Recent advances in COPD disease management with fixed-dose long-acting combination therapies.

PubMed

Bateman, Eric D; Mahler, Donald A; Vogelmeier, Claus F; Wedzicha, Jadwiga A; Patalano, Francesco; Banerji, Donald

2014-06-01

Combinations of two long-acting bronchodilators and long-acting bronchodilators with inhaled corticosteroids (ICS) are recommended therapies in the management of chronic obstructive pulmonary disease (COPD). Three fixed-dose combination products have recently been approved for the treatment of COPD (the long-acting β2-agonist plus long-acting muscarinic antagonist [LABA/LAMA] combinations glycopyrronium/indacaterol [QVA149] and umeclidinium/vilanterol, and the LABA/ICS fluticasone furoate/vilanterol), with others currently in late-stage development. LABA/LAMA and LABA/ICS combination therapies demonstrate positive effects on both lung function and patient-reported outcomes, with significant improvements observed with LABA/LAMA combinations compared with placebo, each component alone and other comparators in current use. No new safety concerns have been observed with combinations of long-acting bronchodilators. Combinations of two long-acting bronchodilators represent a new and convenient treatment option in COPD. This review summarizes published efficacy and safety data from clinical trials of both LABA/LAMA and novel LABA/ICS combinations in patients with COPD.

Beyond lung function in COPD management: effectiveness of LABA/LAMA combination therapy on patient-centred outcomes.

PubMed

van der Molen, Thys; Cazzola, Mario

2012-03-01

Bronchodilators are central to the management of chronic obstructive pulmonary disease (COPD). Clinical studies combining different classes of bronchodilators, in particular a long-acting muscarinic antagonist (LAMA) and a long-acting β2-agonist (LABA), have demonstrated greater improvements in lung function (forced expiratory volume in 1 second, FEV1) in patients with COPD than monotherapy. FEV1 has served as an important diagnostic measurement of COPD, and the majority of clinical studies of currently available pharmacotherapies grade effectiveness of treatment regimens based on improvements in FEV1. However, FEV1 alone may not adequately reflect the overall health status of the patient. Published evidence suggests that LABA/LAMA combination therapies demonstrate greater improvements in patient-centred outcomes such as dyspnoea, symptoms, rescue medication use, and quality of life than individual drugs used alone. Evaluating patient-centred outcomes associated with COPD is likely to play an important role in future research as a measure of overall treatment effectiveness. Raising awareness of the importance of outcomes beyond lung function alone, particularly in primary care where most patients initially present themselves for medical evaluation, should form a fundamental part of a more holistic approach to COPD management.

Safety of Adding Salmeterol to Fluticasone Propionate in Children with Asthma.

PubMed

Stempel, David A; Szefler, Stanley J; Pedersen, Søren; Zeiger, Robert S; Yeakey, Anne M; Lee, Laurie A; Liu, Andrew H; Mitchell, Herman; Kral, Kenneth M; Raphiou, Ibrahim H; Prillaman, Barbara A; Buaron, Kathleen S; Yun Kirby, Suyong; Pascoe, Steven J

2016-09-01

Long-acting beta-agonists (LABAs) have been shown to increase the risk of asthma-related death among adults and the risk of asthma-related hospitalization among children. It is unknown whether the concomitant use of inhaled glucocorticoids with LABAs mitigates those risks. This trial prospectively evaluated the safety of the LABA salmeterol, added to fluticasone propionate, in a fixed-dose combination in children. We randomly assigned, in a 1:1 ratio, children 4 to 11 years of age who required daily asthma medications and had a history of asthma exacerbations in the previous year to receive fluticasone propionate plus salmeterol or fluticasone alone for 26 weeks. The primary safety end point was the first serious asthma-related event (death, endotracheal intubation, or hospitalization), as assessed in a time-to-event analysis. The statistical design specified that noninferiority would be shown if the upper boundary of the 95% confidence interval of the hazard ratio for the primary safety end point was less than 2.675. The main efficacy end point was the first severe asthma exacerbation that led to treatment with systemic glucocorticoids, as assessed in a time-to-event analysis. Among the 6208 patients, 27 patients in the fluticasone-salmeterol group and 21 in the fluticasone-alone group had a serious asthma-related event (all were hospitalizations); the hazard ratio with fluticasone-salmeterol versus fluticasone alone was 1.28 (95% confidence interval [CI], 0.73 to 2.27), which showed the noninferiority of fluticasone-salmeterol (P=0.006). A total of 265 patients (8.5%) in the fluticasone-salmeterol group and 309 (10.0%) in the fluticasone-alone group had a severe asthma exacerbation (hazard ratio, 0.86; 95% CI, 0.73 to 1.01). In this trial involving children with asthma, salmeterol in a fixed-dose combination with fluticasone was associated with the risk of a serious asthma-related event that was similar to the risk with fluticasone alone. (Funded by Glaxo

'Laba' garlic processed by dense phase carbon dioxide: the relation between green colour generation and cellular structure, alliin consumption and alliinase activity.

PubMed

Tao, Dandan; Zhou, Bing; Zhang, Luyao; Hu, Xiaosong; Liao, Xiaojun; Zhang, Yan

2016-07-01

'Laba' garlic is usually processed by soaking garlic in vinegar for more than 1 week during winter. It is popular for its unique green colour and tasty flavour. Greening is desirable and required for this product as its characteristic. Dense phase carbon dioxide (DPCD) had a significant effect on the greening of intact garlic (Allium sativum L.) cloves. The relation between green colour generation and alliin consumption, alliinase activity and the cellular structure of garlic, respectively, were investigated in this work. The effects of treatment time, pressure and temperature of DPCD were also analysed and discussed. DPCD had a significant effect on the cellular structure of garlic cells. Garlic protoplast underwent greater morphological change after DPCD treatments at higher temperatures while the amount of precipitate increased with greater treatment time and temperature. Common trends on garlic greening and alliin consumption were observed except for DPCD treatment at 10 MPa and 65 °C. The alliinase activity decreased with increasing treatment time, pressure and temperature. It reached the lowest level at 13 MPa and 55 °C. The formation of the green colour was a comprehensive result of DPCD on changing cellular structure, alliin consumption and alliinase activity. DPCD treatment at 10 MPa and 55 °C was the optimum condition for the greening of 'Laba' garlic. This work further facilitated the application of DPCD in the industrial production of 'Laba' garlic. © 2015 Society of Chemical Industry. © 2015 Society of Chemical Industry.

Is higher population-level use of ICS/LABA combination associated with better asthma outcomes? Cross-sectional surveys of nationally representative populations in New Zealand and Australia.

PubMed

Reddel, Helen K; Beckert, Lutz; Moran, Angela; Ingham, Tristram; Ampon, Rosario D; Peters, Matthew J; Sawyer, Susan M

2017-11-01

New Zealand (NZ) and Australia (AU) have similarly high asthma prevalence; both have universal public health systems, but different criteria for subsidized medicines. We explored differences in asthma management and asthma-related outcomes between these countries. A web-based survey was administered in AU (2012) and NZ (2013) to individuals aged ≥16 years with current asthma, drawn randomly from web-based panels, stratified by national population proportions. Symptom control was assessed with the Asthma Control Test (ACT). Healthcare utilization was assessed from reported urgent doctor/hospital visits in the previous year. NZ (n = 537) and Australian (n = 2686) participants had similar age and gender distribution. More NZ than Australian participants used inhaled corticosteroid (ICS)-containing medication (68.8% vs 60.9%; P = 0.006) but ICS/long-acting β 2 -agonist (LABA) constituted 44.4% of NZ and 81.5% of Australian total ICS use (P < 0.0001). Adherence was higher with ICS/LABA than ICS-alone (P < 0.0001), and higher in NZ than in AU (P < 0.0001). ACT scores were similar (P = 0.41), with symptoms well controlled in 58.6% and 54.4% participants, respectively. More NZ participants reported non-urgent asthma reviews (56.6% vs 50.4%; P = 0.009). Similar proportions had urgent asthma visits (27.9% and 28.6%, respectively, P = 0.75). This comparison, which included the first nationally representative data for asthma control in NZ, showed that poorly controlled asthma is common in both NZ and AU, despite subsidized ICS-containing medications. The greater use of ICS-alone in NZ relative to ICS/LABA does not appear to have compromised population-level asthma outcomes, perhaps due to better adherence in NZ. Different ICS/LABA subsidy criteria and different patient copayments may also have contributed to these findings. © 2017 Asian Pacific Society of Respirology.

Effect of RareGenetic Variants in the β2 Adrenergic Receptor Geneon the Risk for Exacerbations and Symptom Control During Long-Acting Beta Agonist Treatment in a Multi-Ethnic Asthma Population

PubMed Central

Ortega, Victor E.; Hawkins, Gregory A.; Moore, Wendy C.; Hastie, Annette T.; Ampleford, Elizabeth J.; Busse, William W.; Castro, Mario; Chardon, Domingo; Erzurum, Serpil C.; Israel, Elliot; Montealegre, Federico; Wenzel, Sally E.; Peters, Stephen P.; Meyers, Deborah A.; Bleecker, Eugene R.

2014-01-01

Background Severe adverse life-threatening events associated with long-acting beta agonists (LABA) use have caused the FDA to review LABA safety which has resulted in a boxed warning and a mandatory LABA safety study in 46,800 asthmatics. Identification of an at-risk, susceptible subpopulation using predictive biomarkers is critical in understanding LABA safety. The β2-adrenergic receptor gene (ADRB2) contains a common, nonsynonymous single nucleotide polymorphism, Gly16Arg, that is unlikely to account for rare, life-threatening events. We hypothesize that rare ADRB2 variants with strong effects modulate therapeutic responses to long-acting beta agonist (LABA) therapy and contribute to rare, severe adverse events. Methods ADRB2 was sequenced in 197 African Americans, 191 non-Hispanic Whites, and 73 Puerto Ricans. Sequencing identified six rare variants which were genotyped in 1,165 asthmatics (total=1,626). The primary hypothesis was that severe asthma exacerbations requiring hospitalization were associated with rare ADRB2 variants. Replication was performed in 659 non-Hispanic White asthma subjects. Findings Asthmatics receiving LABA with a rare variant had increased asthma-related hospitalizations (meta-analysis for all ethnic groups: p=2·83 × 10−4), specifically LABA-treated non-Hispanic Whites with the rare Ile164 allele (only rare variant in Whites, OR4·48, 95% CI 1·40–14·0, p=0·01) and African Americans with a 25 base-pair promoter polynucleotide insertion (OR 13·43, 95% CI 2·02–265·4, p=0·006). The subset of non-Hispanic Whites and African Americans receiving LABAs with these rare variants had increased exacerbations requiring urgent outpatient healthcare visits (non-Hispanic Whites with or without the rare Ile164 allele: 2·6 visits versus 1·1 visits, p=8·4 × 10−7 and African Americans with or without the rare insertion: 3·7 visits versus 2·4 visits, 0·01), and more frequently were treated with chronic systemic corticosteroids (OR4�

Impact of Nonadherence to Inhaled Corticosteroid/LABA Therapy on COPD Exacerbation Rates and Healthcare Costs in a Commercially Insured US Population

PubMed Central

Davis, Jill R.; Wu, Bingcao; Kern, David M.; Tunceli, Ozgur; Fox, Kathleen M.; Horton, John; Legg, Randall F.; Trudo, Frank

2017-01-01

Background Evidence of poor patient adherence to medications for chronic obstructive pulmonary disease (COPD) is well-documented, but its impact on disease exacerbation rates and associated healthcare costs remains unclear. Objective To assess the association between adherence levels to different inhaled corticosteroid/long-acting ß2-adrenergic agonist (LABA) and COPD exacerbation rates and costs in a commercially insured population. Methods In this observational cohort study, patients with COPD (aged ≥40 years) who were treatment-naïve to inhaled corticosteroid/LABA and were initiating budesonide plus formoterol or fluticasone plus salmeterol between March 1, 2009, and January 31, 2014, were identified in a national representative claims database and were followed for up to 12 months. The date of the first prescription fill for either drug was defined as the index date. Patients were divided into 4 cohorts based on adherence to the index therapy, which was measured by proportion of days covered (PDC); the cohorts were classified as adherent (PDC ≥0.8), mildly nonadherent (0.5 ≤ PDC <0.8), moderately nonadherent (0.3 ≤ PDC <0.5), and highly nonadherent (PDC <0.3). Each nonadherent group was matched in a 1:1 ratio to the adherent group independently, based on prognostically important variables, using propensity score analyses. Exacerbation rates and healthcare costs were analyzed for 1 year after treatment initiation. Results During the study period, 13,657 eligible patients with COPD initiated inhaled corticosteroid/LABA; of these, only 1898 (13.9%) patients were adherent during follow-up. Group matching resulted in 1572 patients per group for comparison 1 (adherent vs mildly nonadherent), 1604 patients for comparison 2 (adherent vs moderately nonadherent), and 1755 patients for comparison 3 (adherent vs highly nonadherent). The moderately and highly nonadherent cohorts had higher exacerbation rates than the adherent patients (comparison 2: rate ratio [RR

Mechanism of the greening color formation of "laba" garlic, a traditional homemade chinese food product.

PubMed

Bai, Bing; Chen, Fang; Wang, Zhengfu; Liao, Xiaojun; Zhao, Guanghua; Hu, Xiaosong

2005-09-07

While green discoloration during garlic processing is of a major concern, this greening is desirable and required for the traditional homemade Chinese "Laba" garlic. To obtain insights into the mechanism of color formation, simulation of the greening of "Laba" garlic was carried out in the laboratory by soaking aged garlic in 5% (v/v, pH 2.33) acetic acid solution. After 2 days, the garlic cloves turned green. Up to 4 days, pigment(s) diffused from garlic cloves to the pickling solution. The solution exhibits two maximal absorbances at approximately 440 and approximately 590 nm, corresponding to yellow and blue species, respectively, the combination of which creates the green coloration. With increasing time from 4 to 25 days, the concentration of both yellow and blue species increases at nearly the same rate, while after 25 days, the concentration of the yellow species increases faster than that of the blue species. Interestingly, most thiosulfinates ( approximately 85%) in garlic cloves were converted within 4 days, suggesting that thiosulfinate conversion is proportional to the formation of the pigments. Consistent with this conclusion, alliinase and acetic acid were required for the color formation. UV-vis spectral measurements and pH results suggest that the color formation occurs by two kinds of processes: one enzymatic and the other nonenzymatic. Low pH (2.0-3.0) favors nonenzymatic reactions, while high pH (6.0 or above) is conducive to enzymatic reactions. Thus, the ideal pH for the entire process of garlic greening is between 4.0 and 5.0, which is a compromise of the optimal pH of both the enzymatic and nonenzymatic reactions.

42 CFR 3.544 - Post hearing briefs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ORGANIZATIONS AND PATIENT SAFETY WORK PRODUCT Enforcement Program § 3.544 Post hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief... 42 Public Health 1 2010-10-01 2010-10-01 false Post hearing briefs. 3.544 Section 3.544 Public...

42 CFR 3.544 - Post hearing briefs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... ORGANIZATIONS AND PATIENT SAFETY WORK PRODUCT Enforcement Program § 3.544 Post hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief... 42 Public Health 1 2014-10-01 2014-10-01 false Post hearing briefs. 3.544 Section 3.544 Public...

42 CFR 3.544 - Post hearing briefs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... ORGANIZATIONS AND PATIENT SAFETY WORK PRODUCT Enforcement Program § 3.544 Post hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief... 42 Public Health 1 2012-10-01 2012-10-01 false Post hearing briefs. 3.544 Section 3.544 Public...

42 CFR 3.544 - Post hearing briefs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... ORGANIZATIONS AND PATIENT SAFETY WORK PRODUCT Enforcement Program § 3.544 Post hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief... 42 Public Health 1 2011-10-01 2011-10-01 false Post hearing briefs. 3.544 Section 3.544 Public...

42 CFR 3.544 - Post hearing briefs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... ORGANIZATIONS AND PATIENT SAFETY WORK PRODUCT Enforcement Program § 3.544 Post hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief... 42 Public Health 1 2013-10-01 2013-10-01 false Post hearing briefs. 3.544 Section 3.544 Public...

Efficacy and safety of the CRTh2 antagonist AZD1981 as add-on therapy to inhaled corticosteroids and long-acting β2-agonists in patients with atopic asthma.

PubMed

Bateman, Eric D; O'Brien, Christopher; Rugman, Paul; Luke, Sally; Ivanov, Stefan; Uddin, Mohib

2018-01-01

To evaluate the efficacy and safety of AZD1981, a potent, specific antagonist of the CRTh2 receptor, as add-on therapy to inhaled corticosteroids (ICS) and long-acting β 2 -agonists (LABA), in patients with persistent asthma with an allergic component. In this placebo-controlled, parallel-group Phase IIb study, patients with persistent atopic asthma on ICS and LABA were randomized to receive 12 weeks of treatment with placebo or AZD1981 (80 mg daily, 200 mg daily, and 10 mg, 40 mg, 100 mg, or 400 mg twice daily [BID]). The primary end point was the mean change from baseline in predose, prebronchodilator forced expiratory volume in 1 second (FEV 1 ) averaged over weeks 2, 4, 8, and 12 in the AZD1981-treatment group vs the placebo group. Secondary end points included other measures of lung function, symptoms, and asthma control, as well as standard measures of safety. In total, 1,140 patients (99.7%) received study treatment. There were improvements in the primary end point across all treatment groups over 12 weeks of treatment. However, the improvement for the highest AZD1981 dose (400 mg BID) vs placebo was not statistically significant (0.02 L, P =0.58), preventing interpretation of statistical testing for the lower doses. AZD1981 was well tolerated, and the incidence of adverse events was comparable across placebo and treatment groups. In patients with allergic asthma receiving ICS and LABA therapy, the addition of AZD1981 at doses up to 400 mg BID failed to produce a clinically relevant improvement in lung function or any other measured end point, but appeared to have an acceptable safety profile. This clinical study is registered with ClinicalTrials.gov (NCT01197794).

Using long-acting beta2-agonists safely: What will be the impact of the US Food and Drug Administration's panel recommendations?

PubMed

Smart, Brian A

2009-01-01

The US Food and Drug Administration (FDA) has launched an investigation into the safety of long-acting beta(2)-agonists (LABAs). While the impact of this investigation is yet to be seen, clinicians should be circumspect in the use of these agents and prescribe them according to the recommendations of current asthma guidelines, informing patients and their caretakers about potential risks. As clinical trials attempt to address the question of whether LABAs are safe for use in pediatric and adult populations, current data provide no clear answers. A special hearing of the FDA's Pulmonary-Allergy Drugs Advisory Committee, Drug Safety and Risk Management Advisory Committee, and Pediatric Advisory Committee attempted to seek consensus on the matter as it reviewed the results of controlled clinical trials and conducted a benefit:risk assessment of LABAs to make recommendations on their safety.

Recent developments: Industry briefs

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

NONE

1990-09-01

Recent nuclear industry briefs are presented. These briefs include: Bechtel, Westinghouse and consumers form joint venture to operate Palisades; British Goverment to sell PowerGen in public offering; NPT conference opens in Geneva; Soviets buy US computers for nuclear safety; Cameco completes sale of interest in Rabbit Lake; Ebasco and CEGA each win defense reactor contract; East German utility takeover settled; Rio Algom shuts down Quirke and Panel early; and General Atomics buys Beverly mine.

Selling safety: the use of celebrities in improving awareness of safety in commercial aviation.

PubMed

Molesworth, Brett R C; Seneviratne, Dimuth; Burgess, Marion

2016-07-01

The aim of this study was to investigate the influential power of a celebrity to convey key safety messages in commercial aviation using a pre-flight safety briefing video. In addition, the present research sought to examine the effectiveness of subtitles in aiding the recall of these important messages as well as how in-cabin aircraft noise affects recall of this information. A total of 101 participants were randomly divided into four groups (no noise without subtitles, no noise with subtitles, noise without subtitles and noise with subtitles) and following exposure to a pre-recorded pre-flight safety briefing video were tested for recall of key safety messages within that video. Participants who recognised and recalled the name of the celebrity in the safety briefing video recalled significantly more of the messages than participants who did not recognise the celebrity. Subtitles were also found to be effective, however, only in the presence of representative in-cabin aircraft noise. Practitioner Summary: Passenger attention to pre-flight safety briefings on commercial aircraft is poor. Utilising the celebrity status of a famous person may overcome this problem. Results suggest that celebrities do increase the recall of safety-related information.

The impact of dual bronchodilation on cardiovascular serious adverse events and mortality in COPD: a quantitative synthesis

PubMed Central

Rogliani, Paola; Matera, Maria Gabriella; Ora, Josuel; Cazzola, Mario; Calzetta, Luigino

2017-01-01

Objective Long-acting β2-agonists (LABAs) and long-acting muscarinic antagonists (LAMAs) are burdened by the potential risk of inducing cardiovascular serious adverse events (SAEs) in COPD patients. Since the risk of combining a LABA with a LAMA could be greater, we have carried out a quantitative synthesis to investigate the cardiovascular safety profile of LABA/LAMA fixed-dose combinations (FDCs). Methods A pair-wise and network meta-analysis was performed by using the data of the repository database ClinicalTrials.gov concerning the impact of approved LABA/LAMA FDCs versus monocomponents and/or placebo on cardiovascular SAEs in COPD. Results Overall, LABA/LAMA FDCs did not significantly (P>0.05) modulate the risk of cardiovascular SAEs versus monocomponents. However, the network meta-analysis indicated that aclidinium/formoterol 400/12 µg and tiotropium/olodaterol 5/5 µg were the safest FDCs, followed by umeclidinium/vilanterol 62.5/25 µg which was as safe as placebo, whereas glycopyrronium/formoterol 14.9/9.6, glycopyrronium/indacaterol 15.6/27.5 µg, and glycopyrronium/indacaterol 50/110 µg were the least safe FDCs. No impact on mortality was detected for each specific FDC. Conclusion This meta-analysis indicates that LABA/LAMA FDC therapy is characterized by an excellent cardiovascular safety profile in COPD patients. However, the findings of this quantitative synthesis have been obtained from populations that participated in randomized clinical trials, and were devoid of major cardiovascular diseases. Thus, post-marketing surveillance and observational studies may help to better define the real impact of specific FDCs with regard to the cardiovascular risk. PMID:29255354

Is aclidinium alone or combined with a LABA a rational choice for symptomatic COPD patients?

PubMed

Blasi, F; Canonica, G W; Miravitlles, M

2017-01-18

As emphasized by international recommendations and largely confirmed by clinical experience, long-acting bronchodilators play a central role in the maintenance treatment of chronic obstructive pulmonary disease (COPD) due to their proven efficacy in reducing airflow obstruction and improving symptoms. There are some important aspects to define with regard to inhalation therapy for COPD, particularly those concerning the selection criteria and the optimal use of long-acting bronchodilators. First of all, it needs to be determined in which patients and clinical situations monotherapy with one bronchodilator, such as a long-acting muscarinic antagonist (LAMA), should be considered adequate, and in which cases the use of combination therapies, such as the "double bronchodilation" with a LAMA and a long-acting β2-agonist (LABA), should be preferred. Another critical issue concerns the effect of the frequency of daily administration of inhaled agents on the control of symptoms during the 24 h. COPD symptoms are known to exhibit considerable circadian variability with worsening in the early morning, and a significant proportion of patients have disease-related sleep disorders which can adversely affect their quality of life. The worsening of symptoms in the early morning may be due, at least in part, to a reduction in airway caliber caused by an increased "cholinergic tone" at night. As such, the coverage of nighttime and early morning symptoms is a reasonable therapeutic goal, which can be achieved by many patients using LAMAs such as aclidinium bromide twice daily (BID). Therapeutic adherence is known to be a multifactorial phenomenon that is frequently affected by other aspects than dosing frequency, including the technical features and ease of use of the inhalers. To this end, it should be mentioned that certain new-generation inhalers such as Genuair® have been associated in clinical trials with higher patient preference. In this work, in addition to presenting an

The relationship between combination inhaled corticosteroid and long-acting beta-agonist use and severe asthma exacerbations in a diverse population

PubMed Central

Wells, Karen E.; Peterson, Edward L.; Ahmedani, Brian K.; Severson, Richard K.; Gleason-Comstock, Julie; Williams, L. Keoki

2012-01-01

Background Safety concerns surround the use of long-acting beta agonists (LABA) for the treatment of asthma, even in combination with inhaled corticosteroids (ICS) and particularly in high-risk subgroups. Objective To estimate the effect ICS therapy and fixed-dose ICS/LABA combination therapy on severe asthma exacerbations in a racially diverse population. Methods Inhaled corticosteroid and ICS/LABA exposure was estimated from pharmacy data for patients with asthma age 12 to 56 years who were members of a large health maintenance organization. Inhaled corticosteroid and ICS/LABA use was estimated for each day of follow-up to create a moving window of exposure. Proportional hazard models were used to assess the relationship between ICS and ICS/LABA combination therapy and severe asthma exacerbations (i.e., use of oral corticosteroids, asthma-related emergency department visit, or asthma-related hospitalization). Results Among the 1,828 patients who met the inclusion criteria, 37% were African American, 46% were treated with ICS therapy alone, and 54% were treated with an ICS/LABA combination. Models assessing the risk of severe asthma exacerbations among individuals using ICS treatment alone and ICS/LABA combination therapy suggested that the overall protective effect was as good or better for ICS/LABA combination therapy when compared with ICS treatment alone (hazard ratio [HR]=0.65 vs. HR=0.72, respectively). Analyses in several subgroups, including African American patients, showed a similar statistically significant protective association for combination therapy. Conclusion Treatment with ICS/LABA fixed combination therapy appeared to perform as well or better than ICS alone in reducing severe asthma exacerbations; this included multiple high-risk subgroups. PMID:22281166

The 2009 Legislative Briefing

ERIC Educational Resources Information Center

Gaines, Gale F., Comp.

2009-01-01

"The 2009 Legislative Briefing" is a topical summary of actions during the 2009 legislative sessions that affect education in the 16 SREB states. Topics include: state budgets and the economy; tax and revenue; teacher and faculty pay raises; retirement systems; issues affecting teachers and education leaders; health and safety;…

A brief history of inhaled asthma therapy over the last fifty years.

PubMed

Crompton, Graham

2006-12-01

This year is the 50th anniversary of the introduction into clinical use of the first modern inhaler for the management of asthma--the pressurised metered-dose inhaler (pMDI). The pMDI was initially used for the administration of the non-selective beta-agonists adrenaline and isoprenaline. However, the epidemic of asthma deaths which occurred in the 1960s led to these drugs being superseded by the selective short-acting beta-agonist salbutamol, and the first inhaled corticosteroid (ICS) beclomethasone. At the same time, sodium cromoglycate was introduced, to be administered via the first dry-powder inhaler--the Spinhaler--but owing to its relatively weak anti-inflammatory action its use is now very limited. Over the last 10 years, the long-acting beta-agonists (LABAs) have become an important add-on therapy for the management of asthma, and they are now often used with ICS in a single ICS/LABA combination inhaler.

A brief, trauma-informed intervention increases safety behavior and reduces HIV risk for drug-involved women who trade sex.

PubMed

Decker, Michele R; Tomko, Catherine; Wingo, Erin; Sawyer, Anne; Peitzmeier, Sarah; Glass, Nancy; Sherman, Susan G

2017-08-01

Female sex workers (FSWs) are an important population for HIV acquisition and transmission. Their risks are shaped by behavioral, sexual network, and structural level factors. Violence is pervasive and associated with HIV risk behavior and infection, yet interventions to address the dual epidemics of violence and HIV among FSWs are limited. We used participatory methods to develop a brief, trauma-informed intervention, INSPIRE (Integrating Safety Promotion with HIV Risk Reduction), to improve safety and reduce HIV risk for FSWs. A quasi-experimental, single group pretest-posttest study evaluated intervention feasibility, acceptability and efficacy among FSWs in Baltimore, MD, most of whom were drug-involved (baseline n = 60; follow-up n = 39 [65%]; non-differential by demographics or outcomes). Qualitative data collected at follow-up contextualizes findings. Based on community partnership and FSW input, emergent goals included violence-related support, connection with services, and buffering against structural forces that blame FSWs for violence. Qualitative and quantitative results demonstrate feasibility and acceptability. At follow-up, improvements were seen in avoidance of client condom negotiation (p = 0.04), and frequency of sex trade under the influence of drugs or alcohol (p = 0.04). Women's safety behavior increased (p < 0.001). Participants improved knowledge and use of sexual violence support (p < 0.01) and use of intimate partner violence support (p < 0.01). By follow-up, most respondents (68.4%) knew at least one program to obtain assistance reporting violence to police. Over the short follow-up period, client violence increased. In reflecting on intervention acceptability, participants emphasized the value of a safe and supportive space to discuss violence. This brief, trauma-informed intervention was feasible and highly acceptable to FSWs. It prompted safety behavior, mitigated sex trade under the influence, and bolstered confidence in

Efficacy and safety of tiotropium and olodaterol in COPD: a systematic review and meta-analysis.

PubMed

Miravitlles, Marc; Urrutia, Gerard; Mathioudakis, Alexander G; Ancochea, Julio

2017-11-25

Long-acting bronchodilators are the cornerstone of pharmacologic treatment of COPD. The new combination of long-acting muscarinic antagonist (LAMA) tiotropium (TIO) and long acting beta-agonists (LABA) olodaterol (OLO) has been introduced as fist line therapy for COPD. This article analyses the evidence of efficacy and safety of the TIO/OLO combination. A systematic review and metaanalysis of randomized controlled trials (RCT) with a period of treatment of at least 6 weeks, in patients with COPD confirmed by spirometry, comparing combined treatment with TIO/OLO (approved doses only), with any of the mono-components or any other active comparator administered as an inhalator. A total of 10 Randomized controlled trials (RCT) were identified (N = 10,918). TIO/OLO significantly improved trough FEV 1 from baseline to week 12 versus TIO, OLO and LABA/ICS (0.06 L, 0.09 L and between 0.04 and 0.05 L, respectively). TIO/OLO improved transitional dyspnea index (TDI) and St. George's Respiratory Questionnaire (SGRQ) compared with mono-components, with patients more likely to achieve clinically important improvements in TDI (risk ratio [RR]: 1.17, 95% confidence interval [CI]: [1.07, 1.28] versus TIO and RR: 1.14, 95%CI: [1.01, 1.28] versus OLO) and in SGRQ (RR: 1.21, 95%CI: [1.12, 1.30] versus TIO and RR: 1.28, 95%CI: [1.18, 1.40] versus OLO). Patients treated with TIO/OLO showed a significant reduction in the use of rescue medication and no significant differences in frequency of general and serious adverse events were observed between TIO/OLO and mono-components. Treatment with TIO/OLO provided significant improvements in lung function versus mono-components and LABA/ICS with more patients achieving significant improvements in dyspnea and health status. No differences in adverse events were observed compared with other active treatments. PROSPERO register of systematic reviews ( CRD42016040162 ).

Marine Safety Center briefing book

DOT National Transportation Integrated Search

1997-10-30

The U.S. Coast Guard Marine Safety Center was established in 1986 as a consolidation of district Merchant Marine Technical Offices. Our offices are located on the sixth floor of the DOT Headquarters building in Washington, DC. This document provides ...

Safety edge crash modification factors : tech brief.

DOT National Transportation Integrated Search

2016-08-01

The Safety Edge is a relatively low-cost : countermeasure that can be applied : in both asphalt and concrete paving : operations. The Safety Edge has been : promoted as a low-cost countermeasure : to reduce the frequency and severity : of rural roadw...

Better Science Through Safety.

ERIC Educational Resources Information Center

Gerlovich, Jack A.; Downs, Gary E.

Following a brief description of the major components found effective in school safety programs (safety management, education, and services) and data on school accidents in Iowa, this book addresses various aspects of safety related to science instruction, emphasizing that responsibility for safety must be shared by both teacher and students.…

Passengers' perception of the safety demonstration on board an aircraft

NASA Astrophysics Data System (ADS)

Ruenruoy, Ratchada

The cabin safety demonstration on board an aircraft is one of the methods to provide safety information for passengers before aircraft takeoff. However, passengers' enthusiasm toward safety demonstrations is normally low. Therefore, the study of passengers' perception toward safety briefings on board an aircraft is important in increasing the safety awareness for the travelling public on commercial aircraft. A survey was distributed to measure the perceptions of Middle Tennessee State University (MTSU) faculty and staff, Aerospace students, and international students who have traveled in the last year. It was generally found that watching the cabin safety demonstration before aircraft takeoff was believed to be important for passengers. However, the attention to the safety demonstration remained low because the safety briefings were not good enough in terms of clear communication, particularly in the recorded audio demonstration and the live safety demonstration methods of briefing.

NASA's Software Safety Standard

NASA Technical Reports Server (NTRS)

Ramsay, Christopher M.

2005-01-01

NASA (National Aeronautics and Space Administration) relies more and more on software to control, monitor, and verify its safety critical systems, facilities and operations. Since the 1960's there has hardly been a spacecraft (manned or unmanned) launched that did not have a computer on board that provided vital command and control services. Despite this growing dependence on software control and monitoring, there has been no consistent application of software safety practices and methodology to NASA's projects with safety critical software. Led by the NASA Headquarters Office of Safety and Mission Assurance, the NASA Software Safety Standard (STD-18l9.13B) has recently undergone a significant update in an attempt to provide that consistency. This paper will discuss the key features of the new NASA Software Safety Standard. It will start with a brief history of the use and development of software in safety critical applications at NASA. It will then give a brief overview of the NASA Software Working Group and the approach it took to revise the software engineering process across the Agency.

A novel briefing checklist at shift handoff in an emergency department improves situational awareness and safety event identification.

PubMed

Mullan, Paul C; Macias, Charles G; Hsu, Deborah; Alam, Sartaj; Patel, Binita

2015-04-01

Emergency department (ED) shift handoffs are sources of potential medical error, delays in care, and medicolegal liabilities. Few handoff studies exist in the ED literature. We aimed to describe the implementation of a standardized checklist for improving situational awareness during physician handoffs in a pediatric ED. This is a descriptive observational study in a large academic pediatric ED. Checklists were evaluated for rates of use, completion, and identification of potential safety events. We defined a complete checklist as 80% or more of items checked.  A user perception survey was used. After 1 year, all checklist users (residents, fellows, faculty, and charge nurses with ED experience before and after checklist implementation) were anonymously surveyed to assess the checklist's usability, perceived contributions to Institute of Medicine quality domains, and situational awareness. The electronically administered survey used Likert frequency scales. Of 732 handoffs, 98% used the checklist, and 89% were complete. A mean of 1.7 potential safety events were identified per handoff. The most frequent potential safety events were identification of intensive care unit-level patients in the ED (48%), equipment problems (46%), staffing issues (21%), and intensive care unit-level patients in transport (16%). Eighty-one subjects (88%) responded to the survey. The users agreed that the checklist promoted better communication, safety, efficiency, effective care, and situational awareness. The Physician Active Shift Signout in the Emergency Department briefing checklist was used often and at a high completion rate, frequently identifying potential safety events. The users found that it improved the quality of care and team communication. Future studies on outcomes and processes are needed.

Promoting bicycle commuter safety : [research brief].

DOT National Transportation Integrated Search

2012-02-01

A basic premise in this report is that cycling should be encouraged because as the number of cyclists increases, the attention of motorists and safety improves. However, an important caveat is that the number of cyclists has to be commensurate with t...

Safety evaluation of STOP AHEAD pavement markings TechBrief

DOT National Transportation Integrated Search

2008-03-01

The Federal Highway Administration (FHWA) organized 26 States to participate in the FHWA Low-Cost Safety Improvements Pooled Fund Study as part of its strategic highway safety plan support effort. The purpose of the study is to evaluate the safety ef...

Civil helicopter wire strike assessment study. Volume 2: Accident analysis briefs

NASA Technical Reports Server (NTRS)

Tuomela, C. H.; Brennan, M. F.

1980-01-01

A description and analysis of each of the 208 civil helicopter wire strike accidents reported to the National Transportation Safety Board (NTSB) for the ten year period 1970-1979 is given. The accident analysis briefs were based on pilot reports, FAA investigation reports, and such accident photographs as were made available. Briefs were grouped by year and, within year, by NTSB accident report number.

Motorcoach and school bus fire safety analysis : technology brief.

DOT National Transportation Integrated Search

2016-11-01

In 2009, the Federal Motor Carrier Safety Administration (FMCSA) published findings from a study entitled Motorcoach Fire Safety Analysis. The objective of this study was to gather and analyze information regarding the causes, frequency, and se...

Safety Planning Intervention: A Brief Intervention to Mitigate Suicide Risk

ERIC Educational Resources Information Center

Stanley, Barbara; Brown, Gregory K.

2012-01-01

The usual care for suicidal patients who are seen in the emergency department (ED) and other emergency settings is to assess level of risk and refer to the appropriate level of care. Brief psychosocial interventions such as those administered to promote lower alcohol intake or to reduce domestic violence in the ED are not typically employed for…

Safety evaluation of wet-reflective pavement markings : tech brief.

DOT National Transportation Integrated Search

2015-12-01

The Federal Highway Administration (FHWA) organized : 38 States for the FHWA Evaluation of Low-Cost Safety : Improvements Pooled Fund Study as part of its strategic : highway safety plan support effort. The purpose of the : study is to evaluate the s...

Laboratory Safety Manual for Alabama Schools. Bulletin 1975. No. 20.

ERIC Educational Resources Information Center

Alabama State Dept. of Education, Montgomery.

This document presents the Alabama State Department of Education guidelines for science laboratory safety, equipment, storage, chemical safety, rocket safety, electrical safety, safety with radioisotopes, and safety with biologicals. Also included is a brief bibliography, a teacher's checklist, a listing of laser facts and regulations, and a…

Operating room briefings and wrong-site surgery.

PubMed

Makary, Martin A; Mukherjee, Arnab; Sexton, J Bryan; Syin, Dora; Goodrich, Emmanuelle; Hartmann, Emily; Rowen, Lisa; Behrens, Drew C; Marohn, Michael; Pronovost, Peter J

2007-02-01

Wrong-site surgery can be a catastrophic event for a patient, caregiver, and institution. Although communication breakdowns have been identified as the leading cause of wrong-site surgery, the efficacy of preventive strategies remains unknown. This study evaluated the impact of operating room briefings on coordination of care and risk for wrong-site surgery. We administered a case-based version of the Safety Attitudes Questionnaire (SAQ) to operating room (OR) staff at an academic medical center, before and after initiation of an OR briefing program. Items questioned overall coordination and awareness of the surgical site. Response options ranged from 1 (disagree strongly) to 5 (agree strongly). MANOVA was used to compare caregiver assessments before and after the implementation of briefings, and the percentage of OR staff agreeing or disagreeing with each question was reported. The prebriefing response rate was 85% (306 of 360 respondents), and the postbriefing response rate was 75% (116 of 154). Respondents included surgeons (34.9%), anesthesiologists (14.0%), and nurses (44.4%). Briefings were associated with caregiver perceptions of reduced risk for wrong-site surgery and improved collaboration [F (6,390)=10.15, p < 0.001]. Operating room caregiver assessments of briefing and wrong-site surgery issues improved for 5 of 6 items, eg, "Surgery and anesthesia worked together as a well-coordinated team" (67.9% agreed prebriefing, 91.5% agreed postbriefing, p < 0.0001), and "A preoperative discussion increased my awareness of the surgical site and side being operated on" (52.4% agreed prebriefing, 64.4% agreed postbriefing, p < 0.001). OR briefings significantly reduce perceived risk for wrong-site surgery and improve perceived collaboration among OR personnel.

Inappropriate asthma therapy—a tale of two countries: a parallel population-based cohort study

PubMed Central

Belhassen, Manon; Nibber, Anjan; Van Ganse, Eric; Ryan, Dermot; Langlois, Carole; Appiagyei, Francis; Skinner, Derek; Laforest, Laurent; Soriano, Joan B; Price, David

2016-01-01

Against recurrent controversies around the safety of short- and long-acting β2-agonists (SABA and LABA), and the National Review of Asthma Deaths inquiry in the United Kingdom, we investigated the prevalence of inappropriate therapy in asthma. Our study aimed to determine the prevalence of inappropriate use of asthma therapy in the United Kingdom and in France. Two interval, parallel, population-based cohorts (2007 and 2013) were developed in each country by using the UK OPCRD and the French EGB databases. Patients aged 6–40 years were studied over the 12-month period following inclusion, regarding overuse (⩾12 units) of SABA, use of LABA without inhaled corticosteroids (ICS) and ⩾2-fold higher use of LABA compared with that of ICS. Overall, 39,743 UK and 4,910 French patients were included in 2007, and 14,036 and 5,657 patients, respectively, were included in 2013. UK adults were more frequently exposed to SABA overuse compared with those in France in both periods, with an upward trend in the United Kingdom (P<0.05). In 2013, LABA use without ICS occurred in 0.1% and 1.5% of United Kingdom and French adults, respectively. Unbalanced use of LABA relative to ICS became marginal in both countries in 2013. Inappropriate use of therapy was less marked, but present, in children. Inappropriate therapy remains a common issue in asthma. Based on our figures, it may be estimated that >210,000 British and >190,000 French asthmatics aged 6–40 years were inappropriately treated in 2013. PMID:27735927

Inappropriate asthma therapy-a tale of two countries: a parallel population-based cohort study.

PubMed

Belhassen, Manon; Nibber, Anjan; Van Ganse, Eric; Ryan, Dermot; Langlois, Carole; Appiagyei, Francis; Skinner, Derek; Laforest, Laurent; Soriano, Joan B; Price, David

2016-10-13

Against recurrent controversies around the safety of short- and long-acting β 2 -agonists (SABA and LABA), and the National Review of Asthma Deaths inquiry in the United Kingdom, we investigated the prevalence of inappropriate therapy in asthma. Our study aimed to determine the prevalence of inappropriate use of asthma therapy in the United Kingdom and in France. Two interval, parallel, population-based cohorts (2007 and 2013) were developed in each country by using the UK OPCRD and the French EGB databases. Patients aged 6-40 years were studied over the 12-month period following inclusion, regarding overuse (⩾12 units) of SABA, use of LABA without inhaled corticosteroids (ICS) and ⩾2-fold higher use of LABA compared with that of ICS. Overall, 39,743 UK and 4,910 French patients were included in 2007, and 14,036 and 5,657 patients, respectively, were included in 2013. UK adults were more frequently exposed to SABA overuse compared with those in France in both periods, with an upward trend in the United Kingdom (P<0.05). In 2013, LABA use without ICS occurred in 0.1% and 1.5% of United Kingdom and French adults, respectively. Unbalanced use of LABA relative to ICS became marginal in both countries in 2013. Inappropriate use of therapy was less marked, but present, in children. Inappropriate therapy remains a common issue in asthma. Based on our figures, it may be estimated that >210,000 British and >190,000 French asthmatics aged 6-40 years were inappropriately treated in 2013.

Safety culture and the 5 steps to safer surgery: an intervention study.

PubMed

Hill, M R; Roberts, M J; Alderson, M L; Gale, T C E

2015-06-01

Improvements in safety culture have been postulated as one of the mechanisms underlying the association between the introduction of the World Health Organisation (WHO) Surgical Safety Checklist with perioperative briefings and debriefings, and enhanced patient outcomes. The 5 Steps to Safer Surgery (5SSS) incorporates pre-list briefings, the three steps of the WHO Surgical Safety Checklist (SSC) and post-list debriefings in one framework. We aimed to identify any changes in safety culture associated with the introduction of the 5SSS in orthopaedic operating theatres. We assessed the safety culture in the elective orthopaedic theatres of a large UK teaching hospital before and after introduction of the 5SSS using a modified version of the Safety Attitude Questionnaire - Operating Room (SAQ-OR). Primary outcome measures were pre-post intervention changes in the six safety culture domains of the SAQ-OR. We also analysed changes in responses to two items regarding perioperative briefings. The SAQ-OR survey response rate was 80% (60/75) at baseline and 74% (53/72) one yr later. There were significant improvements in both the reported frequency (P<0.001) and perceived importance (P=0.018) of briefings, and in five of the six safety culture domain scores (Working Conditions, Perceptions of Management, Job Satisfaction, Safety Climate and Teamwork Climate) of the SAQ-OR (P<0.001 in all cases). Scores in the sixth domain (Stress Recognition) decreased significantly (P=0.028). Implementation of the 5SSS was associated with a significant improvement in the safety culture of elective orthopaedic operating theatres. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Safety evaluation of intersection conflict warning systems (ICWS), TechBrief

DOT National Transportation Integrated Search

2016-02-02

The Federal Highway Administration (FHWA) organized 40 States to participate in the FHWA Evaluation of LowCost Safety Improvements Pooled Fund Study (ELCSI-PFS) as part of its strategic highway safety plan support effort. The goal of the ELCSI-PFS re...

Safety evaluation of centerline plus shoulder rumble strips, TechBrief

DOT National Transportation Integrated Search

2015-09-01

The Federal Highway Administration (FHWA) organized 37 States to participate in the FHWA Evaluation of Low-Cost Safety Improvements Pooled Fund Study as part of its strategic highway safety plan support effort. The purpose of the study was to evaluat...

Fluticasone furoate and vilanterol inhalation powder for the treatment of chronic obstructive pulmonary disease.

PubMed

Matera, Maria Gabriella; Capuano, Annalisa; Cazzola, Mario

2015-02-01

Fluticasone furoate/vilanterol (FF/VI) is a novel inhaled corticosteroid/long-acting β₂-agonist (ICS/LABA) fixed dose combination that, by simplifying the dosing schedule, allows, for the first time in a member of the ICS/LABA class, a shift from twice-daily to once-daily treatment. FF/VI is delivered via a novel, single-step activation, multi-dose dry powder inhaler for oral inhalation, Ellipta. Regrettably, there are no head-to-head trials that have shown superiority in the safety or efficacy of FF versus other ICSs, but evidence shows that VI has a quicker onset of effect versus salmeterol. However, the clinical utility of this effect in a maintenance medication is still questionable. Furthermore, benefits of FF/VI over twice-daily ICS/LABA comparator have not been shown yet and, in addition, its adverse event profile is generally consistent with the known class effects of an ICS/LABA fixed dose combination. In particular, there is an increase in the risk of pneumonia among patients treated with FF/VI relative to VI, mainly among those who benefit most from FF/VI. Nevertheless, the interesting pharmacological profiles of both FF and VI, the possibility that FF/VI can be administered once-daily, and the attractive characteristics of Ellipta are important features that could help FF/VI to be a successful combination in the treatment of chronic obstructive pulmonary disease.

[Fixed-dose combination fluticasone propionate/formoterol for the treatment of asthma: a review of its pharmacology, efficacy and tolerability].

PubMed

Quintano Jiménez, J A; Ginel Mendoza, L; Entrenas Costa, L M; Polo García, J

2016-02-01

The fixed-dose combination fluticasone propionate/formoterol (FPF) is a novel combination of a widely known and used inhaled glucocorticoid (IGC) and a long-acting β2-adrenergic agonist (LABA), available for the first time in a single device. This fixed-dose combination of FPF has a demonstrated efficacy and safety profile in clinical trials compared with its individual components and other fixed-dose combinations of IGC/LABA and is indicated for the treatment of persistent asthma in adults and adolescents. FPF is available in a wide range of doses that can adequately cover the therapeutic steps recommended by treatment guidelines, constituting a fixed-dose combination of GCI/LABA that is effective, rapid, well tolerated and with a reasonable acquisition cost. Various assessment agencies of the Spanish Autonomous Communities consider this combination to be an appropriate alternative therapy for asthma in the primary care setting. Copyright © 2016 Elsevier España, S.L.U. y Sociedad Española de Medicina Rural y Generalista (SEMERGEN). All rights reserved.

Spotlight on fluticasone furoate/vilanterol trifenatate for the once-daily treatment of asthma: design, development and place in therapy

PubMed Central

Albertson, Timothy E; Bullick, Samuel W; Schivo, Michael; Sutter, Mark E

2016-01-01

The use of inhaled corticosteroids (ICSs) plays a key role in the treatment of asthmatic patients, and international guidelines have designated ICSs as an early maintenance therapy in controlling asthma symptoms. When asthmatic patients remain symptomatic on ICSs, one common option is to add a long-acting beta2 agonist (LABA) to the maintenance treatment. Fixed combination inhalers that contain both an ICS and a LABA have been popular for both chronic obstructive pulmonary disease (COPD) and asthma. Historically, these inhalers have been dosed twice daily. However, currently, there is a once-daily combination therapy with the ICS fluticasone furoate (FF) and the LABA vilanterol trifenatate (VI) with indications for use in both COPD and asthma. This dry powder inhaler (DPI) comes in two doses of FF (100 or 200 μg) both combined with VI (25 μg). This article reviews the clinical trial data for FF, VI and FF/VI combination inhalers and documents the efficacy and safety of once-daily inhaled maintenance therapy by DPI in asthmatic patients. PMID:28008228

Role of Experience, Leadership and Individual Protection in the Cath Lab--A Multicenter Questionnaire and Workshop on Radiation Safety.

PubMed

Kuon, E; Weitmann, K; Hoffmann, W; Dörr, M; Hummel, A; Busch, M C; Felix, S B; Empen, K

2015-10-01

Radiation exposure in invasive cardiology remains considerable. We evaluated the acceptance of radiation protective devices and the role of operator experience, team leadership, and technical equipment in radiation safety efforts in the clinical routine. Cardiologists (115 from 27 centers) answered a questionnaire and documented radiation parameters for 10 coronary angiographies (CA), before and 3.1 months after a 90-min. mini-course in radiation-reducing techniques. Mini-course participants achieved significant median decreases in patient dose area products (DAP: from 26.6 to 13.0 Gy × cm(2)), number of radiographic frames (-29%) and runs (-8%), radiographic DAP/frame (-2%), fluoroscopic DAP/s (-39%), and fluoroscopy time (-16%). Multilevel analysis revealed lower DAPs with decreasing body mass index (-1.4 Gy × cm(2) per kg/m(2)), age (-1.2 Gy × cm(2)/decade), female sex (-5.9 Gy × cm(2)), participation of the team leader (-9.4 Gy × cm(2)), the mini-course itself (-16.1 Gy × cm(2)), experience (-0.7 Gy × cm(2)/1000 CAs throughout the interventionalist's professional life), and use of older catheterization systems (-6.6 Gy × cm(2)). Lead protection included apron (100%), glass sheet (95%), lengthwise (94%) and crosswise (69%) undercouch sheet, collar (89%), glasses (28%), cover around the patients' thighs (19%), foot switch shield (7%), gloves (3%), and cap (1%). Radiation-protection devices are employed less than optimally in the clinical routine. Cardiologists with a great variety of interventional experience profited from our radiation safety workshop - to an even greater extent if the interventional team leader also participated. Radiation protection devices are employed less than optimally in invasive cardiology. The presented radiation-safety mini-course was highly efficient. Cardiologists at all levels of experience profited from the mini-course - considerably more so if the team leader also took part. Interventional experience was less relevant for

Comparative efficacy of fixed-dose combinations of long-acting muscarinic antagonists and long-acting β2-agonists: a systematic review and network meta-analysis

PubMed Central

Schlueter, Max; Gonzalez-Rojas, N; Baldwin, Michael; Groenke, Lars; Voss, Florian; Reason, Tim

2016-01-01

Background: A number of long-acting muscarinic antagonist (LAMA)/long-acting β2-agonist (LABA) fixed-dose combinations (FDCs) for treatment of moderate-to-very severe chronic obstructive pulmonary disease (COPD) have recently become available, but none have been directly compared in head-to-head randomized controlled trials (RCTs). The purpose of this study was to assess the relative clinical benefit of all currently available LAMA/LABA FDCs using a Bayesian network meta-analysis (NMA). Methods: A systematic literature review identified RCTs investigating the efficacy, safety and quality of life associated with licensed LAMA/LABA FDCs for the treatment of moderate-to-very severe COPD. RCTs were screened for inclusion in the NMA using prespecified eligibility criteria. Data were extracted for outcomes of interest, including change in trough forced expiratory volume in 1 second (tFEV1) from baseline, St. George Respiratory Questionnaire (SGRQ) percentage of responders, Transition Dyspnea Index (TDI) percentage of responders, change in SGRQ score from baseline, change in TDI focal score from baseline, moderate-to-severe exacerbations, all-cause discontinuation, and discontinuation due to adverse events. Results: Following screening, a total of 27 trials from 26 publications with 30,361 subjects were eligible for inclusion in the NMA. Nonsignificant results were seen in most analyses comparing efficacy, exacerbations and discontinuation rates of included LAMA/LABA FDCs (i.e. aclidinium/formoterol 400/12 µg, glycopyrronium/indacaterol 110/50 µg, tiotropium + olodaterol 5/5 µg, umeclidinium/vilanterol 62.5/25 µg). Meta-regression controlling for post-bronchodilator percentage of tFEV1 predicted at baseline as well as meta-regression adjusting for concomitant use of inhaled corticosteroids at baseline was performed to assess the magnitude of effect modification and produced similar results as observed in the base case analysis. Conclusion: All LAMA/LABA FDCs were

Organizational Behavior: A Brief Overview and Safety Orientation.

PubMed

Waller, Mary J

2015-12-01

Organizational Behavior (OB) is a discipline of social science that seeks explanations for human behavior in organizations. OB draws on core disciplines such as psychology, sociology, anthropology, economics, communication, and law to create and investigate multilevel explanations of why people engage in particular behaviors, and which behaviors under which circumstances lead to better outcomes in organizations. Created using an applied or pragmatic lens and tested with a wide range of both quantitative and qualitative methodologies, most OB theories and research have direct implications for managers and for other organizational participants. Not surprisingly, one focal area of OB research concerns safety in organizations, and a growing body of safety-oriented literature in OB is based on data collected during simulation training across a variety of organizations such as hospitals, airlines, nuclear power plants, and other high reliability organizations. Copyright © 2015 Mosby, Inc. All rights reserved.

Brief Classroom Training Sessions for Workplace Readiness: Are They Effective?

ERIC Educational Resources Information Center

Palesy, Debra

2017-01-01

Classroom training sessions for new home care workers (HCWs) are often brief and ad hoc, varying in format and content. Yet the application of this training may be central to worker and client safety. A qualitative approach was adopted for this inquiry, comprising two separate but related practical studies. In the first, exploratory study,…

Integrating Occupational Health and Safety into TAFE Courses: Curriculum Topics.

ERIC Educational Resources Information Center

Hall, Bob; Mageean, Pauline

This guide is designed to help technical and further education (TAFE) curriculum writers in Australia integrate safety education into vocational education courses. It provides a general overview of occupational health and safety from the perspective of TAFE trade training and a brief summary of the major health and safety issues that might be…

Are Small Schools Better? School Size Considerations for Safety & Learning. Policy Brief.

ERIC Educational Resources Information Center

McRobbie, Joan

New studies from the 1990s have strengthened an already notable consensus on school size: smaller is better. This policy brief outlines research findings on why size makes a difference, how small is small enough, effective approaches to downsizing, and key barriers. No agreement exists at present on optimal school size, but research suggests a…

Youth Camp Safety & Health. Suggested State Statute & Regulations.

ERIC Educational Resources Information Center

Center for Disease Control (DHEW/PHS), Atlanta, GA.

To assist state regulatory agencies in development of comprehensive youth camp safety programs, this publication contains a brief suggested statute that could be used for initiation or modification of any state's youth camp safety programs and it outlines minimal regulations. Various categories of camps are covered--day, primitive, residential,…

GSFC Safety and Mission Assurance Organization

NASA Technical Reports Server (NTRS)

Kelly, Michael P.

2010-01-01

This viewgraph presentation reviews NASA Goddard Space Flight Center's approach to safety and mission assurance. The contents include: 1) NASA GSFC Background; 2) Safety and Mission Assurance Directorate; 3) The Role of SMA-D and the Technical Authority; 4) GSFC Mission assurance Requirements; 5) GSFC Systems Review Office (SRO); 6) GSFC Supply Chain Management Program; and 7) GSFC ISO9001/AS9100 Status Brief.

The Problem with Briefs, in Brief

ERIC Educational Resources Information Center

Conaway, Carrie L.

2013-01-01

Policy briefs written by academics--the kind typically published in "Education Finance and Policy"--should be a crucial source of information for policy makers. Yet too frequently these briefs fail to garner the consideration they deserve. Their authors are too focused on the potential objections of their fellow academics, who are…

Quality Control: (Material) Safety Data Sheets.

PubMed

Allen, Loyd V

2017-01-01

Safety Data Sheets (formerly Material Safety Data Sheets) are a system for cataloging information on chemicals, chemical compounds, and chemical mixtures and include instructions for the safe use and potential hazards associated with a particular material or product. At present, there are 16 sections of Safety Data Sheets, and these sections are discussed in this article. Two United States Pharmacopeia compounding-related chapters (<795> and <800>) refer to Safety Data Sheets, and this article provides a brief discussion on the terminology contained within those chapters. Copyright© by International Journal of Pharmaceutical Compounding, Inc.

TeamSTEPPS Improves Operating Room Efficiency and Patient Safety.

PubMed

Weld, Lancaster R; Stringer, Matthew T; Ebertowski, James S; Baumgartner, Timothy S; Kasprenski, Matthew C; Kelley, Jeremy C; Cho, Doug S; Tieva, Erwin A; Novak, Thomas E

2016-09-01

The objective was to evaluate the effect of TeamSTEPPS on operating room efficiency and patient safety. TeamSTEPPS consisted of briefings attended by all health care personnel assigned to the specific operating room to discuss issues unique to each case scheduled for that day. The operative times, on-time start rates, and turnover times of all cases performed by the urology service during the initial year with TeamSTEPPS were compared to the prior year. Patient safety issues identified during postoperative briefings were analyzed. The mean case time was 12.7 minutes less with TeamSTEPPS (P < .001). The on-time first-start rate improved by 21% with TeamSTEPPS (P < .001). The mean room turnover time did not change. Patient safety issues declined from an initial rate of 16% to 6% at midyear and remained stable (P < 0.001). TeamSTEPPS was associated with improved operating room efficiency and diminished patient safety issues in the operating room. © The Author(s) 2015.

Antileukotriene Agents Versus Long-Acting Beta-Agonists in Older Adults with Persistent Asthma: A Comparison of Add-On Therapies.

PubMed

Altawalbeh, Shoroq M; Thorpe, Carolyn T; Zgibor, Janice C; Kane-Gill, Sandra; Kang, Yihuang; Thorpe, Joshua M

2016-08-01

To compare the effectiveness and cardiovascular safety of long-acting beta-agonists (LABAs) with those of leukotriene receptor antagonists (LTRAs) as add-on treatments in older adults with asthma already taking inhaled corticosteroids (ICSs). Retrospective cohort study. Medicare fee-for-service (FFS) claims (2009-10) for a 10% random sample of beneficiaries continuously enrolled in Parts A, B, and D in 2009. Medicare beneficiaries aged 66 and older continuously enrolled in FFS Medicare with Part D coverage with a diagnosis of asthma before 2009 treated exclusively with ICSs plus LABAs or ICSs plus LTRAs (N = 14,702). The augmented inverse propensity-weighted estimator was used to compare the effect of LABA add-on therapy with that of LTRA add-on therapy on asthma exacerbations requiring inpatient, emergency, or outpatient care and on cardiovascular (CV) events, adjusting for demographic characteristics, comorbidities, and county-level healthcare-access variables. The primary analysis showed that LTRA add-on treatment was associated with greater odds of asthma-related hospitalizations or emergency department visits (odds ratio (OR) = 1.4, P < .001), as well as outpatient exacerbations requiring oral corticosteroids or antibiotics (OR = 1.41, P < .001) than LABA treatment. LTRA add-on therapy was also less effective in controlling acute symptoms, as indicated by greater use of short-acting beta agonists (rate ratio = 1.58, P < .001). LTRA add-on treatment was associated with lower odds of experiencing a CV event than LABA treatment (OR = 0.86, P = .006). This study provides new evidence specific to older adults to help healthcare providers weigh the risks and benefits of these add-on treatments. Further subgroup analysis is needed to personalize asthma treatments in this high-risk population. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Space station internal environmental and safety concerns

NASA Technical Reports Server (NTRS)

Cole, Matthew B.

1987-01-01

Space station environmental and safety concerns, especially those involving fires, are discussed. Several types of space station modules and the particular hazards associated with each are briefly surveyed. A brief history of fire detection and suppression aboard spacecraft is given. Microgravity fire behavior, spacecraft fire detector systems, space station fire suppression equipment and procedures, and fire safety in hyperbaric chambers are discussed.

"Who's on the team today?" The status of briefing amongst operating theatre practitioners in one UK hospital.

PubMed

Allard, Jon; Bleakley, Alan; Hobbs, Adrian; Vinnell, Tina

2007-03-01

Accidents in health care are mainly due to systemic communication errors. Errors occur more frequently in the operating theatre (OT) than other clinical settings. Hence, it is important that preventive communication practices are adopted in OT teams. Formal team pre-briefing has been shown to improve safety in high risk settings such as aviation, but such briefing is not common practice in OT teams. This paper reviews key literature demonstrating the value of briefing in high-risk practices; presents and analyses the results of a questionnaire survey on the status of briefing after its introduction to OT teams in one UK hospital; and analyses processes that frustrate widespread adoption of briefing. In comparison with other OT practitioners, surgeons generally reported differing perceptions of the meaning and value of briefing, often holding broad notions of what constitutes a "brief", but also showing scepticism towards briefing. However, surgeons who had introduced briefing reported positive results such as greater efficiency, shared understanding, and increased team morale. Collaborative briefing that extends beyond the technical to include the interpersonal could be initiated in principle by any member of the OT team, but a number of factors inhibit this, and surgeons play a pivotal role in establishing briefing.

Processes of technology assessment: The National Transportation Safety Board

NASA Technical Reports Server (NTRS)

Weiss, E.

1972-01-01

The functions and operations of the Safety Board as related to technology assessment are described, and a brief history of the Safety Board is given. Recommendations made for safety in all areas of transportation and the actions taken are listed. Although accident investigation is an important aspect of NTSB's activity, it is felt that the greatest contribution is in pressing for development of better accident prevention programs. Efforts of the Safety Board in changing transportation technology to improve safety and prevent accidents are illustrated.

Fundamentals of quality and safety in diagnostic radiology.

PubMed

Bruno, Michael A; Nagy, Paul

2014-12-01

The most fundamental aspects of quality and safety in radiology are reviewed, including a brief history of the quality and safety movement as applied to radiology, the overarching considerations of organizational culture, team building, choosing appropriate goals and metrics, and the radiologist's quality "tool kit." Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Overview of Federal Motor Carrier Safety Administration safety training research for new entrant motor carriers : [research brief].

DOT National Transportation Integrated Search

2015-07-01

In 2002, the Federal Motor Carrier Safety Administration (FMCSA) issued the New Entrant Program Interim Final Rule in response to the requirement in the Motor Carrier Safety Improvement Act of 1999. The requirement in the Act was based on research fi...

Health Care Utilization and Costs After Initiating Budesonide/Formoterol Combination or Fluticasone/Salmeterol Combination Among COPD Patients New to ICS/LABA Treatment.

PubMed

Davis, Jill R; Kern, David M; Williams, Setareh A; Tunceli, Ozgur; Wu, Bingcao; Hollis, Sally; Strange, Charlie; Trudo, Frank

2016-03-01

Chronic obstructive pulmonary disease (COPD) affects approximately 15 million people in the United States and accounts for approximately $36 billion in economic burden, primarily due to medical costs. To address the increasing clinical and economic burden, the Global Initiative for Chronic Obstructive Lung Disease emphasizes the use of therapies that help prevent COPD exacerbations, including inhaled corticosteroid/long-acting beta2-agonist (ICS/LABA). To evaluate health care costs and utilization among COPD patients newly initiating ICS/LABA combination therapy with budesonide/formoterol (BFC) or fluticasone/salmeterol (FSC) in a managed care system. COPD patients aged 40 years and older who initiated BFC (160/4.5 μg) or FSC (250/50 μg) treatment between March 1, 2009, and March 31, 2012, were identified using claims data from major U.S. health plans. BFC and FSC patients were propensity score matched (1:1) on age, sex, prior asthma diagnosis, prior COPD-related health care utilization, and respiratory medication use. COPD-related, pneumonia-related, and all-cause costs and utilization were analyzed during the 12-month follow-up period. Post-index costs were assessed with generalized linear models (GLMs) with gamma distribution. Health care utilization data were analyzed via logistic regression (any event vs. none) and GLMs with negative binomial distribution (number of visits) and were adjusted for the analogous pre-index variable as well as pre-index characteristics that remained imbalanced after matching. After matching, each cohort had 3,697 patients balanced on age (mean 64 years), sex (female 52% BFC and 54% FSC), asthma and other comorbid conditions, prior COPD-related health care utilization, and respiratory medication use. During the 12-month follow-up, COPD-related costs averaged $316 less for BFC versus FSC patients ($4,326 vs. $4,846; P = 0.003), reflecting lower inpatient ($966 vs. $1,202; P < 0.001), pharmacy ($1,482 vs. $1,609; P = 0.002), and

FMCSA safety program effectiveness measurement : Roadside Intervention Effectiveness Model FY 2012, [analysis brief].

DOT National Transportation Integrated Search

2016-02-01

Roadside Inspection and Traffic Enforcement are two of : the Federal Motor Carrier Safety Administrations : (FMCSAs) key safety programs. The Roadside : Inspection Program consists of roadside inspections : performed by qualified safety inspect...

An Introduction to Eye Safety. General Metals I, Lesson Plan No. 1.

ERIC Educational Resources Information Center

Higa, Floyd

Designed for a 110-hour general metals course, this lesson plan presents an introduction to eye safety, including a brief guided imagery prelude, an overview of the lesson, an overview of Occupational Safety and Health Administration (OSHA) and Department of Occupational Safety and Health (DOSH) rules and regulations regarding eye and face…

FMCSA safety program effectiveness measurement : roadside intervention effectiveness model FY 2011 : [analysis brief].

DOT National Transportation Integrated Search

2015-06-01

Roadside Inspection and Traffic Enforcement are two of the Federal Motor Carrier Safety Administrations (FMCSAs) key safety programs. The Roadside Inspection program consists of roadside inspections performed by qualified safety inspectors. The...

AB033. Assessing the appropriateness of pharmacological prescriptions for COPD to clinical guidelines: EPOCONSUL study

PubMed Central

Alcázar, Bernardino; Calle, Myrian; Soler, Juan José; López-Campos, José Luis; Rodriguez, José-Maria; Soriano, Joan

2016-01-01

Background Adherence to clinical practice guidelines is far from optimal for most of the chronic diseases. Spain has implemented a phenotype based chronic obstructive pulmonary disease (COPD) guideline and there is scarce data about the follow-up of this guideline. The aim of this study is to evaluate the suitability of the pharmacological treatment for COPD to the Spanish Guidelines (GesEPOC) recommendations in patients with COPD recruited at respiratory clinics around Spain. Methods EPOCONSUL study is a observational, multicentre, cross-sectional study aimed to audit clinical histories from stable COPD patients attended at respiratory offices. Patients were recruited prospectively from 62 centres around Spain along June 2014 to June 2015. Results The EPOCONSUL study audited 4,501 medical histories from patients with COPD. Characteristics of study population showed 86.0% males, with a mean age (± SD) of 69.77±9.79 years. In 76.9% of the cases patients were attended at general respiratory offices. Baseline FEV1 values were 52.3%±18.4% of predicted. A COPD diagnosis using GesEPOC guidelines was performed in 2,087 patients (46.3%). The most preferred treatment option was the association of ICS/LABA in fixed-dose combination and LAMA, that was used in 2,450 patients of the whole sample. Among patients with a diagnosis of COPD according to GesEPOC guidelines, the preferred form of treatment was: non-exacerbators (LAMA/LABA 37.8%, LAMA/LABA/ICS 36.6%, LAMA 15.9% and LABA/ICS 4.9%), Asthma-COPD overlap syndrome (LAMA/LABA/ICS 61.9%, LABA/ICS 21.9%, LAMA/LABA 10.3% and LAMA 2.9%), frequent exacerbator with emphysema (LAMA/LABA/ICS 69.2%, LAMA/LABA 18.3%, LABA/ICS 6.4%, and LAMA 3.2%) and finally frequent exacerbator with chronic bronchitis (LAMA/LABA/ICS 77.0%, LAMA/LABA 14.0%, LABA/ICS 5.9% and LAMA 1.1%). Conclusions According to EPOCONSUL study data, the most used pharmacological option for COPD in Spain is triple therapy, which is prescribed in more than half of

Adherence to current guidelines for chronic obstructive pulmonary disease (COPD) among patients treated with combination of long-acting bronchodilators or inhaled corticosteroids

PubMed Central

Asche, Carl Victor; Leader, Shelah; Plauschinat, Craig; Raparla, Swetha; Yan, Ming; Ye, Xiangyang; Young, Dave

2012-01-01

Background To estimate the potential cost savings by following the current Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline recommendations in patients being treated for chronic obstructive pulmonary disease (COPD) with the combination of long-acting β2-agonist (LABA), long-acting muscarinic antagonist (LAMA) or inhaled corticosteroids (ICS). Methods The Geisinger Health System (GHS) database was utilized to identify subjects between January 1, 2004 to March 12, 2007. The index date was based on the first prescription of a LAMA plus LABA, LAMA plus LABA/ICS, or LABA plus ICS. Patients were included in the study if they: had a COPD diagnosis; had data representative of treatment 12 months prior to and 12 months post index date; were 40 years of age or over; had no prior diagnosis for asthma; and had pulmonary function test (PFT) data. We examined the baseline characteristics of these patients along with their healthcare resource utilization. Based on PFT data within 30 days of the index date, a subgroup was classified as adhering or non-adhering to GOLD guidelines. Results A total of 364 subjects could be classified as adhering or non-adherent to current GOLD guidelines based on their PFT results. The adherent subgroup received COPD medications consistent with current GOLD guidelines. Of the LAMA plus LABA cohort, 25 patients adhered and 39 patients were non-adherent to current GOLD guidelines. In the cohort of LABA plus ICS, 74 patients were adherent and 180 patients non-adherent to current GOLD guidelines. In the cohort of LAMA plus LABA/ICS, 21 patients were adherent and 25 patients non-adherent to current GOLD guidelines. GOLD adherence was associated with mean total cost of all services savings of $5,889 for LAMA plus LABA, $3,330 for LABA + ICS, and $10,217 for LAMA plus LABA/ICS cohorts. Conclusion Staging of COPD with a PFT and adherence to current GOLD guidelines was associated with lower costs in subjects with moderate to severe

Adherence to current guidelines for chronic obstructive pulmonary disease (COPD) among patients treated with combination of long-acting bronchodilators or inhaled corticosteroids.

PubMed

Asche, Carl Victor; Leader, Shelah; Plauschinat, Craig; Raparla, Swetha; Yan, Ming; Ye, Xiangyang; Young, Dave

2012-01-01

To estimate the potential cost savings by following the current Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline recommendations in patients being treated for chronic obstructive pulmonary disease (COPD) with the combination of long-acting β(2)-agonist (LABA), long-acting muscarinic antagonist (LAMA) or inhaled corticosteroids (ICS). The Geisinger Health System (GHS) database was utilized to identify subjects between January 1, 2004 to March 12, 2007. The index date was based on the first prescription of a LAMA plus LABA, LAMA plus LABA/ICS, or LABA plus ICS. Patients were included in the study if they: had a COPD diagnosis; had data representative of treatment 12 months prior to and 12 months post index date; were 40 years of age or over; had no prior diagnosis for asthma; and had pulmonary function test (PFT) data. We examined the baseline characteristics of these patients along with their healthcare resource utilization. Based on PFT data within 30 days of the index date, a subgroup was classified as adhering or non-adhering to GOLD guidelines. A total of 364 subjects could be classified as adhering or non-adherent to current GOLD guidelines based on their PFT results. The adherent subgroup received COPD medications consistent with current GOLD guidelines. Of the LAMA plus LABA cohort, 25 patients adhered and 39 patients were non-adherent to current GOLD guidelines. In the cohort of LABA plus ICS, 74 patients were adherent and 180 patients non-adherent to current GOLD guidelines. In the cohort of LAMA plus LABA/ICS, 21 patients were adherent and 25 patients non-adherent to current GOLD guidelines. GOLD adherence was associated with mean total cost of all services savings of $5,889 for LAMA plus LABA, $3,330 for LABA + ICS, and $10,217 for LAMA plus LABA/ICS cohorts. Staging of COPD with a PFT and adherence to current GOLD guidelines was associated with lower costs in subjects with moderate to severe COPD. Appropriate use of LAMA plus LABA

Long-acting β-agonist prescribing in people with asthma in primary care.

PubMed

Morales, Daniel R; Jackson, Cathy; Fielding, Shona; Guthrie, Bruce

2013-02-01

Long-acting β2-agonist (LABA) monotherapy is contraindicated in asthma following reports of serious adverse events. Anonymised Scottish health data were used to determine the prevalence of LABA prescribing and LABA monotherapy (sustained and episodic) in asthma during 2006. Of 73 486 asthma patients identified, 5592 (7.6%; 95% CI 7.4% to 7.8%) were prescribed LABAs as a separate inhaler of which 991 patients had LABA monotherapy (17.7% (95% CI 16.7% to 18.7%) of patients at risk). Asthma reviews were associated with reductions in sustained (OR 0.44; 95% CI 0.32 to 0.61) but not episodic monotherapy (OR 1.16; 95% CI 0.85 to 1.57). These findings support recent changes in UK asthma guidelines recommending LABAs in fixed-dose combination inhalers.

Alcohol and highway safety: screening and brief intervention for alcohol problems as a community approach to improve traffic safety : traffic tech.

DOT National Transportation Integrated Search

2013-09-01

The report discussed in this edition of Traffic Tech reviews the current state of knowledge : on Screening and Brief Intervention (SBI). It specifically : addresses the rationale for addressing at-risk : drinkers, defines SBI, provides examples of ho...

Correlation between safety climate and contractor safety assessment programs in construction

PubMed Central

Sparer, EH1; Murphy, LA; Taylor, KM; Dennerlein, Jt

2015-01-01

Background Contractor safety assessment programs (CSAPs) measure safety performance by integrating multiple data sources together; however, the relationship between these measures of safety performance and safety climate within the construction industry is unknown. Methods 401 construction workers employed by 68 companies on 26 sites and 11 safety managers employed by 11 companies completed brief surveys containing a nine-item safety climate scale developed for the construction industry. CSAP scores from ConstructSecure, Inc., an online CSAP database, classified these 68 companies as high or low scorers, with the median score of the sample population as the threshold. Spearman rank correlations evaluated the association between the CSAP score and the safety climate score at the individual level, as well as with various grouping methodologies. In addition, Spearman correlations evaluated the comparison between manager-assessed safety climate and worker-assessed safety climate. Results There were no statistically significant differences between safety climate scores reported by workers in the high and low CSAP groups. There were, at best, weak correlations between workers’ safety climate scores and the company CSAP scores, with marginal statistical significance with two groupings of the data. There were also no significant differences between the manager-assessed safety climate and the worker-assessed safety climate scores. Conclusions A CSAP safety performance score does not appear to capture safety climate, as measured in this study. The nature of safety climate in construction is complex, which may be reflective of the challenges in measuring safety climate within this industry. PMID:24038403

Achieving Symptom Control in Patients with Moderate Asthma

PubMed Central

Weir, Nargues A.; Levine, Stewart J.

2012-01-01

Disease severity in asthma can be classified as mild, moderate or severe based upon the frequency of symptoms or the severity of airflow obstruction. This review will focus on the treatment of youths greater than 12 years of age and adults with moderate persistent asthma. Moderate asthmatics may have daily symptoms that cause some limitation with normal daily activities and require use of a rescue inhaled short-acting beta2-agonist inhaler or experience nocturnal awakenings secondary to asthma that occur more than once per week. Furthermore, spirometry may reveal airflow obstruction with a reduction in FEV1 to between 60% and 80% of predicted. Although inhaled corticosteroids (ICS) are the primary controller medication used to modify symptoms in moderate asthmatics, additional controller medications, such as inhaled long-acting beta2-agonists (LABA), leukotriene receptor antagonists (LTRA) or theophylline, are often needed to obtain optimal disease control. While the addition of an inhaled LABA to an ICS is very effective at improving disease control in moderate asthma, concerns have arisen over the safety of LABAs, in particular the risk of asthma-related death. Therefore, consideration may be given to initially adding a LTRA, rather than a LABA, to ICS when asthma symptoms are not adequately controlled by ICS alone. Furthermore, individualization of medication regimens, treatment of co-morbid conditions, and patient education are crucial to optimizing compliance with therapy, improving disease control, and reducing the risk of exacerbations. Lastly, the development of new asthma treatments, perhaps based upon personalized medicine, may revolutionize the future treatment of moderate asthma. PMID:22259262

Safety and Toxicology of Cannabinoids.

PubMed

Sachs, Jane; McGlade, Erin; Yurgelun-Todd, Deborah

2015-10-01

There is extensive research on the safety, toxicology, potency, and therapeutic potential of cannabis. However, uncertainty remains facilitating continued debate on medical and recreational cannabis policies at the state and federal levels. This review will include a brief description of cannabinoids and the endocannabinoid system; a summary of the acute and long-term effects of cannabis; and a discussion of the therapeutic potential of cannabis. The conclusions about safety and efficacy will then be compared with the current social and political climate to suggest future policy directions and general guidelines.

TEAC Exercise Workbook: Writing the "Inquiry Brief" and "Inquiry Brief Proposal"

ERIC Educational Resources Information Center

Teacher Education Accreditation Council, 2010

2010-01-01

This workbook is about producing the "Inquiry Brief" or "Inquiry Brief Proposal" for TEAC (Teacher Education Accreditation Council) accreditation. It is designed as a companion to the TEAC "Guide to Accreditation." The exercises in this workbook are selected by the writing workshop presenters to help program faculty get started on their "Brief."…

Briefing and debriefing in the cardiac operating room. Analysis of impact on theatre team attitude and patient safety.

PubMed

Papaspyros, Sotiris C; Javangula, Kalyana C; Adluri, Rajeshwara Krishna Prasad; O'Regan, David J

2010-01-01

Error in health services delivery has long been recognised as a significant cause of inpatient morbidity and mortality. Root-cause analyses have cited communication failure as one of the contributing factors in adverse events. The formalised fighter pilot mission brief and debrief formed the basis of the National Aeronautics and Space Administration (NASA) crew resource management (CRM) concept produced in 1979. This is a qualitative analysis of our experience with the briefing-debriefing process applied to cardiac theatres. We instituted a policy of formal operating room (OR) briefing and debriefing in all cardiac theatre sessions. The first 118 cases were reviewed. A trouble-free operation was noted in only 28 (23.7%) cases. We experienced multiple problems in 38 (32.2%) cases. A gap was identified in the second order problem solving in relation to instrument repair and maintenance. Theatre team members were interviewed and their comments were subjected to qualitative analysis. The collaborative feeling is that communication has improved. The health industry may benefit from embracing the briefing-debriefing technique as an adjunct to continuous improvement through reflective learning, deliberate practice and immediate feedback. This may be the initial step toward a substantive and sustainable organizational transformation.

Correlation between safety climate and contractor safety assessment programs in construction.

PubMed

Sparer, Emily H; Murphy, Lauren A; Taylor, Kathryn M; Dennerlein, Jack T

2013-12-01

Contractor safety assessment programs (CSAPs) measure safety performance by integrating multiple data sources together; however, the relationship between these measures of safety performance and safety climate within the construction industry is unknown. Four hundred and one construction workers employed by 68 companies on 26 sites and 11 safety managers employed by 11 companies completed brief surveys containing a nine-item safety climate scale developed for the construction industry. CSAP scores from ConstructSecure, Inc., an online CSAP database, classified these 68 companies as high or low scorers, with the median score of the sample population as the threshold. Spearman rank correlations evaluated the association between the CSAP score and the safety climate score at the individual level, as well as with various grouping methodologies. In addition, Spearman correlations evaluated the comparison between manager-assessed safety climate and worker-assessed safety climate. There were no statistically significant differences between safety climate scores reported by workers in the high and low CSAP groups. There were, at best, weak correlations between workers' safety climate scores and the company CSAP scores, with marginal statistical significance with two groupings of the data. There were also no significant differences between the manager-assessed safety climate and the worker-assessed safety climate scores. A CSAP safety performance score does not appear to capture safety climate, as measured in this study. The nature of safety climate in construction is complex, which may be reflective of the challenges in measuring safety climate within this industry. Am. J. Ind. Med. 56:1463-1472, 2013. © 2013 Wiley Periodicals, Inc. © 2013 Wiley Periodicals, Inc.

Respiratory medication used in COPD patients from seven Latin American countries: the LASSYC study

PubMed Central

Casas, Alejandro; Montes de Oca, Maria; Menezes, Ana MB; Wehrmeister, Fernando C; Lopez Varela, Maria Victorina; Mendoza, Laura; Ramírez, Larissa; Miravitlles, Marc

2018-01-01

Background Limited information is available regarding medication use in COPD patients from Latin America. This study evaluated the type of medication used and the adherence to different inhaled treatments in stable COPD patients from the Latin American region. Methods This was an observational, cross-sectional, multinational, and multicenter study in COPD patients attended by specialist doctors from seven Latin American countries. Adherence to inhaled therapy was assessed using the Test of Adherence to Inhalers (TAI) questionnaire. The type of medication was assessed as: short-acting β-agonist (SABA) or short-acting muscarinic antagonist (SAMA) only, long-acting muscarinic antagonist (LAMA), long-acting β-agonist (LABA), LABA/LAMA, inhaled corticosteroid (ICS), ICS/LABA, ICS/LAMA/LABA, or other. Results In total, 795 patients were included (59.6% male), with a mean age of 69.5±8.7 years and post-bronchodilator FEV1 of 50.0%±18.6%. The ICS/LAMA/LABA (32.9%) and ICS/LABA (27.7%) combinations were the most common medications used, followed by LABA/LAMA (11.3%), SABA or SAMA (7.9%), LABA (6.4%), LAMA (5.8%), and ICS (4.3%). The types of medication most commonly used in each Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2013 category were ICS/LABA (A: 32.7%; B: 19.8%; C: 25.7%; D: 28.2%) and ICS/LAMA/LABA (A: 17.3%; B: 30.2%; C: 33%; D: 41.1%). The use of long-acting bronchodilators showed the highest adherence (good or high adherence >50%) according to the TAI questionnaire. Conclusion COPD management in specialist practice in Latin America does not follow the current guideline recommendations and there is an overuse of ICSs in patients with COPD from this region. Treatment regimens including the use of long-acting bronchodilators are associated with the highest adherence. PMID:29785104

Respiratory medication used in COPD patients from seven Latin American countries: the LASSYC study.

PubMed

Casas, Alejandro; Montes de Oca, Maria; Menezes, Ana Mb; Wehrmeister, Fernando C; Lopez Varela, Maria Victorina; Mendoza, Laura; Ramírez, Larissa; Miravitlles, Marc

2018-01-01

Limited information is available regarding medication use in COPD patients from Latin America. This study evaluated the type of medication used and the adherence to different inhaled treatments in stable COPD patients from the Latin American region. This was an observational, cross-sectional, multinational, and multicenter study in COPD patients attended by specialist doctors from seven Latin American countries. Adherence to inhaled therapy was assessed using the Test of Adherence to Inhalers (TAI) questionnaire. The type of medication was assessed as: short-acting β-agonist (SABA) or short-acting muscarinic antagonist (SAMA) only, long-acting muscarinic antagonist (LAMA), long-acting β-agonist (LABA), LABA/LAMA, inhaled corticosteroid (ICS), ICS/LABA, ICS/LAMA/LABA, or other. In total, 795 patients were included (59.6% male), with a mean age of 69.5±8.7 years and post-bronchodilator FEV 1 of 50.0%±18.6%. The ICS/LAMA/LABA (32.9%) and ICS/LABA (27.7%) combinations were the most common medications used, followed by LABA/LAMA (11.3%), SABA or SAMA (7.9%), LABA (6.4%), LAMA (5.8%), and ICS (4.3%). The types of medication most commonly used in each Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2013 category were ICS/LABA (A: 32.7%; B: 19.8%; C: 25.7%; D: 28.2%) and ICS/LAMA/LABA (A: 17.3%; B: 30.2%; C: 33%; D: 41.1%). The use of long-acting bronchodilators showed the highest adherence (good or high adherence >50%) according to the TAI questionnaire. COPD management in specialist practice in Latin America does not follow the current guideline recommendations and there is an overuse of ICSs in patients with COPD from this region. Treatment regimens including the use of long-acting bronchodilators are associated with the highest adherence.

Time Trends of Period Prevalence Rates of Patients with Inhaled Long-Acting Beta-2-Agonists-Containing Prescriptions: A European Comparative Database Study

PubMed Central

Rottenkolber, Marietta; Voogd, Eef; van Dijk, Liset; Primatesta, Paola; Becker, Claudia; Schlienger, Raymond; de Groot, Mark C. H.; Alvarez, Yolanda; Durand, Julie; Slattery, Jim; Afonso, Ana; Requena, Gema; Gil, Miguel; Alvarez, Arturo; Hesse, Ulrik; Gerlach, Roman; Hasford, Joerg; Fischer, Rainald; Klungel, Olaf H.; Schmiedl, Sven

2015-01-01

Background Inhaled, long-acting beta-2-adrenoceptor agonists (LABA) have well-established roles in asthma and/or COPD treatment. Drug utilisation patterns for LABA have been described, but few studies have directly compared LABA use in different countries. We aimed to compare the prevalence of LABA-containing prescriptions in five European countries using a standardised methodology. Methods A common study protocol was applied to seven European healthcare record databases (Denmark, Germany, Spain, the Netherlands (2), and the UK (2)) to calculate crude and age- and sex-standardised annual period prevalence rates (PPRs) of LABA-containing prescriptions from 2002–2009. Annual PPRs were stratified by sex, age, and indication (asthma, COPD, asthma and COPD). Results From 2002–2009, age- and sex-standardised PPRs of patients with LABA-containing medications increased in all databases (58.2%–185.1%). Highest PPRs were found in men ≥ 80 years old and women 70–79 years old. Regarding the three indications, the highest age- and sex-standardised PPRs in all databases were found in patients with “asthma and COPD” but with large inter-country variation. In those with asthma or COPD, lower PPRs and smaller inter-country variations were found. For all three indications, PPRs for LABA-containing prescriptions increased with age. Conclusions Using a standardised protocol that allowed direct inter-country comparisons, we found highest rates of LABA-containing prescriptions in elderly patients and distinct differences in the increased utilisation of LABA-containing prescriptions within the study period throughout the five European countries. PMID:25706152

75 FR 63893 - Safety Advisory 2010-03

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-18

... Advisory; staying alert and situational awareness. SUMMARY: FRA is issuing Safety Advisory 2010-03 to... alert whenever the job that is being performed changes, particularly in main track territory. This.... Additionally, the briefing addressed several existing BNSF operating rules mandating that employees be alert...

ALAT-2014 Chronic Obstructive Pulmonary Disease (COPD) Clinical Practice Guidelines: questions and answers.

PubMed

Montes de Oca, María; López Varela, María Victorina; Acuña, Agustín; Schiavi, Eduardo; Rey, María Alejandra; Jardim, José; Casas, Alejandro; Tokumoto, Antonio; Torres Duque, Carlos A; Ramírez-Venegas, Alejandra; García, Gabriel; Stirbulov, Roberto; Camelier, Aquiles; Bergna, Miguel; Cohen, Mark; Guzmán, Santiago; Sánchez, Efraín

2015-08-01

ALAT-2014 COPD Clinical Practice Guidelines used clinical questions in PICO format to compile evidence related to risk factors, COPD screening, disease prognosis, treatment and exacerbations. Evidence reveals the existence of risk factors for COPD other than tobacco, as well as gender differences in disease presentation. It shows the benefit of screening in an at-risk population, and the predictive value use of multidimensional prognostic indexes. In stable COPD, similar benefits in dyspnea, pulmonary function and quality of life are achieved with LAMA or LABA long-acting bronchodilators, whereas LAMA is more effective in preventing exacerbations. Dual bronchodilator therapy has more benefits than monotherapy. LAMA and combination LABA/IC are similarly effective, but there is an increased risk of pneumonia with LABA/IC. Data on the efficacy and safety of triple therapy are scarce. Evidence supports influenza vaccination in all patients and anti-pneumococcal vaccination in patients <65years of age and/or with severe airflow limitation. Antibiotic prophylaxis may decrease exacerbation frequency in patients at risk. The use of systemic corticosteroids and antibiotics are justified in exacerbations requiring hospitalization and in some patients managed in an outpatient setting. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

14 CFR 91.107 - Use of safety belts, shoulder harnesses, and child restraint systems.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false Use of safety belts, shoulder harnesses... OPERATING AND FLIGHT RULES Flight Rules General § 91.107 Use of safety belts, shoulder harnesses, and child... board is briefed on how to fasten and unfasten that person's safety belt and, if installed, shoulder...

14 CFR 91.107 - Use of safety belts, shoulder harnesses, and child restraint systems.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 2 2012-01-01 2012-01-01 false Use of safety belts, shoulder harnesses... OPERATING AND FLIGHT RULES Flight Rules General § 91.107 Use of safety belts, shoulder harnesses, and child... board is briefed on how to fasten and unfasten that person's safety belt and, if installed, shoulder...

14 CFR 91.107 - Use of safety belts, shoulder harnesses, and child restraint systems.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false Use of safety belts, shoulder harnesses... OPERATING AND FLIGHT RULES Flight Rules General § 91.107 Use of safety belts, shoulder harnesses, and child... board is briefed on how to fasten and unfasten that person's safety belt and, if installed, shoulder...

14 CFR 91.107 - Use of safety belts, shoulder harnesses, and child restraint systems.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Use of safety belts, shoulder harnesses... OPERATING AND FLIGHT RULES Flight Rules General § 91.107 Use of safety belts, shoulder harnesses, and child... board is briefed on how to fasten and unfasten that person's safety belt and, if installed, shoulder...

Safety evaluation of access management policies and techniques, TechBrief

DOT National Transportation Integrated Search

2015-08-01

Access management is the process that provides (or manages) access to land development while simultaneously preserving the flow of traffic on the surrounding road network for safety, capacity, and speed. Access management provides important benefits ...

The influence of handling qualities on safety and survivability

NASA Technical Reports Server (NTRS)

Anderson, S. B.

1977-01-01

The relationship of handling qualities to safety and survivability of military aircraft is examined which includes the following: (1) a brief discussion of the philosophy used in the military specifications for treatment of degraded handling qualities, (2) an examination of several example handling qualities problem areas which influence safety and survivability; and (3) a movie illustrating the potential dangers of inadequate handling qualities features.

FMCSA safety program effectiveness measurement : carrier intervention effectiveness model, version 1.0 : [analysis brief].

DOT National Transportation Integrated Search

2015-01-01

The Carrier Intervention Effectiveness Model (CIEM) : provides the Federal Motor Carrier Safety : Administration (FMCSA) with a tool for measuring : the safety benefits of carrier interventions conducted : under the Compliance, Safety, Accountability...

FMCSA safety program effectiveness measurement : carrier intervention effectiveness Model, version 1.1, analysis brief.

DOT National Transportation Integrated Search

2016-11-01

The Carrier Intervention Effectiveness Model (CIEM) provides the Federal Motor Carrier Safety Administration (FMCSA) with a tool for measuring the safety benefits of carrier interventions conducted under the Compliance, Safety, Accountability (CSA) e...

FMCSA safety program effectiveness measurement : Roadside Intervention Effectiveness Model, fiscal year 2010 : [analysis brief].

DOT National Transportation Integrated Search

2014-11-01

Two of the Federal Motor Carrier Safety Administrations (FMCSAs) key safety programs are the Roadside Inspection and Traffic Enforcement programs. The Roadside Inspection program consists of roadside inspections performed by qualified safety in...

NASA's Software Safety Standard

NASA Technical Reports Server (NTRS)

Ramsay, Christopher M.

2007-01-01

requirements. This allows the projects leeway to meet these requirements in many forms that best suit a particular project's needs and safety risk. In other words, it tells the project what to do, not how to do it. This update also incorporated advances in the state of the practice of software safety from academia and private industry. It addresses some of the more common issues now facing software developers in the NASA environment such as the use of Commercial-Off-the-Shelf Software (COTS), Modified OTS (MOTS), Government OTS (GOTS), and reused software. A team from across NASA developed the update and it has had both NASA-wide internal reviews by software engineering, quality, safety, and project management. It has also had expert external review. This presentation and paper will discuss the new NASA Software Safety Standard, its organization, and key features. It will start with a brief discussion of some NASA mission failures and incidents that had software as one of their root causes. It will then give a brief overview of the NASA Software Safety Process. This will include an overview of the key personnel responsibilities and functions that must be performed for safety-critical software.

Bronchial Thermoplasty – Long Term Safety and Effectiveness in Severe Persistent Asthma

PubMed Central

Wechsler, Michael E.; Laviolette, Michel; Rubin, Adalberto S.; Fiterman, Jussara; Lapa e Silva, Jose R.; Shah, Pallav L.; Fiss, Elie; Olivenstein, Ronald; Thomson, Neil C.; Niven, Robert M.; Pavord, Ian D.; Simoff, Michael; Hales, Jeff B.; McEvoy, Charlene; Slebos, Dirk-Jan; Holmes, Mark; Phillips, Martin J.; Erzurum, Serpil C.; Hanania, Nicola A.; Sumino, Kaharu; Kraft, Monica; Cox, Gerard; Sterman, Daniel H.; Hogarth, Kyle; Kline, Joel N.; Mansur, Adel H.; Louie, Brian E.; Leeds, William M.; Barbers, Richard G.; Austin, John H.M.; Shargill, Narinder S.; Quiring, John; Armstrong, Brian; Castro, Mario

2014-01-01

Background Bronchial thermoplasty (BT) has previously been shown to improve asthma control out to 2 years in patients with severe persistent asthma. Objective To assess effectiveness and safety of BT in asthma patients 5 years post therapy. Methods BT-treated subjects from the Asthma Intervention Research 2 (AIR2) Trial (ClinicalTrials.gov NCT01350414) were evaluated annually for 5 years to assess long-term safety of BT and durability of treatment effect. Outcomes assessed post-BT included severe exacerbations, adverse events, healthcare utilization, spirometry data, and high resolution computed tomography (HRCT) scans. Results 162/190 BT-treated subjects (85.3%) from the AIR2 Trial completed 5 years of follow-up. The proportion of subjects experiencing severe exacerbations and Emergency Room visits, and the rates of events in each of years 1 to 5 remained low and were less than those observed in the 12 months prior to BT treatment (average 5 year reduction in proportions: 44% for exacerbations and 78% for ER visits). Respiratory adverse events and respiratory-related hospitalizations remained unchanged in Years 2 through 5 as compared to the first year after BT. Pre-BD FEV1 values remained stable between years 1 and 5 after BT, despite a 17% reduction in average daily inhaled corticosteroid dose. HRCT scans from baseline to 5 years after BT showed no structural abnormalities that could be attributed to BT. Conclusions These data demonstrate the 5-year durability of the benefits of BT with regard to both asthma control (based on maintained reduction in severe exacerbations and ER visits for respiratory symptoms) and safety. BT has become an important addition to our treatment armamentarium and should be considered for patients with severe persistent asthma who remain symptomatic despite taking ICS (inhaled corticosteroids) and LABA (long-acting-β2-agonists). PMID:23998657

Safety huddles to proactively identify and address electronic health record safety

PubMed Central

Menon, Shailaja; Singh, Hardeep; Giardina, Traber D; Rayburn, William L; Davis, Brenda P; Russo, Elise M

2017-01-01

Objective: Methods to identify and study safety risks of electronic health records (EHRs) are underdeveloped and largely depend on limited end-user reports. “Safety huddles” have been found useful in creating a sense of collective situational awareness that increases an organization’s capacity to respond to safety concerns. We explored the use of safety huddles for identifying and learning about EHR-related safety concerns. Design: Data were obtained from daily safety huddle briefing notes recorded at a single midsized tertiary-care hospital in the United States over 1 year. Huddles were attended by key administrative, clinical, and information technology staff. We conducted a content analysis of huddle notes to identify what EHR-related safety concerns were discussed. We expanded a previously developed EHR-related error taxonomy to categorize types of EHR-related safety concerns recorded in the notes. Results: On review of daily huddle notes spanning 249 days, we identified 245 EHR-related safety concerns. For our analysis, we defined EHR technology to include a specific EHR functionality, an entire clinical software application, or the hardware system. Most concerns (41.6%) involved “EHR technology working incorrectly,” followed by 25.7% involving “EHR technology not working at all.” Concerns related to “EHR technology missing or absent” accounted for 16.7%, whereas 15.9% were linked to “user errors.” Conclusions: Safety huddles promoted discussion of several technology-related issues at the organization level and can serve as a promising technique to identify and address EHR-related safety concerns. Based on our findings, we recommend that health care organizations consider huddles as a strategy to promote understanding and improvement of EHR safety. PMID:28031286

39 CFR 3001.34 - Briefs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Commission or the presiding officer shall fix the time for the filing and service of briefs, giving due... limited number of participants involved, the filing of initial and reply briefs, or the filing of initial... also order the filing of briefs during the course of the proceeding. (b) Contents. Each brief filed...

Combined corticosteroid and long-acting beta2-agonist in one inhaler versus long-acting beta2-agonists for chronic obstructive pulmonary disease

PubMed Central

Nannini, Luis Javier; Lasserson, Toby J; Poole, Phillippa

2014-01-01

Background Both inhaled steroids (ICS) and long-acting beta2-agonists (LABA) are used in the management of chronic obstructive pulmonary disease (COPD). This updated review compared compound LABA plus ICS therapy (LABA/ICS) with the LABA component drug given alone. Objectives To assess the efficacy of ICS and LABA in a single inhaler with mono-component LABA alone in adults with COPD. Search methods We searched the Cochrane Airways Group Specialised Register of trials. The date of the most recent search was November 2011. Selection criteria We included randomised, double-blind controlled trials. We included trials comparing compound ICS and LABA preparations with their component LABA preparations in people with COPD. Data collection and analysis Two authors independently assessed study risk of bias and extracted data. The primary outcomes were exacerbations, mortality and pneumonia, while secondary outcomes were health-related quality of life (measured by validated scales), lung function, withdrawals due to lack of efficacy, withdrawals due to adverse events and side-effects. Dichotomous data were analysed as random-effects model odds ratios or rate ratios with 95% confidence intervals (CIs), and continuous data as mean differences and 95% CIs. We rated the quality of evidence for exacerbations, mortality and pneumonia according to recommendations made by the GRADE working group. Main results Fourteen studies met the inclusion criteria, randomising 11,794 people with severe COPD. We looked at any LABA plus ICS inhaler (LABA/ICS) versus the same LABA component alone, and then we looked at the 10 studies which assessed fluticasone plus salmeterol (FPS) and the four studies assessing budesonide plus formoterol (BDF) separately. The studies were well-designed with low risk of bias for randomisation and blinding but they had high rates of attrition, which reduced our confidence in the results for outcomes other than mortality. Primary outcomes There was low quality

29 CFR 2700.75 - Briefs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... exceed 35 pages, and reply briefs shall not exceed 15 pages. A brief of an amicus curiae shall not exceed 25 pages. A brief of an intervenor shall not exceed the page limitation applicable to the party whose position it supports in affirming or reversing the Judge, or if a different position is taken, such brief...

29 CFR 2700.75 - Briefs.

Code of Federal Regulations, 2012 CFR

2012-07-01

... exceed 35 pages, and reply briefs shall not exceed 15 pages. A brief of an amicus curiae shall not exceed 25 pages. A brief of an intervenor shall not exceed the page limitation applicable to the party whose position it supports in affirming or reversing the Judge, or if a different position is taken, such brief...

29 CFR 2700.75 - Briefs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... exceed 35 pages, and reply briefs shall not exceed 15 pages. A brief of an amicus curiae shall not exceed 25 pages. A brief of an intervenor shall not exceed the page limitation applicable to the party whose position it supports in affirming or reversing the Judge, or if a different position is taken, such brief...

False Safety Behavior Elimination Therapy: A randomized study of a brief individual transdiagnostic treatment for anxiety disorders.

PubMed

Riccardi, Christina J; Korte, Kristina J; Schmidt, Norman B

2017-03-01

In response to the ever-growing number of CBT based therapy protocols, transdiagnostic approaches to anxiety treatment, based on models of anxiety emphasizing common elements across anxiety disorders, have been increasingly explored. The aim of the current study was to test the efficacy of an individually administered, brief (5-session) transdiagnostic treatment for anxiety disorders. The current treatment (called F-SET) focuses chiefly on the elimination of anxiety maintaining behaviors and cognitive strategies (so-called "safety" aids) among individuals suffering from a range of anxiety disorders including generalized anxiety disorder (GAD), social anxiety disorder (SAD) and panic disorder (PD). Patients (N=28; mean age=28.5years; 75% female; 71% White) were randomly assigned to F-SET or waitlist control conditions. Participants were assessed prior to, immediately after, and 1-month following treatment. In addition to independent assessments of diagnostic status, standardized self-report measures and assessor ratings of severity and distress associated with anxiety symptoms were used. Participants in the F-SET condition experienced significantly less anxiety (Cohen's d=2.01) and depression (Cohen's d=2.16) than those in the WL condition. Mediational analysis showed that change in avoidance strategies mediated the group changes in anxiety symptoms. The results from the current study are an important first step in identifying a simpler, focused form of CBT that can be delivered with minimal therapist training, at a low cost and with minimal client contact time. Copyright © 2016 Elsevier Ltd. All rights reserved.

Safety of a Brief Emergency Department Observation Protocol for Patients With Presumed Fentanyl Overdose.

PubMed

Scheuermeyer, Frank X; DeWitt, Christopher; Christenson, Jim; Grunau, Brian; Kestler, Andrew; Grafstein, Eric; Buxton, Jane; Barbic, David; Milanovic, Stefan; Torkjari, Reza; Sahota, Indy; Innes, Grant

2018-03-09

Fentanyl overdoses are increasing and few data guide emergency department (ED) management. We evaluate the safety of an ED protocol for patients with presumed fentanyl overdose. At an urban ED, we used administrative data and explicit chart review to identify and describe consecutive patients with uncomplicated presumed fentanyl overdose (no concurrent acute medical issues) from September to December 2016. We linked regional ED and provincial vital statistics databases to ascertain admissions, revisits, and mortality. Primary outcome was a composite of admission and death within 24 hours. Other outcomes included treatment with additional ED naloxone, development of a new medical issue while in the ED, and length of stay. A prespecified subgroup analysis assessed low-risk patients with normal triage vital signs. There were 1,009 uncomplicated presumed fentanyl overdose, mainly by injection. Median age was 34 years, 85% were men, and 82% received out-of-hospital naloxone. One patient was hospitalized and one discharged patient died within 24 hours (combined outcome 0.2%; 95% confidence interval [CI] 0.04% to 0.8%). Sixteen patients received additional ED naloxone (1.6%; 95% CI 1.0% to 2.6%), none developed a new medical issue (0%; 95% CI 0% to 0.5%), and median length of stay was 173 minutes (interquartile range 101 to 267). For 752 low-risk patients, no patients were admitted or developed a new issue, and one died postdischarge; 3 (0.4%; 95% CI 0.01% to 1.3%) received ED naloxone. In our cohort of ED patients with uncomplicated presumed fentanyl overdose-typically after injection-deterioration, admission, mortality, and postdischarge complications appear low; the majority can be discharged after brief observation. Patients with normal triage vital signs are unlikely to require ED naloxone. Copyright © 2018 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

School Safety & Youth Violence: A Legal Primer.

ERIC Educational Resources Information Center

Bailey, Kirk A.; Ross, Catherine J.

This legal primer on violence in schools addresses the responsibility of school officials to respond to undisciplined youths whose behavior threatens the welfare and safety of other children in attendance. It is broken down into sections that provide a brief overview of the key rules and guidelines for school officials and teachers in each topic…

NASA Aviation Safety Reporting System

NASA Technical Reports Server (NTRS)

1980-01-01

Problems in briefing of relief by air traffic controllers are discussed, including problems that arise when duty positions are changed by controllers. Altimeter reading and setting errors as factors in aviation safety are discussed, including problems associated with altitude-including instruments. A sample of reports from pilots and controllers is included, covering the topics of ATIS broadcasts an clearance readback problems. A selection of Alert Bulletins, with their responses, is included.

The cost-effectiveness of brief intervention versus brief treatment of Screening, Brief Intervention and Referral to Treatment (SBIRT) in the United States.

PubMed

Barbosa, Carolina; Cowell, Alexander; Dowd, William; Landwehr, Justin; Aldridge, Arnie; Bray, Jeremy

2017-02-01

To conduct a cost-effectiveness analysis (CEA) comparing the delivery of brief intervention (BI) with brief treatment (BT) within Screening, Brief Intervention and Referral to Treatment (SBIRT) programs. Quasi-experimental differences in observed baseline characteristics between BI and BT patients were adjusted using propensity score techniques. Incremental comparison of costs and health outcomes associated with BI and BT. Health-care settings in four US states participating in Substance Abuse and Mental Health Services Administration SBIRT grant programs. Ninety patients who received BT and 878 who received BI. Per-patient cost of SBIRT, patient demographics and six measures of substance use: proportion using alcohol, proportion using alcohol to intoxication, days of alcohol use, days of alcohol use to intoxication, proportion using drugs and days using drugs. BI and BT were associated with better outcomes. The cost of SBIRT was significantly higher for BT patients ($75.54 versus 16.32, 95% confidence interval, P < 0.01). BT would be cost-effective if the decision-maker had a willingness to pay of $8.90 for a 1 percentage point reduction in the probability of using any alcohol. For the other five outcomes, BT was less effective and more costly, and BI would be a better use of resources. It might be cost-effective to offer brief treatment if the goal is to abstain from alcohol. However, the higher effectiveness of brief treatment for this outcome is associated with considerable uncertainty and, because both brief intervention and brief treatment improve all outcomes, brief treatment does not appear to be a good use of resources. © 2017 Society for the Study of Addiction.

The effect of budesonide/formoterol maintenance and reliever therapy on the risk of severe asthma exacerbations following episodes of high reliever use: an exploratory analysis of two randomised, controlled studies with comparisons to standard therapy

PubMed Central

2012-01-01

Background Divergent strategies have emerged for the management of severe asthma. One strategy utilises high and fixed doses of maintenance treatment, usually inhaled corticosteroid/long-acting β2-agonist (ICS/LABA), supplemented by a short-acting β2-agonist (SABA) as needed. Alternatively, budesonide/formoterol is used as both maintenance and reliever therapy. The latter is superior to fixed-dose treatment in reducing severe exacerbations while achieving similar or better asthma control in other regards. Exacerbations may be reduced by the use of budesonide/formoterol as reliever medication during periods of unstable asthma. We examined the risk of a severe exacerbation in the period after a single day with high reliever use. Methods Episodes of high reliever use were quantified and exacerbations occurring post-index day with these episodes were examined post hoc in two double-blind studies comparing the efficacy and safety of budesonide/formoterol maintenance and reliever therapy (Symbicort SMART™, Turbuhaler®) 160/4.5 μg twice daily plus as needed with similar or higher maintenance doses of ICS/LABA plus SABA or formoterol. Results Budesonide/formoterol maintenance and reliever therapy significantly reduced the risk of episodes of high reliever use (>6 inhalations/day) vs. all alternative ICS/LABA regimens. With conventional fixed-dose treatment the need for exacerbation treatment within 21 days ranged from 6.0–10.1% of days post-index for all regimens compared with 2.5–3.4% of days with budesonide/formoterol maintenance and reliever therapy. Conclusions Budesonide/formoterol maintenance and reliever therapy reduces the incidence of high reliever episodes and the exacerbation burden immediately following these episodes vs. alternative ICS/LABA plus SABA regimens at up to double the maintenance dose of ICS. Trial registration These studies do not have registration numbers as they were conducted before clinical trial registration was required PMID

Briefing sheets on safety and operations of rural two-lane highways.

DOT National Transportation Integrated Search

2016-11-01

The safety and operations of Texas rural two-lane highways are being affected by increased traffic associated : with the energy sector, including the unique characteristics of heavy trucks. Researchers reviewed existing : conditions on select rural t...

North Dakota Statewide Traffic Safety Survey, 2010 : Issue Brief, August 2010

DOT National Transportation Integrated Search

2010-08-01

The United States lags behind many other industrialized : nations in its ability to ensure safety on : public roadways as illustrated in Figure 1. While : progress has been made in reducing traffic deaths, the : continued epidemic of preventable deat...

6 CFR 13.36 - Post-hearing briefs.

Code of Federal Regulations, 2011 CFR

2011-01-01

... § 13.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ will fix the time for filing such briefs. Such briefs... 6 Domestic Security 1 2011-01-01 2011-01-01 false Post-hearing briefs. 13.36 Section 13.36...

6 CFR 13.36 - Post-hearing briefs.

Code of Federal Regulations, 2013 CFR

2013-01-01

... § 13.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ will fix the time for filing such briefs. Such briefs... 6 Domestic Security 1 2013-01-01 2013-01-01 false Post-hearing briefs. 13.36 Section 13.36...

6 CFR 13.36 - Post-hearing briefs.

Code of Federal Regulations, 2012 CFR

2012-01-01

... § 13.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ will fix the time for filing such briefs. Such briefs... 6 Domestic Security 1 2012-01-01 2012-01-01 false Post-hearing briefs. 13.36 Section 13.36...

6 CFR 13.36 - Post-hearing briefs.

Code of Federal Regulations, 2014 CFR

2014-01-01

... § 13.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ will fix the time for filing such briefs. Such briefs... 6 Domestic Security 1 2014-01-01 2014-01-01 false Post-hearing briefs. 13.36 Section 13.36...

North Dakota Statewide Traffic Safety Survey, 2011 : Issue Brief, Summer 2011

DOT National Transportation Integrated Search

2011-01-01

The United States lags behind many other industrial nations in its ability to ensure safety on public roadways (Figure 1). In a national initiative to improve transparency and quantify metrics for behavior-based investments designed to reduce motor v...

Intervention improves physician counseling on teen driving safety.

PubMed

Campbell, Brendan T; Borrup, Kevin; Saleheen, Hassan; Banco, Leonard; Lapidus, Garry

2009-07-01

As part of a statewide campaign, we surveyed physician attitudes and practice regarding teen driving safety before and after a brief intervention designed to facilitate in office counseling. A 31-item self-administered survey was mailed to Connecticut physicians, and this was followed by a mailing of teen driving safety materials to physician practices in the state. A postintervention survey was mailed 8 months after the presurvey. A total of 102 physicians completed both the pre and postsurveys. Thirty-nine percent (39%) reported having had a teen in their practice die in a motor vehicle crash in the presurvey, compared with 49% in the postsurvey. Physician counseling increased significantly for a number of issues: driving while impaired from 86% to 94%; restrictions on teen driving from 53% to 64%; teen driving laws from 53% to 63%; safe vehicle from 32% to 42%; parents model safe driving from 29% to 44%; and teen-parent written contract from 15% to 37%. At baseline, the majority of physicians who provide care to teenagers in Connecticut report discussing and counseling teens on first wave teen driver safety issues (seat belts, alcohol use), but most do not discuss graduate driver licensing laws or related issues. After a brief intervention, there was a significant increase in physician counseling of teens on teen driving laws and on the use of teen-parent contracts. Additional interventions targeting physician practices can improve physician counseling to teens and their parents on issues of teen driving safety.

Combination inhaled steroid and long-acting beta₂-agonist in addition to tiotropium versus tiotropium or combination alone for chronic obstructive pulmonary disease.

PubMed

Rojas-Reyes, Maria Ximena; García Morales, Olga M; Dennis, Rodolfo J; Karner, Charlotta

2016-06-06

The long-acting bronchodilator tiotropium and single-inhaler combination therapy of inhaled corticosteroids and long-acting beta2-agonists (ICS/LABA) are commonly used for maintenance treatment of patients with chronic obstructive pulmonary disease (COPD). Combining these treatments, which have different mechanisms of action, may be more effective than administering the individual components. To assess relative effects of the following treatments on markers of exacerbations, symptoms, quality of life and lung function in patients with COPD.• Tiotropium plus LABA/ICS versus tiotropium.• Tiotropium plus LABA/ICS versus LABA/ICS. We searched the Cochrane Airways Group Specialised Register of Trials (April 2015), ClinicalTrials.gov (www.ClinicalTrials.gov), the World Health Organization (WHO) trials portal and reference lists of relevant articles. We included parallel, randomised controlled trials (RCTs) lasting three months or longer conducted to compare ICS and LABA combination therapy in addition to inhaled tiotropium versus tiotropium alone or combination therapy alone. We independently assessed trials for inclusion, then extracted data on trial quality and outcome results. We contacted study authors to ask for additional information. We collected trial information on adverse effects. Tiotropium plus LABA/ICS versus tiotropiumWe included six studies (1902 participants) with low risk of bias that compared tiotropium in addition to inhaled corticosteroid and long-acting beta2-agonist combination therapy versus tiotropium alone. Investigators found no statistically significant differences in mortality between treatments (odds ratio (OR) 1.80, 95% confidence interval (CI) 0.55 to 5.91; two studies; 961 participants), a reduction in all-cause hospitalisations with the use of combined therapy (tiotropium + LABA/ICS) (OR 0.61, 95% CI 0.40 to 0.92; two studies; 961 participants; number needed to treat for an additional beneficial outcome (NNTB) 19.7, 95% CI 10.75 to

Brief Dynamic Psychotherapy

PubMed Central

HØGLEND, PER; SØRLIE, TORE; HEYERDAHL, OSCAR; SØRBYE, ØYSTEIN; AMLO, SVEIN

1993-01-01

Forty-three neurotic outpatients were treated according to common practice with dynamic psychotherapy of brief to moderate length. Suitability for brief dynamic psychotherapy, measured by quality of interpersonal relations, was independent of DSM-III diagnoses. Suitability was a significant direct predictor of symptomatic and dynamic change 2 and 4 years after therapy. Treatment length added no explained outcome variance over patient characteristics. However, patients with high suitability had a relatively more favorable dynamic outcome with a brief, focused treatment approach, whereas patients with low suitability had relatively more favorable outcome with a longer, less focused treatment of more than 1 year’s duration. The significant interaction emerged at 4-year follow-up. PMID:22700148

Spanish Language Briefs for Parents, 1995.

ERIC Educational Resources Information Center

ERIC Clearinghouse on Rural Education and Small Schools, Charleston, WV.

This packet contains six briefs developed specifically for Spanish-speaking parents of Mexican origin, and English translations of the briefs. In plain language, these briefs state what researchers and practitioners have learned about various ways parents can help their children do well in school. Titles of the briefs are (1) "Apoyando el…

Effects of long-acting beta adrenergic agonists on vocal fold ion transport.

PubMed

Sivasankar, Mahalakshmi; Blazer-Yost, Bonnie

2009-03-01

Inhaled medications prescribed for the hypersensitive airway typically combine corticosteroids and long-acting beta2 adrenergic agonists (LABAs). The phonatory side effects of these combination treatments are widely recognized. However, there is limited understanding of the physiological changes induced by these medications that underlie the phonatory side effects. The objective of this study was to investigate the distinct effects of corticosteroids and LABAs on vocal fold mucosal physiology. Understanding the physiological changes to the vocal folds after corticosteroid and LABA treatments is necessary to prevent the prevalent vocal decrement associated with these medications. Experimental in vitro design with treatment and control groups. Native porcine vocal fold mucosae (N = 38) were exposed to corticosteroid or LABA treatments. Ion transport was measured continuously at baseline and after treatment. To quantify the nature of ion transport, vocal folds were also treated with chloride and sodium channel inhibitors. Corticosteroid treatment did not alter ion transport. Conversely, exposure to LABAs significantly increased ion transport. This increase in ion transport was transient, observed immediately after treatment in all tissue and associated with increased chloride secretion. The distinct effects of corticosteroids and LABAs on vocal fold physiology have not been examined to date. This study demonstrates that short-term treatment with LABAs, but not corticosteroids, significantly increases ion transport. These findings suggest that one underlying physiological mechanism for phonatory changes associated with inhaled treatments may be related to acute alterations in vocal fold ion transport and surface hydration.

Generic School Grounds Design Brief.

ERIC Educational Resources Information Center

Dorset County Council, Dorchester (England).

This document was produced to provide architects, planners, and builders with an educational design brief for Dorset, England school grounds. The County Education Planning and Development Department will use it as an educational and curriculum statement to complement their more detailed and specific building briefs. The brief uses many of the…

Reliability Modeling Methodology for Independent Approaches on Parallel Runways Safety Analysis

NASA Technical Reports Server (NTRS)

Babcock, P.; Schor, A.; Rosch, G.

1998-01-01

This document is an adjunct to the final report An Integrated Safety Analysis Methodology for Emerging Air Transport Technologies. That report presents the results of our analysis of the problem of simultaneous but independent, approaches of two aircraft on parallel runways (independent approaches on parallel runways, or IAPR). This introductory chapter presents a brief overview and perspective of approaches and methodologies for performing safety analyses for complex systems. Ensuing chapter provide the technical details that underlie the approach that we have taken in performing the safety analysis for the IAPR concept.

Workplace bullying in risk and safety professionals.

PubMed

Brewer, Gayle; Holt, Barry; Malik, Shahzeb

2018-02-01

Previous research demonstrates that workplace bullying impacts the welfare of victimized employees, with further consequences for the organization and profession. There is, however, a paucity of information relating to the bullying directed at risk and safety professionals. The present study was conducted to address this issue. Risk and safety professionals (N=420) completed the Negative Acts Questionnaire - Revised and Brief Cope, and reported the extent to which they had been pressured to make or amend a risk or safety based decision. Those experiencing workplace bullying were more likely to engage in a range of coping behaviors, with exposure to work-related and personal bullying particularly influential. Workplace bullying also predicted pressure to make or change a risk or safety based decision. Work related and physically intimidating bullying were particularly important for this aspect of professional practice. Findings are discussed with regard to current practice and the support available to risk and safety professionals. Risk and safety professionals require additional support in relation to workplace bullying and specifically guidance to resist pressure to make or change a risk or safety based decision. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights reserved.

Establishing a culture for patient safety - the role of education.

PubMed

Milligan, Frank J

2007-02-01

This paper argues that the process of making significant moves towards a patient safety culture requires changes in healthcare education. Improvements in patient safety are a shared international priority as too many errors and other forms of unnecessary harm are currently occurring in the process of caring for and treating patients. A description of the patient safety agenda is given followed by a brief analysis of human factors theory and its use in other safety critical industries, most notably aviation. The all too common problem of drug administration errors is used to illustrate the relevance of human factors theory to healthcare education with specific mention made of the Human Factors Analysis and Classification System (HFACS).

"What's on Board" Science Briefing for Cygnus Orbital ATK OA-6

NASA Image and Video Library

2016-03-21

Gary Ruff, NASA project manager and co-investigator for the Spacecraft Fire Safety Demonstration Project, or Saffire, at the Glenn Research Center in Cleveland, speaks to members of the media in the Kennedy Space Center’s Press Site auditorium. The briefing focused on science research and technology work planned for the International Space Station, or ISS, following the arrival of a Cygnus spacecraft. The Cygnus is scheduled to be launched March 22 atop a United Launch Alliance Atlas V rocket on the Orbital ATK CRS-6 commercial resupply services mission.

28 CFR 71.36 - Post-hearing briefs.

Code of Federal Regulations, 2014 CFR

2014-07-01

....36 Post-hearing briefs. ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing such briefs, not to exceed 60... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Post-hearing briefs. 71.36 Section 71.36...

15 CFR 25.36 - Post-hearing briefs.

Code of Federal Regulations, 2013 CFR

2013-01-01

....36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing such briefs, not to... 15 Commerce and Foreign Trade 1 2013-01-01 2013-01-01 false Post-hearing briefs. 25.36 Section 25...

15 CFR 25.36 - Post-hearing briefs.

Code of Federal Regulations, 2010 CFR

2010-01-01

....36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing such briefs, not to... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Post-hearing briefs. 25.36 Section 25...

28 CFR 71.36 - Post-hearing briefs.

Code of Federal Regulations, 2013 CFR

2013-07-01

....36 Post-hearing briefs. ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing such briefs, not to exceed 60... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Post-hearing briefs. 71.36 Section 71.36...

28 CFR 71.36 - Post-hearing briefs.

Code of Federal Regulations, 2010 CFR

2010-07-01

....36 Post-hearing briefs. ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing such briefs, not to exceed 60... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Post-hearing briefs. 71.36 Section 71.36...

28 CFR 71.36 - Post-hearing briefs.

Code of Federal Regulations, 2012 CFR

2012-07-01

....36 Post-hearing briefs. ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing such briefs, not to exceed 60... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Post-hearing briefs. 71.36 Section 71.36...

28 CFR 71.36 - Post-hearing briefs.

Code of Federal Regulations, 2011 CFR

2011-07-01

....36 Post-hearing briefs. ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing such briefs, not to exceed 60... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Post-hearing briefs. 71.36 Section 71.36...

45 CFR 79.36 - Post-hearing briefs.

Code of Federal Regulations, 2012 CFR

2012-10-01

....36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing such briefs, not to... 45 Public Welfare 1 2012-10-01 2012-10-01 false Post-hearing briefs. 79.36 Section 79.36 Public...

15 CFR 25.36 - Post-hearing briefs.

Code of Federal Regulations, 2012 CFR

2012-01-01

....36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing such briefs, not to... 15 Commerce and Foreign Trade 1 2012-01-01 2012-01-01 false Post-hearing briefs. 25.36 Section 25...

45 CFR 79.36 - Post-hearing briefs.

Code of Federal Regulations, 2014 CFR

2014-10-01

....36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing such briefs, not to... 45 Public Welfare 1 2014-10-01 2014-10-01 false Post-hearing briefs. 79.36 Section 79.36 Public...

45 CFR 79.36 - Post-hearing briefs.

Code of Federal Regulations, 2011 CFR

2011-10-01

....36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing such briefs, not to... 45 Public Welfare 1 2011-10-01 2011-10-01 false Post-hearing briefs. 79.36 Section 79.36 Public...

15 CFR 25.36 - Post-hearing briefs.

Code of Federal Regulations, 2014 CFR

2014-01-01

....36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing such briefs, not to... 15 Commerce and Foreign Trade 1 2014-01-01 2014-01-01 false Post-hearing briefs. 25.36 Section 25...

15 CFR 25.36 - Post-hearing briefs.

Code of Federal Regulations, 2011 CFR

2011-01-01

....36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing such briefs, not to... 15 Commerce and Foreign Trade 1 2011-01-01 2011-01-01 false Post-hearing briefs. 25.36 Section 25...

45 CFR 79.36 - Post-hearing briefs.

Code of Federal Regulations, 2013 CFR

2013-10-01

....36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing such briefs, not to... 45 Public Welfare 1 2013-10-01 2013-10-01 false Post-hearing briefs. 79.36 Section 79.36 Public...

Characteristics of team briefings in gynecological surgery.

PubMed

Forsyth, Katherine L; Hildebrand, Emily A; Hallbeck, M Susan; Branaghan, Russell J; Blocker, Renaldo C

2018-02-24

Preoperative briefings have been proven beneficial for improving team performance in the operating room. However, there has been minimal research regarding team briefings in specific surgical domains. As part of a larger project to develop a briefing structure for gynecological surgery, the study aimed to better understand the current state of pre-operative team briefings in one department of an academic hospital. Twenty-four team briefings were observed and video recorded. Communication was analyzed and social network metrics were created based on the team member verbal interactions. Introductions occurred in only 25% of the briefings. Network analysis revealed that average team briefings exhibited a hierarchical structure of communication, with the surgeon speaking the most frequently. The average network for resident-led briefings displayed a non-hierarchical structure with all team members communicating with the resident. Briefings conducted without a standardized protocol can produce variable communication between the role leading and the team members present. Copyright © 2018 Elsevier Ltd. All rights reserved.

22 CFR 521.36 - Post-hearing briefs.

Code of Federal Regulations, 2010 CFR

2010-04-01

... § 521.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing briefs, at a time not... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Post-hearing briefs. 521.36 Section 521.36...

22 CFR 521.36 - Post-hearing briefs.

Code of Federal Regulations, 2011 CFR

2011-04-01

... § 521.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing briefs, at a time not... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Post-hearing briefs. 521.36 Section 521.36...

22 CFR 224.36 - Post-hearing briefs.

Code of Federal Regulations, 2012 CFR

2012-04-01

... ACT § 224.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing briefs, at a time... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Post-hearing briefs. 224.36 Section 224.36...

22 CFR 521.36 - Post-hearing briefs.

Code of Federal Regulations, 2013 CFR

2013-04-01

... § 521.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing briefs, at a time not... 22 Foreign Relations 2 2013-04-01 2009-04-01 true Post-hearing briefs. 521.36 Section 521.36...

22 CFR 224.36 - Post-hearing briefs.

Code of Federal Regulations, 2013 CFR

2013-04-01

... ACT § 224.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing briefs, at a time... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Post-hearing briefs. 224.36 Section 224.36...

22 CFR 224.36 - Post-hearing briefs.

Code of Federal Regulations, 2014 CFR

2014-04-01

... ACT § 224.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing briefs, at a time... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Post-hearing briefs. 224.36 Section 224.36...

22 CFR 521.36 - Post-hearing briefs.

Code of Federal Regulations, 2014 CFR

2014-04-01

... § 521.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing briefs, at a time not... 22 Foreign Relations 2 2014-04-01 2014-04-01 false Post-hearing briefs. 521.36 Section 521.36...

22 CFR 224.36 - Post-hearing briefs.

Code of Federal Regulations, 2010 CFR

2010-04-01

... ACT § 224.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing briefs, at a time... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Post-hearing briefs. 224.36 Section 224.36...

22 CFR 224.36 - Post-hearing briefs.

Code of Federal Regulations, 2011 CFR

2011-04-01

... ACT § 224.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing briefs, at a time... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Post-hearing briefs. 224.36 Section 224.36...

22 CFR 521.36 - Post-hearing briefs.

Code of Federal Regulations, 2012 CFR

2012-04-01

... § 521.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing briefs, at a time not... 22 Foreign Relations 2 2012-04-01 2009-04-01 true Post-hearing briefs. 521.36 Section 521.36...

A Synthetic Vision Preliminary Integrated Safety Analysis

NASA Technical Reports Server (NTRS)

Hemm, Robert; Houser, Scott

2001-01-01

This report documents efforts to analyze a sample of aviation safety programs, using the LMI-developed integrated safety analysis tool to determine the change in system risk resulting from Aviation Safety Program (AvSP) technology implementation. Specifically, we have worked to modify existing system safety tools to address the safety impact of synthetic vision (SV) technology. Safety metrics include reliability, availability, and resultant hazard. This analysis of SV technology is intended to be part of a larger effort to develop a model that is capable of "providing further support to the product design and development team as additional information becomes available". The reliability analysis portion of the effort is complete and is fully documented in this report. The simulation analysis is still underway; it will be documented in a subsequent report. The specific goal of this effort is to apply the integrated safety analysis to SV technology. This report also contains a brief discussion of data necessary to expand the human performance capability of the model, as well as a discussion of human behavior and its implications for system risk assessment in this modeling environment.

Cost-effectiveness of the LABA/LAMA dual bronchodilator indacaterol/glycopyrronium in a Swedish healthcare setting.

PubMed

Price, David; Keininger, Dorothy; Costa-Scharplatz, Madlaina; Mezzi, Karen; Dimova, Maria; Asukai, Yumi; Ställberg, Björn

2014-12-01

Indacaterol/glycopyrronium (IND/GLY) is a once-daily inhaled fixed-dose combination of indacaterol (IND), a long-acting β2-adrenergic agonist (LABA), and glycopyrronium (GLY), a long-acting muscarinic antagonist (LAMA) for use as maintenance treatment to relieve symptoms of chronic obstructive pulmonary disease (COPD) in adults. To determine the economic benefits of IND/GLY compared with the free combination of indacaterol and glycopyrronium (IND + GLY), and with the fixed-dose combination of salmeterol/fluticasone (SFC), in a moderate-to-severe COPD population with low-exacerbation risk. The model-based analysis extrapolated results up to lifetime time horizon and calculated costs per quality-adjusted life year. Assuming equal efficacy, a cost-minimisation analysis compared IND/GLY vs IND + GLY using model inputs from the double-blind, randomised SHINE trial. The double-blind, randomised ILLUMINATE and TORCH trials were used to analyse cost-effectiveness versus SFC. To consider ICS-related pneumonia events, published odds ratio comparing an ICS-exposed group to a control group of COPD patients was used. Direct and indirect drug costs as well as drug acquisition costs (in Swedish Krona [SEK]) were derived from published Swedish sources. Cost and effects were discounted with 3%. Uncertainty was assessed by one-way and probabilistic sensitivity analyses (PSA). IND/GLY was cost-saving vs IND + GLY with incremental savings of SEK (EUR) 768 (85), and 3309 (368) per patient over one and five years. IND/GLY was found to be less costly and more effective compared to SFC with cost savings of SEK (EUR) 2744 (303), 8854 (976), 13,938 (1536), 27,495 (3031) and 43,033 (4744) over one, three, five, ten years and lifetime. The PSA indicated that all iterations produced dominant results for IND/GLY. IND/GLY is cost-minimising vs IND + GLY and dominates SFC in the maintenance treatment of COPD patients in Sweden. Encouraging dual bronchodilator therapy over an ICS

Inhaled glycopyrrolate for the treatment of chronic obstructive pulmonary disease.

PubMed

Tashkin, Donald P; Gross, Nicholas J

2018-01-01

Long-acting muscarinic antagonists (LAMAs), along with long-acting β 2 -agonists (LABAs), are the mainstay for treatment of patients with COPD. Glycopyrrolate, or glycopyrronium bromide, like other LAMAs, inhibits parasympathetic nerve impulses by selectively blocking the binding of acetylcholine to muscarinic receptors. Glycopyrrolate is unusual in that it preferentially binds to M 3 over M 2 muscarinic receptors, thereby specifically targeting the primary muscarinic receptor responsible for bronchoconstriction occurring in COPD. Inhaled glycopyrrolate is slowly absorbed from the lungs and rapidly eliminated from the bloodstream, most likely by renal excretion in its unmetabolized form, limiting the potential for systemic adverse events. Inhaled glycopyrrolate is a fast-acting, efficacious treatment option for patients with moderate-severe COPD. It improves lung function, reduces the risk of exacerbations, and alleviates the symptoms of breathlessness, which in turn may explain the improvement seen in patients' quality of life. Inhaled formulations containing glycopyrrolate are well tolerated, and despite being an anticholinergic, few cardiovascular-related events have been reported. Inhaled glycopyrrolate is thus of value as both monotherapy and in combination with other classes of medication for maintenance treatment of COPD. This review covers the mechanism of action of inhaled glycopyrrolate, including its pharmacokinetic, pharmacodynamic, and safety profiles, and effects on mucus secretion. It also discusses the use of inhaled glycopyrrolate in the treatment of COPD, as monotherapy and in fixed-dose combinations with LABAs and inhaled corticosteroid-LABAs, including a triple therapy recently approved in Europe.

STEREO Press Briefing

NASA Image and Video Library

2011-08-17

David Webb, a research physicist from the Institute for Scientific Research at Boston College speaks during a press briefing, Thursday, Aug. 18, 2011, at NASA Headquarters in Washington. The briefing was held to discuss new details about the structure of solar storms and the impact they have on Earth. The new information comes from NASA's Solar Terrestrial Relations Observatory, or STEREO, spacecraft and other NASA probes. Photo Credit: (NASA/GSFC/Rebecca Roth)

STEREO Press Briefing

NASA Image and Video Library

2011-08-17

Alysha Reinard, as research scientist with National Oceanic and Atmospheric Administration and the University of Colorado Boulder, speaks during a press briefing, Thursday, Aug. 18, 2011, at NASA Headquarters in Washington. The briefing was held to discusses new details about the structure of solar storms and the impact they have on Earth. The new information comes from NASA's Solar Terrestrial Relations Observatory, or STEREO, spacecraft and other NASA probes. Photo Credit: (NASA/GSFC/Rebecca Roth)

STEREO Press Briefing

NASA Image and Video Library

2011-08-17

Craig DeForest, second from left, speaks during a press briefing, Thursday, Aug. 18, 2011, at NASA Headquarters in Washington as Madhulika Guhathakurta, left, David Webb and Alysha Reinard look on. The briefing was held to discusses new details about the structure of solar storms and the impact they have on Earth. The new information comes from NASA's Solar Terrestrial Relations Observatory, or STEREO, spacecraft and other NASA probes. Photo Credit: (NASA/GSFC/Rebecca Roth)

STEREO Press Briefing

NASA Image and Video Library

2011-08-17

Craig DeForest, a staff scientist at the Southwest Research Institute in Boulder, Colo., speaks during a press briefing, Thursday, Aug. 18, 2011, at NASA Headquarters in Washington. The briefing was held to discusses new details about the structure of solar storms and the impact they have on Earth. The new information comes from NASA's Solar Terrestrial Relations Observatory, or STEREO, spacecraft and other NASA probes. Photo Credit: (NASA/GSFC/Rebecca Roth)

Improving the culture of safety on a high-acuity inpatient child/adolescent psychiatric unit by mindfulness-based stress reduction training of staff.

PubMed

Hallman, Ilze S; O'Connor, Nancy; Hasenau, Susan; Brady, Stephanie

2014-11-01

The purpose of this study was to reduce perceived levels of interprofessional staff stress and to improve patient and staff safety by implementing a brief mindfulness-based stress reduction (MBSR) training program on a high-acuity psychiatric inpatient unit. A one-group repeated measure design was utilized to measure the impact of the (MBSR) training program on staff stress and safety immediately post-training and at 2 months. Two instruments were utilized in the study: the Toronto Mindfulness Scale and the Perceived Stress Scale. The MBSR program reduced staff stress across the 2-month post-training period and increased staff mindfulness immediately following the brief training period of 8 days, and across the 2-month post-training period. A trend toward positive impact on patient and staff safety was also seen in a decreased number of staff call-ins, decreased need for 1:1 staffing episodes, and decreased restraint use 2 months following the training period. A brief MBSR training program offered to an interprofessional staff of a high-acuity inpatient adolescent psychiatric unit was effective in decreasing their stress, increasing their mindfulness, and improving staff and patient safety. © 2014 Wiley Periodicals, Inc.

Software Safety Analysis of a Flight Guidance System

NASA Technical Reports Server (NTRS)

Butler, Ricky W. (Technical Monitor); Tribble, Alan C.; Miller, Steven P.; Lempia, David L.

2004-01-01

This document summarizes the safety analysis performed on a Flight Guidance System (FGS) requirements model. In particular, the safety properties desired of the FGS model are identified and the presence of the safety properties in the model is formally verified. Chapter 1 provides an introduction to the entire project, while Chapter 2 gives a brief overview of the problem domain, the nature of accidents, model based development, and the four-variable model. Chapter 3 outlines the approach. Chapter 4 presents the results of the traditional safety analysis techniques and illustrates how the hazardous conditions associated with the system trace into specific safety properties. Chapter 5 presents the results of the formal methods analysis technique model checking that was used to verify the presence of the safety properties in the requirements model. Finally, Chapter 6 summarizes the main conclusions of the study, first and foremost that model checking is a very effective verification technique to use on discrete models with reasonable state spaces. Additional supporting details are provided in the appendices.

Performance-Based Funding Brief

ERIC Educational Resources Information Center

Washington Higher Education Coordinating Board, 2011

2011-01-01

A number of states have made progress in implementing performance-based funding (PFB) and accountability. This policy brief summarizes main features of performance-based funding systems in three states: Tennessee, Ohio, and Indiana. The brief also identifies key issues that states considering performance-based funding must address, as well as…

Professional Development. Issue Brief

ERIC Educational Resources Information Center

Keleher, Julia

2017-01-01

In this professional development research brief, the author sets forth the overarching considerations that should be kept in mind when conceptualizing professional development for educators working with neglected or delinquent youth (N or D). The brief begins by defining professional development and demonstrating why it is a critical support for…

Brief Articles for Latino Parents, 1999 Edition.

ERIC Educational Resources Information Center

ERIC Clearinghouse on Rural Education and Small Schools, Charleston, WV.

This packet contains six briefs developed specifically for Spanish-speaking Latino parents, and English translations of the briefs. These briefs state what researchers and practitioners have learned about various ways parents can help their children do well in school. Earlier editions of brief articles for parents have been used in various ways by…

STEREO Press Briefing

NASA Image and Video Library

2011-08-17

Madhulika Guhathakurta, seated left, STEREO program scientist, speaks during a press briefing, Thursday, Aug. 18, 2011, at NASA Headquarters in Washington as Craig DeForest, David Webb and Alysha Reinard, look on. The briefing was held to discusses new details about the structure of solar storms and the impact they have on Earth. The new information comes from NASA's Solar Terrestrial Relations Observatory, or STEREO, spacecraft and other NASA probes. Photo Credit: (NASA/GSFC/Rebecca Roth)

STEREO Press Briefing

NASA Image and Video Library

2011-08-17

Madhulika Guhathakurta, seated left, STEREO program scientist, speaks during a press briefing, Thursday, Aug. 18, 2011, at NASA Headquarters in Washington as Craig DeForest, David Webb and Alysha Reinard, look on. The briefing was held to discusses new details about the structure of solar storms and the impact they have on Earth. The new information comes from NASA's Solar Terrestrial Relations Observatory, or STEREO, spacecraft and other NASA probes. Photo Credit: (NASA/GSFC/Rebecca Roth).

Safety Study of Double-Decker Motorcoaches with Rear Luggage Compartment : Technology Brief

DOT National Transportation Integrated Search

2017-12-01

The study was conducted through a combination of analyses and tests with a double-decker motorcoach. State transportation safety and law enforcement officials were consulted, and the study plan was revised according to their comments. An exemplar mot...

38 CFR 42.36 - Post-hearing briefs.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) STANDARDS IMPLEMENTING THE PROGRAM FRAUD CIVIL REMEDIES ACT § 42.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Post-hearing briefs. 42...

38 CFR 42.36 - Post-hearing briefs.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) STANDARDS IMPLEMENTING THE PROGRAM FRAUD CIVIL REMEDIES ACT § 42.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Post-hearing briefs. 42...

38 CFR 42.36 - Post-hearing briefs.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) STANDARDS IMPLEMENTING THE PROGRAM FRAUD CIVIL REMEDIES ACT § 42.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Post-hearing briefs. 42...

38 CFR 42.36 - Post-hearing briefs.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) STANDARDS IMPLEMENTING THE PROGRAM FRAUD CIVIL REMEDIES ACT § 42.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Post-hearing briefs. 42...

38 CFR 42.36 - Post-hearing briefs.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) STANDARDS IMPLEMENTING THE PROGRAM FRAUD CIVIL REMEDIES ACT § 42.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Post-hearing briefs. 42...

Limited-scope probabilistic safety analysis for the Los Alamos Meson Physics Facility (LAMPF)

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

Sharirli, M.; Rand, J.L.; Sasser, M.K.

1992-01-01

The reliability of instrumentation and safety systems is a major issue in the operation of accelerator facilities. A probabilistic safety analysis was performed or the key safety and instrumentation systems at the Los Alamos Meson Physics Facility (LAMPF). in Phase I of this unique study, the Personnel Safety System (PSS) and the Current Limiters (XLs) were analyzed through the use of the fault tree analyses, failure modes and effects analysis, and criticality analysis. Phase II of the program was done to update and reevaluate the safety systems after the Phase I recommendations were implemented. This paper provides a brief reviewmore » of the studies involved in Phases I and II of the program.« less

Limited-scope probabilistic safety analysis for the Los Alamos Meson Physics Facility (LAMPF)

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

Sharirli, M.; Rand, J.L.; Sasser, M.K.

1992-12-01

The reliability of instrumentation and safety systems is a major issue in the operation of accelerator facilities. A probabilistic safety analysis was performed or the key safety and instrumentation systems at the Los Alamos Meson Physics Facility (LAMPF). in Phase I of this unique study, the Personnel Safety System (PSS) and the Current Limiters (XLs) were analyzed through the use of the fault tree analyses, failure modes and effects analysis, and criticality analysis. Phase II of the program was done to update and reevaluate the safety systems after the Phase I recommendations were implemented. This paper provides a brief reviewmore » of the studies involved in Phases I and II of the program.« less

20 CFR 355.36 - Post-hearing briefs.

Code of Federal Regulations, 2014 CFR

2014-04-01

... REGULATIONS UNDER THE PROGRAM FRAUD CIVIL REMEDIES ACT OF 1986 § 355.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true Post-hearing briefs. 355.36 Section 355.36...

7 CFR 1.334 - Post-hearing briefs.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Hearings Under the Program Fraud Civil Remedies Act of 1986 § 1.334 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief... 7 Agriculture 1 2013-01-01 2013-01-01 false Post-hearing briefs. 1.334 Section 1.334 Agriculture...

40 CFR 27.36 - Post-hearing briefs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... § 27.36 Post-hearing briefs. The presiding officer may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The presiding officer shall fix the time for... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Post-hearing briefs. 27.36 Section 27...

20 CFR 355.36 - Post-hearing briefs.

Code of Federal Regulations, 2010 CFR

2010-04-01

... REGULATIONS UNDER THE PROGRAM FRAUD CIVIL REMEDIES ACT OF 1986 § 355.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Post-hearing briefs. 355.36 Section 355.36...

7 CFR 1.334 - Post-hearing briefs.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Hearings Under the Program Fraud Civil Remedies Act of 1986 § 1.334 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief... 7 Agriculture 1 2010-01-01 2010-01-01 false Post-hearing briefs. 1.334 Section 1.334 Agriculture...

40 CFR 27.36 - Post-hearing briefs.

Code of Federal Regulations, 2014 CFR

2014-07-01

... § 27.36 Post-hearing briefs. The presiding officer may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The presiding officer shall fix the time for... 40 Protection of Environment 1 2014-07-01 2014-07-01 false Post-hearing briefs. 27.36 Section 27...

10 CFR 13.36 - Post-hearing briefs.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Post-hearing briefs. 13.36 Section 13.36 Energy NUCLEAR REGULATORY COMMISSION PROGRAM FRAUD CIVIL REMEDIES § 13.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall...

10 CFR 13.36 - Post-hearing briefs.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Post-hearing briefs. 13.36 Section 13.36 Energy NUCLEAR REGULATORY COMMISSION PROGRAM FRAUD CIVIL REMEDIES § 13.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall...

5 CFR 185.136 - Post-hearing briefs.

Code of Federal Regulations, 2013 CFR

2013-01-01

... CIVIL REMEDIES § 185.136 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing such... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Post-hearing briefs. 185.136 Section 185...

7 CFR 1.334 - Post-hearing briefs.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Hearings Under the Program Fraud Civil Remedies Act of 1986 § 1.334 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief... 7 Agriculture 1 2014-01-01 2014-01-01 false Post-hearing briefs. 1.334 Section 1.334 Agriculture...

42 CFR 1005.19 - Post-hearing briefs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... APPEALS OF EXCLUSIONS, CIVIL MONEY PENALTIES AND ASSESSMENTS § 1005.19 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief... 42 Public Health 5 2014-10-01 2014-10-01 false Post-hearing briefs. 1005.19 Section 1005.19 Public...

42 CFR 1005.19 - Post-hearing briefs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... APPEALS OF EXCLUSIONS, CIVIL MONEY PENALTIES AND ASSESSMENTS § 1005.19 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief... 42 Public Health 5 2011-10-01 2011-10-01 false Post-hearing briefs. 1005.19 Section 1005.19 Public...

40 CFR 27.36 - Post-hearing briefs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... § 27.36 Post-hearing briefs. The presiding officer may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The presiding officer shall fix the time for... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Post-hearing briefs. 27.36 Section 27...

5 CFR 185.136 - Post-hearing briefs.

Code of Federal Regulations, 2012 CFR

2012-01-01

... CIVIL REMEDIES § 185.136 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing such... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Post-hearing briefs. 185.136 Section 185...

40 CFR 27.36 - Post-hearing briefs.

Code of Federal Regulations, 2012 CFR

2012-07-01

... § 27.36 Post-hearing briefs. The presiding officer may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The presiding officer shall fix the time for... 40 Protection of Environment 1 2012-07-01 2012-07-01 false Post-hearing briefs. 27.36 Section 27...

5 CFR 185.136 - Post-hearing briefs.

Code of Federal Regulations, 2011 CFR

2011-01-01

... CIVIL REMEDIES § 185.136 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing such... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Post-hearing briefs. 185.136 Section 185...

7 CFR 1.334 - Post-hearing briefs.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Hearings Under the Program Fraud Civil Remedies Act of 1986 § 1.334 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief... 7 Agriculture 1 2012-01-01 2012-01-01 false Post-hearing briefs. 1.334 Section 1.334 Agriculture...

10 CFR 13.36 - Post-hearing briefs.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Post-hearing briefs. 13.36 Section 13.36 Energy NUCLEAR REGULATORY COMMISSION PROGRAM FRAUD CIVIL REMEDIES § 13.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall...

42 CFR 1005.19 - Post-hearing briefs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... APPEALS OF EXCLUSIONS, CIVIL MONEY PENALTIES AND ASSESSMENTS § 1005.19 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief... 42 Public Health 5 2010-10-01 2010-10-01 false Post-hearing briefs. 1005.19 Section 1005.19 Public...

42 CFR 1005.19 - Post-hearing briefs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... APPEALS OF EXCLUSIONS, CIVIL MONEY PENALTIES AND ASSESSMENTS § 1005.19 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief... 42 Public Health 5 2013-10-01 2013-10-01 false Post-hearing briefs. 1005.19 Section 1005.19 Public...

40 CFR 27.36 - Post-hearing briefs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... § 27.36 Post-hearing briefs. The presiding officer may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The presiding officer shall fix the time for... 40 Protection of Environment 1 2013-07-01 2013-07-01 false Post-hearing briefs. 27.36 Section 27...

20 CFR 355.36 - Post-hearing briefs.

Code of Federal Regulations, 2011 CFR

2011-04-01

... REGULATIONS UNDER THE PROGRAM FRAUD CIVIL REMEDIES ACT OF 1986 § 355.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Post-hearing briefs. 355.36 Section 355.36...

5 CFR 185.136 - Post-hearing briefs.

Code of Federal Regulations, 2010 CFR

2010-01-01

... CIVIL REMEDIES § 185.136 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing such... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Post-hearing briefs. 185.136 Section 185...

10 CFR 13.36 - Post-hearing briefs.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Post-hearing briefs. 13.36 Section 13.36 Energy NUCLEAR REGULATORY COMMISSION PROGRAM FRAUD CIVIL REMEDIES § 13.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall...

20 CFR 355.36 - Post-hearing briefs.

Code of Federal Regulations, 2013 CFR

2013-04-01

... REGULATIONS UNDER THE PROGRAM FRAUD CIVIL REMEDIES ACT OF 1986 § 355.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Post-hearing briefs. 355.36 Section 355.36...

5 CFR 185.136 - Post-hearing briefs.

Code of Federal Regulations, 2014 CFR

2014-01-01

... CIVIL REMEDIES § 185.136 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing such... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Post-hearing briefs. 185.136 Section 185...

7 CFR 1.334 - Post-hearing briefs.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Hearings Under the Program Fraud Civil Remedies Act of 1986 § 1.334 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief... 7 Agriculture 1 2011-01-01 2011-01-01 false Post-hearing briefs. 1.334 Section 1.334 Agriculture...

10 CFR 13.36 - Post-hearing briefs.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Post-hearing briefs. 13.36 Section 13.36 Energy NUCLEAR REGULATORY COMMISSION PROGRAM FRAUD CIVIL REMEDIES § 13.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall...

42 CFR 1005.19 - Post-hearing briefs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... APPEALS OF EXCLUSIONS, CIVIL MONEY PENALTIES AND ASSESSMENTS § 1005.19 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief... 42 Public Health 5 2012-10-01 2012-10-01 false Post-hearing briefs. 1005.19 Section 1005.19 Public...

20 CFR 355.36 - Post-hearing briefs.

Code of Federal Regulations, 2012 CFR

2012-04-01

... REGULATIONS UNDER THE PROGRAM FRAUD CIVIL REMEDIES ACT OF 1986 § 355.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false Post-hearing briefs. 355.36 Section 355.36...

Appropriate use of inhaled corticosteroid and long-acting beta(2)-adrenergic agonist combination therapy among asthma patients in a US commercially insured population.

PubMed

Ye, Xin; Gutierrez, Benjamin; Zarotsky, Victoria; Nelson, Michael; Blanchette, Christopher M

2009-09-01

To examine health care utilization measures indicating which asthma patients are appropriate for inhaled corticosteroid and long-acting beta(2)-adrenergic agonist (ICS/LABA) therapy and determine whether two ICS/LABA therapies were initiated in accordance with guidelines. A retrospective cohort study of commercially insured asthma patients aged > or =12 years that initiated fluticasone propionate/salmeterol (FSC) or budesonide/formoterol fumarate dihydrate (BFC) combination therapy in 2007 was conducted. Use was considered appropriate if patients met any of the following during a 1-year period before ICS/LABA initiation: ICS or leukotriene receptor antagonist (LTRA) use; an asthma-related emergency department (ED) visit or hospitalization; > or =2 oral corticosteroids (OCS) courses; or > or =6 short-acting beta(2)-adrenergic agonist (SABA) canisters. Multivariate logistic regression was used to assess factors associated with appropriate ICS/LABA use. Certain limitations inherent to the use of claims data for research apply to this study. Of 24,231 patients who initiated ICS/LABA therapy, 993 received BFC and 23,238 received FSC. Among all patients, 37.6% met > or =1 criteria for appropriate use. However, compared with FSC users, BFC users had a significantly higher likelihood of meeting > or =1 of these criteria (odds ratio, 2.01; 95% CI, 1.76-2.30; p < 0.001), and a higher proportion of BFC than FSC patients met 4 of the 5 appropriate use criteria. In total, 58.4% of BFC patients versus 36.7% of FSC patients met > or =1 criteria for appropriate use. Other factors associated with appropriate use included age, region, Charlson comorbidity score, number of medications, and prescriber specialty. Fewer than half of all patients fulfilled the specified criteria for being appropriate for ICS/LABA therapy. However, a significantly higher proportion of BFC than FSC users met the criteria for appropriate use of ICS/LABA therapy. These results may suggest a need for improved

SHPPS 2006: School Health Policies and Programs Study--Food Safety

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2007

2007-01-01

The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports study results in the area of food safety, covering the following topics: (1) Health Education; (2) Health Services; and (3)…

Cybernetics of Brief Family Therapy.

ERIC Educational Resources Information Center

Keeney, Bradford P.; Ross, Jeffrey M.

1983-01-01

Presents a cybernetic view of brief family therapy. Includes a historical discussion of the key ideas underlying brief family therapy, a cybernetic model of therapeutic change, and a clinical case for exemplification. (Author/JAC)

43 CFR 35.36 - Post-hearing briefs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... CLAIMS AND STATEMENTS § 35.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing such... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Post-hearing briefs. 35.36 Section 35.36...

29 CFR 22.36 - Post-hearing briefs.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 1 2014-07-01 2013-07-01 true Post-hearing briefs. 22.36 Section 22.36 Labor Office of the Secretary of Labor PROGRAM FRAUD CIVIL REMEDIES ACT OF 1986 § 22.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The...

43 CFR 35.36 - Post-hearing briefs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... CLAIMS AND STATEMENTS § 35.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing such... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Post-hearing briefs. 35.36 Section 35.36...

43 CFR 35.36 - Post-hearing briefs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... CLAIMS AND STATEMENTS § 35.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing such... 43 Public Lands: Interior 1 2013-10-01 2013-10-01 false Post-hearing briefs. 35.36 Section 35.36...

29 CFR 22.36 - Post-hearing briefs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 1 2010-07-01 2010-07-01 true Post-hearing briefs. 22.36 Section 22.36 Labor Office of the Secretary of Labor PROGRAM FRAUD CIVIL REMEDIES ACT OF 1986 § 22.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The...

43 CFR 35.36 - Post-hearing briefs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... CLAIMS AND STATEMENTS § 35.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing such... 43 Public Lands: Interior 1 2014-10-01 2014-10-01 false Post-hearing briefs. 35.36 Section 35.36...

43 CFR 35.36 - Post-hearing briefs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... CLAIMS AND STATEMENTS § 35.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing brief. The ALJ shall fix the time for filing such... 43 Public Lands: Interior 1 2012-10-01 2011-10-01 true Post-hearing briefs. 35.36 Section 35.36...

37 CFR 41.67 - Appellant's brief.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Appellant's brief. 41.67... Appellant's brief. (a)(1) Appellant(s) may once, within time limits for filing set forth in § 41.66, file a... title. (2) The brief must be signed by the appellant, or the appellant's duly authorized attorney or...

Safety impact of permitting right-turn-on-red : a report to Congress

DOT National Transportation Integrated Search

1994-12-01

The Energy Policy Act of 1992 required NHTSA to conduct a study of the safety impact of permitting right and left turns on red lights. The report presents a brief summary of the current status of State implementation of laws permitting right and left...

37 CFR 41.68 - Respondent's brief.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Respondent's brief. 41.68... Respondent's brief. (a)(1) Respondent(s) in an appeal may once, within the time limit for filing set forth in... title. (2) The brief must be signed by the party, or the party's duly authorized attorney or agent, and...

Biomonitoring at the UK Health and Safety Laboratory.

PubMed

Cocker, J; Jones, K; Morton, J; Mason, H J

2007-05-01

The UK Health and Safety Laboratory (HSL) provides research and analytical support to the Health and Safety Executive, other Government Departments and employers. In the area of biomonitoring HSL conducts research studies and provides an analytical service for regular surveillance of worker exposure to hazardous substances. This paper gives brief examples of how data from such studies can be used to develop biological monitoring guidance values for isocyanates, polycyclic aromatic hydrocarbons and hexavalent chromium. In addition, a study of occupational exposure to copper chrome arsenic wood preservatives is briefly described to show how biological monitoring can be used for post-approval surveillance of a biocide.

Safety in the Air: A Curriculum about Flight and Air Traffic Control Designed for Middle School Students.

ERIC Educational Resources Information Center

Colton, Ted

This six-lesson unit is designed to familiarize sixth, seventh, and eighth grade students with air traffic safety and the individuals who make air traffic safety possible. Each lesson consists of a statement of the concept fostered, a list of objectives, a brief discussion on the focus of the unit, and instructional strategies for lesson topics…

AB013. Inappropriate asthma therapy: a tale of two countries

PubMed Central

Nibber, Anjan; Belhassen, Manon; Van Ganse, Eric; Ryan, Dermot; Langlois, Carole; Appiagyei, Francis; Skinner, Derek; Laforest, Laurent; Soriano, Joan B.; Price, David

2016-01-01

Background Inappropriate prescribing and misuse of asthma medication, have been identified as potentially preventable factors linked to asthma exacerbations and deaths. A recent report by the National Review of Asthma Deaths drew attention to the excessive prescribing of reliever medication, and under-prescribing of controlled medication in the United-Kingdom (UK). The inappropriate prescribing of long-acting beta agonist (LABA) bronchodilator inhalers, as either a monotherapy or without inhaled corticosteroids (ICS) has been highlighted as a major preventable factor of asthma exacerbations and deaths. To determine whether the prevalence of inappropriate LABA therapy use in asthma in the UK and in France has changed over time. Methods Two interval, parallel, population-based cohorts (2007 and 2013), were developed in each country, utilising the UK Optimum Patient Care Research Database and the French Permanent Beneficiaries Sample database. Following inclusion, patients aged 6–40 years were studied over a 12-month period. The use of LABAs without ICS, and ≥2-fold higher use of LABA compared with ICS were investigated. Analyses were stratified by age groups: children (6–13 years) and adults (14–40 years). Results Overall, 39,743 UK and 4,910 French patients were included in 2007 and 14,036 and 5,657 in 2013. In 2013, LABA use without ICS occurred in 0.1% and 1.5% of UK and French adults respectively. This was a marked reduction from 2007 UK and French figures of 0.4% and 2.6% respectively (P<0.05 for both). Excessive use of LABA relative to ICS occurred in 0.2% of UK adults and in 0.7% of French adults in 2013. These percentages represented a decrease from the 2007 figures of 0.6% and 1.4% for UK (P=0.29) and France (P=0.003), respectively. In 2007, LABA inappropriate use was more frequent in French than UK asthmatic children (P<0.0001), but showed a downward trend by time in both countries (0.1% in 2013 in both countries). Conclusions Our study suggests

Biological safety cabinetry.

PubMed Central

Kruse, R H; Puckett, W H; Richardson, J H

1991-01-01

The biological safety cabinet is the one piece of laboratory and pharmacy equipment that provides protection for personnel, the product, and the environment. Through the history of laboratory-acquired infections from the earliest published case to the emergence of hepatitis B and AIDS, the need for health care worker protection is described. A brief description with design, construction, function, and production capabilities is provided for class I and class III safety cabinets. The development of the high-efficiency particulate air filter provided the impetus for clean room technology, from which evolved the class II laminar flow biological safety cabinet. The clean room concept was advanced when the horizontal airflow clean bench was manufactured; it became popular in pharmacies for preparing intravenous solutions because the product was protected. However, as with infectious microorganisms and laboratory workers, individual sensitization to antibiotics and the advent of hazardous antineoplastic agents changed the thinking of pharmacists and nurses, and they began to use the class II safety cabinet to prevent adverse personnel reactions to the drugs. How the class II safety cabinet became the mainstay in laboratories and pharmacies is described, and insight is provided into the formulation of National Sanitation Foundation standard number 49 and its revisions. The working operations of a class II cabinet are described, as are the variations of the four types with regard to design, function, air velocity profiles, and the use of toxins. The main certification procedures are explained, with examples of improper or incorrect certifications. The required levels of containment for microorganisms are given. Instructions for decontaminating the class II biological safety cabinet of infectious agents are provided; unfortunately, there is no method for decontaminating the cabinet of antineoplastic agents. Images PMID:2070345

Long-Acting β-Agonist in Combination or Separate Inhaler as Step-Up Therapy for Children with Uncontrolled Asthma Receiving Inhaled Corticosteroids.

PubMed

Turner, Steve; Richardson, Kathryn; Murray, Clare; Thomas, Mike; Hillyer, Elizabeth V; Burden, Anne; Price, David B

Adding a long-acting β 2 -agonist (LABA) to inhaled corticosteroids (ICS) using a fixed-dose combination (FDC) inhaler is the UK guideline recommendation for children aged more than 4 years with uncontrolled asthma. The evidence of benefit of adding an FDC inhaler over a separate LABA inhaler is limited. The objective of this study was to compare the effectiveness of a LABA added as an FDC inhaler, and as a separate inhaler, in children with uncontrolled asthma. Two UK primary care databases were used to create a matched cohort study with a 2-year follow-up period. We included children prescribed their first step-up from ICS monotherapy. Two cohorts were formed for children receiving an add-on LABA as an FDC inhaler, or a separate LABA inhaler. Matching variables and confounders were identified by comparing characteristics during a baseline year of follow-up. Outcomes were examined during the subsequent year. The primary outcome was an adjusted odds ratio for overall asthma control (defined as follows: no asthma-related hospital admission or emergency room visit, prescription for oral corticosteroids or antibiotic with evidence of respiratory consultation, and ≤2 puffs of short-acting β-agonist daily). The final study consisted of 1330 children in each cohort (mean age 9 years; 59% male). In the separate ICS+LABA cohort, the odds of achieving overall asthma control were lower (adjusted odds ratio, 0.77 [95% confidence interval, 0.66-0.91]; P = .001) compared with the FDC cohort. The study demonstrates a small but significant benefit in achieving asthma control from an add-on LABA as an FDC, compared with a separate inhaler and this supports current guideline recommendations. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Real-world effects of two inhaled corticosteroid/long-acting β₂-agonist combinations in the treatment of asthma.

PubMed

Yatera, Kazuhiro; Yamasaki, Kei; Nishida, Chinatsu; Noguchi, Shingo; Oda, Keishi; Akata, Kentarou; Nagata, Shuya; Kawanami, Yukiko; Kawanami, Toshinori; Ishimoto, Hiroshi; Mukae, Hiroshi

2014-09-01

There are several inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) combinations currently used to treat asthmatic patients, but the differences in the clinical effects of these ICS/LABAs are currently unknown. We herein evaluated the effects of two currently available ICS/LABA combinations in a real-world setting. A fluticasone propionate/salmeterol combined Discus inhaler (FP/SM; 250/50 μg bid) was switched to a budesonide/formoterol Turbuhaler inhaler (BUD/FM; 160/4.5 μg two inhalations bid) and FP/SM (500/50 μg bid) was also switched to BUD/FM (160/4.5 μg four inhalations bid) in symptomatic asthmatic patients treated with FP/SM over 20 years of age. Sixty patients were enrolled in this study, and the scores of the asthma control test (ACT) and asthma control questionnaire-5 item version (ACQ5) were significantly improved 4 and 8 weeks after the switch to ICS/LABA treatments, and well-controlled asthma (ACQ5 score <0.75) and good control (ACT score >20) was achieved in 54 (90%) and 40 (66.7%) patients, respectively, at 8 weeks. The spirometric analysis revealed significant improvements of the values of the peak expiratory flow (PEF) and forced expiratory volume in one second (FEV1) after switching from FP/SM to BUD/FM, and significantly improved small airway impairments ([Formula: see text]50 and [Formula: see text]25) were observed in patients treated with high-dose ICS/LABA. These subjective and objective improvements were also seen in patients aged over 65 years old. These data demonstrated that changing the combined ICS/LABA inhaler from FP/SM to BUD/FM can lead to more effective management of symptomatic patients with asthma, especially in patients treated with high-dose ICS/LABA.

Comparative safety and effectiveness of long-acting inhaled agents for treating chronic obstructive pulmonary disease: a systematic review and network meta-analysis.

PubMed

Tricco, Andrea C; Strifler, Lisa; Veroniki, Areti-Angeliki; Yazdi, Fatemeh; Khan, Paul A; Scott, Alistair; Ng, Carmen; Antony, Jesmin; Mrklas, Kelly; D'Souza, Jennifer; Cardoso, Roberta; Straus, Sharon E

2015-10-26

To compare the safety and effectiveness of long-acting β-antagonists (LABA), long-acting antimuscarinic agents (LAMA) and inhaled corticosteroids (ICS) for managing chronic obstructive pulmonary disease (COPD). Systematic review and network meta-analysis (NMA). 208 randomised clinical trials (RCTs) including 134,692 adults with COPD. LABA, LAMA and/or ICS, alone or in combination, versus each other or placebo. The proportion of patients with moderate-to-severe exacerbations. The number of patients experiencing mortality, pneumonia, serious arrhythmia and cardiovascular-related mortality (CVM) were secondary outcomes. NMA was conducted including 20 RCTs for moderate-to-severe exacerbations for 26,141 patients with an exacerbation in the past year. 32 treatments were effective versus placebo including: tiotropium, budesonide/formoterol, salmeterol, indacaterol, fluticasone/salmeterol, indacaterol/glycopyrronium, tiotropium/fluticasone/salmeterol and tiotropium/budesonide/formoterol. Tiotropium/budesonide/formoterol was most effective (99.2% probability of being the most effective according to the Surface Under the Cumulative RAnking (SUCRA) curve). NMA was conducted on mortality (88 RCTs, 97 526 patients); fluticasone/salmeterol was more effective in reducing mortality than placebo, formoterol and fluticasone alone, and was the most effective (SUCRA=71%). NMA was conducted on CVM (37 RCTs, 55,156 patients) and the following were safest: salmeterol versus each OF placebo, tiotropium and tiotropium (Soft Mist Inhaler (SMR)); fluticasone versus tiotropium (SMR); and salmeterol/fluticasone versus tiotropium and tiotropium (SMR). Triamcinolone acetonide was the most harmful (SUCRA=81%). NMA was conducted on pneumonia occurrence (54 RCTs, 61 551 patients). 24 treatments were more harmful, including 2 that increased risk of pneumonia versus placebo; fluticasone and fluticasone/salmeterol. The most harmful agent was fluticasone/salmeterol (SUCRA=89%). NMA was conducted

Space nuclear safety from a user's viewpoint

NASA Technical Reports Server (NTRS)

Campbell, R. W.

1985-01-01

The National Aeronautics and Space Administration (NASA) launched the Jet Propulsion Laboratory's (JPL) two Voyager spacecraft to Jupiter in 1977, each using three radioisotope thermoelectric generators (RTGs) supplied by the Department of Energy (DOE) for onboard electric power. In 1986 NASA will launch JPL's Galileo spacecraft to Jupiter equipped with two DOE supplied RTGs of an improved design. NASA and JPL are also responsible for obtaining a single RTG of this type from DOE and supplying it to the European Space Agency as part of its participation in the International Solar Polar Mission. As a result of these missions, JPL has been deeply involved in space nuclear safety as a user. This paper will give a brief review of the user contributions by JPL - and NASA in general - to the nuclear safety processes and relate them to the overall nuclear safety program necessary for the launch of an RTG. The two major safety areas requiring user support are the ground operations involving RTGs at the launch site and the failure modes and probabilities associated with launch accidents.

Health and Safety in the Preschool. Together for Children: Cooperative Preschools.

ERIC Educational Resources Information Center

Siska, Heather Smith

The intent of this manual is to present health and safety standards and procedures for the special environment of cooperative preschools, where both teacher-supervisors and parents are present and responsible for the well-being of the children. After a brief discussion about meeting environmental standards, child health is investigated in terms of…

Effects of brief training on use of automated external defibrillators by people without medical expertise.

PubMed

Mitchell, K Blake; Gugerty, Leo; Muth, Eric

2008-04-01

This study examined the effect of three types of brief training on the use of automatic external defibrillators (AEDs) by 43 lay users. Because AEDs were recently approved for home use, brief training for nonprofessional users needs investigation. During training, the exposure training group read an article about AEDs that provided no information on how to operate them; the low-training group inspected the AED and read the operating instructions in the paper-based manual but was not allowed to use the device; and the high-training group watched a training video and performed a mock resuscitation using the AED but no manikin. All participants returned 2 weeks later and performed a surprise simulated AED resuscitation on a manikin. Most participants in each training group met criteria of minimally acceptable performance during the simulated manikin resuscitation, as measured by time to first shock, pad placement accuracy, and safety check performance. All participants who committed errors were able to successfully recover from them to complete the resuscitation. Compared with exposure training, the low and high training had a beneficial effect on time to first shock and errors. Untrained users were able to adequately use this AED, demonstrating walk-up-and-use usability, but additional brief training improved user performance. This study demonstrated the importance of providing high-quality but brief training for home AED users. In conjunction with other findings, the current study helps demonstrate the need for well-designed training for consumer medical devices.

A Brief Review on Multivalent Intercalation Batteries with Aqueous Electrolytes

PubMed Central

Guduru, Ramesh K.; Icaza, Juan C.

2016-01-01

Rapidly growing global demand for high energy density rechargeable batteries has driven the research toward developing new chemistries and battery systems beyond Li-ion batteries. Due to the advantages of delivering more than one electron and giving more charge capacity, the multivalent systems have gained considerable attention. At the same time, affordability, ease of fabrication and safety aspects have also directed researchers to focus on aqueous electrolyte based multivalent intercalation batteries. There have been a decent number of publications disclosing capabilities and challenges of several multivalent battery systems in aqueous electrolytes, and while considering an increasing interest in this area, here, we present a brief overview of their recent progress, including electrode chemistries, functionalities and challenges. PMID:28344298

A Brief Review on Multivalent Intercalation Batteries with Aqueous Electrolytes.

PubMed

Guduru, Ramesh K; Icaza, Juan C

2016-02-26

Rapidly growing global demand for high energy density rechargeable batteries has driven the research toward developing new chemistries and battery systems beyond Li-ion batteries. Due to the advantages of delivering more than one electron and giving more charge capacity, the multivalent systems have gained considerable attention. At the same time, affordability, ease of fabrication and safety aspects have also directed researchers to focus on aqueous electrolyte based multivalent intercalation batteries. There have been a decent number of publications disclosing capabilities and challenges of several multivalent battery systems in aqueous electrolytes, and while considering an increasing interest in this area, here, we present a brief overview of their recent progress, including electrode chemistries, functionalities and challenges.

46 CFR 201.155 - Briefs; request for findings.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 8 2010-10-01 2010-10-01 false Briefs; request for findings. 201.155 Section 201.155... PRACTICE AND PROCEDURE Briefs, Requests for Findings, Decisions, Exceptions (Rule 16) § 201.155 Briefs; request for findings. The time for filing briefs to the presiding officer, and extensions thereof, shall...

A brief review of the occurrence, use, and safety of food-related nanomaterials.

PubMed

Magnuson, Bernadene A; Jonaitis, Tomas S; Card, Jeffrey W

2011-08-01

Nanotechnology and nanomaterials have tremendous potential to enhance the food supply through novel applications, including nutrient and bioactive absorption and delivery systems; ingredient functionality; improved colors and flavors; microbial, allergen, and contaminant detection and control; and food packaging properties and performance. To determine the current state of knowledge regarding the safety of these potential uses of nanomaterials, an appraisal of the published literature on the safety of food-related nanomaterials was undertaken. A method of assessment of reliability of toxicology studies was developed to conduct this appraisal. The review of the toxicology literature on oral exposure to food-related nanomaterials found that the number of studies is limited. Exposure to nanomaterials in the human food chain may occur not only through intentional uses in food manufacturing, but also via uses in agricultural production and carry over from use in other industries. Although a number of analytical methods are useful in physicochemical characterization of manufactured nanomaterials, new methods may be needed to more fully detect and characterize nanomaterials incorporated into foods and in other media. There is a need for additional toxicology studies of sufficient quality and duration on different types of nanomaterials to further our understanding of the characteristics of nanomaterials that affect safety of oral exposure resulting from use in various food applications. © 2011 Institute of Food Technologists®

Kepler Media Briefing

NASA Image and Video Library

2009-02-19

Jon Morse, Director, Astrophysics Division, at NASA Headquarters, left, talks about the Kepler mission during a media briefing, Thursday, Feb. 19, 2008, at NASA Headquarters in Washington. Morse was joined at the briefing by William Borucki, principal investigator for Kepler Science at Ames Research Center, second left, Jim Fanson, Kepler Project Manager at the Jet Propulsion Laboratory and Debra Fischer, professor of Astronomy at San Francisco State University, right. Kepler is scheduled to launch on March 5, 2009 from Cape Canaveral Air Force Station, Fla. aboard a Delta II rocket. Photo Credit: (NASA/Paul. E. Alers)

78 FR 48931 - Railroad Safety Advisory Committee; Notice of Emergency Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-12

..., Quebec, Canada. At this time, it is estimated that this accident resulted in 42 fatalities, and 5 persons... will be briefed on the preliminary findings of the accident, and discussions will involve the safety issues related to the July 6 accident. DATES: The RSAC meeting is scheduled to commence at 9:00 a.m. on...

Cost-effectiveness of roflumilast in combination with bronchodilator therapies in patients with severe and very severe COPD in Switzerland

PubMed Central

Samyshkin, Yevgeniy; Schlunegger, Michael; Haefliger, Susan; Ledderhose, Sabine; Radford, Matthew

2013-01-01

Objective Chronic obstructive pulmonary disease (COPD) represents a burden on patients and health systems. Roflumilast, an oral, selective phosphodiesterase-4-inhibitor reduces exacerbations and improves lung function in severe/very severe COPD patients with a history of exacerbations. This study aimed to estimate the lifetime cost and outcomes of roflumilast added-on to commonly used COPD regimens in Switzerland. Methods A Markov cohort model was developed to simulate COPD progression in patients with disease states of severe, very severe COPD, and death. The exacerbation rate was assumed to be two per year in severe COPD. COPD progression rates were drawn from the published literature. Efficacy was expressed as relative ratios of exacerbation rates associated with roflumilast, derived from a mixed-treatment comparison. A cost-effectiveness analysis was conducted for roflumilast added to long-acting muscarinic antagonists (LAMA), long-acting β2-agonist/ inhaled corticosteroids (LABA/ICS), and LAMA + LABA/ICS. The analysis was conducted from the Swiss payer perspective, with costs and outcomes discounted at 2.5% annually. Parameter uncertainties were explored in one-way and probabilistic sensitivity analyses. Results In each of the comparator regimens mean life expectancy was 9.28 years and quality-adjusted life years (QALYs) gained were 6.19. Mean estimated lifetime costs per patient in the comparator arms were CHF 83,364 (LAMA), CHF 88,161 (LABA/ICS), and CHF 95,564 (LAMA + LABA/ICS) respectively. Adding roflumilast resulted in a mean cost per patient per lifetime of CHF 86,754 (LAMA + roflumilast), CHF 91,470 (LABA/ICS + roflumilast), and CHF 99,364 (LAMA + LABA/ICS + roflumilast), respectively. Life-expectancy and quality-adjusted life-expectancy were 9.63 years and 6.47 QALYs (LAMA + roflumilast), 9.64 years and 6.48 QALYs (LABA/ICS + roflumilast), and 9.63 years and 6.47 QALYs (LAMA + LABA/ ICS + roflumilast). Incremental cost-effectiveness ratios were CHF

25 CFR 700.315 - Post-hearing briefs.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 2 2010-04-01 2010-04-01 false Post-hearing briefs. 700.315 Section 700.315 Indians THE... of Eligibility, Hearing and Administrative Review (Appeals) § 700.315 Post-hearing briefs. Applicants may submit post-hearing briefs or written comments to the Presiding Officer within fourteen days after...

25 CFR 700.315 - Post-hearing briefs.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 2 2011-04-01 2011-04-01 false Post-hearing briefs. 700.315 Section 700.315 Indians THE... of Eligibility, Hearing and Administrative Review (Appeals) § 700.315 Post-hearing briefs. Applicants may submit post-hearing briefs or written comments to the Presiding Officer within fourteen days after...

25 CFR 700.315 - Post-hearing briefs.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 25 Indians 2 2012-04-01 2012-04-01 false Post-hearing briefs. 700.315 Section 700.315 Indians THE... of Eligibility, Hearing and Administrative Review (Appeals) § 700.315 Post-hearing briefs. Applicants may submit post-hearing briefs or written comments to the Presiding Officer within fourteen days after...

25 CFR 700.315 - Post-hearing briefs.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 2 2014-04-01 2014-04-01 false Post-hearing briefs. 700.315 Section 700.315 Indians THE... of Eligibility, Hearing and Administrative Review (Appeals) § 700.315 Post-hearing briefs. Applicants may submit post-hearing briefs or written comments to the Presiding Officer within fourteen days after...

25 CFR 700.315 - Post-hearing briefs.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 2 2013-04-01 2013-04-01 false Post-hearing briefs. 700.315 Section 700.315 Indians THE... of Eligibility, Hearing and Administrative Review (Appeals) § 700.315 Post-hearing briefs. Applicants may submit post-hearing briefs or written comments to the Presiding Officer within fourteen days after...

Believing and Achieving. Issue Brief

ERIC Educational Resources Information Center

Jerald, Craig D.

2007-01-01

This research brief takes a look at the role of teacher efficacy-how teachers' beliefs in their own abilities affect student achievement. The brief examines the influence of perceived efficacy and building teacher confidence (social persuasion, collegiality, and shared decision making). It concludes by asserting that more positive steps must be…

FMCSA safety program effectiveness measurement : roadside intervention effectiveness model FY 2013 : analysis brief.

DOT National Transportation Integrated Search

2017-08-01

The Roadside Inspection and Traffic Enforcement programs are two of FMCSAs most powerful safety tools. By continually examining the results of these programs, FMCSA can ensure that they are being executed effectively and are producing the desired ...

National Highway Safety Administration. Automatic collision notice field test summary.

PubMed

2001-10-01

From 1995 to 2000, the National Highway Traffic Safety Administration (NHTSA) sponsored an initiative to create and operate an Automatic Collision Notification (ACN) system on a demonstration basis in a rural area to provide faster and smarter emergency medical responses and in an attempt to save lives and reduce disabilities from injuries. This article is a brief summary of that demonstration.

45 CFR 79.36 - Post-hearing briefs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Post-hearing briefs. 79.36 Section 79.36 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PROGRAM FRAUD CIVIL REMEDIES § 79.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event...

6 CFR 13.36 - Post-hearing briefs.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 6 Domestic Security 1 2010-01-01 2010-01-01 false Post-hearing briefs. 13.36 Section 13.36 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY PROGRAM FRAUD CIVIL REMEDIES § 13.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event...

45 CFR 160.544 - Post hearing briefs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... REQUIREMENTS GENERAL ADMINISTRATIVE REQUIREMENTS Procedures for Hearings § 160.544 Post hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing... 45 Public Welfare 1 2011-10-01 2011-10-01 false Post hearing briefs. 160.544 Section 160.544...

45 CFR 160.544 - Post hearing briefs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... REQUIREMENTS GENERAL ADMINISTRATIVE REQUIREMENTS Procedures for Hearings § 160.544 Post hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing... 45 Public Welfare 1 2014-10-01 2014-10-01 false Post hearing briefs. 160.544 Section 160.544...

45 CFR 160.544 - Post hearing briefs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... REQUIREMENTS GENERAL ADMINISTRATIVE REQUIREMENTS Procedures for Hearings § 160.544 Post hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing... 45 Public Welfare 1 2012-10-01 2012-10-01 false Post hearing briefs. 160.544 Section 160.544...

45 CFR 160.544 - Post hearing briefs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... REQUIREMENTS GENERAL ADMINISTRATIVE REQUIREMENTS Procedures for Hearings § 160.544 Post hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing... 45 Public Welfare 1 2013-10-01 2013-10-01 false Post hearing briefs. 160.544 Section 160.544...

45 CFR 160.544 - Post hearing briefs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... REQUIREMENTS GENERAL ADMINISTRATIVE REQUIREMENTS Procedures for Hearings § 160.544 Post hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing... 45 Public Welfare 1 2010-10-01 2010-10-01 false Post hearing briefs. 160.544 Section 160.544...

Legal Briefs for School Administrators.

ERIC Educational Resources Information Center

Strahan, Richard Dobbs

The legal briefs in this volume provide insights into operational problems for a practicing administrator. Fifteen briefs provide some general policy statements that appear to be sound practice for the areas covered. In addition, each section propounds questions that are commonly asked by school people. The author has attempted to attack each…

49 CFR 31.36 - Post-hearing briefs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 1 2014-10-01 2014-10-01 false Post-hearing briefs. 31.36 Section 31.36 Transportation Office of the Secretary of Transportation PROGRAM FRAUD CIVIL REMEDIES § 31.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post...

22 CFR 35.36 - Post-hearing briefs.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Post-hearing briefs. 35.36 Section 35.36 Foreign Relations DEPARTMENT OF STATE CLAIMS AND STOLEN PROPERTY PROGRAM FRAUD CIVIL REMEDIES § 35.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may...

22 CFR 35.36 - Post-hearing briefs.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Post-hearing briefs. 35.36 Section 35.36 Foreign Relations DEPARTMENT OF STATE CLAIMS AND STOLEN PROPERTY PROGRAM FRAUD CIVIL REMEDIES § 35.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may...

49 CFR 31.36 - Post-hearing briefs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 1 2011-10-01 2011-10-01 false Post-hearing briefs. 31.36 Section 31.36 Transportation Office of the Secretary of Transportation PROGRAM FRAUD CIVIL REMEDIES § 31.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post...

10 CFR 1013.36 - Post-hearing briefs.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Post-hearing briefs. 1013.36 Section 1013.36 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) PROGRAM FRAUD CIVIL REMEDIES AND PROCEDURES § 1013.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a...

10 CFR 1013.36 - Post-hearing briefs.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Post-hearing briefs. 1013.36 Section 1013.36 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) PROGRAM FRAUD CIVIL REMEDIES AND PROCEDURES § 1013.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a...

49 CFR 31.36 - Post-hearing briefs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Post-hearing briefs. 31.36 Section 31.36 Transportation Office of the Secretary of Transportation PROGRAM FRAUD CIVIL REMEDIES § 31.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post...

10 CFR 1013.36 - Post-hearing briefs.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Post-hearing briefs. 1013.36 Section 1013.36 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) PROGRAM FRAUD CIVIL REMEDIES AND PROCEDURES § 1013.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a...

10 CFR 1013.36 - Post-hearing briefs.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Post-hearing briefs. 1013.36 Section 1013.36 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) PROGRAM FRAUD CIVIL REMEDIES AND PROCEDURES § 1013.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a...

22 CFR 35.36 - Post-hearing briefs.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Post-hearing briefs. 35.36 Section 35.36 Foreign Relations DEPARTMENT OF STATE CLAIMS AND STOLEN PROPERTY PROGRAM FRAUD CIVIL REMEDIES § 35.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may...

14 CFR 1264.135 - Post-hearing briefs.

Code of Federal Regulations, 2010 CFR

2010-01-01

... FRAUD CIVIL PENALTIES ACT OF 1986 § 1264.135 Post-hearing briefs. The presiding officer may require the parties to file post-hearing briefs. In any event, upon approval of the presiding officer, any party may... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Post-hearing briefs. 1264.135 Section 1264...

14 CFR 1264.135 - Post-hearing briefs.

Code of Federal Regulations, 2013 CFR

2013-01-01

... FRAUD CIVIL PENALTIES ACT OF 1986 § 1264.135 Post-hearing briefs. The presiding officer may require the parties to file post-hearing briefs. In any event, upon approval of the presiding officer, any party may... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Post-hearing briefs. 1264.135 Section 1264...

14 CFR 1264.135 - Post-hearing briefs.

Code of Federal Regulations, 2012 CFR

2012-01-01

... FRAUD CIVIL PENALTIES ACT OF 1986 § 1264.135 Post-hearing briefs. The presiding officer may require the parties to file post-hearing briefs. In any event, upon approval of the presiding officer, any party may... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Post-hearing briefs. 1264.135 Section 1264...

49 CFR 31.36 - Post-hearing briefs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 1 2012-10-01 2012-10-01 false Post-hearing briefs. 31.36 Section 31.36 Transportation Office of the Secretary of Transportation PROGRAM FRAUD CIVIL REMEDIES § 31.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post...

22 CFR 35.36 - Post-hearing briefs.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Post-hearing briefs. 35.36 Section 35.36 Foreign Relations DEPARTMENT OF STATE CLAIMS AND STOLEN PROPERTY PROGRAM FRAUD CIVIL REMEDIES § 35.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may...

14 CFR 1264.135 - Post-hearing briefs.

Code of Federal Regulations, 2011 CFR

2011-01-01

... FRAUD CIVIL PENALTIES ACT OF 1986 § 1264.135 Post-hearing briefs. The presiding officer may require the parties to file post-hearing briefs. In any event, upon approval of the presiding officer, any party may... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Post-hearing briefs. 1264.135 Section 1264...

22 CFR 35.36 - Post-hearing briefs.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Post-hearing briefs. 35.36 Section 35.36 Foreign Relations DEPARTMENT OF STATE CLAIMS AND STOLEN PROPERTY PROGRAM FRAUD CIVIL REMEDIES § 35.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may...

10 CFR 1013.36 - Post-hearing briefs.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Post-hearing briefs. 1013.36 Section 1013.36 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) PROGRAM FRAUD CIVIL REMEDIES AND PROCEDURES § 1013.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a...

49 CFR 31.36 - Post-hearing briefs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 1 2013-10-01 2013-10-01 false Post-hearing briefs. 31.36 Section 31.36 Transportation Office of the Secretary of Transportation PROGRAM FRAUD CIVIL REMEDIES § 31.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post...

Kepler Media Briefing

NASA Image and Video Library

2009-02-19

William Borucki, principal investigator for Kepler Science at Ames Research Center, Moffett Field, Calif.,, second from left, talks about the Kepler mission during a media briefing, Thursday, Feb. 19, 2008, at NASA Headquarters in Washington. Kepler, the first mission with the ability to find planets like earth, is scheduled to launch on March 5, 2009 from Cape Canaveral Air Force Station, Fla. aboard a Delta II rocket. Joining Borucki at the briefing were Jon Morse, director, Astrophysics Division, NASA Headquarters, Jim Fanson, Kepler project manager at the Jet Propulsion Laboratory and Debra Fischer, a professor of Astronomy at San Francisco State University. Photo Credit: (NASA/Paul. E. Alers)

SHPPS 2006: School Health Policies and Programs Study--Injury Prevention and Safety

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2007

2007-01-01

The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports study results in the area of injury prevention and safety, covering the following topics: (1) Health Education; (2) Health Services…

12 CFR 308.535 - Post-hearing briefs.

Code of Federal Regulations, 2011 CFR

2011-01-01

... PRACTICE AND PROCEDURE Program Fraud Civil Remedies and Procedures § 308.535 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing... 12 Banks and Banking 4 2011-01-01 2011-01-01 false Post-hearing briefs. 308.535 Section 308.535...

12 CFR 308.535 - Post-hearing briefs.

Code of Federal Regulations, 2012 CFR

2012-01-01

... PRACTICE AND PROCEDURE Program Fraud Civil Remedies and Procedures § 308.535 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing... 12 Banks and Banking 5 2012-01-01 2012-01-01 false Post-hearing briefs. 308.535 Section 308.535...

29 CFR 22.36 - Post-hearing briefs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 1 2011-07-01 2011-07-01 false Post-hearing briefs. 22.36 Section 22.36 Labor Office of the Secretary of Labor PROGRAM FRAUD CIVIL REMEDIES ACT OF 1986 § 22.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing...

12 CFR 308.535 - Post-hearing briefs.

Code of Federal Regulations, 2014 CFR

2014-01-01

... PRACTICE AND PROCEDURE Program Fraud Civil Remedies and Procedures § 308.535 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing... 12 Banks and Banking 5 2014-01-01 2014-01-01 false Post-hearing briefs. 308.535 Section 308.535...

34 CFR 33.36 - Post-hearing briefs.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 1 2012-07-01 2012-07-01 false Post-hearing briefs. 33.36 Section 33.36 Education Office of the Secretary, Department of Education PROGRAM FRAUD CIVIL REMEDIES ACT § 33.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a...

12 CFR 308.535 - Post-hearing briefs.

Code of Federal Regulations, 2010 CFR

2010-01-01

... PRACTICE AND PROCEDURE Program Fraud Civil Remedies and Procedures § 308.535 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Post-hearing briefs. 308.535 Section 308.535...

34 CFR 33.36 - Post-hearing briefs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Post-hearing briefs. 33.36 Section 33.36 Education Office of the Secretary, Department of Education PROGRAM FRAUD CIVIL REMEDIES ACT § 33.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a...

34 CFR 33.36 - Post-hearing briefs.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 34 Education 1 2014-07-01 2014-07-01 false Post-hearing briefs. 33.36 Section 33.36 Education Office of the Secretary, Department of Education PROGRAM FRAUD CIVIL REMEDIES ACT § 33.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a...

34 CFR 33.36 - Post-hearing briefs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 1 2011-07-01 2011-07-01 false Post-hearing briefs. 33.36 Section 33.36 Education Office of the Secretary, Department of Education PROGRAM FRAUD CIVIL REMEDIES ACT § 33.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a...

12 CFR 308.535 - Post-hearing briefs.

Code of Federal Regulations, 2013 CFR

2013-01-01

... PRACTICE AND PROCEDURE Program Fraud Civil Remedies and Procedures § 308.535 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing... 12 Banks and Banking 5 2013-01-01 2013-01-01 false Post-hearing briefs. 308.535 Section 308.535...

29 CFR 22.36 - Post-hearing briefs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 1 2013-07-01 2013-07-01 false Post-hearing briefs. 22.36 Section 22.36 Labor Office of the Secretary of Labor PROGRAM FRAUD CIVIL REMEDIES ACT OF 1986 § 22.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing...

29 CFR 22.36 - Post-hearing briefs.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 1 2012-07-01 2012-07-01 false Post-hearing briefs. 22.36 Section 22.36 Labor Office of the Secretary of Labor PROGRAM FRAUD CIVIL REMEDIES ACT OF 1986 § 22.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post-hearing...

34 CFR 33.36 - Post-hearing briefs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 34 Education 1 2013-07-01 2013-07-01 false Post-hearing briefs. 33.36 Section 33.36 Education Office of the Secretary, Department of Education PROGRAM FRAUD CIVIL REMEDIES ACT § 33.36 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a...

Examining the Efficacy of a Brief Mindfulness-Based Stress Reduction (Brief MBSR) Program on Psychological Health

ERIC Educational Resources Information Center

Bergen-Cico, Dessa; Possemato, Kyle; Cheon, Sanghyeon

2013-01-01

Objective: The purpose of the study was to examine potential psychological health benefits of participating in a brief (5-week) mindfulness-based stress reduction (brief MBSR) program integrated into an academic course. Participants: Participants were 119 undergraduate students (treatment: "n" = 72; control: "n" = 47) enrolled…

A cross-national trial of brief interventions with heavy drinkers. WHO Brief Intervention Study Group.

PubMed Central

1996-01-01

OBJECTIVES. The relative effects of simple advice and brief counseling were evaluated with heavy drinkers identified in primary care and other health settings in eight countries. METHODS. Subjects (1260 men, 299 women) with no prior history of alcohol dependence were selected if they consumed alcohol with sufficient frequency or intensity to be considered at risk of alcohol-related problems. Subjects were randomly assigned to a control group, a simple advice group, or a group receiving brief counseling. Seventy-five percent of subjects were evaluated 9 months later. RESULTS. Male patients exposed to the interventions reported approximately 17% lower average daily alcohol consumption than those in the control group. Reductions in the intensity of drinking were approximately 10%. For women, significant reductions were observed in both the control and the intervention groups. Five minutes of simple advice were as effective as 20 minutes of brief counseling. CONCLUSIONS. Brief interventions are consistently robust across health care settings and sociocultural groups and can make a significant contribution to the secondary prevention of alcohol-related problems if they are widely used in primary care. PMID:8669518

A PC-based simulation of the National Transonic Facitity's safety microprocessor

NASA Technical Reports Server (NTRS)

Thibodeaux, J. J.; Kilgore, W. A.; Balakrishna, S.

1993-01-01

A brief study was undertaken to demonstrate the feasibility of using a state-of-the-art off-the-shelf high speed personal computer for simulating a microprocessor presently used for wind tunnel safety purposes at Langley Research Center's National Transonic Facility (NTF). Currently, there is no active display of tunnel alarm/alert safety information provided to the tunnel operators, but rather such information is periodically recorded on a process monitoring computer printout. This does not provide on-line situational information nor permit rapid identification of safety operational violations which are able to halt tunnel operations. It was therefore decided to simulate the existing algorithms and briefly evaluate a real-time display which could provide both position and trouble shooting information.

Key aspects in managing safety when working with multiple contractors: A case study.

PubMed

Drupsteen, Linda; Rasmussen, Hanna B; Ustailieva, Erika; van Kampen, Jakko

2015-01-01

Working with multiple contractors in a shared workplace can introduce and increase safety risks due to complexity. The aim of this study was to explore how safety issues are recognized in a specific case and to identify whether clients and contractors perceive problems similarly. The safety issues are explored through a brief survey and a workshop in the maintenance department of a logistics company. The results indicate that culture and behavior are recognized differently by clients and by contractors. The contractors and client had different perceptions of involvement of contractors by the client. The contractors complained on lack of involvement, which was not fully recognized by the client. The case study used a practical approach to show differences in perception of safety within a project. The study illustrates the need for more applied studies and interventions on contractor safety.

Impact of multiple-dose versus single-dose inhaler devices on COPD patients’ persistence with long-acting β2-agonists: a dispensing database analysis

PubMed Central

van Boven, Job FM; van Raaij, Joost J; van der Galiën, Ruben; Postma, Maarten J; van der Molen, Thys; Dekhuijzen, PN Richard; Vegter, Stefan

2014-01-01

Background: With a growing availability of different devices and types of medication, additional evidence is required to assist clinicians in prescribing the optimal medication in relation to chronic obstructive pulmonary disease (COPD) patients’ persistence with long-acting β2-agonists (LABAs). Aims: To assess the impact of the type of inhaler device (multiple-dose versus single-dose inhalers) on 1-year persistence and switching patterns with LABAs. Methods: A retrospective observational cohort study was performed comparing a cohort of patients initiating multiple-dose inhalers and a cohort initiating single-dose inhalers. The study population consisted of long-acting bronchodilator naive COPD patients, initiating inhalation therapy with mono-LABAs (formoterol, indacaterol or salmeterol). Analyses were performed using pharmacy dispensing data from 1994 to 2012, obtained from the IADB.nl database. Study outcomes were 1-year persistence and switching patterns. Results were adjusted for initial prescriber, initial medication, dosing regimen and relevant comorbidities. Results: In all, 575 patients initiating LABAs were included in the final study cohort. Among them, 475 (83%) initiated a multiple-dose inhaler and 100 (17%) a single-dose inhaler. Further, 269 (47%) initiated formoterol, 9 (2%) indacaterol and 297 (52%) salmeterol. There was no significant difference in persistence between users of multiple-dose or single-dose inhalers (hazard ratio: 0.98, 95% confidence interval: 0.76–1.26, P=0.99). Over 80% re-started or switched medication. Conclusions: There seems no impact of inhaler device (multiple-dose versus single-dose inhalers) on COPD patients’ persistence with LABAs. Over 80% of patients who initially seemed to discontinue LABAs, re-started their initial medication or switched inhalers or medication within 1 year. PMID:25274453

Anticholinergic vs Long-Acting β-Agonist in Combination With Inhaled Corticosteroids in Black Adults With Asthma: The BELT Randomized Clinical Trial.

PubMed

Wechsler, Michael E; Yawn, Barbara P; Fuhlbrigge, Anne L; Pace, Wilson D; Pencina, Michael J; Doros, Gheorghe; Kazani, Shamsah; Raby, Benjamin A; Lanzillotti, Jane; Madison, Suzanne; Israel, Elliot

2015-10-27

The efficacy and safety of long-acting β-agonists (LABAs) have been questioned. Black populations may be disproportionately affected by LABA risks. To compare the effectiveness and safety of tiotropium vs LABAs, when used with inhaled corticosteroids (ICS) in black adults with asthma and to determine whether allelic variation at the Arg16Gly locus of the β2-adrenergic receptor (ADRB2) geneis associated with treatment response. A multisite (n = 20), open-label, parallel-group, pragmatic randomized clinical trial conducted from March 2011 through July 2013, enrolling black adults with moderate to severe asthma in the United States. Patients eligible for, or receiving, step 3 or step 4 combination therapy per National Heart, Lung, and Blood Institute guidelines, received ICS plus either once-daily tiotropium (n = 532) or twice-daily LABAs (n = 538,) and were followed up for up to 18 months. Patients underwent genotyping, attended study visits at baseline, 1, 6, 12, and 18 months, and completed monthly questionnaires. The primary outcome was time to asthma exacerbation, defined as a worsening asthma event requiring oral or parenteral corticosteroids. Secondary outcomes included patient-reported outcomes (Asthma Quality of Life Questionnaire, Asthma Control Questionnaire [ACQ], Asthma Symptom Utility Index, and Asthma Symptom-Free Days questionnaire), spirometry (FEV1), rescue medication use, asthma deteriorations, and adverse events. There was no difference between LABA + ICS vs tiotropium + ICS in time to first exacerbation (mean No. of exacerbations/person-year, 0.42 vs 0.37 (rate ratio, 0.90 [95% CI, 0.73 to 1.11], log-rank P = .31). There was no difference in change in FEV1 at 12 months (0.003 L for LABA + ICS vs -0.018 L for tiotropium + ICS; between-group difference, 0.020 [95% CI, -0.021 to 0.061], P = .33) and at 18 months (-0.053 L vs -0.078 L; between-group difference, 0.025 [95% CI, -0.045 to 0.095], P = .49). There

The P.A.C.E.S. Grading Rubric: Creating a Student-Owned Assessment Tool for Projects-The Design Brief Brings out All Kinds of "Out of the Box" Thinking, with Many Correct Answers to Solve the Problem

ERIC Educational Resources Information Center

Tufte, Robert B., Jr.

2005-01-01

P.A.C.E.S. stands for Participation, Appearance, Cleanup, Engineering, and Safety. The author has traditionally used design briefs to set the limits on processes and materials to solve a given problem. The design brief brings out all kinds of "out of the box" thinking, with many correct answers to solve the problem. The P.A.C.E.S. rubric ties the…

Adverse weather impact on aviation safety, investigation and oversight

NASA Technical Reports Server (NTRS)

Smith, M. J.

1985-01-01

A brief review of the weather factors that effect aviation safety with respect to U.S. Coast Guard operations is presented. Precise meteorological information is an absolute necessity to the Coast Guard which must conduct life saving and rescue operations under the worst of weather conditions. Many times the weather conditions in which they operate are the cause of or a contributing factor to the predicament from which they must execute a rescue operation.

MAVEN Briefing

NASA Image and Video Library

2014-09-17

Dwayne Brown, NASA public affairs officer, moderates a media briefing where panelist outlined activities around the Sunday, Sept. 21 orbital insertion at Mars of the agency’s Mars Atmosphere and Volatile EvolutioN (MAVEN) spacecraft, Wednesday, Sept. 17, 2014 at NASA Headquarters in Washington. (Photo credit: NASA/Bill Ingalls)

Is the SMART approach better than other treatment approaches for prevention of asthma exacerbations? A meta-analysis.

PubMed

Agarwal, R; Khan, A; Aggarwal, A N; Gupta, D

2009-12-01

The combination of inhaled corticosteroids (ICS) and long-acting beta2 agonists (LABA) has been used as a single inhaler both for maintenance and reliever therapy in asthma, the SMART approach. The administration of additional CS with each reliever inhalation in response to symptoms is expected to provide better control of airway inflammation. The aim of this meta-analysis was to evaluate the efficacy and safety of the SMART approach versus other approaches in the management of asthma in preventing asthma exacerbations. We searched the MEDLINE and EMBASE databases for studies that have reported exacerbations in the SMART group versus the control group. We calculated the odds ratio (OR) and 95% confidence intervals (CI) to assess the exacerbations in the two groups and pooled the results using a random-effects model. Our search yielded eight studies. The use of SMART approach compared to fixed-dose ICS-LABA combination significantly decreased the odds of a severe exacerbation (OR 0.65; 95% CI, 0.53-0.80) and severe exacerbation requiring hospitalization/ER treatment (OR 0.69; 95% CI, 058-0.83). The use of SMART approach compared to fixed-dose ICS also significantly decreased the odds of a severe exacerbation (OR 0.52; 95% CI, 0.45-0.61) and severe exacerbation requiring medical intervention (OR 0.52; 95% CI, 0.42-0.65). The occurrence of adverse events was similar in the two groups. There was some evidence of statistical heterogeneity. The SMART approach using formoterol-budesonide is superior in preventing exacerbations when compared to traditional therapy with fixed dose ICS or ICS-LABA combination without any increase in adverse events.

Aerospace Safety Advisory Panel

NASA Technical Reports Server (NTRS)

2002-01-01

This Annual Report of the Aerospace Safety Advisory Panel (ASAP) presents results of activities during calendar year 2001. The year was marked by significant achievements in the Space Shuttle and International Space Station (ISS) programs and encouraging accomplishments by the Aerospace Technology Enterprise. Unfortunately, there were also disquieting mishaps with the X-43, a LearJet, and a wind tunnel. Each mishap was analyzed in an orderly process to ascertain causes and derive lessons learned. Both these accomplishments and the responses to the mishaps led the Panel to conclude that safety and risk management is currently being well served within NASA. NASA's operations evidence high levels of safety consciousness and sincere efforts to place safety foremost. Nevertheless, the Panel's safety concerns have never been greater. This dichotomy has arisen because the focus of most NASA programs has been directed toward program survival rather than effective life cycle planning. Last year's Annual Report focused on the need for NASA to adopt a realistically long planning horizon for the aging Space Shuttle so that safety would not erode. NASA's response to the report concurred with this finding. Nevertheless, there has been a greater emphasis on current operations to the apparent detriment of long-term planning. Budget cutbacks and shifts in priorities have severely limited the resources available to the Space Shuttle and ISS for application to risk-reduction and life-extension efforts. As a result, funds originally intended for long-term safety-related activities have been used for operations. Thus, while safety continues to be well served at present, the basis for future safety has eroded. Section II of this report develops this theme in more detail and presents several important, overarching findings and recommendations that apply to many if not all of NASA's programs. Section III of the report presents other significant findings, recommendations and supporting

45 CFR 99.31 - Posthearing briefs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Posthearing briefs. 99.31 Section 99.31 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PROCEDURE FOR HEARINGS FOR THE CHILD CARE AND DEVELOPMENT FUND Posthearing Procedures, Decisions § 99.31 Posthearing briefs. The...

45 CFR 150.451 - Posthearing briefs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Posthearing briefs. 150.451 Section 150.451 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS CMS ENFORCEMENT IN GROUP AND INDIVIDUAL INSURANCE MARKETS Administrative Hearings § 150.451 Posthearing briefs...

A review of obesity-themed policy briefs.

PubMed

Dodson, Elizabeth A; Eyler, Amy A; Chalifour, Stephanie; Wintrode, Christopher G

2012-09-01

Policy approaches are one of the most promising population-based means of addressing the epidemic of obesity in the U.S., especially as they create supportive environments for healthy living. Policy briefs can be an effective means of disseminating research information to inform obesity prevention efforts; however, they are often ineffective because of length, density, and inaccessibility. The purposes of this project were to identify a collection of obesity-related policy briefs, analyze the content, and make recommendations for model policy briefs. In 2010, online searching strategies were developed with criteria that included a primary topical focus on obesity, written between 2000 and 2010, targeting any population age group, including a policy-change message, and being readily available online. The research team developed a coding tool and used it to analyze briefs. A subsample of the briefs was used for further analysis on dissemination. Analyses were conducted on 100 briefs. Most (72%) were developed between 2005 and 2010; the average length was five pages. The majority had no tables, few figures, and only 36% included photos. The average reading level was high. A lack of monitoring or evaluating dissemination efforts prevailed. Policy briefs represent an effective, often-preferred, potent tool for public health practitioners and researchers to communicate information to policymakers. Recommendations include presenting information clearly, using a concise format, including design elements, noting reference and contact information, employing active and targeted dissemination efforts, and conducting evaluation. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

A randomized clinical trial of the effectiveness of an acupressure device (relief brief) for managing symptoms of dysmenorrhea.

PubMed

Taylor, Diana; Miaskowski, Christine; Kohn, Joel

2002-06-01

To develop and test the safety and effectiveness of an acupressure garment (the Relief Brief) in decreasing the pain and symptom distress associated with dysmenorrhea. A randomized clinical trial applied a 2 (Relief Brief use or control group) x 3 (baseline and two treatment measurement occasions) mixed factorial design. Sixty-one (61) women with moderately severe primary dysmenorrhea were randomly assigned to the standard treatment control group or the Relief Brief acupressure device group after one pretreatment menses, with 58 women reporting the effect on their pain during two post-treatment menstrual cycles. The acupressure garment: The Relief Brief is a cotton Lycra panty brief with a fixed number of lower abdominal and lower back latex foam acupads that provide pressure to dysmenorrhea-relieving Chinese acupressure points. Menstrual pain severity (worst pain and symptom intensity), pain medication use, and adverse effects were analyzed using between-groups and repeated measures analyses of treatment effects. Statistical and clinical significance criteria were applied a priori. For pain measures and pain medication use, the group main effect, time main effect and group x time interaction were statistically significant. Median pain medication use, the same for both groups at baseline (6 pills per day), dropped to 2 pills per day for the Relief Brief group but remained at 6 pills for the control group at the second treatment cycle. Predicted clinical significance criteria were surpassed: almost all (90%) women wearing the Relief Brief obtained at least a 25% reduction in menstrual pain severity (a 2-3 point drop) compared to only 8% of the control group (z = 6.07; p < 0.05). Relief Brief use was associated with at least a 50% decline in menstrual pain symptom intensity in more than two thirds of the women. An acupressure device is an effective and safe nonpharmacologic strategy for the treatment of primary dysmenorrhea. With design modifications, it could serve

Key performance outcomes of patient safety curricula: root cause analysis, failure mode and effects analysis, and structured communications skills.

PubMed

Fassett, William E

2011-10-10

As colleges and schools of pharmacy develop core courses related to patient safety, course-level outcomes will need to include both knowledge and performance measures. Three key performance outcomes for patient safety coursework, measured at the course level, are the ability to perform root cause analyses and healthcare failure mode effects analyses, and the ability to generate effective safety communications using structured formats such as the Situation-Background-Assessment-Recommendation (SBAR) situational briefing model. Each of these skills is widely used in patient safety work and competence in their use is essential for a pharmacist's ability to contribute as a member of a patient safety team.

The U.S. Commercial Motor Vehicle Safety Act of 1986. Workforce & Workplace Literacy Series.

ERIC Educational Resources Information Center

BCL Brief, 1991

1991-01-01

This brief presents summary information about the U.S. Commercial Motor Vehicle Safety Act of 1986, which mandated the Commercial Driver's License Test (CDL); the compliance status of states and drivers to date; and a recently authorized government grants program that will help fund CDL adult education programs. It also provides…

FMCSA Safety Program Effectiveness Measurement: Carrier Intervention Effectiveness Model, Version 1.1-Report for FY 2014 Interventions - Analysis Brief

DOT National Transportation Integrated Search

2018-04-01

The Carrier Intervention Effectiveness Model (CIEM) provides the Federal Motor Carrier Safety Administration (FMCSA) with a tool for measuring the safety benefits of carrier interventions conducted under the Compliance, Safety, Accountability (CSA) e...

FMCSA safety program effectiveness measurement : carrier intervention effectiveness model, version 1.1 - report for FY 2013 interventions : analysis brief

DOT National Transportation Integrated Search

2017-04-01

The Carrier Intervention Effectiveness Model (CIEM) provides the Federal Motor Carrier Safety Administration (FMCSA) with a tool for measuring the safety benefits of carrier interventions conducted under the Compliance, Safety, Accountability (CSA) e...

STS-121: Discovery Pre-Launch Mission Management Team Press Briefing

NASA Technical Reports Server (NTRS)

2006-01-01

The briefing began with Allard Buetel (NASA Public Affairs) introducing Bill Gerstenmaier (Associate Administrator for Space Operations) who provided an update of the Mission Management team meeting. The 3 criteria reviewed by the team were: a) ascent heating; b) ice formation and c) remaining foam still intact. The ascent heating had a safety factor of 5 and posed no concern. Ice formation was not a concern. In order to insure there was no damage to the remaining foam, an 8ft. pipe with a camera attached was used to provide pictures. The boroscope pictures showed there was no damage to the brackets or foam. The inspection went very well and the foam was acceptable and ready to fly. Then the floor was open to questions from the press.

37 CFR 41.41 - Reply brief.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 37 Patents, Trademarks, and Copyrights 1 2013-07-01 2013-07-01 false Reply brief. 41.41 Section 41.41 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE PRACTICE BEFORE THE PATENT TRIAL AND APPEAL BOARD Ex Parte Appeals § 41.41 Reply brief. (a) Timing...

37 CFR 41.37 - Appeal brief.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 37 Patents, Trademarks, and Copyrights 1 2013-07-01 2013-07-01 false Appeal brief. 41.37 Section 41.37 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE PRACTICE BEFORE THE PATENT TRIAL AND APPEAL BOARD Ex Parte Appeals § 41.37 Appeal brief. (a...

GOES-R Science Briefing

NASA Image and Video Library

2016-11-17

In the Kennedy Space Center's Press Site auditorium, members of the media participate in a mission briefing on the Geostationary Operational Environmental Satellite (GOES-R). Briefing participants included Steven Goodman, NOAA's GOES-R program scientist, and Joseph A. Pica, director of the National Weather Service Office of Observations. GOES-R is the first satellite in a series of next-generation GOES satellites for NOAA, the National Oceanographic and Atmospheric Administration. It will launch to a geostationary orbit over the western hemisphere to provide images of storms and help meteorologists predict severe weather conditionals and develop long-range forecasts.

Building a safety culture in global health: lessons from Guatemala.

PubMed

Rice, Henry E; Lou-Meda, Randall; Saxton, Anthony T; Johnston, Bria E; Ramirez, Carla C; Mendez, Sindy; Rice, Eli N; Aidar, Bernardo; Taicher, Brad; Baumgartner, Joy Noel; Milne, Judy; Frankel, Allan S; Sexton, J Bryan

2018-01-01

Programmes to modify the safety culture have led to lasting improvements in patient safety and quality of care in high-income settings around the world, although their use in low-income and middle-income countries (LMICs) has been limited. This analysis explores (1) how to measure the safety culture using a health culture survey in an LMIC and (2) how to use survey data to develop targeted safety initiatives using a paediatric nephrology unit in Guatemala as a field test case. We used the Safety, Communication, Operational Reliability, and Engagement survey to assess staff views towards 13 health climate and engagement domains. Domains with low scores included personal burnout, local leadership, teamwork and work-life balance. We held a series of debriefings to implement interventions targeted towards areas of need as defined by the survey. Programmes included the use of morning briefings, expansion of staff break resources and use of teamwork tools. Implementation challenges included the need for education of leadership, limited resources and hierarchical work relationships. This report can serve as an operational guide for providers in LMICs for use of a health culture survey to promote a strong safety culture and to guide their quality improvement and safety programmes.

Building a safety culture in global health: lessons from Guatemala

PubMed Central

Rice, Henry E; Lou-Meda, Randall; Saxton, Anthony T; Johnston, Bria E; Ramirez, Carla C; Mendez, Sindy; Rice, Eli N; Aidar, Bernardo; Taicher, Brad; Baumgartner, Joy Noel; Milne, Judy; Frankel, Allan S; Sexton, J Bryan

2018-01-01

Programmes to modify the safety culture have led to lasting improvements in patient safety and quality of care in high-income settings around the world, although their use in low-income and middle-income countries (LMICs) has been limited. This analysis explores (1) how to measure the safety culture using a health culture survey in an LMIC and (2) how to use survey data to develop targeted safety initiatives using a paediatric nephrology unit in Guatemala as a field test case. We used the Safety, Communication, Operational Reliability, and Engagement survey to assess staff views towards 13 health climate and engagement domains. Domains with low scores included personal burnout, local leadership, teamwork and work–life balance. We held a series of debriefings to implement interventions targeted towards areas of need as defined by the survey. Programmes included the use of morning briefings, expansion of staff break resources and use of teamwork tools. Implementation challenges included the need for education of leadership, limited resources and hierarchical work relationships. This report can serve as an operational guide for providers in LMICs for use of a health culture survey to promote a strong safety culture and to guide their quality improvement and safety programmes. PMID:29607099

Legal Briefing: Mandated Reporters and Compulsory Reporting Duties.

PubMed

Pope, Thaddeus Mason

2016-01-01

This issue's "Legal Briefing" column, one product of a Greenwall Foundation grant, reviews recent developments concerning compulsory reporting duties. Most licensed clinicians in the United States are "mandated reporters." When these clinicians discover certain threats to the safety of patients or the public, they are legally required to report that information to specified government officials. Over the past year, several states have legislatively expanded the scope of these reporting duties. In other states, new court cases illustrate the vigorous enforcement of already existing duties. I have organized all these legal developments into the following eight categories: 1. Overview of Mandatory Reporting Duties 2. Controversy over the Benefits of Mandatory Reporting 3. New and Expanded Duties to Report 4. Criminal Penalties for Failing to Report 5. Civil Liability for Failing to Report 6. Disciplinary Penalties for Failing to Report 7. Legal Immunity for Good-Faith Reporting 8. Protection against Employers' Retaliation. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.

Neuropsychological Assessment of Driving Safety Risk in Older Adults With and Without Neurologic Disease

PubMed Central

Anderson, Steven W.; Aksan, Nazan; Dawson, Jeffrey D.; Uc, Ergun Y.; Johnson, Amy M.; Rizzo, Matthew

2013-01-01

Decline in cognitive abilities can be an important contributor to the driving problems encountered by older adults, and neuropsychological assessment may provide a practical approach to evaluating this aspect of driving safety risk. The purpose of the present study was to evaluate several commonly used neuropsychological tests in the assessment of driving safety risk in older adults with and without neurological disease. A further goal of this study was to identify brief combinations of neuropsychological tests that sample performances in key functional domains and thus could be used to efficiently assess driving safety risk. 345 legally licensed and active drivers over the age of 50, with either no neurologic disease (N=185), probable Alzheimer's disease (N=40), Parkinson's disease (N=91), or stroke (N=29), completed vision testing, a battery of 10 neuropsychological tests, and an 18 mile drive on urban and rural roads in an instrumented vehicle. Performances on all neuropsychological tests were significantly correlated with driving safety errors. Confirmatory factor analysis was used to identify 3 key cognitive domains assessed by the tests (speed of processing, visuospatial abilities, and memory), and several brief batteries consisting of one test from each domain showed moderate corrected correlations with driving performance. These findings are consistent with the notion that driving places demands on multiple cognitive abilities that can be affected by aging and age-related neurological disease, and that neuropsychological assessment may provide a practical off-road window into the functional status of these cognitive systems. PMID:22943767

Neuropsychological assessment of driving safety risk in older adults with and without neurologic disease.

PubMed

Anderson, Steven W; Aksan, Nazan; Dawson, Jeffrey D; Uc, Ergun Y; Johnson, Amy M; Rizzo, Matthew

2012-01-01

Decline in cognitive abilities can be an important contributor to the driving problems encountered by older adults, and neuropsychological assessment may provide a practical approach to evaluating this aspect of driving safety risk. The purpose of the present study was to evaluate several commonly used neuropsychological tests in the assessment of driving safety risk in older adults with and without neurological disease. A further goal of this study was to identify brief combinations of neuropsychological tests that sample performances in key functional domains and thus could be used to efficiently assess driving safety risk. A total of 345 legally licensed and active drivers over the age of 50, with no neurologic disease (N = 185), probable Alzheimer's disease (N = 40), Parkinson's disease (N = 91), or stroke (N = 29), completed vision testing, a battery of 10 neuropsychological tests, and an 18-mile drive on urban and rural roads in an instrumented vehicle. Performances on all neuropsychological tests were significantly correlated with driving safety errors. Confirmatory factor analysis was used to identify 3 key cognitive domains assessed by the tests (speed of processing, visuospatial abilities, and memory), and several brief batteries consisting of one test from each domain showed moderate corrected correlations with driving performance. These findings are consistent with the notion that driving places demands on multiple cognitive abilities that can be affected by aging and age-related neurological disease, and that neuropsychological assessment may provide a practical off-road window into the functional status of these cognitive systems.

41 CFR 105-70.036 - Post-hearing briefs.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Administration 70-IMPLEMENTATION OF THE PROGRAM FRAUD CIVIL REMEDIES ACT OF 1986 § 105-70.036 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post... 41 Public Contracts and Property Management 3 2014-01-01 2014-01-01 false Post-hearing briefs. 105...

41 CFR 105-70.036 - Post-hearing briefs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Administration 70-IMPLEMENTATION OF THE PROGRAM FRAUD CIVIL REMEDIES ACT OF 1986 § 105-70.036 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post... 41 Public Contracts and Property Management 3 2013-07-01 2013-07-01 false Post-hearing briefs. 105...

41 CFR 105-70.036 - Post-hearing briefs.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Administration 70-IMPLEMENTATION OF THE PROGRAM FRAUD CIVIL REMEDIES ACT OF 1986 § 105-70.036 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false Post-hearing briefs. 105...

14 CFR § 1264.135 - Post-hearing briefs.

Code of Federal Regulations, 2014 CFR

2014-01-01

... PROGRAM FRAUD CIVIL PENALTIES ACT OF 1986 § 1264.135 Post-hearing briefs. The presiding officer may require the parties to file post-hearing briefs. In any event, upon approval of the presiding officer, any... 14 Aeronautics and Space 5 2014-01-01 2014-01-01 false Post-hearing briefs. § 1264.135 Section Â...

41 CFR 105-70.036 - Post-hearing briefs.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Administration 70-IMPLEMENTATION OF THE PROGRAM FRAUD CIVIL REMEDIES ACT OF 1986 § 105-70.036 Post-hearing briefs. The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post... 41 Public Contracts and Property Management 3 2012-01-01 2012-01-01 false Post-hearing briefs. 105...

NASA Tech Briefs Index 1978. Volume 3, Nos. 1-4

NASA Technical Reports Server (NTRS)

1978-01-01

Tech Briefs are short announcements of new technology derived from the research and development activities of the National Aeronautics and Space Administration. These briefs emphasize information considered likely to be transferrable across industrial, regional, or disciplinary lines and are issued to encourage commercial application. This Index to NASA Tech Briefs contains abstracts and four indexes -- subject, personal author, originating Center, and Tech Brief number -- for 1978 Tech Briefs.

NASA Tech Briefs Index 1979. Volume 4, Nos. 1-4

NASA Technical Reports Server (NTRS)

1980-01-01

Tech Briefs are short announcements of new technology derived from the research and development activities of the National Aeronautics and Space Administration. These briefs emphasize information considered likely to be transferrable across industrial, regional, or disciplinary lines and are issued to encourage commercial application. This Index to NASA Tech Briefs contains abstracts and four indexes -- subject, personal author, originating Center, and Tech Brief number -- for 1979 Tech Briefs.

NASA Tech Briefs Index 1980. Volume 5, Nos. 1-4

NASA Technical Reports Server (NTRS)

1981-01-01

Tech Briefs are short announcements of new technology derived from the research and development activities of the National Aeronautics and Space Administration. These briefs emphasize information considered likely to be transferrable across industrial, regional, or disciplinary lines and are issued to encourage commercial application. This Index to NASA Tech Briefs contains abstracts and four indexes -- subject,. personal author, originating Center, and Tech Brief number -- for 1980 Tech Briefs.

Risk factors for COPD exacerbations in inhaled medication users: the COPDGene study biannual longitudinal follow-up prospective cohort.

PubMed

Busch, Robert; Han, MeiLan K; Bowler, Russell P; Dransfield, Mark T; Wells, J Michael; Regan, Elizabeth A; Hersh, Craig P

2016-02-10

Despite inhaled medications that decrease exacerbation risk, some COPD patients experience frequent exacerbations. We determined prospective risk factors for exacerbations among subjects in the COPDGene Study taking inhaled medications. 2113 COPD subjects were categorized into four medication use patterns: triple therapy with tiotropium (TIO) plus long-acting beta-agonist/inhaled-corticosteroid (ICS ± LABA), tiotropium alone, ICS ± LABA, and short-acting bronchodilators. Self-reported exacerbations were recorded in telephone and web-based longitudinal follow-up surveys. Associations with exacerbations were determined within each medication group using four separate logistic regression models. A head-to-head analysis compared exacerbation risk among subjects using tiotropium vs. ICS ± LABA. In separate logistic regression models, the presence of gastroesophageal reflux, female gender, and higher scores on the St. George's Respiratory Questionnaire were significant predictors of exacerbator status within multiple medication groups (reflux: OR 1.62-2.75; female gender: OR 1.53 - OR 1.90; SGRQ: OR 1.02-1.03). Subjects taking either ICS ± LABA or tiotropium had similar baseline characteristics, allowing comparison between these two groups. In the head-to-head comparison, tiotropium users showed a trend towards lower rates of exacerbations (OR = 0.69 [95 % CI 0.45, 1.06], p = 0.09) compared with ICS ± LABA users, especially in subjects without comorbid asthma (OR = 0.56 [95% CI 0.31, 1.00], p = 0.05). Each common COPD medication usage group showed unique risk factor patterns associated with increased risk of exacerbations, which may help clinicians identify subjects at risk. Compared to similar subjects using ICS ± LABA, those taking tiotropium showed a trend towards reduced exacerbation risk, especially in subjects without asthma. ClinicalTrials.gov NCT00608764, first received 1/28/2008.

Evaluating Mentoring Programs. P/PV Brief

ERIC Educational Resources Information Center

Grossman, Jean Baldwin

2009-01-01

This methodological brief is designed to provide both program operators and researchers with practical advice about how to assess a program's implementation and impact. Adapted from an article that first appeared in "The Handbook of Youth Mentoring" (DuBois and Karcher, ed. 2005), the brief focuses on the evaluation of mentoring programs, but the…

37 CFR 41.41 - Reply brief.

Code of Federal Regulations, 2010 CFR

2010-07-01

... COMMERCE PRACTICE BEFORE THE BOARD OF PATENT APPEALS AND INTERFERENCES Ex Parte Appeals § 41.41 Reply brief... indefinitely. For the convenience of the user, the revised text is set forth as follows: § 41.41 Reply brief... additional facts—see paragraph (f) of this section. (5) Argument—see paragraph (g) of this section. (e...

Beacons In Brief. P/PV In Brief. Issue 2

ERIC Educational Resources Information Center

Blank, Susan; Farley, Chelsea

2004-01-01

This second issue in P/PV's "In Brief" series focuses on the San Francisco Beacon Initiative and P/PV's recently released evaluation results. The Beacon Initiative established after-school programs in eight public schools in low-income San Francisco neighborhoods. P/PV's 36-month evaluation examined key developmental and academic outcomes.…

Food Safety Evaluation Based on Near Infrared Spectroscopy and Imaging: A Review.

PubMed

Fu, Xiaping; Ying, Yibin

2016-08-17

In recent years, due to the increasing consciousness of food safety and human health, much progress has been made in developing rapid and nondestructive techniques for the evaluation of food hazards, food authentication, and traceability. Near infrared (NIR) spectroscopy and imaging techniques have gained wide acceptance in many fields because of their advantages over other analytical techniques. Following a brief introduction of NIR spectroscopy and imaging basics, this review mainly focuses on recent NIR spectroscopy and imaging applications for food safety evaluation, including (1) chemical hazards detection; (2) microbiological hazards detection; (3) physical hazards detection; (4) new technology-induced food safety concerns; and (5) food traceability. The review shows NIR spectroscopy and imaging to be effective tools that will play indispensable roles for food safety evaluation. In addition, on-line/real-time applications of these techniques promise to be a huge growth field in the near future.

NASA tech brief evaluations

NASA Technical Reports Server (NTRS)

Workman, Gary L.

1994-01-01

A major step in transferring technology is to disseminate information about new developments to the appropriate sector(s). A useful vehicle for transferring technology from the government sector to industry has been demonstrated with the use of periodical and journal announcements to highlight technological achievements which may meet the needs of industries other than the one who developed the innovation. To meet this end, NASA has very successfully pursued the goal of identifying technical innovations through the national circulation publication; NASA Tech Briefs. At one time the Technology Utilization Offices of the various centers coordinated the selection of appropriate technologies through a common channel. In recent years, each NASA field center has undertaken the task of evaluating submittals for Tech Brief publication independently of the others. The University of Alabama in Huntsville was selected to assist MSFC in evaluating technology developed under the various programs managed by the NASA center for publication in the NASA Tech Briefs journal. The primary motivation for the NASA Tech Briefs publication is to bring to the attention of industry the various NASA technologies which, in general, have been developed for a specific aerospace requirement, but has application in other areas. Since there are a number of applications outside of NASA that can benefit from innovative concepts developed within the MSPC programs, the ability to transfer technology to other sectors is very high. In most cases, the innovator(s) are not always knowledgeable about other industries which might potentially benefit from their innovation. The evaluation process can therefore contribute to the list of potential users through a knowledgeable evaluator.

Cumulative index to NASA Tech Briefs, 1970-1975. [bibliographies

NASA Technical Reports Server (NTRS)

1979-01-01

Tech briefs of technology derived from the research and development activities of the National Aeronautics and Space Administration are presented. Abstracts and indexes of subject, personal author, originating center, and tech brief number for the 1970-1975 tech briefs are presented.

FMCSA safety program effectiveness measurement compliance review effectiveness model results for carriers with compliance reviews in fiscal year 2009 : [analysis brief].

DOT National Transportation Integrated Search

2014-04-01

This Analysis Brief documents the methodology and results from the Compliance Review Effectiveness Model (CREM) for carriers receiving CRs in fiscal year (FY) 2009. The model measures the effectiveness of the compliance review (CR) program, one of th...

GOES-R Science Briefing

NASA Image and Video Library

2016-11-17

In the Kennedy Space Center's Press Site auditorium, members of the media participate in a mission briefing on the Geostationary Operational Environmental Satellite (GOES-R). Briefing participants from left are: Steven Goodman, NOAA's GOES-R program scientist; Joseph A. Pica, director of the National Weather Service Office of Observations; and Sandra Cauffman, deputy director of NASA's Earth Science Division. GOES-R is the first satellite in a series of next-generation GOES satellites for NOAA, the National Oceanographic and Atmospheric Administration. It will launch to a geostationary orbit over the western hemisphere to provide images of storms and help meteorologists predict severe weather conditionals and develop long-range forecasts.

Transition to Office-based Obstetric and Gynecologic Procedures: Safety, Technical, and Financial Considerations.

PubMed

Peacock, Lisa M; Thomassee, May E; Williams, Valerie L; Young, Amy E

2015-06-01

Office-based surgery is increasingly desired by patients and providers due to ease of access, overall efficiency, reimbursement, and satisfaction. The adoption of office-based surgery requires careful consideration of safety, efficacy, cost, and feasibility within a providers practice. This article reviews the currently available data regarding patient and provider satisfaction as well as practical considerations of staffing, equipment, and supplies. To aid the practitioner, issues of office-based anesthesia and safety with references to currently available national guidelines and protocols are provided. Included is a brief review of billing, coding, and reimbursement. Technical procedural aspects with information and recommendations are summarized.

Impact of asthma controller medications on medical and economic resource utilization in adult asthma patients.

PubMed

Lee, Todd A; Chang, Chun-Lan; Stephenson, Judith J; Sajjan, Shiva G; Maiese, Eric M; Everett, Sharlette; Allen-Ramey, Felicia

2010-12-01

To compare asthma-related resource utilization, adherence and costs among adults prescribed asthma controller regimens. Medical and pharmacy claims from a US managed-care claims database were used to identify adults (18-56 years) initiating asthma controller therapy. Patients had 2 years continuous enrollment and ≥ 1 medical claims for asthma (ICD9: 493.xx) (January 2004 - March 2009). Asthma exacerbations, short-acting β-agonist (SABA) fills, adherence (MPR ≥ 0.80) and asthma-related costs were assessed for 1 year after the initial asthma controller medication claim. Separate logistic and negative binomial regression models for monotherapy and combination therapy were developed to examine the impact of controller therapy on outcomes. A total of 28 074 patients [inhaled corticosteroids (ICS) (26.3%), leukotriene modifiers (LM) (23.2%), ICS  +  long acting β-agonist (LABA) (48.5%), ICS + LM (2%)] were included. LM patients had lower odds of ≥ 6 SABA fills (OR(adj) = 0.83, 95% CI: 0.73-0.96) and lower rates of asthma exacerbations (RR(adj) = 0.82, 0.75-0.89) vs. ICS patients. Odds of ≥ 6 SABA fills were similar for ICS + LM vs. ICS + LABA (OR(adj) = 1.3, 0.96-1.76); the rate of asthma exacerbations was greater for ICS + LM compared with ICS + LABA (OR(adj) = 1.4, 1.2-1.6). The proportion adherent was greatest for LM (14.9%) and ICS + LABA (4.1%). LM patients had higher unadjusted pharmacy costs, but lower medical costs compared to ICS patients. For combination therapy, ICS + LM had higher unadjusted mean medical and pharmacy costs vs. ICS + LABA. Higher adjusted mean total costs in the post-index period were observed for LM vs. ICS patients ($837 vs. 684) and for ICS + LM vs. ICS + LABA patients ($1223 vs. 873). LM monotherapy was associated with lower medical costs but higher total costs resulting from greater treatment adherence. Conversely, higher costs for ICS + LM resulted from greater

14 CFR 91.1013 - Operational control briefing and acknowledgment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... management services contract, the program manager must brief the fractional owner on the owner's operational... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Operational control briefing and... Ownership Operations Operational Control § 91.1013 Operational control briefing and acknowledgment. (a) Upon...

Establishing Teacher Competencies in Early Care and Education: A Review of Current Models and Options for California. Building California's Preschool for All Workforce. A Series of Policy Briefs

ERIC Educational Resources Information Center

Bellm, Dan

2005-01-01

This policy brief provides guidelines grouped into five areas: personal and professional behavior; classroom environment; health, safety and nutrition; working with families and communities; and administration and management. The document discusses the topics that teacher competencies generally cover, options for how they might be developed and…

MAVEN Briefing

NASA Image and Video Library

2014-09-17

Dr. Jim Green, NASA‘s Planetary Science Division Director and Head of Mars Program, gives opening remarks at a media briefing where panelist outlined activities around the Sunday, Sept. 21 orbital insertion at Mars of the agency’s Mars Atmosphere and Volatile EvolutioN (MAVEN) spacecraft, Wednesday, Sept. 17, 2014 at NASA Headquarters in Washington. (Photo credit: NASA/Bill Ingalls)

The Texas Public Education Challenge. Policy Brief No. 1

ERIC Educational Resources Information Center

Center for Public Policy Priorities, 2006

2006-01-01

This is the first in a trilogy of policy briefs discussing public education and taxes. This brief discusses the challenge facing Texas in funding public education. This brief also explains why the Texas Supreme Court's recent decision in "West Orange-Cove II" requires increased state appropriations for public education.

Developing a research agenda for patient safety in primary care. Background, aims and output of the LINNEAUS collaboration on patient safety in primary care.

PubMed

Esmail, Aneez; Valderas, Jose M; Verstappen, Wim; Godycki-Cwirko, Maciek; Wensing, Michel

2015-09-01

This paper is an introduction to a supplement to The European Journal of General Practice, bringing together a body of research focusing on the issue of patient safety in relation to primary care. The supplement represents the outputs of the LINNEAUS collaboration on patient safety in primary care, which was a four-year (2009-2013) coordination and support action funded under the Framework 7 programme by the European Union. Being a coordination and support action, its aim was not to undertake new research, but to build capacity through engaging primary care researchers and practitioners in identifying some of the key challenges in this area and developing consensus statements, which will be an essential part in developing a future research agenda. This introductory article describes the aims of the LINNEAUS collaboration, provides a brief summary of the reasons to focus on patient safety in primary care, the epidemiological and policy considerations, and an introduction to the papers included in the supplement.

Developing a research agenda for patient safety in primary care. Background, aims and output of the LINNEAUS collaboration on patient safety in primary care

PubMed Central

Esmail, Aneez; Valderas, Jose M.; Verstappen, Wim; Godycki-Cwirko, Maciek; Wensing, Michel

2015-01-01

ABSTRACT This paper is an introduction to a supplement to The European Journal of General Practice, bringing together a body of research focusing on the issue of patient safety in relation to primary care. The supplement represents the outputs of the LINNEAUS collaboration on patient safety in primary care, which was a four-year (2009–2013) coordination and support action funded under the Framework 7 programme by the European Union. Being a coordination and support action, its aim was not to undertake new research, but to build capacity through engaging primary care researchers and practitioners in identifying some of the key challenges in this area and developing consensus statements, which will be an essential part in developing a future research agenda. This introductory article describes the aims of the LINNEAUS collaboration, provides a brief summary of the reasons to focus on patient safety in primary care, the epidemiological and policy considerations, and an introduction to the papers included in the supplement. PMID:26339828

Screening and Brief Intervention for Underage Drinkers

PubMed Central

Clark, Duncan B.; Gordon, Adam J.; Ettaro, Lorraine R.; Owens, Jill M.; Moss, Howard B.

2010-01-01

In a 2007 report, the US Surgeon General called for health care professionals to renew efforts to reduce underage drinking. Focusing on the adolescent patient, this review provides health care professionals with recommendations for alcohol-related screening, brief intervention, and referral to treatment. MEDLINE and published reviews were used to identify relevant literature. Several brief screening methods have been shown to effectively identify underage drinkers likely to have alcohol use disorders. After diagnostic assessment when germane, the initial intervention typically focuses on education, motivation for change, and consideration of treatment options. Internet-accessible resources providing effective brief interventions are available, along with supplemental suggestions for parents. Recent changes in federal and commercial insurance reimbursement policies provide some fiscal support for these services, although rate increases and expanded applicability may be required to prompt the participation of many practitioners. Nevertheless, advances in clinical methods and progress on reimbursement policies have made screening and brief intervention for underage drinking more feasible in general health care practice. PMID:20360296

A systematic review of adverse drug events associated with administration of common asthma medications in children

PubMed Central

Johnson, David W.; Sperou, Arissa J.; Crotts, Jennifer; Saude, Erik; Hartling, Lisa; Stang, Antonia

2017-01-01

Objective To systematically review the literature and determine frequencies of adverse drug events (ADE) associated with pediatric asthma medications. Methods Following PRISMA guidelines, we systematically searched six bibliographic databases between January 1991 and January 2017. Study eligibility, data extraction and quality assessment were independently completed and verified by two reviewers. We included randomized control trials (RCT), case-control, cohort, or quasi-experimental studies where the primary objective was identifying ADE in children 1 month– 18 years old exposed to commercial asthma medications. The primary outcome was ADE frequency. Findings Our search identified 14,540 citations. 46 studies were included: 24 RCT, 15 cohort, 4 RCT pooled analyses, 1 case-control, 1 open-label trial and 1 quasi-experimental study. Studies examined the following drug classes: inhaled corticosteroids (ICS) (n = 24), short-acting beta-agonists (n = 10), long-acting beta-agonists (LABA) (n = 3), ICS + LABA (n = 3), Leukotriene Receptor Antagonists (n = 3) and others (n = 3). 29 studies occurred in North America, and 29 were industry funded. We report a detailed index of 406 ADE descriptions and frequencies organized by drug class. The majority of data focuses on ICS, with 174 ADE affecting 13 organ systems including adrenal and growth suppression. We observed serious ADE, although they were rare, with frequency ranging between 0.9–6% per drug. There were no confirmed deaths, except for 13 potential deaths in a LABA study including combined adult and pediatric participants. We identified substantial methodological concerns, particularly with identifying ADE and determining severity. No studies utilized available standardized causality, severity or preventability assessments. Conclusion The majority of studies focus on ICS, with adrenal and growth suppression described. Serious ADE are relatively uncommon, with no confirmed pediatric deaths. We identify substantial

Research in Brief.

ERIC Educational Resources Information Center

Journalism Quarterly, 1984

1984-01-01

Brief research reports discuss Latin America as seen on United States network television; television news coverage of federal regulatory agencies; community perceptions of media impressions; active television viewing and cultivation hypothesis; the impact of cable on traditional television news viewing; George Kibbe Turner; advertising; and…

45 CFR 2554.38 - Are post-hearing briefs required?

Code of Federal Regulations, 2014 CFR

2014-10-01

... COMMUNITY SERVICE PROGRAM FRAUD CIVIL REMEDIES ACT REGULATIONS Hearing Provisions § 2554.38 Are post-hearing briefs required? The ALJ may require the parties to file post-hearing briefs. In any event, any party may... 45 Public Welfare 4 2014-10-01 2014-10-01 false Are post-hearing briefs required? 2554.38 Section...

45 CFR 2554.38 - Are post-hearing briefs required?

Code of Federal Regulations, 2010 CFR

2010-10-01

... COMMUNITY SERVICE PROGRAM FRAUD CIVIL REMEDIES ACT REGULATIONS Hearing Provisions § 2554.38 Are post-hearing briefs required? The ALJ may require the parties to file post-hearing briefs. In any event, any party may... 45 Public Welfare 4 2010-10-01 2010-10-01 false Are post-hearing briefs required? 2554.38 Section...

45 CFR 2554.38 - Are post-hearing briefs required?

Code of Federal Regulations, 2013 CFR

2013-10-01

... COMMUNITY SERVICE PROGRAM FRAUD CIVIL REMEDIES ACT REGULATIONS Hearing Provisions § 2554.38 Are post-hearing briefs required? The ALJ may require the parties to file post-hearing briefs. In any event, any party may... 45 Public Welfare 4 2013-10-01 2013-10-01 false Are post-hearing briefs required? 2554.38 Section...

45 CFR 2554.38 - Are post-hearing briefs required?

Code of Federal Regulations, 2012 CFR

2012-10-01

... COMMUNITY SERVICE PROGRAM FRAUD CIVIL REMEDIES ACT REGULATIONS Hearing Provisions § 2554.38 Are post-hearing briefs required? The ALJ may require the parties to file post-hearing briefs. In any event, any party may... 45 Public Welfare 4 2012-10-01 2012-10-01 false Are post-hearing briefs required? 2554.38 Section...

45 CFR 2554.38 - Are post-hearing briefs required?

Code of Federal Regulations, 2011 CFR

2011-10-01

... COMMUNITY SERVICE PROGRAM FRAUD CIVIL REMEDIES ACT REGULATIONS Hearing Provisions § 2554.38 Are post-hearing briefs required? The ALJ may require the parties to file post-hearing briefs. In any event, any party may... 45 Public Welfare 4 2011-10-01 2011-10-01 false Are post-hearing briefs required? 2554.38 Section...

14 CFR 141.43 - Pilot briefing areas.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Pilot briefing areas. 141.43 Section 141.43... OTHER CERTIFICATED AGENCIES PILOT SCHOOLS Personnel, Aircraft, and Facilities Requirements § 141.43 Pilot briefing areas. (a) An applicant for a pilot school certificate or provisional pilot school...

14 CFR 141.43 - Pilot briefing areas.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Pilot briefing areas. 141.43 Section 141.43... OTHER CERTIFICATED AGENCIES PILOT SCHOOLS Personnel, Aircraft, and Facilities Requirements § 141.43 Pilot briefing areas. (a) An applicant for a pilot school certificate or provisional pilot school...

Use of a Surgical Safety Checklist to Improve Team Communication.

PubMed

Cabral, Richard A; Eggenberger, Terry; Keller, Kathryn; Gallison, Barry S; Newman, David

2016-09-01

To improve surgical team communication, a team at Broward Health Imperial Point Hospital, Ft Lauderdale, Florida, implemented a program for process improvement using a locally adapted World Health Organization Surgical Safety Checklist. This program included a standardized, comprehensive time out and a briefing/debriefing process. Postimplementation responses to the Safety Attitudes Questionnaire revealed a significant increase in the surgical team's perception of communication compared with that reported on the pretest (6% improvement resulting in t79 = -1.72, P < .05, d = 0.39). Perceptions of communication increased significantly for nurses (12% increase, P = .002), although the increase for surgeons and surgical technologists was lower (4% for surgeons, P = .15 and 2.3% for surgical technologists, P = .06). As a result of this program, we have observed improved surgical teamwork behaviors and an enhanced culture of safety in the OR. Copyright © 2016 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Research in Brief.

ERIC Educational Resources Information Center

Journalism Quarterly, 1980

1980-01-01

Eight brief research reports concerning a newspaper's conversion to VDTs, media evaluation by police chiefs, defending and indemnifying reporters in tort actions, newsmagazine coverage of the Supreme Court, pricing of advertising in weekly newspapers, the importance of writing, "yeasaying" in readership surveys, and public service utilization by…

Organizing seniors to protect the health safety net: the way forward.

PubMed

Sharma, Leena; Regan, Carol; Villers, Katherine S

2018-04-12

Over the past century, the organized voice of seniors has been critical in building the U.S. health safety net. Since the 2016 election, that safety net, particularly the Medicaid program, is in jeopardy. As we have seen with the rise of the Tea Party, senior support for health care programs-even programs that they use in large numbers-cannot and should not be taken for granted. This article provides a brief history of senior advocacy and an overview of the current senior organizing landscape. It also identifies opportunities for building the transformational organizing of low-income seniors needed to defend against sustained attacks on critical programs. Several suggestions are made, drawn from years of work in philanthropy, advocacy, and campaigns, for strengthening the ability to organize seniors-particularly low-income seniors-into an effective political force advocating for Medicaid and other safety net programs.

Extra-Curricular Inequality. Research Brief. Edition 1

ERIC Educational Resources Information Center

Sutton Trust, 2014

2014-01-01

This Research Briefing analyses Office for National Statistics data and finds children from the most advantaged households benefit from significantly more spending on extra-curricular activities and private tutoring than their poorer peers. The brief also includes the Trust's annual polling on private tuition and new polling on parents and…

The GO4KIDDS Brief Adaptive Scale

ERIC Educational Resources Information Center

Perry, Adrienne; Taheri, Azin; Ting, Victoria; Weiss, Jonathan

2015-01-01

Background: Accurate measurement of adaptive behaviour is important in both clinical and research contexts. While several good clinical measures exist, as well as brief research measures for adults with intellectual disability, there is need for a brief and efficient measure for research with children and youth. We present preliminary psychometric…

Aflatoxins: A Global Concern for Food Safety, Human Health and Their Management

PubMed Central

Kumar, Pradeep; Mahato, Dipendra K.; Kamle, Madhu; Mohanta, Tapan K.; Kang, Sang G.

2017-01-01

The aflatoxin producing fungi, Aspergillus spp., are widely spread in nature and have severely contaminated food supplies of humans and animals, resulting in health hazards and even death. Therefore, there is great demand for aflatoxins research to develop suitable methods for their quantification, precise detection and control to ensure the safety of consumers’ health. Here, the chemistry and biosynthesis process of the mycotoxins is discussed in brief along with their occurrence, and the health hazards to humans and livestock. This review focuses on resources, production, detection and control measures of aflatoxins to ensure food and feed safety. The review is informative for health-conscious consumers and research experts in the fields. Furthermore, providing knowledge on aflatoxins toxicity will help in ensure food safety and meet the future demands of the increasing population by decreasing the incidence of outbreaks due to aflatoxins. PMID:28144235

Combined bronchodilators (tiotropium plus olodaterol) for patients with chronic obstructive pulmonary disease.

PubMed

Ramadan, Wijdan H; Kabbara, Wissam K; El Khoury, Ghada M; Al Assir, Sarah A

2015-01-01

Chronic obstructive pulmonary disease (COPD), a respiratory disease characterized by a progressive decline in lung function, is considered to be a leading cause of morbidity and mortality. Long-acting inhaled bronchodilators, such as long-acting β2 agonists (LABAs) or long-acting muscarinic antagonists (LAMAs), are the cornerstone of maintenance therapy for patients with moderate-to-very-severe COPD. For patients not sufficiently controlled on a single long-acting bronchodilator, a combination of different bronchodilators has shown a significant increase in lung function. Tiotropium, a once-daily dosing LAMA, demonstrated sustained improvements in lung function as well as improved health-related quality of life, reduced exacerbations, and increased survival without altering the rate of decline in the mean forced expiratory volume in 1 second (FEV1) with fairly tolerable side effects. Olodaterol is a once-daily dosing LABA that has proven to be effective in improving lung function, reducing rescue medication use, and improving dyspnea and health-related quality of life, as well as improving exercise endurance with an acceptable safety profile. The combination of olodaterol and tiotropium provided additional improvements in lung function greater than monotherapy with each drug alone. Several well-designed randomized trials confirmed that the synergistic effect of both drugs in combination was able to improve lung function and health-related quality of life without a significant increase in adverse effects. The objective of this paper is to review available evidence on the clinical efficacy and safety of tiotropium, olodaterol, and their combination in patients with COPD.

Effect of smoking status on the efficacy of the SMART regimen in high risk asthma.

PubMed

Pilcher, Janine; Patel, Mitesh; Reddel, Helen K; Pritchard, Alison; Black, Peter; Shaw, Dominick; Holt, Shaun; Weatherall, Mark; Beasley, Richard

2016-07-01

The optimal management of people with asthma with a significant smoking history is uncertain. The aim of this study was to determine whether the efficacy/safety profile of single combination inhaled corticosteroid (ICS)/long acting beta-agonist (LABA) inhaler maintenance and reliever therapy is influenced by smoking status. We undertook secondary analyses from an open-label 24-week randomized study of 303 high risk adult asthma patients randomized to budesonide/formoterol 200/6-µg-metred dose inhaler for maintenance (two actuations twice daily) and either budesonide/formoterol 200/6-µg-metred dose inhaler one actuation ('single ICS/LABA maintenance and reliever therapy (SMART)' regimen) or salbutamol 100 µg 1-2 actuations for symptom relief ('Standard' regimen). Smoking status was classified in to three groups, as 'current', 'ex' or 'never', and a smoking/treatment interaction term tested for each outcome variable. The primary outcome variable was number of participants with at least one severe exacerbation. There were 59 current, 97 ex and 147 never smokers included in the analyses. The smoking status/treatment interaction term was not statistically significant for any of the outcome measures. With adjustment for smoking status, the number of participants with severe exacerbations was lower with the SMART regimen (OR 0.45, 95% CI: 0.26-0.77, P = 0.004; P value for interaction between smoking status and treatment 0.29). We conclude that the favourable safety/efficacy profile of the SMART regimen applies to patients with high risk asthma, irrespective of smoking status. © 2016 Asian Pacific Society of Respirology.

Cumulative Index to NASA Tech Briefs 1963-1969

NASA Technical Reports Server (NTRS)

1970-01-01

Tech Briefs are short announcements of new technology derived from the research and development activities of the National Aeronautics and Space Administration. These briefs emphasize information considered likely to be transferrable across industrial, regional, or disciplinary lines and are issued to encourage commercial application. This Cumulative index to NASA Tech Briefs lists those published from 1963 through 1969. The main listing is divided into six categokies: Electrical (Electronic), Physical Sciences (Energy Sources), Materials (Chemistry), Life Sciences, Mechanical, and Computer Programs.

The Daily Operational Brief: Fostering Daily Readiness, Care Coordination, and Problem-Solving Accountability in a Large Pediatric Health Care System.

PubMed

Donnelly, Lane F; Basta, Kathryne C; Dykes, Anne M; Zhang, Wei; Shook, Joan E

2018-01-01

At a pediatric health system, the Daily Operational Brief (DOB) was updated in 2015 after three years of operation. Quality and safety metrics, the patient volume and staffing assessment, and the readiness assessment are all presented. In addition, in the problem-solving accountability system, problematic issues are categorized as Quick Hits or Complex Issues. Walk-the-Wall, a biweekly meeting attended by hospital senior administrative leadership and quality and safety leaders, is conducted to chart current progress on Complex Issues. The DOB provides a daily standardized approach to evaluate readiness to provide care to current patients and improvement in the care to be provided for future patients. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

ISAF Overview Brief

DTIC Science & Technology

2011-01-01

Eager Afghans NEW PA STUDENTS NATO / ISAF UNCLASSIFIED NATO / ISAF UNCLASSIFIED ISAF Overview Brief, MHS Conference 2011 – Attrition, Leader deficit...doctors (male/fem), 2 nurses, 2 midwives. 100k-300k XRAY, surgery, OB, physiotherapy , pediatrician, pharmacist, dentist. 10k-15k An extension of the BHC

Brief interventions for illicit drug use among peripartum women.

PubMed

Farr, Sherry L; Hutchings, Yalonda L; Ondersma, Steven J; Creanga, Andreea A

2014-10-01

We review the evidence and identify limitations of the current literature on the effectiveness of brief interventions (≤5 intervention sessions) on illicit drug use, treatment enrollment/retention, and pregnancy outcomes among pregnant and postpartum women; and consider this evidence in the context of the broader brief intervention literature. Among 4 published studies identified via systematic review and meeting a priori quality criteria, we found limited, yet promising evidence of the benefit of brief interventions to reduce illicit drug use among postpartum women. Two of the 4 randomized controlled trials tested similar computer-delivered single-session interventions; both demonstrate effects on postpartum drug use. Neither of the 2 randomized controlled trials that assessed treatment use found differences between intervention and control groups. Studies examining brief interventions for smoking and alcohol use among pregnant women, and for illicit drug use in the general adult population, have shown small but statistically significant results of the effectiveness of such interventions. Larger studies, those that examine the effect of assessment alone on illicit drug use, and those that use technology-delivered brief interventions are needed to assess the effectiveness of brief interventions for drug use in the peripartum period. Published by Elsevier Inc.

Patient and practitioner characteristics predict brief alcohol intervention in primary care.

PubMed

Kaner, E F; Heather, N; Brodie, J; Lock, C A; McAvoy, B R

2001-10-01

The effectiveness of an evidence-based health care intervention depends on it being delivered consistently to appropriate patients. Brief alcohol intervention is known to be effective at reducing excessive drinking and its concomitant health and social problems. However, a recent implementation trial reported partial delivery of brief alcohol intervention by general practitioners (GPs) which is likely to have reduced its impact. To investigate patient-practitioner characteristics influencing brief alcohol intervention in primary care. Cross-sectional analysis of 12,814 completed Alcohol Use Disorders Identification Test (AUDIT) screening questionnaires. Eighty-four GPs who had implemented a brief alcohol intervention programme in a previous trial based in the Northeast of England. GPs were requested to screen all adults (aged over 16 years) presenting to their surgery and follow a structured protocol to give a brief intervention (five minutes of advice plus an information booklet) to all 'risk' drinkers. Anonymized carbon copies of the screening questionnaire were collected from all practices after a three-month implementation period. Although AUDIT identified 4080 'risk' drinkers, only 2043 (50%) received brief intervention. Risk drinkers that were most likely to receive brief intervention were males (58%), unemployed (61%), and technically-trained patients (55%). Risk drinkers that were least likely to receive brief intervention were females (44%), students (38%), and university educated patients (46%). Logistic regression modelling showed that patients' risk status was the most influential predictor of brief intervention. Also, GPs' experience of relevant training and longer average practice consultations predicted brief intervention. However, personal characteristics relating to patients and GPs also predicted brief intervention in routine practice. Interpersonal factors relating to patients and practitioners contributed to the selective provision of brief

Inadequate Preoperative Team Briefings Lead to More Intraoperative Adverse Events.

PubMed

Phadnis, Joideep; Templeton-Ward, Oliver

2018-06-01

Implementation of the World Health Organization checklists has reduced major surgical complications and errors; however, the impact of preoperative briefings on intraoperative adverse events has not been assessed. A prospective case-control study assessing the association between preoperative briefings and minor, potentially major, and major adverse intraoperative events was performed in 2 phases. Phase 1 involved prospective data collection for all trauma and orthopedic lists during a 2-week period. Changes were implemented as a result of the findings, and after this, the study was repeated (phase 2) to assess for the effect of the changes made to the practice. Forty-one lists were audited during phase 1 and 47 lists were audited during phase 2 of the study. Adequate preoperative briefings were performed in 10 (24%) of 41 lists in phase 1. There was a significant association between the occurrences of intraoperative adverse events (n = 37) when a briefing was not performed (P = < 0.01) and when a briefing was performed incompletely (P = 0.01). In phase 2, after staff reeducation and policy change, briefings were found to be adequate in 38 (81%) of 47 lists with the occurrence of only 3 adverse events. Team familiarity also improved significantly as a result of better preoperative briefings (P = 0.02). Inadequate preoperative briefings are associated with an increase in minor adverse events and are detrimental to team familiarity. On the basis of our findings, we recommend that all surgical units perform preoperative briefings thoroughly to minimize these factors.

Proactive assessment of accident risk to improve safety on a system of freeways : [research brief].

DOT National Transportation Integrated Search

2012-05-01

As traffic safety on freeways continues to be a growing concern, much progress has been made in shifting from reactive (incident detection) to proactive (real-time crash risk assessment) traffic strategies. Reliable models that can take in real-time ...

29 CFR 1202.15 - Length of briefs in NMB hearing proceedings.

Code of Federal Regulations, 2010 CFR

2010-07-01

... the Board may require the filing of a summary of argument, suitably paragraphed which shoud be a succinct, but accurate and clear, condensation of the argument actually made in the brief. (b) The page... brief. All briefs shall be submitted on standard 81/2×11 inch paper with double spaced type. (c) Briefs...

Depleted Uranium: Technical Brief

EPA Pesticide Factsheets

This technical brief provides accepted data and references to additional sources for radiological and chemical characteristics, health risks and references for both the monitoring and measurement, and applicable treatment techniques for depleted uranium.

Public Participation Guide: Briefings

EPA Pesticide Factsheets

Briefings are generally short presentations provided directly to community groups at their existing meetings or locations – such as social and civic clubs – to provide an overview or update on a project.

Building food safety into the company culture: a look at Maple Leaf Foods.

PubMed

Lone, Jespersen; Huffman, Randy

2014-07-01

Maple Leaf Foods learned a hard lesson following its tragic 2008 Listeria outbreak that ended up taking the lives of 23 Canadians. The organization has since 2008 transformed its commitment to food safety with a strong drive and manifest in embedding sustainable food safety behaviours into the existing company culture. Its focus on combining technical risk analysis with behavioural sciences has led to the development and deployment of a food safety strategy deeply rooted in the company values and management commitment. Using five tactics described in this article the organization has been on a journey towards food safety transformation through adoption of best practices for people and systems. The approach to food safety has been one where food safety is treated as a non-competitive issue and Maple Leaf Foods have been open to sharing learning about what happened and how the organization will continue to take a leadership position in food safety to continuously raise the bar for food safety across the industry. Maple Leaf Foods has benefited tremendously by learning about best practice from numerous companies in North America and around the world. The authors believe this brief story will bring value to others as we continue to learn and improve.

On Some Methods in Safety Evaluation in Geotechnics

NASA Astrophysics Data System (ADS)

Puła, Wojciech; Zaskórski, Łukasz

2015-06-01

The paper demonstrates how the reliability methods can be utilised in order to evaluate safety in geotechnics. Special attention is paid to the so-called reliability based design that can play a useful and complementary role to Eurocode 7. In the first part, a brief review of first- and second-order reliability methods is given. Next, two examples of reliability-based design are demonstrated. The first one is focussed on bearing capacity calculation and is dedicated to comparison with EC7 requirements. The second one analyses a rigid pile subjected to lateral load and is oriented towards working stress design method. In the second part, applications of random field to safety evaluations in geotechnics are addressed. After a short review of the theory a Random Finite Element algorithm to reliability based design of shallow strip foundation is given. Finally, two illustrative examples for cohesive and cohesionless soils are demonstrated.

Visualizing Patterns of Drug Prescriptions with EventFlow: A Pilot Study of Asthma Medications in the Military Health System

DTIC Science & Technology

2013-06-01

1 Visualizing Patterns of Drug Prescriptions with EventFlow: A Pilot Study of Asthma Medications in the...asthmatics within the Military Health System (MHS). Visualizing the patterns of asthma medication use surrounding a LABA prescription is a quick way to...random sample of 100 asthma patients under age 65 with a new LABA prescription from January 1, 2006-March 1, 2010 in MHS healthcare claims. Analysis was

A Brief History.

ERIC Educational Resources Information Center

Yalouris, Nicolaos

1996-01-01

Provides a brief but concise overview of the historical development of the Olympic Games in ancient Greece. Originally conceived as a one day, single-race event, the Games grew to the point where they represented an apotheosis of Greek culture. Discusses the role played by conflict within the city-states. (MJP)

The potential for technology in brief interventions for substance use, and during-session prediction of computer-delivered brief intervention response.

PubMed

Ondersma, Steven J; Grekin, Emily R; Svikis, Dace

2011-01-01

We first provide an overview of the potential of technology in the area of brief interventions for substance use and describe recent projects from our lab that are illustrative of that potential. Second, we present data from a study of during-session predictors of brief intervention response. In a sample of postpartum women (N = 39), several variables showed promise as predictors of later drug use, and a brief index derived from them predicted abstinence with a sensitivity of .7 and a specificity of .89. This promising approach and initial study findings support the importance of future research in this area.

School Culture: "The Hidden Curriculum." Issue Brief

ERIC Educational Resources Information Center

Jerald, Craig D.

2006-01-01

This is the sixth in a series of issue briefs to be written for The Center for Comprehensive School Reform and Improvement during 2006. The impact of organizational culture on student achievement is discussed in this issue brief. Gaining a deep understanding of what a strong, positive organizational culture looks like and how it works can help…

Internship or Indenture? Research Brief. Edition 2

ERIC Educational Resources Information Center

Sutton Trust, 2014

2014-01-01

This brief analyzes the latest higher education data and government wage statistics to examine the number of unpaid graduate interns in the United Kingdom and the cost to an individual of doing an unpaid internship. It also includes newly published Ipsos Mori polling on attitudes to unpaid internships. Key findings in this brief include: (1) 31%…

Cost-effectiveness of available treatment options for patients suffering from severe COPD in the UK: a fully incremental analysis.

PubMed

Hertel, Nadine; Kotchie, Robert W; Samyshkin, Yevgeniy; Radford, Matthew; Humphreys, Samantha; Jameson, Kevin

2012-01-01

Frequent exacerbations which are both costly and potentially life-threatening are a major concern to patients with chronic obstructive pulmonary disease (COPD), despite the availability of several treatment options. This study aimed to assess the lifetime costs and outcomes associated with alternative treatment regimens for patients with severe COPD in the UK setting. A Markov cohort model was developed to predict lifetime costs, outcomes, and cost-effectiveness of various combinations of a long-acting muscarinic antagonist (LAMA), a long-acting beta agonist (LABA), an inhaled corticosteroid (ICS), and roflumilast in a fully incremental analysis. Patients willing and able to take ICS, and those refusing or intolerant to ICS were analyzed separately. Efficacy was expressed as relative rate ratios of COPD exacerbation associated with alternative treatment regimens, taken from a mixed treatment comparison. The analysis was conducted from the UK National Health Service (NHS) perspective. Parameter uncertainty was explored using one-way and probabilistic sensitivity analysis. Based on the results of the fully incremental analysis a cost-effectiveness frontier was determined, indicating those treatment regimens which represent the most cost-effective use of NHS resources. For ICS-tolerant patients the cost-effectiveness frontier suggested LAMA as initial treatment. Where patients continue to exacerbate and additional therapy is required, LAMA + LABA/ICS can be a cost-effective option, followed by LAMA + LABA/ICS + roflumilast (incremental cost-effectiveness ratio [ICER] versus LAMA + LABA/ICS: £16,566 per quality-adjusted life-year [QALY] gained). The ICER in ICS-intolerant patients, comparing LAMA + LABA + roflumilast versus LAMA + LABA, was £13,764/QALY gained. The relative rate ratio of exacerbations was identified as the primary driver of cost-effectiveness. The treatment algorithm recommended in UK clinical practice represents a cost-effective approach for the

Yemen Country Analysis Brief

EIA Publications

2014-01-01

Update: September 30, 2015 Since the publication of the Yemen Country Analysis Brief in September 2014 below, the situation in Yemen has deteriorated significantly. In September 2014, the Shia Houthi rebel group seized the Yemeni capital of Sanaa. In January 2015, the Houthis captured the presidential palace and other strategic buildings, forcing President Hadi and his ministers to resign and to dissolve parliament. In March 2015, a coalition led by Saudi Arabia began airstrikes on Houthi targets, which are still active as of this publication (September 2015). The report below represents the energy situation in Yemen before the Houthi capture of Sanaa and the rest of Yemen. Lack of data and the halting of nearly all energy sector activity in Yemen do not allow for a full update of the Country Analysis Brief.

Association of Inhaled Corticosteroids and Long-Acting Muscarinic Antagonists With Asthma Control in Patients With Uncontrolled, Persistent Asthma: A Systematic Review and Meta-analysis.

PubMed

Sobieraj, Diana M; Baker, William L; Nguyen, Elaine; Weeda, Erin R; Coleman, Craig I; White, C Michael; Lazarus, Stephen C; Blake, Kathryn V; Lang, Jason E

2018-04-10

Long-acting muscarinic antagonists (LAMAs) are a potential adjunct therapy to inhaled corticosteroids in the management of persistent asthma. To conduct a systematic review and meta-analysis of the effects associated with LAMA vs placebo or vs other controllers as an add-on therapy to inhaled corticosteroids and the use of a LAMA as add-on therapy to inhaled corticosteroids and long-acting β-agonists (LABAs; hereafter referred to as triple therapy) vs inhaled corticosteroids and LABA in patients with uncontrolled, persistent asthma. MEDLINE, EMBASE, Cochrane databases, and clinical trial registries (earliest date through November 28, 2017). Two reviewers selected randomized clinical trials or observational studies evaluating a LAMA vs placebo or vs another controller as an add-on therapy to inhaled corticosteroids or triple therapy vs inhaled corticosteroids and LABA in patients with uncontrolled, persistent asthma reporting on an outcome of interest. Meta-analyses using a random-effects model was conducted to calculate risk ratios (RRs), risk differences (RDs), and mean differences (MDs) with corresponding 95% CIs. Citation screening, data abstraction, risk assessment, and strength-of-evidence grading were completed by 2 independent reviewers. Asthma exacerbations. Of 1326 records identified, 15 randomized clinical trials (N = 7122 patients) were included. Most trials assessed adding LAMA vs placebo or LAMA vs LABA to inhaled corticosteroids. Adding LAMA vs placebo to inhaled corticosteroids was associated with a significantly reduced risk of exacerbation requiring systemic corticosteroids (RR, 0.67 [95% CI, 0.48 to 0.92]; RD, -0.02 [95% CI, -0.04 to 0.00]). Compared with adding LABA, adding LAMA to inhaled corticosteroids was not associated with significant improvements in exacerbation risk (RR, 0.87 [95% CI, 0.53 to 1.42]; RD, 0.00 [95% CI, -0.02 to 0.02]), or any other outcomes of interest. Triple therapy was not significantly associated with improved

Alcohol and prescription drug safety in older adults

PubMed Central

Zanjani, Faika; Hoogland, Aasha I; Downer, Brian G

2013-01-01

Background The objectives of this study were to investigate older adults’ knowledge of prescription drug safety and interactions with alcohol, and to identify pharmacists’ willingness to disseminate prescription drug safety information to older adults. Methods The convenience sample consisted of 48 older adults aged 54–89 years who were recruited from a local pharmacy and who completed surveys addressing their alcohol consumption, understanding of alcohol and prescription drug interactions, and willingness to change habits regarding alcohol consumption and prescription drugs. To address pharmacist willingness, 90 pharmacists from local pharmacies volunteered and answered questions regarding their willingness to convey prescription drug safety information to older adults. Results Older adults reported low knowledge of alcohol and prescription drug safety, with women tending to be slightly more knowledgeable. More importantly, those who drank in the previous few months were less willing to talk to family and friends about how alcohol can have harmful interactions with prescription drugs, or to be an advocate for safe alcohol and prescription drug use than those who had not had a drink recently. Pharmacists reported that they were willing to convey prescription drug safety information to older adults via a variety of formats, including displaying or distributing a flyer, and directly administering a brief intervention. Conclusion In this study, older adults were found to have inadequate knowledge of prescription drug safety and interactions with alcohol, but pharmacists who regularly come in contact with older adults indicated that they were ready and willing to talk to older adults about prescription drug safety. Future research should focus on interventions whereby pharmacists disseminate prescription drug safety information to older adults in order to improve healthy prescription drug and alcohol behavior and reduce medical and health costs associated with

Cumulative Index to NASA Tech Briefs

NASA Technical Reports Server (NTRS)

1969-01-01

Tech Briefs are short announcements of new technology derived from the R&D activities of the National Aeronautics and Space Administration. This Index to NASA Tech Briefs lists the technological innovations derived from the U.S. space program and published during the period January through December 1968. A new five year cycle of cumulative indexes begins with this index. The main section is arranged in six categories: Electrical (Electronic); Physical Sciences (Energy Sources); Materials (Chemistry); Life Sciences; Mechanical; and Computer Programs.

Adapting the Brief COPE for Chinese Adolescents with Visual Impairments

ERIC Educational Resources Information Center

Yuan, Wei; Zhang, Li-fang; Li, Bing

2017-01-01

Introduction: The present research pioneered the effort in assessing adolescents' coping with visual impairment through adapting the Brief COPE in an eastern context. The first study preliminarily explored the applicability of the Brief COPE to Chinese adolescent students with visual impairments. Based on the results, the Brief COPE was modified…

Brief Psychotherapy in Family Practice

PubMed Central

MacDonald, Peter J.; Brown, Alan

1986-01-01

A large number of patients with psychosocial or psychiatric disorders present to family physicians, and the family physician needs a model of psychotherapy with which to cope with their problems. A model of brief psychotherapy is presented which is time limited, goal directed and easy to learn. It consists of four facets drawn from established areas of psychotherapy: characteristics of the therapist; characteristics of the patient; Eriksonian developmental stages; and the process of therapy as described by Carkhuff. These facets fit together in a way which is useful to the family physician in managing those patient problems for which brief psychotherapy is indicated. PMID:21267176

Energy: Conservation, Energy Briefs

ERIC Educational Resources Information Center

Nation's Schools and Colleges, 1975

1975-01-01

A comprehensive energy conservation program at College of the Holy Cross has saved nearly one-third of the fuel oil and one-fifth of the electricity used at the college; briefs on boilers, lights, design. (Author/MLF)

76 FR 50715 - Briefing on Partner Vetting System Pilot Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-16

... Development Briefing on Partner Vetting System Pilot Program AGENCY: U.S. Department of State and U.S. Agency... briefing on the Partner Vetting System (PVS) pilot program. The objective of the briefing is to provide information about the PVS pilot program. Members of the public may attend in person or join via teleconference...

Nuclear health and safety

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

Glenn, J.

1991-02-01

There has been concern over the Department of Energy's (DOE) dual role of producing nuclear weapons and assessing the potential health hazards associated with operating its facilities has raised questions about DOE's ability to effectively manage its health and health effects (epidemiology) research programs. In March 1990, the secrecy of Energy announced several initiatives to address these concerns. These initiatives include, among others, the development of an occupational health and epidemiology program, the transfer of long-term health effects' studies to the Department of Health and Human Services (HHS), the establishment of an advisory committee to oversee DOE's environmental, safety, andmore » health activities, and the design of a data base to store and retrieve health data. This paper provides a brief description of DOE's initiatives, including their status as of December 1990 and general observations of these initiatives.« less

Improving staff perception of a safety climate with crew resource management training.

PubMed

Kuy, SreyRam; Romero, Ramon A L

2017-06-01

Communication failure is one of the top root causes in patient safety adverse events. Crew resource management (CRM) is a team building communication process intended to improve patient safety by improving team dynamics. First, to describe implementation of CRM in a Veterans Affair (VA) surgical service. Second, to assess whether staff CRM training is related to improvement in staff perception of a safety climate. Mandatory CRM training was implemented for all surgical service staff at a VA Hospital at 0 and 12 mo. Safety climate questionnaires were completed by operating room staff at a baseline, 6 and 12 mo after the initial CRM training. Participants reported improvement on all 27 points on the safety climate questionnaire at 6 mo compared with the baseline. At 12 mo, there was sustained improvement in 23 of the 27 areas. This is the first published report about the effect of CRM training on staff perception of a safety climate in a VA surgical service. We demonstrate that CRM training can be successfully implemented widespread in a surgical program. Overall, there was improvement in 100% of areas assessed on the safety climate questionnaire at 6 mo after CRM training. By 1 y, this improvement was sustained in 23 of 27 areas, with the areas of greatest improvement being the performance of briefings, collaboration between nurses and doctors, valuing nursing input, knowledge about patient safety, and institutional promotion of a patient safety climate. Published by Elsevier Inc.

Orbiting Carbon Observatory Briefing

NASA Image and Video Library

2009-01-29

Eric Ianson speaks during a media briefing to discuss the upcoming Orbiting Carbon Observatory mission, the first NASA spacecraft dedicated to studying carbon dioxide, Thursday, Jan. 29, 2009, at NASA Headquarters in Washington. Photo Credit: (NASA/Paul E. Alers)

Orbiting Carbon Observatory Briefing

NASA Image and Video Library

2009-01-29

Ralph Basilio talks during a media briefing to discuss the upcoming Orbiting Carbon Observatory mission, the first NASA spacecraft dedicated to studying carbon dioxide, Thursday, Jan. 29, 2009, at NASA Headquarters in Washington. Photo Credit: (NASA/Paul E. Alers)

Orbiting Carbon Observatory Briefing

NASA Image and Video Library

2009-01-29

Panelists are seen during a media briefing to discuss the upcoming Orbiting Carbon Observatory mission, the first NASA spacecraft dedicated to studying carbon dioxide, Thursday, Jan. 29, 2009, at NASA Headquarters in Washington. Photo Credit: (NASA/Paul E. Alers)

Orbiting Carbon Observatory Briefing

NASA Image and Video Library

2009-01-29

Charles Miller talks during a media briefing to discuss the upcoming Orbiting Carbon Observatory mission, the first NASA spacecraft dedicated to studying carbon dioxide, Thursday, Jan. 29, 2009, at NASA Headquarters in Washington. Photo Credit: (NASA/Paul E. Alers)

36 CFR 1150.101 - Posthearing briefs; proposed findings.

Code of Federal Regulations, 2010 CFR

2010-07-01

... findings. 1150.101 Section 1150.101 Parks, Forests, and Public Property ARCHITECTURAL AND TRANSPORTATION... § 1150.101 Posthearing briefs; proposed findings. The judge shall fix the terms, including time, for filing post-hearing statements of position or briefs, which may contain proposed findings of fact and...

The Impact of Ultrasound on Developing Brain Neurons. Science Briefs

ERIC Educational Resources Information Center

National Scientific Council on the Developing Child, 2007

2007-01-01

"Science Briefs" summarize the findings and implications of a recent study in basic science or clinical research. This brief reports on the study. This Brief summarizes the findings and implications of "Prenatal Exposure to Ultrasound Waves Impacts Neuronal Migration in Mice" (E. S. B. C. Ang, Jr.; V. Gluncic; A. Duque; M. E. Schafer; and P.…

Is modified brief assertiveness training for nurses effective? A single-group study with long-term follow-up.

PubMed

Yoshinaga, Naoki; Nakamura, Yohei; Tanoue, Hiroki; MacLiam, Fionnula; Aoishi, Keiko; Shiraishi, Yuko

2018-01-01

To evaluate the long-term effectiveness of modified brief assertiveness training (with cognitive techniques) for nurses. Most assertiveness training takes a long time to conduct; thus, briefer training is required for universal on-the-job training in the workplace. In this single-group study, nurses received two 90-min training sessions with a 1-month interval between sessions. The degree of assertiveness was assessed by using the Rathus Assertiveness Schedule as the primary outcome, at four time points: pre- and post-training, 3-month follow-up and 6-month follow-up. A total of 33 nurses received the training, and the mean Rathus Assertiveness Schedule score improved from -14.2 (SD = 16.5) pre-training to -10.5 (SD = 18.0) post-training (p < .05). These improvements were maintained until the 6-month follow-up. The pre-post effect size of 0.22 (indicating small effect) was larger than the effect sizes ranging from -0.56 to 0.17 (no effect) reported in previous studies that used brief training. Modified brief assertiveness training seems feasible and may achieve long-term favourable outcomes in improving assertiveness among nurses. The ease of implementation of assertiveness training is important because creating an open environment for communication leads to improved job satisfaction, improved nursing care and increased patient safety. © 2017 The Authors. Journal of Nursing Management Published by John Wiley & Sons Ltd.

Safety of regular formoterol or salmeterol in children with asthma: an overview of Cochrane reviews

PubMed Central

Cates, Christopher J; Oleszczuk, Marta; Stovold, Elizabeth; Wieland, L. Susan

2014-01-01

quality, up to date Cochrane reviews. Four of these related to the safety of regular formoterol or salmeterol (as monotherapy or combination therapy) and these included 19 studies in children. We added data from two recent studies on salmeterol combination therapy in 689 children which were published after the relevant Cochrane review had been completed, making a total of 21 trials on 7474 children (from four to 17 years of age). The two remaining reviews compared the safety of formoterol with salmeterol from trials randomising participants to one or other treatment, but the reviews only included a single trial in children in which there were 156 participants. Only one child died across all the trials, so impact on mortality could not be assessed. We found a statistically significant increase in the odds of suffering a non-fatal serious adverse event of any cause in children on formoterol monotherapy (Peto odds ratio (OR) 2.48; 95% confidence interval (CI) 1.27 to 4.83, I2 = 0%, 5 trials, N = 1335, high quality) and smaller increases in odds which were not statistically significant for salmeterol monotherapy (Peto OR 1.30; 95% CI 0.82 to 2.05, I2 = 17%, 5 trials, N = 1333, moderate quality), formoterol combination therapy (Peto OR 1.60; 95% CI 0.80 to 3.28, I2 = 32%, 7 trials, N = 2788, moderate quality) and salmeterol combination therapy (Peto OR 1.20; 95% CI 0.37 to 2.91, I2 = 0%, 5 trials, N = 1862, moderate quality). We compared the pooled results of the monotherapy and combination therapy trials. There was no significant difference between the pooled ORs of children with a serious adverse event (SAE) from long-acting beta2-agonist beta agonist (LABA) monotherapy (Peto OR 1.60; 95% CI 1.10 to 2.33, 10 trials, N = 2668) and combination trials (Peto OR 1.50; 95% CI 0.82 to 2.75, 12 trials, N = 4,650). However, there were fewer children with an SAE in the regular inhaled corticosteroid (ICS) control group (0.7%) than in the placebo control group (3.6%). As a result

Fifty years of driving safety research.

PubMed

Lee, John D

2008-06-01

This brief review covers the 50 years of driving-related research published in Human Factors, its contribution to driving safety, and emerging challenges. Many factors affect driving safety, making it difficult to assess the impact of specific factors such as driver age, cell phone distractions, or collision warnings. The author considers the research themes associated with the approximately 270 articles on driving published in Human Factors in the past 50 years. To a large extent, current and past research has explored similar themes and concepts. Many articles published in the first 25 years focused on issues such as driver impairment, individual differences, and perceptual limits. Articles published in the past 25 years address similar issues but also point toward vehicle technology that can exacerbate or mitigate the negative effect of these issues. Conceptual and computational models have played an important role in this research. Improved crash-worthiness has contributed to substantial improvements in driving safety over the past 50 years, but future improvements will depend on enhancing driver performance and perhaps, more important, improving driver behavior. Developing models to guide this research will become more challenging as new technology enters the vehicle and shifts the focus from driver performance to driver behavior. Over the past 50 years, Human Factors has accumulated a large base of driving-related research that remains relevant for many of today's design and policy concerns.

14 CFR 121.571 - Briefing passengers before takeoff.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the following: (i) Smoking. Each passenger shall be briefed on when, where, and under what conditions smoking is prohibited including, but not limited to, any applicable requirements of part 252 of this title... purposes as no smoking areas, and crewmember instructions with regard to these items. The briefing shall...

Towards an International Classification for Patient Safety: key concepts and terms

PubMed Central

Runciman, William; Hibbert, Peter; Thomson, Richard; Van Der Schaaf, Tjerk; Sherman, Heather; Lewalle, Pierre

2009-01-01

Background Understanding the patient safety literature has been compromised by the inconsistent use of language. Objectives To identify key concepts of relevance to the International Patient Safety Classification (ICPS) proposed by the World Alliance For Patient Safety of the World Health Organization (WHO), and agree on definitions and preferred terms. Methods Six principles were agreed upon—that the concepts and terms should: be applicable across the full spectrum of healthcare; be consistent with concepts from other WHO Classifications; have meanings as close as possible to those in colloquial use; convey the appropriate meanings with respect to patient safety; be brief and clear, without unnecessary or redundant qualifiers; be fit-for-purpose for the ICPS. Results Definitions and preferred terms were agreed for 48 concepts of relevance to the ICPS; these were described and the relationships between them and the ICPS were outlined. Conclusions The consistent use of key concepts, definitions and preferred terms should pave the way for better understanding, for comparisons between facilities and jurisdictions, and for trends to be tracked over time. Changes and improvements, translation into other languages and alignment with other sets of patient safety definitions will be necessary. This work represents the start of an ongoing process of progressively improving a common international understanding of terms and concepts relevant to patient safety. PMID:19147597

A Randomised Controlled Trial Using Mobile Advertising to Promote Safer Sex and Sun Safety to Young People

ERIC Educational Resources Information Center

Gold, J.; Aitken, C. K.; Dixon, H. G.; Lim, M. S. C.; Gouillou, M.; Spelman, T.; Wakefield, M.; Hellard, M. E.

2011-01-01

Mobile phone text messages (SMS) are a promising method of health promotion, but a simple and low cost way to obtain phone numbers is required to reach a wide population. We conducted a randomised controlled trial with simultaneous brief interventions to (i) evaluate effectiveness of messages related to safer sex and sun safety and (ii) pilot the…

Spotlight on: GraduateFIRST. Spotlight Briefs. Volume I

ERIC Educational Resources Information Center

Regional Resource Center Program, 2011

2011-01-01

This brief is intended to provide State Education Agency (SEA) and Local Education Agency (LEA) educators with a brief overview of key components of GraduateFIRST, a Georgia program targeting issues impacting school completion for students with disabilities. Georgia's GraduateFIRST program has redefined the state's approach to raising graduation…

An evaluation of an airline cabin safety education program for elementary school children.

PubMed

Liao, Meng-Yuan

2014-04-01

The knowledge, attitude, and behavior intentions of elementary school students about airline cabin safety before and after they took a specially designed safety education course were examined. A safety education program was designed for school-age children based on the cabin safety briefings airlines given to their passengers, as well as on lessons learned from emergency evacuations. The course is presented in three modes: a lecture, a demonstration, and then a film. A two-step survey was used for this empirical study: an illustrated multiple-choice questionnaire before the program, and, upon completion, the same questionnaire to assess its effectiveness. Before the program, there were significant differences in knowledge and attitude based on school locations and the frequency that students had traveled by air. After the course, students showed significant improvement in safety knowledge, attitude, and their behavior intention toward safety. Demographic factors, such as gender and grade, also affected the effectiveness of safety education. The study also showed that having the instructor directly interact with students by lecturing is far more effective than presenting the information using only video media. A long-term evaluation, the effectiveness of the program, using TV or video accessible on the Internet to deliver a cabin safety program, and a control group to eliminate potential extraneous factors are suggested for future studies. Copyright © 2013 Elsevier Ltd. All rights reserved.

Informatics: A Brief Survey.

ERIC Educational Resources Information Center

He, Shaoyi

2003-01-01

Provides a brief survey of informatics, defined as the application of information technology to various fields, with respect to its historical background, disciplinary identity, fundamental aspects, applications, and challenges. Highlights include biological, clinical, dental, environmental, geomatics, health, legal, management, medical, museum,…

Laparoscopic and Robotic Total Mesorectal Excision in the Treatment of Rectal Cancer. Brief Review and Personal Remarks

PubMed Central

Bianchi, Paolo Pietro; Petz, Wanda; Luca, Fabrizio; Biffi, Roberto; Spinoglio, Giuseppe; Montorsi, Marco

2014-01-01

The current standard treatment for rectal cancer is based on a multimodality approach with preoperative radiochemotherapy in advanced cases and complete surgical removal through total mesorectal excision (TME). The most frequent surgical approach is traditional open surgery, as laparoscopic TME requires high technical skill, a long learning curve, and is not widespread, still being confined to centers with great experience in minimally invasive techniques. Nevertheless, in several studies, the laparoscopic approach, when compared to open surgery, has shown some better short-term clinical outcomes and at least comparable oncologic results. Robotic surgery for the treatment of rectal cancer is an emerging technique, which could overcome some of the technical difficulties posed by standard laparoscopy, but evidence from the literature regarding its oncologic safety and clinical outcomes is still lacking. This brief review analyses the current status of minimally invasive surgery for rectal cancer therapy, focusing on oncologic safety and the new robotic approach. PMID:24834429

Effects of a Brief Team Training Program on Surgical Teams' Nontechnical Skills: An Interrupted Time-Series Study.

PubMed

Gillespie, Brigid M; Harbeck, Emma; Kang, Evelyn; Steel, Catherine; Fairweather, Nicole; Panuwatwanich, Kriengsak; Chaboyer, Wendy

2017-04-27

Up to 60% of adverse events in surgery are the result of poor communication and teamwork. Nontechnical skills in surgery (NOTSS) are critical to the success of surgery and patient safety. The study aim was to evaluate the effect of a brief team training intervention on teams' observed NOTSS. Pretest-posttest interrupted time-series design with statistical process control analysis was used to detect longitudinal changes in teams' NOTSS. We evaluated NOTSS using the revised NOTECHS weekly for 20 to 25 weeks before and after implementation of a team training program. We observed 179 surgical procedures with cardiac, vascular, upper gastrointestinal, and hepatobiliary teams. Mean posttest NOTECHS scores increased across teams, showing special cause variation. There were also significant before and after improvements in NOTECHS scores in respect to professional role and in the use of the Surgical Safety Checklist. Our results suggest associated improvements in teams' NOTSS after implementation of the team training program.

The Space Station Freedom - International cooperation and innovation in space safety

NASA Technical Reports Server (NTRS)

Rodney, George A.

1989-01-01

The Space Station Freedom (SSF) being developed by the United States, European Space Agency (ESA), Japan, and Canada poses novel safety challenges in design, operations, logistics, and program management. A brief overview discloses many features that make SSF a radical departure from earlier low earth orbit (LEO) space stations relative to safety management: size and power levels; multiphase manned assembly; 30-year planned lifetime, with embedded 'hooks and scars' forevolution; crew size and skill-mix variability; sustained logistical dependence; use of man, robotics and telepresence for on-orbit maintenance of station and free-flyer systems; closed-environment recycling; use of automation and expert systems; long-term operation of collocated life-sciences and materials-science experiments, requiring control and segregation of hazardous and chemically incompatible materials; and materials aging in space.

Poverty. Research Brief

ERIC Educational Resources Information Center

Walker, Karen

2007-01-01

How many people reading this brief believes they could financially survive in a household of four people on $19,784 a year? Yet, this was the official poverty threshold as determined by the federal government for 2005. During this same year, 17% of children under 18 lived below the poverty line, of which 14% were white, 11% Asian, 28% Hispanic and…

STS-133 Briefing

NASA Image and Video Library

2010-10-29

NASA Shuttle Weather Officer Kathy Winters participates in the space shuttle Discovery launch status briefing on Friday, Oct. 29, 2010 at the NASA Kennedy Space Center in Cape Canaveral, Fla. Discovery and it's STS-133 mission crew of six are currently targeted to launch at 4:17p.m. EDT on Tuesday, Nov. 2, 2010. Photo Credit: (NASA/Bill Ingalls)

Situation Climatic Briefs

DTIC Science & Technology

1982-09-01

F-7 CHILE -ARGENTINA SOUTH OF 40 DEGREES SOUTH .... ............. .. F-13 CHILE -PERU BORDER ................. ......................... F...34SITUATION CLIMATIC BRIEF CHILE -ARGENTINA SOUTH OF 40 DEGREES SOUTH ANNUAL 1. GENERAL. The weather is generally cloudy, windy, and cold year-round...conditions can occur for 3 or 4 hours following cold frontal passage during the winter. 4. TERMINAL WEATHER. Puerto Montt, Chile . Fair. Conditions are

NASA Tech Briefs, December 2000. Volume 24, No. 12

NASA Technical Reports Server (NTRS)

2000-01-01

Topics include: special coverage sections on Imaging/Video/Display Technology, and sections on electronic components and systems, test and measurement, software, information sciences, and special sections of Electronics Tech Briefs and Motion Control Tech Briefs.

NASA Tech Briefs, October 2001. Volume 25, No. 10

NASA Technical Reports Server (NTRS)

2001-01-01

Topics include: special coverage section on composites and plastics, electronic components and systems, software, mechanics, physical sciences, information sciences, book and reports, and a special sections of Photonics Tech Briefs and Motion Control Tech Briefs.

NASA Tech Briefs, February 2002. Volume 26, No. 2

NASA Technical Reports Server (NTRS)

2002-01-01

Topics include:a technology focus on computers, electronic components and systems, software, materials, mechanics,physical sciences machinery, manufacturing/fabrication, mathematics, book and reports, motion control tech briefs and a special section on Photonics Tech Briefs.

NASA Tech Briefs, April 1999. Volume 23, No. 4

NASA Technical Reports Server (NTRS)

1999-01-01

Topics include: special coverage sections on automotive technology, and CAM and sections on electronic components and systems, software, materials, machinery/automation, physical sciences, and a special section of Electronic Tech Briefs and Motion Control Tech Briefs.

ETV Tech Brief: Rapid Fungi and Bacteria Detection Technologies

EPA Science Inventory

Technical brief that summarizes the results for Mycometer, Inc. Mycometer®-test and Bactiquant®-test, which are rapid detection technologies for fungi and bacteria. The brief summarizes the results of the verification report and statement.

46 CFR 502.221 - Briefs; requests for findings.

Code of Federal Regulations, 2010 CFR

2010-10-01

... presiding officer shall fix the time and manner of filing briefs and any enlargement of time. The period of... subject index or table of contents with page references and a list of authorities cited. (f) All briefs... pages containing the table of contents, table of authorities, and certificate of service, unless the...

41 CFR 105-70.036 - Post-hearing briefs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Post-hearing briefs. 105-70.036 Section 105-70.036 Public Contracts and Property Management Federal Property Management.... The ALJ may require the parties to file post-hearing briefs. In any event, any party may file a post...

Briefing Book for Education.

ERIC Educational Resources Information Center

National Governors' Association, Washington, DC.

This document presents briefing papers for the seven gubernatorial task forces proposed in the National Governors' Association Action Plan for Attaining Educational Excellence. An introductory section discusses the complementary responsibilities of Federal, State, and local governments for assuring access to educational opportunities for all…

NASA Tech Briefs, September 1998. Volume 22, No. 9

NASA Technical Reports Server (NTRS)

1998-01-01

Topics include: special coverage on data acquisition, also, electronic components and circuits, electronic systems, software, materials, mechanics, machinery/automation, physical sciences, information sciences, This issue contains a special sections of Electronics Tech Briefs and Motion Control Tech Briefs.

Injury prevention counselling to improve safety practices by parents in Mexico.

PubMed Central

Mock, Charles; Arreola-Risa, Carlos; Trevino-Perez, Rodolfo; Almazan-Saavedra, Victoria; Zozaya-Paz, Jaime E.; Gonzalez-Solis, Reynaldo; Simpson, Kate; Rodriguez-Romo, Laura; Hernandez-Torre, Martin H.

2003-01-01

OBJECTIVES: To evaluate the effectiveness of educational counselling programmes aimed at increasing parents' practice of childhood safety in Monterrey, Mexico, and to provide information aimed at helping to improve the effectiveness of future efforts in this field. METHODS: Three different counselling programmes were designed to meet the needs of the upper, middle and lower socioeconomic strata. Evaluation involved the use of baseline questionnaires on parents' existing safety-related practices for intervention and control groups and the administration of corresponding questionnaires after the programmes had been carried out. FINDINGS: Data were obtained on 1124 children before counselling took place and on 625 after it had been given. Overall safety scores (% safe responses) increased from 54% and 65% for the lower and upper socioeconomic strata, respectively, before counselling to 62% and 73% after counselling (P <0.001 for all groups). Improvements occurred both for activities that required caution and for activities that required the use of safety-related devices (e.g. helmets, car seats). However, scores for the use of such devices remained suboptimal even after counselling and there were wide discrepancies between the socioeconomic strata. The post-counselling scores for the use of safety-related devices were 55%, 38% and 19% for the upper, middle and lower socioeconomic strata, respectively. CONCLUSIONS: Brief educational interventions targeting parents' practice of childhood safety improved safe behaviours. Increased attention should be given to specific safety-related devices and to the safety of pedestrians. Educational efforts should be combined with other strategies for injury prevention, such as the use of legislation and the improvement of environmental conditions. PMID:14576891

School Safety and Security Best Practices Approved by the Commissioner of Education. Information Brief. Report.

ERIC Educational Resources Information Center

Florida State Legislature, Tallahassee. Office of Program Policy Analysis and Government Accountability.

The 2001 Florida Legislature passed Ch. 2001-125, Laws of Florida, Section 40, which is often referred to as the Safe Passage Act. It requires all school districts to conduct a self-assessment of their school safety and security using best practices developed by the Office of Program Policy Analysis and Government Accountability (OPPAGA). It also…

The enhanced knowledge translation and exchange framework for road safety: a brief report on its development and potential impacts.

PubMed

Hinchcliff, Reece; Senserrick, Teresa; Travaglia, Joanne; Greenfield, David; Ivers, Rebecca

2017-04-01

Knowledge translation and exchange (KTE) can enable evidence-informed road safety policy and practice by reducing the gap between what is known to be effective and what actually occurs. A quality improvement project, undertaken within a government policy frame, was implemented in 2015 to produce an enhanced KTE framework for road safety (the framework). Information was collected from 35 road safety stakeholders in the UK, the Netherlands, Norway and Sweden. Thirteen KTE facilitators were identified that covered research funding and production, the expertise of knowledge users and dissemination practices. The framework was subsequently developed, which separated facilitators seen as essential for a KTE system, from others perceived as aspirational due to their lesser influence and the considerable time and resources required for their implementation. The framework provides a heuristic device to enable policy agencies to holistically assess and improve current KTE systems for road safety, to encourage evidence-informed policy and practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Safety words inventory and literacy screener: standardization and validation.

PubMed

Glascoe, Frances Page

2002-01-01

When evaluating a school-aged patient, particularly for such issues as attention deficit disorder, or learning disabilities, health-care providers are encouraged to appraise children's school performance. Although some clinicians seek teachers' comments, recent research suggests that teachers' appraisals have limited value. As a consequence, health-care providers need brief methods, functional for busy primary care clinics, for detecting school problems. Because well-visits also include other services such as anticipatory guidance and safety and injury counseling, it would be helpful for detection tools to facilitate delivery of more than one aspect of well-child care. This study was undertaken to develop a brief method for evaluating school performance for elementary-age children and test its accuracy in identifying children with reading and other academic problems. By using common safety signs as the test stimuli, such a tool should also serve as a springboard to injury prevention counseling. Data were drawn from the standardization and validation data of an individually administered wide-range diagnostic achievement test using a geographically diverse, nationally representative sample of 934 children between 5 and 13 years of age. Children were administered the Comprehensive Inventory of Basic Skills-Revised (CIBS-R), which includes among its 10 subtests a 57-item measure of safety word recognition. Data were collected from previously administered measures of academics and intelligence. Forty-one children were administered the measure twice to assess inter-rater reliability. Logistic regression analyses were deployed using children's performance on the nine other subtests of the CIBS-R as the grouping variable, and as predictors, recognition of 57 safety words/phrases. Of these, 22 safety signs (e.g., "Keep out," "No Trespassing," "Danger") were significant predictors of overall academic performance. An additional seven safety words were added due to their

STS-133 Briefing

NASA Image and Video Library

2010-10-29

NASA Spokesperson Allard Beutel, left, and NASA Test Director Jeff Spaulding, participate in the space shuttle Discovery launch status briefing on Friday, Oct. 29, 2010 at the NASA Kennedy Space Center in Cape Canaveral, Fla. Discovery and it's STS-133 mission crew of six are currently targeted to launch at 4:17p.m. EDT on Tuesday, Nov. 2, 2010. Photo Credit: (NASA/Bill Ingalls)

Kepler Media Briefing

NASA Image and Video Library

2009-02-19

Jon Morse, director, Astrophysics Division at NASA Headquarters talks about the Kepler mission during a media briefing, Thursday, Feb. 19, 2008, at NASA Headquarters in Washington. Kepler, the first mission with the ability to find planets like earth, is scheduled to launch on March 5, 2009 from Cape Canaveral Air Force Station, Fla. aboard a Delta II rocket. Photo Credit: (NASA/Paul. E. Alers)

Kepler Media Briefing

NASA Image and Video Library

2009-02-19

Debra Fischer, a professor of Astronomy at San Francisco State University, talks about the Kepler mission during a media briefing, Thursday, Feb. 19, 2008, at NASA Headquarters in Washington. Kepler, the first mission with the ability to find planets like earth, is scheduled to launch on March 5, 2009 from Cape Canaveral Air Force Station, Fla. aboard a Delta II rocket. Photo Credit: (NASA/Paul. E. Alers)

Kepler Media Briefing

NASA Image and Video Library

2009-02-19

Jim Fanson, Kepler project manager, right, talks about the Kepler mission as William Borucki, left, listens during a media briefing, Thursday, Feb. 19, 2008, at NASA Headquarters in Washington. Kepler, the first mission with the ability to find planets like earth, is scheduled to launch on March 5, 2009 from Cape Canaveral Air Force Station, Fla. aboard a Delta II rocket. Photo Credit: (NASA/Paul. E. Alers)

Serious Asthma Events with Fluticasone plus Salmeterol versus Fluticasone Alone.

PubMed

Stempel, David A; Raphiou, Ibrahim H; Kral, Kenneth M; Yeakey, Anne M; Emmett, Amanda H; Prazma, Charlene M; Buaron, Kathleen S; Pascoe, Steven J

2016-05-12

The safe and appropriate use of long-acting beta-agonists (LABAs) for the treatment of asthma has been widely debated. In two large clinical trials, investigators found a potential risk of serious asthma-related events associated with LABAs. This study was designed to evaluate the risk of administering the LABA salmeterol in combination with an inhaled glucocorticoid, fluticasone propionate. In this multicenter, randomized, double-blind trial, adolescent and adult patients (age, ≥12 years) with persistent asthma were assigned to receive either fluticasone with salmeterol or fluticasone alone for 26 weeks. All the patients had a history of a severe asthma exacerbation in the year before randomization but not during the previous month. Patients were excluded from the trial if they had a history of life-threatening or unstable asthma. The primary safety end point was the first serious asthma-related event (death, endotracheal intubation, or hospitalization). Noninferiority of fluticasone-salmeterol to fluticasone alone was defined as an upper boundary of the 95% confidence interval for the risk of the primary safety end point of less than 2.0. The efficacy end point was the first severe asthma exacerbation. Of 11,679 patients who were enrolled, 67 had 74 serious asthma-related events, with 36 events in 34 patients in the fluticasone-salmeterol group and 38 events in 33 patients in the fluticasone-only group. The hazard ratio for a serious asthma-related event in the fluticasone-salmeterol group was 1.03 (95% confidence interval [CI], 0.64 to 1.66), and noninferiority was achieved (P=0.003). There were no asthma-related deaths; 2 patients in the fluticasone-only group underwent asthma-related intubation. The risk of a severe asthma exacerbation was 21% lower in the fluticasone-salmeterol group than in the fluticasone-only group (hazard ratio, 0.79; 95% CI, 0.70 to 0.89), with at least one severe asthma exacerbation occurring in 480 of 5834 patients (8%) in the

FMCSA’s advanced system testing utilizing a data acquisition system on the highways (FAST DASH) safety technology evaluation project #2 : technology brief.

DOT National Transportation Integrated Search

2016-11-01

The Federal Motor Carrier Safety Administration (FMCSA) established the FAST DASH program to perform efficient independent evaluations of promising safety technologies aimed at commercial vehicle operations. In this second FAST DASH safety technology...

Solar Dynamics Observatory Briefing

NASA Image and Video Library

2010-01-21

Madhulika Guhathakurta, SDO Program Scientist, speaks during a briefing to discuss the upcoming launch of NASA's Solar Dynamic Observatory, or SDO, Thursday, Jan. 21, 2010, at NASA Headquarters in Washington. The mission is to study the Sun and its dynamic behavior. Photo Credit: (NASA/Paul E. Alers)

The 2007 Legislative Briefing

ERIC Educational Resources Information Center

Grove, Jeffrey; Gaines, Gale F., Comp.

2007-01-01

"The 2007 Legislative Briefing" is a topical summary of actions during the 2006 legislative sessions that affect education in the 16 SREB states. Topics include state budgets and the economy, tax and revenue, school finance, teacher compensation, licensure, certification and evaluation of teachers, strengthening elementary and secondary…

Voyager Saturn encounter press briefing

NASA Technical Reports Server (NTRS)

1980-01-01

The briefing reviewed the mission planning of the Voyager project. The near encounter trajectories of both Voyager spacecraft were examined. The Saturn system is discussed with particular emphasis on Saturn's moons.

Annual Report To Congress. Department of Energy Activities Relating to the Defense Nuclear Facilities Safety Board, Calendar Year 2003

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

None, None

2004-02-28

The Department of Energy (Department) submits an Annual Report to Congress each year detailing the Department’s activities relating to the Defense Nuclear Facilities Safety Board (Board), which provides advice and recommendations to the Secretary of Energy (Secretary) regarding public health and safety issues at the Department’s defense nuclear facilities. In 2003, the Department continued ongoing activities to resolve issues identified by the Board in formal recommendations and correspondence, staff issue reports pertaining to Department facilities, and public meetings and briefings. Additionally, the Department is implementing several key safety initiatives to address and prevent safety issues: safety culture and review ofmore » the Columbia accident investigation; risk reduction through stabilization of excess nuclear materials; the Facility Representative Program; independent oversight and performance assurance; the Federal Technical Capability Program (FTCP); executive safety initiatives; and quality assurance activities. The following summarizes the key activities addressed in this Annual Report.« less

Evaluation of a Brief Homework Assignment Designed to Reduce Citation Problems

ERIC Educational Resources Information Center

Schuetze, Pamela

2004-01-01

I evaluated a brief homework assignment designed to reduce citation problems in research-based term papers. Students in 2 developmental psychology classes received a brief presentation and handout defining plagiarism with tips on how to cite sources to avoid plagiarizing. In addition, students in 1 class completed 2 brief homework assignments in…

NASA Tech Briefs, November 1998. Volume 22, No. 11

NASA Technical Reports Server (NTRS)

1998-01-01

Topics include: special coverage sections on test and measurement and sections on electronic components and circuits, electronic systems, software, materials, mechanics, machinery/automation, physical sciences, information sciences, book and reports, and special sections of Electronics Tech Briefs amd Rapid Product Development Tech Briefs.

The early history of ideas on brief interventions for alcohol

PubMed Central

McCambridge, Jim; Cunningham, John A

2014-01-01

Aims This study explores the early development of brief interventions for alcohol using a history of ideas approach with a particular focus on intervention content. Methods The source publications of the key primary studies published from approximately 1962 to 1992 were examined, followed by a brief review of the earliest reviews in this field. These studies were placed in the context of developments in alcohol research and in public health. Results After early pioneering work on brief interventions, further advances were not made until thinking about alcohol problems and their treatment, most notably on controlled drinking, along with wider changes in public health, created new conditions for progress. There was then a golden era of rapid advance in the late 1980s and early 1990s, when preventing the development of problem drinking became important for public health reasons, in addition to helping already problematic drinkers. Many research challenges identified at that time remain to be met. The content of brief interventions changed over the period of study, although not in ways well informed by research advances, and there were also obvious continuities, with a renewed emphasis on the facilitation of self-change being one important consequence of the development of internet applications. Conclusions Ideas about brief interventions have changed in important ways. Brief interventions have been studied with different populations of drinkers, with aims embracing both individual and population-level perspectives, and without well-specified contents. The brief intervention field is an appropriate target for further historical investigations, which may help thinking about addressing alcohol and other problems. PMID:24354855

Proteomics in food: Quality, safety, microbes, and allergens.

PubMed

Piras, Cristian; Roncada, Paola; Rodrigues, Pedro M; Bonizzi, Luigi; Soggiu, Alessio

2016-03-01

Food safety and quality and their associated risks pose a major concern worldwide regarding not only the relative economical losses but also the potential danger to consumer's health. Customer's confidence in the integrity of the food supply could be hampered by inappropriate food safety measures. A lack of measures and reliable assays to evaluate and maintain a good control of food characteristics may affect the food industry economy and shatter consumer confidence. It is imperative to create and to establish fast and reliable analytical methods that allow a good and rapid analysis of food products during the whole food chain. Proteomics can represent a powerful tool to address this issue, due to its proven excellent quantitative and qualitative drawbacks in protein analysis. This review illustrates the applications of proteomics in the past few years in food science focusing on food of animal origin with some brief hints on other types. Aim of this review is to highlight the importance of this science as a valuable tool to assess food quality and safety. Emphasis is also posed in food processing, allergies, and possible contaminants like bacteria, fungi, and other pathogens. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

The influence of client brief and change order in construction project

NASA Astrophysics Data System (ADS)

Mahat, N. A. A.; Adnan, H.

2018-02-01

Construction briefing is a statement of needs about intentions and projects objectives. Briefing process is the preliminary stage in the design process and successful briefing can achieve project delivery right on target time, cost and quality of project confidently. Although there are many efforts to approach client’s requirement and needs for a project, it is still not collected adequately to make proper solutions in design. Thus, these may lead the client to include change orders during the construction phase. This paper is concerned toward the influence of client’s briefing of a construction project that impact on the change order on the construction works. The research objective is to identify the influence of client’s brief on change orders, therefore, the aims of the research is to reduce change orders in project delivery. This research adopted both qualitative and quantitative data collection methods which are content analysis and semi structure interview. The findings highlight factors contributing to change orders and the essential attributes of clients during the briefing stage that may help minimise them.

NASA Tech Briefs, May 1999. Volume 23, No. 5

NASA Technical Reports Server (NTRS)

1999-01-01

Topics include: special coverage sections on sensors and composites and plastics, and sections on electronic components and systems, software, materials, mechanics, machinery and automation, bio-medical, physical sciences, book and reports, and a special section of Photonics Tech Briefs and Rapid Product Development Tech Briefs.

NASA Tech Briefs, October 1999. Volume 23, No. 10

NASA Technical Reports Server (NTRS)

1999-01-01

Topics include: special coverage section on data acquisition and sensors and sections on electronic components and systems, software, materials, mechanics, machinery/automation, manufacturing/fabrication, bio-medical, physical sciences, information sciences, book and reports, and special section of Electronics Tech Briefs and Motion Control Tech briefs

LTPP Climate Tool [Tech Brief

DOT National Transportation Integrated Search

2017-01-01

This Product Brief describes the Long-Term Pavement Performance (LTPP) Climate Tool (intended for use by infrastructure engineers) that provides convenient access to the National Aeronautics and Space Administration (NASA) Modern-Era Retrospective An...

NASA Tech Briefs, December 1988. Volume 12, No. 11

NASA Technical Reports Server (NTRS)

1988-01-01

This month's technical section includes forecasts for 1989 and beyond by NASA experts in the following fields: Integrated Circuits; Communications; Computational Fluid Dynamics; Ceramics; Image Processing; Sensors; Dynamic Power; Superconductivity; Artificial Intelligence; and Flow Cytometry. The quotes provide a brief overview of emerging trends, and describe inventions and innovations being developed by NASA, other government agencies, and private industry that could make a significant impact in coming years. A second bonus feature in this month's issue is the expanded subject index that begins on page 98. The index contains cross-referenced listings for all technical briefs appearing in NASA Tech Briefs during 1988.

NASA Tech Briefs, April 1995. Volume 19, No. 4

NASA Technical Reports Server (NTRS)

1995-01-01

This issue of the NASA Tech Briefs has a special focus section on video and imaging, a feature on the NASA invention of the year, and a resource report on the Dryden Flight Research Center. The issue also contains articles on electronic components and circuits, electronic systems, physical sciences, materials, computer programs, mechanics, machinery, manufacturing/fabrication, mathematics and information sciences and life sciences. In addition to the standard articles in the NASA Tech brief, this contains a supplement entitled "Laser Tech Briefs" which features an article on the National Ignition Facility, and other articles on the use of Lasers.

STS-133 Briefing

NASA Image and Video Library

2010-10-29

NASA Spokesperson Allard Beutel, left, NASA Test Director Jeff Spaulding and Shuttle Weather Officer Kathy Winters, right, participate in the space shuttle Discovery launch status briefing on Friday, Oct. 29, 2010 at the NASA Kennedy Space Center in Cape Canaveral, Fla. Discovery and it's STS-133 mission crew of six are currently targeted to launch at 4:17p.m. EDT on Tuesday, Nov. 2, 2010. Photo Credit: (NASA/Bill Ingalls)

Kepler Media Briefing

NASA Image and Video Library

2009-02-19

Jim Fanson, Kepler project manager, at NASA's Jet Propulsion Laboratory in Pasadena, Calif. talks about the Kepler mission during a media briefing, Thursday, Feb. 19, 2008, at NASA Headquarters in Washington. Kepler, the first mission with the ability to find planets like earth, is scheduled to launch on March 5, 2009 from Cape Canaveral Air Force Station, Fla. aboard a Delta II rocket. Photo Credit: (NASA/Paul. E. Alers)

Kepler Media Briefing

NASA Image and Video Library

2009-02-19

William Borucki, principal investigator for Kepler Science at Ames Research Center, Moffett Field, Calif., talks about the Kepler mission during a media briefing, Thursday, Feb. 19, 2008, at NASA Headquarters in Washington. Kepler, the first mission with the ability to find planets like earth, is scheduled to launch on March 5, 2009 from Cape Canaveral Air Force Station, Fla. aboard a Delta II rocket. Photo Credit: (NASA/Paul. E. Alers)

Kepler Media Briefing

NASA Image and Video Library

2009-02-19

Jim Fanson, Kepler project manager, center, talks about the Kepler mission as William Borucki, left, and Debra Fischer, right, listen during a media briefing, Thursday, Feb. 19, 2008, at NASA Headquarters in Washington. Kepler, the first mission with the ability to find planets like earth, is scheduled to launch on March 5, 2009 from Cape Canaveral Air Force Station, Fla. aboard a Delta II rocket. Photo Credit: (NASA/Paul. E. Alers)

Understanding how long‐acting β2‐adrenoceptor agonists enhance the clinical efficacy of inhaled corticosteroids in asthma – an update

PubMed Central

Giembycz, Mark A

2016-01-01

In moderate‐to‐severe asthma, adding an inhaled long‐acting β2‐adenoceptor agonist (LABA) to an inhaled corticosteroid (ICS) provides better disease control than simply increasing the dose of ICS. Acting on the glucocorticoid receptor (GR, gene NR3C1), ICSs promote anti‐inflammatory/anti‐asthma gene expression. In vitro, LABAs synergistically enhance the maximal expression of many glucocorticoid‐induced genes. Other genes, including dual‐specificity phosphatase 1(DUSP1) in human airways smooth muscle (ASM) and epithelial cells, are up‐regulated additively by both drug classes. Synergy may also occur for LABA‐induced genes, as illustrated by the bronchoprotective gene, regulator of G‐protein signalling 2 (RGS2) in ASM. Such effects cannot be produced by either drug alone and may explain the therapeutic efficacy of ICS/LABA combination therapies. While the molecular basis of synergy remains unclear, mechanistic interpretations must accommodate gene‐specific regulation. We explore the concept that each glucocorticoid‐induced gene is an independent signal transducer optimally activated by a specific, ligand‐directed, GR conformation. In addition to explaining partial agonism, this realization provides opportunities to identify novel GR ligands that exhibit gene expression bias. Translating this into improved therapeutic ratios requires consideration of GR density in target tissues and further understanding of gene function. Similarly, the ability of a LABA to interact with a glucocorticoid may be suboptimal due to low β2‐adrenoceptor density or biased β2‐adrenoceptor signalling. Strategies to overcome these limitations include adding‐on a phosphodiesterase inhibitor and using agonists of other Gs‐coupled receptors. In all cases, the rational design of ICS/LABA, and derivative, combination therapies requires functional knowledge of induced (and repressed) genes for therapeutic benefit to be maximized. PMID:27646470

Perceptions of Safety Among LGBTQ People Following the 2016 Pulse Nightclub Shooting.

PubMed

Stults, Christopher B; Kupprat, Sandra A; Krause, Kristen D; Kapadia, Farzana; Halkitis, Perry N

2017-09-01

The goals of this manuscript are two-fold. First, we provide a brief reaction to this journal's "Special Section: Reflections on the Orlando Massacre on its First Anniversary." Second, we present findings from a study on perceptions of safety among LGBTQ individuals following the Pulse shooting. These issues are discussed within the historical context of hate crimes experienced by the LGBTQ population (Herek), media coverage following the shooting (Hancock & Halderman), and the immediate reaction of LGBTQ graduate students to the event (Jackson). Our study sought to examine differences in perceptions of personal and peer safety by race/ethnicity, gender identity, and sexual orientation among a large, diverse sample of LGBTQ people. Findings from our study indicate that there were differences in perceptions of personal safety by gender identity, and differences in perceptions of peer safety by gender identity and sexual orientation. These findings also suggest that subgroups of the LGBTQ community with more marginalized gender and sexual identities (e.g., female, transgender, genderqueer, bisexual, queer respondents) perceived more concerns related to safety, on average, than subgroups with relatively more privilege (e.g., gay, male). Elevated safety concern may exacerbate multiple minority stress burden, a known driver of poor health outcomes among LGBTQ people. These findings are a call to action to healthcare providers to be well informed and trained to provide the appropriate care and counseling referrals that can address the safety-related concerns of LGBTQ individuals in the aftermath of identity-related attacks.

The Briefing Book Concept.

ERIC Educational Resources Information Center

Minix, Dean A.

1990-01-01

Describes an open admissions program, a public university's nontraditional population, and their unique academic needs. Provides a political science briefing book assignment in which students research and write about one country. Claims the book is effective in helping students to organize and focus their thoughts and to improve their research and…

Mars Comet Encounter Briefing

NASA Image and Video Library

2014-10-09

Dwayne Brown, NASA public affairs officer, moderates a media briefing where panelists outlined how space and Earth-based assets will be used to image and study comet Siding Spring during its Sunday, Oct. 19 flyby of Mars, Thursday, Oct. 9, 2014 at NASA Headquarters in Washington. Photo Credit: (NASA/Joel Kowsky)

Solar Dynamics Observatory Briefing

NASA Image and Video Library

2010-01-21

Richard Fisher, Heliophysics Division Director at NASA Headquarters, speaks during a briefing to discuss the upcoming launch of NASA's Solar Dynamic Observatory, or SDO, Thursday, Jan. 21, 2010, at NASA Headquarters in Washington. The mission is to study the Sun and its dynamic behavior. Photo Credit: (NASA/Paul E. Alers)

Cumulative index to NASA Tech Briefs, 1986-1990, volumes 10-14

NASA Technical Reports Server (NTRS)

1992-01-01

Tech Briefs are short announcements of new technology derived from the R&D activities of the National Aeronautics and Space Administration. These briefs emphasize information considered likely to be transferrable across industrial, regional, or disciplinary lines and are issued to encourage commercial application. This cumulative index of Tech Briefs contains abstracts and four indexes (subject, personal author, originating center, and Tech Brief number) and covers the period 1986 to 1990. The abstract section is organized by the following subject categories: electronic components and circuits, electronic systems, physical sciences, materials, computer programs, life sciences, mechanics, machinery, fabrication technology, and mathematics and information sciences.

NASA Tech Briefs, June 1998. Volume 22, No. 6

NASA Technical Reports Server (NTRS)

1998-01-01

Topics include: special coverage on computer hardware and peripherals, electronic components and circuits, electronic systems, software, materials, mechanics, machinery/automation, manufacturing, physical sciences, information sciences, book and reports, and a special section of Photonics Tech Briefs. and a second special section of Motion Control Tech Briefs

14 CFR 121.573 - Briefing passengers: Extended overwater operations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Briefing passengers: Extended overwater... passengers: Extended overwater operations. (a) In addition to the oral briefing required by § 121.571(a), each certificate holder operating an airplane in extended overwater operations shall ensure that all...

14 CFR 121.573 - Briefing passengers: Extended overwater operations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Briefing passengers: Extended overwater... passengers: Extended overwater operations. (a) In addition to the oral briefing required by § 121.571(a), each certificate holder operating an airplane in extended overwater operations shall ensure that all...

14 CFR 121.573 - Briefing passengers: Extended overwater operations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Briefing passengers: Extended overwater... passengers: Extended overwater operations. (a) In addition to the oral briefing required by § 121.571(a), each certificate holder operating an airplane in extended overwater operations shall ensure that all...

14 CFR 121.573 - Briefing passengers: Extended overwater operations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Briefing passengers: Extended overwater... passengers: Extended overwater operations. (a) In addition to the oral briefing required by § 121.571(a), each certificate holder operating an airplane in extended overwater operations shall ensure that all...

14 CFR 121.573 - Briefing passengers: Extended overwater operations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Briefing passengers: Extended overwater... passengers: Extended overwater operations. (a) In addition to the oral briefing required by § 121.571(a), each certificate holder operating an airplane in extended overwater operations shall ensure that all...

NASA Tech Briefs, December 1998. Volume 22, No. 12

NASA Technical Reports Server (NTRS)

1998-01-01

Topics include: special coverage section on design and analysis software, and sections on electronic components and circuits, electronic systems, software, materials, mechanics, machinery/automation, manufacturing/fabrication, physical sciences, and special sections of Photonics Tech Briefs, Motion Control Tech briefs and a Hot Technology File 1999 Resource Guide.

NASA Tech Briefs, October 2000. Volume 24, No. 10

NASA Technical Reports Server (NTRS)

2000-01-01

Topics include: special coverage sections on CAD, CAE, and PDM, and, Composites and Plastics, and sections on electronic components and systems, software, test and measurement, mechanics, manufacturing/fabrication, physical sciences, information sciences, book and reports, and special sections of Electronics Tech Briefs and Motion Control Tech Briefs

Validity of instruments to assess students' travel and pedestrian safety.

PubMed

Mendoza, Jason A; Watson, Kathy; Baranowski, Tom; Nicklas, Theresa A; Uscanga, Doris K; Hanfling, Marcus J

2010-05-18

Safe Routes to School (SRTS) programs are designed to make walking and bicycling to school safe and accessible for children. Despite their growing popularity, few validated measures exist for assessing important outcomes such as type of student transport or pedestrian safety behaviors. This research validated the SRTS school travel survey and a pedestrian safety behavior checklist. Fourth grade students completed a brief written survey on how they got to school that day with set responses. Test-retest reliability was obtained 3-4 hours apart. Convergent validity of the SRTS travel survey was assessed by comparison to parents' report. For the measure of pedestrian safety behavior, 10 research assistants observed 29 students at a school intersection for completion of 8 selected pedestrian safety behaviors. Reliability was determined in two ways: correlations between the research assistants' ratings to that of the Principal Investigator (PI) and intraclass correlations (ICC) across research assistant ratings. The SRTS travel survey had high test-retest reliability (kappa = 0.97, n = 96, p < 0.001) and convergent validity (kappa = 0.87, n = 81, p < 0.001). The pedestrian safety behavior checklist had moderate reliability across research assistants' ratings (ICC = 0.48) and moderate correlation with the PI (r = 0.55, p = < 0.01). When two raters simultaneously used the instrument, the ICC increased to 0.65. Overall percent agreement (91%), sensitivity (85%) and specificity (83%) were acceptable. These validated instruments can be used to assess SRTS programs. The pedestrian safety behavior checklist may benefit from further formative work.

Validity of instruments to assess students' travel and pedestrian safety

PubMed Central

2010-01-01

Background Safe Routes to School (SRTS) programs are designed to make walking and bicycling to school safe and accessible for children. Despite their growing popularity, few validated measures exist for assessing important outcomes such as type of student transport or pedestrian safety behaviors. This research validated the SRTS school travel survey and a pedestrian safety behavior checklist. Methods Fourth grade students completed a brief written survey on how they got to school that day with set responses. Test-retest reliability was obtained 3-4 hours apart. Convergent validity of the SRTS travel survey was assessed by comparison to parents' report. For the measure of pedestrian safety behavior, 10 research assistants observed 29 students at a school intersection for completion of 8 selected pedestrian safety behaviors. Reliability was determined in two ways: correlations between the research assistants' ratings to that of the Principal Investigator (PI) and intraclass correlations (ICC) across research assistant ratings. Results The SRTS travel survey had high test-retest reliability (κ = 0.97, n = 96, p < 0.001) and convergent validity (κ = 0.87, n = 81, p < 0.001). The pedestrian safety behavior checklist had moderate reliability across research assistants' ratings (ICC = 0.48) and moderate correlation with the PI (r = 0.55, p =< 0.01). When two raters simultaneously used the instrument, the ICC increased to 0.65. Overall percent agreement (91%), sensitivity (85%) and specificity (83%) were acceptable. Conclusions These validated instruments can be used to assess SRTS programs. The pedestrian safety behavior checklist may benefit from further formative work. PMID:20482778

Review article: practical current issues in perioperative patient safety.

PubMed

Eichhorn, John H

2013-02-01

This brief review provides an overview and, importantly, a context perspective of relevant current practical issues in perioperative patient safety. The dramatic improvement in anesthesia patient safety over the last 30 years was not initiated by electronic monitors but, rather, largely by a set of behaviours known as "safety monitoring" that were then made decidedly more effective by extending the human senses through electronic monitoring, for example, capnography and pulse oximetry. In the highly developed world, this current success is threatened by complacency and production pressure. In some areas of the developing/underdeveloped world, the challenge is implementing the components of anesthesia practice that will bring safety improvements to parallel the overall current success, for instance, applying the World Federation of Societies of Anaesthesiologists (WFSA) "International Standards for A Safe Practice of Anaesthesia". Generally, expanding the current success in safety involves many practical issues. System issues involve research, effective reporting mechanisms and analysis/broadcasting of results, perioperative communication (including "speaking up to power"), and checklists. Monitoring issues involve enforcing existing published monitoring standards and also recognizing the risk of danger to the patient from hypoventilation during procedural sedation and from postoperative intravenous pain medications. Issues of clinical care include medication errors in the operating room, cerebral hypoperfusion (especially in the head-up position), dangers of airway management, postoperative residual weakness from muscle relaxants, operating room fires, and risks specific in obstetric anesthesia. Recognition of the issues outlined here and empowerment of all anesthesia professionals, from the most senior professors and administrators to the newest practitioners, should help maintain, solidify, and expand the improvements in anesthesia and perioperative patient

Orbiting Carbon Observatory Briefing

NASA Image and Video Library

2009-01-29

Anna Michalak, an Orbiting Carbon Observatory science team member from the University of Michigan, Ann Arbor, speaks during a media briefing to discuss the upcoming Orbiting Carbon Observatory mission, the first NASA spacecraft dedicated to studying carbon dioxide, Thursday, Jan. 29, 2009, at NASA Headquarters in Washington. Photo Credit: (NASA/Paul E. Alers)

The early history of ideas on brief interventions for alcohol.

PubMed

McCambridge, Jim; Cunningham, John A

2014-04-01

This study explores the early development of brief interventions for alcohol using a history of ideas approach with a particular focus on intervention content. The source publications of the key primary studies published from approximately 1962 to 1992 were examined, followed by a brief review of the earliest reviews in this field. These studies were placed in the context of developments in alcohol research and in public health. After early pioneering work on brief interventions, further advances were not made until thinking about alcohol problems and their treatment, most notably on controlled drinking, along with wider changes in public health, created new conditions for progress. There was then a golden era of rapid advance in the late 1980s and early 1990s, when preventing the development of problem drinking became important for public health reasons, in addition to helping already problematic drinkers. Many research challenges identified at that time remain to be met. The content of brief interventions changed over the period of study, although not in ways well informed by research advances, and there were also obvious continuities, with a renewed emphasis on the facilitation of self-change being one important consequence of the development of internet applications. Ideas about brief interventions have changed in important ways. Brief interventions have been studied with different populations of drinkers, with aims embracing both individual and population-level perspectives, and without well-specified contents. The brief intervention field is an appropriate target for further historical investigations, which may help thinking about addressing alcohol and other problems. © 2013 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

22 CFR 401.25 - Government brief regarding navigable waters.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Government brief regarding navigable waters. 401.25 Section 401.25 Foreign Relations INTERNATIONAL JOINT COMMISSION, UNITED STATES AND CANADA RULES OF PROCEDURE Applications § 401.25 Government brief regarding navigable waters. When in the opinion of the...

The Effects of Toxic Stress during Pregnancy. Science Briefs

ERIC Educational Resources Information Center

National Scientific Council on the Developing Child, 2006

2006-01-01

"Science Briefs" summarize the findings and implications of a recent study in basic science or clinical research. This Brief summarizes the findings and implications of "Exposure to Repetitive versus Varied Stress during Prenatal Development Generates Two Distinct Enxiogenic and Veuroendocrine Profiles in Adulthood" (H. N. Richardson; E. P.…

Deep Learning for Computer Vision: A Brief Review

PubMed Central

Doulamis, Nikolaos; Doulamis, Anastasios; Protopapadakis, Eftychios

2018-01-01

Over the last years deep learning methods have been shown to outperform previous state-of-the-art machine learning techniques in several fields, with computer vision being one of the most prominent cases. This review paper provides a brief overview of some of the most significant deep learning schemes used in computer vision problems, that is, Convolutional Neural Networks, Deep Boltzmann Machines and Deep Belief Networks, and Stacked Denoising Autoencoders. A brief account of their history, structure, advantages, and limitations is given, followed by a description of their applications in various computer vision tasks, such as object detection, face recognition, action and activity recognition, and human pose estimation. Finally, a brief overview is given of future directions in designing deep learning schemes for computer vision problems and the challenges involved therein. PMID:29487619

Recent Upgrades at the Safety and Tritium Applied Research Facility

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

Cadwallader, Lee Charles; Merrill, Brad Johnson; Stewart, Dean Andrew

This paper gives a brief overview of the Safety and Tritium Applied Research (STAR) facility operated by the Fusion Safety Program (FSP) at the Idaho National Laboratory (INL). FSP researchers use the STAR facility to carry out experiments in tritium permeation and retention in various fusion materials, including wall armor tile materials. FSP researchers also perform other experimentation as well to support safety assessment in fusion development. This lab, in its present two-building configuration, has been in operation for over ten years. The main experiments at STAR are briefly described. This paper discusses recent work to enhance personnel safety atmore » the facility. The STAR facility is a Department of Energy less than hazard category 3 facility; the personnel safety approach calls for ventilation and tritium monitoring for radiation protection. The tritium areas of STAR have about 4 to 12 air changes per hour, with air flow being once through and then routed to the facility vent stack. Additional radiation monitoring has been installed to read the laboratory room air where experiments with tritium are conducted. These ion chambers and bubblers are used to verify that no significant tritium concentrations are present in the experiment rooms. Standby electrical power has been added to the facility exhaust blower so that proper ventilation will now operate during commercial power outages as well as the real-time tritium air monitors.« less

Mars Briefing

NASA Image and Video Library

2011-08-04

Colin Dundas, a research geologist with the U.S. Geological Survey, speaks during a briefing, Thursday, Aug. 4, 2011, at NASA Headquarters in Washington. Observations from NASA's Mars Reconnaissance Orbiter (MRO) have revealed possible flowing water during the warmest months on Mars. Dark, finger-like features appear and extend down some Martian slopes during late spring through summer, fade in winter, and return during the next spring. Repeated observations have tracked the seasonal changes in these recurring features on several steep slopes in the middle latitudes of Mars' southern hemisphere. Photo Credit: (NASA/Paul E. Alers)

Quality and safety in pediatric anesthesia.

PubMed

Varughese, Anna M; Rampersad, Sally E; Whitney, Gina M; Flick, Randall P; Anton, Blair; Heitmiller, Eugenie S

2013-12-01

Health care quality and value are leading issues in medicine today for patients, health care professionals, and policy makers. Outcome, safety, and service-the components of quality-have been used to define value when placed in the context of cost. Health care organizations and professionals are faced with the challenge of improving quality while reducing health care related costs to improve value. Measurement of quality is essential for assessing what is effective and what is not when working toward improving quality and value. However, there are few tools currently for assessing quality of care, and clinicians often lack the resources and skills required to conduct quality improvement work. In this article, we provide a brief review of quality improvement as a discipline and describe these efforts within pediatric anesthesiology.

Brief dynamic psychotherapy : patient suitability, treatment length, and outcome.

PubMed

Høglend, P; Sørlie, T; Heyerdahl, O; Sørbye, O; Amlo, S

1993-01-01

Forty-three neurotic outpatients were treated according to common practice with dynamic psychotherapy of brief to moderate length. Suitability for brief dynamic psychotherapy, measured by quality of interpersonal relations, was independent of DSM-III diagnoses. Suitability was a significant direct predictor of symptomatic and dynamic change 2 and 4 years after therapy. Treatment length added no explained outcome variance over patient characteristics. However, patients with high suitability had a relatively more favorable dynamic outcome with a brief, focused treatment approach, whereas patients with low suitability had relatively more favorable outcome with a longer, less focused treatment of more than 1 year's duration. The significant interaction emerged at 4-year follow-up.

Comparison of the occupational safety applications in marble quarries of Carrara (Italy) and Iscehisar (Turkey) by using Elmeri method.

PubMed

Ersoy, Metin; Yesilkaya, Liyaddin

2016-01-01

In this paper, a brief summary is given about marble quarries in Carrara (Italy) and Iscehisar (Turkey), the Elmeri method is introduced, work accidents that can happen in marble quarries and their causes besides work safety behaviours in fields are explained, and the Elmeri monitoring method is applied and analysed. For this reason, marble quarries are divided into seven in terms of working conditions and active six quarries both in Carrara and Iscehisar areas, and work safety behaviours are analysed. Analysis process is based on True-False method; there are 18 items in total under six main topics; three items on each topic. The safety index for each section and the main topics are also calculated. According to the calculated safety indexes, Carrara area marble quarries (65.08%) are safer than Iscehisar area marble quarries (46.01%).

Issue Brief on Diversity

ERIC Educational Resources Information Center

Division on Developmental Disabilities, Council for Exceptional Children (NJ1), 2013

2013-01-01

During the past year, the Diversity Committee of the Division of Developmental Disabilities (DDD) Board worked with the Board and the Issues Committee Chair to develop an issue brief addressing diversity, its impact on the membership and the wider community that is served by the work of DDD, resulting in recommendations that will influence policy…

Aikido: a model for brief strategic therapy.

PubMed

Saposnek, D T

1980-09-01

Building on Watzlawick's observations of certain similarities between judo and brief strategic therapy, this paper develops theoretic and pragmatic parallels between brief strategic therapy and a sophisticated martial art system, Aikido. After presenting the contextual similarities of the two conceptual systems as parallel "challenges" to the therapist and Aikidoist to effect change, the similarities in basic principles of practice are presented. The similarities in the philosophical and attitudinal positions of these conceptual systems are then delineated, followed by a case example that integrates the various concepts in the paper.

Organizational Structures to Support Oakland Community Schools. Knowledge Brief

ERIC Educational Resources Information Center

John W. Gardner Center for Youth and Their Communities, 2015

2015-01-01

This brief is part of a series that shares findings from a research collaboration between the John W. Gardner Center for Youth and Their Communities at Stanford University and Oakland Unified School District (OUSD) focused on understanding implementation of the community school model in the district. This brief highlights findings related to…

40 CFR 22.11 - Intervention and non-party briefs.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 1 2014-07-01 2014-07-01 false Intervention and non-party briefs. 22... OR SUSPENSION OF PERMITS Parties and Appearances § 22.11 Intervention and non-party briefs. (a) Intervention. Any person desiring to become a party to a proceeding may move for leave to intervene. A motion...

40 CFR 22.11 - Intervention and non-party briefs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Intervention and non-party briefs. 22... OR SUSPENSION OF PERMITS Parties and Appearances § 22.11 Intervention and non-party briefs. (a) Intervention. Any person desiring to become a party to a proceeding may move for leave to intervene. A motion...

40 CFR 22.11 - Intervention and non-party briefs.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 1 2012-07-01 2012-07-01 false Intervention and non-party briefs. 22... OR SUSPENSION OF PERMITS Parties and Appearances § 22.11 Intervention and non-party briefs. (a) Intervention. Any person desiring to become a party to a proceeding may move for leave to intervene. A motion...

40 CFR 22.11 - Intervention and non-party briefs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 1 2013-07-01 2013-07-01 false Intervention and non-party briefs. 22... OR SUSPENSION OF PERMITS Parties and Appearances § 22.11 Intervention and non-party briefs. (a) Intervention. Any person desiring to become a party to a proceeding may move for leave to intervene. A motion...

40 CFR 22.11 - Intervention and non-party briefs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Intervention and non-party briefs. 22... OR SUSPENSION OF PERMITS Parties and Appearances § 22.11 Intervention and non-party briefs. (a) Intervention. Any person desiring to become a party to a proceeding may move for leave to intervene. A motion...

Fetal Alcohol Exposure Reduces Adult Brain Plasticity. Science Briefs

ERIC Educational Resources Information Center

National Scientific Council on the Developing Child, 2007

2007-01-01

"Science Briefs" summarize the findings and implications of a recent study in basic science or clinical research. This Brief summarizes the findings and implications of "Moderate Fetal Alcohol Exposure Impairs the Neurogenic Response to an Enriched Environment in Adult Mice" (I. Y. Choi; A. M. Allan; and L. A. Cunningham). Observations of mice…

Effects of Interspersed Brief Problems on Students' Endurance at Completing Math Work

ERIC Educational Resources Information Center

Montarello, Staci; Martens, Brian K.

2005-01-01

An alternating treatments design was used to compare the effects of baseline, interspersed brief problems, and interspersed brief problems plus token reinforcement on students' endurance while completing math worksheets. By pairing the completion of brief problems with token reinforcement, the role of problem completion as a conditioned reinforcer…

Three brief assessments of math achievement.

PubMed

Steiner, Eric T; Ashcraft, Mark H

2012-12-01

Because of wide disparities in college students' math knowledge-that is, their math achievement-studies of cognitive processing in math tasks also need to assess their individual level of math achievement. For many research settings, however, using existing math achievement tests is either too costly or too time consuming. To solve this dilemma, we present three brief tests of math achievement here, two drawn from the Wide Range Achievement Test and one composed of noncopyrighted items. All three correlated substantially with the full achievement test and with math anxiety, our original focus, and all show acceptable to excellent reliability. When lengthy testing is not feasible, one of these brief tests can be substituted.

Comparison of Brief Summary Formats Through a Health Literacy Lens.

PubMed

Sharp, Michele L; Hall, Lori; Eleftherion, Anthony; Simpson, Katherine; Neuhauser, Linda

2018-01-01

Print pharmaceutical advertisements in the United States require inclusion of a brief summary of side effects, warnings, precautions, and contraindications from the labeling. The full package insert, which sponsors have traditionally used to fulfill the brief summary requirement, does not adhere to health literacy best practices, limiting its value to consumers. This study compared the understandability and usability of brief summaries in 3 formats designed to be more consumer friendly. Three brief summary formats were tested: (1) 2-column "Question and Answer"; (2) "Prescription Drug Facts Box," similar to current US over-the-counter drug facts labeling; and (3) "Health Literacy," based on clear communication principles. Researchers evaluated the formats using the Suitability Assessment of Materials (SAM) tool and conducted structured, scripted, one-on-one interviews (usability tests) with participants with estimated low to average education levels. This research was replicated across 2 therapeutic areas (type 2 diabetes and plaque psoriasis). SAM scores showed that the Health Literacy format outperformed the Question and Answer format and the Prescription Drug Facts Box format in both therapeutic areas, with both Health Literacy brief summaries rated on the SAM as "superior." Qualitative usability tests supported the SAM findings, with the Health Literacy format preferred consistently over the Question and Answer format, and more often than not over the Prescription Drug Facts Box format. Sponsors can employ a user-tested Health Literacy format to improve the understandability and usability of brief summaries with patients.

4 CFR 28.60 - Briefs.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 4 Accounts 1 2010-01-01 2010-01-01 false Briefs. 28.60 Section 28.60 Accounts GOVERNMENT ACCOUNTABILITY OFFICE GENERAL PROCEDURES GOVERNMENT ACCOUNTABILITY OFFICE PERSONNEL APPEALS BOARD; PROCEDURES APPLICABLE TO CLAIMS CONCERNING EMPLOYMENT PRACTICES AT THE GOVERNMENT ACCOUNTABILITY OFFICE Procedures...

Mars Comet Encounter Briefing

NASA Image and Video Library

2014-10-09

Jim Green, director, Planetary Science Division, NASA Headquarters, Washington gives remarks during a media briefing where he and other panelists outlined how space and Earth-based assets will be used to image and study comet Siding Spring during its Sunday, Oct. 19 flyby of Mars, Thursday, Oct. 9, 2014 at NASA Headquarters in Washington. Photo Credit: (NASA/Joel Kowsky)

Solar Dynamics Observatory Briefing

NASA Image and Video Library

2010-01-21

Richard Fisher, Heliophysics Division Director at NASA Headquarters, left, speaks during a briefing to discuss the upcoming launch of NASA's Solar Dynamic Observatory, or SDO, Thursday, Jan. 21, 2010, as Madhulika Guhathakurta, SDO Program Scientist looks on at NASA Headquarters in Washington. The mission is to study the Sun and its dynamic behavior. Photo Credit: (NASA/Paul E. Alers)

50 CFR 37.33 - Environmental briefing.

Code of Federal Regulations, 2013 CFR

2013-10-01

... (CONTINUED) THE NATIONAL WILDLIFE REFUGE SYSTEM GEOLOGICAL AND GEOPHYSICAL EXPLORATION OF THE COASTAL PLAIN, ARCTIC NATIONAL WILDLIFE REFUGE, ALASKA Environmental Protection § 37.33 Environmental briefing. The...