to whether the PSHAs to which they would be applied were site-specific or regional in scope. Most of the experience gained to date from high-level SSHAC studies has been for site-specific cases, although three

  3. Policies and Procedures That Facilitate Implementation of Evidence-Based Clinical Guidelines in U.S. Dental Schools.

    PubMed

    Polk, Deborah E; Nolan, Beth A D; Shah, Nilesh H; Weyant, Robert J

    2016-01-01

    The aim of this study was to determine the degree to which dental schools in the United States have policies and procedures in place that facilitate the implementation of evidence-based clinical guidelines. The authors sent surveys to all 65 U.S. dental schools in 2014; responses were obtained from 38 (58%). The results showed that, of the nine policies and procedures examined, only two were fully implemented by 50% or more of the responding schools: guidelines supported through clinical faculty education or available chairside (50%), and students informed of guidelines in both the classroom and clinic (65.8%). Although 92% of the respondents reported having an electronic health record, 80% of those were not using it to track compliance with guidelines. Five schools reported implementing more policies than the rest of the schools. The study found that the approach to implementing guidelines at most of the responding schools did not follow best practices although five schools had an exemplary set of policies and procedures to support guideline implementation. These results suggest that most dental schools are currently not implementing guidelines effectively and efficiently, but that the goal of schools' having a comprehensive implementation program for clinical guidelines is achievable since some are doing so. Future studies should determine whether interventions to improve implementation in dental schools are needed. PMID:26729681

  4. Guidelines for Creating, Implementing, and Evaluating Mind-Body Programs in a Military Healthcare Setting.

    PubMed

    Smith, Katherine; Firth, Kimberly; Smeeding, Sandra; Wolever, Ruth; Kaufman, Joanna; Delgado, Roxana; Bellanti, Dawn; Xenakis, Lea

    2016-01-01

    Research suggests that the development of mind-body skills can improve individual and family resilience, particularly related to the stresses of illness, trauma, and caregiving. To operationalize the research evidence that mind-body skills help with health and recovery, Samueli Institute, in partnership with experts in mind-body programming, created a set of guidelines for developing and evaluating mind-body programs for service members, veterans, and their families. The Guidelines for Creating, Implementing, and Evaluating Mind-Body Programs in a Military Healthcare Setting outline key strategies and issues to consider when developing, implementing, and evaluating a mind-body focused family empowerment approach in a military healthcare setting. Although these guidelines were developed specifically for a military setting, most of the same principles can be applied to the development of programs in the civilian setting as well. The guidelines particularly address issues unique to mind-body programs, such as choosing evidence-based modalities, licensure and credentialing, safety and contraindications, and choosing evaluation measures that capture the holistic nature of these types of programs. The guidelines are practical, practice-based guidelines, developed by experts in the fields of program development and evaluation, mind-body therapies, patient- and family-centered care, as well as, experts in military and veteran's health systems. They provide a flexible framework to create mind-body family empowerment programs and describe important issues that program developers and evaluators are encouraged to address to ensure the development of the most impactful, successful, evidence-supported programs possible.

  5. Performance of Implementing Guideline Driven Cervical Cancer Screening Measures in an Inner City Hospital System

    PubMed Central

    Wieland, Daryl L.; Reimers, Laura L.; Wu, Eijean; Nathan, Lisa M.; Gruenberg, Tammy; Abadi, Maria; Einstein, Mark H.

    2013-01-01

    Objective In 2006, the American Society for Colposcopy and Cervical Pathology (ASCCP) updated evidence based guidelines recommending screening intervals for women with abnormal cervical cytology. In our low-income inner city population, we sought to improve performance by uniformly applying the guidelines to all patients. We report the prospective performance of a comprehensive tracking, evidence-based algorithmically driven call-back and appointment scheduling system for cervical cancer screening in a resource-limited inner city population. Materials and Methods Outreach efforts were formalized with algorithm-based protocols for triage to colposcopy, with universal adherence to evidence-based guidelines. During implementation from August 2006 through July 2008, we prospectively tracked performance using the electronic medical record with administrative and pathology reports to determine performance variables such as the total number of Pap tests, colposcopy visits, and the distribution of abnormal cytology and histology results, including all CIN 2,3 diagnoses. Results 86,257 gynecologic visits and 41,527 Pap tests were performed system-wide during this period of widespread and uniform implementation of standard cervical cancer screening guidelines. The number of Pap tests performed per month varied little. The incidence of CIN 1 significantly decreased from 117/171 (68.4%) the first tracked month to 52/95 (54.7%) the last tracked month (p=0.04). The monthly incidence rate of CIN 2,3, including incident cervical cancers did not change. The total number of colposcopy visits declined, resulting in a 50% decrease in costs related to colposcopy services and approximately a 12% decrease in costs related to excisional biopsies. Conclusions Adherence to cervical cancer screening guidelines reduced the number of unnecessary colposcopies without increasing numbers of potentially missed CIN 2,3 lesions, including cervical cancer. Uniform implementation of administrative

  6. Barriers to guideline implementation and educational needs of general practitioners regarding heart failure: a qualitative study

    PubMed Central

    Peters-Klimm, Frank; Natanzon, Iris; Müller-Tasch, Thomas; Ludt, Sabine; Nikendei, Christoph; Lossnitzer, Nicole; Szecsenyi, Joachim; Herzog, Wolfgang; Jünger, Jana

    2012-01-01

    Objectives: A clinical practice guideline (CPG) contains specifically developed recommendations that can serve physicians as a decision aid in evidence-based practice. The implementation of heart failure (HF) CPGs represents a challenge in general practice. As part of the development of a tailored curriculum, aim of this study was to identify barriers of guideline adherence and needs for medical education (CME) in HF care. Methods: We conducted a modified focus group with elements of a workshop of three hours duration. Thirteen GPs collected and discussed together and parallel in smaller groups barriers of guideline implementation. Afterwards they performed a needs assessment for a tailored CME curriculum for chronic HF. The content of the discussions was analysed qualitatively according to Mayring and categorised thematically. Results: Barriers of guideline adherence were found in the following areas: doctor: procedural knowledge (knowledge gaps), communicative and organisational skills (e.g. time management) and attitude (dissatisfaction with time-money-relation). Patients: individual case-related problems (multimorbidity, psychiatric comorbidity, expectations and beliefs). Doctor and patient: Adherence and barriers of communication. Main measures for improvement of care concerned the areas of the identified barriers of guideline adherence with the focus on application-oriented training of the abovementioned procedural knowledge and skills, but also the supply of tools (like patient information leaflets) and patient education. Conclusion: For a CME-curriculum for HF tailored to the needs of GPs, a comprehensive educational approach seems necessary. It should be broad-based and include elements of knowledge and skills to be addressed and trained case-related. Additional elements should include support in the implementation of organisational processes in the practice and patient education. PMID:22737201

  7. A New Security Paradigm for Anti-Counterfeiting: Guidelines and an Implementation Roadmap

    NASA Astrophysics Data System (ADS)

    Lehtonen, Mikko

    Product counterfeitingand piracy continue to plague brand and trademark owners across industry sectors. This chapter analyses the reasons for ineffectiveness of past technical anti-counterfeitingstrategies and formulates managerial guidelines for effective use of RFID in anti-counterfeiting. An implementation roadmap toward secure authentication of products tagged with EPC Gen-2 tags is proposed and possible supply chain locations for product checks are discussed.

  8. Embedded Implementation of VHR Satellite Image Segmentation.

    PubMed

    Li, Chao; Balla-Arabé, Souleymane; Ginhac, Dominique; Yang, Fan

    2016-05-27

    Processing and analysis of Very High Resolution (VHR) satellite images provide a mass of crucial information, which can be used for urban planning, security issues or environmental monitoring. However, they are computationally expensive and, thus, time consuming, while some of the applications, such as natural disaster monitoring and prevention, require high efficiency performance. Fortunately, parallel computing techniques and embedded systems have made great progress in recent years, and a series of massively parallel image processing devices, such as digital signal processors or Field Programmable Gate Arrays (FPGAs), have been made available to engineers at a very convenient price and demonstrate significant advantages in terms of running-cost, embeddability, power consumption flexibility, etc. In this work, we designed a texture region segmentation method for very high resolution satellite images by using the level set algorithm and the multi-kernel theory in a high-abstraction C environment and realize its register-transfer level implementation with the help of a new proposed high-level synthesis-based design flow. The evaluation experiments demonstrate that the proposed design can produce high quality image segmentation with a significant running-cost advantage.

  9. Embedded Implementation of VHR Satellite Image Segmentation.

    PubMed

    Li, Chao; Balla-Arabé, Souleymane; Ginhac, Dominique; Yang, Fan

    2016-01-01

    Processing and analysis of Very High Resolution (VHR) satellite images provide a mass of crucial information, which can be used for urban planning, security issues or environmental monitoring. However, they are computationally expensive and, thus, time consuming, while some of the applications, such as natural disaster monitoring and prevention, require high efficiency performance. Fortunately, parallel computing techniques and embedded systems have made great progress in recent years, and a series of massively parallel image processing devices, such as digital signal processors or Field Programmable Gate Arrays (FPGAs), have been made available to engineers at a very convenient price and demonstrate significant advantages in terms of running-cost, embeddability, power consumption flexibility, etc. In this work, we designed a texture region segmentation method for very high resolution satellite images by using the level set algorithm and the multi-kernel theory in a high-abstraction C environment and realize its register-transfer level implementation with the help of a new proposed high-level synthesis-based design flow. The evaluation experiments demonstrate that the proposed design can produce high quality image segmentation with a significant running-cost advantage. PMID:27240370

  10. Embedded Implementation of VHR Satellite Image Segmentation

    PubMed Central

    Li, Chao; Balla-Arabé, Souleymane; Ginhac, Dominique; Yang, Fan

    2016-01-01

    Processing and analysis of Very High Resolution (VHR) satellite images provide a mass of crucial information, which can be used for urban planning, security issues or environmental monitoring. However, they are computationally expensive and, thus, time consuming, while some of the applications, such as natural disaster monitoring and prevention, require high efficiency performance. Fortunately, parallel computing techniques and embedded systems have made great progress in recent years, and a series of massively parallel image processing devices, such as digital signal processors or Field Programmable Gate Arrays (FPGAs), have been made available to engineers at a very convenient price and demonstrate significant advantages in terms of running-cost, embeddability, power consumption flexibility, etc. In this work, we designed a texture region segmentation method for very high resolution satellite images by using the level set algorithm and the multi-kernel theory in a high-abstraction C environment and realize its register-transfer level implementation with the help of a new proposed high-level synthesis-based design flow. The evaluation experiments demonstrate that the proposed design can produce high quality image segmentation with a significant running-cost advantage. PMID:27240370

  11. Do knowledge brokers facilitate implementation of the stroke guideline in clinical practice?

    PubMed Central

    2013-01-01

    Background The implementation of clinical practice guidelines in rehabilitation practice is often troublesome and incomplete. An intervention to enhance the implementation of guidelines is the knowledge transfer program built around the activities of a knowledge broker (KB). This study investigates the use of KBs to implement guideline recommendations for intensive therapy and physical activity for patients post-stroke in 22 stroke units in hospitals and rehabilitation centers in The Netherlands. Methods/Design This study includes a quantitative evaluation with a non controlled pre-post intervention design and a mixed methods process evaluation. From each stroke unit, enterprising nurses and therapists will be recruited and trained as KB. The KB will work for one year on the implementation of the guideline recommendations in their team. To evaluate the effectiveness of the KB, a questionnaire will be administered to patients, health professionals and KBs at baseline (T0) and after one year (T1). Furthermore, semi structured interviews with 5 KBs will be performed at T1. The primary outcome of this implementation project will be the support health professionals give patients to exercise and be physically active, as reported by patients and health professionals themselves. The support immediately after the intervention is compared with the support at the start of the intervention. Additionally we will explore the influence of socio-demographic characteristics of health professionals and determinants identified in the Theory of Planned Behavior (intention, attitude, subjective norm and perceived behavioral control) on the change of supportive behavior of health professionals. Finally, KBs will complete a questionnaire on their own psychological and social demographic characteristics and on organizational conditions needed for health-care improvement such as time, workforce, sponsoring and support from management. Discussion With this study we will gain insight in when

  12. Staff experiences in implementing guidelines for Kangaroo Mother Care--a qualitative study.

    PubMed

    Wallin, Lars; Rudberg, Agneta; Gunningberg, Lena

    2005-01-01

    The aim of this study was to investigate staff experiences in implementing guidelines for Kangaroo Mother Care in neonatal care. The study was part of a randomized controlled trial, the overall goal of which was to assess the impact of external facilitation. A total of eight focus group interviews were held at two intervention and two control units. The establishment of a change team to implement the guideline resulted in activities that impacted staff behaviour, which in turn was perceived to influence patients' well-being. The guideline and contextual factors, such as leadership and staff colleagues' attitudes, were of significant importance in that process. The study intervention--facilitation--promoted implementation activities and was highly appreciated by the change teams. However, reviewing the development of events at one of the control units, the provided facilitation appeared to be no more effective than an improvement-focused organizational culture in which the nurse manager was actively involved in the change process. Overall, learning and behaviour change seemed to be a social phenomenon, something that greatly benefited from people's interaction with one another.

  13. Implementing distress management guidelines in ambulatory oncology: a quality improvement project.

    PubMed

    Hammelef, Karen J; Friese, Christopher R; Breslin, Tara M; Riba, Michelle; Schneider, Susan M

    2014-01-01

    Distress assessment and referral to psychosocial services is an essential component of evidence-based oncologic nursing care. Oncology nurses have an opportunity to address patient distress needs through leadership of implementation programs and support for the positive outcomes that engaging in psychosocial services provides. This quality improvement project was conducted to evaluate the feasibility and utility of the National Comprehensive Cancer Network's distress management clinical practice guidelines in ambulatory oncology. A theoretical framework guided the process design that included staff education, screening, and management in a cohort implementation project with historical control. PMID:24480661

  14. Guidelines for Implementing Advanced Distribution Management Systems-Requirements for DMS Integration with DERMS and Microgrids

    SciTech Connect

    Wang, Jianhui; Chen, Chen; Lu, Xiaonan

    2015-08-01

    This guideline focuses on the integration of DMS with DERMS and microgrids connected to the distribution grid by defining generic and fundamental design and implementation principles and strategies. It starts by addressing the current status, objectives, and core functionalities of each system, and then discusses the new challenges and the common principles of DMS design and implementation for integration with DERMS and microgrids to realize enhanced grid operation reliability and quality power delivery to consumers while also achieving the maximum energy economics from the DER and microgrid connections.

  15. Implementation of asthma guidelines to West Australian community pharmacies: an exploratory, quasi-experimental study

    PubMed Central

    Trevenen, Michelle; Murray, Kevin; Kendall, Peter A; Schneider, Carl R; Clifford, Rhonda

    2016-01-01

    Objectives Pharmacy assistants are often the first point of contact for patients presenting in community pharmacies. The current role of pharmacy assistants in the supply of asthma-reliever medications (short-acting β-agonists) was identified as a barrier to appropriate guideline-based care. The aim of this research was to devise and evaluate a team-based intervention to formalise the role of pharmacy assistants and to improve asthma guideline-based care in community pharmacy. Design A controlled pre-post intervention study was conducted in 336 metropolitan pharmacies located in Perth, Western Australia. Pharmacies were stratified into 2 groups (187 intervention and 149 control) based on known confounders for asthma control. The intervention was designed using a common-sense approach and resources developed included a checklist, videos and web page. Delivery was via workshops (25 pharmacies) or academic detailing (162 pharmacies). Pharmacy practice was assessed preintervention and postintervention via covert simulated patient methodology. Primary outcome measures included patient medical referral, device use demonstration and counselling, internal referral and/or direct involvement of a pharmacist in consultations. Results There was a significant increase in patient medical referral in intervention pharmacies from 32% to 47% (p=0.0007) from preintervention to postintervention, while control pharmacies showed a non-significant decrease from 50% to 44% (p=0.22). Device counselling was not routinely carried out at any stage or in any cohort of this research and no significant changes in internal referral were observed. Conclusions Increases in medical referral indicate that asthma guideline compliance can be improved in community pharmacy if implementation employs a team-based approach and involves pharmacy assistants. However, results were variable and the intervention did not improve practice related to device counselling or internal referral/pharmacist involvement

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

    PubMed Central

    2014-01-01

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

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

    PubMed Central

    2014-01-01

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

  18. The Use of Systematic Reviews and Reporting Guidelines to Advance the Implementation of the 3Rs

    PubMed Central

    Avey, Marc T; Fenwick, Nicole; Griffin, Gilly

    2015-01-01

    In 1959, Russell and Burch published The Principles of Humane Experimental Technique, which included concrete advice on factors that they considered would govern progress in the implementation of these principles (enunciated as the 3Rs [Replacement, Reduction, and Refinement in animal-based studies]). One challenge to the implementation of the 3Rs was identified as information retrieval. Here, we further explore this challenge—the need for ‘research on research’—and the role that systematic reviews and reporting guidelines can play in implementation of the 3Rs. First, we examine the 2-fold nature of the challenge of information retrieval: 1) the identification of relevant publications spread throughout a large population of nonrelevant publications and 2) the incomplete reporting of relevant details within those publications. Second, we evaluate how systematic reviews and reporting guidelines can be used generally to address this challenge. Third, we assess the explicit reporting of the 3Rs in a cohort of preclinical animal systematic reviews. Our results show that Reduction methods are the most commonly reported by authors of systematic reviews but that, in general, reporting on how findings relate to the 3Rs is limited at best. Although systematic reviews are excellent tools for resolving the challenge of information retrieval, their utility for making progress in implementation of the 3Rs may be limited unless authors improve their reporting of these principles. PMID:25836961

  19. Guideline implementation for breast healthcare in low- and middle-income countries: early detection resource allocation.

    PubMed

    Yip, Cheng-Har; Smith, Robert A; Anderson, Benjamin O; Miller, Anthony B; Thomas, David B; Ang, Eng-Suan; Caffarella, Rosemary S; Corbex, Marilys; Kreps, Gary L; McTiernan, Anne

    2008-10-15

    A key determinant of breast cancer outcome in any population is the degree to which cancers are detected at early stages of disease. Populations in which cancers are detected at earlier stages have lower breast cancer mortality rates. The Breast Health Global Initiative (BHGI) held its third Global Summit in Budapest, Hungary in October 2007, bringing together internationally recognized experts to address the implementation of breast healthcare guidelines for early detection, diagnosis, and treatment in low- and middle-income countries (LMCs). A multidisciplinary panel of experts specifically addressed the implementation of BHGI guidelines for the early detection of disease as they related to resource allocation for public education and awareness, cancer detection methods, and evaluation goals. Public education and awareness are the key first steps, because early detection programs cannot be successful if the public is unaware of the value of early detection. The effectiveness and efficiency of screening modalities, including screening mammography, clinical breast examination (CBE), and breast self-examination, were reviewed in the context of resource availability and population-based need by the panel. Social and cultural barriers should be considered when early detection programs are being established, and the evaluation of early detection programs should include the use of well developed, methodologically sound process metrics to determine the effectiveness of program implementation. The approach and scope of any screening program will determine the success of any early detection program as measured by cancer stage at diagnosis and will drive the breadth of resource allocation needed for program implementation. PMID:18837017

  20. The use of systematic reviews and reporting guidelines to advance the implementation of the 3Rs.

    PubMed

    Avey, Marc T; Fenwick, Nicole; Griffin, Gilly

    2015-03-01

    In 1959, Russell and Burch published The Principles of Humane Experimental Technique, which included concrete advice on factors that they considered would govern progress in the implementation of these principles (enunciated as the 3Rs [Replacement, Reduction, and Refinement in animal-based studies]). One challenge to the implementation of the 3Rs was identified as information retrieval. Here, we further explore this challenge-the need for 'research on research'-and the role that systematic reviews and reporting guidelines can play in implementation of the 3Rs. First, we examine the 2-fold nature of the challenge of information retrieval: 1) the identification of relevant publications spread throughout a large population of nonrelevant publications and 2) the incomplete reporting of relevant details within those publications. Second, we evaluate how systematic reviews and reporting guidelines can be used generally to address this challenge. Third, we assess the explicit reporting of the 3Rs in a cohort of preclinical animal systematic reviews. Our results show that Reduction methods are the most commonly reported by authors of systematic reviews but that, in general, reporting on how findings relate to the 3Rs is limited at best. Although systematic reviews are excellent tools for resolving the challenge of information retrieval, their utility for making progress in implementation of the 3Rs may be limited unless authors improve their reporting of these principles. PMID:25836961

  1. Manual for implementing residual radioactive material guidelines using RESRAD, Version 5.0

    SciTech Connect

    Yu, C.; Zielen, A.J.; Cheng, J.J.

    1993-09-01

    This manual presents information for implementing US Department of Energy (DOE) guidelines for residual radioactive material. It describes the analysis and models used to derive site-specific guidelines for allowable residual concentrations of radionuclides in soil and the design and use of the RESRAD computer code for calculating doses, risks, and guideline values. It also describes procedures for implementing DOE policy for reducing residual radioactivity to levels that are as low as reasonably achievable. Two new pathways, radon inhalation and soil ingestion, have been added to RESRAD. Twenty-seven new radionuclides have also been added, and the cutoff half-life for associated radionuclides has been reduced to six months. Other major improvements to the RESRAD code include the ability to run sensitivity analyses, the addition of graphical output, user-specified dose factors, updated databases, an improved groundwater transport model, optional input of a groundwater concentration and a solubility constant, special models for tritium and carbon-14, calculation of cancer incidence risk, and the use of a mouse with menus.

  2. Barriers and enablers to implementing multiple stroke guideline recommendations: a qualitative study

    PubMed Central

    2013-01-01

    Background Translating evidence into practice is an important final step in the process of evidence-based practice. Medical record audits can be used to examine how well practice compares with published evidence, and identify evidence-practice gaps. After providing audit feedback to professionals, local barriers to practice change can be identified and targetted with focussed behaviour change interventions. This study aimed to identify barriers and enablers to implementing multiple stroke guideline recommendations at one Australian stroke unit. Methods A qualitative methodology was used. A sample of 28 allied health, nursing and medical professionals participated in a group or individual interview. These interviews occurred after staff had received audit feedback and identified areas for practice change. Questions focused on barriers and enablers to implementing guideline recommendations about management of: upper limb sensory impairments, mobility including sitting balance; vision; anxiety and depression; neglect; swallowing; communication; education for stroke survivors and carers; advice about return to work and driving. Qualitative data were analysed for themes using theoretical domains described by Michie and colleagues (2005). Results Six group and two individual interviews were conducted, involving six disciplines. Barriers were different across disciplines. The six key barriers identified were: (1) Beliefs about capabilities of individual professionals and their discipline, and about patient capabilities (2) Beliefs about the consequences, positive and negative, of implementing the recommendations (3) Memory of, and attention to, best practices (4) Knowledge and skills required to implement best practice; (5) Intention and motivation to implement best practice, and (6) Resources. Some barriers were also enablers to change. For example, occupational therapists required new knowledge and skills (a barrier), to better manage sensation and neglect impairments

  3. Non-vitamin K antagonist oral anticoagulants and atrial fibrillation guidelines in practice: barriers to and strategies for optimal implementation

    PubMed Central

    Camm, A. John; Pinto, Fausto J.; Hankey, Graeme J.; Andreotti, Felicita; Hobbs, F.D. Richard

    2015-01-01

    Stroke is a leading cause of morbidity and mortality worldwide. Atrial fibrillation (AF) is an independent risk factor for stroke, increasing the risk five-fold. Strokes in patients with AF are more likely than other embolic strokes to be fatal or cause severe disability and are associated with higher healthcare costs, but they are also preventable. Current guidelines recommend that all patients with AF who are at risk of stroke should receive anticoagulation. However, despite this guidance, registry data indicate that anticoagulation is still widely underused. With a focus on the 2012 update of the European Society of Cardiology (ESC) guidelines for the management of AF, the Action for Stroke Prevention alliance writing group have identified key reasons for the suboptimal implementation of the guidelines at a global, regional, and local level, with an emphasis on access restrictions to guideline-recommended therapies. Following identification of these barriers, the group has developed an expert consensus on strategies to augment the implementation of current guidelines, including practical, educational, and access-related measures. The potential impact of healthcare quality measures for stroke prevention on guideline implementation is also explored. By providing practical guidance on how to improve implementation of the ESC guidelines, or region-specific modifications of these guidelines, the aim is to reduce the potentially devastating impact that stroke can have on patients, their families and their carers. PMID:26116685

  4. Guidelines for Technology Infrastructure in Connecticut Schools: An Implementation Guide for the Connecticut Statewide Educational Technology Plan.

    ERIC Educational Resources Information Center

    Center for Educational Leadership and Technology, Inc., Marlborough, MA.

    This document presents guidelines and recommendations for development of a technology infrastructure in Connecticut public schools that conforms to national industry standards for voice, video, and data communications. The guidelines present information on the state statutes regarding facilities implementation and describe industry standards.…

  5. Implementation of nationwide image sharing system

    NASA Astrophysics Data System (ADS)

    Choi, SeungWook; Sim, Jungsuk; Ko, Wonsun; Park, ChanHyung; Lee, Jaeha; Lim, DongHyun; Lee, Juhyuk; Han, Jungu; Lee, Jongsu; Hong, HeonPyo; Choi, Bongsuk

    2003-05-01

    Korea is one of the leading countries in PACS implementation, and over 15% of all hospitals has been introducing and running in PACS. With the support of the Ministry of Health and Welfare, the National Computerization of Agency and National Cancer Center had a plan to try integration of PACS with a purpose of sharing medical image information. The target hospitals have been selected with over 500 beds, and the distance between hospitals from 40km and to 250km. As the vendors of PACS and HIS that had implemented in target hospitals were different, the 'sharing host' has been developed for the purpose of their integration, which enables communication through DICOM and HL7. In order to monitor the communication among the sharing hosts, the 'sharing center' also has been developed. This project was completed by November 2002. We expected that approximate of 100 doctors including 50 radiologists would use this project, high patient"s satisfaction and the decrease in national insurance fee for test and evaluation period. This project is the first attempt that the government has tried to integrate the independent PACS and HIS. On the model of this project, the government will try to expand it through all nation-wide.

  6. [Measuring quality in the German Guideline Programme in Oncology (GGPO)—methodology and implementation].

    PubMed

    Nothacker, Monika; Muche-Borowski, Cathleen; Kopp, Ina B

    2014-01-01

    The German Guideline Programme in Oncology (GGPO) is a joint initiative between the German Cancer Society, the Association of the Scientific Medical Societies in Germany and German Cancer Aid. In accordance with the aims of the German National Cancer Plan, the GGPO supports the systematic development of high-quality guidelines. To enhance implementation and evaluation, the suggestion of performance measures (PMs) derived from guideline recommendations following a standardised methodology is obligatory within the GGPO. For this purpose, PM teams are convened representing the multidisciplinary guideline development groups including clinical experts, methodologists and patient representatives as well as those organisations that take an active part in and share responsibility for documentation and quality improvement, i.e., clinical cancer registries, certified cancer centres and, if appropriate, the institution responsible for external quality assurance according to the German Social Code (SGB). The primary selection criteria for PMs include strength of the underlying recommendation (strong, grade A), existing potential for improvement of care and measurability. The premises of data economy and standardised documentation are taken into account. Between May 2008 and July 2014, 12 guidelines with suggestions for 100 PMs have been published. The majority of the suggested performance measures is captured by the specific documentation requirements of the clinical cancer registries and certified cancer centres. This creates a solid basis for an active quality management and re-evaluation of the suggested PMs. In addition, the suspension of measures should be considered if improvement has been achieved on a broad scale and for a longer period in order to concentrate on a quality-oriented, economic documentation.

  7. [Measuring quality in the German Guideline Programme in Oncology (GGPO)—methodology and implementation].

    PubMed

    Nothacker, Monika; Muche-Borowski, Cathleen; Kopp, Ina B

    2014-01-01

    The German Guideline Programme in Oncology (GGPO) is a joint initiative between the German Cancer Society, the Association of the Scientific Medical Societies in Germany and German Cancer Aid. In accordance with the aims of the German National Cancer Plan, the GGPO supports the systematic development of high-quality guidelines. To enhance implementation and evaluation, the suggestion of performance measures (PMs) derived from guideline recommendations following a standardised methodology is obligatory within the GGPO. For this purpose, PM teams are convened representing the multidisciplinary guideline development groups including clinical experts, methodologists and patient representatives as well as those organisations that take an active part in and share responsibility for documentation and quality improvement, i.e., clinical cancer registries, certified cancer centres and, if appropriate, the institution responsible for external quality assurance according to the German Social Code (SGB). The primary selection criteria for PMs include strength of the underlying recommendation (strong, grade A), existing potential for improvement of care and measurability. The premises of data economy and standardised documentation are taken into account. Between May 2008 and July 2014, 12 guidelines with suggestions for 100 PMs have been published. The majority of the suggested performance measures is captured by the specific documentation requirements of the clinical cancer registries and certified cancer centres. This creates a solid basis for an active quality management and re-evaluation of the suggested PMs. In addition, the suspension of measures should be considered if improvement has been achieved on a broad scale and for a longer period in order to concentrate on a quality-oriented, economic documentation. PMID:25523845

  8. [How to implement a guideline from theory to practice: the example of the venous thromboembolism prophylaxis].

    PubMed

    Paiva, Edison F; Rocha, Ana T C

    2009-01-01

    The objective of this manuscript is to discuss the existing barriers for the dissemination of medical guidelines, and to present strategies that facilitate the adaptation of the recommendations into clinical practice. The literature shows that it usually takes several years until new scientific evidence is adopted in current practice, even when there is obvious impact in patients' morbidity and mortality. There are some examples where more than thirty years have elapsed since the first case reports about the use of a effective therapy were published until its utilization became routine. That is the case of fibrinolysis for the treatment of acute myocardial infarction. Some of the main barriers for the implementation of new recommendations are: the lack of knowledge of a new guideline, personal resistance to changes, uncertainty about the efficacy of the proposed recommendation, fear of potential side-effects, difficulties in remembering the recommendations, inexistence of institutional policies reinforcing the recommendation and even economical restrains. In order to overcome these barriers a strategy that involves a program with multiple tools is always the best. That must include the implementation of easy-to-use algorithms, continuous medical education materials and lectures, electronic or paper alerts, tools to facilitate evaluation and prescription, and periodic audits to show results to the practitioners involved in the process. It is also fundamental that the medical societies involved with the specific medical issue support the program for its scientific and ethical soundness. The creation of multidisciplinary committees in each institution and the inclusion of opinion leaders that have pro-active and lasting attitudes are the key-points for the program's success. In this manuscript we use as an example the implementation of a guideline for venous thromboembolism prophylaxis, but the concepts described here can be easily applied to any other guideline

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

    PubMed Central

    2011-01-01

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

  10. Chronic kidney disease guideline implementation in primary care: a qualitative report from the TRANSLATE CKD study

    PubMed Central

    Vest, Bonnie M.; York, Trevor R.M.; Sand, Jessica; Fox, Chester H.; Kahn, Linda S.

    2016-01-01

    Background Primary care physicians (PCPs) are optimally situated to identify and manage early-stage chronic kidney disease (CKD). Nonetheless, studies have documented suboptimal PCP understanding, awareness, and management of early CKD. The TRANSLATE CKD study is an ongoing national mixed-methods cluster randomized control trial that examines the implementation of evidence-based guidelines for CKD into primary care practice. Methods As part of mixed-methods process evaluation, semi-structured interviews were conducted by phone with 27 providers participating in the study. Interviews were audio-taped and transcribed. Thematic content analysis was used to identify themes. Themes were categorized according to the four domains of Normalization Process Theory (NPT). Results Identified themes illuminated the complex work undertaken in primary care practices to manage CKD. Barriers to guideline implementation were identified in each of the four NPT domains, including: 1) lack of knowledge and understanding around CKD (coherence), 2) difficulties engaging providers and patients in CKD management (cognitive participation), 3) limited time and competing demands (collective action), and 4) challenges obtaining and utilizing data to monitor progress (reflexive monitoring). Conclusions Addressing the barriers to implementation with concrete interventions at the levels at which they occur, informed by NPT, will ultimately improve the quality of CKD patient care. PMID:26355134

  11. The European Bioanalysis Forum community's evaluation, interpretation and implementation of the European Medicines Agency guideline on Bioanalytical Method Validation.

    PubMed

    van Amsterdam, Peter; Companjen, Arjen; Brudny-Kloeppel, Margarete; Golob, Michaela; Luedtke, Silke; Timmerman, Philip

    2013-03-01

    The European Medicines Agency's (EMA) 2011 guideline on bioanalytical method validation (BMV) was evaluated and subsequently intensely discussed by the European Bioanalysis Forum (EBF) during a 2-day workshop (EBF Workshop on the implementation of the EMA guideline on BMV, Château de Limelette, Limelette, Belgium, 15-16 March 2012). The goal of the evaluation and discussions was to come to a uniform interpretation of the guideline and thus to help facilitate a smooth implementation at our laboratories. Up front preparations for the workshop by dedicated teams concentrated on challenges on implementation: ambiguities, technical or operational challenges and issues in general. In addition, common understandings were identified as well as main differences to the 2011 US FDA guideline. The guideline was perceived as being well written with a clear structure, separating method validation from sample analysis and treating all relevant aspects one-by-one in a logical order. It is the first BMV guideline clearly addressing the specifics for ligand binding assays and it shows a good match with current scientific thinking. The EBF community considers the EMA BMV guideline an excellent basis for countries that are in the process of developing or updating their own BMV guideline.

  12. Return of the pulmonary nodule: the radiologist's key role in implementing the 2015 BTS guidelines on the investigation and management of pulmonary nodules.

    PubMed

    Graham, Richard N J; Baldwin, David R; Callister, Matthew E J; Gleeson, Fergus V

    2016-01-01

    The British Thoracic Society has published new comprehensive guidelines for the management of pulmonary nodules. These guidelines are significantly different from those previously published, as they use two malignancy prediction calculators to better characterize the risk of malignancy. There are recommendations for a higher nodule size threshold for follow-up (≥5 mm or ≥80 mm(3)) and a reduction of the follow-up period to 1 year for solid pulmonary nodules; both of these will reduce the number of follow-up CT scans. PET-CT plays a crucial role in characterization also, with an ordinal scale being recommended for reporting. Radiologists will be the key in implementing these guidelines, and routine use of volumetric image-analysis software will be required to manage patients with pulmonary nodules correctly. PMID:26781558

  13. The essence of the Japan Radiological Society/Japanese College of Radiology Imaging Guideline.

    PubMed

    Yamashita, Yasuyuki; Murayama, Sadayuki; Okada, Masahiro; Watanabe, Yoshiyuki; Kataoka, Masako; Kaji, Yasushi; Imamura, Keiko; Takehara, Yasuo; Hayashi, Hiromitsu; Ohno, Kazuko; Awai, Kazuo; Hirai, Toshinori; Kojima, Kazuyuki; Sakai, Shuji; Matsunaga, Naofumi; Murakami, Takamichi; Yoshimitsu, Kengo; Gabata, Toshifumi; Matsuzaki, Kenji; Tohno, Eriko; Kawahara, Yasuhiro; Nakayama, Takeo; Monzawa, Shuichi; Takahashi, Satoru

    2016-01-01

    Diagnostic imaging is undoubtedly important in modern medicine, and final clinical decisions are often made based on it. Fortunately, Japan has the highest numbers of diagnostic imaging instruments, such as CT and MRI devices, and boasts easy access to them as well as a high level of diagnostic accuracy. In consequence, a very large number of imaging examinations are performed, but diagnostic instruments are installed in so many medical facilities that expert management of these examinations tends to be insufficient. Particularly, in order to avoid risks, clinicians have recently become indifferent to indications of imaging modalities and tend to rely on CT or MRI resulting in increasing the number of imaging examinations in Japan. This is a serious problem from the viewpoints of avoidance of unnecessary exposure and medical economy. Under these circumstances, the Japan Radiological Society and Japanese College of Radiology jointly initiated the preparation of new guidelines for diagnostic imaging. However, the field of diagnostic imaging is extremely wide, and it is impossible to cover all diseases. Therefore, in drafting the guidelines, we selected important diseases and focused on "showing evidence and suggestions in the form of clinical questions (CQs)" concerning clinically encountered questions and "describing routine imaging techniques presently considered to be standards to guarantee the quality of imaging examinations". In so doing, we adhered to the basic principles of assuming the readers to be "radiologists specializing in diagnostic imaging", "simultaneously respecting the global standards and attending to the situation in Japan", and "making the guidelines consistent with those of other scientific societies related to imaging". As a result, the guidelines became the largest ever, consisting of 152 CQs, nine areas of imaging techniques, and seven reviews, but no other guidelines in the world summarize problems concerning diagnostic imaging in the form

  14. The essence of the Japan Radiological Society/Japanese College of Radiology Imaging Guideline.

    PubMed

    Yamashita, Yasuyuki; Murayama, Sadayuki; Okada, Masahiro; Watanabe, Yoshiyuki; Kataoka, Masako; Kaji, Yasushi; Imamura, Keiko; Takehara, Yasuo; Hayashi, Hiromitsu; Ohno, Kazuko; Awai, Kazuo; Hirai, Toshinori; Kojima, Kazuyuki; Sakai, Shuji; Matsunaga, Naofumi; Murakami, Takamichi; Yoshimitsu, Kengo; Gabata, Toshifumi; Matsuzaki, Kenji; Tohno, Eriko; Kawahara, Yasuhiro; Nakayama, Takeo; Monzawa, Shuichi; Takahashi, Satoru

    2016-01-01

    Diagnostic imaging is undoubtedly important in modern medicine, and final clinical decisions are often made based on it. Fortunately, Japan has the highest numbers of diagnostic imaging instruments, such as CT and MRI devices, and boasts easy access to them as well as a high level of diagnostic accuracy. In consequence, a very large number of imaging examinations are performed, but diagnostic instruments are installed in so many medical facilities that expert management of these examinations tends to be insufficient. Particularly, in order to avoid risks, clinicians have recently become indifferent to indications of imaging modalities and tend to rely on CT or MRI resulting in increasing the number of imaging examinations in Japan. This is a serious problem from the viewpoints of avoidance of unnecessary exposure and medical economy. Under these circumstances, the Japan Radiological Society and Japanese College of Radiology jointly initiated the preparation of new guidelines for diagnostic imaging. However, the field of diagnostic imaging is extremely wide, and it is impossible to cover all diseases. Therefore, in drafting the guidelines, we selected important diseases and focused on "showing evidence and suggestions in the form of clinical questions (CQs)" concerning clinically encountered questions and "describing routine imaging techniques presently considered to be standards to guarantee the quality of imaging examinations". In so doing, we adhered to the basic principles of assuming the readers to be "radiologists specializing in diagnostic imaging", "simultaneously respecting the global standards and attending to the situation in Japan", and "making the guidelines consistent with those of other scientific societies related to imaging". As a result, the guidelines became the largest ever, consisting of 152 CQs, nine areas of imaging techniques, and seven reviews, but no other guidelines in the world summarize problems concerning diagnostic imaging in the form

  15. Case study of an inter-professional and inter-organisational programme to adapt, implement and evaluate clinical guidelines in secondary care.

    PubMed

    Hall, L; Eccles, M

    2000-01-01

    This paper describes the implementation of a clinical guideline across three acute Trusts. A Clinical Effectiveness Steering Group identified prevention of venous thromboembolism as a health priority. A local guideline development group adapted the recommendations of an existing review and produced a local guideline. Then, a multidisciplinary implementation group developed the practical aspects of implementing guidelines into routine daily practice. They identified appropriate staff to carry out risk assessment and to administer appropriate prophylaxis, as necessary. They also produced a "guideline pack" containing a training resource manual and implementation aids. Following this a multiple strategy implementation programme was used to introduce the guidelines, and an evaluation was carried out eight to ten months after the introduction of the guidelines. The evaluation identified a number of areas for improving current practice. Guideline implementation is a complex, time-consuming process.

  16. Measuring legal implementation of the international guidelines on HIV/AIDS and human rights.

    PubMed

    Watchirs, H

    2001-01-01

    With over 36 million people now living with the virus and over 21 million people dying of AIDS in the last two decades, HIV/AIDS is a global health and security problem. These shocking figures eclipse the human toll of many wars, and reveal in themselves that human rights are not being respected, protected, or fulfilled, either through negligent omissions or violations. A human rights approach to the epidemic was advocated early by advocates such as Jonathan Mann, who recognized that infections thrived in conditions of inequality. This approach was crystallized in the International Guidelines on HIV/AIDS and Human Rights that were developed at the Second International Consultation in 1996 convened by UNAIDS and the Office of the High Commissioner for Human Rights. The Guidelines cover three main areas: improving governmental responses in terms of multisectoral responsibility and accountability; widespread law reform and legal support services; and supporting increased private sector and community participation in effective responses to the epidemic. This article focuses on the half of the twelve Guidelines that concern rights that are justiciable and amenable to law reform. It highlights the responsibilities of States Parties to human rights treaties, as they bear the principal burden of the obligations to implement. PMID:11837019

  17. Clinical imaging guidelines part 4: challenges in identifying, engaging and collaborating with stakeholders.

    PubMed

    Bettmann, Michael A; Oikarinen, Helja; Rehani, Madan; Holmberg, Ola; del Rosario Perez, Maria; Naidoo, Anusha; Do, Kyung-Hyun; Dreyer, Keith; Ebdon-Jackson, Steve

    2015-04-01

    The effective development and use of clinical imaging guidelines requires an understanding of who the stakeholders are, what their interests in the process are, and what roles they should play. If the appropriate stakeholders are not engaged in the right roles, it is unlikely that clinical imaging guidelines will be successfully developed, relied on, and actually used. Some stakeholders are obvious: for the development of clinical imaging guidelines, both imagers and those who request examinations, such as general practitioners, internists, and medical specialists, must be involved. To gain acceptance, other relevant groups are stakeholders, including medical societies, other health care professionals, insurers, health IT experts and vendors, and patients. The role of stakeholders must be dictated by their specific interest. For some, involvement in the creation of guidelines is the right role. For others, such as regulators or insurers, reviews or invitations to comment are required, and for others, such as medical educators, it is probably sufficient to provide information and create awareness. Only through a careful consideration of who the stakeholders are and what are their interests are the successful development, acceptance, and use of clinical imaging guidelines likely to occur. Future efforts must focus on collaboration, particularly among groups that create clinical imaging guidelines and those that can support their use, and on regulatory roles and mandates. PMID:25842016

  18. Improving children's nutrition environments: A survey of adoption and implementation of nutrition guidelines in recreational facilities

    PubMed Central

    2011-01-01

    Background Although the mandate of recreational facilities is to enhance well-being, many offer foods inconsistent with recommendations for healthy eating. Little is known regarding recreational facility food environments and how they might be improved, as few studies exist. The Alberta Nutrition Guidelines for Children and Youth (ANGCY) are intended to ensure access to healthy food choices in schools, childcare and recreational facilities. This study investigated awareness, adoption and implementation of the ANGCY among recreational facilities in Alberta, Canada, one year following their release. Methods A cross-sectional telephone survey was conducted from June - December, 2009 (n = 151) with managers of publicly funded recreational facilities that served food. The questionnaire included 10 closed and 7 open ended questions to assess the organizational priority for healthy eating, awareness, adoption and implementation of the ANGCY. Chi-squared tests examined quantitative variables, while qualitative data were analysed using directed content analysis. Greenhalgh's model of diffusion of complex innovations within health service organizations constituted the theoretical framework for the study. Results One half of respondents had heard of the ANGCY, however their knowledge of them was limited. Although 51% of facilities had made changes to improve the nutritional quality of foods offered in the past year, only a small fraction (11%) of these changes were motivated by the ANGCY. At the time of the survey, 14% of facilities had adopted the ANGCY and 6% had implemented them. Barriers to adoption and implementation were primarily related to perceived negative attributes of the ANGCY, the inner (organizational) context, and negative feedback received during the implementation process. Managers strongly perceived that implementing nutrition guidelines would limit their profit-making ability. Conclusions If fully adopted and implemented, the ANGCY have the potential to

  19. Creative implementation of 3Rs principles within industry programs: beyond regulations and guidelines.

    PubMed

    Bratcher, Natalie A; Reinhard, Gregory R

    2015-03-01

    The industry involved with using animals as an essential part of research has supported the theory and philosophy of the 3Rs for years. However, both the culture and approach surrounding the 3Rs is evolving rapidly, and many institutions are attempting to surpass the regulations and guidelines to implement the 3Rs for improved science and animal welfare. Regulatory documents and guidelines such as the Animal Welfare Act, the Guide for the Care and Use of Laboratory Animals, the Public Health Service Policy on Humane Care and Use of Laboratory Animals, and the US Government Principles for the Utilization and Care of Vertebrate Animals Used in Testing, Research, and Training clearly outline how the IACUC should address the 3Rs, but there are many additional paradigms and resources that an institution can use to promote the 3Rs creatively. We review the legal mandates and guidelines that institutions must or should follow, and we present some creative approaches toward their compliance, including the creation of full-time dedicated 3Rs roles as well as temporary 3Rs-focused positions such as visiting scientist and postdoctoral fellowships and internships. We also discuss how to creatively achieve 3Rs progress through internal committees and working groups, involvement in 3Rs consortia, recognizing 3Rs advances through awards programs, and creating 3Rs volunteer opportunities. Adherence to regulations and guidelines creates a solid foundation for good animal care and science, and creative 3Rs approaches enable the growth of a robust animal welfare culture that enhances the potential for 3Rs benefits to animals and science.

  20. Creative Implementation of 3Rs Principles within Industry Programs: Beyond Regulations and Guidelines

    PubMed Central

    Bratcher, Natalie A; Reinhard, Gregory R

    2015-01-01

    The industry involved with using animals as an essential part of research has supported the theory and philosophy of the 3Rs for years. However, both the culture and approach surrounding the 3Rs is evolving rapidly, and many institutions are attempting to surpass the regulations and guidelines to implement the 3Rs for improved science and animal welfare. Regulatory documents and guidelines such as the Animal Welfare Act, the Guide for the Care and Use of Laboratory Animals, the Public Health Service Policy on Humane Care and Use of Laboratory Animals, and the US Government Principles for the Utilization and Care of Vertebrate Animals Used in Testing, Research, and Training clearly outline how the IACUC should address the 3Rs, but there are many additional paradigms and resources that an institution can use to promote the 3Rs creatively. We review the legal mandates and guidelines that institutions must or should follow, and we present some creative approaches toward their compliance, including the creation of full-time dedicated 3Rs roles as well as temporary 3Rs-focused positions such as visiting scientist and postdoctoral fellowships and internships. We also discuss how to creatively achieve 3Rs progress through internal committees and working groups, involvement in 3Rs consortia, recognizing 3Rs advances through awards programs, and creating 3Rs volunteer opportunities. Adherence to regulations and guidelines creates a solid foundation for good animal care and science, and creative 3Rs approaches enable the growth of a robust animal welfare culture that enhances the potential for 3Rs benefits to animals and science. PMID:25836958

  1. Avoiding Twisted Pixels: Ethical Guidelines for the Appropriate Use and Manipulation of Scientific Digital Images

    PubMed Central

    2014-01-01

    Digital imaging has provided scientists with new opportunities to acquire and manipulate data using techniques that were difficult or impossible to employ in the past. Because digital images are easier to manipulate than film images, new problems have emerged. One growing concern in the scientific community is that digital images are not being handled with sufficient care. The problem is twofold: (1) the very small, yet troubling, number of intentional falsifications that have been identified, and (2) the more common unintentional, inappropriate manipulation of images for publication. Journals and professional societies have begun to address the issue with specific digital imaging guidelines. Unfortunately, the guidelines provided often do not come with instructions to explain their importance. Thus they deal with what should or should not be done, but not the associated ‘why’ that is required for understanding the rules. This article proposes 12 guidelines for scientific digital image manipulation and discusses the technical reasons behind these guidelines. These guidelines can be incorporated into lab meetings and graduate student training in order to provoke discussion and begin to bring an end to the culture of “data beautification”. PMID:20567932

  2. Enhanced implementation of low back pain guidelines in general practice: study protocol of a cluster randomised controlled trial

    PubMed Central

    2013-01-01

    Background Evidence-based clinical practice guidelines may improve treatment quality, but the uptake of guideline recommendations is often incomplete and slow. Recently new low back pain guidelines are being launched in Denmark. The guidelines are considered to reduce personal and public costs. The aim of this study is to evaluate whether a complex, multifaceted implementation strategy of the low back pain guidelines will reduce secondary care referral and improve patient outcomes compared to the usual simple implementation strategy. Methods/design In a two-armed cluster randomised trial, 100 general practices (clusters) and 2,700 patients aged 18 to 65 years from the North Denmark region will be included. Practices are randomly allocated 1:1 to a simple or a complex implementation strategy. Intervention practices will receive a complex implementation strategy, including guideline facilitator visits, stratification tools, and quality reports on low back pain treatment. Primary outcome is referral to secondary care. Secondary outcomes are pain, physical function, health-related quality of life, patient satisfaction with care and treatment outcome, employment status, and sick leave. Primary and secondary outcomes pertain to the patient level. Assessments of outcomes are blinded and follow the intention-to-treat principle. Additionally, a process assessment will evaluate the degree to which the intervention elements will be delivered as planned, as well as measure changes in beliefs and behaviours among general practitioners and patients. Discussion This study provides knowledge concerning the process and effect of an intervention to implement low back pain guidelines in general practice, and will provide insight on essential elements to include in future implementation strategies in general practice. Trial registration Registered as NCT01699256 on ClinicalTrials.gov. PMID:24139140

  3. Guidelines for a graph-theoretic implementation of structural equation modeling

    USGS Publications Warehouse

    Grace, James B.; Schoolmaster, Donald R.; Guntenspergen, Glenn R.; Little, Amanda M.; Mitchell, Brian R.; Miller, Kathryn M.; Schweiger, E. William

    2012-01-01

    Structural equation modeling (SEM) is increasingly being chosen by researchers as a framework for gaining scientific insights from the quantitative analyses of data. New ideas and methods emerging from the study of causality, influences from the field of graphical modeling, and advances in statistics are expanding the rigor, capability, and even purpose of SEM. Guidelines for implementing the expanded capabilities of SEM are currently lacking. In this paper we describe new developments in SEM that we believe constitute a third-generation of the methodology. Most characteristic of this new approach is the generalization of the structural equation model as a causal graph. In this generalization, analyses are based on graph theoretic principles rather than analyses of matrices. Also, new devices such as metamodels and causal diagrams, as well as an increased emphasis on queries and probabilistic reasoning, are now included. Estimation under a graph theory framework permits the use of Bayesian or likelihood methods. The guidelines presented start from a declaration of the goals of the analysis. We then discuss how theory frames the modeling process, requirements for causal interpretation, model specification choices, selection of estimation method, model evaluation options, and use of queries, both to summarize retrospective results and for prospective analyses. The illustrative example presented involves monitoring data from wetlands on Mount Desert Island, home of Acadia National Park. Our presentation walks through the decision process involved in developing and evaluating models, as well as drawing inferences from the resulting prediction equations. In addition to evaluating hypotheses about the connections between human activities and biotic responses, we illustrate how the structural equation (SE) model can be queried to understand how interventions might take advantage of an environmental threshold to limit Typha invasions. The guidelines presented provide for

  4. 78 FR 17679 - Implementation of the Updated American Veterinary Medical Association Guidelines for the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-22

    ... Association Guidelines for the Euthanasia of Animals: 2013 Edition SUMMARY: The National Institutes of Health... the American Veterinary Medical Association (AVMA) Guidelines for the Euthanasia of Animals: 2013... updated Guidelines. DATES: Public concerns regarding the updated AVMA Guidelines for the Euthanasia...

  5. Barriers Against Implementing Blunt Abdominal Trauma Guidelines in a Hospital: A Qualitative Study

    PubMed Central

    Zaboli, Rouhollah; Tofighi, Shahram; Aghighi, Ali; Shokouh, Seyyed Javad Hosaini; Naraghi, Nader; Goodarzi, Hassan

    2016-01-01

    Introduction Clinical practice guidelines are structured recommendations that help physicians and patients to make proper decisions when dealing with a specific clinical condition. Because blunt abdominal trauma causes a various range of mild, single-system, and multisystem injuries, early detection will help to reduce mortality and resulting disability. Emergency treatment should be initiated based on CPGs. This study aimed to determine the variables affecting implementing blunt abdominal trauma CPGs in an Iranian hospital. Methods This study was conducted as a qualitative and phenomenology study in the Family Hospital in Tehran (Iran) in 2015. The research population included eight experts and key people in the area of blunt abdominal trauma clinical practice guidelines. Sampling was based on purposive and nonrandom methods. A semistructured interview was done for the data collection. A framework method was applied for the data analysis by using Atlas.ti software. Results After framework analyzing and various reviewing and deleting and combining the codes from 251 codes obtained, 15 families and five super families were extracted, including technical knowledge barriers, economical barriers, barriers related to deployment and monitoring, political will barriers, and managing barriers. Conclusion Structural reform is needed for eliminating the defects available in the healthcare system. As with most of the codes, subconcepts and concepts are classified into the field of human resources; it seems that the education and knowledge will be more important than other resources such as capital and equipment. PMID:27757191

  6. Prevention of catheter-associated urinary tract infection: implementation strategies of international guidelines1

    PubMed Central

    Andrade, Vera Lúcia Fonseca; Fernandes, Filipa Alexandra Veludo

    2016-01-01

    Objective to describe strategies used by health professionals on the implementation of the Centers for Disease Control and Prevention guidelines for the prevention of urinary infection related to catheterism. Method systematic review on literature based on data from CINAHL(r), Nursing & Allied Health Collection, Cochrane Plus Collection, MedicLatina, MEDLINE(r), Academic Search Complete, ACS - American Chemical Society, Health Reference Center Academic, Nursing Reference Center, ScienceDirect Journals and Wiley Online Library. A sample of 13 articles was selected. Results studies have highlighted the decrease of urinary tract infection related to catheterism through reminder systems to decrease of people submitted to urinary catheterism, audits about nursing professionals practice and bundles expansion. Conclusion the present review systemizes the knowledge of used strategies by health professionals on introduction to international recommendations, describing a rate decrease of such infection in clinical practice. PMID:27027676

  7. Measure Guideline: Implementing a Plenum Truss for a Compact Air Distribution System

    SciTech Connect

    Burdick, A.

    2013-10-01

    This Measure Guideline presents the steps to implement a compact duct system inside an attic bulkhead (plenum truss) of a one-story, slab-on-grade home. In a compact duct design, ductwork runs are reduced in length to yield a smaller and more compact duct system. Less energy will be lost through ductwork if the ducts are contained within the thermal enclosure of the house. These measures are intended for the production builder working to meet the 2012 International Energy Conservation Code (IECC) requirements and keep the ductwork within the thermal enclosure of the house. This measure of bringing the heating, ventilation and air conditioning (HVAC) equipment and ductwork within the thermal enclosure of the house is appropriate for the builder wishing to avoid cathedralizing the insulation in the attic space (i.e., locating it at the underside of the roof deck rather than along the attic floor) or adding dropped soffits.

  8. Measure Guideline: Implementing a Plenum Truss for a Compact Air Distribution System

    SciTech Connect

    Burdick, A.

    2013-10-01

    This Measure Guideline presents the steps to implement a compact duct system inside an attic bulkhead (plenum truss) of a one-story, slab-on-grade (SOG) home. In a compact duct design, ductwork runs are reduced in length to yield a smaller and more compact duct system. Less energy will be lost through ductwork if the ducts are contained within the thermal enclosure of the house. These measures are intended for the production builder working to meet the 2012 International Energy Conservation Code (IECC) requirements and keep the ductwork within the thermal enclosure of the house. This measure of bringing the heating, ventilation and air conditioning (HVAC) equipment and ductwork within the thermal enclosure of the house is appropriate for the builder wishing to avoid cathedralizing the insulation in the attic space (i.e., locating it at the underside of the roof deck rather than along the attic floor) or adding dropped soffits.

  9. Implementation of EU discharge guidelines at IVAR's Regional Wastewater Treatment Plant of North Jaeren, Stavanger, Norway.

    PubMed

    Tornes, O

    2001-01-01

    Norway is a leading country on wastewater treatment comprising chemical precipitation processes. This is because Norwegian effluent standards to the North Sea have traditionally focused on phosphorus removal. In most cases, chemical treatment therefore has been considered to give lower investment and operating costs than biological treatment. Norwegian wastewater policy and management is based on the EU guidelines resulting from the EEA (European Economic Area) Agreement. According to the 1991 Urban Wastewater Treatment Directive, this will in most cases require secondary treatment. However, primary treatment can be accepted for plants larger than 10,000 PT with effluents to less sensitive coastal areas, if no negative environmental impacts can be proved. The main objective of the Regional Water, Sewerage and Waste Company (IVAR) is to comply with the prevailing effluent limits at lowest possible cost. During the past four years, IVAR has therefore undertaken comprehensive optimising of the precipitation process including full-scale experiments with different coagulant dosing control systems and different types of coagulants. IVAR also accomplished a feasibility study of introducing biological treatment as an alternative to chemical treatment. Under the prevailing frame conditions of discharge requirements and sludge deposit costs, it is not economically feasible to change to organic coagulants or biological treatment. This conclusion might have to be altered resulting from the implementation of new EU regulations and increasing sludge deposit costs. This paper presents results from full-scale experiments, extracts from the feasibility study and a comparison of costs. Furthermore, the practical consequences of implementing the EU-guidelines are discussed.

  10. Implementing ACCM critical care guidelines for septic shock management in a Cuban pediatric intensive care unit.

    PubMed

    Cartaya, José M; Rovira, Luis E; Segredo, Yamilet; Alvarez, Idalys; Acevedo, Yoandra; Moya, Ariel

    2014-01-01

    INTRODUCTION Sepsis is the most common direct cause of death worldwide and septic shock the syndrome's most serious complication. In 2002, the pediatric intensive care unit of the José Luis Miranda Pediatric University Hospital in Santa Clara (Villa Clara Province), Cuba, began implementing the recently published guidelines of the American College of Critical Care Medicine (ACCM) for management of pediatric and neonatal septic shock, observing a drop in case fatality from 34.6% to 19% between the years 2003 and 2007. ACCM updated these Guidelines in 2007. OBJECTIVE Describe experiences with the use of the 2007 ACCM updated Guidelines and discuss their possible impact in reducing case fatality. METHODS Between 2008 and 2010, a study was conducted of 280 children and adolescents, from newborns through 18 years, admitted to the pediatric intensive care unit with a diagnosis of septic shock. The diagnostic and therapeutic criteria used were those recommended in the ACCM's 2007 updated Guidelines. The dependent variable was case fatality. Independent variables were age, sex, comorbidity or prior chronic disease, origin and course of sepsis, hemodynamic state, blood glucose level, hyperglycemia, organ dysfunction, volume of fluid therapy administered, use of mechanical ventilation and therapeutic response. RESULTS In the 3-year period, 28-day case fatality was 11.1% (31/280). A total of 45 patients had comorbidities, with 14 deaths and a case fatality rate of 31.1% vs. 7.2% (17/235) in previously healthy patients. Cold shock with a hemodynamic state of low cardiac output and high systemic vascular resistance predominated (68.9%), with low cardiac output and low systemic vascular resistance the least common type (12.5%), but the one with highest case fatality (34.4%). Hyperglycemia was present in 39.6% of patients, with 15.3% case fatality; case fatality was higher (25.6%) when hyperglycemia was in the 10-15.9 mmol/L range. Fluid therapy of 40-100 mL/kg was administered

  11. Applying the knowledge to action framework to plan a strategy for implementing breast cancer screening guidelines: an interprofessional perspective.

    PubMed

    Munce, Sarah; Kastner, Monika; Cramm, Heidi; Lal, Shalini; Deschêne, Sarah-Maude; Auais, Mohammad; Stacey, Dawn; Brouwers, Melissa

    2013-09-01

    Integrated knowledge translation (IKT) interventions may be one solution to improving the uptake of clinical guidelines. IKT research initiatives are particularly relevant for breast cancer research and initiatives targeting the implementation of clinical guidelines and guideline implementation initiatives, where collaboration with an interdisciplinary team of practitioners, patients, caregivers, and policy makers is needed for producing optimum patient outcomes. The objective of this paper was to describe the process of developing an IKT strategy that could be used by guideline developers to improve the uptake of their new clinical practice guidelines on breast cancer screening. An interprofessional group of students as well as two faculty members met six times over three days at the KT Canada Summer Institute in 2011. The team used all of the phases of the action cycle in the Knowledge to Action Framework as an organizing framework. While the entire framework was used, the step involving assessing barriers to knowledge use was judged to be particularly relevant in anticipating implementation problems and being able to inform the specific KT interventions that would be appropriate to mitigate these challenges and to accomplish goals and outcomes. This activity also underscored the importance of group process and teamwork in IKT. We propose that an a priori assessment of barriers to knowledge use (i.e., level and corresponding barriers), along with the other phases of the Knowledge to Action Framework, is a strategic approach for KT strategy development, implementation, and evaluation planning and could be used in the future planning of KT strategies.

  12. Visual Image Sensor Organ Replacement: Implementation

    NASA Technical Reports Server (NTRS)

    Maluf, A. David (Inventor)

    2011-01-01

    Method and system for enhancing or extending visual representation of a selected region of a visual image, where visual representation is interfered with or distorted, by supplementing a visual signal with at least one audio signal having one or more audio signal parameters that represent one or more visual image parameters, such as vertical and/or horizontal location of the region; region brightness; dominant wavelength range of the region; change in a parameter value that characterizes the visual image, with respect to a reference parameter value; and time rate of change in a parameter value that characterizes the visual image. Region dimensions can be changed to emphasize change with time of a visual image parameter.

  13. Developing and implementing the Active Design Guidelines in New York City.

    PubMed

    Lee, Karen K

    2012-01-01

    Physical inactivity is a leading cause of death in the United States and globally and is also associated with several additional leading causes of death, including obesity, high blood pressure and high blood glucose. The built environment plays a critical role in promoting or discouraging physical activity among adults and children. To create a healthier and more physically active city, a working group comprising several New York City agencies, including the Departments of Design and Construction, Health and Mental Hygiene, Transportation and City Planning, and in collaboration with design organizations and academics, published the Active Design Guidelines (ADG; ) in January 2010. The ADG is a manual of evidence-based and best-practice strategies for increasing physical activity in the design and construction of neighborhoods, streets and buildings. The commentary discusses key activities and events leading up to the publication as well as current implementation activities. It also shares the lessons learned that could assist other communities interested in improving their built environments in developing and implementing similar activities and initiatives.

  14. Implementation of the NCSS Guidelines for Teaching Science-Related Social Issues: Exemplar Lessons.

    ERIC Educational Resources Information Center

    Otto, Robert A., Ed.

    This document contains the Guidelines for Teaching Science-Related Social Issues adopted in 1982 by the National Council for the Social Studies and 10 examplar lessons each keyed to particular guidelines and drawing upon contemporary issues. The premise upon which the guidelines are based is that science is a social issue and that the examination…

  15. The degenerative spine: pattern recognition and guidelines to image interpretation.

    PubMed

    Parizel, P M; Van Hoyweghen, A J L; Bali, A; Van Goethem, J; Van Den Hauwe, L

    2016-01-01

    Degenerative disease of the spine, in the form of intervertebral disc degeneration and bony growth, causing osteophytes and impinging upon the spinal canal and neural foramina, is the most frequent disorder affecting the spine. In this chapter we first discuss briefly the indications for computed tomography or magnetic resonance imaging in suspected degenerative spine disease. We then describe changes of disc height, signal intensity, and disc contour with aging and repeated microtrauma, as well as the imaging techniques most appropriate to image them. A grading system for lumbar disc changes is provided. Stenosis of the canal and neural foramina is reviewed next, concluding with a description of degenerative changes affecting the vertebral endplates and bone marrow.

  16. The degenerative spine: pattern recognition and guidelines to image interpretation.

    PubMed

    Parizel, P M; Van Hoyweghen, A J L; Bali, A; Van Goethem, J; Van Den Hauwe, L

    2016-01-01

    Degenerative disease of the spine, in the form of intervertebral disc degeneration and bony growth, causing osteophytes and impinging upon the spinal canal and neural foramina, is the most frequent disorder affecting the spine. In this chapter we first discuss briefly the indications for computed tomography or magnetic resonance imaging in suspected degenerative spine disease. We then describe changes of disc height, signal intensity, and disc contour with aging and repeated microtrauma, as well as the imaging techniques most appropriate to image them. A grading system for lumbar disc changes is provided. Stenosis of the canal and neural foramina is reviewed next, concluding with a description of degenerative changes affecting the vertebral endplates and bone marrow. PMID:27430442

  17. Guideline report. Medical ultrasound imaging: progress and opportunities.

    PubMed

    Burns, M

    1989-01-01

    Utilization of medical ultrasound has expanded rapidly during the past several years. In 1988, sales of ultrasound equipment will approach $600 million, which is higher than any other individual imaging modality, including the most capital intensive, such as magnetic resonance imaging (MRI), computed tomography (CT), and cath lab angiography. This growth would have been difficult to predict previously, since ultrasound appeared to be a relatively mature imaging modality not too long ago. There are several reasons for this growth. Technological developments have been quite rapid; ultrasound has become easier to use, image quality has improved dramatically, and diagnostic accuracy has been enhanced. There has been a proliferation of new equipment at all ends of the price spectrum, allowing the user a wide choice in instrument performance, multi-function capabilities, and automated features to increase patient throughput. The DRG environment and the prospect for more pre-admission tests have also been a stimulus. Hospital buying activity has expanded, and many more ultrasound exams are now being conducted on an outpatient basis. Sales to freestanding imaging centers and individual physicians have similarly increased. The hospital user is willing to pay a large premium for advanced technical performance and is prepared to retire or replace older technology in less than three years. This replacement cycle is much shorter than the four to five year period which existed prior to 1985. By comparison, some of the more traditional imaging areas, such as radiology, have replacement rates of eight to ten years. The reason for early replacement is obvious. Ultrasound exams in hospitals generate revenues at a rate that justifies the purchase of the most advanced equipment. It also improves the referral rate and positions the hospital as a high quality provider. Even with low utilization rates, an ultrasound instrument can normally pay for itself in less than one year of regular

  18. EANM procedural guidelines for radionuclide myocardial perfusion imaging with SPECT and SPECT/CT: 2015 revision.

    PubMed

    Verberne, Hein J; Acampa, Wanda; Anagnostopoulos, Constantinos; Ballinger, Jim; Bengel, Frank; De Bondt, Pieter; Buechel, Ronny R; Cuocolo, Alberto; van Eck-Smit, Berthe L F; Flotats, Albert; Hacker, Marcus; Hindorf, Cecilia; Kaufmann, Philip A; Lindner, Oliver; Ljungberg, Michael; Lonsdale, Markus; Manrique, Alain; Minarik, David; Scholte, Arthur J H A; Slart, Riemer H J A; Trägårdh, Elin; de Wit, Tim C; Hesse, Birger

    2015-11-01

    Since the publication of the European Association of Nuclear Medicine (EANM) procedural guidelines for radionuclide myocardial perfusion imaging (MPI) in 2005, many small and some larger steps of progress have been made, improving MPI procedures. In this paper, the major changes from the updated 2015 procedural guidelines are highlighted, focusing on the important changes related to new instrumentation with improved image information and the possibility to reduce radiation exposure, which is further discussed in relation to the recent developments of new International Commission on Radiological Protection (ICRP) models. Introduction of the selective coronary vasodilator regadenoson and the use of coronary CT-contrast agents for hybrid imaging with SPECT/CT angiography are other important areas for nuclear cardiology that were not included in the previous guidelines. A large number of minor changes have been described in more detail in the fully revised version available at the EANM home page: http://eanm.org/publications/guidelines/2015_07_EANM_FINAL_myocardial_perfusion_guideline.pdf .

  19. EANM procedural guidelines for radionuclide myocardial perfusion imaging with SPECT and SPECT/CT: 2015 revision.

    PubMed

    Verberne, Hein J; Acampa, Wanda; Anagnostopoulos, Constantinos; Ballinger, Jim; Bengel, Frank; De Bondt, Pieter; Buechel, Ronny R; Cuocolo, Alberto; van Eck-Smit, Berthe L F; Flotats, Albert; Hacker, Marcus; Hindorf, Cecilia; Kaufmann, Philip A; Lindner, Oliver; Ljungberg, Michael; Lonsdale, Markus; Manrique, Alain; Minarik, David; Scholte, Arthur J H A; Slart, Riemer H J A; Trägårdh, Elin; de Wit, Tim C; Hesse, Birger

    2015-11-01

    Since the publication of the European Association of Nuclear Medicine (EANM) procedural guidelines for radionuclide myocardial perfusion imaging (MPI) in 2005, many small and some larger steps of progress have been made, improving MPI procedures. In this paper, the major changes from the updated 2015 procedural guidelines are highlighted, focusing on the important changes related to new instrumentation with improved image information and the possibility to reduce radiation exposure, which is further discussed in relation to the recent developments of new International Commission on Radiological Protection (ICRP) models. Introduction of the selective coronary vasodilator regadenoson and the use of coronary CT-contrast agents for hybrid imaging with SPECT/CT angiography are other important areas for nuclear cardiology that were not included in the previous guidelines. A large number of minor changes have been described in more detail in the fully revised version available at the EANM home page: http://eanm.org/publications/guidelines/2015_07_EANM_FINAL_myocardial_perfusion_guideline.pdf . PMID:26290421

  20. Taking the next step to privacy compliance for hospitals: implementing the OHA guidelines.

    PubMed

    Beardwood, John

    2003-01-01

    The recently released "Guidelines for Managing Privacy, Data Protection and Security for Ontario Hospitals," prepared by the Ontario Hospital eHealth Council Privacy and Security Working Group (the "Guidelines") are useful in that they provide a comprehensive overview of the types of issues raised for hospitals by existing and pending privacy legislation, and a very high-level framework for addressing same. However, the Guidelines are, as stated high-level guidelines only,--leaving hospital management to grapple with the next big step towards privacy compliance: how to operationalize the Guidelines within their particular hospital. PMID:14674181

  1. Outcomes of an Independent Review and Guidelines for the Implementation of a Program Review Model. Volume II. Technical Report.

    ERIC Educational Resources Information Center

    Carvell Education Managment Planning, Inc., Los Angeles, CA.

    The second part of a report on a comprehensive review of the credit instructional programs offered by Pasadena City College (PCC), this volume contains a technical description of the data collection and assembly procedures used in the program review and provides guidelines for the implementation of the program review model. The first section…

  2. Outcomes of Implementing an Evidence-Based Hypertension Clinical Guideline in an Academic Nurse Managed Health Center.

    PubMed

    Dyal, Brenda; Whyte, Maria; Blankenship, S Michele; Ford, Lynn Gallagher

    2016-02-01

    This column shares the best evidence-based strategies and innovative ideas on how to facilitate the learning and implementation of EBP principles and processes by clinicians as well as nursing and interprofessional students. Guidelines for submission are available at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1741-6787. PMID:26765990

  3. 77 FR 61735 - Changes and Examination Guidelines To Implement the First-Inventor-to-File Provisions of the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-11

    ... for Implementing the First-Inventor-to-File Provisions of the Leahy-Smith America Invents Act, 77 FR... written comments in response to the notice of proposed rulemaking published July 26, 2012 (77 FR 43742) and notice of proposed examination guidelines published July 26, 2012 (77 FR 43759) is November...

  4. Adapted Physical Education, Occupational Therapy and Physical Therapy in Special Education Programs in Colorado: Guidelines for Implementation.

    ERIC Educational Resources Information Center

    Colorado State Dept. of Education, Denver. Div. of Special Education Services.

    The guidelines address implementation of related services (adapted physical education, occupational therapy, and physical therapy) in Colorado special education programs. The first section considers factors in organizing services: the legal mandate of P.L. 94-142, the Education for All Handicapped Children Act; characteristics and professional…

  5. Quality Improvement Guidelines for Imaging Detection and Treatment of Endoleaks following Endovascular Aneurysm Repair (EVAR)

    SciTech Connect

    Rand, T.; Uberoi, R.; Cil, B.; Munneke, G.; Tsetis, D.

    2013-02-15

    Major concerns after aortic aneurysm repair are caused by the presence of endoleaks, which are defined as persistent perigraft flow within the aortic aneurysm sac. Diagnosis of endoleaks can be performed with various imaging modalities, and indications for treatment are based on further subclassifications. Early detection and correct classification of endoleaks are crucial for planning patient management. The vast majority of endoleaks can be treated successfully by interventional means. Guidelines for Imaging Detection and Treatment of endoleaks are described in this article.

  6. Barriers of Clinical Practice Guidelines Development and Implementation in Developing Countries: A Case Study in Iran

    PubMed Central

    Baradaran-Seyed, Zahra; Nedjat, Sima; Yazdizadeh, Bahareh; Nedjat, Saharnaz; Majdzadeh, Reza

    2013-01-01

    Background: Knowledge products such as clinical practice guidelines (CPG) are vitally required for evidence-based medicine (EBM). Although the EBM, to some extent, has been attended during recent years, no result has achieved thus far. The current qualitative study is to identify the barriers to establishing development system and implementation of CPGs in Iran. Methods: Twelve semi-structured, in-depth interviews were conducted with a purposive sample of health policy and decision makers, the experts of development and or adaptation of CPGs, and the experts of EBM education and development. In addition, 11 policy-makers, decision-makers, and managers of the health system participated in a focus group discussion. The analysis of the study data was undertaken by thematic framework approach. Result: Six themes emerged in order of their frequency include practice environment, evidence-based health care system, individual professional, politician and political context, innovation (CPG) and patients. Most of the indications in the treatment environment focused on such sub-themes as regulations and rules, economical factors, organizational context, and social context. While the barriers related to the conditions of treatment environment, service provider and the features of innovation and patients had been identified before in other studies, very little attention has been paid to the evidence-based health care system and politician and political context Conclusion: The lack of an evidence-based healthcare system and a political macro support are mentioned as the key barriers in Iran as a developing country. The establishment of a system of development and implementation of CPGs as the evidence-based practice tools will not be possible, unless the barriers are removed. PMID:23626892

  7. Implementation of curriculum guidelines for pharmacology and pharmacotherapeutics in FNP graduate programs: a national survey.

    PubMed

    Morris, N S; Possidente, C J; Muskus, C

    2001-01-01

    Model Pharmacology and Pharmacotherapeutics Curriculum Guidelines were developed by the National Council of State Boards of Nursing and the National Organization of Nurse Practitioner Faculties and published in 1998. To date, no publication of evaluation of adoption or adherence to these guidelines is available. The purpose of this survey was to determine how family nurse practitioner programs incorporate the guidelines into their curriculum. A mailed self-report questionnaire to 193 schools yielded a 41% response rate. Eighty-five percent (n = 68) of the programs have not yet fully integrated the guidelines into their curriculum. Difficulties addressing the extensive content within a 3-credit course and the challenges of teaching students with varied clinical backgrounds and knowledge levels were frequently cited. Although further study of achievement of the guidelines is necessary, an increase in credit allocation, consideration of a conceptual approach to the topic, and use of varied teaching strategies may make achievement of the guidelines more realistic.

  8. Social work with suicidal clients: challenges of implementing practice guidelines and standards of care.

    PubMed

    Callahan, J

    1996-11-01

    Practice guidelines and standards of care are detailed models of intervention processes that describe goals, objectives, processes procedures, and interactions. Disciplines other than social work have developed practice guidelines, and it is appropriate for social work to also define standards or guidelines. This article describes an attempt by hospital social work staff to enact social work standards of care for suicidal clients. The difficulties and challenge of developing standards and guidelines are discussed and reasons for the lack of success of the attempt are highlighted.

  9. The impact of postpartum haemorrhage management guidelines implemented in clinical practice: a systematic review of the literature.

    PubMed

    Nadisauskiene, Ruta J; Kliucinskas, Mindaugas; Dobozinskas, Paulius; Kacerauskiene, Justina

    2014-07-01

    Postpartum haemorrhage (PPH) is an urgent obstetric condition requiring an immediate response and a multidisciplinary approach. The aim of this study was to review PPH management guidelines implemented in clinical practice, to evaluate their impact regarding prevention, diagnosis and treatment, and to analyze how the numbers of PPH cases changed in the post-intervention period. A systematic search in the PubMed database was performed. The references of all included articles were examined. Studies evaluating the management of PPH and the impact on the numbers of cases of this pathology after the implementation of new or updated guidelines were involved in the analysis. Two reviewers independently examined the titles and abstracts of all identified citations, selected potentially eligible studies, and evaluated their full-text versions. Methodological quality was assessed using a checklist based on the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement. We analyzed seven articles that evaluated the impact of new or updated guidelines for PPH management implemented in clinical practice. In four trials, the numbers of PPH cases declined after the intervention. Guidelines for PPH management can have a positive impact on the reduction of the number of PPH cases.

  10. Implementation of Multispectral Image Classification on a Remote Adaptive Computer

    NASA Technical Reports Server (NTRS)

    Figueiredo, Marco A.; Gloster, Clay S.; Stephens, Mark; Graves, Corey A.; Nakkar, Mouna

    1999-01-01

    As the demand for higher performance computers for the processing of remote sensing science algorithms increases, the need to investigate new computing paradigms its justified. Field Programmable Gate Arrays enable the implementation of algorithms at the hardware gate level, leading to orders of m a,gnitude performance increase over microprocessor based systems. The automatic classification of spaceborne multispectral images is an example of a computation intensive application, that, can benefit from implementation on an FPGA - based custom computing machine (adaptive or reconfigurable computer). A probabilistic neural network is used here to classify pixels of of a multispectral LANDSAT-2 image. The implementation described utilizes Java client/server application programs to access the adaptive computer from a remote site. Results verify that a remote hardware version of the algorithm (implemented on an adaptive computer) is significantly faster than a local software version of the same algorithm implemented on a typical general - purpose computer).

  11. CEOS Land Surface Imaging Constellation Mid-Resolution Optical Guidelines

    NASA Technical Reports Server (NTRS)

    Keyes, Jennifer P.; Killough, B.

    2011-01-01

    The LSI community of users is large and varied. To reach all these users as well as potential instrument contributors this document has been organized by measurement parameters of interest such as Leaf Area Index and Land Surface Temperature. These measurement parameters and the data presented in this document are drawn from multiple sources, listed at the end of the document, although the two primary ones are "The Space-Based Global Observing System in 2010 (GOS-2010)" that was compiled for the World Meteorological Organization (WMO) by Bizzarro Bizzarri, and the CEOS Missions, Instruments, and Measurements online database (CEOS MIM). For each measurement parameter the following topics will be discussed: (1) measurement description, (2) applications, (3) measurement spectral bands, and (4) example instruments and mission information. The description of each measurement parameter starts with a definition and includes a graphic displaying the relationships to four general land surface imaging user communities: vegetation, water, earth, and geo-hazards, since the LSI community of users is large and varied. The vegetation community uses LSI data to assess factors related to topics such as agriculture, forest management, crop type, chlorophyll, vegetation land cover, and leaf or canopy differences. The water community analyzes snow and lake cover, water properties such as clarity, and body of water delineation. The earth community focuses on minerals, soils, and sediments. The geo-hazards community is designed to address and aid in emergencies such as volcanic eruptions, forest fires, and large-scale damaging weather-related events.

  12. Novice Designers' Myths about Usability Sessions: Guidelines To Implementing User-Centered Design Principles.

    ERIC Educational Resources Information Center

    Sugar, William A.

    1999-01-01

    Details myths that illustrate novice instructional designers' perspectives on usability sessions and their users. Then offers suggestions for integrating creativity and developing enhanced perspective-taking. Two tables list the myths and guidelines, and potential effects of usability-session guidelines on novice designers' myths are charted. (AEF)

  13. Implementing a guideline for the treatment of type 2 diabetics: results of a Cluster- Randomized Controlled Trial (C-RCT)

    PubMed Central

    Perria, Carla; Mandolini, Donatella; Guerrera, Carmelina; Jefferson, Tom; Billi, Paolo; Calzini, Virgilio; Fiorillo, Alfonso; Grasso, Giuseppe; Leotta, Sergio; Marrocco, Walter; Suraci, Concetta; Pasquarella, Amina

    2007-01-01

    Background In Italy many diabetics still lack adequate care in general practice. We assessed the effectiveness of different strategies for the implementation of an evidence-based guideline for the management of non-complicated type 2 diabetes among General Practitioners (GPs) of Lazio region. Methods Three-arm cluster-randomised controlled trial with GPs as units of randomisation (clusters). 252 GPs were randomised either to an active strategy (training module with administration of the guideline), or to a passive dissemination (administration of the guideline only), or to usual care (control). Data on prescriptions of tests and drugs were collected by existing information systems, whereas patients' data came from GPs' databases. Process outcomes were measured at the cluster level one year after the intervention. Primary outcomes concerned the measurement of glycosilated haemoglobin and the commissioning of micro- and macrovascular complications assessment tests. In order to assess the physicians' drug prescribing behaviour secondary outcomes were also calculated. Results GPs identified 6395 uncomplicated type 2 patients with a high prevalence of cardiovascular risk factors. Data on GPs baseline performance show low proportions of glycosilated haemoglobin assessments. Results of the C-RCT analysis indicate that the active implementation strategy was ineffective relating to all primary outcomes (respectively, OR 1.06 [95% IC: 0.76–1.46]; OR 1.07 [95% IC: 0.80–1.43]; OR 1.4 [95% IC:0.91–2.16]. Similarly, passive dissemination of the guideline showed no effect. Conclusion In our region compliance of GPs with guidelines was not enhanced by a structured learning programme. Implementation through organizational measures appears to be essential to induce behavioural changes. Trial registration ISRCTN80116232 PMID:17547760

  14. Knowledge and Implementation of the S3 Guideline on Gestational Diabetes among Gynecologists and Diabetologists Four Years after Publication

    PubMed Central

    Groten, T.; Schmitz, S.; Schippert, C.; Schleußner, E.; Hillemanns, P.; Lehmann, T.; von Versen-Höynck, F.

    2016-01-01

    Background: An S3 guideline on the diagnosis and differentiated management of gestational diabetes (GDM) was published in Germany in 2011. This guideline replaced the previously applicable recommendations for the diagnosis and treatment of GDM and, for the first time, compiled evidence-based recommendations for the care of patients with GDM. The new guideline has focused particularly on the counselling offered to all patients with GDM about the associated long-term health risks. In this study we investigated the state of knowledge about the guideline among gynecologists and diabetologists in Thuringia and Lower Saxony. Method: A questionnaire with 23 questions was sent out to 773 gynecologists and 76 diabetologists providing outpatient care in Lower Saxony and Thuringia. The statistical analysis was descriptive and inferential for comparisons between groups. Results: The response rate was 54 %; an average of 47.6 % of the individual questions were answered correctly in the completed questionnaires. The questions were answered correctly significantly more frequently by persons in the group with a good knowledge of the guidelines (75 vs. 61 %, p < 0.001). There were no significant differences between groups when differences between federal states or medical specialties were compared. Conclusions: The results of our study show a good general state of knowledge of the guideline and point to a high level of willingness to implement the recommendations of the S3 guideline on GDM. With regard to the follow-up care provided to patients with GDM and depression, this study found a significant need for further training. PMID:27582574

  15. Medical Physics Practice Guideline 4.a: Development, implementation, use and maintenance of safety checklists.

    PubMed

    Fong de Los Santos, Luis E; Evans, Suzanne; Ford, Eric C; Gaiser, James E; Hayden, Sandra E; Huffman, Kristina E; Johnson, Jennifer L; Mechalakos, James G; Stern, Robin L; Terezakis, Stephanie; Thomadsen, Bruce R; Pronovost, Peter J; Fairobent, Lynne A

    2015-05-08

    The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States.The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner.Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized.The following terms are used in the AAPM practice guidelines:Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline.Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances.

  16. IMPLEmenting a clinical practice guideline for acute low back pain evidence-based manageMENT in general practice (IMPLEMENT): Cluster randomised controlled trial study protocol

    PubMed Central

    McKenzie, Joanne E; French, Simon D; O'Connor, Denise A; Grimshaw, Jeremy M; Mortimer, Duncan; Michie, Susan; Francis, Jill; Spike, Neil; Schattner, Peter; Kent, Peter M; Buchbinder, Rachelle; Green, Sally E

    2008-01-01

    Background Evidence generated from reliable research is not frequently implemented into clinical practice. Evidence-based clinical practice guidelines are a potential vehicle to achieve this. A recent systematic review of implementation strategies of guideline dissemination concluded that there was a lack of evidence regarding effective strategies to promote the uptake of guidelines. Recommendations from this review, and other studies, have suggested the use of interventions that are theoretically based because these may be more effective than those that are not. An evidence-based clinical practice guideline for the management of acute low back pain was recently developed in Australia. This provides an opportunity to develop and test a theory-based implementation intervention for a condition which is common, has a high burden, and for which there is an evidence-practice gap in the primary care setting. Aim This study aims to test the effectiveness of a theory-based intervention for implementing a clinical practice guideline for acute low back pain in general practice in Victoria, Australia. Specifically, our primary objectives are to establish if the intervention is effective in reducing the percentage of patients who are referred for a plain x-ray, and improving mean level of disability for patients three months post-consultation. Methods/Design This study protocol describes the details of a cluster randomised controlled trial. Ninety-two general practices (clusters), which include at least one consenting general practitioner, will be randomised to an intervention or control arm using restricted randomisation. Patients aged 18 years or older who visit a participating practitioner for acute non-specific low back pain of less than three months duration will be eligible for inclusion. An average of twenty-five patients per general practice will be recruited, providing a total of 2,300 patient participants. General practitioners in the control arm will receive access

  17. The College of American Pathologists guidelines for whole slide imaging validation are feasible for pediatric pathology: a pediatric pathology practice experience.

    PubMed

    Arnold, Michael A; Chenever, Emily; Baker, Peter B; Boué, Daniel R; Fung, Bonita; Hammond, Sue; Hendrickson, Brett W; Kahwash, Samir B; Pierson, Christopher R; Prasad, Vinay; Nicol, Kathleen K; Barr, Thomas

    2015-01-01

    Whole slide imaging (WSI) is rapidly transforming educational and diagnostic pathology services. Recently, the College of American Pathologists Pathology and Laboratory Quality Center (CAP-PLQC) published recommended guidelines for validating diagnostic WSI. We prospectively evaluated the guidelines to determine their utility in validating pediatric surgical pathology and cytopathology specimens. Our validation included varied pediatric specimen types, including complex or less common diagnoses, in accordance with the guidelines. We completed WSI review of 60 surgical pathology cases and attempted WSI review of 21 cytopathology cases. For surgical pathology cases, WSI diagnoses were highly concordant with glass slide diagnoses; a discordant diagnosis was observed in 1 of 60 cases (98.3% concordance). We found that nucleated red blood cells and eosinophilic granular bodies represented specific challenges to WSI review of pediatric specimens. Cytology specimens were more frequently discordant or failed for technical reasons, with overall concordance of 66.7%. Review of pediatric cytopathology specimens will likely require image capture in multiple focal planes. This study is the first to specifically evaluate WSI review for pediatric specimens and demonstrates that specimens representing the spectrum of pediatric surgical pathology practice can be reviewed using WSI. Our application of the proposed CAP-PLQC guidelines to pediatric surgical pathology specimens is, to our knowledge, the first prospective implementation of the CAP-PLQC guidelines.

  18. Quality improvement for neonatal nurses, part II: using a PDSA quality improvement cycle approach to implement an oral feeding progression guideline for premature infants.

    PubMed

    Marcellus, Lenora; Harrison, Adele; Mackinnon, Kathleen

    2012-01-01

    The development of clinical practice guidelines involving multiple health care providers presents a challenge in the neonatal intensive care unit (NICU). Implementation and evaluation of the guideline is as important as the development of the guideline itself. We explored the use of a quality improvement approach in the implementation of a feeding framework. A Plan-Do-Study-Act (PDSA) quality improvement cycle model was used to implement and evaluate a stepwise oral infant feeding guideline with emphasis on parent and care provider satisfaction. Three PDSA cycles were conducted, with each cycle resulting in modifications to use of the framework and development of knowledge translation and parent education techniques and tools. A PDSA cycle approach can be used effectively in guideline implementation and evaluation involving multidisciplinary health care professionals. This is Part II of a two-part series. Part I introduced the concept of quality improvement and tools for advancing practice changes.

  19. Clinical Development and Implementation of an Institutional Guideline for Prospective EEG Monitoring and Reporting of Delayed Cerebral Ischemia.

    PubMed

    Muniz, Carlos F; Shenoy, Apeksha V; OʼConnor, Kathryn L; Bechek, Sophia C; Boyle, Emily J; Guanci, Mary M; Tehan, Tara M; Zafar, Sahar F; Cole, Andrew J; Patel, Aman B; Westover, Michael B; Rosenthal, Eric S

    2016-06-01

    Delayed cerebral ischemia (DCI) is the most common and disabling complication among patients admitted to the hospital for subarachnoid hemorrhage (SAH). Clinical and radiographic methods often fail to detect DCI early enough to avert irreversible injury. We assessed the clinical feasibility of implementing a continuous EEG (cEEG) ischemia monitoring service for early DCI detection as part of an institutional guideline. An institutional neuromonitoring guideline was designed by an interdisciplinary team of neurocritical care, clinical neurophysiology, and neurosurgery physicians and nursing staff and cEEG technologists. The interdisciplinary team focused on (1) selection criteria of high-risk patients, (2) minimization of safety concerns related to prolonged monitoring, (3) technical selection of quantitative and qualitative neurophysiologic parameters based on expert consensus and review of the literature, (4) a structured interpretation and reporting methodology, prompting direct patient evaluation and iterative neurocritical care, and (5) a two-layered quality assurance process including structured clinician interviews assessing events of neurologic worsening and an adjudicated consensus review of neuroimaging and medical records. The resulting guideline's clinical feasibility was then prospectively evaluated. The institutional SAH monitoring guideline used transcranial Doppler ultrasound and cEEG monitoring for vasospasm and ischemia monitoring in patients with either Fisher group 3 or Hunt-Hess grade IV or V SAH. Safety criteria focused on prevention of skin breakdown and agitation. Technical components included monitoring of transcranial Doppler ultrasound velocities and cEEG features, including quantitative alpha:delta ratio and percent alpha variability, qualitative evidence of new focal slowing, late-onset epileptiform activity, or overall worsening of background. Structured cEEG reports were introduced including verbal communication for findings concerning

  20. Clinical Development and Implementation of an Institutional Guideline for Prospective EEG Monitoring and Reporting of Delayed Cerebral Ischemia.

    PubMed

    Muniz, Carlos F; Shenoy, Apeksha V; OʼConnor, Kathryn L; Bechek, Sophia C; Boyle, Emily J; Guanci, Mary M; Tehan, Tara M; Zafar, Sahar F; Cole, Andrew J; Patel, Aman B; Westover, Michael B; Rosenthal, Eric S

    2016-06-01

    Delayed cerebral ischemia (DCI) is the most common and disabling complication among patients admitted to the hospital for subarachnoid hemorrhage (SAH). Clinical and radiographic methods often fail to detect DCI early enough to avert irreversible injury. We assessed the clinical feasibility of implementing a continuous EEG (cEEG) ischemia monitoring service for early DCI detection as part of an institutional guideline. An institutional neuromonitoring guideline was designed by an interdisciplinary team of neurocritical care, clinical neurophysiology, and neurosurgery physicians and nursing staff and cEEG technologists. The interdisciplinary team focused on (1) selection criteria of high-risk patients, (2) minimization of safety concerns related to prolonged monitoring, (3) technical selection of quantitative and qualitative neurophysiologic parameters based on expert consensus and review of the literature, (4) a structured interpretation and reporting methodology, prompting direct patient evaluation and iterative neurocritical care, and (5) a two-layered quality assurance process including structured clinician interviews assessing events of neurologic worsening and an adjudicated consensus review of neuroimaging and medical records. The resulting guideline's clinical feasibility was then prospectively evaluated. The institutional SAH monitoring guideline used transcranial Doppler ultrasound and cEEG monitoring for vasospasm and ischemia monitoring in patients with either Fisher group 3 or Hunt-Hess grade IV or V SAH. Safety criteria focused on prevention of skin breakdown and agitation. Technical components included monitoring of transcranial Doppler ultrasound velocities and cEEG features, including quantitative alpha:delta ratio and percent alpha variability, qualitative evidence of new focal slowing, late-onset epileptiform activity, or overall worsening of background. Structured cEEG reports were introduced including verbal communication for findings concerning

  1. Computerization of workflows, guidelines, and care pathways: a review of implementation challenges for process-oriented health information systems

    PubMed Central

    Roudsari, Abdul

    2011-01-01

    Objective There is a need to integrate the various theoretical frameworks and formalisms for modeling clinical guidelines, workflows, and pathways, in order to move beyond providing support for individual clinical decisions and toward the provision of process-oriented, patient-centered, health information systems (HIS). In this review, we analyze the challenges in developing process-oriented HIS that formally model guidelines, workflows, and care pathways. Methods A qualitative meta-synthesis was performed on studies published in English between 1995 and 2010 that addressed the modeling process and reported the exposition of a new methodology, model, system implementation, or system architecture. Thematic analysis, principal component analysis (PCA) and data visualisation techniques were used to identify and cluster the underlying implementation ‘challenge’ themes. Results One hundred and eight relevant studies were selected for review. Twenty-five underlying ‘challenge’ themes were identified. These were clustered into 10 distinct groups, from which a conceptual model of the implementation process was developed. Discussion and conclusion We found that the development of systems supporting individual clinical decisions is evolving toward the implementation of adaptable care pathways on the semantic web, incorporating formal, clinical, and organizational ontologies, and the use of workflow management systems. These architectures now need to be implemented and evaluated on a wider scale within clinical settings. PMID:21724740

  2. Unconventional methods of imaging: computational microscopy and compact implementations

    NASA Astrophysics Data System (ADS)

    McLeod, Euan; Ozcan, Aydogan

    2016-07-01

    In the past two decades or so, there has been a renaissance of optical microscopy research and development. Much work has been done in an effort to improve the resolution and sensitivity of microscopes, while at the same time to introduce new imaging modalities, and make existing imaging systems more efficient and more accessible. In this review, we look at two particular aspects of this renaissance: computational imaging techniques and compact imaging platforms. In many cases, these aspects go hand-in-hand because the use of computational techniques can simplify the demands placed on optical hardware in obtaining a desired imaging performance. In the first main section, we cover lens-based computational imaging, in particular, light-field microscopy, structured illumination, synthetic aperture, Fourier ptychography, and compressive imaging. In the second main section, we review lensfree holographic on-chip imaging, including how images are reconstructed, phase recovery techniques, and integration with smart substrates for more advanced imaging tasks. In the third main section we describe how these and other microscopy modalities have been implemented in compact and field-portable devices, often based around smartphones. Finally, we conclude with some comments about opportunities and demand for better results, and where we believe the field is heading.

  3. Unconventional methods of imaging: computational microscopy and compact implementations.

    PubMed

    McLeod, Euan; Ozcan, Aydogan

    2016-07-01

    In the past two decades or so, there has been a renaissance of optical microscopy research and development. Much work has been done in an effort to improve the resolution and sensitivity of microscopes, while at the same time to introduce new imaging modalities, and make existing imaging systems more efficient and more accessible. In this review, we look at two particular aspects of this renaissance: computational imaging techniques and compact imaging platforms. In many cases, these aspects go hand-in-hand because the use of computational techniques can simplify the demands placed on optical hardware in obtaining a desired imaging performance. In the first main section, we cover lens-based computational imaging, in particular, light-field microscopy, structured illumination, synthetic aperture, Fourier ptychography, and compressive imaging. In the second main section, we review lensfree holographic on-chip imaging, including how images are reconstructed, phase recovery techniques, and integration with smart substrates for more advanced imaging tasks. In the third main section we describe how these and other microscopy modalities have been implemented in compact and field-portable devices, often based around smartphones. Finally, we conclude with some comments about opportunities and demand for better results, and where we believe the field is heading.

  4. Unconventional methods of imaging: computational microscopy and compact implementations.

    PubMed

    McLeod, Euan; Ozcan, Aydogan

    2016-07-01

    In the past two decades or so, there has been a renaissance of optical microscopy research and development. Much work has been done in an effort to improve the resolution and sensitivity of microscopes, while at the same time to introduce new imaging modalities, and make existing imaging systems more efficient and more accessible. In this review, we look at two particular aspects of this renaissance: computational imaging techniques and compact imaging platforms. In many cases, these aspects go hand-in-hand because the use of computational techniques can simplify the demands placed on optical hardware in obtaining a desired imaging performance. In the first main section, we cover lens-based computational imaging, in particular, light-field microscopy, structured illumination, synthetic aperture, Fourier ptychography, and compressive imaging. In the second main section, we review lensfree holographic on-chip imaging, including how images are reconstructed, phase recovery techniques, and integration with smart substrates for more advanced imaging tasks. In the third main section we describe how these and other microscopy modalities have been implemented in compact and field-portable devices, often based around smartphones. Finally, we conclude with some comments about opportunities and demand for better results, and where we believe the field is heading. PMID:27214407

  5. Effectiveness of an implementation strategy for a breastfeeding guideline in Primary Care: cluster randomised trial

    PubMed Central

    2011-01-01

    Background The protection and promotion of breastfeeding is considered a priority in Europe where only 22% of infants less than 6 months old are exclusively breastfed. In Spain this percentage reaches 24.8% but in our city it falls to 18.26%. Various studies emphasise that the improvement of these results should be based upon the training of health professionals. Following the recommendations of a breastfeeding guide can modify the practice of health professionals and improve results with respect to exclusively or predominatly breastfed children at 6 months of age. Method/Design This study involves a community based cluster randomized trial in primary healthcare centres in Leganés (Madrid, Spain). The project aims to determine whether the use of an implementation strategy (including training session, information distribution, opinion leader) of a breastfeeding guideline in primary care is more effective than usual diffusion. The number of patients required will be 240 (120 in each arm). It will be included all the mothers of infants born during the study period (6 months) who come to the health centre on the first visit of the child care programme and who give their consent to participate. The main outcome variable is the exclusive o predominant breastfeeding at 6 moths of age.. Main effectiveness will be analyzed by comparing the percentage of infants with exclusive or predominant breastfeeding at 6 months between the intervention group and the control group. All statistical tests will be performed with intention to treat. Logistic regression with random effects will be used to adjust for prognostic factors. Confounding factors or factors that might alter the effect recorded will be taken into account in this analysis. Discussion Strategies need to be found which facilitate the giving of effective advice on breastfeeding by professionals and which provide support to women during the breastfeeding period. By applying the guide's recommendations, clinical

  6. Implementing KDOQI CKD definition and staging guidelines in Southern California Kaiser Permanente.

    PubMed

    Rutkowski, Mark; Mann, Wendy; Derose, Stephen; Selevan, David; Pascual, Noel; Diesto, Jean; Crooks, Peter

    2009-03-01

    We outline the experience of Southern California Kaiser Permanente, a large integrated health maintenance organization, in implementing the chronic kidney disease (CKD) definition and staging guidelines of the Kidney Disease Outcomes Quality Initiative (KDOQI) from 2002 to 2008, including estimated glomerular filtration rate (eGFR) implementation, algorithm for GFR range assignment and reassignment, and practical modifications of CKD staging for population management. We departed from the KDOQI CKD definition and staging as follows: for stages 1 to 2, we required "macroproteinuria" rather than "microalbuminuria" as the marker of kidney damage; for stage 3, we included individuals with macroproteinuria, diabetes mellitus based on diabetic registry, or eGFR + 1/2 age less than 85; and for stage 5, we included only individuals not receiving renal replacement therapy. In an adult population of 2.5 million members, we identified 2.9% (72,005) for CKD population management (0.1%, 0.2%, 1.7%, 0.15%, and 0.01% with stages 1, 2, 3, 4, and 5, respectively). Outpatient visits with a nephrologist in the past 12 months for the prevalent CKD population increased modestly from 2003 to 2008 from 20% to 24%. Nephrologists see a higher risk subset, including 77% of patients with stages 4 to 5, 45% of prevalent patients with CKD stages 1 to 5 with the last urine protein level greater than approximately 1 g, and 21% of patients with stage 3 in the past 12 months, but only 4% of patients with eGFR of 30 to 59 mL/min/1.73 m(2) not meeting our criteria for stage 3. Primary care providers see the majority of patients with stages 1 to 5 in the course of a year (85%) and are aware of kidney disease (79% coded for kidney disease). Other quality indicators during the 12-month window include the following: for patients with prevalent CKD stages 1 to 5, a total of 56% with last blood pressure greater than 129/79 mm Hg, 21% missing qualitative proteinuria, 16% missing angiotensin

  7. A high performance hardware implementation image encryption with AES algorithm

    NASA Astrophysics Data System (ADS)

    Farmani, Ali; Jafari, Mohamad; Miremadi, Seyed Sohrab

    2011-06-01

    This paper describes implementation of a high-speed encryption algorithm with high throughput for encrypting the image. Therefore, we select a highly secured symmetric key encryption algorithm AES(Advanced Encryption Standard), in order to increase the speed and throughput using pipeline technique in four stages, control unit based on logic gates, optimal design of multiplier blocks in mixcolumn phase and simultaneous production keys and rounds. Such procedure makes AES suitable for fast image encryption. Implementation of a 128-bit AES on FPGA of Altra company has been done and the results are as follow: throughput, 6 Gbps in 471MHz. The time of encrypting in tested image with 32*32 size is 1.15ms.

  8. [How to write, how to implement and how to evaluate a practice guideline in order to improve quality of care?].

    PubMed

    Moret, L; Lefort, C; Terrien, N

    2012-11-01

    Initiatives of clinical practices improvement have been gradually developing in France for 20 years. Nevertheless, effective implementation of change is still difficult for numerous reasons. The use of clinical practices guidelines is one of the different ways of improvement. It is however necessary to adapt these national guidelines to the specificities of the hospital and the team, to ensure implementation and appropriation by the professionals. These recommendations are thus translated into applicable and concrete standard operating procedures. These documents have to be built by and for the concerned professionals. They are also communication and training tools, precise, directive, uniform in terms of presentation and attractive visually. Once drafted, they have to be distributed widely to the professionals to facilitate implementation. The simple distribution of the recommendations is insufficient to modify the clinical practices and require association of several methods of promotion for an optimal appropriation. How then to make sure of their effective use? Practices evaluation is one of the steps of continuous professional development, including continuous training and analysis of clinical practices by using methods promoted by the "Haute Autorité de santé". One of them is the clinical audit; use of method assessing non-pertinent treatment is interesting too. Analysis of the non-conformities and gaps between theory and practice allows identifying various possible causes (professional, institutional, organizational or personal) in order to implement corrective action plans, in a logic of continuous improvement. PMID:23039956

  9. One Rural Hospital's Experience Implementing the Society for Healthcare Epidemiology of America Guidelines to Decrease Central Line Infections.

    PubMed

    Curlej, Maria H; Katrancha, Elizabeth

    2016-01-01

    In an effort to take advantage of the Highmark Quality Blue Initiative () requiring information from hospitals detailing their central line-associated blood stream infections (CLABSIs) surveillance system, quality improvement program, and statistics regarding the CLABSI events, this institution investigated the latest evidence-based recommendations to reduce CLABSIs. Recognizing the baseline rate of 2.4 CLABSIs per 1,000 central line days and its effect on patient outcomes and medical costs, this hospital made a commitment to improve their CLABSI outcomes. As a result, the facility adopted the Society for Healthcare Epidemiology of America (SHEA) guidelines. The purpose of this article is to review the CLABSI rates and examine the prevention strategies following implementation of the SHEA guidelines. A quantitative, descriptive retrospective program evaluation examined the hospital's pre- and post-SHEA implementation methods of decreasing CLABSIs and the subsequent CLABSI rates over 3 time periods. Any patient with a CLABSI infection admitted to this hospital July 2007 to June 2010 (N = 78). CLABSI rates decreased from 1.9 to 1.3 over the study period. Compliance with specific SHEA guidelines was evaluated and measures were put into place to increase compliance where necessary. CLABSI rates at this facility remain below the baseline of 2.4 for calendar year 2013 (0.79), 2014 (0.07), and 2015 (0.33). PMID:27618377

  10. Toward public health nutrition strategies in the European Union to implement food based dietary guidelines and to enhance healthier lifestyles.

    PubMed

    Stockley, L

    2001-04-01

    This paper suggests strategies for implementing the EU food based dietary guidelines. Dietary guidelines have been developed and disseminated in many countries across the world. However, the EU guidelines are the first to include a specific section on implementation. The aims of the guidelines are twofold, 1) to provide food based dietary guidelines which can be used as a consistent communication tool and 2) as a springboard to planning, implementing, and evaluating public health nutrition strategies. The report is not intended to be prescriptive. It aims to build upon a solid evidence base to provide practical and cost effective suggestions for developing public health strategies, which member countries can use and tailor to the social, cultural and health needs of their populations. Diet and physical activity related diseases impose vast costs on the European economy. However, despite the enormous costs to healthcare systems and in terms of lost productivity, there have been a very few resources allocated in Europe to attempting to prevent these, rather than treating them. The burden of disease exists in the majority of the population, and not in high-risk groups. The optimal public health strategy is thus to focus on the population as a whole, rather than targeting those with increased risk factors or pre-existing disease. Reviews have been carried out on the health impact effectiveness of various types of intervention to promote healthy eating and physical activity in the population. These conclude that the most effective interventions a) adopt an integrated, multidisciplinary, and comprehensive approach b) involve a complementary range of actions, and c) work at an individual, community, environmental and policy level. Information provision in isolation is not effective, and may exacerbate inequalities in health. In some countries inequities in diet and physical activity are not only significant contributors to inequalities in health, but are increasing

  11. Implementation of a novel floating-image display system having a background of multiview integral images

    NASA Astrophysics Data System (ADS)

    Hong, Suk-Pyo; Oh, Yong-Seok; Shin, Dong-Hak; Kim, Eun-Soo

    2007-09-01

    A floating-image display technique, which can project two-dimensional images into a real space through a convex lens or a concave mirror, has been studied as a new approach for implementation of the next-generation three-dimensional (3D) display system. However, the conventional floating-image display system was implemented just by using active display devices such as LCD panel and it could provide only a real plane image in space to an observer comparing with other 3D display systems having different perspectives. For practical application of a floating-image display system to 3D display systems, multi-layered display structure might be required to present multi-depth images in space. In this paper, a novel floating-image display system composed of two plane images with different depth by use of a half mirror is proposed. One plane image of an object is provided with the conventional floating-image display system to present and the other plane image of a background is provided with the integral imaging technique. Therefore, the proposed display system can provide high-resolution floating images with background images having different perspectives to observers. To show the usefulness of the proposed system, some experiments are carried out and the results are presented as well.

  12. Guidelines from the Canadian Association of Pathologists for establishing a telepathology service for anatomic pathology using whole-slide imaging.

    PubMed

    Bernard, Chantal; Chandrakanth, S A; Cornell, Ian Scott; Dalton, James; Evans, Andrew; Garcia, Bertha M; Godin, Chris; Godlewski, Marek; Jansen, Gerard H; Kabani, Amin; Louahlia, Said; Manning, Lisa; Maung, Raymond; Moore, Lisa; Philley, Joanne; Slatnik, Jack; Srigley, John; Thibault, Alain; Picard, Donald Daniel; Cracower, Hanah; Tetu, Bernard

    2014-01-01

    The use of telepathology for clinical applications in Canada has steadily become more attractive over the last 10 years, driven largely by its potential to provide rapid pathology consulting services throughout the country regardless of the location of a particular institution. Based on this trend, the president of the Canadian Association of Pathologists asked a working group consisting of pathologists, technologists, and healthcare administrators from across Canada to oversee the development of guidelines to provide Canadian pathologists with basic information on how to implement and use this technology. The guidelines were systematically developed, based on available medical literature and the clinical experience of early adopters of telepathology in Canada. While there are many different modalities and applications of telepathology, this document focuses specifically on whole-slide imaging as applied to intraoperative pathology consultation (frozen section), primary diagnosis, expert or second opinions and quality assurance activities. Applications such as hematopathology, microbiology, tumour boards, education, research and technical and/or standard-related issues are not covered. PMID:24843826

  13. Guidelines from the Canadian Association of Pathologists for establishing a telepathology service for anatomic pathology using whole-slide imaging

    PubMed Central

    Bernard, Chantal; Chandrakanth, S. A.; Cornell, Ian Scott; Dalton, James; Evans, Andrew; Garcia, Bertha M.; Godin, Chris; Godlewski, Marek; Jansen, Gerard H.; Kabani, Amin; Louahlia, Said; Manning, Lisa; Maung, Raymond; Moore, Lisa; Philley, Joanne; Slatnik, Jack; Srigley, John; Thibault, Alain; Picard, Donald Daniel; Cracower, Hanah; Tetu, Bernard

    2014-01-01

    The use of telepathology for clinical applications in Canada has steadily become more attractive over the last 10 years, driven largely by its potential to provide rapid pathology consulting services throughout the country regardless of the location of a particular institution. Based on this trend, the president of the Canadian Association of Pathologists asked a working group consisting of pathologists, technologists, and healthcare administrators from across Canada to oversee the development of guidelines to provide Canadian pathologists with basic information on how to implement and use this technology. The guidelines were systematically developed, based on available medical literature and the clinical experience of early adopters of telepathology in Canada. While there are many different modalities and applications of telepathology, this document focuses specifically on whole-slide imaging as applied to intraoperative pathology consultation (frozen section), primary diagnosis, expert or second opinions and quality assurance activities. Applications such as hematopathology, microbiology, tumour boards, education, research and technical and/or standard-related issues are not covered. PMID:24843826

  14. Guidelines from the Canadian Association of Pathologists for establishing a telepathology service for anatomic pathology using whole-slide imaging.

    PubMed

    Bernard, Chantal; Chandrakanth, S A; Cornell, Ian Scott; Dalton, James; Evans, Andrew; Garcia, Bertha M; Godin, Chris; Godlewski, Marek; Jansen, Gerard H; Kabani, Amin; Louahlia, Said; Manning, Lisa; Maung, Raymond; Moore, Lisa; Philley, Joanne; Slatnik, Jack; Srigley, John; Thibault, Alain; Picard, Donald Daniel; Cracower, Hanah; Tetu, Bernard

    2014-01-01

    The use of telepathology for clinical applications in Canada has steadily become more attractive over the last 10 years, driven largely by its potential to provide rapid pathology consulting services throughout the country regardless of the location of a particular institution. Based on this trend, the president of the Canadian Association of Pathologists asked a working group consisting of pathologists, technologists, and healthcare administrators from across Canada to oversee the development of guidelines to provide Canadian pathologists with basic information on how to implement and use this technology. The guidelines were systematically developed, based on available medical literature and the clinical experience of early adopters of telepathology in Canada. While there are many different modalities and applications of telepathology, this document focuses specifically on whole-slide imaging as applied to intraoperative pathology consultation (frozen section), primary diagnosis, expert or second opinions and quality assurance activities. Applications such as hematopathology, microbiology, tumour boards, education, research and technical and/or standard-related issues are not covered.

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

    ERIC Educational Resources Information Center

    Hahn, H. A.; And Others

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

  16. Guidelines for the Implementation of Programs for Pupils Who Are Orthopedically Handicapped.

    ERIC Educational Resources Information Center

    Black, Robert S.; Fusco, Carol B.

    Guidelines are provided for the development of programs in South Carolina for orthopedically handicapped (OH) pupils. Basic information is given concerning the definition of orthopedic handicap, the legal mandates on the education of OH pupils, funding sources, authorized programs (whether self-contained programs, resource rooms, or itinerant…

  17. State Guidelines for Implementation of Chapter 1, Public Law 97-35.

    ERIC Educational Resources Information Center

    Florida State Dept. of Education, Tallahassee.

    The purpose of these guidelines is to provide Florida's school districts with some procedures for developing projects and programs that will meet the letter and intent of Chapter 1 of the Education Consolidation and Improvement Act of 1981. This document addresses: (1) allowable costs; (2) personnel; (3) fiscal requirements that apply to all…

  18. Diagnostic Yield of Chromosomal Microarray Analysis in an Autism Primary Care Practice: Which Guidelines to Implement?

    ERIC Educational Resources Information Center

    McGrew, Susan G.; Peters, Brittany R.; Crittendon, Julie A.; Veenstra-VanderWeele, Jeremy

    2012-01-01

    Genetic testing is recommended for patients with ASD; however specific recommendations vary by specialty. American Academy of Pediatrics and American Academy of Neurology guidelines recommend G-banded karyotype and Fragile X DNA. The American College of Medical Genetics recommends Chromosomal Microarray Analysis (CMA). We determined the yield of…

  19. Supportive Services for Special Needs Students in Mainstreamed Vocational Education Programs: Guidelines for Implementation.

    ERIC Educational Resources Information Center

    National Evaluation Systems, Inc., Amherst, MA.

    Designed for vocational instructors and local school administrative personnel, these guidelines suggest ways for improving the vocational education of mainstreamed special needs students by providing supportive services to best meet visually handicapped, orthepedically impaired, seriously emotionally disturbed, or learning disabled). The first of…

  20. An Implementation Strategy to Improve the Guideline Adherence of Insurance Physicians: A Process Evaluation Alongside an Experiment in a Controlled Setting

    ERIC Educational Resources Information Center

    Zwerver, Feico; Bonefaas-Groenewoud, Karin; Schellart, Antonius J. M.; Anema, Johannes R.; van der Beek, Allard J.

    2013-01-01

    Background: We developed an implementation strategy for the insurance medicine guidelines for depression, which we implemented via a post-graduate course for insurance physicians (IPs). In this study we evaluate the physicians' experiences of the implementation strategy by measuring the following aspects: recruitment and reach, dose delivered and…

  1. Economic Evaluation of Active Implementation versus Guideline Dissemination for Evidence-Based Care of Acute Low-Back Pain in a General Practice Setting

    PubMed Central

    Mortimer, Duncan; French, Simon D.; McKenzie, Joanne E.; O′Connor, Denise A.; Green, Sally E.

    2013-01-01

    Introduction The development and publication of clinical practice guidelines for acute low-back pain has resulted in evidence-based recommendations that have the potential to improve the quality and safety of care for acute low-back pain. Development and dissemination of guidelines may not, however, be sufficient to produce improvements in clinical practice; further investment in active implementation of guideline recommendations may be required. Further research is required to quantify the trade-off between the additional upfront cost of active implementation of guideline recommendations for low-back pain and any resulting improvements in clinical practice. Methods Cost-effectiveness analysis alongside the IMPLEMENT trial from a health sector perspective to compare active implementation of guideline recommendations via the IMPLEMENT intervention (plus standard dissemination) against standard dissemination alone. Results The base-case analysis suggests that delivery of the IMPLEMENT intervention dominates standard dissemination (less costly and more effective), yielding savings of $135 per x-ray referral avoided (-$462.93/3.43). However, confidence intervals around point estimates for the primary outcome suggest that – irrespective of willingness to pay (WTP) – we cannot be at least 95% confident that the IMPLEMENT intervention differs in value from standard dissemination. Conclusions Our findings demonstrate that moving beyond development and dissemination to active implementation entails a significant additional upfront investment that may not be offset by health gains and/or reductions in health service utilization of sufficient magnitude to render active implementation cost-effective. PMID:24146767

  2. Burden of diabetic foot disorders, guidelines for management and disparities in implementation in Europe: a systematic literature review.

    PubMed

    van Acker, Kristien; Léger, Philippe; Hartemann, Agnes; Chawla, Abhineet; Siddiqui, Mohd Kashif

    2014-11-01

    The study aimed to assess the economic and quality of life burden of diabetic foot disorders and to identify disparities in the recommendations from guidelines and the current clinical practice across the EU5 (Spain, Italy, France, UK and Germany) countries. Literature search of electronic databases (MEDLINE®, Embase® and Cochrane Database of Systematic Reviews) was undertaken. English language studies investigating economic and resource burden, quality of life and management of diabetic foot disease in the EU5 countries were included. Additionally, websites were screened for guidelines and current management practices in diabetic foot complication in EU5. Diabetic foot complications accounted for a total annual cost of €509m in the UK and €430 per diabetic patient in Germany, during 2001. The cost of diabetic foot complications increased with disease severity, with hospitalizations (41%) and amputation (9%) incurring 50% of the cost. Medical devices (orthopaedic shoes, shoe lifts and walking aids) were the most frequently utilized resources. Patients with diabetic foot complications experienced worsened quality of life, especially in those undergoing amputations and with non-healed ulcers or recurrent ulcers. Although guidelines advocate the use of multidisciplinary foot care teams, the utilization of multidisciplinary foot care teams was suboptimal. We conclude that diabetic foot disorders demonstrated substantial economic burden and have detrimental effect on quality of life, with more impairment in physical domain. Implementation of the guidelines and set-up of multidisciplinary clinics for holistic management of the diabetic foot disorders varies across Europe and remains suboptimal. Hence, guidelines need to be reinforced to prevent diabetic foot complications and to achieve limb salvage if complications are unpreventable.

  3. Computed Tomography Image Compressibility and Limitations of Compression Ratio-Based Guidelines.

    PubMed

    Pambrun, Jean-François; Noumeir, Rita

    2015-12-01

    Finding optimal compression levels for diagnostic imaging is not an easy task. Significant compressibility variations exist between modalities, but little is known about compressibility variations within modalities. Moreover, compressibility is affected by acquisition parameters. In this study, we evaluate the compressibility of thousands of computed tomography (CT) slices acquired with different slice thicknesses, exposures, reconstruction filters, slice collimations, and pitches. We demonstrate that exposure, slice thickness, and reconstruction filters have a significant impact on image compressibility due to an increased high frequency content and a lower acquisition signal-to-noise ratio. We also show that compression ratio is not a good fidelity measure. Therefore, guidelines based on compression ratio should ideally be replaced with other compression measures better correlated with image fidelity. Value-of-interest (VOI) transformations also affect the perception of quality. We have studied the effect of value-of-interest transformation and found significant masking of artifacts when window is widened. PMID:25804842

  4. Justification of CT examinations in young adults and children can be improved by education, guideline implementation and increased MRI capacity

    PubMed Central

    Oikarinen, H; Pääkkö, E; Karttunen, A; Blanco Sequeiros, R; Tervonen, O

    2013-01-01

    Objective: To determine whether the justification of CT examinations performed on young patients can be improved by various interventions and whether these have an effect on the total number of CTs performed. Methods: Specific interventions—education, guideline implementation and increased MRI capacity—were introduced at the Oulu University Hospital, Oulu, Finland, following a previous study demonstrating unjustified use of CT examination in young patients. In the present study, the justification of 177 CT examinations of the lumbar and cervical spine, head, abdomen, nasal sinuses and trauma performed on patients aged under 35 years in 2009 was analysed retrospectively by looking at requests and corresponding patient files. The indications of the examinations were compared with the referral guidelines recommended by the European Commission. Results from our previously published similar study carried out before the interventions were used as a reference. Results: The proportion of justified CT examinations increased from 71% (141/200) in 2005 to 87% (154/177) in 2009 (p<0.001), and in the lumbar spine group from 23% (7/30) to 81% (22/27) (p<0.001). In the case of most of the unjustified examinations, MRI could have been performed instead. The total number of CT examinations carried out on young patients decreased by 7% (p=0.012) and in the lumbar spine group by 79% (p<0.001). Conclusion: The implemented interventions decreased the number of CT examinations performed on young patients, and the justification of the examinations improved significantly. Advances in knowledge: This study demonstrates that it is possible to reduce the number of various CT examinations and to improve their justification in young patients by regular education, guideline implementation and increased MRI capacity. PMID:23934962

  5. Opinion leaders vs audit and feedback to implement practice guidelines. Delivery after previous cesarean section.

    PubMed

    Lomas, J; Enkin, M; Anderson, G M; Hannah, W J; Vayda, E; Singer, J

    1991-05-01

    A randomized controlled trial with 76 physicians in 16 community hospitals evaluated audit and feedback and local opinion leader education as methods of encouraging compliance with a guideline for the management of women with a previous cesarean section. The guideline recommended clinical actions to increase trial of labor and vaginal birth rates. Charts for all 3552 cases in the study groups were audited. After 24 months the trial of labor and vaginal birth rates in the audit and feedback group were no different from those in the control group, but rates were 46% and 85% higher, respectively, among physicians educated by an opinion leader. Duration of hospital stay was lower in the opinion leader education group than in the other two groups. The overall cesarean section rate was reduced only in the opinion leader education group. There were no adverse clinical outcomes attributable to the interventions. The use of opinion leaders improved the quality of care. PMID:2013952

  6. Implementation of RCGP guidelines for acute low back pain: a cluster randomised controlled trial.

    PubMed Central

    Dey, Paola; Simpson, Carl W R; Collins, Stuart I; Hodgson, G; Dowrick, Christopher F; Simison, A J M; Rose, M J

    2004-01-01

    BACKGROUND: The Royal College of General Practitioners (RCGP) has produced guidelines for the management of acute low back pain in primary care. AIM: To investigate the impact on patient management of an educational strategy to promote these guidelines among general practitioners (GPs). DESIGN OF STUDY: Group randomised controlled trial, using the health centre as the unit of randomisation. SETTING: Primary care teams in north-west England. METHOD: Twenty-four health centres were randomly allocated to an intervention or control arm. Practices in the intervention arm were offered outreach visits to promote national guidelines on acute low back pain, as well as access to fast-track physiotherapy and to a triage service for patients with persistent symptoms. RESULTS: Twenty-four centres were randomised. Two thousand, one hundred and eighty-seven eligible patients presented with acute low back pain during the study period: 1049 in the intervention group and 1138 in the control group. There were no significant differences between study groups in the proportion of patients who were referred for X-ray, issued with a sickness certificate, prescribed opioids or muscle relaxants, or who were referred to secondary care, but significantly more patients in the intervention group were referred to physiotherapy or the back pain unit (difference in proportion = 12.2%, 95% confidence interval [CI] = 2.8% to 21.6%). CONCLUSION: The management of patients presenting with low back pain to primary care was mostly unchanged by an outreach educational strategy to promote greater adherence to RCGP guidelines among GPs. An increase in referral to physiotherapy or educational programmes followed the provision of a triage service. PMID:14965404

  7. Drug Utilization, Dosing, and Costs After Implementation of Intravenous Acetaminophen Guidelines for Pediatric Patients

    PubMed Central

    Fusco, Nicholas M.; Parbuoni, Kristine; Morgan, Jill A.

    2014-01-01

    OBJECTIVES The objectives of this evaluation of medication use were to characterize the use of intravenous acetaminophen at our institution and to determine if acetaminophen was prescribed at age-appropriate dosages per institutional guidelines, as well as to evaluate compliance with restrictions for use. Total acquisition costs associated with intravenous acetaminophen usage is described as well. METHODS This retrospective study evaluated the use of acetaminophen in pediatric patients younger than 18 years of age, admitted to a tertiary care hospital, who received at least 1 dose of intravenous acet-aminophen between August 1, 2011, and January 31, 2012. RESULTS A total of 52 doses of intravenous acetaminophen were administered to 31 patients during the 6-month study period. Most patients were admitted to the otorhinolaryngology service (55%), and the majority of doses were administered either in the operating room (46%) or in the intensive care unit (46%). Nineteen doses (37%) of intravenous acetaminophen were administered to patients who did not meet institutional guidelines' eligibility criteria. Three patients received single doses of intravenous acetaminophen that were greater than the dose recommended for their age. One patient during the study period received more than the recommended 24-hour maximum cumulative dose for acetaminophen. Total acquisition cost of intravenous acetaminophen therapy over the 6-month study period was $530.40. CONCLUSIONS Intravenous acetaminophen was used most frequently among pediatric patients admitted to the otorhinolaryngology service during the perioperative period. Nineteen doses (37%) were administered to patients who did not meet the institutional guidelines' eligibility criteria. Our data support reinforcing the availability of institutional guidelines to promote cost-effective use of intravenous acetaminophen while minimizing the prescription of inappropriate doses. PMID:24782690

  8. The clinical pharmacogenetics implementation consortium guideline for SLCO1B1 and simvastatin-induced myopathy: 2014 update.

    PubMed

    Ramsey, L B; Johnson, S G; Caudle, K E; Haidar, C E; Voora, D; Wilke, R A; Maxwell, W D; McLeod, H L; Krauss, R M; Roden, D M; Feng, Q; Cooper-DeHoff, R M; Gong, L; Klein, T E; Wadelius, M; Niemi, M

    2014-10-01

    Simvastatin is among the most commonly used prescription medications for cholesterol reduction. A single coding single-nucleotide polymorphism, rs4149056T>C, in SLCO1B1 increases systemic exposure to simvastatin and the risk of muscle toxicity. We summarize evidence from the literature supporting this association and provide therapeutic recommendations for simvastatin based on SLCO1B1 genotype. This article is an update to the 2012 Clinical Pharmacogenetics Implementation Consortium guideline for SLCO1B1 and simvastatin-induced myopathy.

  9. Clinical Pharmacogenetics Implementation Consortium Guidelines for Cytochrome P450 2D6 Genotype and Codeine Therapy: 2014 Update

    PubMed Central

    Crews, K R; Gaedigk, A; Dunnenberger, H M; Leeder, J S; Klein, T E; Caudle, K E; Haidar, C E; Shen, D D; Callaghan, J T; Sadhasivam, S; Prows, C A; Kharasch, E D; Skaar, T C

    2014-01-01

    Codeine is bioactivated to morphine, a strong opioid agonist, by the hepatic cytochrome P450 2D6 (CYP2D6); hence, the efficacy and safety of codeine are governed by CYP2D6 activity. Polymorphisms are a major cause of CYP2D6 variability. We summarize evidence from the literature supporting this association and provide therapeutic recommendations for codeine based on CYP2D6 genotype. This document is an update to the 2012 Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines for CYP2D6 genotype and codeine therapy. PMID:24458010

  10. Implementation of Image-Guidance Techniques in Radiation Therapy

    NASA Astrophysics Data System (ADS)

    Thomas, Michael; Clark, Brenda; MacPherson, Miller; Montgomery, Lynn; Gerig, Lee

    2008-06-01

    For more than 100 years, physicists have been a vital part of the medical team required to deliver radiation therapy. Their role encompasses the verification of dose accuracy to the development and implementation of new techniques, the most recent of which is the incorporation of daily image guidance to account for inter- and intra-fraction target changes. For example, computed tomography (CT) integrated into radiotherapy treatment units allows the image-guided treatment of the prostate where the target location depends on the degree of rectal filling--a parameter that changes on timescales from minutes to weeks. Different technology is required for the adequate treatment of small lung tumours since respiration occurs on timescales of seconds. This presentation will review current image-guided techniques.

  11. Measure Guideline. Five Steps to Implement the Public Housing Authority Energy-Efficient Unit Turnover Checklist

    SciTech Connect

    Liaukus, Christine

    2015-07-09

    Five Steps to Implementing the PHA Energy Efficient Unit Turnover Package (ARIES, 2014) is a guide to prepare for the installation of energy efficient measures during a typical public housing authority unit turnover. While a PHA is cleaning, painting and readying a unit for a new resident, there is an opportunity to incorporate energy efficiency measures to further improve the unit's performance. The measures on the list are simple enough to be implemented by in-house maintenance personnel, inexpensive enough to be folded into operating expenses without needing capital budget, and fast enough to implement without substantially changing the number of days between occupancies, a critical factor for organizations where the demand for dwelling units far outweighs the supply. The following guide lays out a five step plan to implement the EE Unit Turnover Package in your PHA, from an initial Self-Assessment through to Package Implementation.

  12. Guidelines for youth sports clubs to develop, implement, and assess health promotion within its activities.

    PubMed

    Kokko, Sami

    2014-05-01

    The settings approach to health promotion is a world-known concept concerning settings like city, hospital, school, and workplace. The concept has also been used in some regionally specific settings, such as island, prison, or university. However, there are still many, often noninstitutional, settings that have a lot of potential but have not yet been recognized. One of the newcomers is the youth sports club, which has the potential to reach a lot of children and adolescents and is effective, via its casual educational nature based on voluntary participation. According to research, health is an important aim for most youth sports clubs, but it has not been converted into practical actions. Indeed, the clubs often recognize the importance of healthy lifestyles, but there is a lack of understanding of what to do to reinforce it within one's activities. That is why, on the basis of the results of the Health Promoting Sports Club survey in Finland, guidelines for clubs to enhance health promotion as a part of their activities were created. The aim of this article is to present the guidelines, theirs rationale, and practical examples. PMID:24357861

  13. Challenges in implementing the new BASHH guidelines for the management of gonorrhoea.

    PubMed

    Rodgers, S; Murgatroyd, M; Perez, K; Kingston, M; Lee, V

    2014-02-01

    Neisseria gonorrhoeae has progressively developed reduced sensitivity to different classes of antibiotics. The British Association for Sexual Health and HIV (BASHH) updated guidelines for the diagnosis and management of gonorrhoea in 2011. New recommendations include an increased dose of ceftriaxone with adjuvant use of azithromycin, as well as test of cure (TOC) in all cases. We present an audit of adherence to new antibiotic prescribing guidelines as well as TOC uptake in an inner city genitourinary medicine clinic. Among the 271 (242 male, 29 female) patients included, 96% (n = 260) received the new first-line treatment. Test of cure uptake was found to be suboptimal at 55% (n = 149) with the majority (67%) of these taking place within 20 days of treatment. The new first-line treatment for gonorrhoea is feasible and generally accepted by patients. However the TOC uptake is low, emphasising the need for robust follow-up and recall policies. Further study is required into the optimal timing for TOC.

  14. Guidelines for youth sports clubs to develop, implement, and assess health promotion within its activities.

    PubMed

    Kokko, Sami

    2014-05-01

    The settings approach to health promotion is a world-known concept concerning settings like city, hospital, school, and workplace. The concept has also been used in some regionally specific settings, such as island, prison, or university. However, there are still many, often noninstitutional, settings that have a lot of potential but have not yet been recognized. One of the newcomers is the youth sports club, which has the potential to reach a lot of children and adolescents and is effective, via its casual educational nature based on voluntary participation. According to research, health is an important aim for most youth sports clubs, but it has not been converted into practical actions. Indeed, the clubs often recognize the importance of healthy lifestyles, but there is a lack of understanding of what to do to reinforce it within one's activities. That is why, on the basis of the results of the Health Promoting Sports Club survey in Finland, guidelines for clubs to enhance health promotion as a part of their activities were created. The aim of this article is to present the guidelines, theirs rationale, and practical examples.

  15. 75 FR 61504 - Global Implementation of the Veterinary Medicinal Products Guidelines

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-05

    ... HUMAN SERVICES Food and Drug Administration Global Implementation of the Veterinary Medicinal Products... OIE's services and activities that are needed to carry out OIE's Veterinary International Conference... level. FOR FURTHER INFORMATION CONTACT: Program Contact: Merton V. Smith, Center for Veterinary...

  16. Adopting and implementing nutrition guidelines in recreational facilities: Public and private sector roles. A multiple case study

    PubMed Central

    2012-01-01

    Background Recreational facilities are an important community resource for health promotion because they provide access to affordable physical activities. However, despite their health mandate, many have unhealthy food environments that may paradoxically increase the risk of childhood obesity. The Alberta Nutrition Guidelines for Children and Youth (ANGCY) are government-initiated, voluntary guidelines intended to facilitate children’s access to healthy food and beverage choices in schools, childcare and recreational facilities, however few recreational facilities are using them. Methods We used mixed methods within an exploratory multiple case study to examine factors that influenced adoption and implementation of the ANGCY and the nature of the food environment within three cases: an adopter, a semi-adopter and a non-adopter of the ANGCY. Diffusion of Innovations theory provided the theoretical platform for the study. Qualitative data were generated through interviews, observations, and document reviews, and were analysed using directed content analysis. Set theoretic logic was used to identify factors that differentiated adopters from the non-adopter. Quantitative sales data were also collected, and the quality of the food environment was scored using four complementary tools. Results The keys to adoption and implementation of nutrition guidelines in recreational facilities related to the managers’ nutrition-related knowledge, beliefs and perceptions, as these shaped his decisions and actions. The manager, however, could not accomplish adoption and implementation alone. Intersectoral linkages with schools and formal, health promoting partnerships with industry were also important for adoption and implementation to occur. The food environment in facilities that had adopted the ANGCY did not appear to be superior to the food environment in facilities that had not adopted the ANGCY. Conclusions ANGCY uptake may continue to falter under the current voluntary

  17. Hematopoietic cell transplantation for mucopolysaccharidosis patients is safe and effective: results after implementation of international guidelines.

    PubMed

    Aldenhoven, Mieke; Jones, Simon A; Bonney, Denise; Borrill, Roisin E; Coussons, Mary; Mercer, Jean; Bierings, Marc B; Versluys, Birgitta; van Hasselt, Peter M; Wijburg, Frits A; van der Ploeg, Ans T; Wynn, Robert F; Boelens, Jaap Jan

    2015-06-01

    Allogeneic hematopoietic cell transplantation (HCT) is the only treatment able to prevent progressive neurodegenerative disease in a selected group of mucopolysaccharidosis (MPS) disorders. However, its use was historically limited by the high risk of graft failure and transplantation-related morbidity and mortality. Therefore, since 2005 new international HCT guidelines for MPS disorders were proposed. The survival and graft outcomes of MPS patients receiving HCT according to these guidelines in 2 European centers of expertise were evaluated. Two consecutive conditioning regimens were used, busulfan/cyclophosphamide or fludarabine/busulfan-based, both with exposure-targeted i.v. busulfan. A noncarrier matched sibling donor (MSD), matched unrelated cord blood (UCB), or matched unrelated donor (MUD) were considered to be preferred donors. If not available, a mismatched UCB donor was used. Participants were 62 MPS patients (56 MPS type I-Hurler, 2 MPS type II, 2 MPS type III, and 2 MPS type VI) receiving HCT at median age 13.5 months (range, 3 to 44). Forty-one patients received a UCB donor, 17 MSD, and 4 MUD. High overall survival (95.2%) and event-free survival (90.3%) were achieved with only low toxicity: 13.3% acute graft-versus-host disease aGVHD) grades II to IV and 14.8% chronic GVHD (1.9% extensive). A mismatched donor predicted for lower event-free survival (P = .04). A higher age at HCT was a predictor for both aGVHD (P = .001) and chronic GVHD (P = .01). The use of a mismatched donor was a predictor for aGVHD (P = .01). Higher rates of full-donor chimerism were achieved in successfully transplanted UCB recipients compared with MSD/MUD (P = .002). If complying with the international HCT guidelines, HCT in MPS patients results in high safety and efficacy. This allows extension of HCT to more attenuated MPS types. Because a younger age at HCT is associated with reduction of HCT-related toxicity, newborn screening may further increase safety. PMID

  18. Implementation of Guidelines for Effective Fieldwork Designs: Exploring Learning Activities, Learning Processes, and Student Engagement in the Classroom and the Field

    ERIC Educational Resources Information Center

    Remmen, Kari Beate; Frøyland, Merethe

    2014-01-01

    Teachers find the implementation of fieldwork challenging. Therefore, this study investigates two teachers' implementation of theoretical guidelines for student-centered fieldwork activities, following their participation in a professional development course focusing on earth science fieldwork pedagogy. Video observation and instructional…

  19. Implementation of an Evidence-Based Guideline for the Referral of Adults Who Are Visually Impaired in the Netherlands: Potential Barriers

    ERIC Educational Resources Information Center

    Cruysberg, Juliette K.; van Rens, Ger H. M. B.

    2007-01-01

    This article reports on a study on the implementation of an evidence-based guideline for the referral for rehabilitation of adults who are visually impaired in the Netherlands. The purpose of the study was to find out if there are potential barriers to the implementation of the Nederlands Oogheelkundig Gezelschap (NOG) (2004) evidence-based…

  20. DSP Implementation of the Retinex Image Enhancement Algorithm

    NASA Technical Reports Server (NTRS)

    Hines, Glenn; Rahman, Zia-Ur; Jobson, Daniel; Woodell, Glenn

    2004-01-01

    The Retinex is a general-purpose image enhancement algorithm that is used to produce good visual representations of scenes. It performs a non-linear spatial/spectral transform that synthesizes strong local contrast enhancement and color constancy. A real-time, video frame rate implementation of the Retinex is required to meet the needs of various potential users. Retinex processing contains a relatively large number of complex computations, thus to achieve real-time performance using current technologies requires specialized hardware and software. In this paper we discuss the design and development of a digital signal processor (DSP) implementation of the Retinex. The target processor is a Texas Instruments TMS320C6711 floating point DSP. NTSC video is captured using a dedicated frame-grabber card, Retinex processed, and displayed on a standard monitor. We discuss the optimizations used to achieve real-time performance of the Retinex and also describe our future plans on using alternative architectures.

  1. Embedded GPU implementation of anomaly detection for hyperspectral images

    NASA Astrophysics Data System (ADS)

    Wu, Yuanfeng; Gao, Lianru; Zhang, Bing; Yang, Bin; Chen, Zhengchao

    2015-10-01

    Anomaly detection is one of the most important techniques for remotely sensed hyperspectral data interpretation. Developing fast processing techniques for anomaly detection has received considerable attention in recent years, especially in analysis scenarios with real-time constraints. In this paper, we develop an embedded graphics processing units based parallel computation for streaming background statistics anomaly detection algorithm. The streaming background statistics method can simulate real-time anomaly detection, which refer to that the processing can be performed at the same time as the data are collected. The algorithm is implemented on NVIDIA Jetson TK1 development kit. The experiment, conducted with real hyperspectral data, indicate the effectiveness of the proposed implementations. This work shows the embedded GPU gives a promising solution for high-performance with low power consumption hyperspectral image applications.

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

    PubMed Central

    2014-01-01

    Background Clinical practice guidelines are important for transmitting research findings into practice and facilitating the application of evidence-based practice (EBP). There is a paucity of knowledge about the impact of guideline implementation strategies in primary care physical therapy. The aim of this study was to evaluate the effect of a guideline implementation intervention in primary care physical therapy in western Sweden. Methods An implementation strategy based on theory and current evidence was developed. A tailored, multi-component implementation intervention, addressing earlier identified determinants, was carried out in three areas comprising 28 physical therapy practices including 277 physical therapists (PTs) (intervention group). In two adjacent areas, 171 PTs at 32 practices received no intervention (control group). The core component of the intervention was an implementation seminar with group discussions. Among other components were a website and email reminders. Data were collected at baseline and follow-up with a web-based questionnaire. Primary outcomes were the self-reported awareness of, knowledge of, access to, and use of guidelines. Secondary outcomes were self-reported attitudes toward EBP and guidelines. Analyses were performed using Pearson’s χ2 test and approximative z-test. Results 168 PTs (60.6%) in the intervention group and 88 PTs (51.5%) in the control group responded to the follow-up questionnaire. 186/277 PTs (67.1%) participated in the implementation seminars, of which 97 (52.2%) responded. The proportions of PTs reporting awareness of (absolute difference in change 20.6%, p = 0.023), knowledge where to find (20.4%, p = 0.007), access to (21.7%, p < 0.001), and frequent use of (9.5%, NS) guidelines increased more in the intervention group than in the control group. The proportion of PTs reporting frequent guideline use after participation in the implementation seminar was 15.2% (p = 0.043) higher than the

  3. Effectiveness of implementation strategies in improving physician adherence to guideline recommendations in heart failure: a systematic review protocol

    PubMed Central

    Van Spall, Harriette G C; Shanbhag, Deepti; Gabizon, Itzhak; Ibrahim, Quazi; Graham, Ian D; Harlos, Karen; Haynes, R Brian; Connolly, Stuart J

    2016-01-01

    Introduction The uptake of Clinical Practice Guideline (CPG) recommendations that improve outcomes in heart failure (HF) remains suboptimal. We will conduct a systematic review to identify implementation strategies that improve physician adherence to class I recommendations, those with clear evidence that benefits outweigh the risks. We will use American, Canadian and European HF guidelines as our reference. Methods and analysis We will conduct a literature search in the databases of MEDLINE, EMBASE, HEALTHSTAR, CINAHL, Cochrane Library, Campbell Collaboration, Joanna Briggs Institute Evidence Based Practice, Centre for Reviews and Dissemination and Evidence Based Practice Centres. We will include prospective studies evaluating implementation interventions aimed at improving uptake of class I CPG recommendations in HF. We will extract data in duplicate. We will classify interventions according to their level of application (ie, provider, organisation, systems level) and common underlying characteristics (eg, education, decision-support, financial incentives) using the Cochrane Effective Practice and Organisation of Care Taxonomy. We will assess the impact of the intervention on adherence to the CPGs. Outcomes will include proportion of eligible patients who were: prescribed a CPG-recommended pharmacological treatment; referred for device consideration; provided self-care education at discharge; and provided left ventricular function assessment. We will include clinical outcomes such as hospitalisations, readmissions and mortality, if data is available. We will identify the common elements of successful and failing interventions, and examine the context in which they were applied, using the Process Redesign contextual framework. We will synthesise the results narratively and, if appropriate, will pool results for meta-analysis. Discussion and dissemination In this review, we will assess the impact of implementation strategies and contextual factors on physician

  4. Prior image constrained compressed sensing: Implementation and performance evaluation

    PubMed Central

    Lauzier, Pascal Thériault; Tang, Jie; Chen, Guang-Hong

    2012-01-01

    Purpose: Prior image constrained compressed sensing (PICCS) is an image reconstruction framework which incorporates an often available prior image into the compressed sensing objective function. The images are reconstructed using an optimization procedure. In this paper, several alternative unconstrained minimization methods are used to implement PICCS. The purpose is to study and compare the performance of each implementation, as well as to evaluate the performance of the PICCS objective function with respect to image quality. Methods: Six different minimization methods are investigated with respect to convergence speed and reconstruction accuracy. These minimization methods include the steepest descent (SD) method and the conjugate gradient (CG) method. These algorithms require a line search to be performed. Thus, for each minimization algorithm, two line searching algorithms are evaluated: a backtracking (BT) line search and a fast Newton-Raphson (NR) line search. The relative root mean square error is used to evaluate the reconstruction accuracy. The algorithm that offers the best convergence speed is used to study the performance of PICCS with respect to the prior image parameter α and the data consistency parameter λ. PICCS is studied in terms of reconstruction accuracy, low-contrast spatial resolution, and noise characteristics. A numerical phantom was simulated and an animal model was scanned using a multirow detector computed tomography (CT) scanner to yield the projection datasets used in this study. Results: For λ within a broad range, the CG method with Fletcher-Reeves formula and NR line search offers the fastest convergence for an equal level of reconstruction accuracy. Using this minimization method, the reconstruction accuracy of PICCS was studied with respect to variations in α and λ. When the number of view angles is varied between 107, 80, 64, 40, 20, and 16, the relative root mean square error reaches a minimum value for α ≈ 0.5. For

  5. Data structures for multimodality imaging: concepts and implementation

    NASA Astrophysics Data System (ADS)

    Mealha, Oscar E. C.; Sousa Pereira, Antonio; Santos, Maria Beatriz S.

    1992-06-01

    The integration of data coming from different imaging modalities is something to take into account, due to the importance it can have in the development of a fast and reliable diagnosis by the health staff. In the medical imaging field, computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), and single photon emission computed tomography (SPECT) are examples of devices that generate 3-D data. Digital subtraction angiography (DSA) or ultrasound (US) output 2-D data, from which its possible to reconstruct 3-D data. An important fact is that 3-D space is common to all these devices and they are all capable of producing large amounts of data. Prior to display or even data integration, matching the various 3-D spaces has to be achieved with some specific technique, according to the anatomical region under examination. The augmented octree, an extension of the linear octree, is used for data integration; its properties can help to overcome some of the constraints that occur in medical imaging. To be fully accepted by the specialist, the display and manipulation of multimodality data must be interactive and done in real-time, or at least in `nearly' real-time. Parallel architectures seem to be a solution for some computation intensive applications, and so an implementation of the linear octree encoding process was developed on a 16 Transputer machine.

  6. Guidelines to Assist the Implementation of Differentiated Learning Activities in South African Secondary Schools

    ERIC Educational Resources Information Center

    de Jager, Thelma

    2013-01-01

    Despite previous research and recommendations in South Africa, secondary-school teachers still encounter economic, social and cultural challenges in implementing differentiated learning activities in the classroom. The diversity of learners with learning barriers inevitably leads to an increase in workload for the teachers. This article draws on…

  7. Guidelines to implement the license renewal technical requirements of 10CFR54 for integrated plant assessments and time-limited aging analyses. Final report

    SciTech Connect

    Lehnert, G.; Philpot, L.

    1995-11-01

    This report documents the initial results of the Nuclear Energy Institute License Renewal Implementation Guideline Task Force over the period August 1994 to July 1995 to develop guidance for complying with technical requirements of 10CFR54. The report also provided a starting point for the development of NEI 95-10, ``Industry Guideline for Implementing the Requirements of 10CCR54-The License Renewal Rule``. Information in this document can be used by utilities to prepare the technical material needed in an application for license renewal (LR) of a nuclear power unit. This guideline provides methods for identifying systems, structures, and components (SSCs) and their intended functions within the scope of license renewal. It identifies structures and components (SCs) requiring aging management review and methods for performing the aging management review. The guideline provides a process for identifying and evaluating time-limited aging analyses.

  8. Implementing the American Academy of Pediatrics Attention-Deficit/Hyperactivity Disorder Diagnostic Guidelines in Primary Care Settings

    PubMed Central

    Leslie, Laurel K.; Weckerly, Jill; Plemmons, Dena; Landsverk, John; Eastman, Sarita

    2006-01-01

    Objectives To evaluate the feasibility of the San Diego Attention-Deficit/Hyperactivity Disorder Project (SANDAP) protocol, a pediatric community-initiated quality improvement effort to foster implementation of the American Academy of Pediatrics (AAP) attention-deficit/hyperactivity disorder (ADHD) diagnostic guidelines, and to identify any additional barriers to providing evidence-based ADHD evaluative care. Methods Seven research-naïve primary care offices in the San Diego area were recruited to participate. Offices were trained in the SANDAP protocol, which included 1) physician education, 2) a standardized assessment packet for parents and teachers, 3) an ADHD coordinator to assist in collection and collation of the assessment packet components, 4) educational materials for clinicians, parents, and teachers, in the form of handouts and a website, and 5) flowcharts delineating local paths for referral to medical subspecialists, mental health practitioners, and school-based professionals. The assessment packet included the parent and teacher versions of the Vanderbilt ADHD Diagnostic Rating Scales. In this study, we chose a conservative interpretation of the AAP ADHD guidelines for diagnosing ADHD, requiring that a child met criteria for ADHD on both the parent and teacher rating scales. A mixed-method analytic strategy was used to address feasibility and barriers, including quantitative surveys with parents and teachers and qualitative debriefing sessions conducted an average of 3 times per year with pediatricians and office staff members. Results Between December 2000 and April 2003, 159 children were consecutively enrolled for evaluation of school and/or behavioral problems. Clinically, only 44% of the children met criteria for ADHD on both the parent and teacher scales, and 73.5% of those children were categorized as having the combined subtype. More than 40% of the subjects demonstrated discrepant results on the Vanderbilt scales, with only the parent or

  9. Clinical practice guideline dissemination and a new approach using Haddon matrix as a conceptual framework of evidence-based implementation strategies.

    PubMed

    Pang, Peter

    2010-01-01

    To err is human. Clinical practice guidelines (CPGs) are often not followed and lead to adverse outcomes. The issue on implementation of CPG is complex. A review of CPG implementation is done to identify the barriers and enablers. For the first time, a fishbone diagram is used to delineate the root-causes. And Haddon matrix is applied to help understand the complexity of evidence-based implementation (EBI) strategies. PMID:25214934

  10. Clinical practice guideline dissemination and a new approach using Haddon matrix as a conceptual framework of evidence-based implementation strategies.

    PubMed

    Pang, Peter

    2010-01-01

    To err is human. Clinical practice guidelines (CPGs) are often not followed and lead to adverse outcomes. The issue on implementation of CPG is complex. A review of CPG implementation is done to identify the barriers and enablers. For the first time, a fishbone diagram is used to delineate the root-causes. And Haddon matrix is applied to help understand the complexity of evidence-based implementation (EBI) strategies.

  11. Guidelines to implement medical examiner/coroner-based surveillance for fatal infectious diseases and bioterrorism ("Med-X").

    PubMed

    Nolte, Kurt B; Fischer, Marc; Reagan, Sarah; Lynfield, Ruth

    2010-12-01

    Medical examiners and coroners investigate deaths that are sudden, unexplained, and violent. Oftentimes these deaths are a consequence of infections, many of which have public health consequences. Additionally, because deaths from bioterrorism are homicides, they fall under the jurisdiction of medical examiners and coroners. Surveillance for infectious disease-related deaths can enhance the opportunities to recognize these deaths. Beginning in 2000, the New Mexico Office of the Medical Investigator developed and tested a medical examiner surveillance model for bioterrorism and infectious disease mortality ("Med-X") using a set of symptoms to determine which cases should receive an autopsy and a set of pathology-based syndromes for early reporting of cases to public health authorities. This model demonstrated that many of the symptoms had a high predictive value for infections and were useful criteria for autopsy performance. The causative organism was identified for 81% of infections of which 58% were notifiable conditions by public health standards. Uniform criteria for performing autopsies and reporting cases to public health authorities enhance surveillance for notifiable infectious diseases and increase the probability of recognizing fatalities related to bioterrorism. We have developed guidelines for medical examiners, coroners and their public health partners to use in implementing Med-X surveillance in their jurisdictions. These guidelines encompass definitions of symptoms and syndromes, specimen collection and storage procedures, laboratory diagnostic approaches, and processes for case flow, case reporting, and data collection. We also suggest resources for autopsy biosafety information and funding.

  12. Asia Oceania Guidelines for the Implementation of Programs for Cervical Cancer Prevention and Control

    PubMed Central

    Ngan, Hextan Y. S.; Garland, Suzanne M.; Bhatla, Neerja; Pagliusi, Sonia R.; Chan, Karen K. L.; Cheung, Annie N. Y.; Chu, Tang-Yuan; Domingo, Efren J.; Qiao, You Lin; Park, Jong Sup; Tay, Eng Hseon; Supakarapongkul, Wisit

    2011-01-01

    This paper aims to provide evidence-based recommendations for health professionals, to develop a comprehensive cervical cancer program for a clinic, a community, or a country. Ensuring access to healthcare is the responsibility of all societies, and the Asia Oceania Research Organisation in Genital Infections and Neoplasia (AOGIN) is committed to working collaboratively with governments and health professionals to facilitate prevention programs, to protect girls and women from cervical cancer, a disease that globally affects 500,000 and kills nearly 300,000 women annually, just over half of whom are in the Asia Oceania region. We share the vision that a comprehensive program of vaccination, screening, and treatment should be made accessible to all girls and women in the world. The primary purpose of these guidelines is to provide information on scientific evidence on the different modalities and approaches of cervical cancer prevention programs, for high resource and low resource settings. The secondary purpose is to provide an overview of the current situation of cervical cancer control and prevention in various Asian Oceania countries: their views of an ideal program, identified obstacles, and suggestions to overcome them are discussed. PMID:21559068

  13. Normalization of stable isotope data for carbonate minerals: Implementation of IUPAC guidelines

    NASA Astrophysics Data System (ADS)

    Kim, Sang-Tae; Coplen, Tyler B.; Horita, Juske

    2015-06-01

    Carbonate minerals provide a rich source of geochemical information because their δ13C and δ18O values provide information about surface and subsurface Earth processes. However, a significant problem is that the same δ18O value is not reported for the identical carbonate sample when analyzed in different isotope laboratories in spite of the fact that the International Union of Pure and Applied Chemistry (IUPAC) has provided reporting guidelines for two decades. This issue arises because (1) the δ18O measurements are performed on CO2 evolved by reaction of carbonates with phosphoric acid, (2) the acid-liberated CO2 is isotopically fractionated (enriched in 18O) because it contains only two-thirds of the oxygen from the solid carbonate, (3) this oxygen isotopic fractionation factor is a function of mineralogy, temperature, concentration of the phosphoric acid, and δ18O value of water in the phosphoric acid, (4) researchers may use any one of an assortment of oxygen isotopic fractionation factors that have been published for various minerals at various reaction temperatures, and (5) it sometimes is not clear how one should calculate δ18OVPDB values on a scale normalized such that the δ18O value of SLAP reference water is -55.5 ‰ relative to VSMOW reference water.

  14. Response to open access endoscopy findings by general practitioners guidelines need education for implementation.

    PubMed

    Todd, J A; Zubir, M A; Goudie, B M; Johnston, D A

    2000-04-01

    General practitioners may gain valuable information from the use of open access endoscopy. The benefit to the individual patient depends on the interpretation of the endoscopy findings and the subsequent action. The aim of the study was to determine GPs response to open access endoscopy findings of three conditions with possible malignant complications: Barrett's oesophagus, gastric ulcer and colonic adenomatous polyps. The study took place at Ninewells Hospital, Dundee. Using the endoscopy unit's records for the year, 1 January 1995 to 31 December 1995, all patients having had an open access upper gastro-intestinal endoscopy or sigmoidoscopy were identified. Case-notes were reviewed of patients who had Barrett's oesophagus, gastric ulcer or colonic polyps diagnosed. During the year, 1158 upper gastro-intestinal endoscopies and 293 sigmoidoscopies were performed by the open access service. The referral rates for the conditions were as follows: Barrett's oesophagus 56%; Gastric ulcers 56%; Adenomatous polyps 88%; Non adenomatous polyps 12.5%. The provision of guidelines does not ensure a high referral rate, education is a vital partner. PMID:10862438

  15. Implementing effective hypertensive management--review of the 2014 high blood pressure management guidelines.

    PubMed

    Li, Shenjing; Kelly, Shawn C; Petrasko, Marian

    2015-01-01

    The Joint National Committee (JNC 8) hypertension guidelines have modified the blood pressure goals across the spectrum of disease processes and patient characteristics. This article will elucidate these changes and help clinicians improve the clinical care of patients with hypertension. Patients are now conceptually categorized into two different patient populations: those who are at a low- or high-risk of developing atherosclerotic cardiovascular disease (ASCVD) or chronic kidney disease (CKD). A low-risk population comprises patients aged 60 or older who do not have disease processes that enhance ASCVD or CKD disease development. High-risk patients are those with CKD and/or diabetes, and patients less than 60 years of age who remain at risk of future development. The current recommendation for blood-pressure goals in the low- and high-risk population is 150/90 mmHg and 140/90 mmHg, respectively. In all patients considered for antihypertensive therapy, the first line antihypertensive pharmacotherapy should include either a thiazide-type diuretic, calcium channel blocker (CCB), angiotensin-converting enzyme inhibitor (ACEI), or an angiotensin receptor blocker (ARB). Beta blockers no longer have a role as standalone therapy. Thiazide- type diuretics and CCB continue to demonstrate benefit in the African American population and should continue to be considered as first line agents. CKD patients with concomitant hypertension should be treated with an ACE inhibitor or ARB. PMID:25985606

  16. High prevalence of soil-transmitted helminths in Western Kenya: failure to implement deworming guidelines in rural Nyanza Province.

    PubMed

    Riesel, Johanna N; Ochieng', Frederick O; Wright, Peter; Vermund, Sten H; Davidson, Mario

    2010-02-01

    Soil-transmitted helminth (STH) infections affect an estimated 2 billion people world wide. Children experience the greatest morbidity, limiting their potential in academic and physical endeavors. Our study assessed the prevalence of STH infections in primary school-aged children in a rural village in the Nyanza Province of Kenya. Over two-thirds (68%) of the sampled population tested positive using a direct smear microscopic analysis of single stool samples. Only heavy worm infections would be detected with this technique; thus 68% is a minimum estimate of prevalence. Prior to our study, there were no deworming programs in this village, despite WHO and Kenyan government guidelines supporting regular deworming programs. Our study demonstrates the significant burden of STH infections in a rural Kenyan village and highlights the need for deworming programs in similar venues. We also demonstrate that with basic infrastructure and community involvement, regular deworming can be implemented effectively in remote, rural communities.

  17. Effectiveness of a clinical practice guideline implementation strategy for patients with anxiety disorders in primary care: cluster randomized trial

    PubMed Central

    2011-01-01

    Background Anxiety is a common mental health problem seen in primary care. However, its management in clinical practice varies greatly. Clinical practice guidelines (CPGs) have the potential to reduce variations and improve the care received by patients by promoting interventions of proven benefit. However, uptake and adherence to their recommendations can be low. Method/design This study involves a community based on cluster randomized trial in primary healthcare centres in the Madrid Region (Spain). The project aims to determine whether the use of implementation strategy (including training session, information, opinion leader, reminders, audit, and feed-back) of CPG for patients with anxiety disorders in primary care is more effective than usual diffusion. The number of patients required is 296 (148 in each arm), all older than 18 years and diagnosed with generalized anxiety disorder, panic disorder, and panic attacks by the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). They are chosen by consecutive sampling. The main outcome variable is the change in two or more points into Goldberg anxiety scale at six and twelve months. Secondary outcome variables include quality of life (EuroQol 5D), and degree of compliance with the CPG recommendations on treatment, information, and referrals to mental health services. Main effectiveness will be analyzed by comparing the patients percentage improvement on the Goldberg scale between the intervention group and the control group. Logistic regression with random effects will be used to adjust for prognostic factors. Confounding factors or factors that might alter the effect recorded will be taken into account in this analysis. Discussion There is a need to identify effective implementation strategies for CPG for the management of anxiety disorders present in primary care. Ensuring the appropriate uptake of guideline recommendations can reduce clinical variation and improve the care patients receive. Trial

  18. [Evaluating the total incapacity to work: implementing French National Authority for Health guidelines in clinical practice].

    PubMed

    Chariot, Patrick; Bécache, Nathalie; François-Purssell, Irène; Dantchev, Nicolas; Delpla, Pierre-André; Fournier, Lionel; Proust, Bernard

    2013-10-01

    Total incapacity to work (TIW) is a legal concept that allows magistrates to assess the severity of violence against persons. The TIW is the duration of the victims' inability to fulfil their usual activities and is determined by physicians. Professional guidelines from the French National Authority for Health indicate that TIW applies both to physical and psychological problems. The law of 9 July 2010 makes explicit reference to TIW in cases of psychological violence and intimate partner harassment. Prosecutors base criminal penalties on the duration of TIW in cases of assault and battery. Whatever the physician, they should describe the mental state of the victim and identify the signs that may indicate the mental impact of reported assaults. Identifying combinations of symptoms can be useful in deciding whether the duration of TIW should be increased because of the psychic state. In case of stalking, assessment of TIW can allow prosecutors to link the reported facts to a criminal offence. In complex situations, the physician may be unable to assess a duration of TIW and can suggest expert assessment. In all cases, the duration of TIW needs to be based on functional criteria. The extent of harm to the life of relationships results from suffered violence, from the victim's reaction, and from the perception of their family and friends. In this area, we suggest to limit the first assessment of TIW to a few days and to reassess it later, according to real information reported by the victims, to careful observation of their behaviour, and to results of a questioning that should be as little suggestive as possible. At either end of the age scale and in case of preexisting functional impairment, assessment of TIW should take into account the actual and global capacity of the person before the assault.

  19. Implementation of Out-of-Office Blood Pressure Monitoring in the Netherlands: From Clinical Guidelines to Patients' Adoption of Innovation.

    PubMed

    Carrera, Pricivel M; Lambooij, Mattijs S

    2015-10-01

    Out-of-office blood pressure monitoring is promoted by various clinical guidelines toward properly diagnosing and effectively managing hypertension and engaging the patient in their care process. In the Netherlands, however, the Dutch cardiovascular risk management (CVRM) guidelines do not explicitly prescribe 24-hour ambulatory blood pressure measurement (ABPM) and home BP measurement (HBPM). The aim of this descriptive study was to develop an understanding of patients' and physicians' acceptance and use of out-of-office BP monitoring in the Netherlands given the CVRM recommendations.Three small focus group discussions (FGDs) with patients and 1 FGD with physicians were conducted to explore the mechanisms behind the acceptance and use of out-of-office BP monitoring and reveal real-world challenges that limit the implementation of out-of-office BP monitoring methods. To facilitate the FGDs, an analytical framework based on the technology acceptance model (TAM), the theory of planned behavior and the model of personal computing utilization was developed to guide the FGDs and analysis of the transcriptions of each FGD.ABPM was the out-of-office BP monitoring method prescribed by physicians and used by patients. HBPM was not offered to patients even with patients' feedback of poor tolerance of ABPM. Even as there was little awareness about HBPM among patients, there were a few patients who owned and used sphygmomanometers. Patients professed and seemed to exhibit self-efficacy, whereas physicians had reservations about (all of their) patients' self-efficacy in properly using ABPM. Since negative experience with ABPM impacted patients' acceptance of ABPM, the interaction of factors that determined acceptance and use was found to be dynamic among patients but not for physicians.In reference to the CVRM guidelines, physicians implemented out-of-office BP monitoring but showed a strong preference for ABPM even where there is poor tolerance of the method. We found that

  20. The Impact of Social Media on Dissemination and Implementation of Clinical Practice Guidelines: A Longitudinal Observational Study

    PubMed Central

    Gronseth, Gary; Dubinsky, Richard; Penfold-Murray, Rebecca; Cox, Julie; Bever Jr, Christopher; Martins, Yolanda; Rheaume, Carol; Shouse, Denise; Getchius, Thomas SD

    2015-01-01

    Background Evidence-based clinical practice guidelines (CPGs) are statements that provide recommendations to optimize patient care for a specific clinical problem or question. Merely reading a guideline rarely leads to implementation of recommendations. The American Academy of Neurology (AAN) has a formal process of guideline development and dissemination. The last few years have seen a burgeoning of social media such as Facebook, Twitter, and LinkedIn, and newer methods of dissemination such as podcasts and webinars. The role of these media in guideline dissemination has not been studied. Systematic evaluation of dissemination methods and comparison of the effectiveness of newer methods with traditional methods is not available. It is also not known whether specific dissemination methods may be more effectively targeted to specific audiences. Objective Our aim was to (1) develop an innovative dissemination strategy by adding social media-based dissemination methods to traditional methods for the AAN clinical practice guidelines “Complementary and alternative medicine in multiple sclerosis” (“CAM in MS”) and (2) evaluate whether the addition of social media outreach improves awareness of the CPG and knowledge of CPG recommendations, and affects implementation of those recommendations. Methods Outcomes were measured by four surveys in each of the two target populations: patients and physicians/clinicians (“physicians”). The primary outcome was the difference in participants’ intent to discuss use of complementary and alternative medicine (CAM) with their physicians or patients, respectively, after novel dissemination, as compared with that after traditional dissemination. Secondary outcomes were changes in awareness of the CPG, knowledge of CPG content, and behavior regarding CAM use in multiple sclerosis (MS). Results Response rates were 25.08% (622/2480) for physicians and 43.5% (348/800) for patients. Awareness of the CPG increased after traditional

  1. Implementation of contemporary radiation therapy planning concepts for pediatric Hodgkin lymphoma: Guidelines from the International Lymphoma Radiation Oncology Group.

    PubMed

    Hodgson, David C; Dieckmann, Karin; Terezakis, Stephanie; Constine, Louis

    2015-01-01

    The optimal management of children with Hodgkin lymphoma (HL) should limit the risk of treatment-related toxicity without compromising disease control. Consequently, increasing effort is being directed to retaining the demonstrated efficacy of radiation therapy (RT) in maximizing the cure of HL while reducing the radiation exposure of normal tissues. Historically, guidelines for RT volume definition used in pediatric HL trials have referenced 2-dimensional imaging and bony landmarks to define classical involved field RT. With recognition of the efficacy of chemotherapy, the data on the adverse late effects of radiation, and the evolution of advanced imaging techniques that reveal the location of both tumor and normal tissues, it is necessary that radiation techniques for children and adolescents be refined. The concepts described by the International Commission on Radiation Units provide a common approach for field definition using 3-dimensional computed tomographic--based RT planning and volumetric image guidance. Here we describe the application of these concepts in the planning of RT for pediatric HL. This will be increasingly important as current and upcoming pediatric HL trials will employ these concepts to deliver RT.

  2. [ILCOR's new resuscitation guidelines in preterm and term infants: critical discussion and suggestions for implementation].

    PubMed

    Hansmann, G; Humpl, T; Zimmermann, A; Bührer, C; Wauer, R; Stannigel, H; Hoehn, T

    2007-01-01

    Recommendations of the International Liaison Committee on Resuscitation (ILCOR) become updated every five years with changing evidence resulting in revised recommendations for clinical practice. New data exist concerning the adequate oxygen concentration to be used in the delivery room, the management of imminent meconium aspiration, ventilation strategies and the role of body temperature during and after resuscitation of preterm and term newborn infants. Only in some cases new evidence has led to clear-cut recommendations for or against specific interventions. Therefore the present publication cites the original ILCOR-recommendations and discusses these with regard to their practical implementation. The authors of the present work suggest to commence resuscitation independendly of gestational age with room air and adjust the inspiratory oxygen concentration thereafter on clinical grounds. The authors also advocate the retention of the presently performed intranatal suction procedure in cases of meconium-stained amniotic fluid and the use of therapeutic hypothermia following perinatal asphyxia in term newborns according to the protocol of one of the published randomized, controlled trials. Standard equipment for neonatal resuscitation should include pressure gauge for monitoring of inspiratory pressures, oxygen blender, and pulse oxymeter. The predominant majority of ILCOR-recommendations have only been cited and have been commented with respect to their practical implementation within the clinical context.

  3. NASA System Safety Handbook. Volume 2: System Safety Concepts, Guidelines, and Implementation Examples

    NASA Technical Reports Server (NTRS)

    Dezfuli, Homayoon; Benjamin, Allan; Everett, Christopher; Feather, Martin; Rutledge, Peter; Sen, Dev; Youngblood, Robert

    2015-01-01

    This is the second of two volumes that collectively comprise the NASA System Safety Handbook. Volume 1 (NASASP-210-580) was prepared for the purpose of presenting the overall framework for System Safety and for providing the general concepts needed to implement the framework. Volume 2 provides guidance for implementing these concepts as an integral part of systems engineering and risk management. This guidance addresses the following functional areas: 1.The development of objectives that collectively define adequate safety for a system, and the safety requirements derived from these objectives that are levied on the system. 2.The conduct of system safety activities, performed to meet the safety requirements, with specific emphasis on the conduct of integrated safety analysis (ISA) as a fundamental means by which systems engineering and risk management decisions are risk-informed. 3.The development of a risk-informed safety case (RISC) at major milestone reviews to argue that the systems safety objectives are satisfied (and therefore that the system is adequately safe). 4.The evaluation of the RISC (including supporting evidence) using a defined set of evaluation criteria, to assess the veracity of the claims made therein in order to support risk acceptance decisions.

  4. ANSI/AIAA S-081A, Pressure Vessel Standards Implementation Guidelines

    NASA Technical Reports Server (NTRS)

    Greene, Nathanael J.

    2009-01-01

    The stress rupture specification for Composite Overwrapped Pressure Vessels (COPV) is discussed. The composite shell of the COPV shall be designed to meet the design life considering the time it is under sustained load. A Mechcanical Damage Control Plan (MDCP) shall be created and implemented that assures the COPV will not fail due to mechanical damage due to manufacturing, testing, shipping, installation, or flight. Proven processes and procedures for fabrication and repair shall be used to preclude damage or material degradation during material processing, manufacturing operations, and refurbushment.Selected NDI techniques for the liner and/or boss(es) shall be performed before overwrapping with composite. When visual inspection reveals mechanical damage or defects exceeding manufacturing specification levels (and standard repair procedures), the damaged COPV shall be submitted to a material review board (MRB) for disposition. Every COPV shall be subjected to visual and other non-destructive inspection (NDI), per the inspection plan.

  5. Clinical practice guidelines at an HMO: development and implementation in a quality improvement model.

    PubMed

    Gottlieb, L K; Margolis, C Z; Schoenbaum, S C

    1990-02-01

    Harvard Community Health Plan (HCHP) is adapting to clinical medicine the managerial principles and methods of quality improvement theory that were originally developed and successfully applied in industrial settings. An essential step in applying the quality improvement cycle to clinical medicine is the setting of standards or specifications for clinical care. HCHP has chosen to focus its standard-setting efforts on the development of clinical algorithms, which provide an excellent basis for specifying and communicating optimal care processes and for evaluating actual clinical care. When implemented effectively, clinical algorithms may improve quality and decrease costs by guiding clinicians toward more standardized, high-quality, cost-effective clinical strategies and by facilitating more valid measurement of clinical process and outcomes. This article describes the evolution, structure, methods, and future agenda of the Algorithm Based Clinical Quality Improvement Process (ABCQIP) at HCHP.

  6. Implementation of a foveated image coding system for image bandwidth reduction

    NASA Astrophysics Data System (ADS)

    Kortum, Philip; Geisler, Wilson S.

    1996-04-01

    We have developed a preliminary version of a foveated imaging system, implemented on a general purpose computer, which greatly reduces the transmission bandwidth of images. The system is based on the fact that the spatial resolution of the human eye is space variant, decreasing with increasing eccentricity from the point of gaze. By taking advantage of this fact, it is possible to create an image that is almost perceptually indistinguishable from a constant resolution image, but requires substantially less information to code it. This is accomplished by degrading the resolution of the image so that it matches the space-variant degradation in the resolution of the human eye. Eye movements are recorded so that the high resolution region of the image can be kept aligned with the high resolution region of the human visual system. This system has demonstrated that significant reductions in bandwidth can be achieved while still maintaining access to high detail at any point in an image. The system has been tested using 256 by 256 8 bit gray scale images with a 20 degree field-of-view and eye-movement update rates of 30 Hz (display refresh was 60 Hz). users of the system have reported minimal perceptual artifacts at bandwidth reductions of up to 94.7% (a factor of 18.8). Bandwidth reduction factors of over 100 are expected once lossless compression techniques are added to the system.

  7. When rheumatologists report that they agree with a guideline, does this mean that they practise the guideline in clinical practice? Results of the International Recommendation Implementation Study (IRIS)

    PubMed Central

    Gvozdenović, Emilia; Allaart, Cornelia F; van der Heijde, Désirée; Ferraccioli, Gianfranco; Smolen, Josef S; Huizinga, Tom W J; Landewé, Robert

    2016-01-01

    Introduction The European League Against Rheumatism (EULAR) recommendations for the management of rheumatoid arthritis (RA) and the treat-to-target (T2T) principles have been developed in order to improve the treatment outcome of patients with RA, and have received broad attention. It is not clear, though, whether these recommendations are indeed followed up in clinical practice. Objective To investigate if rheumatologists that report to agree with existing guidelines indeed follow them up in clinical practice. Methods The International Recommendation Implementation Study (IRIS) included 132 participating rheumatologists from 14 countries. Participating rheumatologists received a questionnaire measuring their awareness/commitment with the EULAR/T2T recommendations and followed a dedicated educational programme. Subsequently, they were asked to enrol 5–10 patients with new-onset RA in the online IRIS database and monitor disease activity and treatment for a period of 1–2 years. Four recommendations (3 from the EULAR recommendations and one from the T2T recommendations) were selected on the basis of testability, and analysed with regard to compliance by participating rheumatologists. Results In total, 72 of the 132 participating rheumatologists contributed 378 patients to the database. Of these participants, 70 (98%) agreed upfront with the recommendation that disease-modifying antirheumatic drug (DMARD) therapy should be started as soon as possible after diagnosis in every patient; 69 (96%) of the rheumatologists agreed with the recommendation that methotrexate (MTX) should be part of the first treatment strategy. When measuring the actual performance, it was found that the recommendation on early DMARD start was met in 253 (67%) of the recorded patients, and the recommendation on MTX in 225 (60%) of the recorded patients. Of the participants, 60 (83%) agreed that composite measures should be recorded regularly, but only in 134(54%) of the patients were

  8. Method for Implementing Subsurface Solid Derived Concentration Guideline Levels (DCGL) - 12331

    SciTech Connect

    Lively, J.W.

    2012-07-01

    The U.S. Nuclear Regulatory Commission (NRC) and other federal agencies currently approve the Multi-Agency Radiation Site Survey and Investigation Manual (MARSSIM) as guidance for licensees who are conducting final radiological status surveys in support of decommissioning. MARSSIM provides a method to demonstrate compliance with the applicable regulation by comparing residual radioactivity in surface soils with derived concentration guideline levels (DCGLs), but specifically discounts its applicability to subsurface soils. Many sites and facilities undergoing decommissioning contain subsurface soils that are potentially impacted by radiological constituents. In the absence of specific guidance designed to address the derivation of subsurface soil DCGLs and compliance demonstration, decommissioning facilities have attempted to apply DCGLs and final status survey techniques designed specifically for surface soils to subsurface soils. The decision to apply surface soil limits and surface soil compliance metrics to subsurface soils typically results in significant over-excavation with associated cost escalation. MACTEC, Inc. has developed the overarching concepts and principles found in recent NRC decommissioning guidance in NUREG 1757 to establish a functional method to derive dose-based subsurface soil DCGLs. The subsurface soil method developed by MACTEC also establishes a rigorous set of criterion-based data evaluation metrics (with analogs to the MARSSIM methodology) that can be used to demonstrate compliance with the developed subsurface soil DCGLs. The method establishes a continuum of volume factors that relate the size and depth of a volume of subsurface soil having elevated concentrations of residual radioactivity with its ability to produce dose. The method integrates the subsurface soil sampling regime with the derivation of the subsurface soil DCGL such that a self-regulating optimization is naturally sought by both the responsible party and regulator

  9. Evaluation of the Impact of Implementing the Emergency Medical Services Traumatic Brain Injury Guidelines in Arizona: The Excellence in Prehospital Injury Care (EPIC) Study Methodology

    PubMed Central

    Spaite, Daniel W.; Bobrow, Bentley J.; Stolz, Uwe; Sherrill, Duane; Chikani, Vatsal; Barnhart, Bruce; Sotelo, Michael; Gaither, Joshua B.; Viscusi, Chad; Adelson, P. David; Denninghoff, Kurt R.

    2014-01-01

    Traumatic brain injury (TBI) exacts a great toll on society. Fortunately, there is growing evidence that the management of TBI in the early minutes after injury may significantly reduce morbidity and mortality. In response, evidence-based prehospital and in-hospital TBI treatment guidelines have been established by authoritative bodies. However, no large studies have yet evaluated the effectiveness of implementing these guidelines in the prehospital setting. This article describes the background, design, implementation, emergency medical services (EMS) treatment protocols, and statistical analysis of a prospective, controlled (before/after), statewide study designed to evaluate the effect of implementing the EMS TBI guidelines—the Excellence in Prehospital Injury Care (EPIC) study (NIH/NINDS R01NS071049, “EPIC”; and 3R01NS071049-S1, “EPIC4Kids”). The specific aim of the study is to test the hypothesis that statewide implementation of the international adult and pediatric EMS TBI guidelines will significantly reduce mortality and improve nonmortality outcomes in patients with moderate or severe TBI. Furthermore, it will specifically evaluate the effect of guideline implementation on outcomes in the subgroup of patients who are intubated in the field. Over the course of the entire study (~9 years), it is estimated that approximately 25,000 patients will be enrolled. PMID:25112451

  10. Advanced Imaging and Receipt of Guideline Concordant Care in Women with Early Stage Breast Cancer

    PubMed Central

    Buist, Diana S. M.; Gold, Laura S.; Zeliadt, Steven; Hunter Merrill, Rachel; Etzioni, Ruth; Ramsey, Scott D.; Sullivan, Sean D.; Kessler, Larry

    2016-01-01

    Objective. It is unknown whether advanced imaging (AI) is associated with higher quality breast cancer (BC) care. Materials and Methods. Claims and Surveillance Epidemiology and End Results data were linked for women diagnosed with incident stage I-III BC between 2002 and 2008 in western Washington State. We examined receipt of preoperative breast magnetic resonance imaging (MRI) or AI (defined as computed tomography [CT]/positron emission tomography [PET]/PET/CT) versus mammogram and/or ultrasound (M-US) alone and receipt of guideline concordant care (GCC) using multivariable logistic regression. Results. Of 5247 women, 67% received M-US, 23% MRI, 8% CT, and 3% PET/PET-CT. In 2002, 5% received MRI and 5% AI compared to 45% and 12%, respectively, in 2008. 79% received GCC, but GCC declined over time and was associated with younger age, urban residence, less comorbidity, shorter time from diagnosis to surgery, and earlier year of diagnosis. Breast MRI was associated with GCC for lumpectomy plus radiation therapy (RT) (OR 1.55, 95% CI 1.08–2.26, and p = 0.02) and AI was associated with GCC for adjuvant chemotherapy for estrogen-receptor positive (ER+) BC (OR 1.74, 95% CI 1.17–2.59, and p = 0.01). Conclusion. GCC was associated with prior receipt of breast MRI and AI for lumpectomy plus RT and adjuvant chemotherapy for ER+ BC, respectively. PMID:27525122

  11. Advanced Imaging and Receipt of Guideline Concordant Care in Women with Early Stage Breast Cancer.

    PubMed

    Loggers, Elizabeth Trice; Buist, Diana S M; Gold, Laura S; Zeliadt, Steven; Hunter Merrill, Rachel; Etzioni, Ruth; Ramsey, Scott D; Sullivan, Sean D; Kessler, Larry

    2016-01-01

    Objective. It is unknown whether advanced imaging (AI) is associated with higher quality breast cancer (BC) care. Materials and Methods. Claims and Surveillance Epidemiology and End Results data were linked for women diagnosed with incident stage I-III BC between 2002 and 2008 in western Washington State. We examined receipt of preoperative breast magnetic resonance imaging (MRI) or AI (defined as computed tomography [CT]/positron emission tomography [PET]/PET/CT) versus mammogram and/or ultrasound (M-US) alone and receipt of guideline concordant care (GCC) using multivariable logistic regression. Results. Of 5247 women, 67% received M-US, 23% MRI, 8% CT, and 3% PET/PET-CT. In 2002, 5% received MRI and 5% AI compared to 45% and 12%, respectively, in 2008. 79% received GCC, but GCC declined over time and was associated with younger age, urban residence, less comorbidity, shorter time from diagnosis to surgery, and earlier year of diagnosis. Breast MRI was associated with GCC for lumpectomy plus radiation therapy (RT) (OR 1.55, 95% CI 1.08-2.26, and p = 0.02) and AI was associated with GCC for adjuvant chemotherapy for estrogen-receptor positive (ER+) BC (OR 1.74, 95% CI 1.17-2.59, and p = 0.01). Conclusion. GCC was associated with prior receipt of breast MRI and AI for lumpectomy plus RT and adjuvant chemotherapy for ER+ BC, respectively. PMID:27525122

  12. Guidelines for Hanford Site implementation of the National Environmental Policy Act

    SciTech Connect

    King, S.E.

    1989-03-01

    The National Environmental Policy Act (NEPA) environmental review process is mandatory for federal agencies. Understanding and complying with NEPA is extremely important to successfully planning and implementing programs at the Hanford Site. This report is intended to help planners and decision makers understand NEPA by describing the NEPA process as it is outlined in NEPA, in regulations, and in guidance information. The requirements and guidance documents that set forth the NEPA process are discussed. Some of the major NEPA concepts and issues are also addressed. This report is intended to be used as a general road map through the maze of NEPA requirements and guidance to ensure that Hanford Site activities are conducted in compliance with NEPA. Enhanced knowledge of the NEPA process is expected to increase the ability of the Hanford Site to work with regulators, interested parties and the public to ensure that the potential environmental impacts of DOE activities are fully considered at the Hanford Site. In addition, an enhanced understanding of NEPA will help project and program managers to integrate NEPA compliance requirements with program planning. 43 refs., 6 figs., 3 tabs.

  13. Implementation of national guidelines for the prevention and treatment of overweight and obesity in children and adolescents: a phenomenographic analysis of public health nurses’ perceptions

    PubMed Central

    Nordstrand, Aina; Fridlund, Bengt; Sollesnes, Ragnhild

    2016-01-01

    Objective To explore and describe how public health nurses (PHNs) perceive the implementation of national guidelines for the prevention and treatment of overweight and obesity among children and adolescents in well-baby clinics and school health services. Design, sample, and measurements An explorative descriptive design was carried out through individual interviews with 18 PHNs and analysed according to the phenomenographic tradition. Results Four implementation strategies were described and assigned a metaphor: the structured PHN, pragmatic PHN, critical PHN, and the resigned PHN. Competence, patient receptiveness, internal consensus, interdisciplinary collaboration, resources, and organizational embedding were the determinants identified that most frequently affect implementation, and these determinants were distributed at different levels of the organization. The extent of facilitation seemed to determine which implementation strategy would be used. Conclusions How PHNs implemented the guidelines for overweight and obesity were affected by determinants at different organizational levels. Contextual facilitation of implementation seemed better in larger organizations, but factors such as leadership, drive, and experience compensated in smaller municipalities. The implementation of guidelines was hindered when the barriers exceeded the benefits. PMID:27543411

  14. Japanese consensus guidelines for pediatric nuclear medicine. Part 1: Pediatric radiopharmaceutical administered doses (JSNM pediatric dosage card). Part 2: Technical considerations for pediatric nuclear medicine imaging procedures.

    PubMed

    Koizumi, Kiyoshi; Masaki, Hidekazu; Matsuda, Hiroshi; Uchiyama, Mayuki; Okuno, Mitsuo; Oguma, Eiji; Onuma, Hiroshi; Kanegawa, Kimio; Kanaya, Shinichi; Kamiyama, Hiroshi; Karasawa, Kensuke; Kitamura, Masayuki; Kida, Tetsuo; Kono, Tatsuo; Kondo, Chisato; Sasaki, Masayuki; Terada, Hitoshi; Nakanishi, Atsushi; Hashimoto, Teisuke; Hataya, Hiroshi; Hamano, Shin-ichiro; Hirono, Keishi; Fujita, Yukihiko; Hoshino, Ken; Yano, Masayuki; Watanabe, Seiichi

    2014-06-01

    The Japanese Society of Nuclear Medicine has recently published the consensus guidelines for pediatric nuclear medicine. This article is the English version of the guidelines. Part 1 proposes the dose optimization in pediatric nuclear medicine studies. Part 2 comprehensively discusses imaging techniques for the appropriate conduct of pediatric nuclear medicine procedures, considering the characteristics of imaging in children.

  15. The Adoption of Roles by Primary Care Providers during Implementation of the New Chronic Disease Guidelines in Urban Mongolia: A Qualitative Study

    PubMed Central

    Chimeddamba, Oyun; Ayton, Darshini; Bazarragchaa, Nansalmaa; Dorjsuren, Bayarsaikhan; Peeters, Anna; Joyce, Catherine

    2016-01-01

    (1) Background: In 2011, new chronic disease guidelines were introduced across Mongolia. No formal advice was provided regarding role delineation. This study aimed to analyse the roles that different primary care providers adopted, and the variations in these, in the implementation of the guidelines in urban Mongolia; (2) Methods: Ten group interviews with nurses and ten individual interviews each with practice doctors and practice directors were conducted. Data was analysed using a thematic approach based on the identified themes relevant to role delineation; (3) Results: There was some variability and flexibility in role delineation. Factors involving teamwork, task rotation and practice flexibility facilitated well the guideline implementation. However, factors including expectations and decision making, nursing shortage, and training gaps adversely influenced in the roles and responsibilities. Some role confusion and dissatisfaction was identified, often associated with a lack of training or staff turnover; (4) Conclusions: Findings suggest that adequate ongoing training is required to maximize the range of roles particular provider types, especially primary care nurses, are competent to perform. Ensuring that role delineation is specified in guidelines could remove confusion and enhance implementation of such guidelines. PMID:27070630

  16. The challenges of implementing ADHD clinical guidelines and research best evidence in routine clinical care settings: Delphi survey and mixed-methods study

    PubMed Central

    Taylor, John A.; Newell, Karen; Baldwin, Laurence; Sayal, Kapil; Hollis, Chris

    2016-01-01

    Background The landmark US Multimodal Treatment of ADHD (MTA) study established the benefits of individualised medication titration and optimisation strategies to improve short- to medium-term outcomes in attention-deficit hyperactivity disorder (ADHD). This individualised medication management approach was subsequently incorporated into the National Institute for Health and Care Excellence (NICE) ADHD Clinical Guidelines (NICE CG78). However, little is known about clinicians’ attitudes towards implementing these medication management strategies for ADHD in routine care. Aims To examine National Health Service (NHS) healthcare professionals’ consensus on ADHD medication management strategies. Method Using the Delphi method, we examined perceptions on the importance and feasibility of implementing 103 ADHD treatment statements from sources including the UK NICE ADHD guidelines and US medication management algorithms. Results Certain recommendations for ADHD medication management were judged as important and feasible to implement, including a stepwise titration of stimulant medication. Other recommendations were perceived as important but not feasible to implement in routine practice, such as weekly clinic follow-up with the family during titration and collection of follow-up symptom questionnaires. Conclusions Many of the key guideline recommendations for ADHD medication management are viewed by clinicians as important and feasible to implement. However, some recommendations present significant implementation challenges within the context of routine NHS clinical care in England. Declaration of interest C.H. and K.S. were members of the Guideline Development Group for the NICE ADHD Clinical Guideline (NICE CG78). Copyright and usage © 2016 The Royal College of Psychiatrists. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence. PMID:27703750

  17. Imaging of Scaphoid Fractures According to the New S3 Guidelines.

    PubMed

    Schmitt, R; Rosenthal, H

    2016-05-01

     Schmitt R, Rosenthal H. Imaging of Scaphoid Fractures According to the New S3 Guidelines. Fortschr Röntgenstr 2016; 188: 459 - 469.

  18. Imaging of Scaphoid Fractures According to the New S3 Guidelines.

    PubMed

    Schmitt, R; Rosenthal, H

    2016-05-01

     Schmitt R, Rosenthal H. Imaging of Scaphoid Fractures According to the New S3 Guidelines. Fortschr Röntgenstr 2016; 188: 459 - 469. PMID:27074424

  19. The Importance and Degree of Implementation of the European Standards and Guidelines for Internal Quality Assurance in Universities: The Views of Portuguese Academics

    ERIC Educational Resources Information Center

    Manatos, Maria J.; Rosa, Maria J.; Sarrico, Cláudia S.

    2015-01-01

    This research seeks to explore academics' perceptions of the importance and degree of implementation of the Standards and Guidelines for Quality Assurance in the European Higher Education Area (ESG) for internal quality assurance. It uses empirical evidence from Portugal, gathered via a questionnaire given to all university academics. Results show…

  20. Dissemination Strategies to Improve Implementation of the PHS Smoking Cessation Guideline in MCH Public Health Clinics: Experimental Evaluation Results and Contextual Factors

    ERIC Educational Resources Information Center

    Manfredi, Clara; Cho, Young Ik; Warnecke, Richard; Saunders, Stephen; Sullivan, Myrtis

    2011-01-01

    We report results from an experimental study that tested the effectiveness of dissemination interventions to improve implementation of smoking cessation guidelines in maternal and child public health clinics. We additionally examine individual clinic results for contextual explanations not apparent from the experimental findings alone. Twelve…

  1. Development of a theory- and evidence-based intervention to enhance implementation of physical therapy guidelines for the management of low back pain

    PubMed Central

    2014-01-01

    Background Systematic planning could improve the generally moderate effectiveness of interventions to enhance adherence to clinical practice guidelines. The aim of our study was to demonstrate how the process of Intervention Mapping was used to develop an intervention to address the lack of adherence to the national CPG for low back pain by Dutch physical therapists. Methods We systematically developed a program to improve adherence to the Dutch physical therapy guidelines for low back pain. Based on multi-method formative research, we formulated program and change objectives. Selected theory-based methods of change and practical applications were combined into an intervention program. Implementation and evaluation plans were developed. Results Formative research revealed influential determinants for physical therapists and practice quality managers. Self-regulation was appropriate because both the physical therapists and the practice managers needed to monitor current practice and make and implement plans for change. The program stimulated interaction between practice levels by emphasizing collective goal setting. It combined practical applications, such as knowledge transfer and discussion-and-feedback, based on theory-based methods, such as consciousness raising and active learning. The implementation plan incorporated the wider environment. The evaluation plan included an effect and process evaluation. Conclusions Intervention Mapping is a useful framework for formative data in program planning in the field of clinical guideline implementation. However, a decision aid to select determinants of guideline adherence identified in the formative research to analyse the problem may increase the efficiency of the application of the Intervention Mapping process. PMID:24428945

  2. South Dakota Special Education Guidelines (Phase One) Recommendations for Local Education Agencies in Implementing Comprehensive Program Planning for their Exceptional Children.

    ERIC Educational Resources Information Center

    Elsberry, Michael J.; And Others

    Presented are guidelines based on statutes, rules, and regulations of the federal government and the South Dakota state board of education to be used by school districts for planning and implementing comprehensive special education programs for exceptional children. Noted are specifications for special school accreditation. Provided are pertinent…

  3. Overview of quality in cardiovascular imaging and procedures for clinicians: focus on appropriate-use-criteria guidelines.

    PubMed

    Stainback, Raymond F

    2014-01-01

    Cardiovascular imaging and procedures have experienced exponential growth over the past 20 years in terms of new modalities, procedure volume, technological sophistication, and cost. As a result, related quality improvement tools have become multifaceted works in progress. This article briefly summarizes the evolution of the time-honored American College of Cardiology Foundation/American Heart Association clinical practice guidelines versus the newer American College of Cardiology Foundation appropriate-use-criteria guidelines and how these may interact with emerging performance measures, clinical data registries, and cardiovascular laboratory accreditation initiatives.

  4. Design and implementation of semantics-based image retrieval system

    NASA Astrophysics Data System (ADS)

    Ni, Chundi; Liu, Shenkui; Pan, Ligong; Yin, Xiaowei

    2015-07-01

    Through the study of the existing image retrieval technology, in this paper, a new design scheme of semantics-based image retrieval system is presented. Based on the establishment of mapping relationship between the low-level image features and the low layer of semantic image, this scheme associates the low layer of semantic image with high-level semantics, thus realizing hierarchical semantics description structure, to improve the high-level semantic image recognition accuracy rate.

  5. MACVIA-ARIA Sentinel NetworK for allergic rhinitis (MASK-rhinitis): the new generation guideline implementation.

    PubMed

    Bousquet, J; Schunemann, H J; Fonseca, J; Samolinski, B; Bachert, C; Canonica, G W; Casale, T; Cruz, A A; Demoly, P; Hellings, P; Valiulis, A; Wickman, M; Zuberbier, T; Bosnic-Anticevitch, S; Bedbrook, A; Bergmann, K C; Caimmi, D; Dahl, R; Fokkens, W J; Grisle, I; Lodrup Carlsen, K; Mullol, J; Muraro, A; Palkonen, S; Papadopoulos, N; Passalacqua, G; Ryan, D; Valovirta, E; Yorgancioglu, A; Aberer, W; Agache, I; Adachi, M; Akdis, C A; Akdis, M; Annesi-Maesano, I; Ansotegui, I J; Anto, J M; Arnavielhe, S; Arshad, H; Baiardini, I; Baigenzhin, A K; Barbara, C; Bateman, E D; Beghé, B; Bel, E H; Ben Kheder, A; Bennoor, K S; Benson, M; Bewick, M; Bieber, T; Bindslev-Jensen, C; Bjermer, L; Blain, H; Boner, A L; Boulet, L P; Bonini, M; Bonini, S; Bosse, I; Bourret, R; Bousquet, P J; Braido, F; Briggs, A H; Brightling, C E; Brozek, J; Buhl, R; Burney, P G; Bush, A; Caballero-Fonseca, F; Calderon, M A; Camargos, P A M; Camuzat, T; Carlsen, K H; Carr, W; Cepeda Sarabia, A M; Chavannes, N H; Chatzi, L; Chen, Y Z; Chiron, R; Chkhartishvili, E; Chuchalin, A G; Ciprandi, G; Cirule, I; Correia de Sousa, J; Cox, L; Crooks, G; Costa, D J; Custovic, A; Dahlen, S E; Darsow, U; De Carlo, G; De Blay, F; Dedeu, T; Deleanu, D; Denburg, J A; Devillier, P; Didier, A; Dinh-Xuan, A T; Dokic, D; Douagui, H; Dray, G; Dubakiene, R; Durham, S R; Dykewicz, M S; El-Gamal, Y; Emuzyte, R; Fink Wagner, A; Fletcher, M; Fiocchi, A; Forastiere, F; Gamkrelidze, A; Gemicioğlu, B; Gereda, J E; González Diaz, S; Gotua, M; Grouse, L; Guzmán, M A; Haahtela, T; Hellquist-Dahl, B; Heinrich, J; Horak, F; Hourihane, J O 'b; Howarth, P; Humbert, M; Hyland, M E; Ivancevich, J C; Jares, E J; Johnston, S L; Joos, G; Jonquet, O; Jung, K S; Just, J; Kaidashev, I; Kalayci, O; Kalyoncu, A F; Keil, T; Keith, P K; Khaltaev, N; Klimek, L; Koffi N'Goran, B; Kolek, V; Koppelman, G H; Kowalski, M L; Kull, I; Kuna, P; Kvedariene, V; Lambrecht, B; Lau, S; Larenas-Linnemann, D; Laune, D; Le, L T T; Lieberman, P; Lipworth, B; Li, J; Louis, R; Magard, Y; Magnan, A; Mahboub, B; Majer, I; Makela, M J; Manning, P; De Manuel Keenoy, E; Marshall, G D; Masjedi, M R; Maurer, M; Mavale-Manuel, S; Melén, E; Melo-Gomes, E; Meltzer, E O; Merk, H; Miculinic, N; Mihaltan, F; Milenkovic, B; Mohammad, Y; Molimard, M; Momas, I; Montilla-Santana, A; Morais-Almeida, M; Mösges, R; Namazova-Baranova, L; Naclerio, R; Neou, A; Neffen, H; Nekam, K; Niggemann, B; Nyembue, T D; O'Hehir, R E; Ohta, K; Okamoto, Y; Okubo, K; Ouedraogo, S; Paggiaro, P; Pali-Schöll, I; Palmer, S; Panzner, P; Papi, A; Park, H S; Pavord, I; Pawankar, R; Pfaar, O; Picard, R; Pigearias, B; Pin, I; Plavec, D; Pohl, W; Popov, T A; Portejoie, F; Postma, D; Potter, P; Price, D; Rabe, K F; Raciborski, F; Radier Pontal, F; Repka-Ramirez, S; Robalo-Cordeiro, C; Rolland, C; Rosado-Pinto, J; Reitamo, S; Rodenas, F; Roman Rodriguez, M; Romano, A; Rosario, N; Rosenwasser, L; Rottem, M; Sanchez-Borges, M; Scadding, G K; Serrano, E; Schmid-Grendelmeier, P; Sheikh, A; Simons, F E R; Sisul, J C; Skrindo, I; Smit, H A; Solé, D; Sooronbaev, T; Spranger, O; Stelmach, R; Strandberg, T; Sunyer, J; Thijs, C; Todo-Bom, A; Triggiani, M; Valenta, R; Valero, A L; van Hage, M; Vandenplas, O; Vezzani, G; Vichyanond, P; Viegi, G; Wagenmann, M; Walker, S; Wang, D Y; Wahn, U; Williams, D M; Wright, J; Yawn, B P; Yiallouros, P K; Yusuf, O M; Zar, H J; Zernotti, M E; Zhang, L; Zhong, N; Zidarn, M; Mercier, J

    2015-11-01

    Several unmet needs have been identified in allergic rhinitis: identification of the time of onset of the pollen season, optimal control of rhinitis and comorbidities, patient stratification, multidisciplinary team for integrated care pathways, innovation in clinical trials and, above all, patient empowerment. MASK-rhinitis (MACVIA-ARIA Sentinel NetworK for allergic rhinitis) is a simple system centred around the patient which was devised to fill many of these gaps using Information and Communications Technology (ICT) tools and a clinical decision support system (CDSS) based on the most widely used guideline in allergic rhinitis and its asthma comorbidity (ARIA 2015 revision). It is one of the implementation systems of Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA). Three tools are used for the electronic monitoring of allergic diseases: a cell phone-based daily visual analogue scale (VAS) assessment of disease control, CARAT (Control of Allergic Rhinitis and Asthma Test) and e-Allergy screening (premedical system of early diagnosis of allergy and asthma based on online tools). These tools are combined with a clinical decision support system (CDSS) and are available in many languages. An e-CRF and an e-learning tool complete MASK. MASK is flexible and other tools can be added. It appears to be an advanced, global and integrated ICT answer for many unmet needs in allergic diseases which will improve policies and standards. PMID:26148220

  6. Implementation of a comprehensive skin care program across care settings using the AHCPR pressure ulcer prevention and treatment guidelines.

    PubMed

    Suntken, G; Starr, B; Ermer-Seltun, J; Hopkins, L; Preftakes, D

    1996-03-01

    Healthcare professionals in the Central Midwest identified the need for a comprehensive skin care program for pressure ulcer prevention and treatment across care settings. A multidisciplinary team, representing acute, extended and home care, was formed to create a program for all three settings based upon the AHCPR pressure ulcer guidelines. The team performed literature reviews on which to base the development and use of tools, conducted prevalence studies, and developed educational approaches. Implementation of the program was tailored for each setting. Some of the approaches used were a skin care fair, quality studies, continuous quality improvement concepts, a "Product Book" and educational presentations. Outcomes include improvement of continuity of care across settings and the use of the Braden Scale and the NPUAP pressure ulcer staging system. The focus has turned toward patient outcomes. Professionals have a better understanding of the care that is provided by other disciplines. Referrals are made based upon decision trees. Appropriate resources are used. Other outcomes anticipated include a decrease in nosocomial pressure ulcers, shortened wound healing time, appropriate referral of unresponsive chronic wounds, decreased discrepancies in wound documentation, decreased length of stay, improved financial outcomes, and improved client knowledge and participation. PMID:8703293

  7. MACVIA-ARIA Sentinel NetworK for allergic rhinitis (MASK-rhinitis): the new generation guideline implementation.

    PubMed

    Bousquet, J; Schunemann, H J; Fonseca, J; Samolinski, B; Bachert, C; Canonica, G W; Casale, T; Cruz, A A; Demoly, P; Hellings, P; Valiulis, A; Wickman, M; Zuberbier, T; Bosnic-Anticevitch, S; Bedbrook, A; Bergmann, K C; Caimmi, D; Dahl, R; Fokkens, W J; Grisle, I; Lodrup Carlsen, K; Mullol, J; Muraro, A; Palkonen, S; Papadopoulos, N; Passalacqua, G; Ryan, D; Valovirta, E; Yorgancioglu, A; Aberer, W; Agache, I; Adachi, M; Akdis, C A; Akdis, M; Annesi-Maesano, I; Ansotegui, I J; Anto, J M; Arnavielhe, S; Arshad, H; Baiardini, I; Baigenzhin, A K; Barbara, C; Bateman, E D; Beghé, B; Bel, E H; Ben Kheder, A; Bennoor, K S; Benson, M; Bewick, M; Bieber, T; Bindslev-Jensen, C; Bjermer, L; Blain, H; Boner, A L; Boulet, L P; Bonini, M; Bonini, S; Bosse, I; Bourret, R; Bousquet, P J; Braido, F; Briggs, A H; Brightling, C E; Brozek, J; Buhl, R; Burney, P G; Bush, A; Caballero-Fonseca, F; Calderon, M A; Camargos, P A M; Camuzat, T; Carlsen, K H; Carr, W; Cepeda Sarabia, A M; Chavannes, N H; Chatzi, L; Chen, Y Z; Chiron, R; Chkhartishvili, E; Chuchalin, A G; Ciprandi, G; Cirule, I; Correia de Sousa, J; Cox, L; Crooks, G; Costa, D J; Custovic, A; Dahlen, S E; Darsow, U; De Carlo, G; De Blay, F; Dedeu, T; Deleanu, D; Denburg, J A; Devillier, P; Didier, A; Dinh-Xuan, A T; Dokic, D; Douagui, H; Dray, G; Dubakiene, R; Durham, S R; Dykewicz, M S; El-Gamal, Y; Emuzyte, R; Fink Wagner, A; Fletcher, M; Fiocchi, A; Forastiere, F; Gamkrelidze, A; Gemicioğlu, B; Gereda, J E; González Diaz, S; Gotua, M; Grouse, L; Guzmán, M A; Haahtela, T; Hellquist-Dahl, B; Heinrich, J; Horak, F; Hourihane, J O 'b; Howarth, P; Humbert, M; Hyland, M E; Ivancevich, J C; Jares, E J; Johnston, S L; Joos, G; Jonquet, O; Jung, K S; Just, J; Kaidashev, I; Kalayci, O; Kalyoncu, A F; Keil, T; Keith, P K; Khaltaev, N; Klimek, L; Koffi N'Goran, B; Kolek, V; Koppelman, G H; Kowalski, M L; Kull, I; Kuna, P; Kvedariene, V; Lambrecht, B; Lau, S; Larenas-Linnemann, D; Laune, D; Le, L T T; Lieberman, P; Lipworth, B; Li, J; Louis, R; Magard, Y; Magnan, A; Mahboub, B; Majer, I; Makela, M J; Manning, P; De Manuel Keenoy, E; Marshall, G D; Masjedi, M R; Maurer, M; Mavale-Manuel, S; Melén, E; Melo-Gomes, E; Meltzer, E O; Merk, H; Miculinic, N; Mihaltan, F; Milenkovic, B; Mohammad, Y; Molimard, M; Momas, I; Montilla-Santana, A; Morais-Almeida, M; Mösges, R; Namazova-Baranova, L; Naclerio, R; Neou, A; Neffen, H; Nekam, K; Niggemann, B; Nyembue, T D; O'Hehir, R E; Ohta, K; Okamoto, Y; Okubo, K; Ouedraogo, S; Paggiaro, P; Pali-Schöll, I; Palmer, S; Panzner, P; Papi, A; Park, H S; Pavord, I; Pawankar, R; Pfaar, O; Picard, R; Pigearias, B; Pin, I; Plavec, D; Pohl, W; Popov, T A; Portejoie, F; Postma, D; Potter, P; Price, D; Rabe, K F; Raciborski, F; Radier Pontal, F; Repka-Ramirez, S; Robalo-Cordeiro, C; Rolland, C; Rosado-Pinto, J; Reitamo, S; Rodenas, F; Roman Rodriguez, M; Romano, A; Rosario, N; Rosenwasser, L; Rottem, M; Sanchez-Borges, M; Scadding, G K; Serrano, E; Schmid-Grendelmeier, P; Sheikh, A; Simons, F E R; Sisul, J C; Skrindo, I; Smit, H A; Solé, D; Sooronbaev, T; Spranger, O; Stelmach, R; Strandberg, T; Sunyer, J; Thijs, C; Todo-Bom, A; Triggiani, M; Valenta, R; Valero, A L; van Hage, M; Vandenplas, O; Vezzani, G; Vichyanond, P; Viegi, G; Wagenmann, M; Walker, S; Wang, D Y; Wahn, U; Williams, D M; Wright, J; Yawn, B P; Yiallouros, P K; Yusuf, O M; Zar, H J; Zernotti, M E; Zhang, L; Zhong, N; Zidarn, M; Mercier, J

    2015-11-01

    Several unmet needs have been identified in allergic rhinitis: identification of the time of onset of the pollen season, optimal control of rhinitis and comorbidities, patient stratification, multidisciplinary team for integrated care pathways, innovation in clinical trials and, above all, patient empowerment. MASK-rhinitis (MACVIA-ARIA Sentinel NetworK for allergic rhinitis) is a simple system centred around the patient which was devised to fill many of these gaps using Information and Communications Technology (ICT) tools and a clinical decision support system (CDSS) based on the most widely used guideline in allergic rhinitis and its asthma comorbidity (ARIA 2015 revision). It is one of the implementation systems of Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA). Three tools are used for the electronic monitoring of allergic diseases: a cell phone-based daily visual analogue scale (VAS) assessment of disease control, CARAT (Control of Allergic Rhinitis and Asthma Test) and e-Allergy screening (premedical system of early diagnosis of allergy and asthma based on online tools). These tools are combined with a clinical decision support system (CDSS) and are available in many languages. An e-CRF and an e-learning tool complete MASK. MASK is flexible and other tools can be added. It appears to be an advanced, global and integrated ICT answer for many unmet needs in allergic diseases which will improve policies and standards.

  8. Soft Tissue Tumors in Adults: ESSR-Approved Guidelines for Diagnostic Imaging.

    PubMed

    Noebauer-Huhmann, Iris M; Weber, Marc-André; Lalam, Radhesh K; Trattnig, Siegfried; Bohndorf, Klaus; Vanhoenacker, Filip; Tagliafico, Alberto; van Rijswijk, Carla; Vilanova, Joan C; Afonso, P Diana; Breitenseher, Martin; Beggs, Ian; Robinson, Philip; de Jonge, Milko C; Krestan, Christian; Bloem, Johan L

    2015-12-01

    Soft tissue sarcomas are rare, but early, accurate diagnosis with subsequent appropriate treatment is crucial for the clinical outcome. The ESSR guidelines are intended to help radiologists in their decision-making and support discussion among clinicians who deal with patients with suspected or proven soft tissue tumors. Potentially malignant lesions recognized by ultrasound should be referred for magnetic resonance imaging (MRI), which also serves as a preoperative local staging modality, with specific technical requirements and mandatory radiological report elements. Radiography may add information about matrix calcification and osseous involvement. Indeterminate lesions, or lesions in which therapy is dependent on histology results, should be biopsied. For biopsy, we strongly recommend referral to a specialist sarcoma center, where an interdisciplinary tumor group, with a specialized pathologist, radiologist, and the surgeon are involved. In sarcoma, a CT scan of the chest is mandatory. Additional staging modalities are entity-specific. There are no evidence-based recommendations for routine follow-up in surgically treated sarcomas. However, we would recommend regular follow-up with intervals dependent on tumor grade, for 10 years after the initial diagnosis. PMID:26696086

  9. Systematic tailoring for the implementation of guideline recommendations for anxiety and depressive disorders in general practice: perceived usefulness of tailored interventions

    PubMed Central

    2013-01-01

    Background The uptake of guideline recommendations in general practice can potentially be improved by designing implementation interventions that are tailored to prospectively identify barriers. However, there is insufficient evidence regarding the most effective and efficient approaches to tailoring. Our study provides an insight into the usefulness of tailored interventions to prospectively identified barriers affecting the uptake of guideline recommendations for anxiety and depressive disorders experienced by general practitioners (GPs) in their local context. Methods A qualitative study was conducted, in which 23 GPs gave informed consent and 14 finally participated. To explore the barriers affecting the uptake of guideline recommendations, a face-to-face interview was conducted with each GP to generate a personalised list. In response to this list, interventions were tailored to remove the barriers experienced by the GPs. To examine the perceived usefulness of the tailored interventions, telephone interviews were conducted after one year and coded through thematic coding. The analysis was descriptive in nature. Results The most frequently perceived barriers were: a lack of knowledge and skills, no agreement on guideline recommendations, negative outcome expectancy, low self-efficacy, no consensus with patients, and a lack of information about treatments provided by mental health professionals, together with waiting lists. The tailored interventions ‘peer group supervision’ and ‘individualised telephone consultations’ were perceived as useful by most GPs. Besides the tailored interventions, a perceived benefit of using a self-rating scale, measuring depressive and anxiety symptoms, and the idea of delivering better patient care, were supportive in the uptake of guideline recommendations. Conclusions Our findings suggest that tailoring interventions to prospectively identified barriers, affecting the uptake of guideline recommendations for anxiety and

  10. Guidelines for lumbar spine radiography in acute low back pain: effect of implementation in an accident and emergency department.

    PubMed Central

    Tracey, N. G.; Martin, J. B.; McKinstry, C. S.; Mathew, B. M.

    1994-01-01

    Guidelines for lumbar spine radiography were agreed by consultation between staff in the radiology, accident and emergency and neurosurgical departments of a large teaching hospital. Study of 322 consecutive patients over an eight month period showed that the proportion of patients referred for radiography was reduced from 48.4% to 27.2% following introduction of the guidelines (p = 0.0002). Successful use of such guidelines requires cooperation between clinical and radiological staff and frequent review of performance. PMID:8658989

  11. Implementation of pregnancy weight management and obesity guidelines: a meta-synthesis of healthcare professionals' barriers and facilitators using the Theoretical Domains Framework.

    PubMed

    Heslehurst, N; Newham, J; Maniatopoulos, G; Fleetwood, C; Robalino, S; Rankin, J

    2014-06-01

    Obesity in pregnancy is rising and is associated with severe health consequences for both the mother and the child. There is an increasing international focus on guidelines to manage the clinical risks of maternal obesity, and for pregnancy weight management. However, passive dissemination of guidelines is not effective and more active strategies are required for effective guideline implementation into practice. Implementation of guidelines is a form of healthcare professional behaviour change, and therefore implementation strategies should be based on appropriate behaviour change theory. This systematic review aimed to identify the determinants of healthcare professionals' behaviours in relation to maternal obesity and weight management. Twenty-five studies were included. Data synthesis of the existing international qualitative and quantitative evidence base used the Theoretical Domains Framework to identify the barriers and facilitators to healthcare professionals' maternal obesity and weight management practice. The domains most frequently identified included 'knowledge', 'beliefs about consequences' and 'environmental context and resources'. Healthcare professionals' weight management practice had the most barriers compared with any other area of maternal obesity practice. The results of this review will be used to inform the development of an intervention to support healthcare professional behaviour change.

  12. Impact of the Creation and Implementation of a Clinical Management Guideline for Personality Disorders in Reducing Use of Mechanical Restraints in a Psychiatric Inpatient Unit

    PubMed Central

    Fernandez-Rivas, Aranzazu; Bustamante, Sonia; Rico-Vilademoros, Fernando; Vivanco, Esther; Martinez, Karmele; Angel Vecino, Miguel; Martín, Melba; Herrera, Sonia; Rodriguez, Jorge; Saenz, Carlos

    2014-01-01

    Objective: To evaluate the impact of the implementation of a guideline for the management of personality disorders on reducing the frequency of use of mechanical restraints in a psychiatric inpatient unit. Method: This retrospective study was conducted in a psychiatric inpatient unit with 42 beds, which serves an urban area of 330,000 inhabitants. The sample consisted of all patients with a clinical diagnosis of personality disorder (DSM-IV-TR criteria) who were admitted to the unit from January 2010 to December 2010 and from January 2011 to December 2011 (ie, before and after, respectively, the implementation of the guideline). The guideline focused on cluster B disorders and follows a psychodynamic perspective. Results: Restraint use was reduced from 38 of 87 patients with personality disorders (43.7%) to 3 of 112 (2.7%), for a relative risk of 0.06 (95% CI, 0.02–0.19) and an absolute risk reduction of 41% (95% CI, 29.9%–51.6%). The risk of being discharged against medical advice increased after the intervention, with a relative risk of 1.84 (95% CI, 0.96–3.51). Restraint use in patients with other diagnoses was also reduced to a similar extent. Conclusions: The use of mechanical restraints was dramatically reduced after the implementation of a clinical practice guideline on personality disorders, suggesting that these coercive measures might be decreased in psychiatric inpatient units. PMID:25834763

  13. Guidelines for development and implementation of state solid waste management plans and criteria for classification of solid waste disposal facilities and practices--Environmental Protection Agency. Final rule.

    PubMed

    1981-09-23

    This rule modifies the Environmental Protection Agency's Guidelines for the Development and Implementation of State Solid Waste Management Plans (40 CFR Part 256) and the Criteria for the Classification of Solid Waste Disposal Facilities and Practices (40 CFR Part 257). The Guidelines are being amended to expand public participation opportunities in the planning process and provide for expedited approval of certain portions of the State plans. The Criteria are being amended to modify the groundwater, surface water and air protection criteria. EPA is taking this action as part of a settlement agreement reached with industrial groups which have challenged these regulations in Federal Court.

  14. Implementation of the American College of Cardiology/American Heart Association 2008 Guidelines for the Management of Adults With Congenital Heart Disease.

    PubMed

    Goossens, Eva; Fernandes, Susan M; Landzberg, Michael J; Moons, Philip

    2015-08-01

    Although different guidelines on adult congenital heart disease (ACHD) care advocate for lifetime cardiac follow-up, a critical appraisal of the guideline implementation is lacking. We investigated the implementation of the American College of Cardiology/American Heart Association 2008 guidelines for ACHD follow-up by investigating the type of health care professional, care setting, and frequency of outpatient visits in young adults with CHD. Furthermore, correlates for care in line with the recommendations or untraceability were investigated. A cross-sectional observational study was conducted, including 306 patients with CHD who had a documented outpatient visit at pediatric cardiology before age 18 years. In all, 210 patients (68.6%) were in cardiac follow-up; 20 (6.5%) withdrew from follow-up and 76 (24.9%) were untraceable. Overall, 198 patients were followed up in tertiary care, 1/4 (n = 52) of which were seen at a formalized ACHD care program and 3/4 (n = 146) remained at pediatric cardiology. Of those followed in formalized ACHD and pediatric cardiology care, the recommended frequency was implemented in 94.2% and 89%, respectively (p = 0.412). No predictors for the implementation of the guidelines were identified. Risk factors for becoming untraceable were none or lower number of heart surgeries, health insurance issues, and nonwhite ethnicity. In conclusion, a significant number of adults continue to be cared for by pediatric cardiologists, indicating that transfer to adult-oriented care was not standard practice. Frequency of follow-up for most patients was in line with the ACC/AHA 2008 guidelines. A considerable proportion of young adults were untraceable in the system, which makes them vulnerable for discontinuation of care.

  15. [Guideline for the Development of Evidence-based Patient Information: insights into the methods and implementation of evidence-based health information].

    PubMed

    Lühnen, Julia; Albrecht, Martina; Hanßen, Käthe; Hildebrandt, Julia; Steckelberg, Anke

    2015-01-01

    The "Guideline for the Development of Evidence-based Patient Information" project is a novelty. The aim of this project is to enhance the quality of health information. The development and implementation process is guided by national and international standards. Involvement of health information developers plays an essential role. This article provides an insight into the guideline's underlying methodology, using graphics as an example. In addition, the results of a qualitative study exploring the competencies of health information developers are presented. These results will guide the implementation of the guideline. We conducted systematic literature searches (until June 2014), critical appraisal and descriptive analyses applying GRADE for two selected guideline questions. Out of 3,287 hits 11 RCTs were included in the analysis. The evidence has been rated to be of low to moderate quality. Additional graphics may have a positive effect on cognitive outcomes. However, the relevance of the results is questionable. For graphics, we found some indication that especially pictograms but also bar graphs have a positive effect on cognitive outcomes and meet patients' preferences. In order to prepare for the implementation of the guideline, we conducted a qualitative study to explore the competencies of health information developers using expert interviews. Four telephone interviews were conducted, audio recorded, transcribed and analysed according to Grounded Theory. Six categories were identified: literature search, development of health information, participation of target groups, continuing education and further training of health information developers, cooperation with different institutions, essential competencies. Levels of competencies regarding the methods of evidence-based medicine and evidence-based health information vary considerably and indicate a need for training. These results have informed the development of a training programme that will support the

  16. Implementation of the 2013 American College of Cardiology/American Heart Association Blood Cholesterol Guideline Including Data From the Improved Reduction of Outcomes: Vytorin Efficacy International Trial.

    PubMed

    Ziaeian, Boback; Dinkler, John; Watson, Karol

    2015-01-01

    Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of morbidity and mortality in developed countries. The management of blood cholesterol through use of 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase inhibitors (statins) in at-risk patients is a pillar of medical therapy for the primary and secondary prevention of cardiovascular disease. The recent 2013 American College of Cardiology/American Heart Association guideline on managing blood cholesterol provides an important framework for the effective implementation of risk-reduction strategies. The guideline identifies four cohorts of patients with proven benefits from statin therapy and streamlines the dosing and monitoring recommendations based on evidence from published, randomized controlled trials. Primary care physicians and cardiologists play key roles in identifying populations at elevated ASCVD risk. In providing a practical management overview of the current blood cholesterol guideline, we facilitate more informed discussions on treatment options between healthcare providers and their patients.

  17. Implementation of the 2013 American College of Cardiology/American Heart Association Blood Cholesterol Guideline Including Data From the Improved Reduction of Outcomes: Vytorin Efficacy International Trial.

    PubMed

    Ziaeian, Boback; Dinkler, John; Watson, Karol

    2015-01-01

    Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of morbidity and mortality in developed countries. The management of blood cholesterol through use of 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase inhibitors (statins) in at-risk patients is a pillar of medical therapy for the primary and secondary prevention of cardiovascular disease. The recent 2013 American College of Cardiology/American Heart Association guideline on managing blood cholesterol provides an important framework for the effective implementation of risk-reduction strategies. The guideline identifies four cohorts of patients with proven benefits from statin therapy and streamlines the dosing and monitoring recommendations based on evidence from published, randomized controlled trials. Primary care physicians and cardiologists play key roles in identifying populations at elevated ASCVD risk. In providing a practical management overview of the current blood cholesterol guideline, we facilitate more informed discussions on treatment options between healthcare providers and their patients. PMID:26198559

  18. Implementation of the Pain, Agitation, and Delirium Clinical Practice Guidelines and promoting patient mobility to prevent post-intensive care syndrome.

    PubMed

    Davidson, Judy E; Harvey, Maurene A; Bemis-Dougherty, Anita; Smith, James M; Hopkins, Ramona O

    2013-09-01

    Surviving critical illness is associated with persistent and severe physical, cognitive, and psychological morbidities. The Society of Critical Care Medicine has developed pain, agitation, and delirium guidelines and promoted mobility to improve care of critically ill patients. A task force has developed tools to facilitate and rapidly implement the translation of guideline care recommendations into practice. The Society of Critical Care Medicine has also assembled a task force to assess the long-term consequences of critical illness. This article will explore relationships between the pain, agitation, and delirium guidelines, mobility recommendations, and post-intensive care syndrome initiative. Implementation of the pain, agitation, and delirium guidelines taking into account current data regarding post-intensive care syndrome outcomes and potential interventions are an important first step toward improving outcomes for patients and their families. Research is needed to reduce the impact of long-term negative consequences of critical illness and to fully understand the best within- and post-ICU interventions, along with the optimal timing and dose of such interventions to produce the best long-term outcomes.

  19. Hybrid imaging in planar scintigraphy: new implementations and historical precedents.

    PubMed

    Zuckier, Lionel S

    2012-01-01

    Fusion of tomographic radionuclide studies with anatomical examinations has become standard practice in positron emission tomography (PET) and single photon emission computed tomography (SPECT) imaging. Nonetheless, fusion of planar scintigraphic images with an anatomical modality remains distinctly uncommon, although methods to do so have appeared sporadically in the literature during the past 2 decades. In this article we review several techniques that have been used to combine planar scintigraphic images with radiographs and visual (photographic) images. Rigid or affine transformations have been performed to co-register the planar images with each other using custom, commercial, or public domain software. Display of the hybrid images has been achieved primarily with nonselective color-fusion methods. Promising efforts are underway to develop a technique of fusing planar lymphoscintigraphic images with CT topograms (scout images) obtained on the SPECT-CT camera in a manner that compensates for position-dependent variation in magnification that affects the CT scout. An advantage of this approach is that both of the component images are acquired on the same gantry, without need for repositioning of the patient. It is instructive to note that techniques of fusing rectilinear scans with radiographic and visual images were first developed more than 50 years ago. The revisiting of these methods after many decades reflects a fundamental need for spatial orientation in nuclear medicine that fusion imaging can also bring to planar scintigraphic studies.

  20. Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America.

    PubMed

    Barlam, Tamar F; Cosgrove, Sara E; Abbo, Lilian M; MacDougall, Conan; Schuetz, Audrey N; Septimus, Edward J; Srinivasan, Arjun; Dellit, Timothy H; Falck-Ytter, Yngve T; Fishman, Neil O; Hamilton, Cindy W; Jenkins, Timothy C; Lipsett, Pamela A; Malani, Preeti N; May, Larissa S; Moran, Gregory J; Neuhauser, Melinda M; Newland, Jason G; Ohl, Christopher A; Samore, Matthew H; Seo, Susan K; Trivedi, Kavita K

    2016-05-15

    Evidence-based guidelines for implementation and measurement of antibiotic stewardship interventions in inpatient populations including long-term care were prepared by a multidisciplinary expert panel of the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. The panel included clinicians and investigators representing internal medicine, emergency medicine, microbiology, critical care, surgery, epidemiology, pharmacy, and adult and pediatric infectious diseases specialties. These recommendations address the best approaches for antibiotic stewardship programs to influence the optimal use of antibiotics.

  1. Executive Summary: Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America.

    PubMed

    Barlam, Tamar F; Cosgrove, Sara E; Abbo, Lilian M; MacDougall, Conan; Schuetz, Audrey N; Septimus, Edward J; Srinivasan, Arjun; Dellit, Timothy H; Falck-Ytter, Yngve T; Fishman, Neil O; Hamilton, Cindy W; Jenkins, Timothy C; Lipsett, Pamela A; Malani, Preeti N; May, Larissa S; Moran, Gregory J; Neuhauser, Melinda M; Newland, Jason G; Ohl, Christopher A; Samore, Matthew H; Seo, Susan K; Trivedi, Kavita K

    2016-05-15

    Evidence-based guidelines for implementation and measurement of antibiotic stewardship interventions in inpatient populations including long-term care were prepared by a multidisciplinary expert panel of the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. The panel included clinicians and investigators representing internal medicine, emergency medicine, microbiology, critical care, surgery, epidemiology, pharmacy, and adult and pediatric infectious diseases specialties. These recommendations address the best approaches for antibiotic stewardship programs to influence the optimal use of antibiotics.

  2. Issues to consider before implementing digital breast tomosynthesis into a breast imaging practice.

    PubMed

    Hardesty, Lara A

    2015-03-01

    OBJECTIVE. The purpose of this article is to discuss issues surrounding the implementation of digital breast tomosynthesis (DBT) into a clinical breast imaging practice and assist radiologists, technologists, and administrators who are considering the addition of this new technology to their practices. CONCLUSION. When appropriate attention is given to image acquisition, interpretation, storage, technologist and radiologist training, patient selection, billing, radiation dose, and marketing, implementation of DBT into a breast imaging practice can be successful. PMID:25714303

  3. Issues to consider before implementing digital breast tomosynthesis into a breast imaging practice.

    PubMed

    Hardesty, Lara A

    2015-03-01

    OBJECTIVE. The purpose of this article is to discuss issues surrounding the implementation of digital breast tomosynthesis (DBT) into a clinical breast imaging practice and assist radiologists, technologists, and administrators who are considering the addition of this new technology to their practices. CONCLUSION. When appropriate attention is given to image acquisition, interpretation, storage, technologist and radiologist training, patient selection, billing, radiation dose, and marketing, implementation of DBT into a breast imaging practice can be successful.

  4. Considerations for imaging system implementation in a networked environment

    SciTech Connect

    Hudson, B.J.

    1991-01-01

    Information storage and retrieval systems that utilize raster images are increasing in popularity on a wide variety of platforms. Image systems typically involve the transmission of data files in the 100 KiloByte to 1 MegaByte range to users on specialized workstations who expect retrieval in a matter of seconds. The results of the pilot study outlines the potential for the sharing of image information among various platforms and systems, and sets expectations regarding the level of integration.

  5. Considerations for imaging system implementation in a networked environment

    SciTech Connect

    Hudson, B.J.

    1991-12-31

    Information storage and retrieval systems that utilize raster images are increasing in popularity on a wide variety of platforms. Image systems typically involve the transmission of data files in the 100 KiloByte to 1 MegaByte range to users on specialized workstations who expect retrieval in a matter of seconds. The results of the pilot study outlines the potential for the sharing of image information among various platforms and systems, and sets expectations regarding the level of integration.

  6. [DESIGN AND VALIDATION OF AN IMAGE FOR DISSEMINATION AND IMPLEMENTATION OF CHILEAN DIETARY GUIDELINES].

    PubMed

    Olivares Cortés, Sonia; Zacarías Hasbún, Isabel; González González, Carmen Gloria; Fonseca Morán, Lilian; Mediano Stoltze, Fernanda; Pinheiro Fernandes, Anna Christina; Rodríguez Osiac, Lorena

    2015-08-01

    Introducción: las Guías Alimentarias Basadas en Alimentos (GABA) generalmente van acompañadas de una imagen para su difusión e implementación. Objetivo: diseñar y validar una imagen que represente la variedad y proporcionalidad de las nuevas guías alimentarias para la población chilena, incluyendo los alimentos altos en nutrientes críticos que es necesario evitar y la actividad física. Método: un panel de expertos analizó siete propuestas gráficas y seleccionó tres que fueron validadas con 12 grupos focales de personas de 10-14 y 20-40 años, distinto sexo, nivel socioeconómico y sector urbano/rural. Se analizó la percepción de la variedad y proporcionalidad de los grupos de alimentos a comer diariamente y la motivación a la acción en alimentación y actividad física. Se trabajó con METAPLÁN, método ya utilizado en la validación de las GABA. Resultados y discusión: la imagen definitiva es un círculo que presenta la variedad y proporcionalidad de los grupos de alimentos a consumir durante el día (en fotografías), incluye la actividad física en una franja que rodea la mitad del círculo y un rectángulo inferior con ejemplos de alimentos altos en nutrientes críticos en blanco y negro. La imagen elegida fue modificada con las aportaciones de los participantes y validada con tres nuevos grupos focales, mejorando su comprensión y aceptación. Conclusión: la mayoría de los participantes comprendió que la imagen representaba la relación entre la alimentación saludable y la actividad física diaria, identificando los grupos de alimentos de los que se sugiere comer más y de los que se necesita reducir o evitar su consumo.

  7. Image segmentation with genetic algorithms: a formulation and implementation

    NASA Astrophysics Data System (ADS)

    Seetharaman, Gunasekaran; Narasimhan, Amruthur; Sathe, Anand; Storc, Lisa

    1991-10-01

    Image segmentation is an important step in any computer vision system. Segmentation refers to the partitioning of the image plane into several regions, such that each region corresponds to a logical entity present in the scene. The problem is inherently NP, and the theory on the existence and uniqueness of the ideal segmentation is not yet established. Several methods have been proposed in literature for image segmentation. With the exception of the state-space approach to segmentation, other methods lack generality. The state-space approach, however, amounts to searching for the solution in a large search space of 22n(2) possibilities for a n X n image. In this paper, a classic approach based on state-space techniques for segmentation due to Brice and Fennema is reformulated using genetic algorithms. The state space representation of a partially segmented image lends itself to binary strings, in which the dominant substrings are easily explained in terms of chromosomes. Also the operations such as crossover and mutations are easily abstracted. In particular, when multiple images are segmented from an image sequence, fusion of constraints from one to the other becomes clear under this formulation.

  8. Medical emergency aid through telematics: design, implementation guidelines and analysis of user requirements for the MERMAID project.

    PubMed

    Anogianakis, G; Maglavera, S; Pomportsis, A; Bountzioukas, S; Beltrame, F; Orsi, G

    1997-01-01

    MERMAID is an EU financed telemedicine project with global reach and 24-hour, multilingual capability. It aspires to provide a model for the provision of health care services based on the electronic transmission of medical information, via ISDN based videoconferencing. This model will not be limited to medical diagnostics but it will encompass all cases where the actual delivery of health care services involves a patient who is not located where the provider is. Its implementation requires the commissioning of an expensive telecommunications infrastructure and the exploration of a number of solutions. In fact, all categories of telemedical applications (audio and video conferencing, multimedia communications, flat file and image transfer with low, medium and high bandwidth data requirements) will be considered while the full range of network choices (Digital land lines, Cellular/Wireless, Satellite and Broadband) will be tested in terms of cost/performance tradeoffs that are inherent to them and the developmental stage each of these options occupies in their in its life cycle. Finally, out that MERMAID utilises advanced land based line transmission technologies to aid the remote patient by making available the specialist care that is best suited in the particular case.

  9. Medical emergency aid through telematics: design, implementation guidelines and analysis of user requirements for the MERMAID project.

    PubMed

    Anogianakis, G; Maglavera, S; Pomportsis, A; Bountzioukas, S; Beltrame, F; Orsi, G

    1998-01-01

    MERMAID is an EU financed telemedicine project with global reach and 24-h, multilingual capability. It aspires to provide a model for the provision of health care services based on the electronic transmission of medical information, via ISDN based videoconferencing. This model will not be limited to medical diagnostics but it will encompass all cases where the actual delivery of health care services involves a patient who is not located where the provider is. Its implementation requires the commissioning of an expensive telecommunications infrastructure and the exploration of a number of solutions. In fact, all categories of telemedical applications (audio and video conferencing, multimedia communications, flat file and image transfer with low, medium and high bandwidth data requirements) are considered while the full range of network choices (digital land lines, cellular/wireless, satellite and broadband) are being tested in terms of cost/performance tradeoffs that are inherent to them and the developmental stage each of these options occupies in their in its life cycle. Finally, out that MERMAID utilises advanced land based line transmission technologies to aid the remote patient by making available the specialist care that is best suited in the particular case.

  10. 2014 Korean Guidelines for Appropriate Utilization of Cardiovascular Magnetic Resonance Imaging: A Joint Report of the Korean Society of Cardiology and the Korean Society of Radiology

    PubMed Central

    Yoon, Yeonyee E.; Hong, Yoo Jin; Kim, Hyung-Kwan; Kim, Jeong A; Na, Jin Oh; Yang, Dong Hyun

    2014-01-01

    Cardiac magnetic resonance (CMR) imaging is now widely used in several fields of cardiovascular disease assessment due to recent technical developments. CMR can give physicians information that cannot be found with other imaging modalities. However, there is no guideline which is suitable for Korean people for the use of CMR. Therefore, we have prepared a Korean guideline for the appropriate utilization of CMR to guide Korean physicians, imaging specialists, medical associates and patients to improve the overall medical system performances. By addressing CMR usage and creating these guidelines we hope to contribute towards the promotion of public health. This guideline is a joint report of the Korean Society of Cardiology and the Korean Society of Radiology. PMID:25469078

  11. 2014 Korean Guidelines for Appropriate Utilization of Cardiovascular Magnetic Resonance Imaging: A Joint Report of the Korean Society of Cardiology and the Korean Society of Radiology

    PubMed Central

    Yoon, Yeonyee E.; Hong, Yoo Jin; Kim, Hyung-Kwan; Kim, Jeong A; Na, Jin Oh; Yang, Dong Hyun

    2014-01-01

    Cardiac magnetic resonance (CMR) imaging is now widely used in several fields of cardiovascular disease assessment due to recent technical developments. CMR can give physicians information that cannot be found with other imaging modalities. However, there is no guideline which is suitable for Korean people for the use of CMR. Therefore, we have prepared a Korean guideline for the appropriate utilization of CMR to guide Korean physicians, imaging specialists, medical associates and patients to improve the overall medical system performances. By addressing CMR usage and creating these guidelines we hope to contribute towards the promotion of public health. This guideline is a joint report of the Korean Society of Cardiology and the Korean Society of Radiology. PMID:25469139

  12. Compact Video Microscope Imaging System Implemented in Colloid Studies

    NASA Technical Reports Server (NTRS)

    McDowell, Mark

    2002-01-01

    Long description Photographs showing fiber-optic light source, microscope and charge-coupled discharge (CCD) camera head connected to camera body, CCD camera body feeding data to image acquisition board in PC, and Cartesian robot controlled via PC board. The Compact Microscope Imaging System (CMIS) is a diagnostic tool with intelligent controls for use in space, industrial, medical, and security applications. CMIS can be used in situ with a minimum amount of user intervention. This system can scan, find areas of interest in, focus on, and acquire images automatically. Many multiple-cell experiments require microscopy for in situ observations; this is feasible only with compact microscope systems. CMIS is a miniature machine vision system that combines intelligent image processing with remote control. The software also has a user-friendly interface, which can be used independently of the hardware for further post-experiment analysis. CMIS has been successfully developed in the SML Laboratory at the NASA Glenn Research Center and adapted for use for colloid studies and is available for telescience experiments. The main innovations this year are an improved interface, optimized algorithms, and the ability to control conventional full-sized microscopes in addition to compact microscopes. The CMIS software-hardware interface is being integrated into our SML Analysis package, which will be a robust general-purpose image-processing package that can handle over 100 space and industrial applications.

  13. Development and implementation of software systems for imaging spectroscopy

    USGS Publications Warehouse

    Boardman, J.W.; Clark, R.N.; Mazer, A.S.; Biehl, L.L.; Kruse, F.A.; Torson, J.; Staenz, K.

    2006-01-01

    Specialized software systems have played a crucial role throughout the twenty-five year course of the development of the new technology of imaging spectroscopy, or hyperspectral remote sensing. By their very nature, hyperspectral data place unique and demanding requirements on the computer software used to visualize, analyze, process and interpret them. Often described as a marriage of the two technologies of reflectance spectroscopy and airborne/spaceborne remote sensing, imaging spectroscopy, in fact, produces data sets with unique qualities, unlike previous remote sensing or spectrometer data. Because of these unique spatial and spectral properties hyperspectral data are not readily processed or exploited with legacy software systems inherited from either of the two parent fields of study. This paper provides brief reviews of seven important software systems developed specifically for imaging spectroscopy.

  14. Fast Implementation of Matched Filter Based Automatic Alignment Image Processing

    SciTech Connect

    Awwal, A S; Rice, K; Taha, T

    2008-04-02

    Video images of laser beams imprinted with distinguishable features are used for alignment of 192 laser beams at the National Ignition Facility (NIF). Algorithms designed to determine the position of these beams enable the control system to perform the task of alignment. Centroiding is a common approach used for determining the position of beams. However, real world beam images suffer from intensity fluctuation or other distortions which make such an approach susceptible to higher position measurement variability. Matched filtering used for identifying the beam position results in greater stability of position measurement compared to that obtained using the centroiding technique. However, this gain is achieved at the expense of extra processing time required for each beam image. In this work we explore the possibility of using a field programmable logic array (FPGA) to speed up these computations. The results indicate a performance improvement of 20 using the FPGA relative to a 3 GHz Pentium 4 processor.

  15. Handbook of Procedural Guidelines for Implementation of Special Education Curriculum: Critical Skills/Community-Based and Special Education Curriculum Guide.

    ERIC Educational Resources Information Center

    Riverside County Office of Education, CA. Div. of Special Schools and Services.

    The special education procedural handbook and the special education curriculum guide provide guidelines for teachers and other school personnel. The procedural handbook covers the following areas: individual education program process (IEP) and program placement, individual education program team, administrative placements, parent interviews,…

  16. 77 FR 43759 - Examination Guidelines for Implementing the First-Inventor-to-File Provisions of the Leahy-Smith...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-26

    ...The United States Patent and Trademark Office (Office) is publishing proposed examination guidelines concerning the first-inventor-to-file (FITF) provisions of the Leahy-Smith America Invents Act (AIA). The AIA amends the patent laws pertaining to the conditions of patentability to convert the United States patent system from a ``first to invent'' system to a ``first inventor to file'' system,......

  17. 78 FR 11059 - Examination Guidelines for Implementing the First Inventor To File Provisions of the Leahy-Smith...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-14

    ... of the Leahy-Smith America Invents Act, 77 FR 43742 (July 26, 2012) (notice of proposed rulemaking... America Invents Act, 77 FR 43759 (July 26, 2012) (notice of proposed examination guidelines). The Office... First Inventor To File Provisions of the Leahy-Smith America Invents Act, 77 FR 49427 (Aug. 16,...

  18. "Let Me Get You a Nicotine Patch": Nurses' Perceptions of Implementing Smoking Cessation Guidelines for Hospitalized Veterans.

    PubMed

    Katz, David A; Stewart, Kenda; Paez, Monica; Holman, John; Adams, Susan L; Vander Weg, Mark W; Battaglia, Catherine T; Joseph, Anne M; Titler, Marita G; Ono, Sarah

    2016-04-01

    Many hospitalized smokers do not receive guideline-recommended tobacco treatment, but little is known about the perceptions of inpatient nurses with regard to tobacco treatment. We used a sequential explanatory mixed methods design to help explain the findings of an academic detailing intervention trial on the inpatient medicine units of four Veterans Affairs (VA) hospitals. We surveyed 164 nurses and conducted semistructured interviews in a purposeful sample of 33 nurses with different attitudes toward cessation counseling. Content analysis was used to inductively characterize the issues raised by participants. Emerging themes were categorized using the knowledge-attitudes-behavior framework of guideline adherence. Knowledge-related and attitudinal barriers included perceived lack of skills in cessation counseling and skepticism about the effectiveness of cessation guidelines in hospitalized veterans. Nurses also reported multiple behavioral and organizational barriers to guideline adherence: resistance from patients, insufficient time and resources, the presence of smoking areas on VA premises, and lack of coordination with primary care. VA hospitals should train inpatient staff how to negotiate behavior change, integrate cessation counseling into nurses' workflow, develop alternative referral mechanisms for post-discharge cessation counseling, and adopt hospital policies to promote inpatient abstinence. PMID:27046185

  19. Teaching High School Science Using Image Processing: A Case Study of Implementation of Computer Technology.

    ERIC Educational Resources Information Center

    Greenberg, Richard; Raphael, Jacqueline; Keller, Jill L.; Tobias, Sheila

    1998-01-01

    Outlines an in-depth case study of teachers' use of image processing in biology, earth science, and physics classes in one high school science department. Explores issues surrounding technology implementation. Contains 21 references. (DDR)

  20. Parallel asynchronous hardware implementation of image processing algorithms

    NASA Technical Reports Server (NTRS)

    Coon, Darryl D.; Perera, A. G. U.

    1990-01-01

    Research is being carried out on hardware for a new approach to focal plane processing. The hardware involves silicon injection mode devices. These devices provide a natural basis for parallel asynchronous focal plane image preprocessing. The simplicity and novel properties of the devices would permit an independent analog processing channel to be dedicated to every pixel. A laminar architecture built from arrays of the devices would form a two-dimensional (2-D) array processor with a 2-D array of inputs located directly behind a focal plane detector array. A 2-D image data stream would propagate in neuron-like asynchronous pulse-coded form through the laminar processor. No multiplexing, digitization, or serial processing would occur in the preprocessing state. High performance is expected, based on pulse coding of input currents down to one picoampere with noise referred to input of about 10 femtoamperes. Linear pulse coding has been observed for input currents ranging up to seven orders of magnitude. Low power requirements suggest utility in space and in conjunction with very large arrays. Very low dark current and multispectral capability are possible because of hardware compatibility with the cryogenic environment of high performance detector arrays. The aforementioned hardware development effort is aimed at systems which would integrate image acquisition and image processing.

  1. High responsivity CMOS imager pixel implemented in SOI technology

    NASA Technical Reports Server (NTRS)

    Zheng, X.; Wrigley, C.; Yang, G.; Pain, B.

    2000-01-01

    Availability of mature sub-micron CMOS technology and the advent of the new low noise active pixel sensor (APS) concept have enabled the development of low power, miniature, single-chip, CMOS digital imagers in the decade of the 1990's.

  2. EVALUATION OF MAGNETIC RESONANCE IMAGING GUIDELINES FOR DIFFERENTIATION BETWEEN THORACOLUMBAR INTERVERTEBRAL DISK EXTRUSIONS AND INTERVERTEBRAL DISK PROTRUSIONS IN DOGS.

    PubMed

    De Decker, Steven; Gomes, Sergio A; Packer, Rowena Ma; Kenny, Patrick J; Beltran, Elsa; Parzefall, Birgit; Fenn, Joe; Nair, Devi; Nye, George; Volk, Holger A

    2016-09-01

    Four MRI variables have recently been suggested to be independently associated with a diagnosis of thoracolumbar intervertebral disk extrusion or protrusion. Midline intervertebral disk herniation, and partial intervertebral disk degeneration were associated with intervertebral disk protrusion, while presence of a single intervertebral disk herniation and disk material dispersed beyond the boundaries of the intervertebral disk space were associated with intervertebral disk extrusion. The aim of this retrospective, cross-sectional study was to determine whether using these MRI variables improves differentiation between thoracolumbar intervertebral disk extrusions and protrusions. Eighty large breed dogs with surgically confirmed thoracolumbar intervertebral disk extrusions or protrusions were included. Randomized MRI studies were presented on two occasions to six blinded observers, which were divided into three experience categories. During the first assessment, observers made a presumptive diagnosis of thoracolumbar intervertebral disk extrusion or protrusion without guidelines. During the second assessment they were asked to make a presumptive diagnosis with the aid of guidelines. Agreement was evaluated by Kappa-statistics. Diagnostic accuracy significantly improved from 70.8 to 79.6% and interobserver agreement for making a diagnosis of intervertebral disk extrusion or intervertebral disk protrusion improved from fair (κ = 0.27) to moderate (κ = 0.41) after using the proposed guidelines. Diagnostic accuracy was significantly influenced by degree of observer experience. Intraobserver agreement for the assessed variables ranged from fair to excellent and interobserver agreement ranged from fair to moderate. The results of this study suggest that the proposed imaging guidelines can aid in differentiating thoracolumbar intervertebral disk extrusions from protrusions. PMID:27374979

  3. Advance care planning for residents in aged care facilities: what is best practice and how can evidence-based guidelines be implemented?

    PubMed

    Lyon, Cheryl

    2007-12-01

    Background  Advance care planning in a residential care setting aims to assist residents to make decisions about future healthcare and to improve end-of-life care through medical and care staff knowing and respecting the wishes of the resident. The process enables individuals and others who are important to them, to reflect on what is important to the resident including their beliefs/values and preferences about care when they are dying. This paper describes a project conducted as part of the Joanna Briggs Institute Clinical Aged Care Fellowship Program implemented at the Manningham Centre in metropolitan Melbourne in a unit providing services for 46 low and high care residents. Objectives  The objectives of the study were to document implementation of best practice in advance care planning in a residential aged care facility using a cycle of audit, feedback and re-audit cycle audit with a clinical audit software program, the Practical Application of Clinical Evidence System. The evidence-based guidelines found in 'Guidelines for a Palliative Approach in Residential Aged Care' were used to inform the process of clinical practice review and to develop a program to implement advance care planning. Results  The pre-implementation audit results showed that advance care planning practice was not based on high level evidence as initial compliance with five audit criteria was 0%. The barriers to implementation that became apparent during the feedback stage included the challenge of creating a culture where advance care planning policy, protocols and guidelines could be implemented, and advance care planning discussions held, by adequately prepared health professionals and carers. Opportunities were made to equip the resident to discuss their wishes with family, friends and healthcare staff. Some residents made the decision to take steps to formally document those wishes and/or appoint a Medical Enduring Power of Attorney to act on behalf of the resident when they

  4. Method for implementation of back-illuminated CMOS or CCD imagers

    NASA Technical Reports Server (NTRS)

    Pain, Bedabrata (Inventor)

    2008-01-01

    A method for implementation of back-illuminated CMOS or CCD imagers. An oxide layer buried between silicon wafer and device silicon is provided. The oxide layer forms a passivation layer in the imaging structure. A device layer and interlayer dielectric are formed, and the silicon wafer is removed to expose the oxide layer.

  5. The Measurement, Analysis and Implementation of a Corporate Image Program: The Case of a Psychiatric Hospital.

    ERIC Educational Resources Information Center

    Elbeck, Matt A.; Buchanan, Gary W.

    1987-01-01

    Measured a psychiatric hospital's image, using qualitative and quantitative methods. Used data from the consumer public to illustrate the development and implementation of an image program stressing multi-public awareness, preference and utilization of the hospital's services vis-a-vis the hospital's mission statement. This study demonstrated…

  6. A VLSI implementation for synthetic aperture radar image processing

    NASA Technical Reports Server (NTRS)

    Premkumar, A.; Purviance, J.

    1990-01-01

    A simple physical model for the Synthetic Aperture Radar (SAR) is presented. This model explains the one dimensional and two dimensional nature of the received SAR signal in the range and azimuth directions. A time domain correlator, its algorithm, and features are explained. The correlator is ideally suited for VLSI implementation. A real time SAR architecture using these correlators is proposed. In the proposed architecture, the received SAR data is processed using one dimensional correlators for determining the range while two dimensional correlators are used to determine the azimuth of a target. The architecture uses only three different types of custom VLSI chips and a small amount of memory.

  7. Implementation of multispectral image fusion system based on SoPC

    NASA Astrophysics Data System (ADS)

    Meng, Lingfei; Wang, Zhihui

    2013-10-01

    Combining the theory of wavelet transform based image fusion and SOPC design method, the authors uses SOPC as the core device to design and implement a image fusion system. The fusion system adopts the Verilog hardware description language, Dsp builder and Quartus II development platform together with macro module to complete the logic design and timing control of each module. In the fusion system, we can achieve simple pixel-level image fusion of two registered images. This design not only builds up an image fusion system based on SOPC in accident, but also provides a hardware design principle in SoPC for the future design and Implementation of more comprehensive function of image processing.

  8. Individualized risk management in diabetics: how to implement best practice guidelines--design and concept of the IRIDIEM studies.

    PubMed

    Lameire, N; Stevens, P; Raptis, S; Thomas, S; Schernthaner, G

    2004-01-01

    The prevalence of type 2 diabetes mellitus is rising rapidly in all developed countries, particularly in the growing population of persons >50 years of age. As a dangerous consequence, this is accompanied by a proportionate increase in the incidence of chronic renal disease. Evidence-based medicine has shown that tight blood glucose control can delay the onset and retard the progression of diabetic complications, and while it is a challenge to closely manage the complexity of diabetes, it is more difficult to effectively treat the multiple associated comorbidities that develop. Best practice guidelines support early intervention and aggressive treatment of hypertension, hyperglycaemia, proteinuria, hypercholesterolemia, and anaemia. To date, guideline-based management has been proven to be difficult. This article describes the concept of the IRIDIEM studies. The objective of these studies is to endorse and facilitate the use of current best practice guidelines for the management of frequent comorbid diseases and established risk factors in the treatment of type 2 diabetes associated with chronic kidney disease. Additionally, IRIDIEM will assess the impact of this improved disease management model on the progression of chronic kidney disease that can result from electronically prompting clinicians with evidence-based treatment advice.

  9. Implementation of real-time digital endoscopic image processing system

    NASA Astrophysics Data System (ADS)

    Song, Chul Gyu; Lee, Young Mook; Lee, Sang Min; Kim, Won Ky; Lee, Jae Ho; Lee, Myoung Ho

    1997-10-01

    Endoscopy has become a crucial diagnostic and therapeutic procedure in clinical areas. Over the past four years, we have developed a computerized system to record and store clinical data pertaining to endoscopic surgery of laparascopic cholecystectomy, pelviscopic endometriosis, and surgical arthroscopy. In this study, we developed a computer system, which is composed of a frame grabber, a sound board, a VCR control board, a LAN card and EDMS. Also, computer system controls peripheral instruments such as a color video printer, a video cassette recorder, and endoscopic input/output signals. Digital endoscopic data management system is based on open architecture and a set of widely available industry standards; namely Microsoft Windows as an operating system, TCP/IP as a network protocol and a time sequential database that handles both images and speech. For the purpose of data storage, we used MOD and CD- R. Digital endoscopic system was designed to be able to store, recreate, change, and compress signals and medical images. Computerized endoscopy enables us to generate and manipulate the original visual document, making it accessible to a virtually unlimited number of physicians.

  10. The FAO/NACA Asia Regional Technical Guidelines on Health Management for the Responsible Movement of Live Aquatic Animals: lessons learned from their development and implementation.

    PubMed

    Subasinghe, R P; Bondad-Reantaso, M G

    2008-04-01

    Aquaculture is the fastest growing food producing sector in the world and it is expected to produce significant quantities of fish in the coming years to meet the growing global demand for aquatic animal products. The expansion and diversification of the sector, along with globalisation and trade liberalisation have resulted in aquatic animals and animal products moving around the world rapidly, causing serious disease outbreaks stemming from incursions of pathogens through unregulated transboundary movements. It has become necessary to develop appropriate guidelines for establishing national regulatory frameworks to improve responsibility in transboundary movement of live aquatic animals. In 2000, the Food and Agriculture Organization of the United Nations (FAO), in collaboration with the Network of Aquaculture Centres in Asia-Pacific (NACA) and in partnership with 21 Asian countries, developed the Asia Regional Technical Guidelines on Health Management for the Responsible Movement of Live Aquatic Animals. The present article outlines the development process of the guidelines, the lessons learned from their implementation at national level and the way forward. PMID:18666478

  11. The FAO/NACA Asia Regional Technical Guidelines on Health Management for the Responsible Movement of Live Aquatic Animals: lessons learned from their development and implementation.

    PubMed

    Subasinghe, R P; Bondad-Reantaso, M G

    2008-04-01

    Aquaculture is the fastest growing food producing sector in the world and it is expected to produce significant quantities of fish in the coming years to meet the growing global demand for aquatic animal products. The expansion and diversification of the sector, along with globalisation and trade liberalisation have resulted in aquatic animals and animal products moving around the world rapidly, causing serious disease outbreaks stemming from incursions of pathogens through unregulated transboundary movements. It has become necessary to develop appropriate guidelines for establishing national regulatory frameworks to improve responsibility in transboundary movement of live aquatic animals. In 2000, the Food and Agriculture Organization of the United Nations (FAO), in collaboration with the Network of Aquaculture Centres in Asia-Pacific (NACA) and in partnership with 21 Asian countries, developed the Asia Regional Technical Guidelines on Health Management for the Responsible Movement of Live Aquatic Animals. The present article outlines the development process of the guidelines, the lessons learned from their implementation at national level and the way forward.

  12. SU-E-I-68: Practical Considerations On Implementation of the Image Gently Pediatric CT Protocols

    SciTech Connect

    Zhang, J; Adams, C; Lumby, C; Dillon, J; Woods, E; Richer, E

    2014-06-01

    Purpose: One limitation associated with the Image Gently pediatric CT protocols is practical implementation of the recommended manual techniques. Inconsistency as a result of different practice is a possibility among technologist. An additional concern is the added risk of data error that would result in over or underexposure. The Automatic Exposure Control (AEC) features automatically reduce radiation for children. However, they do not work efficiently for the patients of very small size and relative large size. This study aims to implement the Image Gently pediatric CT protocols in the practical setting while maintaining the use of AEC features for pediatric patients of varying size. Methods: Anthropomorphological abdomen phantoms were scanned in a CT scanner using the Image Gently pediatric protocols, the AEC technique with a fixed adult baseline, and automatic protocols with various baselines. The baselines were adjusted corresponding to patient age, weight and posterioranterior thickness to match the Image Gently pediatric CT manual techniques. CTDIvol was recorded for each examination. Image noise was measured and recorded for image quality comparison. Clinical images were evaluated by pediatric radiologists. Results: By adjusting vendor default baselines used in the automatic techniques, radiation dose and image quality can match those of the Image Gently manual techniques. In practice, this can be achieved by dividing pediatric patients into three major groups for technologist reference: infant, small child, and large child. Further division can be done but will increase the number of CT protocols. For each group, AEC can efficiently adjust acquisition techniques for children. This implementation significantly overcomes the limitation of the Image Gently manual techniques. Conclusion: Considering the effectiveness in clinical practice, Image Gently Pediatric CT protocols can be implemented in accordance with AEC techniques, with adjusted baselines, to

  13. A cluster randomized controlled trial of a behavioral intervention to facilitate the development and implementation of clinical practice guidelines in Latin American maternity hospitals: the Guidelines Trial: Study protocol [ISRCTN82417627

    PubMed Central

    Althabe, Fernando; Buekens, Pierre; Bergel, Eduardo; Belizán, José M; Kropp, Nora; Wright, Linda; Goco, Norman; Moss, Nancy

    2005-01-01

    Background A significant proportion of the health care administered to women in Latin American maternity hospitals during labor and delivery has been demonstrated to be ineffective or harmful, whereas effective interventions remain underutilized. The routine use of episiotomies and the failure to use active management of the third stage of labor are good examples. Methods/Design The aim of this trial is to evaluate the effect of a multifaceted behavioral intervention on the use of two evidence-based birth practices, the selective use of episiotomies and active management of the third stage of labor (injection of 10 International Units of oxytocin). The intervention is based on behavioral and organizational change theories and was based on formative research. Twenty-four hospitals in three urban districts of Argentina and Uruguay will be randomized. Opinion leaders in the 12 intervention hospitals will be identified and trained to develop and implement evidence-based guidelines. They will then disseminate the guidelines using a multifaceted approach including academic detailing, reminders, and feedback on utilization rates. The 12 hospitals in the control group will continue with their standard in-service training activities. The main outcomes to be assessed are the rates of episiotomy and oxytocin use during the third stage of labor. Secondary outcomes will be perineal sutures, postpartum hemorrhages, and birth attendants' opinions. PMID:15823211

  14. SIMPLE: implementation of recommendations from international evidence-based guidelines on caesarean sections in the Netherlands. Protocol for a controlled before and after study

    PubMed Central

    2013-01-01

    Background Caesarean section (CS) rates are rising worldwide. In the Netherlands, the most significant rise is observed in healthy women with a singleton in vertex position between 37 and 42 weeks gestation, whereas it is doubtful whether an improved outcome for the mother or her child was obtained. It can be hypothesized that evidence-based guidelines on CS are not implemented sufficiently. Therefore, the present study has the following objectives: to develop quality indicators on the decision to perform a CS based on key recommendations from national and international guidelines; to use the quality indicators in order to gain insight into actual adherence of Dutch gynaecologists to guideline recommendations on the performance of a CS; to explore barriers and facilitators that have a direct effect on guideline application regarding CS; and to develop, execute, and evaluate a strategy in order to reduce the CS incidence for a similar neonatal outcome (based on the information gathered in the second and third objectives). Methods An independent expert panel of Dutch gynaecologists and midwives will develop a set of quality indicators on the decision to perform a CS. These indicators will be used to measure current care in 20 hospitals with a population of 1,000 women who delivered by CS, and a random selection of 1,000 women who delivered vaginally in the same period. Furthermore, by interviewing healthcare professionals and patients, the barriers and facilitators that may influence the decision to perform a CS will be measured. Based on the results, a tailor-made implementation strategy will be developed and tested in a controlled before-and-after study in 12 hospitals (six intervention, six control hospitals) with regard to effectiveness, experiences, and costs. Discussion This study will offer insight into the current CS care and into the hindering and facilitating factors influencing obstetrical policy on CS. Furthermore, it will allow definition of patient

  15. Systematic review of the cost-effectiveness of implementing guidelines on low back pain management in primary care: is transferability to other countries possible?

    PubMed Central

    Jensen, Cathrine Elgaard; Jensen, Martin Bach; Petersen, Karin Dam

    2016-01-01

    Objective The primary aim is to identify, summarise and quality assess the available literature on the cost-effectiveness of implementing low back pain guidelines in primary care. The secondary aim is to assess the transferability of the results to determine whether the identified studies can be included in a comparison with a Danish implementation study to establish which strategy procures most value for money. Design Systematic review. Data sources The search was conducted in Embase, PubMed, Cochrane Library, NHS Economic Evaluation Database, Scopus, CINAHL and EconLit. No restrictions were made concerning language, year of publication or publication type. The bibliographies of the included studies were searched for any studies not captured in the literature search. Eligibility criteria for selecting studies To be included, a study must be: (1) based on a randomised controlled trial comparing implementation strategies, (2) the guideline must concern treatment of low back pain in primary care and (3) the economic evaluation should contain primary data on cost and cost-effectiveness. Results The title and abstract were assessed for 308 studies; of these, three studies were found eligible for inclusion. The Consensus Health Economic Criteria (CHEC) list showed that the 3 studies were of moderate methodological quality while application of Welte's model showed that cost results from two studies could, with adjustments, be transferred to a Danish setting. It was questionable whether the associated effects could be transferred. Conclusions Despite the resemblance of the implementation strategies, the 3 studies report conflicting results on cost-effectiveness. This review showed that transferring the results from the identified studies is not straightforward and underlines the importance of transparent reporting. Future research should focus on transferability of effects, for example, development of a supplement to Welte's model. PMID:27267108

  16. Using the Six Sigma Process to Implement the Centers for Disease Control and Prevention Guideline for Hand Hygiene in 4 Intensive Care Units

    PubMed Central

    Eldridge, Noel E; Woods, Susan S; Bonello, Robert S; Clutter, Kay; Ellingson, LeAnn; Harris, Mary Ann; Livingston, Barbara K; Bagian, James P; Danko, Linda H; Dunn, Edward J; Parlier, Renee L; Pederson, Cheryl; Reichling, Kim J; Roselle, Gary A; Wright, Steven M

    2006-01-01

    BACKGROUND The Centers for Disease Control and Prevention (CDC) Guideline for Hand Hygiene in Health Care Settings was issued in 2002. In 2003, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) established complying with the CDC Guideline as a National Patient Safety Goal for 2004. This goal has been maintained through 2006. The CDC's emphasis on the use of alcohol-based hand rubs (ABHRs) rather than soap and water was an opportunity to improve compliance, but the Guideline contained over 40 specific recommendations to implement. OBJECTIVE To use the Six Sigma process to examine hand hygiene practices and increase compliance with the CDC hand hygiene recommendations required by JCAHO. DESIGN Six Sigma Project with pre-post design. PARTICIPANTS Physicians, nurses, and other staff working in 4 intensive care units at 3 hospitals. MEASUREMENTS Observed compliance with 10 required hand hygiene practices, mass of ABHR used per month per 100 patient-days, and staff attitudes and perceptions regarding hand hygiene reported by questionnaire. RESULTS Observed compliance increased from 47% to 80%, based on over 4,000 total observations. The mass of ABHR used per 100 patient-days in 3 intensive care units (ICUs) increased by 97%, 94%, and 70%; increases were sustained for 9 months. Self-reported compliance using the questionnaire did not change. Staff reported increased use of ABHR and increased satisfaction with hand hygiene practices and products. CONCLUSIONS The Six Sigma process was effective for organizing the knowledge, opinions, and actions of a group of professionals to implement the CDC's evidence-based hand hygiene practices in 4 ICUs. Several tools were developed for widespread use. PMID:16637959

  17. Design and implementation of the parallel processing system of multi-channel polarization images

    NASA Astrophysics Data System (ADS)

    Li, Zhi-yong; Huang, Qin-chao

    2013-08-01

    Compared with traditional optical intensity image processing, polarization images processing has two main problems. One is that the amount of data is larger. The other is that processing tasks is more complex. To resolve these problems, the parallel processing system of multi-channel polarization images is designed by the multi-DSP technique. It contains a communication control unit (CCU) and a data processing array (DPA). CCU controls communications inside and outside the system. Its logics are designed by a FPGA chip. DPA is made up of four Digital Signal Processor (DSP) chips, which are interlinked by the loose coupling method. DPA implements processing tasks including images registration and images synthesis by parallel processing methods. The polarization images parallel processing model is designed on multi levels including the system task, the algorithm and the operation. Its program is designed by the assemble language. While the polarization image resolution is 782x582 pixels, the pixel data length is 12 bits in the experiment. After it received 3 channels of polarization image simultaneously, this system implements parallel task to acquire the target polarization characteristics. Experimental results show that this system has good real-time and reliability. The processing time of images registration is 293.343ms while the registration accuracy achieves 0.5 pixel. The processing time of images synthesis is 3.199ms.

  18. Design, implementation and operation of a multimodality research imaging informatics repository

    PubMed Central

    2015-01-01

    Background Biomedical imaging research increasingly involves acquiring, managing and processing large amounts of distributed imaging data. Integrated systems that combine data, meta-data and workflows are crucial for realising the opportunities presented by advances in imaging facilities. Methods This paper describes the design, implementation and operation of a multi-modality research imaging data management system that manages imaging data obtained from biomedical imaging scanners operated at Monash Biomedical Imaging (MBI), Monash University in Melbourne, Australia. In addition to Digital Imaging and Communications in Medicine (DICOM) images, raw data and non-DICOM biomedical data can be archived and distributed by the system. Imaging data are annotated with meta-data according to a study-centric data model and, therefore, scientific users can find, download and process data easily. Results The research imaging data management system ensures long-term usability, integrity inter-operability and integration of large imaging data. Research users can securely browse and download stored images and data, and upload processed data via subject-oriented informatics frameworks including the Distributed and Reflective Informatics System (DaRIS), and the Extensible Neuroimaging Archive Toolkit (XNAT). PMID:25870760

  19. Neuro-inspired smart image sensor: analog Hmax implementation

    NASA Astrophysics Data System (ADS)

    Paindavoine, Michel; Dubois, Jérôme; Musa, Purnawarman

    2015-03-01

    Neuro-Inspired Vision approach, based on models from biology, allows to reduce the computational complexity. One of these models - The Hmax model - shows that the recognition of an object in the visual cortex mobilizes V1, V2 and V4 areas. From the computational point of view, V1 corresponds to the area of the directional filters (for example Sobel filters, Gabor filters or wavelet filters). This information is then processed in the area V2 in order to obtain local maxima. This new information is then sent to an artificial neural network. This neural processing module corresponds to area V4 of the visual cortex and is intended to categorize objects present in the scene. In order to realize autonomous vision systems (consumption of a few milliwatts) with such treatments inside, we studied and realized in 0.35μm CMOS technology prototypes of two image sensors in order to achieve the V1 and V2 processing of Hmax model.

  20. Implementation of total focusing method for phased array ultrasonic imaging on FPGA

    NASA Astrophysics Data System (ADS)

    Guo, JianQiang; Li, Xi; Gao, Xiaorong; Wang, Zeyong; Zhao, Quanke

    2015-02-01

    This paper describes a multi-FPGA imaging system dedicated for the real-time imaging using the Total Focusing Method (TFM) and Full Matrix Capture (FMC). The system was entirely described using Verilog HDL language and implemented on Altera Stratix IV GX FPGA development board. The whole algorithm process is to: establish a coordinate system of image and divide it into grids; calculate the complete acoustic distance of array element between transmitting array element and receiving array element, and transform it into index value; then index the sound pressure values from ROM and superimpose sound pressure values to get pixel value of one focus point; and calculate the pixel values of all focus points to get the final imaging. The imaging result shows that this algorithm has high SNR of defect imaging. And FPGA with parallel processing capability can provide high speed performance, so this system can provide the imaging interface, with complete function and good performance.

  1. General Practitioners’ Intentions and Prescribing for Asthma: Using the Theory of Planned Behavior to Explain Guideline Implementation

    PubMed Central

    Rashidian, Arash; Russell, Ian

    2012-01-01

    Objectives: Limited studies have demonstrated that the Theory of Planned Behavior (TPB) may be able to help in explaining the variation in physicians’ behavior. We selected the management of asthma as the tracer topic because asthma had nationally known clinical guidelines, and the main medicinal therapies used for asthma had limited applications for the treatment of other diseases, and hence, it was possible to trace the relevant prescribing from routine data. In this study we used the TPB to explain general practitioners (GPs) intentions and prescribing in accordance with asthma clinical guidelines. Methods: We surveyed a stratified random sample of 122 GPs in England. The GPs demographic and prescribing data were obtained from routine sources. The participants completed a TPB questionnaire that was developed based on qualitative interviews and had been tested in a pilot study. Regression methods were utilized for data analysis. Results: Forty-three percent of variance in prescribing intentions was explained by direct TPB measures. Perceived controls were the main predictors of variation in intentions. TPB belief item variables contributed to regression analysis that explained up to 34% of variation in the efficiency prescribing indicators. Effective prescribing indicators were unrelated to TPB variables. Conclusions: Using TPB was helpful in understanding the prescribing intentions of GPs. This could help in promoting the prophylactic usage of inhaler corticosteroids and prevent chronic asthma symptoms and side-effects. However, further empirical and methodological researches are required. PMID:22355473

  2. Meta-analysis of the technical performance of an imaging procedure: guidelines and statistical methodology.

    PubMed

    Huang, Erich P; Wang, Xiao-Feng; Choudhury, Kingshuk Roy; McShane, Lisa M; Gönen, Mithat; Ye, Jingjing; Buckler, Andrew J; Kinahan, Paul E; Reeves, Anthony P; Jackson, Edward F; Guimaraes, Alexander R; Zahlmann, Gudrun

    2015-02-01

    Medical imaging serves many roles in patient care and the drug approval process, including assessing treatment response and guiding treatment decisions. These roles often involve a quantitative imaging biomarker, an objectively measured characteristic of the underlying anatomic structure or biochemical process derived from medical images. Before a quantitative imaging biomarker is accepted for use in such roles, the imaging procedure to acquire it must undergo evaluation of its technical performance, which entails assessment of performance metrics such as repeatability and reproducibility of the quantitative imaging biomarker. Ideally, this evaluation will involve quantitative summaries of results from multiple studies to overcome limitations due to the typically small sample sizes of technical performance studies and/or to include a broader range of clinical settings and patient populations. This paper is a review of meta-analysis procedures for such an evaluation, including identification of suitable studies, statistical methodology to evaluate and summarize the performance metrics, and complete and transparent reporting of the results. This review addresses challenges typical of meta-analyses of technical performance, particularly small study sizes, which often causes violations of assumptions underlying standard meta-analysis techniques. Alternative approaches to address these difficulties are also presented; simulation studies indicate that they outperform standard techniques when some studies are small. The meta-analysis procedures presented are also applied to actual [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) test-retest repeatability data for illustrative purposes. PMID:24872353

  3. Meta-analysis of the technical performance of an imaging procedure: guidelines and statistical methodology.

    PubMed

    Huang, Erich P; Wang, Xiao-Feng; Choudhury, Kingshuk Roy; McShane, Lisa M; Gönen, Mithat; Ye, Jingjing; Buckler, Andrew J; Kinahan, Paul E; Reeves, Anthony P; Jackson, Edward F; Guimaraes, Alexander R; Zahlmann, Gudrun

    2015-02-01

    Medical imaging serves many roles in patient care and the drug approval process, including assessing treatment response and guiding treatment decisions. These roles often involve a quantitative imaging biomarker, an objectively measured characteristic of the underlying anatomic structure or biochemical process derived from medical images. Before a quantitative imaging biomarker is accepted for use in such roles, the imaging procedure to acquire it must undergo evaluation of its technical performance, which entails assessment of performance metrics such as repeatability and reproducibility of the quantitative imaging biomarker. Ideally, this evaluation will involve quantitative summaries of results from multiple studies to overcome limitations due to the typically small sample sizes of technical performance studies and/or to include a broader range of clinical settings and patient populations. This paper is a review of meta-analysis procedures for such an evaluation, including identification of suitable studies, statistical methodology to evaluate and summarize the performance metrics, and complete and transparent reporting of the results. This review addresses challenges typical of meta-analyses of technical performance, particularly small study sizes, which often causes violations of assumptions underlying standard meta-analysis techniques. Alternative approaches to address these difficulties are also presented; simulation studies indicate that they outperform standard techniques when some studies are small. The meta-analysis procedures presented are also applied to actual [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) test-retest repeatability data for illustrative purposes.

  4. Monitoring and evaluating recovery from natural disasters using remote sensing - towards creating guidelines on the use of satellite images in the context of disaster recovery

    NASA Astrophysics Data System (ADS)

    Saito, K.; Brown, D.; Spence, R.; Chenvidyakarn, T.; Adams, B.; Bevington, J.; Platt, S.; Chuenpagdee, R.; Juntarashote, K.; Khan, A.

    2009-04-01

    The use of high-resolution optical satellite images is being investigated for evaluating and monitoring recovery after natural disasters. Funded by EPSRC, UK, the aim of the RECOVERY project is to develop indicators of recovery that can exploit the wealth of data now available, including those from satellite imagery, internet-based statistics and advanced field survey techniques. The final output will be a set of guidelines that suggests how remote sensing can be used to help monitor and evaluate the recovery process after natural disasters. The final guideline that will be produced at the end of the two year project, which started in February 2008, will be freely available to aid agencies and anyone that is interested. Currently there is no agreed standard approach for evaluating the effectiveness of recovery aid, although international frameworks such as PDNA (Post-Disaster Needs Assessment, United Nations Development Program, European Commission and World Bank) is currently being developed, and TRIAMS (Tsunami Recovery and Impact Assessment and Monitoring System, by UNDP and WHO) is being implemented to monitor the recovery from the Indian Ocean Tsunami. The RECOVERY project consists of three phases. Phase 1 was completed by September 2008 and focused on user needs survey, developing the recovery indicators and satellite image data identification/acquisition. The user needs survey was conducted to identify whether there were any indicators that the aid community would like to see prioritised. The survey result suggested that most indicators are equally important. Based on this result and also referring to the TRIAMS framework, a comprehensive list of indicators were developed which belong to six large categories, i.e. housing, infrastructure, services, livelihood, environment, social/security, risk reduction. For the RECOVERY project, two case study sites have been identified, i.e. the village of Baan Nam Khem on the west coast of Thailand, which was heavily

  5. Encrypted imaging based on algebraic implementation of double random phase encoding.

    PubMed

    Nakano, Kazuya; Takeda, Masafumi; Suzuki, Hiroyuki; Yamaguchi, Masahiro

    2014-05-10

    The security of important information captured by sensors and cameras is currently a growing concern as information theft via techniques such as side-channel attacks become increasingly more prevalent. Double random phase encoding (DRPE) is an optical encryption method based on optical Fourier transform that is currently being used to implement secure coherent optical systems. In this paper, we propose a new DRPE implementation for incoherent optical systems based on integral photography that can be applied to "encrypted imaging (EI)" to optically encrypt an image before it is captured by an image sensor. Because the proposed incoherent DRPE is constituted from conventional DRPE by rewriting the optical encryption via discretization and Euler's formula, its security level is the same as that of conventional DRPE. The results of an experiment in which we encrypted a plaintext image optically and then decrypted it numerically demonstrate that our proposed incoherent optical security system is feasible.

  6. Custom instruction for NIOS II processor FFT implementation for image processing

    NASA Astrophysics Data System (ADS)

    Sundararajana, Sindhuja; Meyer-Baese, Uwe; Botella, Guillermo

    2016-05-01

    Image processing can be considered as signal processing in two dimensions (2D). Filtering is one of the basic image processing operation. Filtering in frequency domain is computationally faster when compared to the corresponding spatial domain operation as the complex convolution process is modified as multiplication in frequency domain. The popular 2D transforms used in image processing are Fast Fourier Transform (FFT), Discrete Cosine Transform (DCT) and Discrete Wavelet Transform (DWT). The common values for resolution of an image are 640x480, 800x600, 1024x768 and 1280x1024. As it can be seen, the image formats are generally not a power of 2. So power of 2 FFT lengths are not required and these cannot be built using shorter Discrete Fourier Transform (DFT) blocks. Split radix based FFT algorithms like Good-Thomas FFT algorithm simplifies the implementation logic required for such applications and hence can be implemented in low area and power consumption and also meet the timing constraints thereby operating at high frequency. The Good-Thomas FFT algorithm which is a Prime Factor FFT algorithm (PFA) provides the means of computing DFT with least number of multiplication and addition operations. We will be providing an Altera FPGA based NIOS II custom instruction implementation of Good-Thomas FFT algorithm to improve the system performance and also provide the comparison when the same algorithm is completely implemented in software.

  7. Experimental implementation of coded aperture coherent scatter spectral imaging of cancerous and healthy breast tissue samples

    NASA Astrophysics Data System (ADS)

    Lakshmanan, Manu N.; Greenberg, Joel A.; Samei, Ehsan; Kapadia, Anuj J.

    2015-03-01

    A fast and accurate scatter imaging technique to differentiate cancerous and healthy breast tissue is introduced in this work. Such a technique would have wide-ranging clinical applications from intra-operative margin assessment to breast cancer screening. Coherent Scatter Computed Tomography (CSCT) has been shown to differentiate cancerous from healthy tissue, but the need to raster scan a pencil beam at a series of angles and slices in order to reconstruct 3D images makes it prohibitively time consuming. In this work we apply the coded aperture coherent scatter spectral imaging technique to reconstruct 3D images of breast tissue samples from experimental data taken without the rotation usually required in CSCT. We present our experimental implementation of coded aperture scatter imaging, the reconstructed images of the breast tissue samples and segmentations of the 3D images in order to identify the cancerous and healthy tissue inside of the samples. We find that coded aperture scatter imaging is able to reconstruct images of the samples and identify the distribution of cancerous and healthy tissues (i.e., fibroglandular, adipose, or a mix of the two) inside of them. Coded aperture scatter imaging has the potential to provide scatter images that automatically differentiate cancerous and healthy tissue inside of ex vivo samples within a time on the order of a minute.

  8. Structure for implementation of back-illuminated CMOS or CCD imagers

    NASA Technical Reports Server (NTRS)

    Pain, Bedabrata (Inventor); Cunningham, Thomas J. (Inventor)

    2009-01-01

    A structure for implementation of back-illuminated CMOS or CCD imagers. An epitaxial silicon layer is connected with a passivation layer, acting as a junction anode. The epitaxial silicon layer converts light passing through the passivation layer and collected by the imaging structure to photoelectrons. A semiconductor well is also provided, located opposite the passivation layer with respect to the epitaxial silicon layer, acting as a junction cathode. Prior to detection, light does not pass through a dielectric separating interconnection metal layers.

  9. Guidelines for Postsecondary Institutions for Implementation of the Family Educational Rights and Privacy Act of 1974 as Amended. Revised Edition.

    ERIC Educational Resources Information Center

    American Association of Collegiate Registrars and Admissions Officers, Washington, DC.

    This publication is designed to provide guidance, clarification of intent, and suggested implementation processes and procedures for officials of postsecondary educational institutions concerning the Family Educational Rights and Privacy Act of 1974 (FERPA), as Amended in 1988 and 1993. FERPA's purpose is to ensure certain student rights…

  10. The Archival Appraisal of Moving Images: A RAMP Study with Guidelines.

    ERIC Educational Resources Information Center

    Kula, Sam

    Produced as part of the United Nations Educational, Scientific, and Cultural Organization (UNESCO) Records and Archives Management Programme (RAMP), this publication provides government and non-government archivists and records managers with a comparative study of past and present policies and practices for selecting moving images for…

  11. Implementation workshop of WHO guidelines on evaluation of malaria vaccines: Current regulatory concepts and issues related to vaccine quality, Pretoria, South Africa 07 Nov 2014.

    PubMed

    Ho, Mei Mei; Baca-Estrada, Maria; Conrad, Christoph; Karikari-Boateng, Eric; Kang, Hye-Na

    2015-08-26

    The current World Health Organization (WHO) guidelines on the quality, safety and efficacy of recombinant malaria vaccines targeting the pre-erythrocytic and blood stages of Plasmodium falciparum were adopted by the WHO Expert Committee on Biological Standardization in 2012 to provide guidance on the quality, nonclinical and clinical aspects of recombinant malaria vaccines. A WHO workshop was organised to facilitate implementation into African (national/regional) regulatory practices, of the regulatory evaluation principles outlined in the guidelines regarding quality aspects. The workshop was used also to share knowledge and experience on regulatory topics of chemistry, manufacturing and control with a focus on vaccines through presentations and an interactive discussion using a case study approach. The basic principles and concepts of vaccine quality including consistency of production, quality control and manufacturing process were presented and discussed in the meeting. By reviewing and practicing a case study, better understanding on the relationship between consistency of production and batch release tests of an adjuvanted pre-erythrocytic recombinant malaria vaccine was reached. The case study exercise was considered very useful to understand regulatory evaluation principles of vaccines and a suggestion was made to WHO to provide such practices also through its Global Learning Opportunities for Vaccine Quality programme.

  12. Design and Implementation of CNEOST Image Database Based on NoSQL System

    NASA Astrophysics Data System (ADS)

    Wang, Xin

    2014-04-01

    The China Near Earth Object Survey Telescope is the largest Schmidt telescope in China, and it has acquired more than 3 TB astronomical image data since it saw the first light in 2006. After the upgrade of the CCD camera in 2013, over 10 TB data will be obtained every year. The management of the massive images is not only an indispensable part of data processing pipeline but also the basis of data sharing. Based on the analysis of requirement, an image management system is designed and implemented by employing the non-relational database.

  13. Design and Implementation of CNEOST Image Database Based on NoSQL System

    NASA Astrophysics Data System (ADS)

    Wang, X.

    2013-07-01

    The China Near Earth Object Survey Telescope (CNEOST) is the largest Schmidt telescope in China, and it has acquired more than 3 TB astronomical image data since it saw the first light in 2006. After the upgradation of the CCD camera in 2013, over 10 TB data will be obtained every year. The management of massive images is not only an indispensable part of data processing pipeline but also the basis of data sharing. Based on the analysis of requirement, an image management system is designed and implemented by employing the non-relational database.

  14. Concept and implementation of a virtual image slicer at the VLT

    NASA Astrophysics Data System (ADS)

    Guisard, S.; Sterzik, M.; Muñoz, I.

    2014-07-01

    The concept of "Virtual Image Slicer" was developed and implemented at the Very Large Telescope (VLT). The Virtual Image Slicer consists in elongating the stars in a given direction by the use of the Active Optics of the telescope. Alignment of the major axis of the elongated star along the entrance slit of the spectrograph allows to increase the total signal collected in a single (polarimetric) spectrum by a factor of up to 100 or more relative to a perfectly shaped image for bright sources.

  15. Guidelines for Implementation of an Advanced Outage Control Center to Improve Outage Coordination, Problem Resolution, and Outage Risk Management

    SciTech Connect

    St. Germain, Shawn W.; Farris, Ronald K.; Whaley, April M.; Medema, Heather D.; Gertman, David I.

    2014-09-01

    This research effort is a part of the Light-Water Reactor Sustainability (LWRS) Program, which is a research and development (R&D) program sponsored by Department of Energy (DOE) and performed in close collaboration with industry R&D programs that provide the technical foundations for licensing and managing the long-term, safe, and economical operation of current nuclear power plants. The LWRS program serves to help the U.S. nuclear industry adopt new technologies and engineering solutions that facilitate the continued safe operation of the plants and extension of the current operating licenses. The purpose of this research is to improve management of nuclear power plant (NPP) outages through the development of an advanced outage control center (AOCC) that is specifically designed to maximize the usefulness of communication and collaboration technologies for outage coordination and problem resolution activities. This technical report for industry implementation outlines methods and considerations for the establishment of an AOCC. This report provides a process for implementation of a change management plan, evaluation of current outage processes, the selection of technology, and guidance for the implementation of the selected technology. Methods are presented for both adoption of technologies within an existing OCC and for a complete OCC replacement, including human factors considerations for OCC design and setup.

  16. Consensus guidelines for implementation of quality processes to prevent invasive fungal disease and enhanced surveillance measures during hospital building works, 2014.

    PubMed

    Chang, C C; Ananda-Rajah, M; Belcastro, A; McMullan, B; Reid, A; Dempsey, K; Athan, E; Cheng, A C; Slavin, M A

    2014-12-01

    Healthcare-associated fungal outbreaks impose a substantial economic burden on the health system and typically result in high patient morbidity and mortality, particularly in the immunocompromised host. As the population at risk of invasive fungal infection continues to grow due to the increased burden of cancer and related factors, the need for hospitals to employ preventative measures has become increasingly important. These guidelines outline the standard quality processes hospitals need to accommodate into everyday practice and at times of healthcare-associated outbreak, including the role of antifungal stewardship programmes and best practice environmental sampling. Specific recommendations are also provided to help guide the planning and implementation of quality processes and enhanced surveillance before, during and after high-risk activities, such as hospital building works. Areas in which information is still lacking and further research is required are also highlighted. PMID:25482747

  17. Public informations guidelines

    SciTech Connect

    1986-06-01

    The purpose of these Public Information Guidelines is to provide principles for the implementation of the NWPA mandate and the Mission Plan requirements for the provision of public information. These Guidelines set forth the public information policy to be followed by all Office of Civilian Radioactive Waste Management (OCRWM) performance components. The OCRWM offices should observe these Guidelines in shaping and conducting public information activities.

  18. Development and Implementation of Image-based Algorithms for Measurement of Deformations in Material Testing

    PubMed Central

    Barazzetti, Luigi; Scaioni, Marco

    2010-01-01

    This paper presents the development and implementation of three image-based methods used to detect and measure the displacements of a vast number of points in the case of laboratory testing on construction materials. Starting from the needs of structural engineers, three ad hoc tools for crack measurement in fibre-reinforced specimens and 2D or 3D deformation analysis through digital images were implemented and tested. These tools make use of advanced image processing algorithms and can integrate or even substitute some traditional sensors employed today in most laboratories. In addition, the automation provided by the implemented software, the limited cost of the instruments and the possibility to operate with an indefinite number of points offer new and more extensive analysis in the field of material testing. Several comparisons with other traditional sensors widely adopted inside most laboratories were carried out in order to demonstrate the accuracy of the implemented software. Implementation details, simulations and real applications are reported and discussed in this paper. PMID:22163612

  19. PACS image archive server implementation in the developing countries such as China

    NASA Astrophysics Data System (ADS)

    Zhang, Dong; Shu, Yunhong; Zhuang, Tian-ge

    2000-05-01

    While Picture Archiving and Communicating System project is underway through out the western countries, China is making a revolutionary advance in digital medical record. Hospitals in China have made their first steps toward implementation of PACS. Due to the ever-increasing amount of medical image data, a completed archive server is of great need as the base of filmless radiology, a cost effective, high performance digital archive system will remain as the most essential and challenging part of PACS. However there is an inevitable and inherent dilemma in those hospitals in the developing countries like China -- limited amount of development funds. So we are urged to design a low cost but efficient image archive system to cater to the expectation of the hospital. This paper describes a high capacity PACS image archive system model that is developed with rather low cost. To build a reliable and flexible image archive system involves a number of factors such as system capacity requirement, storage and retrieval performance and cost saving etc. We have undertaken the hierarchy image storage mechanism. Judicious image dispatch is employed to meet the goal of timely image retrieval. The whole design can be divided into two parts, one is Scheduled Image Flow Service (SIFS) whose purpose is to periodically backup, archive and pre-fetch image, the other one is Online Image Retrieval Service (OIRS) to provide quick access to the online and nearline images through the network interface. Automatic image transfer is realized between different storage tiers with high level of control. All the procedure is highly automatic except the manually depositing and undepositing off-line optical disks. System evaluations on random retrieval time are presented to show the effect of image location. The concept of image tiered storage will largely reduce the cost of storage. Real-time response to the retrieval demand can send wanted images to a radiologist in a reasonable time. We have done

  20. Selection and Pilot Implementation of a Mobile Image Viewer: A Case Study

    PubMed Central

    He, Miao; Wu, Teresa; Demaerschalk, Bart M; Mitchell, Joseph Ross; Hara, Amy K

    2015-01-01

    Background For health care providers, mobile image viewing increases image accessibility, which could lead to faster interpretation/consultations and improved patient outcomes. Objective We explored the technical requirements and challenges associated with implementing a commercial mobile image viewer and conducted a small study testing the hypothesis that the mobile image viewer would provide faster image access. Methods A total of 19 clinicians (9 radiologists, 3 surgeons, 4 neurologists, and 3 physician assistants) evaluated (1) a desktop commercial picture archiving and communication system (PACS) viewer, (2) a desktop viewer developed internally over 20 years and deployed throughout the enterprise (ENTERPRISE viewer) and (3) a commercial Food and Drug Administration class II-cleared mobile viewer compatible with Web browsers, tablets, and mobile phones. Data were collected during two separate 7-day periods, before and after mobile image viewer deployment. Data included image viewer chosen, time to view first image, technical issues, diagnostic confidence, and ease of use. Results For 565 image-viewing events, ease of use was identical for PACS and mobile viewers (mean 3.6 for all scores of a possible 4.0), and significantly worse for the enterprise viewer (mean 2.9, P=.001). Technical issues were highest with the enterprise viewer (26%, 56/215) compared with the mobile (7%,19/259, P=.001) and PACS (8%, 7/91, P=.003) viewers. Mean time to first image for the mobile viewer (2.4 minutes) was significantly faster than PACS (12.5 minutes, P=.001) and the enterprise viewer (4.5 minutes, P=.001). Diagnostic confidence was similar for PACS and mobile viewers and worst for enterprise viewer. Mobile image viewing increased by sixfold, from 14% (37/269, before the deployment) to 88.9% (263/296, after the deployment). Conclusions A mobile viewer provided faster time to first image, improved technical performance, ease of use, and diagnostic confidence, compared with

  1. Implementation of quality control performance criteria and approved guidelines for upgrading of clinical chemistry laboratory procedures in Alexandria University hospitals.

    PubMed

    Rizk, Mohamed Moustafa M; el-Badawi, Nashwa A; Moez, Pacint E; Khattab, Azza A

    2009-03-01

    The aim of the present work was to assess the quality of work in Clinical Pathology Department, Alexandria Main University Hospital, Egypt; as regards the pre-analytical and analytical phases of testing; for later accreditation. This evaluation was performed using inspection sheets that were designed according to the CAP 2006 recommendations. All checklist questions that could not be answered "yes" were considered deficiencies and had to be corrected before being accredited. The questions were classified into ten groups; each group contained a number of questions concerning one of the pre-analytical and analytical assessment activities. We ranked our results into 4 categories according to the degree of fulfillment. The total number of questions that were answered "no" at the start and the end of the study accounted for 64/101 (63.4%) and 34/101 (33.7%) questions respectively. Most of the deficiencies were detected in the pre-analytical phase of the testing process; the first two checklists were used for the evaluation of this phase. At the start of the study, the degree of requirements fulfillment in checklist I and II were 0% and 21.1% respectively. By the end of the study the degree of fulfillment became, 85.7% and 63.2% respectively. Average number of sample rejection due to different causes was evaluated before and after implementing CAP recommendations; these causes include haemolysis, clotted serum, quantity not sufficient, and lost samples; the percentage of rejected samples before implementing CAP recommendations was 15.8%, 1.81%, 0.70%, and 0.51% respectively, while after implementing CAP recommendations it was 7%, 0.77%, 0.08%, and 0.05%, respectively. We concluded that the presence of standardized protocol for the pre-analytical activities had improved the quality of samples received by the lab, and we also concluded that accreditation allows laboratories to evaluate their performance, their compliance with the requirements of the accrediting association

  2. LIFE CYCLE ENGINEERING GUIDELINES

    EPA Science Inventory

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

  3. Mapping ASTI patient's therapeutic-data model to virtual Medical Record: can VMR represent therapeutic data elements used by ASTI in clinical guideline implementations?

    PubMed

    Ebrahiminia, Vahid; Yasini, Mobin; Lamy, Jean Baptiste

    2013-01-01

    Lack of interoperability between health information systems is a major obstacle in implementing Clinical decision supports systems (CDSS) and their widespread disseminations. Virtual Medical Record (vMR) proposed by HL7 is a common data model for representing clinical information Inputs and outputs that can be used by CDSS and local clinical systems. A CDSS called ASTI used a similar model to represent clinical data and therapeutic history of patient. In order to evaluate the compatibility of ASTI with vMR, we started to map the ASTI model of representing patient's therapeutic data to vMR. We compared the data elements and associated terminologies used in ASTI and vMR and we evaluated the semantic fidelity between the models. Only one data element the qualitative description of drug dosage, did not match the vMR model. However, it can be calculated in the execution engine. The semantic fidelity was satisfactorily preserved in 12 of 17 elements mapped between the models. This model of ASTI seems compatible to vMR. Further work is necessary to evaluate the compatibility of clinical data model of ASTI to vMR and the use of vMR in implementing practice guidelines.

  4. The parallel implementation of a backpropagation neural network and its applicability to SPECT image reconstruction

    SciTech Connect

    Kerr, J.P.

    1992-12-31

    The objective of this study was to determine the feasibility of using an Artificial Neural Network (ANN), in particular a backpropagation ANN, to improve the speed and quality of the reconstruction of three-dimensional SPECT (single photon emission computed tomography) images. In addition, since the processing elements (PE)s in each layer of an ANN are independent of each other, the speed and efficiency of the neural network architecture could be better optimized by implementing the ANN on a massively parallel computer. The specific goals of this research were: to implement a fully interconnected backpropagation neural network on a serial computer and a SIMD parallel computer, to identify any reduction in the time required to train these networks on the parallel machine versus the serial machine, to determine if these neural networks can learn to recognize SPECT data by training them on a section of an actual SPECT image, and to determine from the knowledge obtained in this research if full SPECT image reconstruction by an ANN implemented on a parallel computer is feasible both in time required to train the network, and in quality of the images reconstructed.

  5. The parallel implementation of a backpropagation neural network and its applicability to SPECT image reconstruction

    SciTech Connect

    Kerr, J.P.

    1992-01-01

    The objective of this study was to determine the feasibility of using an Artificial Neural Network (ANN), in particular a backpropagation ANN, to improve the speed and quality of the reconstruction of three-dimensional SPECT (single photon emission computed tomography) images. In addition, since the processing elements (PE)s in each layer of an ANN are independent of each other, the speed and efficiency of the neural network architecture could be better optimized by implementing the ANN on a massively parallel computer. The specific goals of this research were: to implement a fully interconnected backpropagation neural network on a serial computer and a SIMD parallel computer, to identify any reduction in the time required to train these networks on the parallel machine versus the serial machine, to determine if these neural networks can learn to recognize SPECT data by training them on a section of an actual SPECT image, and to determine from the knowledge obtained in this research if full SPECT image reconstruction by an ANN implemented on a parallel computer is feasible both in time required to train the network, and in quality of the images reconstructed.

  6. Facies dimensions within carbonate reservoirs - guidelines from satellite images of modern analogs

    SciTech Connect

    Harris, P.M.; Kowalik, W.S.

    1995-08-01

    Modern analogs illustrate the distribution of carbonate facies within an overall depositional setting and can be an integral part of a subsurface geologic model in indicating the dimensions, trend, and interrelationships of facies that might be related to reservoir and non-reservoir distribution. Satellite images from several modern carbonate areas depict the geologic characteristics that can be expected in ancient shallow-water settings. Isolated carbonate platforms- the Bahamas, Caicos Platform in the British West Indies, Chinchorro Bank offshore of Yucatan, and portions of the Belize area; Ramp-style shelf-to-basin transitions - Abu Dhabi and northern Yucatan; Rimmed shelf margins - South Florida, portions of Belize, and the Great Barrier Reef of Australia; Broad, deep shelf lagoons - the Great Barrier Reef and Belize; Reef variability - South Florida, the Bahamas, Caicos, Northern Yucatan, and Abu Dhabi; Shallow lagoon/tidal flat settings - South Florida, the Bahamas, Caicos, Northern Yucatan, Shark Bay in Western Australia, Abu Dhabi; Mixed carbonate and siliciclastic depostion - South Florida, Belize, the Great Barrier Reef, Shark Bay and Abu Dhabi. The geologic framework as illustrated by these areas is important at the development scale where lateral variation of porosity and permeability, i.e. reservoir quality, is commonly tied to facies changes and facies dimensions are required as input to reservoir models. The geologic framework is essential at the exploration scale for reservoir facies prediction and stratigraphic play concepts which are related directly to depositional facies patterns.

  7. Magnetic resonance imaging research in sub-Saharan Africa: challenges and satellite-based networking implementation.

    PubMed

    Latourette, Matthew T; Siebert, James E; Barto, Robert J; Marable, Kenneth L; Muyepa, Anthony; Hammond, Colleen A; Potchen, Michael J; Kampondeni, Samuel D; Taylor, Terrie E

    2011-08-01

    As part of an NIH-funded study of malaria pathogenesis, a magnetic resonance (MR) imaging research facility was established in Blantyre, Malaŵi to enhance the clinical characterization of pediatric patients with cerebral malaria through application of neurological MR methods. The research program requires daily transmission of MR studies to Michigan State University (MSU) for clinical research interpretation and quantitative post-processing. An intercontinental satellite-based network was implemented for transmission of MR image data in Digital Imaging and Communications in Medicine (DICOM) format, research data collection, project communications, and remote systems administration. Satellite Internet service costs limited the bandwidth to symmetrical 384 kbit/s. DICOM routers deployed at both the Malaŵi MRI facility and MSU manage the end-to-end encrypted compressed data transmission. Network performance between DICOM routers was measured while transmitting both mixed clinical MR studies and synthetic studies. Effective network latency averaged 715 ms. Within a mix of clinical MR studies, the average transmission time for a 256 × 256 image was ~2.25 and ~6.25 s for a 512 × 512 image. Using synthetic studies of 1,000 duplicate images, the interquartile range for 256 × 256 images was [2.30, 2.36] s and [5.94, 6.05] s for 512 × 512 images. Transmission of clinical MRI studies between the DICOM routers averaged 9.35 images per minute, representing an effective channel utilization of ~137% of the 384-kbit/s satellite service as computed using uncompressed image file sizes (including the effects of image compression, protocol overhead, channel latency, etc.). Power unreliability was the primary cause of interrupted operations in the first year, including an outage exceeding 10 days.

  8. Hardware Implementation of Lossless Adaptive Compression of Data From a Hyperspectral Imager

    NASA Technical Reports Server (NTRS)

    Keymeulen, Didlier; Aranki, Nazeeh I.; Klimesh, Matthew A.; Bakhshi, Alireza

    2012-01-01

    Efficient onboard data compression can reduce the data volume from hyperspectral imagers on NASA and DoD spacecraft in order to return as much imagery as possible through constrained downlink channels. Lossless compression is important for signature extraction, object recognition, and feature classification capabilities. To provide onboard data compression, a hardware implementation of a lossless hyperspectral compression algorithm was developed using a field programmable gate array (FPGA). The underlying algorithm is the Fast Lossless (FL) compression algorithm reported in Fast Lossless Compression of Multispectral- Image Data (NPO-42517), NASA Tech Briefs, Vol. 30, No. 8 (August 2006), p. 26 with the modification reported in Lossless, Multi-Spectral Data Comressor for Improved Compression for Pushbroom-Type Instruments (NPO-45473), NASA Tech Briefs, Vol. 32, No. 7 (July 2008) p. 63, which provides improved compression performance for data from pushbroom-type imagers. An FPGA implementation of the unmodified FL algorithm was previously developed and reported in Fast and Adaptive Lossless Onboard Hyperspectral Data Compression System (NPO-46867), NASA Tech Briefs, Vol. 36, No. 5 (May 2012) p. 42. The essence of the FL algorithm is adaptive linear predictive compression using the sign algorithm for filter adaption. The FL compressor achieves a combination of low complexity and compression effectiveness that exceeds that of stateof- the-art techniques currently in use. The modification changes the predictor structure to tolerate differences in sensitivity of different detector elements, as occurs in pushbroom-type imagers, which are suitable for spacecraft use. The FPGA implementation offers a low-cost, flexible solution compared to traditional ASIC (application specific integrated circuit) and can be integrated as an intellectual property (IP) for part of, e.g., a design that manages the instrument interface. The FPGA implementation was benchmarked on the Xilinx

  9. Image preprocessing for improving computational efficiency in implementation of restoration and superresolution algorithms.

    PubMed

    Sundareshan, Malur K; Bhattacharjee, Supratik; Inampudi, Radhika; Pang, Ho-Yuen

    2002-12-10

    Computational complexity is a major impediment to the real-time implementation of image restoration and superresolution algorithms in many applications. Although powerful restoration algorithms have been developed within the past few years utilizing sophisticated mathematical machinery (based on statistical optimization and convex set theory), these algorithms are typically iterative in nature and require a sufficient number of iterations to be executed to achieve the desired resolution improvement that may be needed to meaningfully perform postprocessing image exploitation tasks in practice. Additionally, recent technological breakthroughs have facilitated novel sensor designs (focal plane arrays, for instance) that make it possible to capture megapixel imagery data at video frame rates. A major challenge in the processing of these large-format images is to complete the execution of the image processing steps within the frame capture times and to keep up with the output rate of the sensor so that all data captured by the sensor can be efficiently utilized. Consequently, development of novel methods that facilitate real-time implementation of image restoration and superresolution algorithms is of significant practical interest and is the primary focus of this study. The key to designing computationally efficient processing schemes lies in strategically introducing appropriate preprocessing steps together with the superresolution iterations to tailor optimized overall processing sequences for imagery data of specific formats. For substantiating this assertion, three distinct methods for tailoring a preprocessing filter and integrating it with the superresolution processing steps are outlined. These methods consist of a region-of-interest extraction scheme, a background-detail separation procedure, and a scene-derived information extraction step for implementing a set-theoretic restoration of the image that is less demanding in computation compared with the

  10. Computationally efficient image restoration and super-resolution algorithns for real-time implementation

    NASA Astrophysics Data System (ADS)

    Sundareshan, Malur K.

    2002-07-01

    Computational complexity is a major impediment to the real- time implementation of image restoration and super- resolution algorithms. Although powerful restoration algorithms have been developed within the last few years utilizing sophisticated mathematical machinery (based on statistical optimization and convex set theory), these algorithms are typically iterative in nature and require enough number of iterations to be executed to achieve desired resolution gains in order to meaningfully perform detection and recognition tasks in practice. Additionally, recent technological breakthroughs have facilitated novel sensor designs (focal plane arrays, for instance) that make it possible to capture mega-pixel imagery data at video frame rates. A major challenge in the processing of these large format images is to complete the execution of the image processing steps within the frame capture times and to keep up with the output rate of the sensor so that all data captured by the sensor can be efficiently utilized. Consequently, development of novel methods that facilitate real-time implementation of image restoration and super- resolution algorithms is of significant practical interest and will be the primary focus of this paper. The key to designing computationally efficient processing schemes lies in strategically introducing appropriate pre-processing and post-processing steps together with the super-resolution iterations in order to tailor optimized overall processing sequences for imagery data of specific formats. Three distinct methods for tailoring a pre-processing filter and integrating it with the super-resolution processing steps will be outlined in this paper. These methods consist of a Region-of-Interest (ROI) extraction scheme, a background- detail separation procedure, and a scene-derived information extraction step for implementing a set-theoretic restoration of the image that is less demanding in computation compared to the super-resolution iterations. A

  11. Image preprocessing for improving computational efficiency in implementation of restoration and superresolution algorithms

    NASA Astrophysics Data System (ADS)

    Sundareshan, Malur K.; Bhattacharjee, Supratik; Inampudi, Radhika; Pang, Ho-Yuen

    2002-12-01

    Computational complexity is a major impediment to the real-time implementation of image restoration and superresolution algorithms in many applications. Although powerful restoration algorithms have been developed within the past few years utilizing sophisticated mathematical machinery (based on statistical optimization and convex set theory), these algorithms are typically iterative in nature and require a sufficient number of iterations to be executed to achieve the desired resolution improvement that may be needed to meaningfully perform postprocessing image exploitation tasks in practice. Additionally, recent technological breakthroughs have facilitated novel sensor designs (focal plane arrays, for instance) that make it possible to capture megapixel imagery data at video frame rates. A major challenge in the processing of these large-format images is to complete the execution of the image processing steps within the frame capture times and to keep up with the output rate of the sensor so that all data captured by the sensor can be efficiently utilized. Consequently, development of novel methods that facilitate real-time implementation of image restoration and superresolution algorithms is of significant practical interest and is the primary focus of this study. The key to designing computationally efficient processing schemes lies in strategically introducing appropriate preprocessing steps together with the superresolution iterations to tailor optimized overall processing sequences for imagery data of specific formats. For substantiating this assertion, three distinct methods for tailoring a preprocessing filter and integrating it with the superresolution processing steps are outlined. These methods consist of a region-of-interest extraction scheme, a background-detail separation procedure, and a scene-derived information extraction step for implementing a set-theoretic restoration of the image that is less demanding in computation compared with the

  12. Identifying factors likely to influence compliance with diagnostic imaging guideline recommendations for spine disorders among chiropractors in North America: a focus group study using the Theoretical Domains Framework

    PubMed Central

    2012-01-01

    Background The Theoretical Domains Framework (TDF) was developed to investigate determinants of specific clinical behaviors and inform the design of interventions to change professional behavior. This framework was used to explore the beliefs of chiropractors in an American Provider Network and two Canadian provinces about their adherence to evidence-based recommendations for spine radiography for uncomplicated back pain. The primary objective of the study was to identify chiropractors’ beliefs about managing uncomplicated back pain without x-rays and to explore barriers and facilitators to implementing evidence-based recommendations on lumbar spine x-rays. A secondary objective was to compare chiropractors in the United States and Canada on their beliefs regarding the use of spine x-rays. Methods Six focus groups exploring beliefs about managing back pain without x-rays were conducted with a purposive sample. The interview guide was based upon the TDF. Focus groups were digitally recorded, transcribed verbatim, and analyzed by two independent assessors using thematic content analysis based on the TDF. Results Five domains were identified as likely relevant. Key beliefs within these domains included the following: conflicting comments about the potential consequences of not ordering x-rays (risk of missing a pathology, avoiding adverse treatment effects, risks of litigation, determining the treatment plan, and using x-ray-driven techniques contrasted with perceived benefits of minimizing patient radiation exposure and reducing costs; beliefs about consequences); beliefs regarding professional autonomy, professional credibility, lack of standardization, and agreement with guidelines widely varied ( social/professional role & identity); the influence of formal training, colleagues, and patients also appeared to be important factors ( social influences); conflicting comments regarding levels of confidence and comfort in managing patients without x-rays ( belief

  13. Haemorrhagia post partum; an implementation study on the evidence-based guideline of the Dutch Society of Obstetrics and Gynaecology (NVOG) and the MOET (Managing Obstetric Emergencies and Trauma-course) instructions; the Fluxim study

    PubMed Central

    2010-01-01

    Background One of the most important causes of maternal mortality and severe morbidity worldwide is post partum haemorrhage (PPH). Factors as substandard care are frequently reported in the international literature and there are similar reports in the Netherlands. The incidence of PPH in the Dutch population is 5% containing 10.000 women a year. The introduction of an evidence-based guideline on PPH by the Dutch society of Obstetrics and Gynaecology (NVOG) and the initiation of the MOET course (Managing Obstetrics Emergencies and Trauma) did not lead to a reduction of PPH. This implies the possibility of an incomplete implementation of both the NVOG guideline and MOET-instructions. Therefore, the aim of this study is to develop and test a tailored strategy to implement both the NVOG guideline and MOET-instructions Methods/Design One step in the development procedure is to evaluate the implementation of the guideline and MOET-instructions in the current care. Therefore measurement of the actual care will be performed in a representative sample of 20 hospitals. This will be done by prospective observation of the third stage of labour of 320 women with a high risk of PPH using quality indicators extracted from the NVOG guideline and MOET instructions. In the next step barriers and facilitators for guideline adherence will be analyzed by performance of semi structured interviews with 30 professionals and 10 patients, followed by a questionnaire study among all Dutch gynaecologists and midwives to quantify the barriers mentioned. Based on the outcomes, a tailored strategy to implement the NVOG guideline and MOET-instructions will be developed and tested in a feasibility study in 4 hospitals, including effect-, process- and cost evaluation. Discussion This study will provide insight into current Dutch practice, in particular to what extent the PPH guidelines of the NVOG and the MOET-instructions have been implemented in the actual care, and into the barriers and

  14. The design and implementation of a global satellite image organization and web-based publication system

    NASA Astrophysics Data System (ADS)

    Jiang, Jie; Cao, Rui; Wu, Lingda

    2010-11-01

    As satellite remote sensing information has gradually become an important data source and plays more and more important role in multi-domain, this paper does an in-depth study on global satellite remote sensing image data scheduling and publishing mechanism. It also design and implements a grid-based management and publication engine of satellite image data. For meeting the multi-request from clients with different access interface at the same time, the designed web-based high-effective general-purpose publication system is represented in the end.

  15. Implementation of a laser beam analyzer using the image acquisition card IMAQ (NI)

    NASA Astrophysics Data System (ADS)

    Rojas-Laguna, R.; Avila-Garcia, M. S.; Alvarado-Mendez, Edgar; Andrade-Lucio, Jose A.; Obarra-Manzano, O. G.; Torres-Cisneros, Miguel; Castro-Sanchez, R.; Estudillo-Ayala, J. M.; Ibarra-Escamilla, Baldeamr

    2001-08-01

    In this work we address our attention to the implementation of a beam analyzer. The software was designed under LabView, platform and using the Image Acquisition Card IMAQ of National Instruments. The objective is to develop a graphic interface which has to include image processing tools such as characteristic enhancement such as bright, contrast and morphologic operations and quantification of dimensions. An application of this graphic interface is like laser beam analyzer of medium cost, versatile, precise and easily reconfigurable under this programing environment.

  16. On the design and implementation of a parallel, object-oriented, image processing toolkit

    SciTech Connect

    Kamath, C; Baldwin, C; Fodor, I; Tang, N A

    2000-06-22

    Advanced in technology have enabled us to collect data from observations, experiments, and simulations at an ever increasing pace. As these data sets approach the terabyte and petabyte range, scientists are increasingly using semi-automated techniques from data mining and pattern recognition to find useful information in the data. In order for data mining to be successful, the raw data must first be processed into a form suitable for the detection of patterns. When the data is in the form of images, this can involve a substantial amount of processing on very large data sets. To help make this task more efficient, they are designing and implementing an object-oriented image processing toolkit that specifically targets massively-parallel, distributed-memory architectures. They first show that it is possible to use object-oriented technology to effectively address the diverse needs of image applications. Next, they describe how we abstract out the similarities in image processing algorithms to enable re-use in the software. They will also discuss the difficulties encountered in parallelizing image algorithms on massively parallel machines as well as the bottlenecks to high performance. They will demonstrate the work using images from an astronomical data set, and illustrate how techniques such as filters and denoising through the thresholding of wavelet coefficients can be applied when a large image is distributed across several processors.

  17. Optical image encryption based on cascaded iterative angular spectrum algorithm and its implementation with parallel hardware

    NASA Astrophysics Data System (ADS)

    Yu, Biin; Peng, Xiang; Tian, Jindong; Niu, Hanben

    2006-01-01

    A cascaded iterative angular spectrum approach (CIASA) based on the methodology of virtual optics is presented for optical security applications. The technique encodes the target image into two different phase only masks (POM) using a concept of free-space angular spectrum propagation. The two phase-masks are designed and located in any two arbitrary planes interrelated through the free space propagation domain in order to implement the optical encryption or authenticity verification. And both phase masks can serve as enciphered texts. Compared with previous methods, the proposed algorithm employs an improved searching strategy: modifying the phase-distributions of both masks synchronously as well as enlarging the searching space. And with such a scheme, we make use of a high performance floating-point Digital Signal Processor (DSP) to accomplish a design of multiple-locks and multiple-keys optical image encryption system. An evaluation of the system performance is made and it is shown that the algorithm results in much faster convergence and better image quality for the recovered image. And two masks and system parameters can be used to design keys for image encryption, therefore the decrypted image can be obtained only when all these keys are under authorization. This key-assignment strategy may reduce the risk of being intruded and show a high security level. These characters may introduce a high level security that makes the encrypted image more difficult to be decrypted by an unauthorized person.

  18. Star-field identification algorithm. [for implementation on CCD-based imaging camera

    NASA Technical Reports Server (NTRS)

    Scholl, M. S.

    1993-01-01

    A description of a new star-field identification algorithm that is suitable for implementation on CCD-based imaging cameras is presented. The minimum identifiable star pattern element consists of an oriented star triplet defined by three stars, their celestial coordinates, and their visual magnitudes. The algorithm incorporates tolerance to faulty input data, errors in the reference catalog, and instrument-induced systematic errors.

  19. Gaining insight into the Clinical Practice Guideline development processes: qualitative study in a workshop to implement the GRADE proposal in Spain

    PubMed Central

    Calderón, Carlos; Rotaeche, Rafael; Etxebarria, Arritxu; Marzo, Mercé; Rico, Rosa; Barandiaran, Marta

    2006-01-01

    Background The GRADE method represents a new approach to grading the quality of evidence and strength of recommendations in the preparation of Clinical Practice Guidelines (CPG). In the context of a pilot study to assess the implementability of the system in Spain, we considered it relevant to gain an insight into the significance of the perceptions and attitudes expressed by the actual experts participating in the system try-out. Methods Qualitative research with an ethnographic approach, through non-participant observation and focus groups within the context of a consensus workshop in which 19 CPG experts participated to evaluate the GRADE proposal using 12 evidence tables taken from hypertension, asthma and arthritis CPGs. The interventions were recorded, under a guarantee of confidentiality. The transcriptions and field notes were analyzed, based on a sociological discourse analysis model, and the provisional findings were re-sent to participants in order to improve their validity. Results 1) Certain problems over procedure and terminology hindered the acceptance of this new method as a common reference system for the preparation of CPGs. 2). A greater closeness to clinical practice was accompanied by concerns over value judgments and subjectivity, with a demand for greater explicitness in the consensus process. 3). The type of "evidence" on which the guidelines are based, how and by whom the evidence is prepared, and what the role of the different actors should be, all constitute unresolved concerns in the CPG preparation and implementation processes. 4). The grading process is not neutral: professional background, prior experience and the degree of leadership all condition the participants' input and interactions. Conclusion The findings obtained allow the quantitative evaluation to be better interpreted and, in turn, go beyond the particularities of the GRADE method. Adaptation to the complexities of clinical practice, the need for carefully designed multi

  20. Pediatric guidelines for dyslipidemia.

    PubMed

    Daniels, Stephen R

    2015-01-01

    Clinical guidelines are developed to assist clinicians in complex clinical decision making. Modern guideline development includes a systematic review and grading of relevant literature and then using the evidence review to construct recommendations for clinical care which are also graded regarding the level of evidence supporting them. Pediatric guidelines for dyslipidemia were first published in 1992. There was then a gap during which no formal guidelines were developed. In 2011, the National Heart, Lung, and Blood Institute Integrated Guidelines for Cardiovascular Disease Risk Reduction in Children were published. This included an evidence review and clinical recommendations regarding dyslipidemia. This review process began in 2006. The evidence review ended in 2008, and they were published in 2011 because of an extensive and prolonged review process. These guidelines recommend universal screening for dyslipidemia at age 9 to 11 y with a focus on identifying young individuals with genetic dyslipidemia such as familial hypercholesterolemia. The guidelines also include lifestyle recommendations and recommendations for pharmacologic treatment for children with markedly elevated low-density lipoprotein cholesterol. The guideline process should include review of the implementation of guidelines in practice and should also include ongoing review of the guidelines with respect to a growing evidence base with new research findings.

  1. Medical image denoising via optimal implementation of non-local means on hybrid parallel architecture.

    PubMed

    Nguyen, Tuan-Anh; Nakib, Amir; Nguyen, Huy-Nam

    2016-06-01

    The Non-local means denoising filter has been established as gold standard for image denoising problem in general and particularly in medical imaging due to its efficiency. However, its computation time limited its applications in real world application, especially in medical imaging. In this paper, a distributed version on parallel hybrid architecture is proposed to solve the computation time problem and a new method to compute the filters' coefficients is also proposed, where we focused on the implementation and the enhancement of filters' parameters via taking the neighborhood of the current voxel more accurately into account. In terms of implementation, our key contribution consists in reducing the number of shared memory accesses. The different tests of the proposed method were performed on the brain-web database for different levels of noise. Performances and the sensitivity were quantified in terms of speedup, peak signal to noise ratio, execution time, the number of floating point operations. The obtained results demonstrate the efficiency of the proposed method. Moreover, the implementation is compared to that of other techniques, recently published in the literature. PMID:27084318

  2. Labview Implementation of Image Processing and Phasing Control for the SIBOA Segmented Mirror Testbed

    NASA Technical Reports Server (NTRS)

    Partridge, James D.

    2002-01-01

    'NASA is preparing to launch the Next Generation Space Telescope (NGST). This telescope will be larger than the Hubble Space Telescope, be launched on an Atlas missile rather than the Space Shuttle, have a segmented primary mirror, and be placed in a higher orbit. All these differences pose significant challenges.' This effort addresses the challenge of implementing an algorithm for aligning the segments of the primary mirror during the initial deployment that was designed by Philip Olivier and members of SOMTC (Space Optics Manufacturing Technology Center). The implementation was to be performed on the SIBOA (Systematic Image Based Optical Alignment) test bed. Unfortunately, hardware/software aspect concerning SIBOA and an extended time period for algorithm development prevented testing before the end of the study period. Properties of the digital camera were studied and understood, resulting in the current ability of selecting optimal settings regarding saturation. The study was successful in manually capturing several images of two stacked segments with various relative phases. These images can be used to calibrate the algorithm for future implementation. Currently the system is ready for testing.

  3. Medical image denoising via optimal implementation of non-local means on hybrid parallel architecture.

    PubMed

    Nguyen, Tuan-Anh; Nakib, Amir; Nguyen, Huy-Nam

    2016-06-01

    The Non-local means denoising filter has been established as gold standard for image denoising problem in general and particularly in medical imaging due to its efficiency. However, its computation time limited its applications in real world application, especially in medical imaging. In this paper, a distributed version on parallel hybrid architecture is proposed to solve the computation time problem and a new method to compute the filters' coefficients is also proposed, where we focused on the implementation and the enhancement of filters' parameters via taking the neighborhood of the current voxel more accurately into account. In terms of implementation, our key contribution consists in reducing the number of shared memory accesses. The different tests of the proposed method were performed on the brain-web database for different levels of noise. Performances and the sensitivity were quantified in terms of speedup, peak signal to noise ratio, execution time, the number of floating point operations. The obtained results demonstrate the efficiency of the proposed method. Moreover, the implementation is compared to that of other techniques, recently published in the literature.

  4. FPGA implementation of a 32x32 autocorrelator array for analysis of fast image series.

    PubMed

    Buchholz, Jan; Krieger, Jan Wolfgang; Mocsár, Gábor; Kreith, Balázs; Charbon, Edoardo; Vámosi, György; Kebschull, Udo; Langowski, Jörg

    2012-07-30

    With the evolving technology in CMOS integration, new classes of 2D-imaging detectors have recently become available. In particular, single photon avalanche diode (SPAD) arrays allow detection of single photons at high acquisition rates (≥ 100 kfps), which is about two orders of magnitude higher than with currently available cameras. Here we demonstrate the use of a SPAD array for imaging fluorescence correlation spectroscopy (imFCS), a tool to create 2D maps of the dynamics of fluorescent molecules inside living cells. Time-dependent fluorescence fluctuations, due to fluorophores entering and leaving the observed pixels, are evaluated by means of autocorrelation analysis. The multi-τ correlation algorithm is an appropriate choice, as it does not rely on the full data set to be held in memory. Thus, this algorithm can be efficiently implemented in custom logic. We describe a new implementation for massively parallel multi-τ correlation hardware. Our current implementation can calculate 1024 correlation functions at a resolution of 10 μs in real-time and therefore correlate real-time image streams from high speed single photon cameras with thousands of pixels.

  5. Implementation and performance of a general purpose graphics processing unit in hyperspectral image analysis

    NASA Astrophysics Data System (ADS)

    van der Werff, H. M. A.; Bakker, W. H.

    2014-02-01

    A graphics processing unit (GPU) can perform massively parallel computations at relatively low cost. Software interfaces like NVIDIA CUDA allow for General Purpose computing on a GPU (GPGPU). Wrappers of the CUDA libraries for higher-level programming languages such as MATLAB and IDL allow its use in image processing. In this paper, we implement GPGPU in IDL with two distance measures frequently used in image classification, Euclidean distance and spectral angle, and apply these to hyperspectral imagery. First we vary the data volume of a synthetic dataset by changing the number of image pixels, spectral bands and classification endmembers to determine speed-up and to find the smallest data volume that would still benefit from using graphics hardware. Then we process real datasets that are too large to fit in the GPU memory, and study the effect of resulting extra data transfers on computing performance. We show that our GPU algorithms outperform the same algorithms for a central processor unit (CPU), that a significant speed-up can already be obtained on relatively small datasets, and that data transfers in large datasets do not significantly influence performance. Given that no specific knowledge on parallel computing is required for this implementation, remote sensing scientists should now be able to implement and use GPGPU for their data analysis.

  6. A DSP implementation of lifting based DWT for image processing applications

    NASA Astrophysics Data System (ADS)

    Gholipour, Morteza; Noubari, Hossein A.; Kamarei, Mahmoud

    2011-10-01

    Discrete Wavelet Transform (DWT) is widely used in signal processing applications. In this paper, we describe hardware implementation of a lifting-based DWT, which is used in image compression. The CDF(2,2) lifting-based wavelet transform is modeled and simulated using MATLAB. Based on DSP methodologies, the signal flow graph and dependence graph are derived. The dependence graph is optimized and used to implement the hardware description of the circuit in Verilog. We have synthesized and implemented the circuit using both Field Programmable Gate Array (FPGA) and Application Specific Integrated Circuit (ASIC) design approaches. To confirm the circuit operation, post-synthesis and post-layout simulations were done for FPGA and ASIC designs, respectively.

  7. Implementation of quantitative perfusion imaging techniques for functional brain mapping using pulsed arterial spin labeling.

    PubMed

    Wong, E C; Buxton, R B; Frank, L R

    1997-01-01

    We describe here experimental considerations in the implementation of quantitative perfusion imaging techniques for functional MRI using pulsed arterial spin labeling. Three tagging techniques: EPISTAR, PICORE, and FAIR are found to give very similar perfusion results despite large differences in static tissue contrast. Two major sources of systematic error in the perfusion measurement are identified: the transit delay from the tagging region to the imaging slice; and the inclusion of intravascular tagged signal. A modified technique called QUIPSS II is described that decreases sensitivity to these effects by explicitly controlling the time width of the tag bolus and imaging after the bolus is entirely deposited into the slice. With appropriate saturation pulses the pulse sequence can be arranged so as to allow for simultaneous collection of perfusion and BOLD data that can be cleanly separated. Such perfusion and BOLD signals reveal differences in spatial location and dynamics that may be useful both for functional brain mapping and for study of the BOLD contrast mechanism. The implementation of multislice perfusion imaging introduces additional complications, primarily in the elimination of signal from static tissue. In pulsed ASL, this appears to be related to the slice profile of the inversion tag pulse in the presence of relaxation, rather than magnetization transfer effects as in continuous arterial spin labeling, and can be alleviated with careful adjustment of inversion pulse parameters. PMID:9430354

  8. Implementational Aspects of the Contourlet Filter Bank and Application in Image Coding

    NASA Astrophysics Data System (ADS)

    Nguyen, Truong T.; Liu, Yilong; Chauris, Hervé; Oraintara, Soontorn

    2008-12-01

    This paper analyzed the implementational aspects of the contourlet filter bank (or the pyramidal directional filter bank (PDFB)), and considered its application in image coding. First, details of the binary tree-structured directional filter bank (DFB) are presented, including a modification to minimize the phase delay factor and necessary steps for handling rectangular images. The PDFB is viewed as an overcomplete filter bank, and the directional filters are expressed in terms of polyphase components of the pyramidal filter bank and the conventional DFB. The aliasing effect of the conventional DFB and the Laplacian pyramid to the directional filters is then considered, and the conditions for reducing this effect are presented. The new filters obtained by redesigning the PDFBs satisfying these requirements have much better frequency responses. A hybrid multiscale filter bank consisting of the PDFB at higher scales and the traditional maximally decimated wavelet filter bank at lower scales is constructed to provide a sparse image representation. A novel embedded image coding system based on the image decomposition and a morphological dilation algorithm is then presented. The coding algorithm efficiently clusters the significant coefficients using progressive morphological operations. Context models for arithmetic coding are designed to exploit the intraband dependency and the correlation existing among the neighboring directional subbands. Experimental results show that the proposed coding algorithm outperforms the current state-of-the-art wavelet-based coders, such as JPEG2000, for images with directional features.

  9. Implementation of a multi-spectral color imaging device without color filter array

    NASA Astrophysics Data System (ADS)

    Langfelder, G.; Longoni, A. F.; Zaraga, F.

    2011-01-01

    In this work the use of the Transverse Field Detector (TFD) as a device for multispectral image acquisition is proposed. The TFD is a color imaging pixel capable of color reconstruction without color filters. Its basic working principle is based on the generation of a suitable electric field configuration inside a Silicon depleted region by means of biasing voltages applied to surface contacts. With respect to previously proposed methods for performing multispectral capture, the TFD has a unique characteristic of electrically tunable spectral responses. This feature allows capturing an image with different sets of spectral responses (RGB, R'G'B', and so on) simply by tuning the device biasing voltages in multiple captures. In this way no hardware complexity (no external filter wheels or varying sources) is added with respect to a colorimetric device. The estimation of the spectral reflectance of the area imaged by a TFD pixel is based in this work on a linear combination of six eigenfunctions. It is shown that a spectral reconstruction can be obtained either (1) using two subsequent image captures that generate six TFD spectral responses or (2) using a new asymmetric biasing scheme, which allows the implementation of five spectral responses for each TFD pixel site in a single configuration, definitely allowing one-shot multispectral imaging.

  10. On the Implementation of a Land Cover Classification System for SAR Images Using Khoros

    NASA Technical Reports Server (NTRS)

    Medina Revera, Edwin J.; Espinosa, Ramon Vasquez

    1997-01-01

    The Synthetic Aperture Radar (SAR) sensor is widely used to record data about the ground under all atmospheric conditions. The SAR acquired images have very good resolution which necessitates the development of a classification system that process the SAR images to extract useful information for different applications. In this work, a complete system for the land cover classification was designed and programmed using the Khoros, a data flow visual language environment, taking full advantages of the polymorphic data services that it provides. Image analysis was applied to SAR images to improve and automate the processes of recognition and classification of the different regions like mountains and lakes. Both unsupervised and supervised classification utilities were used. The unsupervised classification routines included the use of several Classification/Clustering algorithms like the K-means, ISO2, Weighted Minimum Distance, and the Localized Receptive Field (LRF) training/classifier. Different texture analysis approaches such as Invariant Moments, Fractal Dimension and Second Order statistics were implemented for supervised classification of the images. The results and conclusions for SAR image classification using the various unsupervised and supervised procedures are presented based on their accuracy and performance.

  11. Logic design and implementation of FPGA for a high frame rate ultrasound imaging system

    NASA Astrophysics Data System (ADS)

    Liu, Anjun; Wang, Jing; Lu, Jian-Yu

    2002-05-01

    Recently, a method has been developed for high frame rate medical imaging [Jian-yu Lu, ``2D and 3D high frame rate imaging with limited diffraction beams,'' IEEE Trans. Ultrason. Ferroelectr. Freq. Control 44(4), 839-856 (1997)]. To realize this method, a complicated system [multiple-channel simultaneous data acquisition, large memory in each channel for storing up to 16 seconds of data at 40 MHz and 12-bit resolution, time-variable-gain (TGC) control, Doppler imaging, harmonic imaging, as well as coded transmissions] is designed. Due to the complexity of the system, field programmable gate array (FPGA) (Xilinx Spartn II) is used. In this presentation, the design and implementation of the FPGA for the system will be reported. This includes the synchronous dynamic random access memory (SDRAM) controller and other system controllers, time sharing for auto-refresh of SDRAMs to reduce peak power, transmission and imaging modality selections, ECG data acquisition and synchronization, 160 MHz delay locked loop (DLL) for accurate timing, and data transfer via either a parallel port or a PCI bus for post image processing. [Work supported in part by Grant 5RO1 HL60301 from NIH.

  12. Implementation of a Near Back-Scattering Imaging System on The National Ignition Facility

    SciTech Connect

    Mackinnon, A; McCarville, T; Niemann, C; Piston, K; Jones, G; Reinbachs, I; Costa, R; Celeste, J; Griffith, R; Kirkwood, R; MacGowan, B; Glenzer, S

    2004-04-15

    A near back-scattering imaging diagnostic system is being implemented on the first quad of beams on the National Ignition Facility. This diagnostic images diffusing scatter plates, placed around the final focus lenses on the NIF target chamber, to quantitatively measure the fraction of light back-scattered outside of the incident cone of the focusing optics. The imaging system consists of a wide-angle lens coupled to a gated CCD camera, providing 3mm resolution over a 2m field of view. To account for changes of the system throughput due to exposure to target debris the system will be routinely calibrated in situ at 532nm and 355nm using a dedicated pulsed laser source. The diagnostic will be described and recent results will be presented. Work performed under the auspices of the U.S. Department of Energy by UC/Lawrence Livermore National Laboratory under Contract No. W-7405-ENG-48.

  13. Hardware implementation of LOTRRP compression for real-time image compression

    NASA Astrophysics Data System (ADS)

    Crooks, Marc W.; Capps, Charles; Hawkins, Eric; Wesley, Michael

    1996-03-01

    Lapped Orthogonal Transforms (LOT) are becoming more widely used in image coding applications for image transmission and archival schemes. Previously sponsored U.S. Army Missile Command research has developed a LOT Recursive Residual Projection (RRP) that uses the following multiple bases functions: Discrete Cosine Transform (DCT), Discrete Walsh Transform (DWT), and Discrete Slant Transform (DST). For high compression ratios the LOTRRP was shown no outperform the single bases transforms at the cost increased computations. The work presented in this paper describes a VHSIC Hardware Description Language (VHDL) design of the LOTDCT, LOTDWT, and LOTDST targeted for implementation on Application Specific Integrated Circuits (ASICs). This hardware solution was chosen to compress RS-170 standard video for real-time image transmission on a very low bandwidth packetized data link.

  14. Using indium tin oxide material to implement the imaging of microwave plasma ignition process

    SciTech Connect

    Wang, Qiang; Hou, Lingyun; Zhang, Guixin Zhang, Boya; Liu, Cheng; Wang, Zhi; Huang, Jian

    2014-02-17

    In this paper, a method is introduced to get global observation of microwave plasma ignition process at high pressure. A microwave resonator was designed with an indium tin oxide coated glass at bottom. Microwave plasma ignition was implemented in methane and air mixture at 10 bars by a 2 ms-3 kW-2.45 GHz microwave pulse, and the high speed images of the ignition process were obtained. The images visually proved that microwave plasma ignition could lead to a multi-point ignition. The system may also be applied to obtain Schlieren images, which is commonly used to observe the development of flame kernel in an ignition process.

  15. Commercial Implementation of Ultrasonic Velocity Imaging Methods via Cooperative Agreement Between NASA Lewis Research Center and Sonix, Inc.

    NASA Technical Reports Server (NTRS)

    Roth, Don J.; Hendricks, J. Lynne; Whalen, Mike F.; Bodis, James R.; Martin, Katherine

    1996-01-01

    This article describes the commercial implementation of ultrasonic velocity imaging methods developed and refined at NASA Lewis Research Center on the Sonix c-scan inspection system. Two velocity imaging methods were implemented: thickness-based and non-thickness-based reflector plate methods. The article demonstrates capabilities of the commercial implementation and gives the detailed operating procedures required for Sonix customers to achieve optimum velocity imaging results. This commercial implementation of velocity imaging provides a 100x speed increase in scanning and processing over the lab-based methods developed at LeRC. The significance of this cooperative effort is that the aerospace and other materials development-intensive industries which use extensive ultrasonic inspection for process control and failure analysis will now have an alternative, highly accurate imaging method commercially available.

  16. Design and implementation of Dilation X-ray Imager for NIF "DIXI"

    NASA Astrophysics Data System (ADS)

    Ayers, M. J.; Nagel, S. R.; Felker, B.; Bell, P. M.; Bradley, D. K.; Piston, K.; Parker, J.; Lamb, Z.; Kilkenny, J. D.; Hilsabeck, T. J.; Chung, T.; Hares, J. D.; Dymoke-Bradshaw, A. K. L.

    2013-09-01

    Gated X-Ray imagers have been used on many ICF experiments around the world for time resolved imaging of the target implosions. DIXI (Dilation X-ray Imager) is a new fixed base diagnostic that has been developed for use in the National Ignition Facility. The DIXI diagnostic utilizes pulse-dilation technology [1,2,3,4] and uses a high magnification pinhole imaging system to project images onto the instrument. DIXI is located outside the NIF target chamber approximately 6.5m from target chamber center (TCC). The pinholes are located 10cm from TCC and are aligned to the DIXI optical axis using a diagnostic instrument manipulator (DIM) on an adjacent port. By use of an extensive lead and poly shielded drawer enclosure DIXI is capable of collecting data at DT neutron yields up to Yn~ 1016 on CCD readout and up to Yn~ 1017 on film. Compared to existing pinhole x-ray framing cameras DIXI also provides a significant improvement in temporal resolution, <10ps, and the ability to capture a higher density of images due to the fact the pinhole array does not require collimators. The successful deployment of DIXI on the NIF required careful attention to the following subsystems, pinhole imaging, debris shielding, filtering and image plate (FIP), EMI protection, large format CsI photocathode design, detector head, detector head electronics, control electronics, CCD, film recording and neutron shielding. Here we discuss the initial design, improvements implemented after rigorous testing, infrastructure and commissioning of DIXI on the NIF.

  17. Multithreaded real-time 3D image processing software architecture and implementation

    NASA Astrophysics Data System (ADS)

    Ramachandra, Vikas; Atanassov, Kalin; Aleksic, Milivoje; Goma, Sergio R.

    2011-03-01

    Recently, 3D displays and videos have generated a lot of interest in the consumer electronics industry. To make 3D capture and playback popular and practical, a user friendly playback interface is desirable. Towards this end, we built a real time software 3D video player. The 3D video player displays user captured 3D videos, provides for various 3D specific image processing functions and ensures a pleasant viewing experience. Moreover, the player enables user interactivity by providing digital zoom and pan functionalities. This real time 3D player was implemented on the GPU using CUDA and OpenGL. The player provides user interactive 3D video playback. Stereo images are first read by the player from a fast drive and rectified. Further processing of the images determines the optimal convergence point in the 3D scene to reduce eye strain. The rationale for this convergence point selection takes into account scene depth and display geometry. The first step in this processing chain is identifying keypoints by detecting vertical edges within the left image. Regions surrounding reliable keypoints are then located on the right image through the use of block matching. The difference in the positions between the corresponding regions in the left and right images are then used to calculate disparity. The extrema of the disparity histogram gives the scene disparity range. The left and right images are shifted based upon the calculated range, in order to place the desired region of the 3D scene at convergence. All the above computations are performed on one CPU thread which calls CUDA functions. Image upsampling and shifting is performed in response to user zoom and pan. The player also consists of a CPU display thread, which uses OpenGL rendering (quad buffers). This also gathers user input for digital zoom and pan and sends them to the processing thread.

  18. Sequential Principal Component Analysis -An Optimal and Hardware-Implementable Transform for Image Compression

    NASA Technical Reports Server (NTRS)

    Duong, Tuan A.; Duong, Vu A.

    2009-01-01

    This paper presents the JPL-developed Sequential Principal Component Analysis (SPCA) algorithm for feature extraction / image compression, based on "dominant-term selection" unsupervised learning technique that requires an order-of-magnitude lesser computation and has simpler architecture compared to the state of the art gradient-descent techniques. This algorithm is inherently amenable to a compact, low power and high speed VLSI hardware embodiment. The paper compares the lossless image compression performance of the JPL's SPCA algorithm with the state of the art JPEG2000, widely used due to its simplified hardware implementability. JPEG2000 is not an optimal data compression technique because of its fixed transform characteristics, regardless of its data structure. On the other hand, conventional Principal Component Analysis based transform (PCA-transform) is a data-dependent-structure transform. However, it is not easy to implement the PCA in compact VLSI hardware, due to its highly computational and architectural complexity. In contrast, the JPL's "dominant-term selection" SPCA algorithm allows, for the first time, a compact, low-power hardware implementation of the powerful PCA algorithm. This paper presents a direct comparison of the JPL's SPCA versus JPEG2000, incorporating the Huffman and arithmetic coding for completeness of the data compression operation. The simulation results show that JPL's SPCA algorithm is superior as an optimal data-dependent-transform over the state of the art JPEG2000. When implemented in hardware, this technique is projected to be ideally suited to future NASA missions for autonomous on-board image data processing to improve the bandwidth of communication.

  19. Efficient lossy compression implementations of hyperspectral images: tools, hardware platforms, and comparisons

    NASA Astrophysics Data System (ADS)

    García, Aday; Santos, Lucana; López, Sebastián.; Callicó, Gustavo M.; Lopez, Jose F.; Sarmiento, Roberto

    2014-05-01

    Efficient onboard satellite hyperspectral image compression represents a necessity and a challenge for current and future space missions. Therefore, it is mandatory to provide hardware implementations for this type of algorithms in order to achieve the constraints required for onboard compression. In this work, we implement the Lossy Compression for Exomars (LCE) algorithm on an FPGA by means of high-level synthesis (HSL) in order to shorten the design cycle. Specifically, we use CatapultC HLS tool to obtain a VHDL description of the LCE algorithm from C-language specifications. Two different approaches are followed for HLS: on one hand, introducing the whole C-language description in CatapultC and on the other hand, splitting the C-language description in functional modules to be implemented independently with CatapultC, connecting and controlling them by an RTL description code without HLS. In both cases the goal is to obtain an FPGA implementation. We explain the several changes applied to the original Clanguage source code in order to optimize the results obtained by CatapultC for both approaches. Experimental results show low area occupancy of less than 15% for a SRAM-based Virtex-5 FPGA and a maximum frequency above 80 MHz. Additionally, the LCE compressor was implemented into an RTAX2000S antifuse-based FPGA, showing an area occupancy of 75% and a frequency around 53 MHz. All these serve to demonstrate that the LCE algorithm can be efficiently executed on an FPGA onboard a satellite. A comparison between both implementation approaches is also provided. The performance of the algorithm is finally compared with implementations on other technologies, specifically a graphics processing unit (GPU) and a single-threaded CPU.

  20. Coronary computed tomography angiography for the assessment of acute chest pain in the emergency department: evidence, guidelines, and tips for implementation.

    PubMed

    Ropp, Alan; Lin, Cheng T; White, Charles S

    2015-05-01

    Acute chest pain is an important clinical challenge and a major reason for presentation to the emergency department. Although multiple imaging techniques are available to assess such patients, considerable interest has focused on the use of coronary computed tomography (CT) angiography. Three recent multicenter trials have demonstrated the value of coronary CT angiography (CCTA) to diagnose patients with acute coronary syndrome (ACS) rapidly and accurately. Guidelines developed on the basis of these and other studies suggest that CCTA is optimally used in patients with low to intermediate risk for ACS. A related protocol, the triple rule-out scan, may be valuable if overlapping symptoms occur, particularly between those of ACS and pulmonary embolism. In developing a program to perform CCTA in the emergency room, it is important to work closely with emergency physicians and cardiologists to maximize appropriate use of this technique and to develop appropriate protocols that minimize radiation dose. Ongoing efforts to improve existing capabilities of CCTA include better characterization of coronary plaque and the use of CT fractional flow reserve and perfusion techniques.

  1. A new architecture for hyperspectral image processing and analysis system: design and implementation

    NASA Astrophysics Data System (ADS)

    Yu, Jianlin; Hu, Xingtang; Zhang, Bing; Ning, Shunian

    2003-09-01

    A new architecture for HIPAS (Hyperspectral Image Processing and Analysis System V2.0) was introduced in this paper which was modified and improved based on the first version of HIPAS V1.0. The comprehensive hyperspectral image analyzing system has been developed under VC++6.0 integrated development environment (IDE) and obtained perfect runtime efficiency and stability. The base architecture was specially designed and implemented to meet the requirements for the rapid preprocessing of imaging spectrometer data and easy prototyping of algorithms. Based on the modularized and object oriented software engineering construction, the architecture is compatible for other UNIX platforms with little modification. The most important components of HIPAS were presented in this paper including tools for input/output, preprocessing, data visualization, information extraction, conventional image analysis, advanced tools, and integrated interface to connect with general spectral databases. Some new methodologies for data analysis and processing were realized and applied to reach some valuable results based on the architecture including mineral identification, agriculture investigation, urban mapping etc. With an open storage architecture, HIPAS is entirely compatible with some advanced special commercial software such as ENVI and ERDAS and even the common image processing system Photoshop. At last, a strict and careful software test was carried out and the results were also analyzed and discussed.

  2. Implementation of a direct-imaging and FX correlator for the BEST-2 array

    NASA Astrophysics Data System (ADS)

    Foster, G.; Hickish, J.; Magro, A.; Price, D.; Zarb Adami, K.

    2014-04-01

    A new digital backend has been developed for the Basic Element for SKA Training II (BEST-2) array at Radiotelescopi di Medicina, INAF-IRA, Italy, which allows concurrent operation of an FX correlator, and a direct-imaging correlator and beamformer. This backend serves as a platform for testing some of the spatial Fourier transform concepts which have been proposed for use in computing correlations on regularly gridded arrays. While spatial Fourier transform-based beamformers have been implemented previously, this is, to our knowledge, the first time a direct-imaging correlator has been deployed on a radio astronomy array. Concurrent observations with the FX and direct-imaging correlator allow for direct comparison between the two architectures. Additionally, we show the potential of the direct-imaging correlator for time-domain astronomy, by passing a subset of beams though a pulsar and transient detection pipeline. These results provide a timely verification for spatial Fourier transform-based instruments that are currently in commissioning. These instruments aim to detect highly redshifted hydrogen from the epoch of reionization and/or to perform wide-field surveys for time-domain studies of the radio sky. We experimentally show the direct-imaging correlator architecture to be a viable solution for correlation and beamforming.

  3. Pre-Hardware Optimization of Spacecraft Image Processing Software Algorithms and Hardware Implementation

    NASA Technical Reports Server (NTRS)

    Kizhner, Semion; Flatley, Thomas P.; Hestnes, Phyllis; Jentoft-Nilsen, Marit; Petrick, David J.; Day, John H. (Technical Monitor)

    2001-01-01

    Spacecraft telemetry rates have steadily increased over the last decade presenting a problem for real-time processing by ground facilities. This paper proposes a solution to a related problem for the Geostationary Operational Environmental Spacecraft (GOES-8) image processing application. Although large super-computer facilities are the obvious heritage solution, they are very costly, making it imperative to seek a feasible alternative engineering solution at a fraction of the cost. The solution is based on a Personal Computer (PC) platform and synergy of optimized software algorithms and re-configurable computing hardware technologies, such as Field Programmable Gate Arrays (FPGA) and Digital Signal Processing (DSP). It has been shown in [1] and [2] that this configuration can provide superior inexpensive performance for a chosen application on the ground station or on-board a spacecraft. However, since this technology is still maturing, intensive pre-hardware steps are necessary to achieve the benefits of hardware implementation. This paper describes these steps for the GOES-8 application, a software project developed using Interactive Data Language (IDL) (Trademark of Research Systems, Inc.) on a Workstation/UNIX platform. The solution involves converting the application to a PC/Windows/RC platform, selected mainly by the availability of low cost, adaptable high-speed RC hardware. In order for the hybrid system to run, the IDL software was modified to account for platform differences. It was interesting to examine the gains and losses in performance on the new platform, as well as unexpected observations before implementing hardware. After substantial pre-hardware optimization steps, the necessity of hardware implementation for bottleneck code in the PC environment became evident and solvable beginning with the methodology described in [1], [2], and implementing a novel methodology for this specific application [6]. The PC-RC interface bandwidth problem for the

  4. Implementation for temporal noise identification using adaptive threshold of infrared imaging system

    NASA Astrophysics Data System (ADS)

    Lim, Inok

    2007-10-01

    Bad pixels are spatial or temporal noise which arise from dead pixels by fixed signal levels or blinking pixels by variable signal levels that go beyond the bounds of normal pixel levels at the temperature. Because bad pixels are the false targets over infrared imaging system for tracking, those must be corrected. Main contribution to the number of bad pixels is fixed pattern noise (FPN) according to increasing array size. And it is more simple to establish whether FPN is or not through analyzing of accumulated frames. But it needs to calculate with more complex implementation such standard deviation from frame to frame in case of the temporal noise. Both cases it is very important to establish the threshold levels for identifying at variable operating temperatures. In this paper, we propose a more efficient data analysis method and a temporal noise identification method using adaptive threshold for infrared imaging system, and the hardware is implemented to identify and replace bad pixels. And its result is confirmed visually by bad pixel map images.

  5. Implementation methods of medical image sharing for collaborative health care based on IHE XDS-I profile.

    PubMed

    Zhang, Jianguo; Zhang, Kai; Yang, Yuanyuan; Sun, Jianyong; Ling, Tonghui; Wang, Mingqing; Bak, Peter

    2015-10-01

    IHE XDS-I profile proposes an architecture model for cross-enterprise medical image sharing, but there are only a few clinical implementations reported. Here, we investigate three pilot studies based on the IHE XDS-I profile to see whether we can use this architecture as a foundation for image sharing solutions in a variety of health-care settings. The first pilot study was image sharing for cross-enterprise health care with federated integration, which was implemented in Huadong Hospital and Shanghai Sixth People's Hospital within the Shanghai Shen-Kang Hospital Management Center; the second pilot study was XDS-I-based patient-controlled image sharing solution, which was implemented by the Radiological Society of North America (RSNA) team in the USA; and the third pilot study was collaborative imaging diagnosis with electronic health-care record integration in regional health care, which was implemented in two districts in Shanghai. In order to support these pilot studies, we designed and developed new image access methods, components, and data models such as RAD-69/WADO hybrid image retrieval, RSNA clearinghouse, and extension of metadata definitions in both the submission set and the cross-enterprise document sharing (XDS) registry. We identified several key issues that impact the implementation of XDS-I in practical applications, and conclude that the IHE XDS-I profile is a theoretically good architecture and a useful foundation for medical image sharing solutions across multiple regional health-care providers. PMID:26835497

  6. A taxonomy for education and training in professional psychology health service specialties: evolution and implementation of new guidelines for a common language.

    PubMed

    Rozensky, Ronald H; Grus, Catherine L; Nutt, Roberta L; Carlson, Cindy I; Eisman, Elena J; Nelson, Paul D

    2015-01-01

    The Education and Training Guidelines: A Taxonomy for Education and Training in Professional Psychology Health Service Specialties was endorsed as a policy of the American Psychological Association in 2012. These Guidelines have the potential for broad impact on the field by providing both a structure and recommendations for the consistent usage of language--definitions and terminology--to reduce current descriptive inconsistencies across education and training programs in professional psychology. The Guidelines are not designed to define specifics of the training or practice of individual psychologists; they are to be used only to describe programmatic structure in a consistent manner. This article details the developmental history of these Guidelines and highlights the strong alliance between the leaders of the various recognized specialties in professional psychology and the education and training community in health service psychology. The content, application, future dissemination and impact of the Guidelines are presented.

  7. Performance Sensitivity Studies on the PIAA Implementation of the High-Contrast Imaging Testbed

    NASA Technical Reports Server (NTRS)

    Sidick, Erkin; Lou, John Z.; Shaklan, Stuart; Levine, Marie

    2009-01-01

    We have investigated the dependence of the High Contrast Imaging Testbed (HCIT) Phase Induced Amplitude Apodization (PIAA) coronagraph system performance on the rigid-body perturbations of various optics. The structural design of the optical system as well as the parameters of various optical elements used in the analysis are drawn from those of the PIAA/HCIT system that have been and will be implemented, and the simulation takes into account the surface errors of various optics. In this paper, we report our findings when the input light is a narrowband beam.

  8. Implementation of ILLIAC 4 algorithms for multispectral image interpretation. [earth resources data

    NASA Technical Reports Server (NTRS)

    Ray, R. M.; Thomas, J. D.; Donovan, W. E.; Swain, P. H.

    1974-01-01

    Research has focused on the design and partial implementation of a comprehensive ILLIAC software system for computer-assisted interpretation of multispectral earth resources data such as that now collected by the Earth Resources Technology Satellite. Research suggests generally that the ILLIAC 4 should be as much as two orders of magnitude more cost effective than serial processing computers for digital interpretation of ERTS imagery via multivariate statistical classification techniques. The potential of the ARPA Network as a mechanism for interfacing geographically-dispersed users to an ILLIAC 4 image processing facility is discussed.

  9. Dragonfly: an implementation of the expand–maximize–compress algorithm for single-particle imaging1

    PubMed Central

    Ayyer, Kartik; Lan, Ti-Yen; Elser, Veit; Loh, N. Duane

    2016-01-01

    Single-particle imaging (SPI) with X-ray free-electron lasers has the potential to change fundamentally how biomacromolecules are imaged. The structure would be derived from millions of diffraction patterns, each from a different copy of the macromolecule before it is torn apart by radiation damage. The challenges posed by the resultant data stream are staggering: millions of incomplete, noisy and un-oriented patterns have to be computationally assembled into a three-dimensional intensity map and then phase reconstructed. In this paper, the Dragonfly software package is described, based on a parallel implementation of the expand–maximize–compress reconstruction algorithm that is well suited for this task. Auxiliary modules to simulate SPI data streams are also included to assess the feasibility of proposed SPI experiments at the Linac Coherent Light Source, Stanford, California, USA. PMID:27504078

  10. Phantoms for diffuse optical imaging based on totally absorbing objects, part 2: experimental implementation.

    PubMed

    Martelli, Fabrizio; Di Ninni, Paola; Zaccanti, Giovanni; Contini, Davide; Spinelli, Lorenzo; Torricelli, Alessandro; Cubeddu, Rinaldo; Wabnitz, Heidrun; Mazurenka, Mikhail; Macdonald, Rainer; Sassaroli, Angelo; Pifferi, Antonio

    2014-01-01

    We present the experimental implementation and validation of a phantom for diffuse optical imaging based on totally absorbing objects for which, in the previous paper [J. Biomed. Opt.18(6), 066014, (2013)], we have provided the basic theory. Totally absorbing objects have been manufactured as black polyvinyl chloride (PVC) cylinders and the phantom is a water dilution of intralipid-20% as the diffusive medium and India ink as the absorber, filled into a black scattering cell made of PVC. By means of time-domain measurements and of Monte Carlo simulations, we have shown the reliability, the accuracy, and the robustness of such a phantom in mimicking typical absorbing perturbations of diffuse optical imaging. In particular, we show that such a phantom can be used to generate any absorption perturbation by changing the volume and position of the totally absorbing inclusion.

  11. In vivo visualization of robotically implemented synthetic tracked aperture ultrasound (STRATUS) imaging system using curvilinear array

    NASA Astrophysics Data System (ADS)

    Zhang, Haichong K.; Aalamifar, Fereshteh; Boctor, Emad M.

    2016-04-01

    Synthetic aperture for ultrasound is a technique utilizing a wide aperture in both transmit and receive to enhance the ultrasound image quality. The limitation of synthetic aperture is the maximum available aperture size limit determined by the physical size of ultrasound probe. We propose Synthetic-Tracked Aperture Ultrasound (STRATUS) imaging system to overcome the limitation by extending the beamforming aperture size through ultrasound probe tracking. With a setup involving a robotic arm, the ultrasound probe is moved using the robotic arm, while the positions on a scanning trajectory are tracked in real-time. Data from each pose are synthesized to construct a high resolution image. In previous studies, we have demonstrated the feasibility through phantom experiments. However, various additional factors such as real-time data collection or motion artifacts should be taken into account when the in vivo target becomes the subject. In this work, we build a robot-based STRATUS imaging system with continuous data collection capability considering the practical implementation. A curvilinear array is used instead of a linear array to benefit from its wider capture angle. We scanned human forearms under two scenarios: one submerged the arm in the water tank under 10 cm depth, and the other directly scanned the arm from the surface. The image contrast improved 5.51 dB, and 9.96 dB for the underwater scan and the direct scan, respectively. The result indicates the practical feasibility of STRATUS imaging system, and the technique can be potentially applied to the wide range of human body.

  12. Motion correction of PET brain images through deconvolution: II. Practical implementation and algorithm optimization.

    PubMed

    Raghunath, N; Faber, T L; Suryanarayanan, S; Votaw, J R

    2009-02-01

    Image quality is significantly degraded even by small amounts of patient motion in very high-resolution PET scanners. When patient motion is known, deconvolution methods can be used to correct the reconstructed image and reduce motion blur. This paper describes the implementation and optimization of an iterative deconvolution method that uses an ordered subset approach to make it practical and clinically viable. We performed ten separate FDG PET scans using the Hoffman brain phantom and simultaneously measured its motion using the Polaris Vicra tracking system (Northern Digital Inc., Ontario, Canada). The feasibility and effectiveness of the technique was studied by performing scans with different motion and deconvolution parameters. Deconvolution resulted in visually better images and significant improvement as quantified by the Universal Quality Index (UQI) and contrast measures. Finally, the technique was applied to human studies to demonstrate marked improvement. Thus, the deconvolution technique presented here appears promising as a valid alternative to existing motion correction methods for PET. It has the potential for deblurring an image from any modality if the causative motion is known and its effect can be represented in a system matrix.

  13. TH-A-16A-01: Image Quality for the Radiation Oncology Physicist: Review of the Fundamentals and Implementation

    SciTech Connect

    Seibert, J; Imbergamo, P

    2014-06-15

    The expansion and integration of diagnostic imaging technologies such as On Board Imaging (OBI) and Cone Beam Computed Tomography (CBCT) into radiation oncology has required radiation oncology physicists to be responsible for and become familiar with assessing image quality. Unfortunately many radiation oncology physicists have had little or no training or experience in measuring and assessing image quality. Many physicists have turned to automated QA analysis software without having a fundamental understanding of image quality measures. This session will review the basic image quality measures of imaging technologies used in the radiation oncology clinic, such as low contrast resolution, high contrast resolution, uniformity, noise, and contrast scale, and how to measure and assess them in a meaningful way. Additionally a discussion of the implementation of an image quality assurance program in compliance with Task Group recommendations will be presented along with the advantages and disadvantages of automated analysis methods. Learning Objectives: Review and understanding of the fundamentals of image quality. Review and understanding of the basic image quality measures of imaging modalities used in the radiation oncology clinic. Understand how to implement an image quality assurance program and to assess basic image quality measures in a meaningful way.

  14. Synthetic transmit aperture technique in medical ultrasound imaging implemented on a GPU

    NASA Astrophysics Data System (ADS)

    Li, Ying; Chen, Xiaodong; Zhang, Chuang; Wang, Yi; Jiao, Zhihai; Yu, Daoyin

    2014-11-01

    In the medical ultrasound imaging, the synthetic transmit aperture (STA) technique is very promising and has been a hot research topic. It is dynamically focused in both transmit and receive yielding an improvement in resolution. But this imaging technique sets high demands on processing capabilities and makes implementation of a full STA system very challenging and costly. Many attempts have been made to reduce the demands on the system making it a more realistic task to implement. In this paper we don't consider how to reduce the demands, but consider how to accelerate the processing speed of the system. The recent introduction of general-purpose graphic processing units (GPU) seems to be quite promising in this view, especially for the affordable programming complexity. In this paper we explain the main computational features of STA processing unit, trying to disclose the degree of parallelism in the operations. On the basis of the compute unified device architecture (CUDA) programming model and the extremely flexible structure of the Single Instruction Multiple Threads (SIMT) model, we show that the optimization of STA processing unit can be performed more efficiently. The input data is read from Matlab, the post-processing and display also use Matlab. Performance shows that, using a single NIVDIA GTX-650 GPU board, this amount to a speed up of more than a factor of 30 compared to a highly optimized beamformer running on our test workstation with a 3.20-GHz Intel Core-i5 processor.

  15. A hardware implementation of the discrete Pascal transform for image processing

    NASA Astrophysics Data System (ADS)

    Goodman, Thomas J.; Aburdene, Maurice F.

    2006-02-01

    The discrete Pascal transform is a polynomial transform with applications in pattern recognition, digital filtering, and digital image processing. It already has been shown that the Pascal transform matrix can be decomposed into a product of binary matrices. Such a factorization leads to a fast and efficient hardware implementation without the use of multipliers, which consume large amounts of hardware. We recently developed a field-programmable gate array (FPGA) implementation to compute the Pascal transform. Our goal was to demonstrate the computational efficiency of the transform while keeping hardware requirements at a minimum. Images are uploaded into memory from a remote computer prior to processing, and the transform coefficients can be offloaded from the FPGA board for analysis. Design techniques like as-soon-as-possible scheduling and adder sharing allowed us to develop a fast and efficient system. An eight-point, one-dimensional transform completes in 13 clock cycles and requires only four adders. An 8x8 two-dimensional transform completes in 240 cycles and requires only a top-level controller in addition to the one-dimensional transform hardware. Finally, through minor modifications to the controller, the transform operations can be pipelined to achieve 100% utilization of the four adders, allowing one eight-point transform to complete every seven clock cycles.

  16. PCIPS 2.0: Powerful multiprofile image processing implemented on PCs

    NASA Technical Reports Server (NTRS)

    Smirnov, O. M.; Piskunov, N. E.

    1992-01-01

    Over the years, the processing power of personal computers has steadily increased. Now, 386- and 486-based PC's are fast enough for many image processing applications, and inexpensive enough even for amateur astronomers. PCIPS is an image processing system based on these platforms that was designed to satisfy a broad range of data analysis needs, while requiring minimum hardware and providing maximum expandability. It will run (albeit at a slow pace) even on a 80286 with 640K memory, but will take full advantage of bigger memory and faster CPU's. Because the actual image processing is performed by external modules, the system can be easily upgraded by the user for all sorts of scientific data analysis. PCIPS supports large format lD and 2D images in any numeric type from 8-bit integer to 64-bit floating point. The images can be displayed, overlaid, printed and any part of the data examined via an intuitive graphical user interface that employs buttons, pop-up menus, and a mouse. PCIPS automatically converts images between different types and sizes to satisfy the requirements of various applications. PCIPS features an API that lets users develop custom applications in C or FORTRAN. While doing so, a programmer can concentrate on the actual data processing, because PCIPS assumes responsibility for accessing images and interacting with the user. This also ensures that all applications, even custom ones, have a consistent and user-friendly interface. The API is compatible with factory programming, a metaphor for constructing image processing procedures that will be implemented in future versions of the system. Several application packages were created under PCIPS. The basic package includes elementary arithmetics and statistics, geometric transformations and import/export in various formats (FITS, binary, ASCII, and GIF). The CCD processing package and the spectral analysis package were successfully used to reduce spectra from the Nordic Telescope at La Palma. A

  17. Implementation of Fiducial-Based Image Registration in the Cyberknife Robotic System

    SciTech Connect

    Saw, Cheng B. Chen Hungcheng; Wagner, Henry

    2008-07-01

    Fiducial-based image registration methodology as implemented in the Cyberknife system is explored. The Cyberknife is a radiosurgery system that uses image guidance technology and computer-controlled robotics to determine target positions and adjust beam directions accordingly during the dose delivery. The image guidance system consists of 2 x-ray sources mounted on the ceiling and a detection system mounted on both sides of the treatment couch. Two orthogonal live radiographs are taken prior to and during patient treatment. Fiducial markers are identified on these radiographs and compared to a library of digital reconstructed radiographs (DRRs) using the fiducial extraction software. The fiducial extraction software initially sets an intensity threshold on the live radiographs to generate white areas on black images referred to as 'blobs.' Different threshold values are being used and blobs at the same location are assumed to originate from the same object. The number of blobs is then reduced by examining each blob against a predefined set of properties such as shape and exposure levels. The remaining blobs are further reduced by examining the location of the blobs in the inferior-superior patient axis. Those blobs that have the corresponding positions are assumed to originate from the same object. The remaining blobs are used to create fiducial configurations and are compared to the reference configuration from the computed tomography (CT) image dataset for treatment planning. The best-fit configuration is considered to have the appropriate fiducial markers. The patient position is determined based on these fiducial markers. During the treatment, the radiation beam is turned off when the Cyberknife changes nodes. This allows a time window to acquire live radiographs for the determination of the patient target position and to update the robotic manipulator to change beam orientations accordingly.

  18. Critical appraisal of clinical guidelines.

    PubMed

    Netsch, Debra S; Kluesner, Jean A

    2010-01-01

    Utilization of clinical guidelines is gaining in popularity due to their significant impact on clinical practice. While a plethora of guidelines exist, many are lacking in quality, based on current critical appraisal standards. It then becomes necessary for the end users of the guidelines to adopt or develop those that are deemed adequate for implementation. This often requires that users possess critical appraisal skills as they become proficient in discerning between guidelines of varying quality. This article provides direction and tools to support the critical appraisal process in the adoption of clinical guidelines. PMID:20838314

  19. A new morphological anomaly detection algorithm for hyperspectral images and its GPU implementation

    NASA Astrophysics Data System (ADS)

    Paz, Abel; Plaza, Antonio

    2011-10-01

    Anomaly detection is considered a very important task for hyperspectral data exploitation. It is now routinely applied in many application domains, including defence and intelligence, public safety, precision agriculture, geology, or forestry. Many of these applications require timely responses for swift decisions which depend upon high computing performance of algorithm analysis. However, with the recent explosion in the amount and dimensionality of hyperspectral imagery, this problem calls for the incorporation of parallel computing techniques. In the past, clusters of computers have offered an attractive solution for fast anomaly detection in hyperspectral data sets already transmitted to Earth. However, these systems are expensive and difficult to adapt to on-board data processing scenarios, in which low-weight and low-power integrated components are essential to reduce mission payload and obtain analysis results in (near) real-time, i.e., at the same time as the data is collected by the sensor. An exciting new development in the field of commodity computing is the emergence of commodity graphics processing units (GPUs), which can now bridge the gap towards on-board processing of remotely sensed hyperspectral data. In this paper, we develop a new morphological algorithm for anomaly detection in hyperspectral images along with an efficient GPU implementation of the algorithm. The algorithm is implemented on latest-generation GPU architectures, and evaluated with regards to other anomaly detection algorithms using hyperspectral data collected by NASA's Airborne Visible Infra-Red Imaging Spectrometer (AVIRIS) over the World Trade Center (WTC) in New York, five days after the terrorist attacks that collapsed the two main towers in the WTC complex. The proposed GPU implementation achieves real-time performance in the considered case study.

  20. Comprehensive computerized medical imaging at Victoria General Hospital: final implementation plan

    NASA Astrophysics Data System (ADS)

    Fisher, Paul D.; Brauer, Gerhard W.; Nosil, Josip; Scobie, Duncan L.; Clark, R. P.; Ritchie, Gordon W.; Weigl, Wilhelm J.

    1990-08-01

    A plan for the installation and implementation of a comprehensive computer-based system for the management and communication of digital radiographic images and diagnostic information is described. The paper is based on the authors' experience with, and evaluation of, prototype equipment and systems over the past 5 years. The final configuration will be realized in 1992 at the completion of a 3-phase installation plan. The system will address the clinical, data management, and administrative needs of the different types of users within the department, as well as the requirement to distribute radiographic information and images to locations outside of the department. In order to be considered successful, the system described herein will need to bring about a 90% reduction in both paper- and film-based communication of images and information. The British Columbia Ministry of Health is funding this phase of the project in order to obtain information on which to base decisions regarding installation of similar systems at other sites within the Province and predict with some confidence the cost effectiveness of such decisions.

  1. SPAN security policies and guidelines

    NASA Technical Reports Server (NTRS)

    Sisson, Patricia L.; Green, James L.

    1989-01-01

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

  2. Implementation of wireless 3D stereo image capture system and synthesizing the depth of region of interest

    NASA Astrophysics Data System (ADS)

    Ham, Woonchul; Song, Chulgyu; Kwon, Hyeokjae; Badarch, Luubaatar

    2014-05-01

    In this paper, we introduce the mobile embedded system implemented for capturing stereo image based on two CMOS camera module. We use WinCE as an operating system and capture the stereo image by using device driver for CMOS camera interface and Direct Draw API functions. We send the raw captured image data to the host computer by using WiFi wireless communication and then use GPU hardware and CUDA programming for implementation of real time three-dimensional stereo image by synthesizing the depth of ROI(region of interest). We also try to find and declare the mechanism of deblurring of CMOS camera module based on the Kirchhoff diffraction formula and propose a deblurring model. Synthesized stereo image is real time monitored on the shutter glass type three-dimensional LCD monitor and disparity values of each segment are analyzed to prove the validness of emphasizing effect of ROI.

  3. Guidelines International Network: toward international standards for clinical practice guidelines.

    PubMed

    Qaseem, Amir; Forland, Frode; Macbeth, Fergus; Ollenschläger, Günter; Phillips, Sue; van der Wees, Philip

    2012-04-01

    Guideline development processes vary substantially, and many guidelines do not meet basic quality criteria. Standards for guideline development can help organizations ensure that recommendations are evidence-based and can help users identify high-quality guidelines. Such organizations as the U.S. Institute of Medicine and the United Kingdom's National Institute for Health and Clinical Excellence have developed recommendations to define trustworthy guidelines within their locales. Many groups charged with guideline development find the lengthy list of standards developed by such organizations to be aspirational but infeasible to follow in entirety. Founded in 2002, the Guidelines International Network (G-I-N) is a network of guideline developers that includes 93 organizations and 89 individual members representing 46 countries. The G-I-N board of trustees recognized the importance of guideline development processes that are both rigorous and feasible even for modestly funded groups to implement and initiated an effort toward consensus about minimum standards for high-quality guidelines. In contrast to other existing standards for guideline development at national or local levels, the key components proposed by G-I-N will represent the consensus of an international, multidisciplinary group of active guideline developers. This article presents G-I-N's proposed set of key components for guideline development. These key components address panel composition, decision-making process, conflicts of interest, guideline objective, development methods, evidence review, basis of recommendations, ratings of evidence and recommendations, guideline review, updating processes, and funding. It is hoped that this article promotes discussion and eventual agreement on a set of international standards for guideline development.

  4. Images of Doctors and their Implements: A Visual Dialogue between the Patient and the Doctor.

    PubMed

    Baker, Patricia A

    2016-01-01

    Images of physicians, patients, and medical instruments were placed on Graeco-Roman funerary monuments, altars and fresco paintings. These representations are examined here to determine whether there existed a standard convention by which physicians were depicted in order that the lay and possibly illiterate viewers could identify what the scene represented. Greek physicians were frequently shown with cupping vessels, midwives were seen with birthing stools, while Roman physicians were often shown with various surgical implements. It is argued that the correlation between the types of objects depicted with the medical practitioner was deliberately made by the artist to signify the nature of medicine the individual practiced, so that the viewer could identify the role the practitioner had in their society. PMID:26946686

  5. Crews-l'Ecritoire analysis for the implementation of a medical image database for mammography

    NASA Astrophysics Data System (ADS)

    Demigha, Souad; Rolland, Colette; Baum, Thierry-Pascal; Balleyguier, Corinne; Vincent, Benedicte; Chabriais, Joel; Menu, Yves

    2001-08-01

    In this paper, we present our approach in order to implement a Medical Image Database (MIDB) for archiving mammograms and their related information in the Department of Radiology of the Necker Hospital (Paris). The aim of such a database is to help breast cancer screening in clinics, research and education. As implementation of such a MIDB requires the understanding of users' needs, we have analyzed requirements by using the Crews-l'Ecritoire (Cooperative REquirements With Scenarios) approach developed in our laboratory. This approach is based on the 'Requirement Engineering' concept. It helps understanding users' needs using a semi-automatic analysis of textual scenarios, i.e. scenarios written in natural language. This approach mixes concepts of goals and of scenarios into the notion of 'Requirement Chunk'. Authored scenarios and goal discovery are guided by rules, which lead to a structured network of scenarios. Our analysis results in 58 Requirements Chunks gathering 72 authored scenarios and 300 goals which represent MIDB services requested by radiologists in the course of their daily practice.

  6. Thermal imaging as a smartphone application: exploring and implementing a new concept

    NASA Astrophysics Data System (ADS)

    Yanai, Omer

    2014-06-01

    Today's world is going mobile. Smartphone devices have become an important part of everyday life for billions of people around the globe. Thermal imaging cameras have been around for half a century and are now making their way into our daily lives. Originally built for military applications, thermal cameras are starting to be considered for personal use, enabling enhanced vision and temperature mapping for different groups of professional individuals. Through a revolutionary concept that turns smartphones into fully functional thermal cameras, we have explored how these two worlds can converge by utilizing the best of each technology. We will present the thought process, design considerations and outcome of our development process, resulting in a low-power, high resolution, lightweight USB thermal imaging device that turns Android smartphones into thermal cameras. We will discuss the technological challenges that we faced during the development of the product, and what are the system design decisions taken during the implementation. We will provide some insights we came across during this development process. Finally, we will discuss the opportunities that this innovative technology brings to the market.

  7. Implementation of an imaging spectrometer for localization and identification of radioactive sources

    NASA Astrophysics Data System (ADS)

    Lemaire, H.; Khalil, R. Abou; Amgarou, K.; Angélique, J.-C.; Bonnet, F.; De Toro, D.; Carrel, F.; Giarmana, O.; Gmar, M.; Menaa, N.; Menesguen, Y.; Normand, S.; Patoz, A.; Schoepff, V.; Talent, P.; Timi, T.

    2014-11-01

    Spatial localization of radioactive sources is currently a main issue interesting nuclear industry as well as homeland security applications and can be achieved using gamma cameras. For several years, CEA LIST has been designing a new system, called GAMPIX, with improved sensitivity, portability and ease of use. The main remaining limitation of this system is the lack of spectrometric information, preventing the identification of radioactive materials. This article describes the development of an imaging spectrometer based on the GAMPIX technology. Experimental tests have been carried out according to both spectrometric methods enabled by the pixelated Timepix chip used in the GAMPIX gamma camera. The first method is based on the size of the impacts produced by a gamma-ray energy deposition in the detection matrix. The second one uses the Time over Threshold (ToT) mode of the Timepix chip and deals with time spent by pulses generated by charge preamplifiers over a user-specified threshold. Both energy resolution and sensitivity studies demonstrated the superiority of the ToT approach which will consequently be further explored. Energy calibration, tests of different pixel sizes for the Timepix chip and use of the Medipix3 chip are future milestones to improve performances of the newly implemented imaging spectrometer.

  8. From image edges to geons to viewpoint-invariant object models: a neural net implementation

    NASA Astrophysics Data System (ADS)

    Biederman, Irving; Hummel, John E.; Gerhardstein, Peter C.; Cooper, Eric E.

    1992-03-01

    Three striking and fundamental characteristics of human shape recognition are its invariance with viewpoint in depth (including scale), its tolerance of unfamiliarity, and its robustness with the actual contours present in an image (as long as the same convex parts [geons] can be activated). These characteristics are expressed in an implemented neural network model (Hummel & Biederman, 1992) that takes a line drawing of an object as input and generates a structural description of geons and their relations which is then used for object classification. The model's capacity for structural description derives from its solution to the dynamic binding problem of neural networks: independent units representing an object's parts (in terms of their shape attributes and interrelations) are bound temporarily when those attributes occur in conjunction in the system's input. Temporary conjunctions of attributes are represented by synchronized activity among the units representing those attributes. Specifically, the model induces temporal correlation in the firing of activated units to: (1) parse images into their constituent parts; (2) bind together the attributes of a part; and (3) determine the relations among the parts and bind them to the parts to which they apply. Because it conjoins independent units temporarily, dynamic binding allows tremendous economy of representation, and permits the representation to reflect an object's attribute structure. The model's recognition performance conforms well to recent results from shape priming experiments. Moreover, the manner in which the model's performance degrades due to accidental synchrony produced by an excess of phase sets suggests a basis for a theory of visual attention.

  9. Improvement of dem Generation from Aster Images Using Satellite Jitter Estimation and Open Source Implementation

    NASA Astrophysics Data System (ADS)

    Girod, L.; Nuth, C.; Kääb, A.

    2015-12-01

    The Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) system embarked on the Terra (EOS AM-1) satellite has been a source of stereoscopic images covering the whole globe at a 15m resolution at a consistent quality for over 15 years. The potential of this data in terms of geomorphological analysis and change detection in three dimensions is unrivaled and needs to be exploited. However, the quality of the DEMs and ortho-images currently delivered by NASA (ASTER DMO products) is often of insufficient quality for a number of applications such as mountain glacier mass balance. For this study, the use of Ground Control Points (GCPs) or of other ground truth was rejected due to the global "big data" type of processing that we hope to perform on the ASTER archive. We have therefore developed a tool to compute Rational Polynomial Coefficient (RPC) models from the ASTER metadata and a method improving the quality of the matching by identifying and correcting jitter induced cross-track parallax errors. Our method outputs more accurate DEMs with less unmatched areas and reduced overall noise. The algorithms were implemented in the open source photogrammetric library and software suite MicMac.

  10. A travel report of the implementation of virtual whole slide images in routine surgical pathology.

    PubMed

    Nap, Marius; Teunissen, Rob; Pieters, Math

    2012-04-01

    Virtual microscopy is the terminology used to indicate the use of digitized images of whole slides for inspection of cells and tissue sections on computer screens as an add-on or replacement for conventional microscopy using bright field or other types of illumination in combination with a wide variety of microscope brands. Although technically there is no longer a limit in the size and colour composition of the images, the logistics of embedding virtual microscopy in daily routine of a diagnostic process are still a relatively open area where new pitfalls and opportunities can be found. In this article, we described various aspects in the process. None of them had been planned in advance, but mostly originated from observations done during the different steps towards implementation of virtual microscopy in daily routine, for example, the choice between the different scanner types and their (dis)advantages, issues on storing and retrieval and at last, the effect of digitalization on the diagnostic process. This approach resulted in a manuscript that in a way has more the appearance of a story than of a scientific study with strict protocols, with a clear cut question in advance, a research plan and expected outcome. Depending on the purpose of the virtual slides in a given situation, different solutions must be found locally.

  11. 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,…

  12. Adaptive Behavior Guidelines.

    ERIC Educational Resources Information Center

    Ohio Association of Supervisors and Work-Study Coordinators.

    These guidelines were prepared to provide direction toward implementing a functional instruction curriculum that leads to independence and occupational skills for Ohio's developmentally handicapped and multihandicapped students. The curriculum uses a three-part definition of adaptive behavior, involving independent functioning, personal…

  13. Virginia School Health Guidelines.

    ERIC Educational Resources Information Center

    Virginia State Dept. of Education, Richmond.

    Virginia's Department of Education and Department of Health are concerned with the health of children and youth, and with the implementation of comprehensive school health programs. These guidelines provide a basis for developing a model school health program or for enriching an existing program, focusing on health services and school environment.…

  14. [Guidelines for clinical practice].

    PubMed

    Vleugels, A M

    1997-01-01

    Clinical practice guidelines are systematically developed statements that are intended to support medical decision making in well-defined clinical situations. Essentially, their object is to reduce the variability in medical practice, to improve quality, and to make appropriated control of the financial resources possible. Internationally, ever more organisations, associations, and institutions are concerned with the development of guidelines in many different areas of care. Making implicit knowledge explicit is one of the associated advantages of guidelines: they have a potential utility in training, in process evaluation, and in the reevaluation of outcome studies. In liability issues, their existence has a double effect: they can be used to justify medical behaviour, and they constitute a generally accepted reference point. A derivative problem is the legal liability of the compilers of the guidelines. The principle of the guideline approach can be challenged academically: science cannot give a definition of optimal care with absolute certainty. What is called objectivity often rests on methodologically disputable analyses; also the opinion of opinion leaders is not always a guarantee for scientific soundness. Moreover, patients are not all identical: biological variability, situational factors, patient expectations, and other elements play a role in this differentiation. Clinicians are often hesitant with respect to clinical guidelines: they are afraid of cookbook medicine and curtailment of their professional autonomy. Patients fear reduction of individualization of care and the use of guidelines as a rationing instrument. The effects of the introduction of clinical practice guidelines on medical practice, on the results and on the cost of care vary but are generally considered to be favourable. The choice of appropriate strategies in development, dissemination, and implementation turns out to be of critical importance. The article ends with concrete

  15. Alliance for a Healthier Generation's Competitive Beverage and Food Guidelines: Do Elementary School Administrators Know about Them and Do They Report Implementing Them?

    ERIC Educational Resources Information Center

    Ohri-Vachaspati, Punam; Turner, Lindsey; Chaloupka, Frank J.

    2012-01-01

    Background: The availability of competitive foods in schools is a modifiable factor in efforts to prevent childhood obesity. The Alliance for a Healthier Generation launched the Healthy Schools Program in 2006 to encourage schools to create healthier food environments, including the adoption of nutritional guidelines for competitive beverages and…

  16. Implementation of wireless 3D stereo image capture system and 3D exaggeration algorithm for the region of interest

    NASA Astrophysics Data System (ADS)

    Ham, Woonchul; Song, Chulgyu; Lee, Kangsan; Badarch, Luubaatar

    2015-05-01

    In this paper, we introduce the mobile embedded system implemented for capturing stereo image based on two CMOS camera module. We use WinCE as an operating system and capture the stereo image by using device driver for CMOS camera interface and Direct Draw API functions. We aslo comments on the GPU hardware and CUDA programming for implementation of 3D exaggeraion algorithm for ROI by adjusting and synthesizing the disparity value of ROI (region of interest) in real time. We comment on the pattern of aperture for deblurring of CMOS camera module based on the Kirchhoff diffraction formula and clarify the reason why we can get more sharp and clear image by blocking some portion of aperture or geometric sampling. Synthesized stereo image is real time monitored on the shutter glass type three-dimensional LCD monitor and disparity values of each segment are analyzed to prove the validness of emphasizing effect of ROI.

  17. Implementation of real-time nonuniformity correction with multiple NUC tables using FPGA in an uncooled imaging system

    NASA Astrophysics Data System (ADS)

    Oh, Gyong Jin; Kim, Lyang-June; Sheen, Sue-Ho; Koo, Gyou-Phyo; Jin, Sang-Hun; Yeo, Bo-Yeon; Lee, Jong-Ho

    2009-05-01

    This paper presents a real time implementation of Non Uniformity Correction (NUC). Two point correction and one point correction with shutter were carried out in an uncooled imaging system which will be applied to a missile application. To design a small, light weight and high speed imaging system for a missile system, SoPC (System On a Programmable Chip) which comprises of FPGA and soft core (Micro-blaze) was used. Real time NUC and generation of control signals are implemented using FPGA. Also, three different NUC tables were made to make the operating time shorter and to reduce the power consumption in a large range of environment temperature. The imaging system consists of optics and four electronics boards which are detector interface board, Analog to Digital converter board, Detector signal generation board and Power supply board. To evaluate the imaging system, NETD was measured. The NETD was less than 160mK in three different environment temperatures.

  18. Dentists United to Extinguish Tobacco (DUET): a study protocol for a cluster randomized, controlled trial for enhancing implementation of clinical practice guidelines for treating tobacco dependence in dental care settings

    PubMed Central

    2014-01-01

    Background Although dental care settings provide an exceptional opportunity to reach smokers and provide brief cessation advice and treatment to reduce oral and other tobacco-related health conditions, dental care providers demonstrate limited adherence to evidence-based guidelines for treatment of tobacco use and dependence. Methods/Design Guided by a multi-level, conceptual framework that emphasizes changes in provider beliefs and organizational characteristics as drivers of improvement in tobacco treatment delivery, the current protocol will use a cluster, randomized design and multiple data sources (patient exit interviews, provider surveys, site observations, chart audits, and semi-structured provider interviews) to study the process of implementing clinical practice guidelines for treating tobacco dependence in 18 public dental care clinics in New York City. The specific aims of this comparative-effectiveness research trial are to: compare the effectiveness of three promising strategies for implementation of tobacco use treatment guidelines—staff training and current best practices (CBP), CBP + provider performance feedback (PF), and CBP + PF + provider reimbursement for delivery of tobacco cessation treatment (pay-for-performance, or P4P); examine potential theory-driven mechanisms hypothesized to explain the comparative effectiveness of three strategies for implementation; and identify baseline organizational factors that influence the implementation of evidence-based tobacco use treatment practices in dental clinics. The primary outcome is change in providers’ tobacco treatment practices and the secondary outcomes are cost per quit, use of tobacco cessation treatments, quit attempts, and smoking abstinence. Discussion We hypothesize that the value of these promising implementation strategies is additive and that incorporating all three strategies (CBP, PF, and P4P) will be superior to CBP alone and CBP + PF in improving delivery of

  19. German Guidelines.

    PubMed

    Kruis, Wolfgang; Nguyen, Gia P; Leifeld, Ludger

    2016-10-01

    Because of its frequency, diverticular disease is a burden on health care systems. Only few formal guidelines covering all aspects of the disease exist. Here, some selected statements from the German guidelines are given. The guidelines include significant recommendations for the diagnosis and management of diverticular disease. Both diagnosis and management depend definitely on clear definitions of the situation of an individual patient. Therefore, a new classification is proposed that is based on earlier suggestions. An internationally established classification would not only enable better patient care but could also lead to studies with comparable results.

  20. [Infective endocarditis : New ESC guidelines 2015].

    PubMed

    Plicht, B; Lind, A; Erbel, R

    2016-07-01

    Infective endocarditis is an endovascular infection usually caused by bacteria. Mortality rate is still approximately 20 %. To improve patients' prognosis by implementation of current diagnostic and therapeutic evidence, the European Society of Cardiology published an updated version of the guidelines for management of infective endocarditis in 2015. It strengthens the role of imaging modalities like PET/CT for detection of infectious foci when echocardiography remains negative and highlights the use of modern tests for identification of possible pathogens. New diagnostic criteria were introduced to integrate these methods for improved diagnostic sensitivity. Complicated cases should be treated in reference centers with on-site cardiac surgery. The antibiotic and early surgical management should be discussed in a multidisciplinary endocarditis team. A few years ago, the indication for endocarditis prophylaxis was limited to high-risk patients. These recommendations were confirmed in current guidelines. PMID:27307162

  1. Rationale, design, and implementation protocol of the Dutch clinical practice guideline Pain in patients with cancer: a cluster randomised controlled trial with short message service (SMS) and interactive voice response (IVR)

    PubMed Central

    2011-01-01

    Background One-half of patients with cancer have pain. In nearly one out of two cancer patients with pain, this was undertreated. Inadequate pain control still remains an important problem in this group of patients. Therefore, in 2008 a national, evidence-based multidisciplinary clinical practice guideline 'pain in patients with cancer' has been developed. Yet, publishing a guideline is not enough. Implementation is needed to improve pain management. An innovative implementation strategy, Short Message Service with Interactive Voice Response (SVS-IVR), has been developed and pilot tested. This study aims to evaluate on effectiveness of this strategy to improve pain reporting, pain measurement and adequate pain therapy. In addition, whether the active role of the patient and involvement of caregivers in pain management may change. Methods/design A cluster randomised controlled trial with two arms will be performed in six oncology outpatient clinics of hospitals in the Southeastern region of the Netherlands, with three hospitals in the intervention and three in the control condition. Follow-up measurements will be conducted in all hospitals to study the long-term effect of the intervention. The intervention includes training of professionals (medical oncologists, nurses, and general practitioners) and SMS-IVR to report pain in patients with cancer to improve pain reporting by patients, pain management by medical oncologists, nurses, and general practitioners, and decrease pain intensity. Discussion This innovative implementation strategy with technical tools and the involvement of patients, may enhance the use of the guideline 'pain in patients with cancer' for pain management. Short Message Service alerts may serve as a tool to support self-management of patients. Therefore, the SMS-IVR intervention may increase the feeling of having control over one's life. Trail registration Netherlands Trial Register (NTR): NTR2739 PMID:22142327

  2. Assessment of analysis-of-variance-based methods to quantify the random variations of observers in medical imaging measurements: guidelines to the investigator.

    PubMed

    Zeggelink, William F A Klein; Hart, Augustinus A M; Gilhuijs, Kenneth G A

    2004-07-01

    The random variations of observers in medical imaging measurements negatively affect the outcome of cancer treatment, and should be taken into account during treatment by the application of safety margins that are derived from estimates of the random variations. Analysis-of-variance- (ANOVA-) based methods are the most preferable techniques to assess the true individual random variations of observers, but the number of observers and the number of cases must be taken into account to achieve meaningful results. Our aim in this study is twofold. First, to evaluate three representative ANOVA-based methods for typical numbers of observers and typical numbers of cases. Second, to establish guidelines to the investigator to determine which method, how many observers, and which number of cases are required to obtain the a priori chosen performance. The ANOVA-based methods evaluated in this study are an established technique (pairwise differences method: PWD), a new approach providing additional statistics (residuals method: RES), and a generic technique that uses restricted maximum likelihood (REML) estimation. Monte Carlo simulations were performed to assess the performance of the ANOVA-based methods, which is expressed by their accuracy (closeness of the estimates to the truth), their precision (standard error of the estimates), and the reliability of their statistical test for the significance of a difference in the random variation of an observer between two groups of cases. The highest accuracy is achieved using REML estimation, but for datasets of at least 50 cases or arrangements with 6 or more observers, the differences between the methods are negligible, with deviations from the truth well below +/-3%. For datasets up to 100 cases, it is most beneficial to increase the number of cases to improve the precision of the estimated random variations, whereas for datasets over 100 cases, an improvement in precision is most efficiently achieved by increasing the number of

  3. [An increase of infective endocarditis cases in England seen with concomitant reduction in antibiotic prophylaxis since the implementation of NICE guidelines in 2008: possible explanations].

    PubMed

    Tiberi, Simon; Pink, Frederick; Jayakumar, Angelina; Arioli, Francesco

    2015-01-01

    Dayer and colleagues recently reported in The Lancet an increased incidence of infective endocarditis in England since 2008, year of NICE guideline on the restriction of antibiotic prophylaxis. They observed a concomitant decrease in the use of antibiotic prophylaxis. The temporal link between reduction of prophylaxis prescribing and increase of infective endocarditis raises the question of whether there is a causal association. In view of this observation, should we rethink antibiotic prophylaxis to prevent infective endocarditis?

  4. STS payloads mission control study continuation phase A-1. Volume 2-B: Task 2. Evaluation and refinement of implementation guidelines for the selected STS payload operator concept

    NASA Technical Reports Server (NTRS)

    1976-01-01

    The functions of Payload Operations Control Centers (POCC) at JSC, GSFC, JPL, and non-NASA locations are analyzed to establish guidelines for standardization, and facilitate the development of a fully integrated NASA-wide system of ground facilities for all classes of payloads. Operational interfaces between the space transportation system operator and the payload operator elements are defined. The advantages and disadvantages of standardization are discussed.

  5. Fast l₁-SPIRiT compressed sensing parallel imaging MRI: scalable parallel implementation and clinically feasible runtime.

    PubMed

    Murphy, Mark; Alley, Marcus; Demmel, James; Keutzer, Kurt; Vasanawala, Shreyas; Lustig, Michael

    2012-06-01

    We present l₁-SPIRiT, a simple algorithm for auto calibrating parallel imaging (acPI) and compressed sensing (CS) that permits an efficient implementation with clinically-feasible runtimes. We propose a CS objective function that minimizes cross-channel joint sparsity in the wavelet domain. Our reconstruction minimizes this objective via iterative soft-thresholding, and integrates naturally with iterative self-consistent parallel imaging (SPIRiT). Like many iterative magnetic resonance imaging reconstructions, l₁-SPIRiT's image quality comes at a high computational cost. Excessively long runtimes are a barrier to the clinical use of any reconstruction approach, and thus we discuss our approach to efficiently parallelizing l₁-SPIRiT and to achieving clinically-feasible runtimes. We present parallelizations of l₁-SPIRiT for both multi-GPU systems and multi-core CPUs, and discuss the software optimization and parallelization decisions made in our implementation. The performance of these alternatives depends on the processor architecture, the size of the image matrix, and the number of parallel imaging channels. Fundamentally, achieving fast runtime requires the correct trade-off between cache usage and parallelization overheads. We demonstrate image quality via a case from our clinical experimentation, using a custom 3DFT spoiled gradient echo (SPGR) sequence with up to 8× acceleration via Poisson-disc undersampling in the two phase-encoded directions. PMID:22345529

  6. Ultrasound Imaging System Implementation and Ignition Protocol for the Microgravity Smoldering Combustion (MSC) Experiments

    NASA Technical Reports Server (NTRS)

    Walther, David C.; Anthenien, Ralph A.; Roslon, Mark; Fernandez-Pello, A. Carlos; Urban, David L.

    1999-01-01

    The Microgravity Smoldering Combustion (MSC) experiment is a study of the smolder characteristics of porous combustible materials in a microgravity environment. The objective of the study is to provide a better understanding of the controlling mechanisms of smolder, both in microgravity and normal earth gravity. Experiments have been conducted aboard the NASA Space Shuttle in the Get Away Special Canister (GAS-CAN), an apparatus requiring completely remote operation. Future GAS-CAN experiments will utilize an ultrasound imaging system (UIS) which has been incorporated into the MSC experimental apparatus. Thermocouples are currently used to measure temperature and reaction front velocities. A less intrusive method is desirable, however, as smolder is a very weak reaction and it has been found that heat transfer along the thermocouple is sufficient to affect the smolder reaction. It is expected that the UIS system will eventually replace the existing array of thermocouples as a non-intrusive technique without compromising data acquisition. The UIS measures line of sight permeability, providing information about the reaction front position and extent. Additionally, the ignition sequence of the MSC experiments has been optimized from previous experiments to provide longer periods of self-supported smolder. An ignition protocol of a fixed power to the igniter for a fixed time is now implemented. This, rather than a controlled temperature profile ignition protocol at the igniter surface, along with the UIS system, will allow for better study of the effect of gravity on a smolder reaction.

  7. Evaluation of multifrequency range-imaging technique implemented on the Chung-Li VHF atmospheric radar

    NASA Astrophysics Data System (ADS)

    Chen, J.-S.; Tsai, S.-C.; Su, C.-L.; Chu, Y.-H.

    2015-09-01

    Multifrequency range imaging technique (RIM) has been implemented on the Chung-Li VHF-array radar since 2008 after its renovation. This study made a more complete examination and evaluation of the RIM technique to facilitate the performance of the radar for atmospheric studies. Various experiments of RIM with different radar parameters such as pulse length, pulse shape, receiver bandwidth, transmitter frequency set, and so on, were conducted. The radar data employed for the study were collected from 2008 to 2013. It has been shown that two factors, the range/time delay of the signal traveling in the media and the standard deviation of Gaussian-shaped range-weighting function, play crucial roles in ameliorating the RIM-produced brightness (or power distribution); the two factors are associated with some radar parameters. In addition to radar parameters, long-term RIM data show that the aging of cable lines or key components of the radar system may result in an increase of the range/time delay of signal. It is also found that the range/time delay was visibly different for the echoes from the atmosphere with and without the presence of significant precipitation. A procedure of point-by-point correction of range/time delay was thus conducted to minimize the bogus brightness discontinuity at range gate boundaries. With the RIM technique, the Chung-Li VHF radar demonstrates its first successful observation of double-layer structures as well as their temporal and spatial variations with time.

  8. Evaluation of multifrequency range imaging technique implemented on the Chung-Li VHF atmospheric radar

    NASA Astrophysics Data System (ADS)

    Chen, Jenn-Shyong; Tsai, Shih-Chiao; Su, Ching-Lun; Chu, Yen-Hsyang

    2016-05-01

    The multifrequency range imaging technique (RIM) has been implemented on the Chung-Li VHF array radar since 2008 after its renovation. This study made a more complete examination and evaluation of the RIM technique to facilitate the performance of the radar for atmospheric studies. RIM experiments with various radar parameters such as pulse length, pulse shape, receiver bandwidth, transmitter frequency set, and so on were conducted. The radar data employed for the study were collected from 2008 to 2013. It has been shown that two factors, the range/time delay of the signal traveling in the media and the standard deviation of Gaussian-shaped range-weighting function, play crucial roles in ameliorating the RIM-produced brightness (or power distribution); the two factors are associated with some radar parameters and system characteristics. The range/time delay of the signal was found to increase with time; moreover, it was slightly different for the echoes from the atmosphere with and without the presence of significant precipitation. A procedure of point-by-point correction of range/time delay was thus executed for the presence of precipitation to minimize the bogus brightness discontinuity at range gate boundaries. With the RIM technique, the Chung-Li VHF radar demonstrates its first successful observation of double-layer structures as well as their temporal and spatial variations with time.

  9. Compressed sensing reconstruction for whole-heart imaging with 3D radial trajectories: a graphics processing unit implementation.

    PubMed

    Nam, Seunghoon; Akçakaya, Mehmet; Basha, Tamer; Stehning, Christian; Manning, Warren J; Tarokh, Vahid; Nezafat, Reza

    2013-01-01

    A disadvantage of three-dimensional (3D) isotropic acquisition in whole-heart coronary MRI is the prolonged data acquisition time. Isotropic 3D radial trajectories allow undersampling of k-space data in all three spatial dimensions, enabling accelerated acquisition of the volumetric data. Compressed sensing (CS) reconstruction can provide further acceleration in the acquisition by removing the incoherent artifacts due to undersampling and improving the image quality. However, the heavy computational overhead of the CS reconstruction has been a limiting factor for its application. In this article, a parallelized implementation of an iterative CS reconstruction method for 3D radial acquisitions using a commercial graphics processing unit is presented. The execution time of the graphics processing unit-implemented CS reconstruction was compared with that of the C++ implementation, and the efficacy of the undersampled 3D radial acquisition with CS reconstruction was investigated in both phantom and whole-heart coronary data sets. Subsequently, the efficacy of CS in suppressing streaking artifacts in 3D whole-heart coronary MRI with 3D radial imaging and its convergence properties were studied. The CS reconstruction provides improved image quality (in terms of vessel sharpness and suppression of noise-like artifacts) compared with the conventional 3D gridding algorithm, and the graphics processing unit implementation greatly reduces the execution time of CS reconstruction yielding 34-54 times speed-up compared with C++ implementation. PMID:22392604

  10. Implementation of a real-time software-only image smoothing filter for a block-transform video codec

    NASA Astrophysics Data System (ADS)

    Miaw, Wesley F.; Rowe, Lawrence A.

    2003-05-01

    The JPEG compression standard is a popular image format. However, at high compression ratios JPEG compression, which uses block-transform coding, can produce blocking artifacts, or artificially introduced edges within the image. Several post-processing algorithms have been developed to remove these artifacts. This paper describes an implementation of a post-processing algorithm developed by Ramchandran, Chou, and Crouse (RCC) which is fast enough for real-time software-only video applications. The original implementation of the RCC algorithm involved calculating thresholds to identify artificial edges. These calculations proved too expensive for use in real-time software-only applications. We replaced these calculations with a linear scale approximating ideal threshold values based on a combination of peak signal-to-noise ratio calculations and subjective visual quality. The resulting filter implementation is available in the widely-deployed Open Mash streaming media toolkit.

  11. Radiology Preparedness in Ebola Virus Disease: Guidelines and Challenges for Disinfection of Medical Imaging Equipment for the Protection of Staff and Patients

    PubMed Central

    Palmore, Tara N.; Folio, Les R.; Bluemke, David A.

    2015-01-01

    The overlap of early Ebola virus disease (EVD) symptoms (eg, fever, headache, abdominal pain, diarrhea, emesis, and fatigue) with symptoms of other more common travel-related diseases (eg, malaria, typhoid fever, pneumonia, and meningococcemia) may result in delayed diagnosis of EVD before isolation of infected patients. Radiology departments should consider policies for and approaches to decontamination of expensive and potentially easily damaged radiology equipment. In addition, the protection of radiology personnel must be considered during the work-up phase of undiagnosed EVD patients presenting to emergency departments. The purpose of this article is to consider the effect of EVD on radiology departments and imaging equipment, with particular consideration of guidelines currently available from the Centers for Disease Control and Prevention that may be applicable to radiology. © RSNA, 2015 PMID:25654616

  12. 7 CFR 622.5 - Guidelines.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... NEPA (40 CFR parts 1500-1508) issued by the Council on Environmental Quality, and in Economic and Environmental Principles and Guidelines for Water and Related Land Resources Implementation Studies issued by... AGRICULTURE WATER RESOURCES WATERSHED PROJECTS General § 622.5 Guidelines. Guidelines for carrying...

  13. 7 CFR 622.5 - Guidelines.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... AGRICULTURE WATER RESOURCES WATERSHED PROJECTS General § 622.5 Guidelines. Guidelines for carrying out... NEPA (40 CFR parts 1500-1508) issued by the Council on Environmental Quality, and in Economic and Environmental Principles and Guidelines for Water and Related Land Resources Implementation Studies issued...

  14. 7 CFR 622.5 - Guidelines.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AGRICULTURE WATER RESOURCES WATERSHED PROJECTS General § 622.5 Guidelines. Guidelines for carrying out... NEPA (40 CFR parts 1500-1508) issued by the Council on Environmental Quality, and in Economic and Environmental Principles and Guidelines for Water and Related Land Resources Implementation Studies issued...

  15. Guidelines for Project Management

    NASA Technical Reports Server (NTRS)

    Ben-Arieh, David

    2001-01-01

    Project management is an important part of the professional activities at Kennedy Space Center (KSC). Project management is the means by which many of the operations at KSC take shape. Moreover, projects at KSC are implemented in a variety of ways in different organizations. The official guidelines for project management are provided by NASA headquarters and are quite general. The project reported herein deals with developing practical and detailed project management guidelines in support of the project managers. This report summarizes the current project management effort in the Process Management Division and presents a new modeling approach of project management developed by the author. The report also presents the Project Management Guidelines developed during the summer.

  16. Overtaking Vehicle Detection Method and Its Implementation Using IMAPCAR Highly Parallel Image Processor

    NASA Astrophysics Data System (ADS)

    Sakurai, Kazuyuki; Kyo, Shorin; Okazaki, Shin'ichiro

    This paper describes the real-time implementation of a vision-based overtaking vehicle detection method for driver assistance systems using IMAPCAR, a highly parallel SIMD linear array processor. The implemented overtaking vehicle detection method is based on optical flows detected by block matching using SAD and detection of the flows' vanishing point. The implementation is done efficiently by taking advantage of the parallel SIMD architecture of IMAPCAR. As a result, video-rate (33 frames/s) implementation could be achieved.

  17. Design and implementation of coded aperture coherent scatter spectral imaging of cancerous and healthy breast tissue samples.

    PubMed

    Lakshmanan, Manu N; Greenberg, Joel A; Samei, Ehsan; Kapadia, Anuj J

    2016-01-01

    A scatter imaging technique for the differentiation of cancerous and healthy breast tissue in a heterogeneous sample is introduced in this work. Such a technique has potential utility in intraoperative margin assessment during lumpectomy procedures. In this work, we investigate the feasibility of the imaging method for tumor classification using Monte Carlo simulations and physical experiments. The coded aperture coherent scatter spectral imaging technique was used to reconstruct three-dimensional (3-D) images of breast tissue samples acquired through a single-position snapshot acquisition, without rotation as is required in coherent scatter computed tomography. We perform a quantitative assessment of the accuracy of the cancerous voxel classification using Monte Carlo simulations of the imaging system; describe our experimental implementation of coded aperture scatter imaging; show the reconstructed images of the breast tissue samples; and present segmentations of the 3-D images in order to identify the cancerous and healthy tissue in the samples. From the Monte Carlo simulations, we find that coded aperture scatter imaging is able to reconstruct images of the samples and identify the distribution of cancerous and healthy tissues (i.e., fibroglandular, adipose, or a mix of the two) inside them with a cancerous voxel identification sensitivity, specificity, and accuracy of 92.4%, 91.9%, and 92.0%, respectively. From the experimental results, we find that the technique is able to identify cancerous and healthy tissue samples and reconstruct differential coherent scatter cross sections that are highly correlated with those measured by other groups using x-ray diffraction. Coded aperture scatter imaging has the potential to provide scatter images that automatically differentiate cancerous and healthy tissue inside samples within a time on the order of a minute per slice. PMID:26962543

  18. High-Resolution Fast Spin Echo Imaging of the Human Brain at 4.7 T: Implementation and Sequence Characteristics

    PubMed Central

    Thomas, David L.; Vita, Enrico De; Roberts, Steven; Turner, Robert; Yousry, Tarek A.; Ordidge, Roger J.

    2007-01-01

    In this work, a number of important issues associated with fast spin echo (FSE) imaging of the human brain at 4.7 T are addressed. It is shown that FSE enables the acquisition of images with high resolution and good tissue contrast throughout the brain at high field strength. By employing an echo spacing (ES) of 22 ms, one can use large flip angle refocusing pulses (162°) and a low acquisition bandwidth (50 kHz) to maximize the signal-to-noise ratio (SNR). A new method of phase encode (PE) ordering (called “feathering”) designed to reduce image artifacts is described, and the contributions of RF (B1) inhomogeneity, different echo coherence pathways, and magnetization transfer (MT) to FSE signal intensity and contrast are investigated. B1 inhomogeneity is measured and its effect is shown to be relatively minor for high-field FSE, due to the self-compensating characteristics of the sequence. Thirty-four slice data sets (slice thickness = 2 mm; in-plane resolution = 0.469 mm; acquisition time = 11 min 20 s) from normal volunteers are presented, which allow visualization of brain anatomy in fine detail. This study demonstrates that high-field FSE produces images of the human brain with high spatial resolution, SNR, and tissue contrast, within currently prescribed power deposition guidelines. Magn Reson Med 51:1254-1264, 2004. PMID:15170847

  19. Architecture, development and implementation of a SWIR to visible integrated up-conversion imaging device

    NASA Astrophysics Data System (ADS)

    Sarusi, Gabby; Templeman, Tzvi; Hechster, Elad; Nissim, Nimrod; Vitenberg, Vladimir; Maman, Nitzan; Tal, Amir; Solodar, Assi; Makov, Guy; Abdulhalim, Ibrahim; Visoly-Fisher, Iris; Golan, Yuval

    2016-04-01

    A new concept of short wavelength infrared (SWIR) to visible upconversion integrated imaging device is proposed, modeled and some initial measured results are presented. The device is a hybrid inorganic-organic device that comprises six nano-metric scale sub-layers grown on n-type GaAs substrates. The first layer is a ~300nm thick PbSe nano-columnar absorber layer grown in (111) orientation to the substrate plan (100), with a diameter of 8- 10nm and therefore exhibit quantum confinement effects parallel to the substrate and bulk properties perpendicular to it. The advantage of this structure is the high oscillator strength and hence absorption to incoming SWIR photons while maintaining the high bulk mobility of photo-excited charges along the columns. The top of the PbSe absorber layer is coated with 20nm thick metal layer that serves as a dual sided mirror, as well as a potentially surface plasmon enhanced absorption in the PbSe nano-columns layer. The photo-excited charges (holes and electrons in opposite directions) are drifted under an external applied field to the OLED section (that is composed of a hole transport layer, an emission layer and an electron transport layer) where they recombine with injected electron from the transparent cathode and emit visible light through this cathode. Due to the high absorption and enhanced transport properties this architecture has the potential of high quantum efficiency, low cost and easy implementation in any optical system. As a bench-mark, alternative concept where InGaAs/InP heterojunction couple to liquid crystal optical spatial light modulator (OSLM) structure was built that shows a full upconversion to visible of 1550nm laser light.

  20. Parallel implementation of linear and nonlinear spectral unmixing of remotely sensed hyperspectral images

    NASA Astrophysics Data System (ADS)

    Plaza, Antonio; Plaza, Javier

    2011-11-01

    Hyperspectral unmixing is a very important task for remotely sensed hyperspectral data exploitation. It addresses the (possibly) mixed nature of pixels collected by instruments for Earth observation, which are due to several phenomena including limited spatial resolution, presence of mixing effects at different scales, etc. Spectral unmixing involves the separation of a mixed pixel spectrum into its pure component spectra (called endmembers) and the estimation of the proportion (abundance) of endmember in the pixel. Two models have been widely used in the literature in order to address the mixture problem in hyperspectral data. The linear model assumes that the endmember substances are sitting side-by-side within the field of view of the imaging instrument. On the other hand, the nonlinear mixture model assumes nonlinear interactions between endmember substances. Both techniques can be computationally expensive, in particular, for high-dimensional hyperspectral data sets. In this paper, we develop and compare parallel implementations of linear and nonlinear unmixing techniques for remotely sensed hyperspectral data. For the linear model, we adopt a parallel unsupervised processing chain made up of two steps: i) identification of pure spectral materials or endmembers, and ii) estimation of the abundance of each endmember in each pixel of the scene. For the nonlinear model, we adopt a supervised procedure based on the training of a parallel multi-layer perceptron neural network using intelligently selected training samples also derived in parallel fashion. The compared techniques are experimentally validated using hyperspectral data collected at different altitudes over a so-called Dehesa (semi-arid environment) in Extremadura, Spain, and evaluated in terms of computational performance using high performance computing systems such as commodity Beowulf clusters.

  1. On the numerical implementation of time-reversal mirrors for tomographic imaging

    NASA Astrophysics Data System (ADS)

    Masson, Yder; Cupillard, Paul; Capdeville, Yann; Romanowicz, Barbara

    2014-03-01

    A general approach for constructing numerical equivalents of time-reversal mirrors is introduced. These numerical mirrors can be used to regenerate an original wavefield locally within a confined volume of arbitrary shape. Though time-reversal mirrors were originally designed to reproduce a time-reversed version of an original wavefield, the proposed method is independent of the time direction and can be used to regenerate a wavefield going either forward in time or backward in time. Applications to computational seismology and tomographic imaging of such local wavefield reconstructions are discussed. The key idea of the method is to directly express the source terms constituting the time-reversal mirror by introducing a spatial window function into the wave equation. The method is usable with any numerical method based on the discrete form of the wave equation, for example, with finite difference (FD) methods and with finite/spectral elements methods. The obtained mirrors are perfect in the sense that no additional error is introduced into the reconstructed wavefields apart from rounding errors that are inherent in floating-point computations. They are fully transparent as they do not interact with waves that are not part of the original wavefield and are permeable to these. We establish a link between some hybrid methods introduced in seismology, such as wave-injection, and the proposed time-reversal mirrors. Numerical examples based on FD and spectral elements methods in the acoustic, the elastic and the visco-elastic cases are presented. They demonstrate the accuracy of the method and illustrate some possible applications. An alternative implementation of the time-reversal mirrors based on the discretization of the surface integrals in the representation theorem is also introduced. Though it is out of the scope of the paper, the proposed method also apply to numerical schemes for modelling of other types of waves such as electro-magnetic waves.

  2. Human Factors Guidance for Control Room and Digital Human-System Interface Design and Modification, Guidelines for Planning, Specification, Design, Licensing, Implementation, Training, Operation and Maintenance

    SciTech Connect

    R. Fink, D. Hill, J. O'Hara

    2004-11-30

    Nuclear plant operators face a significant challenge designing and modifying control rooms. This report provides guidance on planning, designing, implementing and operating modernized control rooms and digital human-system interfaces.

  3. Implementing ethics in the professions: preparing guidelines on scientific communication for the Society for Neuroscience. Commentary on 'Implementing ethics in the professions: examples from environmental epidemiology' (Soskolne and Sieswerda).

    PubMed

    Zigmond, Michael J

    2003-04-01

    In 1994, the governing council of the Society for Neuroscience was asked to make a brief statement on an issue regarding responsible conduct in publishing. The present article reviews how that initial request grew over the next four years into a lengthy document. Drawing on that experience, which was presided over by the author, comments are made about the potential impact of such guidelines, the lessons learned, and the proper role of professional societies in promoting responsible conduct in research. PMID:12774651

  4. Pediatric cT: Implementation of ASIR for Substantial Radiation Dose Reduction While Maintaining Pre-ASIR Image Noise1

    PubMed Central

    Brady, Samuel L.; Moore, Bria M.; Yee, Brian S.; Kaufman, Robert A.

    2015-01-01

    Purpose To determine a comprehensive method for the implementation of adaptive statistical iterative reconstruction (ASIR) for maximal radiation dose reduction in pediatric computed tomography (CT) without changing the magnitude of noise in the reconstructed image or the contrast-to-noise ratio (CNR) in the patient. Materials and Methods The institutional review board waived the need to obtain informed consent for this HIPAA-compliant quality analysis. Chest and abdominopelvic CT images obtained before ASIR implementation (183 patient examinations; mean patient age, 8.8 years ± 6.2 [standard deviation]; range, 1 month to 27 years) were analyzed for image noise and CNR. These measurements were used in conjunction with noise models derived from anthropomorphic phantoms to establish new beam current–modulated CT parameters to implement 40% ASIR at 120 and 100 kVp without changing noise texture or magnitude. Image noise was assessed in images obtained after ASIR implementation (492 patient examinations; mean patient age, 7.6 years ± 5.4; range, 2 months to 28 years) the same way it was assessed in the pre-ASIR analysis. Dose reduction was determined by comparing size-specific dose estimates in the pre- and post-ASIR patient cohorts. Data were analyzed with paired t tests. Results With 40% ASIR implementation, the average relative dose reduction for chest CT was 39% (2.7/4.4 mGy), with a maximum reduction of 72% (5.3/18.8 mGy). The average relative dose reduction for abdominopelvic CT was 29% (4.8/6.8 mGy), with a maximum reduction of 64% (7.6/20.9 mGy). Beam current modulation was unnecessary for patients weighing 40 kg or less. The difference between 0% and 40% ASIR noise magnitude was less than 1 HU, with statistically nonsignificant increases in patient CNR at 100 kVp of 8% (15.3/14.2; P = .41) for chest CT and 13% (7.8/6.8; P = .40) for abdominopelvic CT. Conclusion Radiation dose reduction at pediatric CT was achieved when 40% ASIR was implemented as a dose

  5. Design, implementation and investigation of an image guide-based optical flip-flop array

    NASA Technical Reports Server (NTRS)

    Griffith, P. C.

    1987-01-01

    Presented is the design for an image guide-based optical flip-flop array created using a Hughes liquid crystal light valve and a flexible image guide in a feedback loop. This design is used to investigate the application of image guides as a communication mechanism in numerical optical computers. It is shown that image guides can be used successfully in this manner but mismatch match between the input and output fiber arrays is extremely limiting.

  6. Guideline-based careflow systems.

    PubMed

    Quaglini, S; Stefanelli, M; Cavallini, A; Micieli, G; Fassino, C; Mossa, C

    2000-08-01

    This paper describes a methodology for achieving an efficient implementation of clinical practice guidelines. Three main steps are illustrated: knowledge representation, model simulation and implementation within a health care organisation. The resulting system can be classified as a 'guideline-based careflow management system'. It is based on computational formalisms representing both medical and health care organisational knowledge. This aggregation allows the implementation of a guideline, not only as a simple reminder, but also as an 'organiser' that facilitates health care processes. As a matter of fact, the system not only suggests the tasks to be performed, but also the resource allocation. The methodology initially comprehends a graphical editor, that allows an unambiguous representation of the guideline. Then the guideline is translated into a high-level Petri net. The resources, both human and technological necessary for performing guideline-based activities, are also represented by means of an organisational model. This allows the running of the Petri net for simulating the implementation of the guideline in the clinical setting. The purpose of the simulation is to validate the careflow model and to suggest the optimal resource allocation before the careflow system is installed. The final step is the careflow implementation. In this phase, we show that the 'workflow management' technology, widely used in business process automation, may be transferred to the health care setting. This requires augmenting the typical workflow management systems with the flexibility and the uncertainty management, typical of the health care processes. For illustrating the proposed methodology, we consider a guideline for the management of patients with acute ischemic stroke. PMID:11185420

  7. Laboratory implementation of edge illumination X-ray phase-contrast imaging with energy-resolved detectors

    NASA Astrophysics Data System (ADS)

    Diemoz, P. C.; Endrizzi, M.; Vittoria, F. A.; Hagen, C. K.; Kallon, G.; Basta, D.; Marenzana, M.; Delogu, P.; Vincenzi, A.; De Ruvo, L.; Spandre, G.; Brez, A.; Bellazzini, R.; Olivo, A.

    2015-03-01

    Edge illumination (EI) X-ray phase-contrast imaging (XPCI) has potential for applications in different fields of research, including materials science, non-destructive industrial testing, small-animal imaging, and medical imaging. One of its main advantages is the compatibility with laboratory equipment, in particular with conventional non-microfocal sources, which makes its exploitation in normal research laboratories possible. In this work, we demonstrate that the signal in laboratory implementations of EI can be correctly described with the use of the simplified geometrical optics. Besides enabling the derivation of simple expressions for the sensitivity and spatial resolution of a given EI setup, this model also highlights the EI's achromaticity. With the aim of improving image quality, as well as to take advantage of the fact that all energies in the spectrum contribute to the image contrast, we carried out EI acquisitions using a photon-counting energy-resolved detector. The obtained results demonstrate that this approach has great potential for future laboratory implementations of EI.

  8. Time-resolved hyperspectral single-pixel camera implementation for compressive wide-field fluorescence lifetime imaging

    NASA Astrophysics Data System (ADS)

    Pian, Qi; Yao, Ruoyang; Intes, Xavier

    2016-03-01

    Single-pixel imaging based on compressive sensing theory has been a highlighted technique in the biomedical imaging field for many years. This interest has been driven by the possibility of performing microscopic or macroscopic imaging based on low-cost detector arrays, increased SNR (signal-to-noise ratio) in the acquired data sets and the ability to perform high quality image reconstruction with compressed data sets by exploiting signal sparsity. In this work, we present our recent work in implementing this technique to perform time domain fluorescence-labeled investigations in preclinical settings. More precisely, we report on our time-resolved hyperspectral single-pixel camera for fast, wide-field mapping of molecular labels and lifetime-based quantification. The hyperspectral single-pixel camera implements a DMD (Digital micro-mirror device) to generate optical masks for modulating the illumination field before it is delivered onto the sample and focuses the emission light signals into a multi-anode hyperspectral time-resolved PMT (Photomultiplier tube) to acquire spatial, temporal and spectral information enriched 4-D data sets. Fluorescence dyes with lifetime and spectral contrast are embedded in well plates and thin tissues. L-1 norm based regularization or the least square method, is applied to solve the underdetermined inverse problem during image reconstruction. These experimental results prove the possibility of fast, wide-field mapping of fluorescent labels with lifetime and spectral contrast in thin media.

  9. Implementation of improved interactive image analysis at the Advanced Photon Source (APC) linac.

    SciTech Connect

    Arnold, N.

    1998-09-11

    An image-analysis system, based on commercially available data visualization software (IDL [1]), allows convenient interaction with image data while still providing calculated beam parameters at a rate of up to 2 Hz. Image data are transferred from the IOC to the workstation via EPICS [2] channel access. A custom EPICS record was created in order to overcome the channel access limit of 16k bytes per array. The user can conveniently calibrate optical transition radiation (OTR) and fluorescent screens, capture background images, acquire and average a series of images, and specify several other filtering and viewing options. The images can be saved in either IDL format or APS-standard format (SDDS [3]), allowing for rapid postprocessing of image data by numerous other software tools.

  10. The x-ray light valve: A potentially low-cost, digital radiographic imaging system-concept and implementation considerations

    SciTech Connect

    Webster, Christie Ann; Koprinarov, Ivaylo; Germann, Stephen; Rowlands, J. A.

    2008-03-15

    New x-ray radiographic systems based on large-area flat-panel technology have revolutionized our capability to produce digital x-ray images. However, these imagers are extraordinarily expensive compared to the systems they are replacing. Hence, there is a need for a low-cost digital imaging system for general applications in radiology. A novel potentially low-cost radiographic imaging system based on established technologies is proposed--the X-Ray Light Valve (XLV). This is a potentially high-quality digital x-ray detector made of a photoconducting layer and a liquid-crystal cell, physically coupled in a sandwich structure. Upon exposure to x rays, charge is collected on the surface of the photoconductor. This causes a change in the optical properties of the liquid-crystal cell and a visible image is generated. Subsequently, it is digitized by a scanned optical imager. The image formation is based on controlled modulation of light from an external source. The operation and practical implementation of the XLV system are described. The potential performance of the complete system and issues related to sensitivity, spatial resolution, noise, and speed are discussed. The feasibility of clinical use of an XLV device based on amorphous selenium (a-Se) as the photoconductor and a reflective electrically controlled birefringence cell is analyzed. The results of our analysis indicate that the XLV can potentially be adapted to a wide variety of radiographic tasks.

  11. Agent-based computational model of the prevalence of gonococcal infections after the implementation of HIV pre-exposure prophylaxis guidelines

    PubMed Central

    Escobar, Erik; Durgham, Ryan; Dammann, Olaf; Stopka, Thomas J.

    2015-01-01

    Recently, the first comprehensive guidelines were published for pre-exposure prophylaxis (PrEP) for the prevention of HIV infection in populations with substantial risk of infection. Guidelines include a daily regimen of emtricitabine/tenofovir disoproxil fumarate (TDF/FTC) as well as condom usage during sexual activity. The relationship between the TDF/FTC intake regimen and condom usage is not yet fully understood. If men who have sex with men (MSM,) engage in high-risk sexual activities without using condoms when prescribed TDF/FTC they might be at an increased risk for other sexually transmitted diseases (STD). Our study focuses on the possible occurrence of behavioral changes among MSM in the United States over time with regard to condom usage. In particular, we were interested in creating a model of how increased uptake of TDF/FTC might cause a decline in condom usage, causing significant increases in non-HIV STD incidence, using gonococcal infection incidence as a biological endpoint. We used the agent-based modeling software NetLogo, building upon an existing model of HIV infection. We found no significant evidence for increased gonorrhea prevalence due to increased PrEP usage at any level of sample-wide usage, with a range of 0-90% PrEP usage. However, we did find significant evidence for decreased prevalence of HIV, with a maximal effect being reached when 5% to 10% of the MSM population used PrEP. Our findings appear to indicate that attitudes of aversion, within the medical community, toward the promotion of PrEP due to the potential risk of increased STD transmission are unfounded. PMID:26834937

  12. Agent-based computational model of the prevalence of gonococcal infections after the implementation of HIV pre-exposure prophylaxis guidelines.

    PubMed

    Escobar, Erik; Durgham, Ryan; Dammann, Olaf; Stopka, Thomas J

    2015-01-01

    Recently, the first comprehensive guidelines were published for pre-exposure prophylaxis (PrEP) for the prevention of HIV infection in populations with substantial risk of infection. Guidelines include a daily regimen of emtricitabine/tenofovir disoproxil fumarate (TDF/FTC) as well as condom usage during sexual activity. The relationship between the TDF/FTC intake regimen and condom usage is not yet fully understood. If men who have sex with men (MSM,) engage in high-risk sexual activities without using condoms when prescribed TDF/FTC they might be at an increased risk for other sexually transmitted diseases (STD). Our study focuses on the possible occurrence of behavioral changes among MSM in the United States over time with regard to condom usage. In particular, we were interested in creating a model of how increased uptake of TDF/FTC might cause a decline in condom usage, causing significant increases in non-HIV STD incidence, using gonococcal infection incidence as a biological endpoint. We used the agent-based modeling software NetLogo, building upon an existing model of HIV infection. We found no significant evidence for increased gonorrhea prevalence due to increased PrEP usage at any level of sample-wide usage, with a range of 0-90% PrEP usage. However, we did find significant evidence for decreased prevalence of HIV, with a maximal effect being reached when 5% to 10% of the MSM population used PrEP. Our findings appear to indicate that attitudes of aversion, within the medical community, toward the promotion of PrEP due to the potential risk of increased STD transmission are unfounded. PMID:26834937

  13. Feasibility and implementation of a literature information management system for human papillomavirus in head and neck cancers with imaging.

    PubMed

    Wu, Dee H; Matthiesen, Chance L; Alleman, Anthony M; Fournier, Aaron L; Gunter, Tyler C

    2014-01-01

    This work examines the feasibility and implementation of information service-orientated architecture (ISOA) on an emergent literature domain of human papillomavirus, head and neck cancer, and imaging. From this work, we examine the impact of cancer informatics and generate a full set of summarizing clinical pearls. Additionally, we describe how such an ISOA creates potential benefits in informatics education, enhancing utility for creating enduring digital content in this clinical domain.

  14. Theoretical aspects of implementation of kilovoltage cone-beam CT onboard linear accelerator for image-guided radiotherapy.

    PubMed

    Rodríguez Cordón, Marta; Ferrer Albiach, Carlos

    2009-08-01

    The main objective of image-guided radiation therapy (IGRT) equipment is to reduce and correct inherent errors in external radiotherapy processes. At the present time, there are different IGRT systems available, but here we will refer exclusively to the kilovoltage cone-beam CT onboard linear accelerator (CBkVCT) and the different aspects that, from a clinical point of view, should be taken into consideration before the implementation of this equipment.

  15. Feasibility and implementation of a literature information management system for human papillomavirus in head and neck cancers with imaging.

    PubMed

    Wu, Dee H; Matthiesen, Chance L; Alleman, Anthony M; Fournier, Aaron L; Gunter, Tyler C

    2014-01-01

    This work examines the feasibility and implementation of information service-orientated architecture (ISOA) on an emergent literature domain of human papillomavirus, head and neck cancer, and imaging. From this work, we examine the impact of cancer informatics and generate a full set of summarizing clinical pearls. Additionally, we describe how such an ISOA creates potential benefits in informatics education, enhancing utility for creating enduring digital content in this clinical domain. PMID:25392683

  16. Feasibility and Implementation of a Literature Information Management System for Human Papillomavirus in Head and Neck Cancers with Imaging

    PubMed Central

    Wu, Dee H; Matthiesen, Chance L; Alleman, Anthony M; Fournier, Aaron L; Gunter, Tyler C

    2014-01-01

    This work examines the feasibility and implementation of information service-orientated architecture (ISOA) on an emergent literature domain of human papillomavirus, head and neck cancer, and imaging. From this work, we examine the impact of cancer informatics and generate a full set of summarizing clinical pearls. Additionally, we describe how such an ISOA creates potential benefits in informatics education, enhancing utility for creating enduring digital content in this clinical domain. PMID:25392683

  17. Implementation and evaluation of ILLIAC 4 algorithms for multispectral image processing

    NASA Technical Reports Server (NTRS)

    Swain, P. H.

    1974-01-01

    Data concerning a multidisciplinary and multi-organizational effort to implement multispectral data analysis algorithms on a revolutionary computer, the Illiac 4, are reported. The effectiveness and efficiency of implementing the digital multispectral data analysis techniques for producing useful land use classifications from satellite collected data were demonstrated.

  18. Optical implementation of improved resolution with intermediate-view reconstruction technique based on integral imaging

    NASA Astrophysics Data System (ADS)

    Lee, Keong-Jin; Lee, Sang-Tae; Oh, Yong-Seok; Hong, Suk-Pyo; Kim, Chang-Keun; Kim, Eun-Soo

    2008-02-01

    To overcome the viewing resolution limit defined by the Nyquist sampling theorem for a given lenslet pitch, a Moving Array-Lens Technique (MALT) was developed in 3-D integral imaging technique. Even though the MALT is an effective method for resolution improvement of Integral Imaging, this cannot be applied to a real-time 3-D integral imaging display system because of its mechanical movement. In this paper, we propose an integral imaging display using a computational pick-up method based on Intermediate-View Reconstruction Technique instead of optical moving pickup. We show that the proposed system can provide optically resolution-improved 3-D images of integral imaging by use of EIs generated by the IVRT through the optical experiments.

  19. The design and implementation of image query system based on color feature

    NASA Astrophysics Data System (ADS)

    Yao, Xu-Dong; Jia, Da-Chun; Li, Lin

    2013-07-01

    ASP.NET technology was used to construct the B/S mode image query system. The theory and technology of database design, color feature extraction from image, index and retrieval in the construction of the image repository were researched. The campus LAN and WAN environment were used to test the system. From the test results, the needs of user queries about related resources were achieved by system architecture design.

  20. The design and implementation of a remote sensing image processing system based on grid middleware

    NASA Astrophysics Data System (ADS)

    Zhong, Liang; Ma, Hongchao; Xu, Honggen; Ding, Yi

    2009-10-01

    In this article, a remote sensing image processing system is established to carry out the significant scientific problem that processing and distributing the mass earth-observed data quantitatively and intelligently with high efficiency under the Condor Environment. This system includes the submitting of the long-distantly task, the Grid middleware in the mass image processing and the quick distribution of the remote-sensing images, etc. A conclusion can be gained from the application of this system based on Grid environment. It proves to be an effective way to solve the present problem of fast processing, quick distribution and sharing of the mass remote-sensing images.

  1. Design and Implementation of a Compact Low-Dose Diffraction Enhanced Medical Imaging System

    SciTech Connect

    Parham, C.; Zhong, Z; Connor, D; Chapman, D; Pisano, E

    2009-01-01

    This paper describes the design, construction, and performance of a new DEI system using a commercially available tungsten anode x-ray tube and includes the first high-quality low-dose diffraction-enhanced images of full-thickness human tissue specimens. Diffraction-enhanced imaging (DEI) is a new x-ray imaging modality that differs from conventional radiography in its use of three physical mechanisms to generate contrast. DEI is able to generate contrast from x-ray absorption, refraction, and ultra-small-angle scatter rejection (extinction) to produce high-contrast images with a much lower radiation dose compared to conventional radiography.

  2. Implementation and assessment of an animal management system for small-animal micro-CT / micro-SPECT imaging

    NASA Astrophysics Data System (ADS)

    Holdsworth, David W.; Detombe, Sarah A.; Chiodo, Chris; Fricke, Stanley T.; Drangova, Maria

    2011-03-01

    Advances in laboratory imaging systems for CT, SPECT, MRI, and PET facilitate routine micro-imaging during pre-clinical investigations. Challenges still arise when dealing with immune-compromised animals, biohazardous agents, and multi-modality imaging. These challenges can be overcome with an appropriate animal management system (AMS), with the capability for supporting and monitoring a rat or mouse during micro-imaging. We report the implementation and assessment of a new AMS system for mice (PRA-3000 / AHS-2750, ASI Instruments, Warren MI), designed to be compatible with a commercial micro-CT / micro-SPECT imaging system (eXplore speCZT, GE Healthcare, London ON). The AMS was assessed under the following criteria: 1) compatibility with the imaging system (i.e. artifact generation, geometric dimensions); 2) compatibility with live animals (i.e. positioning, temperature regulation, anesthetic supply); 3) monitoring capabilities (i.e. rectal temperature, respiratory and cardiac monitoring); 4) stability of co-registration; and 5) containment. Micro-CT scans performed using a standardized live-animal protocol (90 kVp, 40 mA, 900 views, 16 ms per view) exhibited low noise (+/-19 HU) and acceptable artifact from high-density components within the AMS (e.g. ECG pad contacts). Live mice were imaged repeatedly (with removal and replacement of the AMS) and spatial registration was found to be stable to within +/-0.07 mm. All animals tolerated enclosure within the AMS for extended periods (i.e. > one hour) without distress, based on continuous recordings of rectal temperature, ECG waveform and respiratory rate. A sealed AMS system extends the capability of a conventional micro-imaging system to include immune-compromised and biosafety level 2 mouse-imaging protocols.

  3. ["Second opinion" in online radiology via Internet: report on implementation and analysis of reliability of findings in sectional images].

    PubMed

    Ricke, J; van der Donk, E; Wolf, M; Ostendorf, B; Hosten, N; Zielinski, C; Liebig, T; Stroszczinski, C; Lopez-Hänninen, E; Lemke, A J; Gillessen, C; Gürvit, O; Amthauer, H; Kleinholz, L; Bartelink, H; Felix, R

    1997-01-01

    Numerous medical on-line services have already been established in the world-wide internet. In connection with the Information service TELESCAN, sponsored by the EU, a pilot project has been initiated which offers a radiological "second opinion" via the transmission of radiological findings and images that have been previously rendered anonymous. In addition to a description of the basic implementation, tests of the diagnostic certainty of the transmitted cranial computed tomographs have been performed. The CT images were digitized with a document camera, transmitted over the Internet, and then evaluated on the receiver's monitor. Both the transfer of originally generated digital image files (in ACR-NEMA or DICOM) as well as graphic files after digitization of X-ray films, for example by a document camera, is possible via electronic post (e-mail). Visualization by the receiver requires the use of current proprietary software for special medical image formats, while standard graphic formats such as GIFF or JPEG can be visualized with the usual Internet software. In an ROC analysis, 56 individual images of cranial computed tomographs, half with pathological findings such as space-occupying lesions, infarcts, or brain edema, were tested with regard to the diagnostic certainty after digitization and transmission. In comparison with the original film findings, there was a slight but statistically not significant reduction in diagnostic certainty of the images evaluated on screen after transfer via the Internet. We believe that this result is due to the low local resolution, low dynamic range, the high image noise and of CT arising from the window technique. The same parameters are probably valid for MRI. The result cannot be applied to conventional radiography including mammography because, in comparison to the mentioned image techniques, their local resolution is high and image noise is considerably lower.

  4. Multiparametric magnetic resonance imaging for pre-treatment local staging of prostate cancer: A Cancer Care Ontario clinical practice guideline

    PubMed Central

    Salerno, Jennifer; Finelli, Antonio; Morash, Chris; Morgan, Scott C.; Power, Nicholas; Schieda, Nichola; Haider, Masoom A.

    2016-01-01

    Introduction: The utility of T2-weighted magnetic resonance imaging (MRI) in the local staging of prostate cancer is controversial. Due to the success of multiparametric MRI in cancer localization, there is renewed interested in MRI (± functional sequences) for local staging. Guidance on pre-treatment local staging of prostate cancer by MRI was developed using systematic review methodology and expert consultation. Methods: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and other databases were searched to identify studies comparing: (1) MRI staging vs. radical prostatectomy staging on diagnostic accuracy outcomes; and (2) MRI staging vs. routine clinical staging on clinical and patient outcomes. Studies meeting inclusion criteria were synthesized by outcome and sensitivity/specificity analysis by tumour location was performed. Evidence quality of included studies was assessed and considered in recommendation formulation. Results: The literature search identified 2510 citations; 62 studies were included. Analysis of MRI ≥1.5 T plus endorectal coil (ER) (± functional sequences) in the detection of extraprostatic extension or seminal vesicle invasion showed modest sensitivities (≥50%) and excellent specificities (>85%) among patients scheduled for radical prostatectomy. MRI upstaging was shown in 20/21 studies, with large variation in correctness (11–85%). Scarcity of clinical and patient outcomes among studies limited synthesis and evaluation. Quality assessment found non-trivial biases. Conclusions: Modest imaging performance was shown for MRI (1.5 T + ER and 3 T ± ER) ± functional sequences in regards to sensitivity. Limitations in study design, reporting of clinical and patient outcomes, and the heterogeneous use of MRI tempered the strength of the recommendations. PMID:27800062

  5. Design and Implementation of a Self-Directed Stereochemistry Lesson Using Embedded Virtual Three-Dimensional Images in a Portable Document Format

    ERIC Educational Resources Information Center

    Cody, Jeremy A.; Craig, Paul A.; Loudermilk, Adam D.; Yacci, Paul M.; Frisco, Sarah L.; Milillo, Jennifer R.

    2012-01-01

    A novel stereochemistry lesson was prepared that incorporated both handheld molecular models and embedded virtual three-dimensional (3D) images. The images are fully interactive and eye-catching for the students; methods for preparing 3D molecular images in Adobe Acrobat are included. The lesson was designed and implemented to showcase the 3D…

  6. Real-time imaging with radial GRAPPA: Implementation on a Heterogeneous Architecture for Low-Latency Reconstructions

    PubMed Central

    Saybasili, Haris; Herzka, Daniel A.; Seiberlich, Nicole; A.Griswold, Mark

    2014-01-01

    Combination of non-Cartesian trajectories with parallel MRI permits to attain unmatched acceleration rates when compared to traditional Cartesian MRI during real-time imaging.However, computationally demanding reconstructions of such imaging techniques, such as k-space domain radial generalized auto-calibrating partially parallel acquisitions (radial GRAPPA) and image domain conjugate gradient sensitivity encoding (CG-SENSE), lead to longer reconstruction times and unacceptable latency for online real-time MRI on conventional computational hardware. Though CG-SENSE has been shown to work with low-latency using a general purpose graphics processing unit (GPU), to the best of our knowledge, no such effort has been made for radial GRAPPA. radial GRAPPA reconstruction, which is robust even with highly undersampled acquisitions, is not iterative, requiring only significant computation during initial calibration while achieving good image quality for low-latency imaging applications. In this work, we present a very fast, low-latency, reconstruction framework based on a heterogeneous system using multi-core CPUs and GPUs. We demonstrate an implementation of radial GRAPPA that permits reconstruction times on par with or faster than acquisition of highly accelerated datasets in both cardiac and dynamic musculoskeletal imaging scenarios. Acquisition and reconstructions times are reported. PMID:24690453

  7. Real-time imaging with radial GRAPPA: Implementation on a heterogeneous architecture for low-latency reconstructions.

    PubMed

    Saybasili, Haris; Herzka, Daniel A; Seiberlich, Nicole; Griswold, Mark A

    2014-07-01

    Combination of non-Cartesian trajectories with parallel MRI permits to attain unmatched acceleration rates when compared to traditional Cartesian MRI during real-time imaging. However, computationally demanding reconstructions of such imaging techniques, such as k-space domain radial generalized auto-calibrating partially parallel acquisitions (radial GRAPPA) and image domain conjugate gradient sensitivity encoding (CG-SENSE), lead to longer reconstruction times and unacceptable latency for online real-time MRI on conventional computational hardware. Though CG-SENSE has been shown to work with low-latency using a general purpose graphics processing unit (GPU), to the best of our knowledge, no such effort has been made for radial GRAPPA. Radial GRAPPA reconstruction, which is robust even with highly undersampled acquisitions, is not iterative, requiring only significant computation during initial calibration while achieving good image quality for low-latency imaging applications. In this work, we present a very fast, low-latency, reconstruction framework based on a heterogeneous system using multi-core CPUs and GPUs. We demonstrate an implementation of radial GRAPPA that permits reconstruction times on par with or faster than acquisition of highly accelerated datasets in both cardiac and dynamic musculoskeletal imaging scenarios. Acquisition and reconstruction times are reported.

  8. Implementation of a segmentation method for agricultural fields in aerial sequences of images based on CSAR model

    NASA Astrophysics Data System (ADS)

    Chen, Haijun; Houkes, Zweitze

    1998-09-01

    In this paper, a segmentation method for agricultural fields in aerial sequences of images based on the Circular Symmetri Auto-Regressive (CSAR) model is presented. The image sequences assumed to be acquired by a video camera (RGB-CCD system) from an aeroplane, which moves linearly over the scene. The objects in the scenes being considered in this paper, are agricultural fields. The classes of agricultural fields to be distinguished are determined by the type of crop, e.g. potatoes sugar beet, wheat, etc. In order to recognize and classify these fields from aerial sequence of images, a reliable segmentatio is required. Here texture features are used for segmentation. The implementation of segmentation for agricultural fields in aerial sequences of images is based on CSAR model in texture analysis. By comparing the estimated parameters of CSAR model from different area in an image, the characteristics and the class of a texture may be determined. The paper describes the segmentation method and its evaluation through experiments. Based on segmentation results, classification for surface texture of vegetation from aerial sequences of images is realized.

  9. WSCLEAN: an implementation of a fast, generic wide-field imager for radio astronomy

    NASA Astrophysics Data System (ADS)

    Offringa, A. R.; McKinley, B.; Hurley-Walker, N.; Briggs, F. H.; Wayth, R. B.; Kaplan, D. L.; Bell, M. E.; Feng, L.; Neben, A. R.; Hughes, J. D.; Rhee, J.; Murphy, T.; Bhat, N. D. R.; Bernardi, G.; Bowman, J. D.; Cappallo, R. J.; Corey, B. E.; Deshpande, A. A.; Emrich, D.; Ewall-Wice, A.; Gaensler, B. M.; Goeke, R.; Greenhill, L. J.; Hazelton, B. J.; Hindson, L.; Johnston-Hollitt, M.; Jacobs, D. C.; Kasper, J. C.; Kratzenberg, E.; Lenc, E.; Lonsdale, C. J.; Lynch, M. J.; McWhirter, S. R.; Mitchell, D. A.; Morales, M. F.; Morgan, E.; Kudryavtseva, N.; Oberoi, D.; Ord, S. M.; Pindor, B.; Procopio, P.; Prabu, T.; Riding, J.; Roshi, D. A.; Shankar, N. Udaya; Srivani, K. S.; Subrahmanyan, R.; Tingay, S. J.; Waterson, M.; Webster, R. L.; Whitney, A. R.; Williams, A.; Williams, C. L.

    2014-10-01

    Astronomical wide-field imaging of interferometric radio data is computationally expensive, especially for the large data volumes created by modern non-coplanar many-element arrays. We present a new wide-field interferometric imager that uses the w-stacking algorithm and can make use of the w-snapshot algorithm. The performance dependences of CASA's w-projection and our new imager are analysed and analytical functions are derived that describe the required computing cost for both imagers. On data from the Murchison Widefield Array, we find our new method to be an order of magnitude faster than w-projection, as well as being capable of full-sky imaging at full resolution and with correct polarization correction. We predict the computing costs for several other arrays and estimate that our imager is a factor of 2-12 faster, depending on the array configuration. We estimate the computing cost for imaging the low-frequency Square Kilometre Array observations to be 60 PetaFLOPS with current techniques. We find that combining w-stacking with the w-snapshot algorithm does not significantly improve computing requirements over pure w-stacking. The source code of our new imager is publicly released.

  10. Jogging Guidelines.

    ERIC Educational Resources Information Center

    President's Council on Physical Fitness and Sports, Washington, DC.

    Jogging guidelines are set forth under the following headings: a) What Is Jogging; c) Why One Should Jog; c) How To Begin; d) What To Wear (with the emphasis on proper shoes); e) When and Where To Jog; and f) How To Jog. A 16-week basic program, outlined for inactive adults, recommends for each week the number of days to exercise, the distance,…

  11. Italian Guidelines.

    PubMed

    Annibale, Bruno; Carabotti, Marilia; Cuomo, Rosario

    2016-10-01

    Diverticular disease (DD) is a widespread condition, however limited evidences are available about its management and complications. In the last years, an Italian Consensus Conference promoted by GRIMAD (Gruppo Italiano Malattia Diverticolare, Italian Group on Diverticular Diseases) and a Guideline, by Italian Society of Colorectal Surgery (SICCR) were published. The aim of the Consensus was to provide clinical recommendation for appropriate definition, diagnosis, and management of DD, in particular 4 areas of interest were identified, namely: (i) definition and epidemiology, (ii) pathophysiology, (iii) diagnosis, and (iv) medical and surgical treatment. A total of 55 statements graded according to different level of evidence and strength of recommendation were approved. However, if we consider the grade of recommendation, their strength remains suboptimal, with only 3 statements with grade of evidence A in the area of diagnosis. The Clinical guidelines by SICCR focus mainly on acute diverticulitis, and surgical treatment of complicated DD. One of the main topic analyzed, is represented by the management of the acute uncomplicated diverticulitis, in particular about the use of antibiotics and need of hospitalization. Despite the presence of many recent European and western country guidelines, there is a lack of robust data on epidemiology, risk factors, and medical and surgical management of DD, calling the need of further studies aimed to obtain an evidence-based approach in this condition. PMID:27622363

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

    PubMed Central

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

    2014-01-01

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

  13. Cardiovascular flow measurement with phase-contrast MR imaging: basic facts and implementation.

    PubMed

    Lotz, Joachim; Meier, Christian; Leppert, Andreas; Galanski, Michael

    2002-01-01

    Phase-contrast magnetic resonance (MR) imaging is a well-known but undervalued method of obtaining quantitative information on blood flow. Applications of this technique in cardiovascular MR imaging are expanding. According to the sequences available, phase-contrast measurement can be performed in a breath hold or during normal respiration. Prospective as well as retrospective gating techniques can be used. Common errors in phase-contrast imaging include mismatched encoding velocity, deviation of the imaging plane, inadequate temporal resolution, inadequate spatial resolution, accelerated flow and spatial misregistration, and phase offset errors. Flow measurements are most precise if the imaging plane is perpendicular to the vessel of interest and flow encoding is set to through-plane flow. The sequence should be repeated at least once, with a high encoding velocity used initially. If peak velocity has to be estimated, flow measurement is repeated with an adapted encoding velocity. The overall error of a phase-contrast flow measurement comprises errors during prescription as well as errors that occur during image analysis of the flow data. With phase-contrast imaging, the overall error in flow measurement can be reduced to less than 10%, an acceptable level of error for routine clinical use. PMID:12006694

  14. The design and implementation of a high-fidelity Raman imaging microscope.

    PubMed

    Goldstein, S R; Kidder, L H; Herne, T M; Levin, I W; Lewis, E N

    1996-10-01

    We describe a Raman imaging microscope that produces high-fidelity, large format Raman images and Raman spectra from samples as small as 1 micron in size. Laser illumination is delivered to the object by means of an infinity corrected microscope objective, either by a galvanometer scanning system or a widefield fibre optic. Wavelength selection of Raman scattered emission is achieved by an acousto-optic tunable filter (AOTF), which maintains image fidelity and provides either continuous or random wavelength selection. The collimated AOTF output is imaged first by a tube lens and then by a projection lens onto a cooled silicon CCD array. Instrument features, including factors that determine the system's spatial and spectral resolution, and design considerations are discussed in detail. Images and spectra of test objects and samples that demonstrate the capability of this imaging spectrometer are presented. The potential of intrinsic chemical imaging is discussed in terms of its use in the analyses of a variety of chemical and biological samples. PMID:8923757

  15. Woods Hole Image Processing System Software implementation; using NetCDF as a software interface for image processing

    USGS Publications Warehouse

    Paskevich, Valerie F.

    1992-01-01

    The Branch of Atlantic Marine Geology has been involved in the collection, processing and digital mosaicking of high, medium and low-resolution side-scan sonar data during the past 6 years. In the past, processing and digital mosaicking has been accomplished with a dedicated, shore-based computer system. With the need to process sidescan data in the field with increased power and reduced cost of major workstations, a need to have an image processing package on a UNIX based computer system which could be utilized in the field as well as be more generally available to Branch personnel was identified. This report describes the initial development of that package referred to as the Woods Hole Image Processing System (WHIPS). The software was developed using the Unidata NetCDF software interface to allow data to be more readily portable between different computer operating systems.

  16. Implementation of a Gaussian beam laser and aspheric optics for high spatial resolution MALDI imaging MS.

    PubMed

    Zavalin, Andre; Yang, Junhai; Haase, Andreas; Holle, Armin; Caprioli, Richard

    2014-06-01

    We have investigated the use of a Gaussian beam laser for MALDI Imaging Mass Spectrometry to provide a precisely defined laser spot of 5 μm diameter on target using a commercial MALDI TOF instrument originally designed to produce a 20 μm diameter laser beam spot at its smallest setting. A Gaussian beam laser was installed in the instrument in combination with an aspheric focusing lens. This ion source produced sharp ion images at 5 μm spatial resolution with signals of high intensity as shown for images from thin tissue sections of mouse brain.

  17. Implementation of a Gaussian Beam Laser and Aspheric Optics for High Spatial Resolution MALDI Imaging MS

    NASA Astrophysics Data System (ADS)

    Zavalin, Andre; Yang, Junhai; Haase, Andreas; Holle, Armin; Caprioli, Richard

    2014-06-01

    We have investigated the use of a Gaussian beam laser for MALDI Imaging Mass Spectrometry to provide a precisely defined laser spot of 5 μm diameter on target using a commercial MALDI TOF instrument originally designed to produce a 20 μm diameter laser beam spot at its smallest setting. A Gaussian beam laser was installed in the instrument in combination with an aspheric focusing lens. This ion source produced sharp ion images at 5 μm spatial resolution with signals of high intensity as shown for images from thin tissue sections of mouse brain.

  18. Image processing algorithm design and implementation for real-time autonomous inspection of mixed waste

    SciTech Connect

    Schalkoff, R.J.; Shaaban, K.M.; Carver, A.E.

    1996-12-31

    The ARIES {number_sign}1 (Autonomous Robotic Inspection Experimental System) vision system is used to acquire drum surface images under controlled conditions and subsequently perform autonomous visual inspection leading to a classification as `acceptable` or `suspect`. Specific topics described include vision system design methodology, algorithmic structure,hardware processing structure, and image acquisition hardware. Most of these capabilities were demonstrated at the ARIES Phase II Demo held on Nov. 30, 1995. Finally, Phase III efforts are briefly addressed.

  19. Image-based mechanical analysis of stent deformation: concept and exemplary implementation for aortic valve stents.

    PubMed

    Gessat, Michael; Hopf, Raoul; Pollok, Thomas; Russ, Christoph; Frauenfelder, Thomas; Sündermann, Simon Harald; Hirsch, Sven; Mazza, Edoardo; Székely, Gábor; Falk, Volkmar

    2014-01-01

    An approach for extracting the radial force load on an implanted stent from medical images is proposed. To exemplify the approach, a system is presented which computes a radial force estimation from computer tomography images acquired from patients who underwent transcatheter aortic valve implantation (TAVI). The deformed shape of the implanted valve prosthesis' Nitinol frame is extracted from the images. A set of displacement vectors is computed that parameterizes the observed deformation. An iterative relaxation algorithm is employed to adapt the information extracted from the images to a finite-element model of the stent, and the radial components of the interaction forces between the stent and the tissue are extracted. For the evaluation of the method, tests were run using the clinical data from 21 patients. Stent modeling and extraction of the radial forces were successful in 18 cases. Synthetic test cases were generated, in addition, for assessing the sensitivity to the measurement errors. In a sensitivity analysis, the geometric error of the stent reconstruction was below 0.3 mm, which is below the image resolution. The distribution of the radial forces was qualitatively and quantitatively reasonable. An uncertainty remains in the quantitative evaluation of the radial forces due to the uncertainty in defining a radial direction on the deformed stent. With our approach, the mechanical situation of TAVI stents after the implantation can be studied in vivo, which may help to understand the mechanisms that lead to the complications and improve stent design. PMID:24626769

  20. Software and Information Life Cycle (SILC) for the Integrated Information Services Organization. Analysis and implementation phase adaptations of the Sandia software guidelines: Issue A, April 18, 1995

    SciTech Connect

    Eaton, D.; Cassidy, A.; Cuyler, D.

    1995-07-01

    This document describes the processes to be used for creating corporate information systems within the scope of the Integrated information Services (IIS) Center. This issue A describes the Analysis and Implementation phases within the context of the entire life cycle. Appendix A includes a full set of examples of the analysis set deliverables. Subsequent issues will describe the other life cycle processes as we move toward enterprise-level management of information assets, including information meta-models and an integrated corporate information model. The analysis phase as described here, when combined with a specifications repository, will provide the basis for future reusable components and improve traceability of information system specifications to enterprise business rules.

  1. A new algorithm for determining 3D biplane imaging geometry: theory and implementation

    NASA Astrophysics Data System (ADS)

    Singh, Vikas; Xu, Jinhui; Hoffmann, Kenneth R.; Xu, Guang; Chen, Zhenming; Gopal, Anant

    2005-04-01

    Biplane imaging is a primary method for visual and quantitative assessment of the vasculature. A key problem called Imaging Geometry Determination problem (IGD for short) in this method is to determine the rotation-matrix R and the translation-vector t which relate the two coordinate systems. In this paper, we propose a new approach, called IG-Sieving, to calculate R and t using corresponding points in the two images. Our technique first generates an initial estimate of R and t from the gantry angles of the imaging system, and then optimizes them by solving an optimal-cell-search problem in a 6-D parametric space (three variables defining R plus the three variables of t). To efficiently find the optimal imaging geometry (IG) in 6-D, our approach divides the high dimensional search domain into a set of lower-dimensional regions, thereby reducing the optimal-cell-search problem to a set of optimization problems in 3D sub-spaces. For each such sub-space, our approach first applies efficient computational geometry techniques to identify "possibly-feasible"" IG"s, and then uses a criterion we call fall-in-number to sieve out good IGs. We show that in a bounded number of optimization steps, a (possibly infinite) set of near-optimal IGs can be determined. Simulation results indicate that our method can reconstruct 3D points with average 3D center-of-mass errors of about 0.8cm for input image-data errors as high as 0.1cm. More importantly, our algorithm provides a novel insight into the geometric structure of the solution-space, which could be exploited to significantly improve the accuracy of other biplane algorithms.

  2. Implementation and assessment of diffusion-weighted partial Fourier readout-segmented echo-planar imaging.

    PubMed

    Frost, Robert; Porter, David A; Miller, Karla L; Jezzard, Peter

    2012-08-01

    Single-shot echo-planar imaging has been used widely in diffusion magnetic resonance imaging due to the difficulties in correcting motion-induced phase corruption in multishot data. Readout-segmented EPI has addressed the multishot problem by introducing a two-dimensional nonlinear navigator correction with online reacquisition of uncorrectable data to enable acquisition of high-resolution diffusion data with reduced susceptibility artifact and T*(2) blurring. The primary shortcoming of readout-segmented EPI in its current form is its long acquisition time (longer than similar resolution single-shot echo-planar imaging protocols by approximately the number of readout segments), which limits the number of diffusion directions. By omitting readout segments at one side of k-space and using partial Fourier reconstruction, readout-segmented EPI imaging times could be reduced. In this study, the effects of homodyne and projection onto convex sets reconstructions on estimates of the fractional anisotropy, mean diffusivity, and diffusion orientation in fiber tracts and raw T(2)- and trace-weighted signal are compared, along with signal-to-noise ratio results. It is found that projections onto convex sets reconstruction with 3/5 segments in a 2 mm isotropic diffusion tensor image acquisition and 9/13 segments in a 0.9 × 0.9 × 4.0 mm(3) diffusion-weighted image acquisition provide good fidelity relative to the full k-space parameters. This allows application of readout-segmented EPI to tractography studies, and clinical stroke and oncology protocols.

  3. Implementation of an LED-based clinical spatial frequency domain imaging system

    NASA Astrophysics Data System (ADS)

    Mazhar, Amaan; Sharif, Seyed A.; Saggese, Steve; Choi, Bernard; Cuccia, David J.; Durkin, Anthony J.

    2012-03-01

    Spatial Frequency Domain Imaging (SFDI) is a non-contact imaging method that uses multiple frequency spatial illumination to generate two dimensional maps of tissue optical properties (absorption and reduced scattering) and chromophore concentrations. We present phantom validation and pilot clinical data of a deployed light-emitting diode (LED) based system. The system employs four LED wavelengths (658 nm, 730 nm, 850 nm, 970 nm) to quantitatively assess tissue health by measurement of common tissue constituents. Phantom validation results and maps of oxyhemoglobin, deoxy-hemoglobin, water content, reduced scattering, and surface topography will be presented for pilot studies assessing burn severity and efficacy of port wine stain treatment.

  4. Ship detection in panchromatic images: a new method and its DSP implementation

    NASA Astrophysics Data System (ADS)

    Yao, Yuan; Jiang, Zhiguo; Zhang, Haopeng; Wang, Mengfei; Meng, Gang

    2016-03-01

    In this paper, a new ship detection method is proposed after analyzing the characteristics of panchromatic remote sensing images and ship targets. Firstly, AdaBoost(Adaptive Boosting) classifiers trained by Haar features are utilized to make coarse detection of ship targets. Then LSD (Line Segment Detector) is adopted to extract the line features in target slices to make fine detection. Experimental results on a dataset of panchromatic remote sensing images with a spatial resolution of 2m show that the proposed algorithm can achieve high detection rate and low false alarm rate. Meanwhile, the algorithm can meet the needs of practical applications on DSP (Digital Signal Processor).

  5. Hyper-Fractal Analysis v04: Implementation of a fuzzy box-counting algorithm for image analysis of artistic works

    NASA Astrophysics Data System (ADS)

    Grossu, I. V.; El-Shamali, S. A.

    2013-07-01

    This work presents a new version of a Visual Basic 6.0 application for estimating the fractal dimension of images and 4D objects (Grossu et al. 2013 [1]). Following our attempt of investigating artistic works by fractal analysis of craquelure, we encountered important difficulties in filtering real information from noise. In this context, trying to avoid a sharp delimitation of "black" and "white" pixels, we implemented a fuzzy box-counting algorithm. Hyper-Fractal Analysis v04 example of use. Fuzzy fractal dimension of painting craquelure. Running time: In a first approximation, the algorithm is linear [2].

  6. Conical diffraction as a versatile building block to implement new imaging modalities for superresolution in fluorescence microscopy

    NASA Astrophysics Data System (ADS)

    Fallet, Clément; Caron, Julien; Oddos, Stephane; Tinevez, Jean-Yves; Moisan, Lionel; Sirat, Gabriel Y.; Braitbart, Philippe O.; Shorte, Spencer L.

    2014-08-01

    We present a new technology for super-resolution fluorescence imaging, based on conical diffraction. Conical diffraction is a linear, singular phenomenon taking place when a polarized beam is diffracted through a biaxial crystal. The illumination patterns generated by conical diffraction are more compact than the classical Gaussian beam; we use them to generate a super-resolution imaging modality. Conical Diffraction Microscopy (CODIM) resolution enhancement can be achieved with any type of objective on any kind of sample preparation and standard fluorophores. Conical diffraction can be used in multiple fashion to create new and disruptive technologies for super-resolution microscopy. This paper will focus on the first one that has been implemented and give a glimpse at what the future of microscopy using conical diffraction could be.

  7. Automated detection and analysis of Ca(2+) sparks in x-y image stacks using a thresholding algorithm implemented within the open-source image analysis platform ImageJ.

    PubMed

    Steele, Elliot M; Steele, Derek S

    2014-02-01

    Previous studies have used analysis of Ca(2+) sparks extensively to investigate both normal and pathological Ca(2+) regulation in cardiac myocytes. The great majority of these studies used line-scan confocal imaging. In part, this is because the development of open-source software for automatic detection of Ca(2+) sparks in line-scan images has greatly simplified data analysis. A disadvantage of line-scan imaging is that data are collected from a single row of pixels, representing only a small fraction of the cell, and in many instances x-y confocal imaging is preferable. However, the limited availability of software for Ca(2+) spark analysis in two-dimensional x-y image stacks presents an obstacle to its wider application. This study describes the development and characterization of software to enable automatic detection and analysis of Ca(2+) sparks within x-y image stacks, implemented as a plugin within the open-source image analysis platform ImageJ. The program includes methods to enable precise identification of cells within confocal fluorescence images, compensation for changes in background fluorescence, and options that allow exclusion of events based on spatial characteristics.

  8. Echo Planar Correlated Spectroscopic Imaging (EP-COSI): Implementation and Pilot Evaluation in Human Calf in Vivo#

    PubMed Central

    Lipnick, Scott; Verma, Gaurav; Ramadan, Saadallah; Furuyama, Jon; Thomas, M. Albert

    2010-01-01

    Exploiting the speed benefits of echo-planar imaging (EPI), the echo-planar spectroscopic imaging (EPSI) sequence facilitates recording of one spectral and two to three spatial dimensions faster than the conventional MR Spectroscopic Imaging (MRSI). A novel four dimensional (4D) echo-planar correlated spectroscopic imaging (EP-COSI) was implemented on a whole body 3T MRI scanner combining two spectral with two spatial encodings. Similar to EPSI, the EP-COSI sequence used a bipolar spatial read-out train facilitating simultaneous spatial and spectral encoding, and the conventional phase and spectral encodings for the other spatial and indirect spectral dimensions, respectively. Multiple 2D correlated spectroscopy (COSY) spectra were recorded over the spatially resolved volume of interest (VOI) localized by a train of three slice-selective radio-frequency (RF) pulses (90°-180°-90°). After the initial optimization using phantom solutions, the EP-COSI data were recorded in the lower leg of eight healthy volunteers including one endurance trained volunteer. Pilot results showed acceptable spatial and spectral quality achievable using the EP-COSI sequence. There was a detectable separation of cross peaks arising from the skeletal muscle intramyocellular lipids (IMCL) and extramyocellular lipids (EMCL) saturated and unsaturated pools. Residual dipolar interaction between the N-methylene and N-methyl protons of creatine/phosphocreatine (Cr/PCr) was also observed in the tibialis anterior region. PMID:20574964

  9. Parallel implementation of a unified approach to image focus and defocus analysis on the Parallel Virtual Machine

    NASA Astrophysics Data System (ADS)

    Liu, Yen-Fu; Lo, Nai-Wei; Subbarao, Murali; Carlson, Bradley S.

    1998-07-01

    A unified approach to image focus and defocus analysis (UFDA) was proposed recently for three-dimensional shape and focused image recovery of objects. One version of this approach which yields very accurate results is highly computationally intensive. In this paper we present a parallel implementation of this version of UFDA on the Parallel Virtual Machine (PVM). One of the most computationally intensive parts of the UFDA approach is the estimation of image data that would be recorded by a camera for a given solution for 3D shape and focused image. This computational step has to be repeated once during each iteration of the optimization algorithm. Therefore this step has been sped up by using the Parallel Virtual Machine (PVM). PVM is a software package that allows a heterogeneous network of parallel and serial computers to appear as a single concurrent computational resource. In our experimental environment PVM is installed on four UNIX workstations communicating over Ethernet to exploit parallel processing capability. Experimental results show that the communication over-head in this case is relatively low. An average of 1.92 speedup is attained by the parallel UFDA algorithm running on 2 PVM connected computers compared to the execution time of sequential processing. By applying the UFDA algorithm on 4 PVM connected machines an average of 3.44 speedup is reached. This demonstrates a practical application of PVM to 3D machine vision.

  10. Loop closure detection by algorithmic information theory: implemented on range and camera image data.

    PubMed

    Ravari, Alireza Norouzzadeh; Taghirad, Hamid D

    2014-10-01

    In this paper the problem of loop closing from depth or camera image information in an unknown environment is investigated. A sparse model is constructed from a parametric dictionary for every range or camera image as mobile robot observations. In contrast to high-dimensional feature-based representations, in this model, the dimension of the sensor measurements' representations is reduced. Considering the loop closure detection as a clustering problem in high-dimensional space, little attention has been paid to the curse of dimensionality in the existing state-of-the-art algorithms. In this paper, a representation is developed from a sparse model of images, with a lower dimension than original sensor observations. Exploiting the algorithmic information theory, the representation is developed such that it has the geometrically transformation invariant property in the sense of Kolmogorov complexity. A universal normalized metric is used for comparison of complexity based representations of image models. Finally, a distinctive property of normalized compression distance is exploited for detecting similar places and rejecting incorrect loop closure candidates. Experimental results show efficiency and accuracy of the proposed method in comparison to the state-of-the-art algorithms and some recently proposed methods.

  11. Dosimetry of an In-Line Kilovoltage Imaging System and Implementation in Treatment Planning

    SciTech Connect

    Dzierma, Yvonne; Alaei, Parham; Licht, Norbert; Rübe, Christian

    2014-03-15

    Purpose: To present the beam properties of the Siemens 70-kV and 121-kV linear accelerator-mounted imaging modalities and commissioning of the 121-kV beam in the Philips Pinnacle treatment planning system (TPS); measurements in an Alderson phantom were performed for verification of the model and to estimate the cone-beam CT (CBCT) imaging dose in the head and neck, thorax, and pelvis. Methods and Materials: The beam profiles and depth–dose curve were measured in an acrylic phantom using thermoluminescent dosimeters and a soft x-ray ionization chamber. Measurements were imported into the TPS, modeled, and verified by phantom measurements. Results: Modeling of the profiles and the depth–dose curve can be achieved with good quality. Comparison with the measurements in the Alderson phantom is generally good; only very close to bony structures is the dose underestimated by the TPS. For a 200° arc CBCT of the head and neck, a maximum dose of 7 mGy is measured; the thorax and pelvis 360° CBCTs give doses of 4-10 mGy and 7-15 mGy, respectively. Conclusions: Dosimetric characteristics of the Siemens kVision imaging modalities are presented and modeled in the Pinnacle TPS. Thermoluminescent dosimeter measurements in the Alderson phantom agree well with the calculated TPS dose, validating the model and providing an estimate of the imaging dose for different protocols.

  12. Measurement of object structure from size-encoded images generated by optically-implemented Gabor filters.

    PubMed

    Sierra, Heidy; Zheng, Jing-Yi; Rabin, Bryan; Boustany, Nada N

    2012-12-17

    We use optical Fourier processing based on two dimensional (2D) Gabor filters to obtain size-encoded images which depict with 20nm sensitivity to size while preserving a 0.36μm spatial resolution, the spatial distribution of structural features within transparent objects. The size of the object feature measured at each pixel in the encoded image is determined by the optimal Gabor filter period, S(max), that maximizes the scattering signal from that location in the object. We show that S(max) (in μm) depends linearly on feature size (also in μm) over a size range from 0.11μm to 2μm. This linear response remains largely unchanged when the refractive index ratio is varied and can be predicted from numerical simulations of Gabor-filtered light scattering. Pixel histograms of the size-encoded images of isolated spheres and diatoms were used to generate highly resolved size distributions ("size spectra") exhibiting sharp peaks characterizing the known major structural features within the studied objects. Dynamic signal associated with changes in selected feature sizes within living cells is also demonstrated. Taken together, our data suggest that a label-free, direct and objective measurement of sample structure is enabled by the size-encoded images and associated pixel histograms generated from a calibrated optical processing microscope based on Gabor filtering.

  13. Loop closure detection by algorithmic information theory: implemented on range and camera image data.

    PubMed

    Ravari, Alireza Norouzzadeh; Taghirad, Hamid D

    2014-10-01

    In this paper the problem of loop closing from depth or camera image information in an unknown environment is investigated. A sparse model is constructed from a parametric dictionary for every range or camera image as mobile robot observations. In contrast to high-dimensional feature-based representations, in this model, the dimension of the sensor measurements' representations is reduced. Considering the loop closure detection as a clustering problem in high-dimensional space, little attention has been paid to the curse of dimensionality in the existing state-of-the-art algorithms. In this paper, a representation is developed from a sparse model of images, with a lower dimension than original sensor observations. Exploiting the algorithmic information theory, the representation is developed such that it has the geometrically transformation invariant property in the sense of Kolmogorov complexity. A universal normalized metric is used for comparison of complexity based representations of image models. Finally, a distinctive property of normalized compression distance is exploited for detecting similar places and rejecting incorrect loop closure candidates. Experimental results show efficiency and accuracy of the proposed method in comparison to the state-of-the-art algorithms and some recently proposed methods. PMID:24968363

  14. Guidelines for identifying suspect/counterfeit material

    SciTech Connect

    1995-09-01

    These guidelines are intended to assist users of products in identifying: substandard, misrepresented, or fraudulently marked items. The guidelines provide information about such topics as: precautions, inspection and testing, dispositioning identified items, installed inspection and reporting suspect/counterfeit materials. These guidelines apply to users who are developing procurement documents, product acceptance/verification methods, company procedures, work instructions, etc. The intent of these SM guidelines in relation to the Quality Assurance Program Description (QAPD) and implementing company Management Control Procedures is not to substitute or replace existing requirements, as defined in either the QAPD or company implementing instructions (Management Control Procedures). Instead, the guidelines are intended to provide a consolidated source of information addressing the issue of Suspect/Counterfeit materials. These guidelines provide an extensive suspect component listing and suspect indications listing. Users can quickly check their suspect items against the list of manufacturers products (i.e., type, LD. number, and nameplate information) by consulting either of these listings.

  15. 78 FR 18562 - Economic and Environmental Principles and Guidelines for Water and Related Land Resources...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-27

    ... QUALITY Economic and Environmental Principles and Guidelines for Water and Related Land Resources... Quality. ACTION: Draft guidelines with request for comments. SUMMARY: Section 2031 of the Water Resources... Environmental Principles and Guidelines for Water and Related Land Resources Implementation...

  16. Design and Implementation of a Fast Imaging System for Detection of Optical Lattices

    NASA Astrophysics Data System (ADS)

    Gillette, Matthew; Hachtel, Andrew; Clements, Ethan; Zhong, Shan; Ducay, Ray; Bali, Samir

    2014-05-01

    A home built system for imaging optical lattices is presented. Our imaging system uses a repurposed astronomy camera- the complete system costs less than 5000 while rivaling the performance of a commercially available system which costs 40-50000. The camera must have an extremely low dark current, high quantum efficiency, as well as the ability to take precisely timed millisecond exposures. Using LabVIEW a sequence of precise electronic pulses is created to control the laser beams in order to load the lattice structure with cold atoms. When running a LabVIEW VI at millisecond timescales Windows introduces inaccuracies in pulse timing. A master slave computer setup, called a real time target (RTT) is created in order to increase this accuracy to the microsecond level. We gratefully acknowledge support from the Petroleum Research Fund and Miami University. We acknowledge invaluable help from the Miami University Instrumentation Lab.

  17. Implementation of intensity ratio change and line-of-sight rate change algorithms for imaging infrared trackers

    NASA Astrophysics Data System (ADS)

    Viau, C. R.

    2012-06-01

    The use of the intensity change and line-of-sight (LOS) change concepts have previously been documented in the open-literature as techniques used by non-imaging infrared (IR) seekers to reject expendable IR countermeasures (IRCM). The purpose of this project was to implement IR counter-countermeasure (IRCCM) algorithms based on target intensity and kinematic behavior for a generic imaging IR (IIR) seeker model with the underlying goal of obtaining a better understanding of how expendable IRCM can be used to defeat the latest generation of seekers. The report describes the Intensity Ratio Change (IRC) and LOS Rate Change (LRC) discrimination techniques. The algorithms and the seeker model are implemented in a physics-based simulation product called Tactical Engagement Simulation Software (TESS™). TESS is developed in the MATLAB®/Simulink® environment and is a suite of RF/IR missile software simulators used to evaluate and analyze the effectiveness of countermeasures against various classes of guided threats. The investigation evaluates the algorithm and tests their robustness by presenting the results of batch simulation runs of surface-to-air (SAM) and air-to-air (AAM) IIR missiles engaging a non-maneuvering target platform equipped with expendable IRCM as self-protection. The report discusses how varying critical parameters such track memory time, ratio thresholds and hold time can influence the outcome of an engagement.

  18. Implementation of image-guided brachytherapy (IGBT) for patients with uterine cervix cancer: a tumor volume kinetics approach

    PubMed Central

    Mendez, Lucas Castro; Stuart, Silvia Radwanski; Guimarães, Roger Guilherme Rodrigues; Ramos, Clarissa Cerchi Angotti; de Paula, Lucas Assad; de Sales, Camila Pessoa; Chen, André Tsin Chih; Blasbalg, Roberto; Baroni, Ronaldo Hueb

    2016-01-01

    Purpose To evaluate tumor shrinking kinetics in order to implement image-guided brachytherapy (IGBT) for the treatment of patients with cervix cancer. Material and methods This study has prospectively evaluated tumor shrinking kinetics of thirteen patients with uterine cervix cancer treated with combined chemoradiation. Four high dose rate brachytherapy fractions were delivered during the course of pelvic external beam radiation therapy (EBRT). Magnetic resonance imaging (MRI) exams were acquired at diagnosis (D), first (B1), and third (B3) brachytherapy fractions. Target volumes (GTV and HR-CTV) were calculated by both the ellipsoid formula (VE) and MRI contouring (VC), which were defined by a consensus between at least two radiation oncologists and a pelvic expert radiologist. Results Most enrolled patients had squamous cell carcinoma and FIGO stage IIB disease, and initiated brachytherapy after the third week of pelvic external beam radiation. Gross tumor volume volume reduction from diagnostic MRI to B1 represented 61.9% and 75.2% of the initial volume, when measured by VE and VC, respectively. Only a modest volume reduction (15-20%) was observed from B1 to B3. Conclusions The most expressive tumor shrinking occurred in the first three weeks of oncological treatment and was in accordance with gynecological examination. These findings may help in IGBT implementation. PMID:27648083

  19. Implementation of image-guided brachytherapy (IGBT) for patients with uterine cervix cancer: a tumor volume kinetics approach

    PubMed Central

    Mendez, Lucas Castro; Stuart, Silvia Radwanski; Guimarães, Roger Guilherme Rodrigues; Ramos, Clarissa Cerchi Angotti; de Paula, Lucas Assad; de Sales, Camila Pessoa; Chen, André Tsin Chih; Blasbalg, Roberto; Baroni, Ronaldo Hueb

    2016-01-01

    Purpose To evaluate tumor shrinking kinetics in order to implement image-guided brachytherapy (IGBT) for the treatment of patients with cervix cancer. Material and methods This study has prospectively evaluated tumor shrinking kinetics of thirteen patients with uterine cervix cancer treated with combined chemoradiation. Four high dose rate brachytherapy fractions were delivered during the course of pelvic external beam radiation therapy (EBRT). Magnetic resonance imaging (MRI) exams were acquired at diagnosis (D), first (B1), and third (B3) brachytherapy fractions. Target volumes (GTV and HR-CTV) were calculated by both the ellipsoid formula (VE) and MRI contouring (VC), which were defined by a consensus between at least two radiation oncologists and a pelvic expert radiologist. Results Most enrolled patients had squamous cell carcinoma and FIGO stage IIB disease, and initiated brachytherapy after the third week of pelvic external beam radiation. Gross tumor volume volume reduction from diagnostic MRI to B1 represented 61.9% and 75.2% of the initial volume, when measured by VE and VC, respectively. Only a modest volume reduction (15-20%) was observed from B1 to B3. Conclusions The most expressive tumor shrinking occurred in the first three weeks of oncological treatment and was in accordance with gynecological examination. These findings may help in IGBT implementation.

  20. Commodity cluster and hardware-based massively parallel implementations of hyperspectral imaging algorithms

    NASA Astrophysics Data System (ADS)

    Plaza, Antonio; Chang, Chein-I.; Plaza, Javier; Valencia, David

    2006-05-01

    The incorporation of hyperspectral sensors aboard airborne/satellite platforms is currently producing a nearly continual stream of multidimensional image data, and this high data volume has soon introduced new processing challenges. The price paid for the wealth spatial and spectral information available from hyperspectral sensors is the enormous amounts of data that they generate. Several applications exist, however, where having the desired information calculated quickly enough for practical use is highly desirable. High computing performance of algorithm analysis is particularly important in homeland defense and security applications, in which swift decisions often involve detection of (sub-pixel) military targets (including hostile weaponry, camouflage, concealment, and decoys) or chemical/biological agents. In order to speed-up computational performance of hyperspectral imaging algorithms, this paper develops several fast parallel data processing techniques. Techniques include four classes of algorithms: (1) unsupervised classification, (2) spectral unmixing, and (3) automatic target recognition, and (4) onboard data compression. A massively parallel Beowulf cluster (Thunderhead) at NASA's Goddard Space Flight Center in Maryland is used to measure parallel performance of the proposed algorithms. In order to explore the viability of developing onboard, real-time hyperspectral data compression algorithms, a Xilinx Virtex-II field programmable gate array (FPGA) is also used in experiments. Our quantitative and comparative assessment of parallel techniques and strategies may help image analysts in selection of parallel hyperspectral algorithms for specific applications.