19 CFR Annex IV to Part 351 - Deadlines for Parties in Antidumping Administrative Reviews

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 3 2013-04-01 2013-04-01 false Deadlines for Parties in Antidumping Administrative Reviews IV Annex IV to Part 351 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE ANTIDUMPING AND COUNTERVAILING DUTIES Pt. 351, Annex IV Annex IV to Part 351—Deadlines for Parties...

19 CFR Annex IV to Part 351 - Deadlines for Parties in Antidumping Administrative Reviews

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 3 2014-04-01 2014-04-01 false Deadlines for Parties in Antidumping Administrative Reviews IV Annex IV to Part 351 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE ANTIDUMPING AND COUNTERVAILING DUTIES Pt. 351, Annex IV Annex IV to Part 351—Deadlines for Parties...

19 CFR Annex IV to Part 351 - Deadlines for Parties in Antidumping Administrative Reviews

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 3 2012-04-01 2012-04-01 false Deadlines for Parties in Antidumping Administrative Reviews IV Annex IV to Part 351 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE ANTIDUMPING AND COUNTERVAILING DUTIES Pt. 351, Annex IV Annex IV to Part 351—Deadlines for Parties...

19 CFR Annex IV to Part 351 - Deadlines for Parties in Antidumping Administrative Reviews

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 3 2011-04-01 2011-04-01 false Deadlines for Parties in Antidumping Administrative Reviews IV Annex IV to Part 351 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE ANTIDUMPING AND COUNTERVAILING DUTIES Pt. 351, Annex IV Annex IV to Part 351—Deadlines for Parties...

46 CFR Appendix IV to Part 150 - Data Sheet

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 5 2014-10-01 2014-10-01 false Data Sheet IV Appendix IV to Part 150 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES COMPATIBILITY OF CARGOES Pt. 150, App. IV Appendix IV to Part 150—Data Sheet EC02FE91.080 EC02FE91.081 ...

46 CFR Appendix IV to Part 150 - Data Sheet

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 5 2013-10-01 2013-10-01 false Data Sheet IV Appendix IV to Part 150 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES COMPATIBILITY OF CARGOES Pt. 150, App. IV Appendix IV to Part 150—Data Sheet EC02FE91.080 EC02FE91.081 ...

46 CFR Appendix IV to Part 150 - Data Sheet

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 5 2012-10-01 2012-10-01 false Data Sheet IV Appendix IV to Part 150 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES COMPATIBILITY OF CARGOES Pt. 150, App. IV Appendix IV to Part 150—Data Sheet EC02FE91.080 EC02FE91.081 ...

46 CFR Appendix IV to Part 150 - Data Sheet

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 5 2011-10-01 2011-10-01 false Data Sheet IV Appendix IV to Part 150 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES COMPATIBILITY OF CARGOES Pt. 150, App. IV Appendix IV to Part 150—Data Sheet EC02FE91.080 EC02FE91.081 ...

46 CFR Appendix IV to Part 150 - Data Sheet

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 5 2010-10-01 2010-10-01 false Data Sheet IV Appendix IV to Part 150 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES COMPATIBILITY OF CARGOES Pt. 150, App. IV Appendix IV to Part 150—Data Sheet EC02FE91.080 EC02FE91.081 ...

Information and the War against Terrorism, Part IV: Civil Liberties versus Security in the Age of Terrorism.

ERIC Educational Resources Information Center

Strickland, Lee S.

2002-01-01

Discussion of information and the war on terrorism following the September 11th attacks focuses on a survey of legal provisions and new security-related practices in government and business as security competes with civil liberties. Topics include the Fourth Amendment overseas; Department of Justice legal initiatives; military tribunals; security…

Teaching Note-CASA Volunteerism: Preparing MSW Students for Public Child Welfare Practice

ERIC Educational Resources Information Center

Berrick, Jill Duerr; Durst, Wendy

2014-01-01

In an effort to reform public child welfare systems across the nation, Title IV-E child welfare training programs were established over 2 decades ago. Participating students typically engage in a customized educational experience as part of their MSW program that prepares them to work in the field of child welfare upon graduation. This article…

Frequency Control: Proceedings of the 40th Annual Symposium on held in Philadelphia, Pennsylvania on 28-30 May 1986

DTIC Science & Technology

1986-05-30

nonuniform and in part not specified. The actual values of the calculable quantities listed in TABLE IV and obtained on the basis of 61 observations of...is zero. GROUND FOR Since there are no known data on frequency shifts of PPER ELECTRODE. WHEN USED crystals for such nonuniform fields and voltages...PROTECTED BY US COPYRIGHT’ distribution of motional activity. In practical IRE National Convention Record, Part 6, cases, the nonuniform mode shape

40 CFR Appendix IV to Part 600 - Reserved

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 30 2014-07-01 2014-07-01 false Reserved IV Appendix IV to Part 600 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY AND GREENHOUSE GAS EXHAUST EMISSIONS OF MOTOR VEHICLES Appendix IV to Part 600 [Reserved] ...

40 CFR Appendix IV to Part 600 - Sample Fuel Economy Labels for 2008 and Later Model Year Vehicles

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Sample Fuel Economy Labels for 2008 and Later Model Year Vehicles IV Appendix IV to Part 600 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY AND CARBON-RELATED EXHAUST EMISSIONS OF MOTOR VEHICLES Pt. 600, App. IV Appendix IV to Part 600...

12 CFR Appendix IV to Part 27 - Home Loan Data Submission

Code of Federal Regulations, 2014 CFR

2014-01-01

... 12 Banks and Banking 1 2014-01-01 2014-01-01 false Home Loan Data Submission IV Appendix IV to Part 27 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY FAIR HOUSING HOME LOAN DATA SYSTEM Pt. 27, App. IV Appendix IV to Part 27—Home Loan Data Submission ER21JN94.003 ER21JN94...

12 CFR Appendix IV to Part 27 - Home Loan Data Submission

Code of Federal Regulations, 2013 CFR

2013-01-01

... 12 Banks and Banking 1 2013-01-01 2013-01-01 false Home Loan Data Submission IV Appendix IV to Part 27 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY FAIR HOUSING HOME LOAN DATA SYSTEM Pt. 27, App. IV Appendix IV to Part 27—Home Loan Data Submission ER21JN94.003 ER21JN94...

12 CFR Appendix IV to Part 27 - Home Loan Data Submission

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 1 2011-01-01 2011-01-01 false Home Loan Data Submission IV Appendix IV to Part 27 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY FAIR HOUSING HOME LOAN DATA SYSTEM Pt. 27, App. IV Appendix IV to Part 27—Home Loan Data Submission ER21JN94.003 ER21JN94...

12 CFR Appendix IV to Part 27 - Home Loan Data Submission

Code of Federal Regulations, 2012 CFR

2012-01-01

... 12 Banks and Banking 1 2012-01-01 2012-01-01 false Home Loan Data Submission IV Appendix IV to Part 27 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY FAIR HOUSING HOME LOAN DATA SYSTEM Pt. 27, App. IV Appendix IV to Part 27—Home Loan Data Submission ER21JN94.003 ER21JN94...

12 CFR Appendix IV to Part 27 - Home Loan Data Submission

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Home Loan Data Submission IV Appendix IV to Part 27 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY FAIR HOUSING HOME LOAN DATA SYSTEM Pt. 27, App. IV Appendix IV to Part 27—Home Loan Data Submission ER21JN94.003 ER21JN94...

40 CFR 63.2870 - What parts of the General Provisions apply to me?

Code of Federal Regulations, 2010 CFR

2010-07-01

... emissions to the extent practical § 63.6(e)(3)(iv) Operation and maintenance requirements No Report SSM and... Yes Except, report each revision to your SSM plan in accordance with § 63.2861(c) rather than § 63.10...) Compliance with nonopacity emission standards except during SSM Comply with emission standards at all times...

40 CFR 63.2870 - What parts of the General Provisions apply to me?

Code of Federal Regulations, 2011 CFR

2011-07-01

... emissions to the extent practical § 63.6(e)(3)(iv) Operation and maintenance requirements No Report SSM and... Yes Except, report each revision to your SSM plan in accordance with § 63.2861(c) rather than § 63.10...) Compliance with nonopacity emission standards except during SSM Comply with emission standards at all times...

Integrated Microphotonic Receiver for Ka-Band

NASA Technical Reports Server (NTRS)

Levi, A. F. J.

2005-01-01

This report consists of four main sections. Part I: LiNbO3 microdisk resonant optical modulator. Brief review of microdisk optical resonator and RF ring resonator. Microwave and photonic design challenges for achieving simultaneous RF-optical resonance are addressed followed by our solutions. Part II: Experimental demonstration of LiNbO3 microdisk modulator performance in wired and wireless RF-optical links. Part III: Microphotonic RF receiver architecture that exploits the nonlinear modulation in the LiNbO3 microdisk modulator to achieve direct photonic down-conversion from RF carrier without using any high-speed electronic elements. Part IV: Ultimate sensitivity of the microdisk photonic receiver and the future road map toward a practical device.

Multiple Intravenous Infusions Phase 2a: Ontario Survey

PubMed Central

Fan, Mark; Koczmara, Christine; Masino, Caterina; Cassano-Piché, Andrea; Trbovich, Patricia; Easty, Anthony

2014-01-01

Background Research conducted in earlier phases of this study prospectively identified a number of concerns related to the safe administration of multiple intravenous (IV) infusions in Ontario hospitals. Objective To investigate the potential prevalence of practices or policies that may contribute to the patient safety risks identified in Phase 1b of this study. Data Sources and Review Methods Sixty-four survey responses were analyzed from clinical units where multiple IV infusions may occur (e.g., adult intensive care units). Survey questions were organized according to the topics identified in Phase 1b as potential contributors to patient harm (e.g., labelling practices, patient transfer practices, secondary infusion policies). Results Survey results indicated suboptimal practices and policies in some clinical units, and variability in a number of infusion practices. Key areas of concern included the following: use of primary IV tubing without back check valves when administering secondary infusions administration of secondary infusions with/as high-alert continuous IV medications potential confusion about how IV tubing should be labelled to reflect replacement date and time interruptions to IV therapy due to IV pump and/or tubing changes when patients are transferred between clinical units coadministration of continuous or intermittent infusions on central venous pressure monitoring ports variability in respondents’ awareness of the infusion pump's bolus capabilities Limitations Due to the limited sample size, survey responses may not be representative of infusion practices across Ontario. Answers to some questions indicated that the intent of the questions might have been misunderstood. Due to a design error, 1 question about bolus administration methods was not shown to as many respondents as appropriate. Conclusions The Ontario survey revealed variability in IV infusion practice across the province and potential opportunities to improve safety. PMID:26257837

76 FR 36095 - Defense Transportation Regulation, Part IV

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-21

... with the Defense Personal Property Program (DP3) Phase III Domestic Small Shipments (dS2) and... Regulation, Part IV Web site at http://www.transcom.mil/dtr/part-iv/phaseiii.cfm . All identified changes... based on completion of Defense Personal Property System (DPS) Phase III programming projected for FY15...

KSC-2011-2030

NASA Image and Video Library

2011-03-01

CAPE CANAVERAL, Fla. – Volunteers portraying injured astronauts are loaded onto a helicopter as part of an emergency exit, or Mode II/IV, exercise that allows teams to practice an emergency response at Launch Pad 39A at NASA's Kennedy Space Center in Florida. The exercise involves NASA fire rescue personnel, volunteers portraying astronauts with simulated injuries, helicopters and personnel from the Air Force’s 920th Rescue Wing, and medical trauma teams at three Central Florida hospitals. The drill allows teams to practice an emergency response at the launch pad, including helicopter evacuation to local hospitals. Photo credit: NASA/Kim Shiflett

KSC-2011-2026

NASA Image and Video Library

2011-03-01

CAPE CANAVERAL, Fla. – Volunteers portraying injured astronauts are transported to a helicopter as part of an emergency exit, or Mode II/IV, exercise that allows teams to practice an emergency response at Launch Pad 39A at NASA's Kennedy Space Center in Florida. The exercise involves NASA fire rescue personnel, volunteers portraying astronauts with simulated injuries, helicopters and personnel from the Air Force’s 920th Rescue Wing, and medical trauma teams at three Central Florida hospitals. The drill allows teams to practice an emergency response at the launch pad, including helicopter evacuation to local hospitals. Photo credit: NASA/Kim Shiflett

KSC-2011-2029

NASA Image and Video Library

2011-03-01

CAPE CANAVERAL, Fla. – Volunteers portraying injured astronauts are transported to a helicopter as part of an emergency exit, or Mode II/IV, exercise that allows teams to practice an emergency response at Launch Pad 39A at NASA's Kennedy Space Center in Florida. The exercise involves NASA fire rescue personnel, volunteers portraying astronauts with simulated injuries, helicopters and personnel from the Air Force’s 920th Rescue Wing, and medical trauma teams at three Central Florida hospitals. The drill allows teams to practice an emergency response at the launch pad, including helicopter evacuation to local hospitals. Photo credit: NASA/Kim Shiflett

KSC-2011-2027

NASA Image and Video Library

2011-03-01

CAPE CANAVERAL, Fla. – Volunteers portraying injured astronauts are loaded onto a helicopter as part of an emergency exit, or Mode II/IV, exercise that allows teams to practice an emergency response at Launch Pad 39A at NASA's Kennedy Space Center in Florida. The exercise involves NASA fire rescue personnel, volunteers portraying astronauts with simulated injuries, helicopters and personnel from the Air Force’s 920th Rescue Wing, and medical trauma teams at three Central Florida hospitals. The drill allows teams to practice an emergency response at the launch pad, including helicopter evacuation to local hospitals. Photo credit: NASA/Kim Shiflett

Popular Astronomy

NASA Astrophysics Data System (ADS)

Newcomb, Simon

2011-10-01

Preface; Part I. The System of the World Historically Developed: Introduction; 1. The ancient astronomy, or the apparent motions of the heavenly bodies; 2. The Copernican system, or the true motions of the heavenly bodies; 3. Universal gravitation; Part II. Practical Astronomy: Introductory remarks; 1. The telescope; 2. Application of the telescope to celestial measurements; 3. Measuring distances in the heavens; 4. The motion of light; 5. The spectroscope; Part III. The Solar System: 1. General structure of the solar system; 2. The sun; 3. The inner group of planets; 4. The outer group of planets; 5. Comets and meteors; Part IV. The Stellar Universe: 1. The stars as they are seen; 2. The structure of the universe; 3. The cosmogony; Addendum to Part III chapter 2; Appendix; Index; Addendum II, the satellites of Mars; Explanation of the star maps.

Understanding the Recent Increase in Ferritin Levels in United States Dialysis Patients: Potential Impact of Changes in Intravenous Iron and Erythropoiesis-Stimulating Agent Dosing.

PubMed

Karaboyas, Angelo; Zee, Jarcy; Morgenstern, Hal; Nolen, Jacqueline G; Hakim, Raymond; Kalantar-Zadeh, Kamyar; Zager, Philip; Pisoni, Ronald L; Port, Friedrich K; Robinson, Bruce M

2015-10-07

Anemia management changed substantially among dialysis patients in the United States around the time of implementation of the new Centers for Medicare & Medicaid Services bundled payment system and erythropoiesis-stimulating agent (ESA) label change in 2011. Among these, average ferritin levels increased dramatically and have remained high since; this study sought to gain understanding of this sustained rise in ferritin levels. Trends in mean ferritin, hemoglobin, IV iron dose, and ESA dose from 2009 to 2013 were examined in 9735 patients from 91 United States Dialysis Outcomes and Practice Patterns Study facilities. Linear mixed models were used to assess the extent to which intravenous (IV) iron and ESA dose accounted for patients' changes in ferritin over time. Mean ESA dose and hemoglobin levels declined throughout the study. Mean IV iron dose increased from 210 mg/mo in 2009-2010 to a peak of 280 mg/mo in 2011, then declined back to 200 mg/mo and remained stable from 2012 to 2013. Mean ferritin increased from 601 ng/ml in the third quarter of 2009 to 887 ng/ml in the first quarter of 2012; models suggest that higher IV iron dosing was a primary determinant during 2011, but lower ESA doses contributed to the sustained high ferritin levels thereafter. In a subset of 17 facilities that decreased IV iron dose in 2011, mean ferritin rose by 120 ng/ml to 764 ng/ml, which appeared to be primarily due to ESA reduction. Together, changes in IV iron and ESA doses accounted for 46% of the increase in ferritin over the study period. In contrast to expectations, the rise in average IV iron dose did not persist beyond 2011. The sustained rise in ferritin levels in United States dialysis patients after policy changes in 2011, to average levels well in excess of 800 ng/ml, appeared to be partly due to reductions in ESA dosing and not solely IV iron dosing practices. The effect of these changes in ferritin on health outcomes requires further investigation. Copyright © 2015 by the American Society of Nephrology.

Understanding the Recent Increase in Ferritin Levels in United States Dialysis Patients: Potential Impact of Changes in Intravenous Iron and Erythropoiesis-Stimulating Agent Dosing

PubMed Central

Zee, Jarcy; Morgenstern, Hal; Nolen, Jacqueline G.; Hakim, Raymond; Kalantar-Zadeh, Kamyar; Zager, Philip; Pisoni, Ronald L.; Port, Friedrich K.; Robinson, Bruce M.

2015-01-01

Background and objectives Anemia management changed substantially among dialysis patients in the United States around the time of implementation of the new Centers for Medicare & Medicaid Services bundled payment system and erythropoiesis-stimulating agent (ESA) label change in 2011. Among these, average ferritin levels increased dramatically and have remained high since; this study sought to gain understanding of this sustained rise in ferritin levels. Design, setting, participants, & measurements Trends in mean ferritin, hemoglobin, IV iron dose, and ESA dose from 2009 to 2013 were examined in 9735 patients from 91 United States Dialysis Outcomes and Practice Patterns Study facilities. Linear mixed models were used to assess the extent to which intravenous (IV) iron and ESA dose accounted for patients’ changes in ferritin over time. Results Mean ESA dose and hemoglobin levels declined throughout the study. Mean IV iron dose increased from 210 mg/mo in 2009–2010 to a peak of 280 mg/mo in 2011, then declined back to 200 mg/mo and remained stable from 2012 to 2013. Mean ferritin increased from 601 ng/ml in the third quarter of 2009 to 887 ng/ml in the first quarter of 2012; models suggest that higher IV iron dosing was a primary determinant during 2011, but lower ESA doses contributed to the sustained high ferritin levels thereafter. In a subset of 17 facilities that decreased IV iron dose in 2011, mean ferritin rose by 120 ng/ml to 764 ng/ml, which appeared to be primarily due to ESA reduction. Together, changes in IV iron and ESA doses accounted for 46% of the increase in ferritin over the study period. Conclusions In contrast to expectations, the rise in average IV iron dose did not persist beyond 2011. The sustained rise in ferritin levels in United States dialysis patients after policy changes in 2011, to average levels well in excess of 800 ng/ml, appeared to be partly due to reductions in ESA dosing and not solely IV iron dosing practices. The effect of these changes in ferritin on health outcomes requires further investigation. PMID:26286925

Clinical use of closed-system safety peripheral intravenous cannulas.

PubMed

Barton, Andrew

2018-04-26

Peripheral intravenous (IV) cannulas are the quickest and most effective way of gaining venous vascular access and administering IV therapy. Closed-system peripheral IV cannulas have been shown to be safe and more reliable than open, non-valved peripheral cannulas in clinical practice. This article introduces the Smiths Medical DeltaVen closed-system peripheral IV cannula and includes three case studies describing its use in clinical practice and associated patient outcomes.

Changing paradigms from a historical DSM-III and DSM-IV view toward an evidence-based definition of premature ejaculation. Part I--validity of DSM-IV-TR.

PubMed

Waldinger, Marcel D; Schweitzer, Dave H

2006-07-01

In former days, information obtained from randomized well-controlled clinical trials and epidemiological studies on premature ejaculation (PE) was not available, thereby hampering the efforts of the consecutive DSM Work Groups on Sexual Disorders to formulate an evidence-based definition of PE. The current DSM-IV-TR definition of PE is still nonevidence based. In addition, the requirement that persistent self-perceived PE, distress, and interpersonal difficulties, in absence of a quantified ejaculation time, are necessary to establish the diagnosis remains disputable. To investigate the validity and reliability of DSM and ICD diagnosis of premature ejaculation. The historical development of DSM and ICD classification of mental disorders is critically reviewed, and two studies using the DSM-IV-TR definition of PE is critically reanalyzed. Reanalysis of two studies using the DSM-IV-TR definition of PE has shown that DSM-diagnosed PE can be accompanied by long intravaginal ejaculation latency time (IELT) values. The reanalysis revealed a low positive predictive value for the DSM-IV-TR definition when used as a diagnostic test. A similar situation pertains to the American Urological Association (AUA) definition of PE, which is practically a copy of the DSM-IV-TR definition. It should be emphasized that any evidence-based definition of PE needs objectively collected patient-reported outcome (PRO) data from epidemiological studies, as well as reproducible quantifications of the IELT.

Towards an Open Learning Environment for the Young Child: Some Principles, Practices and Issues in Curriculum Planning. Notes, Comments...(Child, Family, Community). Digest No. IV.

ERIC Educational Resources Information Center

Prakasha, Veda

This digest explores the question, What types of activities and experiences should a good learning environment offer to the young child to help him grow normally and happily? Part 1 focuses on basic considerations in the development of early childhood care and education (ECCE) curricula. Four chapters concern: (1) the learning needs of the young…

Temporal Stability of the Dutch Version of the Wechsler Memory Scale-Fourth Edition (WMS-IV-NL).

PubMed

Bouman, Zita; Hendriks, Marc P H; Aldenkamp, Albert P; Kessels, Roy P C

2015-01-01

The Wechsler Memory Scale-Fourth Edition (WMS-IV) is one of the most widely used memory batteries. We examined the test-retest reliability, practice effects, and standardized regression-based (SRB) change norms for the Dutch version of the WMS-IV (WMS-IV-NL) after both short and long retest intervals. The WMS-IV-NL was administered twice after either a short (M = 8.48 weeks, SD = 3.40 weeks, range = 3-16) or a long (M = 17.87 months, SD = 3.48, range = 12-24) retest interval in a sample of 234 healthy participants (M = 59.55 years, range = 16-90; 118 completed the Adult Battery; and 116 completed the Older Adult Battery). The test-retest reliability estimates varied across indexes. They were adequate to good after a short retest interval (ranging from .74 to .86), with the exception of the Visual Working Memory Index (r = .59), yet generally lower after a long retest interval (ranging from .56 to .77). Practice effects were only observed after a short retest interval (overall group mean gains up to 11 points), whereas no significant change in performance was found after a long retest interval. Furthermore, practice effect-adjusted SRB change norms were calculated for all WMS-IV-NL index scores. Overall, this study shows that the test-retest reliability of the WMS-IV-NL varied across indexes. Practice effects were observed after a short retest interval, but no evidence was found for practice effects after a long retest interval from one to two years. Finally, the SRB change norms were provided for the WMS-IV-NL.

29 CFR Appendix IV to Part 1918 - Special Cargo Gear and Container Spreader Test Requirements (Mandatory) [see § 1918.61 (f), (g...

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 7 2012-07-01 2012-07-01 false Special Cargo Gear and Container Spreader Test Requirements... REGULATIONS FOR LONGSHORING Pt. 1918, App. IV Appendix IV to Part 1918—Special Cargo Gear and Container... structural damage repair 3. Intermodal container spreaders not part of vessel's cargo handling gear Prior to...

29 CFR Appendix IV to Part 1918 - Special Cargo Gear and Container Spreader Test Requirements (Mandatory) [see § 1918.61 (f), (g...

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 7 2014-07-01 2014-07-01 false Special Cargo Gear and Container Spreader Test Requirements... REGULATIONS FOR LONGSHORING Pt. 1918, App. IV Appendix IV to Part 1918—Special Cargo Gear and Container... structural damage repair 3. Intermodal container spreaders not part of vessel's cargo handling gear Prior to...

29 CFR Appendix IV to Part 1918 - Special Cargo Gear and Container Spreader Test Requirements (Mandatory) [see § 1918.61 (f), (g...

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 7 2013-07-01 2013-07-01 false Special Cargo Gear and Container Spreader Test Requirements... REGULATIONS FOR LONGSHORING Pt. 1918, App. IV Appendix IV to Part 1918—Special Cargo Gear and Container... structural damage repair 3. Intermodal container spreaders not part of vessel's cargo handling gear Prior to...

Multiple Intravenous Infusions Phase 2b: Laboratory Study

PubMed Central

Pinkney, Sonia; Fan, Mark; Chan, Katherine; Koczmara, Christine; Colvin, Christopher; Sasangohar, Farzan; Masino, Caterina; Easty, Anthony; Trbovich, Patricia

2014-01-01

Background Administering multiple intravenous (IV) infusions to a single patient via infusion pump occurs routinely in health care, but there has been little empirical research examining the risks associated with this practice or ways to mitigate those risks. Objectives To identify the risks associated with multiple IV infusions and assess the impact of interventions on nurses’ ability to safely administer them. Data Sources and Review Methods Forty nurses completed infusion-related tasks in a simulated adult intensive care unit, with and without interventions (i.e., repeated-measures design). Results Errors were observed in completing common tasks associated with the administration of multiple IV infusions, including the following (all values from baseline, which was current practice): setting up and programming multiple primary continuous IV infusions (e.g., 11.7% programming errors) identifying IV infusions (e.g., 7.7% line-tracing errors) managing dead volume (e.g., 96.0% flush rate errors following IV syringe dose administration) setting up a secondary intermittent IV infusion (e.g., 11.3% secondary clamp errors) administering an IV pump bolus (e.g., 11.5% programming errors) Of 10 interventions tested, 6 (1 practice, 3 technology, and 2 educational) significantly decreased or even eliminated errors compared to baseline. Limitations The simulation of an adult intensive care unit at 1 hospital limited the ability to generalize results. The study results were representative of nurses who received training in the interventions but had little experience using them. The longitudinal effects of the interventions were not studied. Conclusions Administering and managing multiple IV infusions is a complex and risk-prone activity. However, when a patient requires multiple IV infusions, targeted interventions can reduce identified risks. A combination of standardized practice, technology improvements, and targeted education is required. PMID:26316919

Periodontal soft tissue root coverage procedures: a systematic review from the AAP Regeneration Workshop.

PubMed

Chambrone, Leandro; Tatakis, Dimitris N

2015-02-01

This paper aims to create a "bridge" between research and practice by developing a practical, extensive, and clinically relevant study that translates evidence-based findings on soft tissue root coverage (RC) of recession-type defects to daily clinical practice. This review is prepared in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement based on the proposed focused questions. A literature search with no restrictions regarding status or the language of publication was performed for MEDLINE and EMBASE databases up to and including June 2013. Systematic reviews (SRs), randomized clinical trials, controlled clinical trials, case series, and case reports evaluating recession areas that were treated by means of RC procedures were considered eligible for inclusion through the three parts of the study (part I, an overview of the base of SRs; part II, an alternative random-effects meta-analyses on mean percentage of RC and sites exhibiting complete RC; and part III, an SR of non-randomized trials exploring other conditions not extensively evaluated by previous SRs). Data on Class I, II, III, and IV recessions, type of histologic attachment achieved with treatment, recipient- and donor-site anatomic characteristics, smoking-related outcomes, root surface conditions, tooth type and location, long-term effectiveness outcomes, unusual conditions that may be reported during conventional daily practice, and patient-centered outcomes were assessed as well. Of the 2,456 potentially eligible trials, 234 were included. Data on Class I, II, III, and IV gingival recessions, histologic attachment achieved after treatment, recipient- and donor-site anatomic characteristics, smoking-related outcomes, root surface conditions/biomodification, tooth type and location, long-term effectiveness outcomes and unusual conditions that may be reported during conventional daily practice, and patient-centered outcomes (i.e., esthetic, visual analog scale, complications, hypersensitivity, patients perceptions) were assessed. Subepithelial connective tissue (CT)-based procedures and coronally advanced flap plus acellular dermal matrix grafts, enamel matrix derivative, or collagen matrix led to the best improvements of recession depth, clinical attachment level (CAL) gain, and keratinized tissue (KT). Some conditions, such as smoking and use of magnification, may affect RC outcomes. All RC procedures can provide significant reduction in recession depth and CAL gain for Miller Class I and II recession-type defects. Subepithelial CT graft-based procedures provided the best outcomes for clinical practice because of their superior percentages of mean and complete RC, as well as significant increase of KT.

The six most essential questions in psychiatric diagnosis: A pluralogue part 2: Issues of conservatism and pragmatism in psychiatric diagnosis

PubMed Central

2012-01-01

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM – whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article took up the first two questions. Part II will take up the second two questions. Question 3 deals with the question as to whether DSM-V should assume a conservative or assertive posture in making changes from DSM-IV. That question in turn breaks down into discussion of diagnoses that depend on, and aim toward, empirical, scientific validation, and diagnoses that are more value-laden and less amenable to scientific validation. Question 4 takes up the role of pragmatic consideration in a psychiatric nosology, whether the purely empirical considerations need to be tempered by considerations of practical consequence. As in Part 1 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. PMID:22512887

Intravenous fluid temperature management by infrared thermometer.

PubMed

Lapostolle, Frédéric; Catineau, Jean; Le Toumelin, Philippe; Proust, Clément; Garrigue, Bruno; Galinski, Michel; Adnet, Frédéric

2006-03-01

The management of intravenous (IV) fluid temperature is a daily challenge in critical care, anesthesiology, and emergency medicine. Infusion of IV fluids at the right temperature partly influences clinical outcomes of critically ill patients. Nowadays, intravenous fluid temperature is poorly managed, as no suitable device is routinely available. Infrared (IR) thermometers have been recently developed for industrial, personal, or medical purposes. The aim of this study was to evaluate the accuracy of an IR thermometer in measuring temperature of warmed and cooled infusion fluids in fluid bags. This study compared temperatures simultaneously recorded by an infrared thermometer and a temperature sensor. Temperatures of warmed (41 degrees C) and cooled (4 degrees C) infusion fluids in fluid bags were recorded by 2 independent operators every minute until IV bags' temperature reached ambient temperature. The relation curve was established with 576 measures. Temperature measures performed with an IR thermometer were perfectly linear and perfectly correlated with the reference method (R(2) = 0.995, P < 10(-5)). Infrared thermometers are efficient to measure IV fluid bag temperature in the range of temperatures used in clinical practice. As these devices are easy to use and inexpensive, they could be largely used in critical care, anesthesiology, or emergency medicine.

What Governing Boards Need To Know and Do about Institutional Change. On Change IV. An Occasional Paper Series of the ACE Project on Leadership and Institutional Transformation and The Kellogg Forum on Higher Education Transformation.

ERIC Educational Resources Information Center

Hill, Barbara; Green, Madeleine; Eckel, Peter

This essay, part of a series on change in higher education stemming from the American Council on Education (ACE) Project on Leadership and Institutional Transformation, aims to help higher education governing boards at both public and private institutions understand the complexities of the change process and find practical advice about policies…

46 CFR Appendix IV to Part 390 - Sample Addendum to Maritime Administration Capital Construction Fund Agreement

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 8 2010-10-01 2010-10-01 false Sample Addendum to Maritime Administration Capital Construction Fund Agreement IV Appendix IV to Part 390 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF... 390—Sample Addendum to Maritime Administration Capital Construction Fund Agreement This Agreement...

Tanks Versus Infantry in a Smoke Environment (TISE)

DTIC Science & Technology

1978-08-01

maneuvering toward stationary armor vehicles in an attempt to detect and recognize them. Finally, Part IV trials were limited free - play , two-sided...long. Each armor vehicle lane (average 40 meters in width) was marked on the ground by white tape. These markings were removed for part IV free - play trials...recognize them. Data were collected from both sides. (4) Part IV was free - play , force-on-force engagement trials. Defensive positions were tactically

Practice patterns for the use of iodinated i.v. contrast media for pediatric CT studies: a survey of the Society for Pediatric Radiology.

PubMed

Callahan, Michael J; Servaes, Sabah; Lee, Edward Y; Towbin, Alexander J; Westra, Sjirk J; Frush, Donald P

2014-04-01

There are limited data available on the use of i.v. contrast media for CT studies in the pediatric population. The purpose of this study is to determine the practice patterns of i.v. contrast media usage for pediatric CT by members of the Society for Pediatric Radiology (SPR). SPR members were surveyed regarding the use of i.v. contrast media for pediatric CT studies. Questions pertained to information required before administering i.v. contrast media, types of central catheters for injecting i.v. contrast media, injection rates based on angiocatheter size and study type, and management of i.v. contrast media extravasation. The response rate of 6% (88/1545) represented practice patterns of 26% (401/1545) of the SPR membership. Most respondents thought the following clinical information was mandatory before i.v. contrast media administration: allergy to i.v. contrast media (97%), renal insufficiency (97%), current metformin use (72%), significant allergies (61%), diabetes (54%), and asthma (52%). Most administered i.v. contrast media through nonimplanted central venous catheters (78%), implanted venous ports (78%), and peripherally inserted central catheters (72%). The most common maximum i.v. contrast media injection rates were 5.0 mL/s or greater for a 16-gauge angiocatheter, 4.0 mL/s for an 18-gauge angiocatheter, 3.0 mL/s for a 20-gauge angiocatheter, and 2.0 mL/s for a 22-gauge angiocatheter. For soft-tissue extravasation of i.v. contrast media, 95% elevate the affected extremity, 76% use ice, and 45% use heat. The results of this survey illustrate the collective opinion of a subset of SPR members relating to the use of i.v. contrast media in pediatric CT, providing guidelines for clinical histories needed before i.v. contrast media, maximum i.v. contrast injection rates for standard angiocatheters, contrast media injection rates for specific CT studies, and management of i.v. contrast media soft-tissue extravasation.

KSC-2009-5278

NASA Image and Video Library

2009-10-01

CAPE CANAVERAL, Fla. – At NASA's Kennedy Space Center in Florida, volunteers portraying astronauts are transported to helicopters as part of a Mode II-IV exercise that allows teams to practice an emergency response at Launch Pad 39A, including helicopter evacuation to local hospitals. The exercise allows teams to practice an emergency response at Launch Pad 39A, including helicopter evacuation to local hospitals. The exercise involves NASA fire rescue personnel, volunteers portraying astronauts with simulated injuries, helicopters and personnel from the Air Force’s 920th Rescue Wing and medical trauma teams at three central Florida hospitals. The Space Shuttle Program and U.S. Air Force are conducting the emergency simulation. Photo credit: NASA/Troy Cryder

40 CFR Appendix IV to Part 600 - Sample Fuel Economy Labels for 2008 Through 2012 Model Year Vehicles

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 31 2013-07-01 2013-07-01 false Sample Fuel Economy Labels for 2008 Through 2012 Model Year Vehicles IV Appendix IV to Part 600 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY AND GREENHOUSE GAS EXHAUST EMISSIONS OF MOTOR...

40 CFR Appendix IV to Part 600 - Sample Fuel Economy Labels for 2008 Through 2012 Model Year Vehicles

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 31 2012-07-01 2012-07-01 false Sample Fuel Economy Labels for 2008 Through 2012 Model Year Vehicles IV Appendix IV to Part 600 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY AND GREENHOUSE GAS EXHAUST EMISSIONS OF MOTOR...

2017 The 7th International Conference on Computer Engineering and Networks

NASA Astrophysics Data System (ADS)

This conference proceeding is a collection of the papers accepted by the CENet 2017 - the 7th International Conference on Computer Engineering and Networks held on Shanghai from 22-23 July, 2017. This proceeding contains the five parts: Part I focuses on Machine learning (21 papers); Part II Wireless communication (21 papers); Part III Information theory (21 papers), Part IV Cloud science (14 papers) and Part V Data analysis (21 papers). Each part can be used as an excellent reference by industry practitioners, university faculty, and undergraduate as well as graduate students who need to build a knowledge base of the most current advances and state-of-practice in the topics covered by this conference proceedings. This will enable them to produce, maintain, and manage systems with high levels of trustworthiness and complexity Thanks go to the authors for their hard work and dedication as well as the reviewers for ensuring the selection of only the highest quality papers; their efforts made this proceedings possible.

40 CFR Appendix IV to Part 261 - Reserved

Code of Federal Regulations, 2010 CFR

2010-07-01

... AND LISTING OF HAZARDOUS WASTE Financial Requirements for Management of Excluded Hazardous Secondary Materials Wording of the instruments. Appendix IV to Part 261 [Reserved for Radioactive Waste Test Methods] ...

40 CFR 85.2114 - Basis of certification.

Code of Federal Regulations, 2010 CFR

2010-07-01

... an alternative, the aftermarket part manufacturer may use a different durability procedure if it can..., appendix IV. As an alternative, the aftermarket part manufacturer may use a different durability procedure..., appendix IV can be used. As an alternative, the aftermarket part manufacturer may use a different...

Comparing Canadian and American normative scores on the Wechsler Adult Intelligence Scale-Fourth Edition.

PubMed

Harrison, Allyson G; Armstrong, Irene T; Harrison, Laura E; Lange, Rael T; Iverson, Grant L

2014-12-01

Psychologists practicing in Canada must decide which set of normative data to use for the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV). The purpose of this study was to compare the interpretive effects of applying American versus Canadian normative systems in a sample of 432 Canadian postsecondary-level students who were administered the WAIS-IV as part of an evaluation for a learning disability, attention-deficit hyperactivity disorder, or other mental health problems. Employing the Canadian normative system yielded IQ, Index, and subtest scores that were systematically lower than those obtained using the American norms. Furthermore, the percentage agreement in normative classifications, defined as American and Canadian index scores within five points or within the same classification range, was between 49% and 76%. Substantial differences are present between the American and Canadian WAIS-IV norms. Clinicians should consider carefully the implications regarding which normative system is most appropriate for specific types of evaluations. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

20 CFR 410.591 - Eligibility for services and supplies under part C of title IV of the act.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Eligibility for services and supplies under part C of title IV of the act. 410.591 Section 410.591 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Payment of...

40 CFR Appendix IV to Part 600 - Sample Fuel Economy Labels for 2008 and Later Model Year Vehicles

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 30 2011-07-01 2011-07-01 false Sample Fuel Economy Labels for 2008... PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY AND CARBON-RELATED EXHAUST EMISSIONS OF MOTOR VEHICLES Pt. 600, App. IV Appendix IV to Part 600—Sample Fuel Economy Labels for 2008 and Later Model Year...

10 CFR Appendix IV to Part 960 - Types of Information for the Nomination of Sites as Suitable for Characterization

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Types of Information for the Nomination of Sites as Suitable for Characterization IV Appendix IV to Part 960 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR..., diapirism, tilting, subsidence, faulting, and volcanism. • Estimate of the geothermal gradient. • Estimate...

40 CFR Appendix IV to Part 268 - Wastes Excluded From Lab Packs Under the Alternative Treatment Standards of § 268.42(c)

Code of Federal Regulations, 2013 CFR

2013-07-01

... Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) LAND DISPOSAL RESTRICTIONS Pt. 268, App. IV Appendix IV to Part 268—Wastes Excluded From Lab Packs Under the Alternative Treatment... 40 Protection of Environment 28 2013-07-01 2013-07-01 false Wastes Excluded From Lab Packs Under...

40 CFR Appendix IV to Part 268 - Wastes Excluded From Lab Packs Under the Alternative Treatment Standards of § 268.42(c)

Code of Federal Regulations, 2012 CFR

2012-07-01

... Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) LAND DISPOSAL RESTRICTIONS Pt. 268, App. IV Appendix IV to Part 268—Wastes Excluded From Lab Packs Under the Alternative Treatment... 40 Protection of Environment 28 2012-07-01 2012-07-01 false Wastes Excluded From Lab Packs Under...

40 CFR Appendix IV to Part 268 - Wastes Excluded From Lab Packs Under the Alternative Treatment Standards of § 268.42(c)

Code of Federal Regulations, 2011 CFR

2011-07-01

... Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) LAND DISPOSAL RESTRICTIONS Pt. 268, App. IV Appendix IV to Part 268—Wastes Excluded From Lab Packs Under the Alternative Treatment... 40 Protection of Environment 27 2011-07-01 2011-07-01 false Wastes Excluded From Lab Packs Under...

40 CFR Appendix IV to Part 268 - Wastes Excluded From Lab Packs Under the Alternative Treatment Standards of § 268.42(c)

Code of Federal Regulations, 2010 CFR

2010-07-01

... Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) LAND DISPOSAL RESTRICTIONS Pt. 268, App. IV Appendix IV to Part 268—Wastes Excluded From Lab Packs Under the Alternative Treatment... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Wastes Excluded From Lab Packs Under...

40 CFR Appendix IV to Part 268 - Wastes Excluded From Lab Packs Under the Alternative Treatment Standards of § 268.42(c)

Code of Federal Regulations, 2014 CFR

2014-07-01

... Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) LAND DISPOSAL RESTRICTIONS Pt. 268, App. IV Appendix IV to Part 268—Wastes Excluded From Lab Packs Under the Alternative Treatment... 40 Protection of Environment 27 2014-07-01 2014-07-01 false Wastes Excluded From Lab Packs Under...

45 CFR 310.0 - What does this part cover?

Code of Federal Regulations, 2010 CFR

2010-10-01

... COMPUTERIZED TRIBAL IV-D SYSTEMS AND OFFICE AUTOMATION General Provisions § 310.0 What does this part cover... and Office Automation including: (a) The automated systems options for comprehensive Tribal IV-D... and Office Automation in § 310.15 of this part; (d) The conditions for funding the installation...

Features of current-voltage characteristic of nonequilibrium trench MOS barrier Schottky diode

NASA Astrophysics Data System (ADS)

Mamedov, R. K.; Aslanova, A. R.

2018-06-01

The trench MOS barrier Schottky diodes (TMBS diode) under the influence of the voltage drop of the additional electric field (AEF) appearing in the near-contact region of the semiconductor are in a nonequilibrium state and their closed external circuit flows currents in the absence of an external voltage. When an external voltage is applied to the TMBS diode, the current transmission is described by the thermionic emission theory with a specific feature. Both forward and reverse I-V characteristics of the TMBS diode consist of two parts. In the initial first part of the forward I-V characteristic there are no forward currents, but reverse saturation currents flow, in its subsequent second part the currents increase exponentially with the voltage. In the initial first part of the reverse I-V characteristic, the currents increase in an abrupt way and in the subsequent second part the saturation currents flow under the action of the image force. The mathematical expressions for forward and reverse I-V characteristic of the TMBS diode and also narrow or nanostructure Schottky diode are proposed, which are in good agreement with the results of experimental and calculated I-V characteristics.

Intravenous Therapy Instruction for Licensed Practical Nurses. Instructor's Guide.

ERIC Educational Resources Information Center

Springer, Pam; Carey, Jean

This Idaho instructor's guide lists tasks and enabling objectives, outlines instruction, and provides handout masters, overhead masters, and tests for intravenous therapy (IV) instruction for licensed practical nurses. Following an introduction and a list of criteria for successful completion of IV therapy courses, the document lists tasks and…

VenUS IV (Venous leg Ulcer Study IV) - compression hosiery compared with compression bandaging in the treatment of venous leg ulcers: a randomised controlled trial, mixed-treatment comparison and decision-analytic model.

PubMed

Ashby, Rebecca L; Gabe, Rhian; Ali, Shehzad; Saramago, Pedro; Chuang, Ling-Hsiang; Adderley, Una; Bland, J Martin; Cullum, Nicky A; Dumville, Jo C; Iglesias, Cynthia P; Kang'ombe, Arthur R; Soares, Marta O; Stubbs, Nikki C; Torgerson, David J

2014-09-01

Compression is an effective and recommended treatment for venous leg ulcers. Although the four-layer bandage (4LB) is regarded as the gold standard compression system, it is recognised that the amount of compression delivered might be compromised by poor application technique. Also the bulky nature of the bandages might reduce ankle or leg mobility and make the wearing of shoes difficult. Two-layer compression hosiery systems are now available for the treatment of venous leg ulcers. Two-layer hosiery (HH) may be advantageous, as it has reduced bulk, which might enhance ankle or leg mobility and patient adherence. Some patients can also remove and reapply two-layer hosiery, which may encourage self-management and could reduce costs. However, little robust evidence exists about the effectiveness of two-layer hosiery for ulcer healing and no previous trials have compared two-layer hosiery delivering 'high' compression with the 4LB. Part I To compare the clinical effectiveness and cost-effectiveness of HH and 4LB in terms of time to complete healing of venous leg ulcers. Part II To synthesise the relative effectiveness evidence (for ulcer healing) of high-compression treatments for venous leg ulcers using a mixed-treatment comparison (MTC). Part III To construct a decision-analytic model to assess the cost-effectiveness of high-compression treatments for venous leg ulcers. Part I A multicentred, pragmatic, two-arm, parallel, open randomised controlled trial (RCT) with an economic evaluation. Part II MTC using all relevant RCT data - including Venous leg Ulcer Study IV (VenUS IV). Part III A decision-analytic Markov model. Part I Community nurse teams or services, general practitioner practices, leg ulcer clinics, tissue viability clinics or services and wound clinics within England and Northern Ireland. Part I Patients aged ≥ 18 years with a venous leg ulcer, who were willing and able to tolerate high compression. Part I Participants in the intervention group received HH. The control group received the 4LB, which was applied according to standard practice. Both treatments are designed to deliver 40 mmHg of compression at the ankle. Part II and III All relevant high-compression treatments including HH, the 4LB and the two-layer bandage (2LB). Part I The primary outcome measure was time to healing of the reference ulcer (blinded assessment). Part II Time to ulcer healing. Part III Quality-adjusted life-years (QALYs) and costs. Part I A total of 457 participants were recruited. There was no evidence of a difference in time to healing of the reference ulcer between groups in an adjusted analysis [hazard ratio (HR) 0.99, 95% confidence interval (CI) 0.79 to 1.25; p = 0.96]. Time to ulcer recurrence was significantly shorter in the 4LB group (HR = 0.56, 95% CI 0.33 to 0.94; p = 0.026). In terms of cost-effectiveness, using QALYs as the measure of benefit, HH had a > 95% probability of being the most cost-effective treatment based on the within-trial analysis. Part II The MTC suggests that the 2LB has the highest probability of ulcer healing compared with other high-compression treatments. However, this evidence is categorised as low to very low quality. Part III Results suggested that the 2LB had the highest probability of being the most cost-effective high-compression treatment for venous leg ulcers. Trial data from VenUS IV found no evidence of a difference in venous ulcer healing between HH and the 4LB. HH may reduce ulcer recurrence rates compared with the 4LB and be a cost-effective treatment. When all available high-compression treatments were considered, the 2LB had the highest probability of being clinically effective and cost-effective. However, the underpinning evidence was sparse and more research is needed. Further research should thus focus on establishing, in a high-quality trial, the effectiveness of this compression system in particular. Current Controlled Trials ISRCTN49373072. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 18, No. 57. See the NIHR Journals Library website for further project information.

Human Rehabilitation Techniques. Project Papers. Volume IV, Part B.

ERIC Educational Resources Information Center

Dudek, R. A.; And Others

Volume IV, Part B of a six-volume final report (which covers the findings of a research project on policy and technology related to rehabilitation of disabled individuals) presents a continuation of papers (Part A) giving an overview of project methodology, much of the data used in projecting consequences and policymaking impacts in project…

Underutilization of IV nitrates in the treatment of acute heart failure.

PubMed

Mohan, Mohapradeep; Hawkey, Sean; Baig, Fatima; Choy, Anna Maria; Lang, Chim C

2015-08-01

Acute heart failure (AHF) is a growing public health concern with high inhospital mortality and costs. Clinical practice guidelines, underpinned by positive randomized controlled trials, recommend the early use of intravenous (IV) nitrates in the treatment of AHF. However, the "real-world" usage of IV nitrates has not been clearly defined. The objective of this study was to examine the use of IV nitrates in the treatment of AHF as recommended by clinical practice guidelines. A case-record analysis was conducted of all admissions with AHF at a large teaching hospital. Of the 81 AHF patients (mean age 77 ± 11, mean SBP 130 ± 27 mmHg) enrolled for this analysis, only 5 (6%) received IV nitrates at the time of AHF admission. Forty (49%, mean age 77 ± 11, mean SBP 131 ± 27 mmHg) of these 81 patients met the guideline criteria for suitability for IV nitrates and only 5 (12%) of these received them during this admission. Patients who received IV nitrates were more likely to have higher blood pressure and all had myocardial ischemia as a precipitant. Seventy-five (93%) of the total population received loop diuretics on admission. Overall, this study shows that loop diuretics remain the first-line therapy in AHF with little use of IV nitrates, despite recommendations from clinical practice guidelines. © 2015 John Wiley & Sons Ltd.

COLLABORATE©, Part IV: Ramping Up Competency-Based Performance Management.

PubMed

Treiger, Teresa M; Fink-Samnick, Ellen

The purpose of this fourth part of the COLLABORATE© article series provides an expansion and application of previously presented concepts pertaining to the COLLABORATE paradigm of professional case management practice. The model is built upon a value-driven foundation that: PRIMARY PRACTICE SETTING(S):: Applicable to all health care sectors where case management is practiced. As an industry, health care continues to evolve. Terrain shifts and new influences continually surface to challenge professional case management practice. The need for top-performing and nimble professionals who are knowledgeable and proficient in the workplace continues to challenge human resource departments. In addition to care setting knowledge, professional case managers must continually invest in their practice competence toolbox to grow skills and abilities that transcend policies and processes. These individuals demonstrate agility in framing (and reframing) their professional practice to facilitate the best possible outcomes for their clients. Therefore, the continued emphasis on practice competence conveyed through the performance management cycle is an essential ingredient to performance management focused on customer service excellence and organizational improvement. Professional case management transcends professional disciplines, educational levels, and practice settings. Business objectives continue to drive work process and priorities in many practice settings. However, competencies that align with regulatory and accreditation requirements should be the critical driver for consistent, high-quality case management practice. Although there is inherent value in what various disciplines bring to the table, this advanced model unifies behind case management's unique, strengths-based identity instead of continuing to align within traditional divisions (e.g., discipline, work setting, population served). This model fosters case management's expanding career advancement opportunities.

Coordinator(a) de Servicios Clinicos. Parte I (Unidad I-IV). Parte II (Unidad V-VI). Guia. Documento de Trabajo (Clinical Services Coordinator. Part I. Units I-IV. Part II. Units V-VI. Guide. Working Document).

ERIC Educational Resources Information Center

Puerto Rico State Dept. of Education, Hato Rey. Area for Vocational and Technical Education.

This guide is intended for instructing secondary students in the occupation of clinical services coordinator in a hospital. The first part contains four units on the following subjects: the occupation of clinical services coordinator; interpersonal relationships; ethical/legal aspects; and communications (telephone, intercom, and others). For each…

KSC-2009-5275

NASA Image and Video Library

2009-10-01

CAPE CANAVERAL, Fla. – At NASA's Kennedy Space Center in Florida, volunteers portraying astronauts are loaded into a helicopter as part of a Mode II-IV exercise that allows teams to practice an emergency response at Launch Pad 39A, including helicopter evacuation to local hospitals. The exercise involves NASA fire rescue personnel, volunteers portraying astronauts with simulated injuries, helicopters and personnel from the Air Force’s 920th Rescue Wing and medical trauma teams at three central Florida hospitals. The Space Shuttle Program and U.S. Air Force are conducting the emergency simulation. Photo credit: NASA/Troy Cryder

KSC-2009-5271

NASA Image and Video Library

2009-10-01

CAPE CANAVERAL, Fla. – At NASA's Kennedy Space Center in Florida, volunteers portraying astronauts are taking part in a Mode II-IV exercise that allows teams to practice an emergency response at Launch Pad 39A, including helicopter evacuation to local hospitals. The exercise involves NASA fire rescue personnel, volunteers portraying astronauts with simulated injuries, helicopters and personnel from the Air Force’s 920th Rescue Wing and medical trauma teams at three central Florida hospitals. The Space Shuttle Program and U.S. Air Force are conducting the emergency simulation. Photo credit: NASA/Troy Cryder

KSC-2009-5276

NASA Image and Video Library

2009-10-01

CAPE CANAVERAL, Fla. – At NASA's Kennedy Space Center in Florida, volunteers portraying astronauts are transported to helicopters as part of a Mode II-IV exercise that allows teams to practice an emergency response at Launch Pad 39A, including helicopter evacuation to local hospitals. The exercise involves NASA fire rescue personnel, volunteers portraying astronauts with simulated injuries, helicopters and personnel from the Air Force’s 920th Rescue Wing and medical trauma teams at three central Florida hospitals. The Space Shuttle Program and U.S. Air Force are conducting the emergency simulation. Photo credit: NASA/Troy Cryder

KSC-2009-5273

NASA Image and Video Library

2009-10-01

CAPE CANAVERAL, Fla. – At NASA's Kennedy Space Center in Florida, volunteers and teams take part in a Mode II-IV exercise that allows teams to practice an emergency response at Launch Pad 39A, including helicopter evacuation to local hospitals. The exercise involves NASA fire rescue personnel, volunteers portraying astronauts with simulated injuries, helicopters and personnel from the Air Force’s 920th Rescue Wing and medical trauma teams at three central Florida hospitals. The Space Shuttle Program and U.S. Air Force are conducting the emergency simulation. Photo credit: NASA/Troy Cryder

KSC-2009-5285

NASA Image and Video Library

2009-10-01

CAPE CANAVERAL, Fla. – At NASA's Kennedy Space Center in Florida, volunteers portraying astronauts are transported to ambulances as part of a Mode II-IV exercise that allows teams to practice an emergency response at Launch Pad 39A, including helicopter evacuation to local hospitals. The exercise involves NASA fire rescue personnel, volunteers portraying astronauts with simulated injuries, helicopters and personnel from the Air Force’s 920th Rescue Wing and medical trauma teams at three central Florida hospitals. The Space Shuttle Program and U.S. Air Force are conducting the emergency simulation. Photo credit: NASA/Jack Pfaller

KSC-2009-5274

NASA Image and Video Library

2009-10-01

CAPE CANAVERAL, Fla. – At NASA's Kennedy Space Center in Florida, volunteers and teams take part in a Mode II-IV exercise that allows teams to practice an emergency response at Launch Pad 39A, including helicopter evacuation to local hospitals. The exercise involves NASA fire rescue personnel, volunteers portraying astronauts with simulated injuries, helicopters and personnel from the Air Force’s 920th Rescue Wing and medical trauma teams at three central Florida hospitals. The Space Shuttle Program and U.S. Air Force are conducting the emergency simulation. Photo credit: NASA/Troy Cryder

Clinical Neuropsychology in Integrated Rehabilitation Care Teams.

PubMed

Johnson-Greene, Doug

2018-05-01

Neuropsychologists have been an integral part of rehabilitation-oriented integrated care teams for some time and they provide care that is complimentary to other specialties, such as rehabilitation psychologists. Neuropsychologists are more likely than other specialties to offer objective cognitive data that includes consideration of emotional and behavioral features when assessing patients who have known or suspected brain injury or illness. Objective cognitive data is then often used for treatment and discharge planning as well as anticipating safety issues and impairment of functional skills. Unlike a consultative model, neuropsychologists in rehabilitation must work as part of a team of rehabilitation professionals and understand the contributions each specialty offers patients. This paper will highlight a number of issues pertaining to the practice of neuropsychology in rehabilitation settings including: (i) essential skills and duties, (ii) reimbursement, (iii) practice specifics, (iv) types of recommendations, (v) communication issues, (vi) impact of neuropsychological services, (vii) role satisfaction; (viii) advice for early career neuropsychologists, and (ix) a sample report.

Intravenous Fluid Therapy Course for the Licensed Practical Nurse. Instructor Guide.

ERIC Educational Resources Information Center

Missouri Univ., Columbia. Instructional Materials Lab.

This curriculum guide provides materials for a 10-unit intravenous (IV) therapy course for licensed practical nurses. Units contain from one to nine lessons. The first unit provides an introduction and orientation to the course. Subsequent units concern documentation, anatomy and physiology as applied to IV therapy, fundamental aspects of fluid…

A Review of Best Practices for Intravenous Push Medication Administration.

PubMed

Lenz, Janelle R; Degnan, Daniel D; Hertig, John B; Stevenson, James G

In 2015, the Institute for Safe Medication Practices (ISMP) released safe practice guidelines for adult intravenous (IV) push medications. ISMP's most recent set of guidelines has added to a growing list of recommendations from professional groups on the safe use of IV medications. These recommendations and guidelines vary with regard to their audience, scope, and terminology. In some ways, these variations may contribute to confusion and delayed adoption of the standards. This report attempts to provide clarity about the rationale and background regarding the need for practice improvement, discussion of various guidelines, and practice mitigation strategies to improve patient safety.

Goal setting and action planning in the rehabilitation setting: development of a theoretically informed practice framework.

PubMed

Scobbie, Lesley; Dixon, Diane; Wyke, Sally

2011-05-01

Setting and achieving goals is fundamental to rehabilitation practice but has been criticized for being a-theoretical and the key components of replicable goal-setting interventions are not well established. To describe the development of a theory-based goal setting practice framework for use in rehabilitation settings and to detail its component parts. Causal modelling was used to map theories of behaviour change onto the process of setting and achieving rehabilitation goals, and to suggest the mechanisms through which patient outcomes are likely to be affected. A multidisciplinary task group developed the causal model into a practice framework for use in rehabilitation settings through iterative discussion and implementation with six patients. Four components of a goal-setting and action-planning practice framework were identified: (i) goal negotiation, (ii) goal identification, (iii) planning, and (iv) appraisal and feedback. The variables hypothesized to effect change in patient outcomes were self-efficacy and action plan attainment. A theory-based goal setting practice framework for use in rehabilitation settings is described. The framework requires further development and systematic evaluation in a range of rehabilitation settings.

Independent Examination of the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV): What Does the WAIS-IV Measure?

ERIC Educational Resources Information Center

Benson, Nicholas; Hulac, David M.; Kranzler, John H.

2010-01-01

Published empirical evidence for the Wechsler Adult Intelligence Scale--Fourth Edition (WAIS-IV) does not address some essential questions pertaining to the applied practice of intellectual assessment. In this study, the structure and cross-age invariance of the latest WAIS-IV revision were examined to (a) elucidate the nature of the constructs…

The Education of Royalty in the Eighteenth Century: George IV and William IV

ERIC Educational Resources Information Center

Clarke, M. L.

1978-01-01

George IV, the Prince of Wales, and William IV, his younger brother, both the sons of George III, were given all the educational advantage one could be granted in the eighteenth century. The precise curriculum and practices of their teachers are discussed with an evaluation of both students as a moral for future consideration. (RK)

20 CFR 634.3 - Eligible recipients.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR LABOR MARKET INFORMATION PROGRAMS UNDER TITLE IV, PART E OF THE JOB TRAINING PARTNERSHIP ACT Comprehensive Labor Market Information System § 634.3 Eligible recipients. (a) For funds appropriated pursuant to JTPA title IV, part E...

Current management practices and interventions prioritised as part of a nationwide mastitis control plan

PubMed Central

Bradley, A. J.; Breen, J. E.; Hudson, C. D.; Green, M. J.

2016-01-01

The objectives of this study were to report performance and management data taken from a sample of UK dairy farms that have participated in the Agriculture and Horticulture Development Board Dairy Mastitis Control Plan (DMCP) and to identify important mastitis prevention practices that are not currently widely implemented. A total of 234 UK dairy herds were included in the study from which farm management and udder health data were collected. Herds were grouped according to their mastitis epidemiology and could be classed as (i) environmental dry period (EDP) (i.e. environmental pathogen with majority of infections being acquired during the dry period), (ii) environmental lactation (EL), (iii) contagious dry period (CDP) or (iv) contagious lactation (CL). The results of this study showed that many mastitis-related management practices that are generally considered to be important were not widely performed. A better understanding of those practices not widely adopted by UK dairy farmers at present may aid practitioners in identifying and overcoming potential barriers to improved mastitis control. PMID:26966249

76 FR 22878 - Defense Transportation Regulation, Part IV

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-25

... Military Services, DFAS and SDDC. In addition, the proposed electronic billing processes will compliment... in the Defense Transportation Regulation (DTR) Part IV (DTR 4500.9R). This process proposes mandatory... Transportation Service Providers (TSP). Implementation of electronic payments for NTS at all Military Services...

Dielectric Constant and Loss Data Part 2

DTIC Science & Technology

1975-12-01

fluoride, single crystal, Melamine - formaldehyde resins , Columbia Univ., P.R.-75 IV-21,22,112; V-8,88 Manganese-magnesium ferrite, Melamine GMG, IV-2i...butylperoxy) Urea - formaldehyde resins , IV-23 hexane, P.R.-197 U.S. Army Engineering Research and War Dept., Picatinny Arsenal, see Dev. Lab., Fort...IV.-36 irradiated, P.R,-161 "Bakelite" polyvinyl chloride- "Amplifilm," IV-14; V-74 acetate, see "Vinylites" Axiiliine- formaldehyde resins , IV-21

48 CFR 1315.204-570 - Part IV representations and instructions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Part IV representations and instructions. 1315.204-570 Section 1315.204-570 Federal Acquisition Regulations System DEPARTMENT.... Contracting officers shall tailor the provision to suit their acquisition. (3) The contracting officer shall...

48 CFR 1315.204-570 - Part IV representations and instructions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Part IV representations and instructions. 1315.204-570 Section 1315.204-570 Federal Acquisition Regulations System DEPARTMENT.... Contracting officers shall tailor the provision to suit their acquisition. (3) The contracting officer shall...

48 CFR 1315.204-570 - Part IV representations and instructions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Part IV representations and instructions. 1315.204-570 Section 1315.204-570 Federal Acquisition Regulations System DEPARTMENT.... Contracting officers shall tailor the provision to suit their acquisition. (3) The contracting officer shall...

48 CFR 1315.204-570 - Part IV representations and instructions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Part IV representations and instructions. 1315.204-570 Section 1315.204-570 Federal Acquisition Regulations System DEPARTMENT.... Contracting officers shall tailor the provision to suit their acquisition. (3) The contracting officer shall...

48 CFR 1315.204-570 - Part IV representations and instructions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 5 2012-10-01 2012-10-01 false Part IV representations and instructions. 1315.204-570 Section 1315.204-570 Federal Acquisition Regulations System DEPARTMENT.... Contracting officers shall tailor the provision to suit their acquisition. (3) The contracting officer shall...

Enter the Madcap Prince of Wales: Students Directing "Henry IV, Part I."

ERIC Educational Resources Information Center

Earthman, Elise Ann

1993-01-01

Argues that William Shakespeare's "Henry IV, Part I" is an appropriate and useful text for secondary English classrooms. Shows how the play lends itself to performance-based instruction. Outlines ways of accomplishing student engagement, using film versions, and assigning written work. (HB)

78 FR 18325 - Defense Transportation Regulation, Part IV

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-26

... received in connection with the Defense Personal Property Program (DP3) Phase III Direct Procurement Method... at http://www.transcom.mil/dtr/part-iv/phaseiii.cfm (DPM SECTION). All identified changes will be... Defense Personal Property System (DPS) Phase III programming projected for FY17. FOR FURTHER INFORMATION...

20 CFR 410.101 - Introduction.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV.... The regulations in this part 410 (Regulation No. 10 of the Social Security Administration) relate to the provisions of part B (Black Lung Benefits) of title IV of the Federal Coal Mine Health and Safety...

In-vehicle signing concepts: An analytical precursor to an in-vehicle information system

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

Spelt, P.F.; Tufano, D.R.; Knee, H.E.

The purpose of the project described in this report is to develop alternative In-Vehicle Signing (IVS) system concepts based on allocation of the functions associated with driving a road vehicle. In the driving milieu, tasks can be assigned to one of three agents, the driver, the vehicle or the infrastructure. Assignment of tasks is based on a philosophy of function allocation which can emphasize any of several philosophical approaches. In this project, function allocations were made according to the current practice in vehicle design and signage as well as a human-centered strategy. Several IVS system concepts are presented based onmore » differing functional allocation outcomes. A design space for IVS systems is described, and a technical analysis of a map-based and sever beacon-based IVS systems are presented. Because of problems associated with both map-based and beacon-based concepts, a hybrid IVS concept was proposed. The hybrid system uses on-board map-based databases to serve those areas in which signage can be anticipated to be relatively static, such as large metropolitan areas where few if any new roads will be built. For areas where sign density is low, and/or where population growth causes changes in traffic flow, beacon-based concepts function best. For this situation, changes need only occur in the central database from which sign information is transmitted. This report presents system concepts which enable progress from the IVS system concept-independent functional requirements to a more specific set of system concepts which facilitate analysis and selection of hardware and software to perform the functions of IVS. As such, this phase of the project represents a major step toward the design and development of a prototype WS system. Once such a system is developed, a program of testing, evaluation, an revision will be undertaken. Ultimately, such a system can become part of the road vehicle of the future.« less

45 CFR 310.40 - What requirements apply for accessing systems and records for monitoring Computerized Tribal IV-D...

Code of Federal Regulations, 2010 CFR

2010-10-01

... records for monitoring Computerized Tribal IV-D Systems and Office Automation? 310.40 Section 310.40... COMPUTERIZED TRIBAL IV-D SYSTEMS AND OFFICE AUTOMATION Accountability and Monitoring Procedures for... monitoring Computerized Tribal IV-D Systems and Office Automation? In accordance with Part 95 of this title...

Quality assurance, an administrative means to a managerial end: Part IV.

PubMed

Clark, G B

1992-01-01

This is the fourth and final part of a series of articles on laboratory quality surveillance. Part I addressed the historical background of medical quality assurance. Part II covered surveillance guidelines of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the College of American Pathologists with emphasis on quality assurance (QA) and the ten-step process. Part III focused on the JCAHO transition from QA to quality assessment and improvement. Part IV concludes the series by discussing the systematic identification of quality indicators in the total quality management and continuous quality improvement environment.

KSC-2009-5270

NASA Image and Video Library

2009-10-01

CAPE CANAVERAL, Fla. – At NASA's Kennedy Space Center in Florida, volunteers portraying astronauts are helped with the launch-and-entry suits. The volunteers are taking part in a Mode II-IV exercise that allows teams to practice an emergency response at Launch Pad 39A, including helicopter evacuation to local hospitals. The exercise involves NASA fire rescue personnel, volunteers portraying astronauts with simulated injuries, helicopters and personnel from the Air Force’s 920th Rescue Wing and medical trauma teams at three central Florida hospitals. The Space Shuttle Program and U.S. Air Force are conducting the emergency simulation. Photo credit: NASA/Troy Cryder

KSC-2009-5284

NASA Image and Video Library

2009-10-01

CAPE CANAVERAL, Fla. – At NASA's Kennedy Space Center in Florida, volunteers portraying astronauts are transported to and from a triage site as part of a Mode II-IV exercise that allows teams to practice an emergency response at Launch Pad 39A, including helicopter evacuation to local hospitals. The exercise involves NASA fire rescue personnel, volunteers portraying astronauts with simulated injuries, helicopters and personnel from the Air Force’s 920th Rescue Wing and medical trauma teams at three central Florida hospitals. The Space Shuttle Program and U.S. Air Force are conducting the emergency simulation. Photo credit: NASA/Jack Pfaller

40 CFR 52.2465 - Original identification of plan section.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., 2FSD, and pre-dryer 3FSD from Part IV, Rule EX-4, Section 4.41(i) until December 15, 1981, submitted on...) Appendix K (7) Appendix N (8) Appendix P (9) Appendix R I., II.B., II.D., II.E., II.F., II.G., II.H., II.I...) Amendments to Part I, Subpart 1.01 (Certain Terms Defined) and to Part IV, Section 4.52 (former Section 4.705...

Mariner IV Mission to Mars. Part I

NASA Technical Reports Server (NTRS)

James, Jack N.

1965-01-01

This technical report is a series of individual papers documenting the Mariner-Mars project from its beginning in 1962 following the successful Mariner-Venus mission. Part I is pre-encounter data. It includes papers on the design, development, and testing of Mariner IV, as well as papers detailing methods of maintaining communication with and obtaining data from the spacecraft during flight, and expected results during encounter with Mars. Part 11, post-encounter data, to be published later, will consist of documentation of the events taking place during Mariner IV's encounter with Mars and thereafter. The Mariner-Mars mission, the culmination of an era of spacecraft development, has contributed much new technology to be used in future projects.

Variation in intravenous iron use internationally and over time: the Dialysis Outcomes and Practice Patterns Study (DOPPS).

PubMed

Bailie, George R; Larkina, Maria; Goodkin, David A; Li, Yun; Pisoni, Ronald L; Bieber, Brian; Mason, Nancy; Tong, Lin; Locatelli, Francesco; Marshall, Mark R; Inaba, Masaki; Robinson, Bruce M

2013-10-01

To examine patterns of intravenous (IV) iron use across 12 countries from 1999 to 2011. Trends in iron use are described among 32 192 hemodialysis (HD) patients in the Dialysis Outcomes and Practice Patterns Study. Adjusted associations of IV iron dose with serum ferritin and transferrin saturation (TSAT) values were also studied. IV iron was administered to 50% of patients over 4 months in 1999, increasing to 71% during 2009-11, with increasing use in most countries. Among patients receiving IV iron, the mean monthly dose increased from 232 ± 167 to 281 ± 211 mg. Most countries used 3 to 4 doses/month, but Canada used about 2 doses/month, Italy increased from 3 to almost 6 doses/month and Germany used 5 to 6 doses/month. The USA and most European countries predominantly used iron sucrose and sodium ferric gluconate. A significant use of iron dextran was limited to Canada and France; iron polymaltose was used in Australia and New Zealand; and Japan used ferric oxide saccharate, chondroitin polysulfate iron complex and cideferron. Ferritin values rose in most countries: 22% of patients had ≥ 800 ng/mL in the recent years of study. TSAT levels increased to a lesser degree over time. Japan had much lower IV iron dosing and ferritin levels, but similar TSAT levels. In adjusted analyses, serum ferritin and TSAT levels increased signifcantly by 14 ng/mL and 0.16%, respectively, for every 100 mg/month higher mean monthly iron dose. IV iron prescription patterns varied between countries and changed over time from 1999 to 2011. IV iron use and dose increased in most countries, with notable increases in ferritin but not TSAT levels. With rising cumulative IV iron doses, studies of the effects of changing IV iron dosing and other anemia management practices on clinical outcomes should be a high priority.

77 FR 41891 - Airworthiness Directives; Gulfstream Aerospace Corporation Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-17

....regulations.gov ; or in person at the Docket Management Facility between 9 a.m. and 5 p.m., Monday through... surface (ailerons, rudder, and elevator) and corrective actions if necessary. The customer bulletins also... mils). For Model G-IV airplanes: Gulfstream IV Customer Bulletin 223, including Part I and Part II...

Shunt resistance and saturation current determination in CdTe and CIGS solar cells. Part 2: application to experimental IV measurements and comparison with other methods

NASA Astrophysics Data System (ADS)

Rangel-Kuoppa, Victor-Tapio; Albor-Aguilera, María-de-Lourdes; Hérnandez-Vásquez, César; Flores-Márquez, José-Manuel; Jiménez-Olarte, Daniel; Sastré-Hernández, Jorge; González-Trujillo, Miguel-Ángel; Contreras-Puente, Gerardo-Silverio

2018-04-01

In this Part 2 of this series of articles, the procedure proposed in Part 1, namely a new parameter extraction technique of the shunt resistance (R sh ) and saturation current (I sat ) of a current-voltage (I-V) measurement of a solar cell, within the one-diode model, is applied to CdS-CdTe and CIGS-CdS solar cells. First, the Cheung method is used to obtain the series resistance (R s ) and the ideality factor n. Afterwards, procedures A and B proposed in Part 1 are used to obtain R sh and I sat . The procedure is compared with two other commonly used procedures. Better accuracy on the simulated I-V curves used with the parameters extracted by our method is obtained. Also, the integral percentage errors from the simulated I-V curves using the method proposed in this study are one order of magnitude smaller compared with the integral percentage errors using the other two methods.

45 CFR 309.150 - What start-up costs are allowable for Tribal IV-D programs carried out under § 309.65(b) of this...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false What start-up costs are allowable for Tribal IV-D... ENFORCEMENT (IV-D) PROGRAM Tribal IV-D Program Funding § 309.150 What start-up costs are allowable for Tribal IV-D programs carried out under § 309.65(b) of this part? Federal funds are available for costs of...

Thai Undergraduate Chemistry Practical Learning Experiences Using the Jigsaw IV Method

ERIC Educational Resources Information Center

Jansoon, Ninna; Somsook, Ekasith; Coll, Richard K.

2008-01-01

The research reported in this study consisted of an investigation of student learning experiences in Thai chemistry laboratories using the Jigsaw IV method. A hands-on experiment based on the Jigsaw IV method using a real life example based on green tea beverage was designed to improve student affective variables for studying topics related to…

Instrumental variable specifications and assumptions for longitudinal analysis of mental health cost offsets.

PubMed

O'Malley, A James

2012-12-01

Instrumental variables (IVs) enable causal estimates in observational studies to be obtained in the presence of unmeasured confounders. In practice, a diverse range of models and IV specifications can be brought to bear on a problem, particularly with longitudinal data where treatment effects can be estimated for various functions of current and past treatment. However, in practice the empirical consequences of different assumptions are seldom examined, despite the fact that IV analyses make strong assumptions that cannot be conclusively tested by the data. In this paper, we consider several longitudinal models and specifications of IVs. Methods are applied to data from a 7-year study of mental health costs of atypical and conventional antipsychotics whose purpose was to evaluate whether the newer and more expensive atypical antipsychotic medications lead to a reduction in overall mental health costs.

24 CFR Appendix IV to Subpart B of... - Promissory Note for Payment upon Resale by Homebuyer at Profit

Code of Federal Regulations, 2011 CFR

2011-04-01

... Turnkey III Program Description Pt. 904, Subpt. B, App. IV Appendix IV to Subpart B of Part 904—Promissory... of (1) the Homeowner's purchase price, (2) the costs incidental to his acquisition of ownership, (3...

24 CFR Appendix IV to Subpart B of... - Promissory Note for Payment upon Resale by Homebuyer at Profit

Code of Federal Regulations, 2010 CFR

2010-04-01

... Turnkey III Program Description Pt. 904, Subpt. B, App. IV Appendix IV to Subpart B of Part 904—Promissory... of (1) the Homeowner's purchase price, (2) the costs incidental to his acquisition of ownership, (3...

Undergraduate medical textbooks do not provide adequate information on intravenous fluid therapy: a systematic survey and suggestions for improvement.

PubMed

Powell, Arfon G M T; Paterson-Brown, Simon; Drummond, Gordon B

2014-02-20

Inappropriate prescribing of intravenous (IV) fluid, particularly 0.9% sodium chloride, causes post-operative complications. Fluid prescription is often left to junior medical staff and is frequently poorly managed. One reason for poor intravenous fluid prescribing practices could be inadequate coverage of this topic in the textbooks that are used. We formulated a comprehensive set of topics, related to important common clinical situations involving IV fluid therapy, (routine fluid replacement, fluid loss, fluids overload) to assess the adequacy of textbooks in common use. We assessed 29 medical textbooks widely available to students in the UK, scoring the presence of information provided by each book on each of the topics. The scores indicated how fully the topics were considered: not at all, partly, and adequately. No attempt was made to judge the quality of the information, because there is no consensus on these topics. The maximum score that a book could achieve was 52. Three of the topics we chose were not considered by any of the books. Discounting these topics as "too esoteric", the maximum possible score became 46. One textbook gained a score of 45, but the general score was poor (median 11, quartiles 4, 21). In particular, coverage of routine postoperative management was inadequate. Textbooks for undergraduates cover the topic of intravenous therapy badly, which may partly explain the poor knowledge and performance of junior doctors in this important field. Systematic revision of current textbooks might improve knowledge and practice by junior doctors. Careful definition of the remit and content of textbooks should be applied more widely to ensure quality and "fitness for purpose", and avoid omission of vital knowledge.

Undergraduate medical textbooks do not provide adequate information on intravenous fluid therapy: a systematic survey and suggestions for improvement

PubMed Central

2014-01-01

Background Inappropriate prescribing of intravenous (IV) fluid, particularly 0.9% sodium chloride, causes post-operative complications. Fluid prescription is often left to junior medical staff and is frequently poorly managed. One reason for poor intravenous fluid prescribing practices could be inadequate coverage of this topic in the textbooks that are used. Methods We formulated a comprehensive set of topics, related to important common clinical situations involving IV fluid therapy, (routine fluid replacement, fluid loss, fluids overload) to assess the adequacy of textbooks in common use. We assessed 29 medical textbooks widely available to students in the UK, scoring the presence of information provided by each book on each of the topics. The scores indicated how fully the topics were considered: not at all, partly, and adequately. No attempt was made to judge the quality of the information, because there is no consensus on these topics. Results The maximum score that a book could achieve was 52. Three of the topics we chose were not considered by any of the books. Discounting these topics as “too esoteric”, the maximum possible score became 46. One textbook gained a score of 45, but the general score was poor (median 11, quartiles 4, 21). In particular, coverage of routine postoperative management was inadequate. Conclusions Textbooks for undergraduates cover the topic of intravenous therapy badly, which may partly explain the poor knowledge and performance of junior doctors in this important field. Systematic revision of current textbooks might improve knowledge and practice by junior doctors. Careful definition of the remit and content of textbooks should be applied more widely to ensure quality and “fitness for purpose”, and avoid omission of vital knowledge. PMID:24555812

A model of ergonomics intervention in industry: case study in Japan.

PubMed

Chavalitsakulchai, P; Ohkubo, T; Shahnavaz, H

1994-06-01

This paper presents the results of an ergonomics survey in four different Japanese work places. The survey consisted of two parts. In the first part, the physical and psycho-social problems of the female workers were investigated. Questionnaire techniques were used to assess musculoskeletal disorders in various parts of the body and of psycho-social stress at work as well as in the daily life situation. Furthermore, work posture analysis, task analysis, simple clinical tests and flexibility tests were conducted. In the second part, the ergonomics intervention practices in different types of Japanese work places were examined. Three different questionnaires were developed and used to collect information from representatives of employees, management and responsible governmental agents of the Department of Industrial Safety and Health, Ministry of Labor, with regard to ergonomic interventions at work places. Management, employees, and government representatives expressed desire for cooperation and participation for arrangement of the ergonomics intervention program. A model for appropriate ergonomics intervention in industry is developed with regard to physical and psycho-social problems at work. Factors influencing worker participation and the establishment of a dynamic system of ergonomics intervention at work places are discussed. Practical ways for improving the working conditions of female workers are: (i) cooperation between managers, workers, and government officers is regarded as vital for the ergonomics intervention program, (ii) worker participation, (iii) appropriate training course with regard to ergonomics education, and (iv) managerial support.

76 FR 5811 - Adjusted Federal Medical Assistance Percentage (FMAP) Rate for the First Quarter of Fiscal Year...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-02

.... The increased FMAP is available for expenditures under part E of title IV (including Foster Care... temporary increase in FMAP rates for Medicaid and title IV-E Foster Care, Adoption Assistance and... are not part of the calculation process. Expenditures for which the increased FMAP is not available...

Tin Whisker Risk Assessment of TDRSS IV Transponder Units 101 and 102

NASA Technical Reports Server (NTRS)

Zellitti, Ron; Royse, Jeff; Jackson, Steve

2000-01-01

This report documents the plating requirements for the electrical and mechanical parts used in the TDRSS IV transponder manufactured by MOTOROLA, INC., SSG, SSSD. The intent of this report is to identify any electrical, electromechanical or mechanical part that does not have adequate requirements to prevent the use of a pure tin finish.

77 FR 70373 - Cost of Living Adjustment to Satellite Carrier Compulsory License Royalty Rates

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-26

... ROYALTY FEES FOR SECONDARY TRANSMISSIONS BY SATELLITE CARRIERS 0 1. The authority citation for part 386... revising paragraphs (b)(1)(iv) and (b)(2)(iv) as follows: Sec. 386.2 Royalty fee for secondary transmission... LIBRARY OF CONGRESS Copyright Royalty Board 37 CFR Part 386 [Docket No. 2012-8 CRB Satellite COLA...

Actively Experiencing Shakespeare: Students "Get on Their Feet" for "Henry IV, Part One."

ERIC Educational Resources Information Center

Meyer, Herbert M.; Thomsen, Lee

1999-01-01

Discusses how a literature and multimedia course for 11th and 12th graders used active-learning experiences to engage students with Shakespeare's "Henry IV, Part One." Describes how shouting Hal's soliloquy; constructing a chart of character relations; rewriting a scene in their own words; performing, filming, and critiquing a scene; and…

Projects and Programs: Libraries and Learning Resources-1978-1979. Standards ESEA IV, PART B.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Bureau of School Libraries.

These standards are intended to assist local school districts in New York State in selecting educational resources and audiovisual equipment and in providing for testing, guidance, and counseling services under Title IV, Part B of the Elementary and Secondary Education Act. The main purpose of the standards is to establish qualitative and…

Availability and Use of Medical Isotopes in Canada - Performed as part of a Radiological Terrorism Risk Assessment

DTIC Science & Technology

2004-12-01

placenta localization 1. Chromic chloride 2. Chromium disodium edetate 3. Labeled human serum albumin 4. Sodium chromate labeled red blood cells...orally 4. Iodinated fibrinogen, i.v. or in vitro 5. Iodinated human serum albumin (IHSA) 6. Iodinated levothyroxine , i.v. or in vitro 7...Iodinated liothyronine, in vitro 8. Iodinated povidone, i.v. 9. Iodinated rose Bengal, i.v. 10. Sodium iodide, orally or i.v. 5. 0.74 MBq (0.02 mCi

Practical Clinical Training in Skills Labs: Theory and Practice

PubMed Central

Bugaj, T. J.; Nikendei, C.

2016-01-01

Today, skills laboratories or “skills labs”, i.e. specific practical skill training facilities, are a firmly established part of medical education offering the possibility of training clinical procedures in a safe and fault-forging environment prior to real life application at bedside or in the operating room. Skills lab training follows a structured teaching concept, takes place under supervision and in consideration of methodological-didactic concepts, ideally creating an atmosphere that allows the repeated, anxiety- and risk-free practice of targeted skills. In this selective literature review, the first section is devoted to (I) the development and dissemination of the skills lab concept. There follows (II) an outline of the underlying idea and (III) an analysis of key efficacy factors. Thereafter, (IV) the training method’s effectiveness and transference are illuminated, before (V) the use of student tutors, in the sense of peer-assisted-learning, in skills labs is discussed separately. Finally, (VI) the efficiency of the skills lab concept is analyzed, followed by an outlook on future developments and trends in the field of skills lab training. PMID:27579363

Installation Restoration Program. Phase I. Records. Loring AFB, Maine.

DTIC Science & Technology

1984-01-01

forest, mixed forest, forested bogs, streams, and ponds. Managed timber lands total 4,635 acres on Loring AFB. Major harvested tree species include...Habitat 111-22 2. Threatened and Endangered Species 111-23 IV. FINDINGS IV-1 A. Activity Review IV-l 1. Industrial Waste Disposal Practices IV-1 2...Site No. 13, the BX Service Station, a number of cedar trees in the area of the fuel-saturated soil appear to have been dead for several years. 3

DIVWAG Model Documentation. Volume II. Programmer/Analyst Manual. Part 4.

DTIC Science & Technology

1976-07-01

Model Constant Data Deck Structure . .. .... IV-13-A-40 Appendix B. Movement Model Program Descriptions . .. .. . .IV-13-B-1 1. Introduction...Data ................ IV-15-A-17 11. Airmobile Constant Data Deck Structure .. ...... .. IV-15-A-30 Appendix B. Airmobile Model Program Descriptions...Make no changes. 12. AIRMOBILE CONSTANT DATA DECK STRUCTURE . The deck structure required by the Airmobile Model constant data load program and the data

[Crops: Classifying, Selecting, Harvesting, Grading, and Packing.] Student Materials. V.A. III. [IV-B-1 through IV-B-2; IV-C-1 through IV-C-2].

ERIC Educational Resources Information Center

Texas A and M Univ., College Station. Vocational Instructional Services.

Part of a series of eight student learning modules in vocational agriculture, this booklet deals with crop-related activities. The first section is on harvesting methods and equipment. The following portions address the handling, grading, and packing of crops; and the classification and selection of fruits, vegetables, and ornamental plants. There…

Venous envy: the post-World War II debate over IV nursing.

PubMed

Sandelowski, M

1999-09-01

After World War II, a debate ensued over whether nurses should perform intravenous (IV) therapy. The debate was resolved by permitting nurses to do venipunctures as physicians' agents and by recirculating the familiar tautology: if nurses were already doing venipunctures, they must be simple enough for nurses to do. The vein was a portal of entry for nurses, but one with limited access. What was ultimately ceded to nurses was not full jurisdiction over a domain of nursing practice, but rather a limited settlement in a domain of medical practice. The debate over IV therapy demonstrated how technology, in combination with ideology, can both create and destroy nursing jurisdictions.

Helping General Physical Educators and Adapted Physical Educators Address the Office of Civil Rights Dear Colleague Guidance Letter: Part IV--Sport Groups

ERIC Educational Resources Information Center

Lieberman, Lauren; Lucas, Mark; Jones, Jeffery; Humphreys, Dan; Cody, Ann; Vaughn, Bev; Storms, Tommie

2013-01-01

"Helping General Physical Educators and Adapted Physical Educators Address the Office of Civil Rights Dear Colleague Guidance Letter: Part IV--Sport Groups" provides the the following articles: (1) "Sport Programming Offered by Camp Abilities and the United States Association for Blind Athletes" (Lauren Lieberman and Mark…

Kidney diseases caused by glomerular basement membrane type IV collagen defects in dogs.

PubMed

Lees, George E

2013-01-01

To review the pathogenesis, as well as the clinical and pathologic features of canine glomerular diseases caused by genetic type IV collagen defects. Original studies and review articles from human and veterinary medical fields. Presence in glomerular basement membranes (GBM) of a network composed of α3.α4.α5 heterotrimers of type IV collagen is required to maintain structure and function of glomerular capillary walls. Hereditary nephropathy (HN) is the most commonly used name for kidney diseases that occur in dogs due to genetic type IV collagen abnormalities. To date, 4 different collagen IV gene mutations have been identified in dogs with HN; 2 are COL4A5 mutations that cause X-linked HN (XL-HN), and 2 are COL4A4 mutations that cause autosomal recessive HN (AR-HN). Affected males with XL-HN and affected males and females with AR-HN develop juvenile-onset kidney disease manifested by proteinuria typically starting at 3-6 months of age and followed by progressive kidney disease leading to terminal failure usually at 6-24 months of age. Carrier female dogs with XL-HN also develop proteinuria starting at 3-6 months of age, but progressive disease causing kidney failure is uncommon until they are >5 years old. The distinctive pathologic lesions of HN are extensive multilaminar splitting and thickening of the GBM, as demonstrated by electron microscopy, and abnormal type IV collagen α-chain content of basement membranes, as demonstrated by immunolabeling. Identification of the underlying gene mutations has permitted genetic testing and selective breeding practices that currently are minimizing HN in breeds known to be at risk. Canine HN is a rare disease that should be considered whenever a dog exhibits a juvenile-onset kidney disease characterized partly by proteinuria, but highly specialized methods are required to pursue a definitive diagnosis. © Veterinary Emergency and Critical Care Society 2013.

Extraction of Carbon Dioxide and Hydrogen from Seawater by an Electrochemical Acidification Cell. Part 4. Electrode Compartments of Cell Modified and Tested in Scaled-Up Mobile Unit

DTIC Science & Technology

2013-09-03

Electrochemical Acidification Cell Part IV: Electrode Compartments of Cell Modified and Tested in Scaled-Up Mobile Unit September 3, 2013 Approved for public...OF ABSTRACT Extraction of Carbon Dioxide and Hydrogen from Seawater by an Electrochemical Acidification Cell Part IV: Electrode Compartments of Cell...Electrochemical acidification cell Carbon dioxide Hydrogen Polarity reversal An electrochemical acidification cell was scaled-up and integrated into a

The fiduciary obligation of the physician-researcher in phase IV trials

PubMed Central

2014-01-01

Background In this manuscript, we argue that within the context of phase IV, physician-researchers retain their fiduciary obligation to treat the patient-participants. Discussion We first clarify why the perspective that research ethics ought to be differentiated from clinical ethics is not applicable in phase IV, and therefore, why therapeutic orientation is most convivial in this phase. Next, assuming that ethics guidelines may be representative of common morality, we show that ethics guidelines see physician-researchers primarily as physicians and only secondarily as researchers. We then elaborate on what a fiduciary obligation is and how some of the obligations are default duties. Lastly, we look at the fiduciary obligation of the physician-researcher in phase IV interventional trials. Conclusion The fiduciary obligation to treat is not as easily waived as in earlier trials. Assuming the entwinement of research and practice in phase IV, physician-researchers, in collaboration with other researchers, investigators, and research ethics committees, should ensure that in terms of study design, methodology, and research practice, the therapeutic value of the research to the patient-participants is not diminished. PMID:24507449

49 CFR 240.125 - Criteria for testing knowledge.

Code of Federal Regulations, 2010 CFR

2010-10-01

... practices for the safe operation of trains. (c) The testing methods selected by the railroad shall be: (1) Designed to examine a person's knowledge of the railroad's rules and practices for the safe operation of...) Personal safety practices; (ii) Operating practices; (iii) Equipment inspection practices; (iv) Train...

20 CFR 410.591 - Eligibility for services and supplies under part C of title IV of the act.

Code of Federal Regulations, 2010 CFR

2010-04-01

... ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Payment of... DOL regulations covering the time period in which the miner must file with DOL for these benefits are published at 20 CFR part 725. (Sec. 411, Federal Coal Mine Health and Safety Act of 1969, as amended; 85...

Financial Analysis and Mathematics of Business: Part IV in a Series--Preparation for Certified Professional Secretary Examination. An Instructor's Guide for an Adult Course.

ERIC Educational Resources Information Center

Gonyea, Adrian C.

The instructor's guide provides a review for those preparing to take Part IV of the Certified Professional Secretary (CPS) examination. Course content can also help secretaries update their skills in accounting and business mathematics. Organized into lessons with objectives, content outline, and teaching suggestions and references, the units…

20 CFR Appendix IV to Subpart C of... - Earnings Needed for a Year of Coverage After 1950

Code of Federal Regulations, 2010 CFR

2010-04-01

... 1950 IV Appendix IV to Subpart C of Part 404 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Computing Primary Insurance Amounts Pt. 404... Minimum Social Security Earnings to Qualify for a Year of Coverage After 1950 for Purposes of the— Year...

Compliance with a pediatric clinical practice guideline for intravenous fluid and electrolyte administration.

PubMed

Hurdowar, Amanda; Urmson, Lynn; Bohn, Desmond; Geary, Denis; Laxer, Ronald; Stevens, Polly

2009-01-01

The occurrence of acute hyponatremia associated with cerebral edema in hospitalized children has been increasingly recognized, with over 50 cases of neurological morbidity and mortality reported in the past decade. This condition most commonly occurs in previously healthy children where maintenance intravenous (IV) fluids have been prescribed in the form of hypotonic saline (e.g., 0.2 or 0.3 NaCl). In response to similar problems at The Hospital for Sick Children (six identified through hospital morbidity and mortality reviews and safety reports prior to fall 2007), an interdisciplinary clinician group from our institution developed a clinical practice guideline (CPG) to guide fluid and electrolyte administration for pediatric patients. This article reviews the evaluation of one patient safety improvement to change the prescribing practice for IV fluids in an acute care pediatric hospital, including the removal of the ability to prescribe hypotonic IV solutions with a sodium concentration of < 75 mmol/L. The evaluation of key components of the CPG included measuring practice and process changes pre- and post-implementation. The evaluation showed that the use of restricted IV fluids was significantly reduced across the organization. Success factors of this safety initiative included the CPG development, forcing functions, reminders, team engagement and support from the hospital leadership. A key learning was that a project leader with considerable dedicated time is required during the implementation to develop change concepts, organize and liaise with stakeholders and measure changes in practice. This project highlights the importance of active implementation for policy and guideline documents.

Instrumental variable methods in comparative safety and effectiveness research.

PubMed

Brookhart, M Alan; Rassen, Jeremy A; Schneeweiss, Sebastian

2010-06-01

Instrumental variable (IV) methods have been proposed as a potential approach to the common problem of uncontrolled confounding in comparative studies of medical interventions, but IV methods are unfamiliar to many researchers. The goal of this article is to provide a non-technical, practical introduction to IV methods for comparative safety and effectiveness research. We outline the principles and basic assumptions necessary for valid IV estimation, discuss how to interpret the results of an IV study, provide a review of instruments that have been used in comparative effectiveness research, and suggest some minimal reporting standards for an IV analysis. Finally, we offer our perspective of the role of IV estimation vis-à-vis more traditional approaches based on statistical modeling of the exposure or outcome. We anticipate that IV methods will be often underpowered for drug safety studies of very rare outcomes, but may be potentially useful in studies of intended effects where uncontrolled confounding may be substantial.

Maintenance of Certification Part IV Quality-Improvement Project for Hypertension Control: A Preliminary Retrospective Analysis

PubMed Central

Kolasinski, Vallerie A; Price, David W

2015-01-01

Context: A Maintenance of Certification Part IV project was created on the basis of an existing, multifaceted hypertension improvement program. Objective: To evaluate the impact of the Maintenance of Certification project, the effects of the improvement options on blood pressure control in hypertensive patients, and the participants’ perception of the workload related to participation in the project. Design: Nonexperimental retrospective analysis. Setting: Kaiser Permanente hospitals and medical office buildings in Northern California. Intervention: Participants used one or more options from a defined menu of strategies to attempt to increase the percentage of hypertensive patients on their patient panels who had controlled blood pressure. Main Outcome Measure: Proportion of hypertensive patients with blood pressure ≤ 139/89 mm Hg. Results: Fifty-two American Board of Family Medicine and 19 American Board of Internal Medicine certified physicians completed projects. Mean panel blood pressure control improved from 79.49% (standard deviation [SD] = 11.32) to 84.64% (SD = 7.80). The choice of improvement option was not associated with the level of improvement or with the participants’ perception of the workload related to completing the project. Conclusion: Project participants improved the care of their patients without an increased perceived burden to their practice. We found no association between the choice of improvement option and either the level of improvement or the perception of workload. PMID:25785642

The effects of yoga on the attention and behavior of boys with Attention-Deficit/ hyperactivity Disorder (ADHD).

PubMed

Jensen, Pauline S; Kenny, Dianna T

2004-05-01

Boys diagnosed with ADHD by specialist pediatricians and stabilized on medication were randomly assigned to a 20-session yoga group (n = 11) or a control group (cooperative activities; n = 8). Boys were assessed pre- and post-intervention on the Conners' Parent and Teacher Rating Scales-Revised: Long (CPRS-R:L & CTRS-R:L; Conners, 1997), the Test of Variables of Attention (TOVA; Greenberg, Cormna, & Kindschi, 1997), and the Motion Logger Actigraph. Data were analyzed using one-way repeated measures analysis of variance (ANOVA). Significant improvements from pre-test to post-test were found for the yoga, but not for the control group on five subscales of the Conners' Parents Rating Scales (CPRS): Oppositional, Global Index Emotional Lability, Global Index Total, Global Index Restless/Impulsive and ADHD Index. Significant improvements from pre-test to post-test were found for the control group, but not the yoga group on three CPRS subscales: Hyperactivity, Anxious/Shy, and Social Problems. Both groups improved significantly on CPRS Perfectionism, DSM-IV Hyperactive/ Impulsive, and DSM-IV Total. For the yoga group, positive change from pre- to post-test on the Conners' Teacher Rating Scales (CTRS) was associated with the number of sessions attended on the DSM-IV Hyperactive-Impulsive subscale and with a trend on DSM-IV Inattentive subscale. Those in the yoga group who engaged in more home practice showed a significant improvement on TOVA Response Time Variability with a trend on the ADHD score, and greater improvements on the CTRS Global Emotional Lability subscale. Results from the Motion Logger Actigraph were inconclusive. Although these data do not provide strong support for the use of yoga for ADHD, partly because the study was under-powered, they do suggest that yoga may have merit as a complementary treatment for boys with ADHD already stabilized on medication, particularly for its evening effect when medication effects are absent. Yoga remains an investigational treatment, but this study supports further research into its possible uses for this population. These findings need to be replicated on larger groups with a more intensive supervised practice program.

International VLBI Service for Geodesy and Astrometry 2012 Annual Report

NASA Technical Reports Server (NTRS)

Baver, Karen D.; Behrend, Dirk; Armstrong, Kyla L.

2013-01-01

This volume of reports is the 2012 Annual Report of the International VLBI Service for Geodesy and Astrometry (IVS). The individual reports were contributed by VLBI groups in the international geodetic and astrometric community who constitute the permanent components of IVS. The IVS 2012 Annual Report documents the work of the IVS components for the calendar year 2012, our fourteenth year of existence. The reports describe changes, activities, and progress ofthe IVS. Many thanks to all IVS components who contributed to this Annual Report. With the exception of the first section and parts of the last section (described below), the contents of this Annual Report also appear on the IVS Web site athttp:ivscc.gsfc.nasa.gov/publications/ar2012

A survey of dog and cat anaesthesia in a sample of veterinary practices in New Zealand.

PubMed

Sano, H; Barker, K; Odom, T; Lewis, K; Giordano, P; Walsh, V; Chambers, J P

2018-03-01

To survey current anaesthesia practices for dogs and cats in small and mixed animal practices in New Zealand in order to improve anaesthesia education. A questionnaire was sent to 440 small and mixed animal practices, including questions regarding the type of practice, preanaesthetic examination, anaesthetic drugs and management, anaesthetic machines, monitoring and topics of interest for continuing professional development. Responses were obtained from 113/440 (26%) practices, with 78 (69%) respondents from small and 35 (31%) from mixed animal practices. A preanaesthetic physical examination was carried out by >95% of respondents and premedication was usually given to dogs (112/113; 99%) and cats (95/113; 85%). Acepromazine was the preferred sedative for dogs and cats, with morphine or buprenorphine. Propofol and alfaxalone were the preferred induction agents, and isoflurane was preferred for maintenance in both dogs and cats. A venous catheter was usually placed for anaesthesia in dogs (59/113; 52%), but less so in cats (39/113; 35%). Perioperative fluid was administered at 10 mL/kg/hour by 62/110 (56%) respondents. Intubation was usually used for anaesthesia in dogs (111/112; 99%), and cats (87/112; 78%). Almost 40% of respondents usually administered supplementary oxygen if patients were not intubated. Local analgesia was used by 69/111 (88%) respondents sometimes or always if applicable. Morphine or buprenorphine, and meloxicam were common choices for post-operative analgesia after neuter surgery in dogs and cats. A semiclosed (non-rebreathing) system was used in animals weighing <10 kg, and a Mapleson E or F non-rebreathing circuit was used by 66/109 (61%) practices. Only 15/111 (14%) practices had a ventilator in their practice. A dedicated anaesthetist was usually used by 104/113 (92%) practices, and apnoea alarms, pulse oximeters, thermometers and oesophageal stethoscopes were the main monitoring devices available in practices. Loco-regional block, pain management, and anaesthetic drugs were the main topics of interest for continuing education. Responses by the veterinarians taking part in this survey indicated that they had a reasonably good standard of anaesthetic practice. A physical examination was carried out preanaesthesia, and premedication including analgesia was routinely administered to most patients. A dedicated anaesthetist usually monitored patients and most respondents reported they had access to basic anaesthetic monitoring equipment. Areas where changes could lead to improved anaesthetic practice were increased use of I/V catheterisation, endotracheal intubation, and supplementary oxygen, and reduced I/V fluid rates.

Use and Effectiveness of Intraperitoneal Chemotherapy for Treatment of Ovarian Cancer

PubMed Central

Wright, Alexi A.; Cronin, Angel; Milne, Dana E.; Bookman, Michael A.; Burger, Robert A.; Cohn, David E.; Cristea, Mihaela C.; Griggs, Jennifer J.; Keating, Nancy L.; Levenback, Charles F.; Mantia-Smaldone, Gina; Matulonis, Ursula A.; Meyer, Larissa A.; Niland, Joyce C.; Weeks, Jane C.; O'Malley, David M.

2015-01-01

Purpose A 2006 randomized trial demonstrated a 16-month survival benefit with intraperitoneal and intravenous (IP/IV) chemotherapy administered to patients who had ovarian cancer, compared with IV chemotherapy alone, but more treatment-related toxicities. The objective of this study was to examine the use and effectiveness of IP/IV chemotherapy in clinical practice. Patients and Methods Prospective cohort study of 823 women with stage III, optimally cytoreduced ovarian cancer diagnosed at six National Comprehensive Cancer Network institutions. We examined IP/IV chemotherapy use in all patients diagnosed between 2003 and 2012 (N = 823), and overall survival and treatment-related toxicities with Cox regression and logistic regression, respectively, in a propensity score–matched sample (n = 402) of patients diagnosed from 2006 to 2012, excluding trial participants, to minimize selection bias. Results Use of IP/IV chemotherapy increased from 0% to 33% between 2003 and 2006, increased to 50% from 2007 to 2008, and plateaued thereafter. Between 2006 and 2012, adoption of IP/IV chemotherapy varied by institution from 4% to 67% (P < .001) and 43% of patients received modified IP/IV regimens at treatment initiation. In the propensity score–matched sample, IP/IV chemotherapy was associated with significantly improved overall survival (3-year overall survival, 81% v 71%; hazard ratio, 0.68; 95% CI, 0.47 to 0.99), compared with IV chemotherapy, but also more frequent alterations in chemotherapy delivery route (adjusted rates discontinuation or change, 20.4% v 10.0%; adjusted odds ratio, 2.83; 95% CI, 1.47 to 5.47). Conclusion Although the use of IP/IV chemotherapy increased significantly at National Comprehensive Cancer Network centers between 2003 and 2012, fewer than 50% of eligible patients received it. Increasing IP/IV chemotherapy use in clinical practice may be an important and underused strategy to improve ovarian cancer outcomes. PMID:26240233

Education as Power. Report of Americans for Indian Opportunity Title IV, Part A, Technical Assistance Conference (Albuquerque, New Mexico, October 4-6, 1977).

ERIC Educational Resources Information Center

Americans for Indian Opportunity, Inc., Albuquerque, NM.

Included in this report on the 1977 Title IV Part A Technical Assistance conference held in Albuquerque are: (1) a descriptive narrative of conference events; (2) a summary of the 120 evaluation responses; and (3) the resolutions adopted by conference participants as a specific vehicle to make their concerns known to the Office of Indian Education…

Flight Attendant Fatigue. Part IV. Analysis of Incident Reports

DTIC Science & Technology

2009-12-01

Flight Attendant Fatigue, Part IV: Analysis of Incident Reports Kali Holcomb Katrina Avers Lena Dobbins Joy Banks Lauren Blackwell Thomas Nesthus...Incident Reports 6. Performing Organization Code 7. Author(s) 8. Performing Organization Report No. Holcomb K, Avers K, Dobbins L, Banks J...observed by erC members of the flight attendant ASAP programs, a survey was developed. Surveys were distributed via e -Mail to 23 participants for

17 CFR Table IV to Subpart E of... - Civil Monetary Penalty Inflation Adjustments

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Civil Monetary Penalty Inflation Adjustments IV Table IV to Subpart E of Part 201 Commodity and Securities Exchanges SECURITIES AND... Securities and Exchange Commission: 15 U.S.C. 77t(d) For natural person 2001 $6,500 $7,500 For any other...

Method matters: Understanding diagnostic reliability in DSM-IV and DSM-5.

PubMed

Chmielewski, Michael; Clark, Lee Anna; Bagby, R Michael; Watson, David

2015-08-01

Diagnostic reliability is essential for the science and practice of psychology, in part because reliability is necessary for validity. Recently, the DSM-5 field trials documented lower diagnostic reliability than past field trials and the general research literature, resulting in substantial criticism of the DSM-5 diagnostic criteria. Rather than indicating specific problems with DSM-5, however, the field trials may have revealed long-standing diagnostic issues that have been hidden due to a reliance on audio/video recordings for estimating reliability. We estimated the reliability of DSM-IV diagnoses using both the standard audio-recording method and the test-retest method used in the DSM-5 field trials, in which different clinicians conduct separate interviews. Psychiatric patients (N = 339) were diagnosed using the SCID-I/P; 218 were diagnosed a second time by an independent interviewer. Diagnostic reliability using the audio-recording method (N = 49) was "good" to "excellent" (M κ = .80) and comparable to the DSM-IV field trials estimates. Reliability using the test-retest method (N = 218) was "poor" to "fair" (M κ = .47) and similar to DSM-5 field-trials' estimates. Despite low test-retest diagnostic reliability, self-reported symptoms were highly stable. Moreover, there was no association between change in self-report and change in diagnostic status. These results demonstrate the influence of method on estimates of diagnostic reliability. (c) 2015 APA, all rights reserved).

Radiation Monitor,IV-TEPC

NASA Image and Video Library

2012-12-30

View of radiation monitor,Intra-Vehicular Tissue Equivalent Proportional Counter (IV-TEPC),relocated to NOD2 P3,Part Number (P/N): SEG33120960-301,Serial Number (S/N): 1002,in the Node 2. Photo was taken during Expedition 34.

Considerations of Alloy 617 Application in the Gen IV Nuclear Reactor Systems - Part I: Mechanical Property Challenges

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

Ren, Weiju

2010-01-01

Alloy 617 is currently considered as a leading candidate material for high temperature components in the Gen IV Nuclear Reactor Systems. Because of the unprecedented severe working conditions beyond its commercial service experience required by the Gen IV systems, the alloy faces various challenges in both mechanical and metallurgical properties. This paper, as Part I of the discussion, is focused on the challenges and issues in the mechanical properties of Alloy 617 for the intended nuclear application. Considerations are given in details in its mechanical property data scatter, low creep strength in the desired high temperature range, lack of longtermmore » creep curves, high loading rate dependency, and preponderant tertiary creep. Some research and development activities are suggested with discussions on their viability to satisfy the Gen IV Nuclear Reactor System needs in near future and in the long run.« less

40 CFR 63.11508 - What are my compliance requirements?

Code of Federal Regulations, 2014 CFR

2014-07-01

...) You must be in compliance with the applicable management practices and equipment standards in this.... (iii) You must implement the applicable management practices specified in § 63.11507(g), “What are my standards and management practices?”, as practicable. (iv) You must state in your Notification of Compliance...

40 CFR 63.11508 - What are my compliance requirements?

Code of Federal Regulations, 2013 CFR

2013-07-01

...) You must be in compliance with the applicable management practices and equipment standards in this.... (iii) You must implement the applicable management practices specified in § 63.11507(g), “What are my standards and management practices?”, as practicable. (iv) You must state in your Notification of Compliance...

40 CFR 63.11508 - What are my compliance requirements?

Code of Federal Regulations, 2012 CFR

2012-07-01

...) You must be in compliance with the applicable management practices and equipment standards in this.... (iii) You must implement the applicable management practices specified in § 63.11507(g), “What are my standards and management practices?”, as practicable. (iv) You must state in your Notification of Compliance...

The Mediterranean Crucible, 1942-1943: Did Technology or Tenets Achieve Air Superiority

DTIC Science & Technology

2012-06-01

messages of critical Luftwaffe communications. The decryption, analysis, and dissemination of messages from the German Enigma coding machine, facilitated...the ability to “read the Luftwaffe [Enigma] keys in North Africa from the first day of their introduction” in the theater.5 This system, code ...IRIS no. 118168, in USAF Collection, AFHRA, Part IV, 1. 21 AWPD-42, Part IV, 1. superiority which enables its possessor to conduct air

Education as Experimentation: A Planned Variation Model. Volume IV-B: Effects of Follow Through Models. Volume IV-C: Appendices, Part I and Part II.

ERIC Educational Resources Information Center

Bock, Geoffrey; And Others

This segment of the national evaluation study of the Follow Through Planned Variation Model describes each of the 17 models represented in the study and reports the results of analyses of 4 years of student performance data for each model. First a purely descriptive synthesis of findings is presented for each model, with interpretation of the data…

[Economic Evaluation of Integrated Care Systems - Scientific Standard Specifications, Challenges, Best Practice Model].

PubMed

Pimperl, A; Schreyögg, J; Rothgang, H; Busse, R; Glaeske, G; Hildebrandt, H

2015-12-01

 Transparency of economic performance of integrated care systems (IV) is a basic requirement for the acceptance and further development of integrated care. Diverse evaluation methods are used but are seldom openly discussed because of the proprietary nature of the different business models. The aim of this article is to develop a generic model for measuring economic performance of IV interventions.  A catalogue of five quality criteria is used to discuss different evaluation methods -(uncontrolled before-after-studies, control group-based approaches, regression models). On this -basis a best practice model is proposed.  A regression model based on the German morbidity-based risk structure equalisation scheme (MorbiRSA) has some benefits in comparison to the other methods mentioned. In particular it requires less resources to be implemented and offers advantages concerning the relia-bility and the transparency of the method (=important for acceptance). Also validity is sound. Although RCTs and - also to a lesser -extent - complex difference-in-difference matching approaches can lead to a higher validity of the results, their feasibility in real life settings is limited due to economic and practical reasons. That is why central criticisms of a MorbiRSA-based model were addressed, adaptions proposed and incorporated in a best practice model: Population-oriented morbidity adjusted margin improvement model (P-DBV(MRSA)).  The P-DBV(MRSA) approach may be used as a standardised best practice model for the economic evaluation of IV. Parallel to the proposed approach for measuring economic performance a balanced, quality-oriented performance measurement system should be introduced. This should prevent incentivising IV-players to undertake short-term cost cutting at the expense of quality. © Georg Thieme Verlag KG Stuttgart · New York.

Identification of Novel Human Dipeptidyl Peptidase-IV Inhibitors of Natural Origin (Part II): In Silico Prediction in Antidiabetic Extracts

PubMed Central

Guasch, Laura; Sala, Esther; Ojeda, María José; Valls, Cristina; Bladé, Cinta; Mulero, Miquel; Blay, Mayte; Ardévol, Anna; Garcia-Vallvé, Santiago; Pujadas, Gerard

2012-01-01

Background Natural extracts play an important role in traditional medicines for the treatment of diabetes mellitus and are also an essential resource for new drug discovery. Dipeptidyl peptidase IV (DPP-IV) inhibitors are potential candidates for the treatment of type 2 diabetes mellitus, and the effectiveness of certain antidiabetic extracts of natural origin could be, at least partially, explained by the inhibition of DPP-IV. Methodology/Principal Findings Using an initial set of 29,779 natural products that are annotated with their natural source and an experimentally validated virtual screening procedure previously developed in our lab (Guasch et al.; 2012) [1], we have predicted 12 potential DPP-IV inhibitors from 12 different plant extracts that are known to have antidiabetic activity. Seven of these molecules are identical or similar to molecules with described antidiabetic activity (although their role as DPP-IV inhibitors has not been suggested as an explanation for their bioactivity). Therefore, it is plausible that these 12 molecules could be responsible, at least in part, for the antidiabetic activity of these extracts through their inhibitory effect on DPP-IV. In addition, we also identified as potential DPP-IV inhibitors 6 molecules from 6 different plants with no described antidiabetic activity but that share the same genus as plants with known antidiabetic properties. Moreover, none of the 18 molecules that we predicted as DPP-IV inhibitors exhibits chemical similarity with a group of 2,342 known DPP-IV inhibitors. Conclusions/Significance Our study identified 18 potential DPP-IV inhibitors in 18 different plant extracts (12 of these plants have known antidiabetic properties, whereas, for the remaining 6, antidiabetic activity has been reported for other plant species from the same genus). Moreover, none of the 18 molecules exhibits chemical similarity with a large group of known DPP-IV inhibitors. PMID:23028712

OGLE-IV Transient Search report 31 December 2016, part 1

NASA Astrophysics Data System (ADS)

Wyrzykowski, L.; Hamanowicz, A.; Kostrzewa-Rutkowska, Z.; Klencki, J.; Sitek, M.; Udalski, A.; Kozlowski, S.; Ulaczyk, K.; Soszynski, I.; Mroz, P.; Szymanski, M. K.; Poleski, R.; Pietrukowicz, P.; Pawlak, M.; Skowron, J.

2016-12-01

The OGLE-IV Transient Detection System (Wyrzykowski et al. 2014, AcA,64,197; Kozlowski et al. 2013; Klencki et al. 2016, AcA, 66,15) announces discovery of 52 transients discovered in last three months.

OGLE-IV Transient Search report 31 December 2016, part 2

NASA Astrophysics Data System (ADS)

Wyrzykowski, L.; Hamanowicz, A.; Kostrzewa-Rutkowska, Z.; Klencki, J.; Sitek, M.; Udalski, A.; Kozlowski, S.; Ulaczyk, K.; Soszynski, I.; Mroz, P.; Szymanski, M. K.; Poleski, R.; Pietrukowicz, P.; Pawlak, M.; Skowron, J.

2016-12-01

The OGLE-IV Transient Detection System (Wyrzykowski et al. 2014, AcA,64,197; Kozlowski et al. 2013; Klencki et al. 2016, AcA, 66,15) announces discovery of 46 transients discovered in last three months.

Collaborative Communication in Pediatric Palliative Care: A Foundation for Problem-Solving and Decision-Making

PubMed Central

Feudtner, Chris

2007-01-01

Summary In an ideal world, all of us – patients, parents, family members, nurses, physicians, social workers, therapists, pastoral care workers, and others – would always work together in a collaborative manner to provide the best care possible to the patient: this article is committed to this ideal. The chapter will base the frameworks and suggestions in part upon studies of communication between patients, families, and clinicians, as well as more general works on communication, collaboration, decision-making, mediation, and ethics. This article unfolds in four parts. In Part I, we will explore what we mean by collaborative communication. In Part II, we will examine key concepts that influence how we frame the situations that children with life-threatening conditions confront and how these frameworks shape the care we provide. In Part III, we will consider a few general topics that are quite important to the task of collaborative communication, specifically how we use little “habits of thought”– called heuristics – when we set about to solve complicated problems; how emotion affects the exchange of information between people; and how we can avoid certain pitfalls when engaging in difficult conversations. In Part IV, we will proceed through three common tasks of collaborative communication offering practical advice for patient care. PMID:17933613

77 FR 55180 - Notice of Proposed Changes to Section IV of the Virginia State Technical Guide

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-07

... DEPARTMENT OF AGRICULTURE Natural Resources Conservation Service Notice of Proposed Changes to Section IV of the Virginia State Technical Guide AGENCY: Natural Resources Conservation Service (NRCS), U..., Virginia 23229-5014; Telephone number (804) 287-1691 or [email protected] Copies of the practice...

Instrumental variable methods in comparative safety and effectiveness research†

PubMed Central

Brookhart, M. Alan; Rassen, Jeremy A.; Schneeweiss, Sebastian

2010-01-01

Summary Instrumental variable (IV) methods have been proposed as a potential approach to the common problem of uncontrolled confounding in comparative studies of medical interventions, but IV methods are unfamiliar to many researchers. The goal of this article is to provide a non-technical, practical introduction to IV methods for comparative safety and effectiveness research. We outline the principles and basic assumptions necessary for valid IV estimation, discuss how to interpret the results of an IV study, provide a review of instruments that have been used in comparative effectiveness research, and suggest some minimal reporting standards for an IV analysis. Finally, we offer our perspective of the role of IV estimation vis-à-vis more traditional approaches based on statistical modeling of the exposure or outcome. We anticipate that IV methods will be often underpowered for drug safety studies of very rare outcomes, but may be potentially useful in studies of intended effects where uncontrolled confounding may be substantial. PMID:20354968

Incidence of intravenous contrast extravasation: increased risk for patients with deep brachial catheter placement from the emergency department.

PubMed

Hardie, Andrew D; Kereshi, Borko

2014-06-01

Deep brachial intravenous catheter (IV) placement can be performed in emergency department patients with difficult vascular access, but the safety of deep brachial IV for iodinated contrast administration has not been assessed. This study compares the relative risk for extravasation of deep brachial IV compared with antecubital IV during power injected computed tomography (CT) examinations. A departmental practice quality improvement was performed to assess the rate of IV extravasation for all CT examinations during a 1 year period. De-identified data was analyzed with a waiver of informed consent to identify the rate and relative risk of iodinated contrast extravasation by catheter type. A total of 10,750 injections were performed, with 82 extravasation events (0.8 %). There were 51 extravasations of antecubital IV from approximately 8,599 placed (0.6 %). For 123 deep brachial IV placed, there were eight extravasations (6.5 %). The relative risk of a deep brachial IV extravasation was 9.4 compared to 0.4 for antecubital placement. Deep brachial IV demonstrated a markedly higher rate of contrast extravasation than antecubital IV. For power injected iodinated contrast administration, it is recommended to avoid the use of deep brachial IV whenever possible.

45 CFR 1388.6 - Program criteria-services and supports.

Code of Federal Regulations, 2011 CFR

2011-10-01

... according to accepted practices of scientific evaluation; (iv) Research methods that are used to test hypotheses, validate procedures, and field test projects; and (v) Direct service and project practices and...

75 FR 62759 - Notice of Proposed Change to Section IV of the Virginia State Technical Guide

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-13

... following practice standards: 314, Brush Management, 324, Deep Tillage, 330, Contour Farming, 332, Contour.... These practices will be used to plan and install conservation practices. DATES: Comments will be...-1737. Copies of the practice standards will be made available upon written request to the address shown...

Complication Rates of 3% Hypertonic Saline Infusion Through Peripheral Intravenous Access.

PubMed

Perez, Claudia Andira; Figueroa, Stephen A

2017-06-01

Hyperosmolar therapy with hypertonic saline (HTS) is a cornerstone in the management of intracranial hypertension and hyponatremia in the neurological intensive care unit. Theoretical safety concerns remain for infiltration, thrombophlebitis, tissue ischemia, and venous thrombosis associated with continuous 3% HTS administered via peripheral intravenous (pIV) catheters. It is common practice at many institutions to allow only central venous catheter infusion of 3% HTS. Hospital policy was changed to allow the administration of 3% HTS via 16- to 20-gauge pIVs to a maximum infusion rate of 50 mL/h in patients without central venous access. We prospectively monitored patients who received peripheral 3% HTS as part of a quality improvement project. We documented gauge, location, maximum infusion rate, and total hours of administration. Patients were assessed for infiltration, erythema, swelling, phlebitis, thrombosis, and line infection. There were 28 subjects across 34 peripheral lines monitored. Overall, subjects received 3% HTS for a duration between 1 and 124 hours with infusion rates of 30 to 50 mL/h. The rate of complications observed was 10.7% among all subjects. Documented complications included infiltration (n = 2), with an incidence of 6%, and thrombophlebitis (n = 1), with an incidence of 3%. There has been a long concern among healthcare providers, including nursing staff, in regard to pIV administration of prolonged 3% HTS infusion therapy. Our study indicates that peripheral administration of 3% HTS carries a low risk of minor, nonlimb, or life-threatening complications. Although central venous infusion may reduce the risk of these minor complications, it may increase the risk of more serious complications such as large vessel thrombosis, bloodstream infection, pneumothorax, and arterial injury. The concern regarding the risks of pIV administration of 3% HTS may be overstated and unfounded.

Cryptococcal meningitis management in Tanzania with strict schedule of serial lumber punctures using intravenous tubing sets: an operational research study.

PubMed

Meda, John; Kalluvya, Samuel; Downs, Jennifer A; Chofle, Awilly A; Seni, Jeremiah; Kidenya, Benson; Fitzgerald, Daniel W; Peck, Robert N

2014-06-01

Cryptococcal meningitis (CM) has a mortality rate of ∼70% among HIV-infected adults in low-income countries. Controlling intracranial pressure (ICP) is essential in CM, but it is difficult in low-income countries because manometers and practical ICP management protocols are lacking. As part of a continuous quality improvement project, our Tanzanian hospital initiated a new protocol for ICP management for CM. All adult inpatients with CM are included in a prospective patient registry. At the time of analysis, this registry included data from 2 years before the initiation of this new ICP management protocol and for a 9-month period after. ICP was measured at baseline and at days 3, 7, and 14 by both manometer and intravenous (IV) tubing set. All patients were given IV fluconazole according to Tanzanian treatment guidelines and were followed until 30 days after admission. Among adult inpatients with CM, 32 of 35 patients (91%) had elevated ICP on admission. Cerebrospinal fluid pressure measurements using the improvised IV tubing set demonstrated excellent agreement (r = 0.96) with manometer measurements. Compared with historical controls, the new ICP management protocol was associated with a significant reduction in 30-day mortality (16/35 [46%] vs. 48/64 [75%] in historical controls; hazard ratio = 2.1 [95% CI: 1.1 to 3.8]; P = 0.018]. Increased ICP is almost universal among HIV-infected adults admitted with CM in Tanzania. Intensive ICP management with a strict schedule of serial lumbar punctures reduced in-hospital mortality compared with historical controls. ICP measurement with IV tubing sets may be a good alternative in resource-limited health facilities where manometers are not available.

Shunt resistance and saturation current determination in CdTe and CIGS solar cells. Part 1: a new theoretical procedure and comparison with other methodologies

NASA Astrophysics Data System (ADS)

Rangel-Kuoppa, Victor-Tapio; Albor-Aguilera, María-de-Lourdes; Hérnandez-Vásquez, César; Flores-Márquez, José-Manuel; González-Trujillo, Miguel-Ángel; Contreras-Puente, Gerardo-Silverio

2018-04-01

A new proposal for the extraction of the shunt resistance (R sh ) and saturation current (I sat ) of a current-voltage (I-V) measurement of a solar cell, within the one-diode model, is given. First, the Cheung method is extended to obtain the series resistance (R s ), the ideality factor (n) and an upper limit for I sat . In this article which is Part 1 of two parts, two procedures are proposed to obtain fitting values for R sh and I sat within some voltage range. These two procedures are used in two simulated I-V curves (one in darkness and the other one under illumination) to recover the known solar cell parameters R sh , R s , n, I sat and the light current I lig and test its accuracy. The method is compared with two different common parameter extraction methods. These three procedures are used and compared in Part 2 in the I-V curves of CdS-CdTe and CIGS-CdS solar cells.

Pneumocystis carinii pneumonia: a late presentation following treatment for stage IV neuroblastoma.

PubMed

Clarke, Edward; Glaser, Adam W; Picton, Susan V

2003-09-01

This report describes a child who develops Pneumocystis carinii pneumonia 7 months after high-dose chemotherapy for stage IV neuroblastoma. In addition to chemotherapy the child had also been treated with abdominal radiotherapy and 13-cis-retinoic acid. Standard practice has been to treat patients with prophylactic co-trimoxazole for 3 months after high-dose therapy, but this report highlights the intensity and complexity of current treatment for stage IV neuroblastoma and the need to be aware of prolonged lymphopenia after such treatment.

Patronage Versus Professionalism in New Security Institutions

DTIC Science & Technology

2011-09-01

27–IV-30. 49 Ibid., IV-27–IV-28. 50 Charles F. Wald , “New Thinking at USEUCOM: The Phase Zero Campaign,” Joint Force Quarterly 43 (4th Quarter, 2006...Stability Operations Require More U.S. Focus, Gates Says,” American Forces Press Service, April 14, 2009. 53 Wald , 73. 54 JP 3–0, VII-10. 55 Defense...friendly and a potential bulwark against the brutal Interior Ministry police. Yet the Egyptian military is known to practice patronage. Analyst Lisa

Trends in anemia management practices in patients receiving hemodialysis and peritoneal dialysis: a retrospective cohort analysis.

PubMed

Wetmore, James B; Peng, Yi; Monda, Keri L; Kats, Allyson M; Kim, Deborah H; Bradbury, Brian D; Collins, Allan J; Gilbertson, David T

2015-01-01

Recent changes in clinical practice guidelines and reimbursement policies may have affected the use of anemia-related medications and red blood cell (RBC) transfusions in peritoneal dialysis (PD) and hemodialysis (HD) patients. We sought to compare patterns of erythropoiesis-stimulating agents (ESA) and intravenous (IV) iron use, achieved hemoglobin levels, and RBC transfusion use in PD and HD patients. In quarterly cohorts of prevalent dialysis patients receiving persistent therapy (>3 months), 2007-2011, with Medicare Parts A and B coverage, we assessed ESA and IV iron use and dose, RBC transfusions, and hemoglobin levels. Quarterly transfusion rates were calculated. Observable PD and HD patients numbered 14,958 and 221,866 in Q1/2007 and 17,842 and 256,942 in Q4/2011. Adjusted ESA use was lower in PD (71.4-80.1%) than in HD (86.9-92.0%) patients, decreasing from 80.1% (Q1/2010) to 71.4% (Q4/2011) in PD patients, and from 92.0 to 86.9% in HD patients. The mean adjusted ESA dose decreased by 67.5% in PD and 58.4% in HD patients. IV iron use tended to increase, peaking at 39.3% for PD (Q3/2011) and 80.5% for HD (Q2/2011) patients. Adjusted mean hemoglobin levels fell from 11.7 to 10.6 mg/dl in PD and from 12.0 to 10.7 mg/dl in HD ESA users; adjusted transfusion rates increased from 2.4 to 3.0 per 100 patient-months in PD and from 2.6 to 3.3 in HD patients. In patients receiving persistent dialysis, dose and frequency of ESA administrations decreased during the period 2007-2011. Mean hemoglobin levels decreased by more than 1 g/dl, while transfusion rates increased by approximately 25%. © 2015 S. Karger AG, Basel.

OGLE-IV Transient Search report 25 September 2017 part 2

NASA Astrophysics Data System (ADS)

Wyrzykowski, L.; Gromadzki, M.; Hamanowicz, A.; Rybicki, K.; Klencki, J.; Kozlowski, S.; Udalski, A.; Poleski, R.; Szymanski, M. K.; Skowron, J.; Ulaczyk, K.; Pawlak, M.; Mroz, P.; Soszynski, I.; Pietrukowicz, P.; Sitek, M.; Ihanec, N.

2017-09-01

The OGLE-IV Transient Detection System (Wyrzykowski et al. 2014, AcA,64,197; Kozlowski et al. 2013; Klencki et al. 2016, AcA, 66,15) announces discovery of 49 new on-going and recently finished transients discovered since Jan 2017.

OGLE-IV Transient Search report 25 September 2017 part 1

NASA Astrophysics Data System (ADS)

Wyrzykowski, L.; Gromadzki, M.; Hamanowicz, A.; Rybicki, K.; Klencki, J.; Kozlowski, S.; Udalski, A.; Poleski, R.; Szymanski, M. K.; Skowron, J.; Ulaczyk, K.; Pawlak, M.; Mroz, P.; Soszynski, I.; Pietrukowicz, P.; Sitek, M.; Ihanec, N.

2017-09-01

The OGLE-IV Transient Detection System (Wyrzykowski et al. 2014, AcA,64,197; Kozlowski et al. 2013; Klencki et al. 2016, AcA, 66,15) announces discovery of 50 new on-going and recently finished transients discovered since Jan 2017.

5 CFR 1203.11 - Request for regulation review.

Code of Federal Regulations, 2010 CFR

2010-01-01

... PROCEDURES FOR REVIEW OF RULES AND REGULATIONS OF THE OFFICE OF PERSONNEL MANAGEMENT Procedures for Review... reasons why the regulation would require an employee to commit a prohibited personnel practice; or the... practice; (iv) Specific identification of the prohibited personnel practice at issue; and (v) A description...

75 FR 47259 - Notice of Proposed Change to Section IV of the Virginia State Technical Guide

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-05

... DEPARTMENT OF AGRICULTURE Natural Resources Conservation Service Notice of Proposed Change to Section IV of the Virginia State Technical Guide AGENCY: Natural Resources Conservation Service (NRCS), U..., Virginia 23229-5014; Telephone number (804) 287-1691; Fax number (804) 287-1737. Copies of the practice...

Christian Ethics. A Teacher Information Bulletin for Division IV.

ERIC Educational Resources Information Center

Saskatchewan Dept. of Education, Regina.

Listed are print and audiovisual materials that support the "Curriculum Guide for Division IV: Christian Ethics" intended for use in grades 10, 11, and 12. The course is designed to help students articulate, reflect upon, and understand what they believe and practice. Cited in this resource manual are textbooks, teacher's guides,…

Rapid and sensitive detection of early esophageal squamous cell carcinoma with fluorescence probe targeting dipeptidylpeptidase IV

PubMed Central

Onoyama, Haruna; Kamiya, Mako; Kuriki, Yugo; Komatsu, Toru; Abe, Hiroyuki; Tsuji, Yosuke; Yagi, Koichi; Yamagata, Yukinori; Aikou, Susumu; Nishida, Masato; Mori, Kazuhiko; Yamashita, Hiroharu; Fujishiro, Mitsuhiro; Nomura, Sachiyo; Shimizu, Nobuyuki; Fukayama, Masashi; Koike, Kazuhiko; Urano, Yasuteru; Seto, Yasuyuki

2016-01-01

Early detection of esophageal squamous cell carcinoma (ESCC) is an important prognosticator, but is difficult to achieve by conventional endoscopy. Conventional lugol chromoendoscopy and equipment-based image-enhanced endoscopy, such as narrow-band imaging (NBI), have various practical limitations. Since fluorescence-based visualization is considered a promising approach, we aimed to develop an activatable fluorescence probe to visualize ESCCs. First, based on the fact that various aminopeptidase activities are elevated in cancer, we screened freshly resected specimens from patients with a series of aminopeptidase-activatable fluorescence probes. The results indicated that dipeptidylpeptidase IV (DPP-IV) is specifically activated in ESCCs, and would be a suitable molecular target for detection of esophageal cancer. Therefore, we designed, synthesized and characterized a series of DPP-IV-activatable fluorescence probes. When the selected probe was topically sprayed onto endoscopic submucosal dissection (ESD) or surgical specimens, tumors were visualized within 5 min, and when the probe was sprayed on biopsy samples, the sensitivity, specificity and accuracy reached 96.9%, 85.7% and 90.5%. We believe that DPP-IV-targeted activatable fluorescence probes are practically translatable as convenient tools for clinical application to enable rapid and accurate diagnosis of early esophageal cancer during endoscopic or surgical procedures. PMID:27245876

A survey of critical care nurses' practices and perceptions surrounding early intravenous antibiotic initiation during septic shock.

PubMed

Roberts, Russel J; Alhammad, Abdullah M; Crossley, Lindsay; Anketell, Eric; Wood, LeeAnn; Schumaker, Greg; Garpestad, Erik; Devlin, John W

2017-08-01

Delays in antibiotic administration after severe sepsis recognition increases mortality. While physician and pharmacy-related barriers to early antibiotic initiation have been well evaluated, those factors that affect the speed by which critical care nurses working in either the emergency department or the intensive care unit setting initiate antibiotic therapy remains poorly characterized. To evaluate the knowledge, practices and perceptions of critical care nurses regarding antibiotic initiation in patients with newly recognised septic shock. A validated survey was distributed to 122 critical care nurses at one 320-bed academic institution with a sepsis protocol advocating intravenous(IV) antibiotic initiation within 1hour of shock recognition. Among 100 (82%) critical care nurses responding, nearly all (98%) knew of the existence of the sepsis protocol. However, many critical care nurses stated they would optimise blood pressure [with either fluid (38%) or both fluid and a vasopressor (23%)] before antibiotic initiation. Communicated barriers to rapid antibiotic initiation included: excessive patient workload (74%), lack of awareness IV antibiotic(s) ordered (57%) or delivered (69%), need for administration of multiple non-antibiotic IV medications (54%) and no IV access (51%). Multiple nurse-related factors influence IV antibiotic(s) initiation speed and should be incorporated into sepsis quality improvement efforts. Copyright © 2017 Elsevier Ltd. All rights reserved.

Concept analysis: lack of anonymity.

PubMed

Swan, Marilyn A; Hobbs, Barbara B

2017-05-01

To re-examine and expand understanding of the concept 'lack of anonymity' as a component of rural nursing theory. Early healthcare literature reports lack of anonymity as part of social and working environments, particularly rural nursing. Rural nursing theory included the first published concept analysis on lack of anonymity but lacked empirical referents. Workforce, societal and rural healthcare changes support an updated analysis. To further understand lack of anonymity, its present day use and applicability to diverse environments, research from multiple disciplines was reviewed. Concept analysis. A literature search using eight terms in eleven databases was conducted of literature published between 2008-2013. Walker and Avant's concept analysis methodology guided the analysis. The previous concept analysis is supported in part by current literature. The defining attributes, 'identifiable', 'establishing boundaries for public and private self and interconnectedness' in a community were updated. Updated antecedents include: (i) environmental context; (ii) opportunities to become visible; (iii) developing relationships and (iv) unconscious or limited awareness of public or personal privacy. Consequences are: (i) familiarity; (ii) visibility; (iii) awareness of privacy and (iv) manage or balance of lack of anonymity. Cases were constructed and empirical referents identified. The concept of lack of anonymity was updated; portions of the original definition remain unchanged. Empirical referents reveal the defining attributes in daily life and may guide future research on the effect of lack of anonymity on nursing practice. This analysis advances the conceptual understanding of rural nursing theory. © 2016 John Wiley & Sons Ltd.

[Clinical practice guidelines: Irritable bowel syndrome with constipation and functional constipation in adults: Concept, diagnosis, and healthcare continuity. (Part 1 of 2)].

PubMed

Mearin, F; Ciriza, C; Mínguez, M; Rey, E; Mascort, J J; Peña, E; Cañones, P; Júdez, J

In this Clinical practice guide, an analysis is made of the diagnosis and treatment of adult patients with constipation and abdominal discomfort, under the spectrum of irritable bowel syndrome and functional constipation. These have an important personal, health and social impact, affecting the quality of life of these patients. In irritable bowel syndrome with a predominance of constipation, this is the predominant change in bowel movements, with recurrent abdominal pain, bloating and frequent abdominal distension. Constipation is characterised by infrequent or difficulty in bowel movements, associated with excessive straining during bowel movement or sensation of incomplete evacuation. There is often no underling cause, with an intestinal functional disorder being considered. They have many clinical and pathophysiological similarities, with a similar response of the constipation to common drugs. The fundamental difference is the presence or absence of pain, but not in a way evaluable way; "all or nothing". The severity depends on the intensity of bowel symptoms and other factors, a combination of gastrointestinal and extra-intestinal symptoms, level of involvement, forms of perception, and behaviour. The Rome criteria diagnose functional bowel disorders. This guide is adapted to the Rome criteria IV (May 2016) and in this first part an analysis is made of the alarm criteria, diagnostic tests, and the criteria for referral between Primary Care and Digestive Disease specialists. In the second part, a review will be made of the therapeutic alternatives available (exercise, diet, drug therapies, neurostimulation of sacral roots, or surgery), making practical recommendations for each one of them. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

[Clinical practice guidelines: Irritable bowel syndrome with constipation and functional constipation in adults: Concept, diagnosis, and healthcare continuity. (Part 1 of 2)].

PubMed

Mearin, F; Ciriza, C; Mínguez, M; Rey, E; Mascort, J J; Peña, E; Cañones, P; Júdez, J

2017-01-01

In this Clinical practice guide, an analysis is made of the diagnosis and treatment of adult patients with constipation and abdominal discomfort, under the spectrum of irritable bowel syndrome and functional constipation. These have an important personal, health and social impact, affecting the quality of life of these patients. In irritable bowel syndrome with a predominance of constipation, this is the predominant change in bowel movements, with recurrent abdominal pain, bloating and frequent abdominal distension. Constipation is characterised by infrequent or difficulty in bowel movements, associated with excessive straining during bowel movement or sensation of incomplete evacuation. There is often no underling cause, with an intestinal functional disorder being considered. They have many clinical and pathophysiological similarities, with a similar response of the constipation to common drugs. The fundamental difference is the presence or absence of pain, but not in a way evaluable way; "all or nothing". The severity depends on the intensity of bowel symptoms and other factors, a combination of gastrointestinal and extra-intestinal symptoms, level of involvement, forms of perception, and behaviour. The Rome criteria diagnose functional bowel disorders. This guide is adapted to the Rome criteria IV (May 2016) and in this first part an analysis is made of the alarm criteria, diagnostic tests, and the criteria for referral between Primary Care and Digestive Disease specialists. In the second part, a review will be made of the therapeutic alternatives available (exercise, diet, drug therapies, neurostimulation of sacral roots, or surgery), making practical recommendations for each one of them. Copyright © 2016. Publicado por Elsevier España, S.L.U.

Technical communication: new teaching model for practicing ultrasound-guided regional anesthesia techniques: no perishable food products!

PubMed

Liu, Yang; Glass, Nancy L; Power, Robert W

2010-04-01

There is a pronounced learning curve for the technique of ultrasound-guided regional anesthesia. Practicing with a simulator model has been shown to speed the acquisition of these skills for various ultrasound-guided procedures. However, commercial models for ultrasound-guided regional anesthesia may be too costly or not readily available. Models using turkey breasts or tofu blocks have the disadvantage of containing perishable food products that can be a source for infection. We describe an alternative inexpensive model that is made from nonperishable components readily available in the operating room. The materials required include 1 clean used 500-mL bag of IV fluids, a bottle of Premisorb (TYCO Healthcare Group, Mansfield, MA), and a piece of foam material approximately 0.3 cm in diameter and 5 cm in length trimmed from operating room foam pads. After filling the IV bag with tap water and inserting the foam into the IV bag from the outlet port of the IV bag, one-third of a bottle of Premisorb (approximately 15 g) is poured into the IV bag. The outlet port of the bag is then sealed by taping the rubber stopper that originally came with the bag. Premisorb, a solidifying agent frequently used to absorb irrigating fluids or blood in operating room suction canisters, produces a gel-like material in the IV bag. The foam inserted into the bag creates a relatively hyperechoic target. This gel-like substance in the bag will seal the holes created after multiple practice needle insertions, resulting in minimal leakage. The semitransparent nature of the gel allows the trainee to visualize the target directly and on the ultrasound screen. The model we describe is inexpensive and easy to make from materials readily available in the operating room with the advantages of being nonperishable, easy to carry, and reusable.

49 CFR 383.113 - Required skills.

Code of Federal Regulations, 2014 CFR

2014-10-01

... inspected to ensure a safe operating condition of each part, including: (i) Engine compartment; (ii) Cab/engine start; (iii) Steering; (iv) Suspension; (v) Brakes; (vi) Wheels; (vii) Side of vehicle; (viii... they will activate in emergency situations; (iv) With the engine running, make sure that the system...

49 CFR 383.113 - Required skills.

Code of Federal Regulations, 2012 CFR

2012-10-01

... inspected to ensure a safe operating condition of each part, including: (i) Engine compartment; (ii) Cab/engine start; (iii) Steering; (iv) Suspension; (v) Brakes; (vi) Wheels; (vii) Side of vehicle; (viii... they will activate in emergency situations; (iv) With the engine running, make sure that the system...

49 CFR 383.113 - Required skills.

Code of Federal Regulations, 2013 CFR

2013-10-01

... inspected to ensure a safe operating condition of each part, including: (i) Engine compartment; (ii) Cab/engine start; (iii) Steering; (iv) Suspension; (v) Brakes; (vi) Wheels; (vii) Side of vehicle; (viii... they will activate in emergency situations; (iv) With the engine running, make sure that the system...

49 CFR 383.113 - Required skills.

Code of Federal Regulations, 2011 CFR

2011-10-01

... inspected to ensure a safe operating condition of each part, including: (i) Engine compartment; (ii) Cab/engine start; (iii) Steering; (iv) Suspension; (v) Brakes; (vi) Wheels; (vii) Side of vehicle; (viii... they will activate in emergency situations; (iv) With the engine running, make sure that the system...

Evidence-Based Diagnosis: Incorporating Diagnostic Instruments into Clinical Practice

ERIC Educational Resources Information Center

Doss, Amanda Jensen

2005-01-01

This article is intended to serve as a practical guide for practitioners interested in incorporating evidence-based diagnosis (EBD) instruments into their clinical practices to refine the diagnostic process. Three measures are used to illustrate this process, the DISC-IV (Shaffer et al., 2000), the Schedule for Affective Disorders and…

75 FR 52627 - Disenrollment Procedures

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-27

... program that has been discontinued. It also amends the regulation to reflect current VA practice and to... conform with current VA practice, which does not disenroll veterans based on their failure to file VA Form 10-10EZ. Current practice is reflected in current paragraph (d)(3)(iv). Removing paragraph (d)(5)(iii...

Alumni of a BSW-Level Specialized Title IV-E Program Voice Their Experiences in the Workplace

ERIC Educational Resources Information Center

Falk, Diane S.

2015-01-01

This study surveyed 289 alumni of a specialized Title IV-E program that prepares undergraduate social work students for careers in public child welfare, examining factors such as turnover rates, adherence to strengths-based practice principles, perceptions of work conditions, and intent to stay. Findings indicate that graduates of this program…

75 FR 33761 - Notice of Proposed Change to Section IV of the Virginia State Technical Guide

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-15

... Section IV of the Virginia State Technical Guide AGENCY: Natural Resources Conservation Service (NRCS), U... Rosa Road, Suite 209, Richmond, Virginia 23229-5014; Telephone number (804) 287-1691; Fax number (804) 287-1737. Copies of the practice standards will be made available upon written request to the address...

Deciphering the Diagnostic Codes: A Guide for School Counselors. Practical Skills for Counselors.

ERIC Educational Resources Information Center

Jones, W. Paul

Although school counselors have more contact with children and adolescents than most other human service professionals, they are frequently left out of discussions on diagnostic coding. Ways in which school counselors can use the codes in the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) are explored in this text. The book…

Analytical Modelling and Optimization of the Temperature-Dependent Dynamic Mechanical Properties of Fused Deposition Fabricated Parts Made of PC-ABS.

PubMed

Mohamed, Omar Ahmed; Masood, Syed Hasan; Bhowmik, Jahar Lal

2016-11-04

Fused deposition modeling (FDM) additive manufacturing has been intensively used for many industrial applications due to its attractive advantages over traditional manufacturing processes. The process parameters used in FDM have significant influence on the part quality and its properties. This process produces the plastic part through complex mechanisms and it involves complex relationships between the manufacturing conditions and the quality of the processed part. In the present study, the influence of multi-level manufacturing parameters on the temperature-dependent dynamic mechanical properties of FDM processed parts was investigated using IV-optimality response surface methodology (RSM) and multilayer feed-forward neural networks (MFNNs). The process parameters considered for optimization and investigation are slice thickness, raster to raster air gap, deposition angle, part print direction, bead width, and number of perimeters. Storage compliance and loss compliance were considered as response variables. The effect of each process parameter was investigated using developed regression models and multiple regression analysis. The surface characteristics are studied using scanning electron microscope (SEM). Furthermore, performance of optimum conditions was determined and validated by conducting confirmation experiment. The comparison between the experimental values and the predicted values by IV-Optimal RSM and MFNN was conducted for each experimental run and results indicate that the MFNN provides better predictions than IV-Optimal RSM.

Analytical Modelling and Optimization of the Temperature-Dependent Dynamic Mechanical Properties of Fused Deposition Fabricated Parts Made of PC-ABS

PubMed Central

Mohamed, Omar Ahmed; Masood, Syed Hasan; Bhowmik, Jahar Lal

2016-01-01

Fused deposition modeling (FDM) additive manufacturing has been intensively used for many industrial applications due to its attractive advantages over traditional manufacturing processes. The process parameters used in FDM have significant influence on the part quality and its properties. This process produces the plastic part through complex mechanisms and it involves complex relationships between the manufacturing conditions and the quality of the processed part. In the present study, the influence of multi-level manufacturing parameters on the temperature-dependent dynamic mechanical properties of FDM processed parts was investigated using IV-optimality response surface methodology (RSM) and multilayer feed-forward neural networks (MFNNs). The process parameters considered for optimization and investigation are slice thickness, raster to raster air gap, deposition angle, part print direction, bead width, and number of perimeters. Storage compliance and loss compliance were considered as response variables. The effect of each process parameter was investigated using developed regression models and multiple regression analysis. The surface characteristics are studied using scanning electron microscope (SEM). Furthermore, performance of optimum conditions was determined and validated by conducting confirmation experiment. The comparison between the experimental values and the predicted values by IV-Optimal RSM and MFNN was conducted for each experimental run and results indicate that the MFNN provides better predictions than IV-Optimal RSM. PMID:28774019

Decision-making theories and their usefulness to the midwifery profession both in terms of midwifery practice and the education of midwives.

PubMed

Jefford, Elaine; Fahy, Kathleen; Sundin, Deborah

2011-06-01

What are the strengths and limitations of existing Decision-Making Theories as a basis for guiding best practice clinical decision-making within a framework of midwifery philosophy? Each theory is compared in relation with how well they provide a teachable framework for midwifery clinical reasoning that is consistent with midwifery philosophy. Hypothetico-Deductive Theory, from which medical clinical reasoning is based; intuitive decision-making; Dual Processing Theory; The International Confederation of Midwives Clinical Decision-Making Framework; Australian Nursing and Midwifery Council Midwifery Practice Decisions Flowchart and Midwifery Practice. Best practice midwifery clinical Decision-Making Theory needs to give guidance about: (i) effective use of cognitive reasoning processes; (ii) how to include contextual and emotional factors; (iii) how to include the interests of the baby as an integral part of the woman; (iv) decision-making in partnership with woman; and (v) how to recognize/respond to clinical situations outside the midwife's legal/personal scope of practice. No existing Decision-Making Theory meets the needs of midwifery. Medical clinical reasoning has a good contribution to make in terms of cognitive reasoning processes. Two limitations of medical clinical reasoning are its reductionistic focus and privileging of reason to the exclusion of emotional and contextual factors. Hypothetico-deductive clinical reasoning is a necessary but insufficient condition for best practice clinical decision-making in midwifery. © 2011 Blackwell Publishing Asia Pty Ltd.

National Water Infrastructure Adaptation Assessment, Part I: Climate Change Adaptation Readiness Analysis

EPA Science Inventory

The report “National Water Infrastructure Adaptation Assessment” is comprised of four parts (Part I to IV), each in an independent volume. The Part I report presented herein describes a preliminary regulatory and technical analysis of water infrastructure and regulations in the ...

The Transmission of Family Food and Mealtime Practices From Adolescence to Adulthood: Longitudinal Findings From Project EAT-IV.

PubMed

Watts, Allison; Berge, Jerica M; Loth, Katie; Larson, Nicole; Neumark-Sztainer, Dianne

2018-02-01

To determine whether family food and mealtime practices experienced in adolescence are carried forward into parenthood. Baseline (Project Eating and Activity in Teens and Young Adults [EAT]-I) and 15-year follow-up (EAT-IV) survey data from a population-based cohort study (Project EAT). Cohort members identified as parents at follow-up (n = 727). To gain additional data about the practices of both parents in the household, significant others completed surveys at EAT-IV (n = 380). Frequency of family meals, healthfulness of foods at home, frequency of meals in front of the television, and expectations of being home for dinner. Linear regression models tested associations between parent food and mealtime practices reported at baseline and follow-up controlling for demographics. Healthy and unhealthy home food availability, expectations to be home for dinner, and eating in front of the television in adolescence predicted similar outcomes 15 years later among female parents (effect sizes range: β = .2-.3; P < .001), and to a lesser extent among males. Families ate more frequent family meals when either 1 or both parents reported frequent family meals as an adolescent compared with when neither parent reported frequent family meals as an adolescent. It is important to invest in parenting interventions that target healthful family food and mealtime practices because of the potential long-term impact on their own children's parenting practices. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Willis Lamb, Jr., the Hydrogen Atom, and the Lamb Shift

Science.gov Websites

1955, Lamb won the Nobel Prize in Physics for his discoveries concerning "the fine structure of , May 7 - September 30, 1979 Fine Structure of the Hydrogen Atom, Part I; Part II; Part III; Part IV ; Part V; Part VI (from Physical Review 1950-1953) Microwave Technique for Determining the Fine Structure

Societal cost of subcutaneous and intravenous trastuzumab for HER2-positive breast cancer - An observational study prospectively recording resource utilization in a Swedish healthcare setting.

PubMed

Olofsson, Sara; Norrlid, Hanna; Karlsson, Eva; Wilking, Ulla; Ragnarson Tennvall, Gunnel

2016-10-01

Trastuzumab is part of the standard treatment for HER2-positive breast cancer. The aim of this study was to estimate the societal value of trastuzumab administered through subcutaneous (SC) injection compared to intravenous (IV) infusion. Female patients with HER2-positive breast cancer receiving SC or IV trastuzumab were consecutively enrolled from five Swedish oncology clinics from 2013 to 2015. Data on time and resource utilization was collected prospectively using patient and nurse questionnaires. Societal costs were calculated by multiplying the resource use by its corresponding unit price, including direct medical costs (pharmaceuticals, materials, nurse time, etc.), direct non-medical costs (transportation) and indirect costs (production loss, lost leisure time). Costs were reported separately for patients receiving trastuzumab for the first time and non-first time ("subsequent treatment"). In total, 101 IV and 94 SC patients were included in the study. The societal costs were lower with SC administration. For subsequent treatments the cost difference was €117 (IV €2099; SC €1983), partly explained by a higher time consumption both for nurses (14 min) and patients (23 min) with IV administration. Four IV and 16 SC patients received trastuzumab for the first time and were analysed separately, resulting in a difference in societal costs of €897 per treatment. A majority of patients preferred SC to IV administration. SC administration resulted in both less direct medical costs and indirect costs, and was consequently less costly than IV administration from a societal perspective in a Swedish setting. Copyright © 2016 Elsevier Ltd. All rights reserved.

Building Analytic Capacity and Statistical Literacy Among Title IV-E MSW Students

PubMed Central

LERY, BRIDGETTE; PUTNAM-HORNSTEIN, EMILY; WIEGMANN, WENDY; KING, BRYN

2016-01-01

Building and sustaining effective child welfare practice requires an infrastructure of social work professionals trained to use data to identify target populations, connect interventions to outcomes, adapt practice to varying contexts and dynamic populations, and assess their own effectiveness. Increasingly, public agencies are implementing models of self-assessment in which administrative data are used to guide and continuously evaluate the implementation of programs and policies. The research curriculum described in the article was developed to provide Title IV-E and other students interested in public child welfare systems with hands-on opportunities to become experienced and “statistically literate” users of aggregated public child welfare data from California’s administrative child welfare system, attending to the often missing link between data/research and practice improvement. PMID:27429600

34 CFR 668.26 - End of an institution's participation in the Title IV, HEA programs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... institution's students; (2) The institution loses its institutional eligibility under 34 CFR part 600; (3) The...) All financial, performance, and other reports required by appropriate Title IV, HEA program... Aid Report to the institution or when an institution has received a valid institutional student...

12 CFR Appendix A to Part 1720 - Policy Guidance; Minimum Safety and Soundness Requirements

Code of Federal Regulations, 2011 CFR

2011-01-01

... effectively and to model the effect of differing interest rate scenarios on the Enterprise's financial... liquidity under varying scenarios. IV. Information technology. An Enterprise should establish and implement... functions; iv. Adequate testing and review of audited areas together with adequate documentation of findings...

Title IV Indian Education Program Evaluation 1986-87.

ERIC Educational Resources Information Center

Albuquerque Public Schools, NM. Planning, Research and Accountability.

Albuquerque (New Mexico) public schools used a Title IV Part A grant to improve academic and behavioral functioning of American Indian elementary and secondary school students. The program's focus was tutoring provided to 899 Indian students from Canoncito Navajo Reservation, the Isleta Pueblo, and the city. A project coordinator, a resource…

Title IV Indian Education Program Evaluation, 1985-86.

ERIC Educational Resources Information Center

Albuquerque Public Schools, NM. Planning, Research and Accountability.

Public schools in Albuquerque, New Mexico, used a Title IV Part A grant to assist American Indian elementary and secondary school students in receiving passing grades and improving school-related behaviors. Canoncito Navajo Reservation, the Isleta Pueblo, and urban Indian students in Albuquerque participated in the program. Personnel consisted of…

14 CFR 61.5 - Certificates and ratings issued under this part.

Code of Federal Regulations, 2010 CFR

2010-01-01

.... (iii) Glider. (iv) Lighter-than-air. (v) Powered-lift. (vi) Powered parachute. (vii) Weight-shift...—Airplane. (ii) Instrument—Helicopter. (iii) Instrument—Powered-lift. (c) The following ratings are placed.... (iii) Glider. (iv) Powered-lift. (2) Airplane class ratings— (i) Single-engine. (ii) Multiengine. (3...

14 CFR 61.5 - Certificates and ratings issued under this part.

Code of Federal Regulations, 2011 CFR

2011-01-01

.... (iii) Glider. (iv) Lighter-than-air. (v) Powered-lift. (vi) Powered parachute. (vii) Weight-shift...—Airplane. (ii) Instrument—Helicopter. (iii) Instrument—Powered-lift. (c) The following ratings are placed.... (iii) Glider. (iv) Powered-lift. (2) Airplane class ratings— (i) Single-engine. (ii) Multiengine. (3...

45 CFR 309.01 - What does this part cover?

Code of Federal Regulations, 2011 CFR

2011-10-01

... Public Welfare Regulations Relating to Public Welfare OFFICE OF CHILD SUPPORT ENFORCEMENT (CHILD SUPPORT... CHILD SUPPORT ENFORCEMENT (IV-D) PROGRAM Tribal IV-D Program: General Provisions § 309.01 What does this... Social Security Act. Section 455(f) of the Act authorizes direct grants to Indian Tribes and Tribal...

78 FR 69604 - Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-20

... Manufacturing Practice and Hazard Analysis and Risk- Based Preventive Controls for Human Food; Extension of... Hazard Analysis and Risk- Based Preventive Controls for Human Food'' and its information collection... Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for Human Food.'' IV. How To...

Dollar$ & $en$e. Part V: What is your added value?

PubMed

Wilkinson, I

2001-01-01

In Part I of this series, I introduced the concept of memes (1). Memes are ideas or concepts--the information world equivalent of genes. The goal of this series of articles is to infect you with memes, so that you will assimilate, translate, and express them. No matter what our area of expertise or "-ology," we all are in the information business. Our goal is to be in the wisdom business. In the previous papers in this series, I showed that when we convert raw data into wisdom we are moving along a value chain. Each step in the chain adds a different amount of value to the final product: timely, relevant, accurate, and precise knowledge that can be applied to create the ultimate product in the value chain: wisdom. In Part II of this series, I introduced a set of memes for measuring the cost of adding value (2). In Part III of this series, I presented a new set of memes for measuring the added value of knowledge, i.e., intellectual capital (3). In Part IV of this series, I discussed practical knowledge management tools for measuring the value of people, structural, and customer capital (4). In Part V of this series, I will apply intellectual capital and knowledge management concepts at the individual level, to help answer a fundamental question: What is my added value?

Parents' and children's knowledge of oral health: a qualitative study of children with cleft palate.

PubMed

Davies, Karen; Lin, Yin-Ling; Callery, Peter

2017-07-01

Children with cleft lip and/or palate (CLP) are prone to poorer oral health outcomes than their peers, with serious implications for treatment. Little is known of the knowledge and practice of children with CLP in caring for teeth and how these contribute to oral health. To investigate (i) parents' and children's knowledge of oral health, (ii) how knowledge is acquired, and (iii) how knowledge is implemented. A qualitative design was used to investigate knowledge, beliefs, and practices reported by parents and children, age 5-11 years with CLP. Data were collected from 22 parents and 16 children and analysed using thematic analysis. Four themes were derived as follows: (i) implicit knowledge: children express simple knowledge underpinned by basic rationales, (ii) situated knowledge: children gain skills as part of everyday childhood routines, (iii) maintaining good practice in oral health: parents take a lead role in motivating, monitoring, and maintaining children's toothbrushing, and (iv) learning opportunities: pivotal moments provide opportunities for children to extend their knowledge. Developers of oral health education interventions should take account of children's implicit knowledge and the transmission of beliefs between generations that influence toothbrushing behaviours. This could enhance interventions to support parents and children's practice. © 2016 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Theory of Holors

NASA Astrophysics Data System (ADS)

Hiram Moon, Parry; Eberle Spencer, Domina

2005-09-01

Preface; Nomenclature; Historical introduction; Part I. Holors: 1. Index notation; 2. Holor algebra; 3. Gamma products; Part II. Transformations: 4. Tensors; 5. Akinetors; 6. Geometric spaces; Part III. Holor Calculus: 7. The linear connection; 8. The Riemann-Christoffel tensors; Part IV. Space Structure: 9. Non-Riemannian spaces; 10. Riemannian space; 11. Euclidean space; References; Index.

Single Crystal Diffractometry

NASA Astrophysics Data System (ADS)

Arndt, U. W.; Willis, B. T. M.

2009-06-01

Preface; Acknowledgements; Part I. Introduction; Part II. Diffraction Geometry; Part III. The Design of Diffractometers; Part IV. Detectors; Part V. Electronic Circuits; Part VI. The Production of the Primary Beam (X-rays); Part VII. The Production of the Primary Beam (Neutrons); Part VIII. The Background; Part IX. Systematic Errors in Measuring Relative Integrated Intensities; Part X. Procedure for Measuring Integrated Intensities; Part XI. Derivation and Accuracy of Structure Factors; Part XII. Computer Programs and On-line Control; Appendix; References; Index.

Health Occupations Education I. Module No. IV-A to IV-F.

ERIC Educational Resources Information Center

Dunmeyer, Kathryn; And Others

This set of 6 modules on patient body mechanics is 1 of 11 sets in the Health Occupations Education I instructional package for the first year of a 2-year course of study. The materials are designed to prepare students through individualized instruction for entry-level job opportunities on health care teams in a variety of practice settings. Each…

Multiple Intravenous Infusions Phase 1b

PubMed Central

Cassano-Piché, A; Fan, M; Sabovitch, S; Masino, C; Easty, AC

2012-01-01

Background Minimal research has been conducted into the potential patient safety issues related to administering multiple intravenous (IV) infusions to a single patient. Previous research has highlighted that there are a number of related safety risks. In Phase 1a of this study, an analysis of 2 national incident-reporting databases (Institute for Safe Medical Practices Canada and United States Food and Drug Administration MAUDE) found that a high percentage of incidents associated with the administration of multiple IV infusions resulted in patient harm. Objectives The primary objectives of Phase 1b of this study were to identify safety issues with the potential to cause patient harm stemming from the administration of multiple IV infusions; and to identify how nurses are being educated on key principles required to safely administer multiple IV infusions. Data Sources and Review Methods A field study was conducted at 12 hospital clinical units (sites) across Ontario, and telephone interviews were conducted with program coordinators or instructors from both the Ontario baccalaureate nursing degree programs and the Ontario postgraduate Critical Care Nursing Certificate programs. Data were analyzed using Rasmussen’s 1997 Risk Management Framework and a Health Care Failure Modes and Effects Analysis. Results Twenty-two primary patient safety issues were identified with the potential to directly cause patient harm. Seventeen of these (critical issues) were categorized into 6 themes. A cause-consequence tree was established to outline all possible contributing factors for each critical issue. Clinical recommendations were identified for immediate distribution to, and implementation by, Ontario hospitals. Future investigation efforts were planned for Phase 2 of the study. Limitations This exploratory field study identifies the potential for errors, but does not describe the direct observation of such errors, except in a few cases where errors were observed. Not all issues are known in advance, and the frequency of errors is too low to be observed in the time allotted and with the limited sample of observations. Conclusions The administration of multiple IV infusions to a single patient is a complex task with many potential associated patient safety risks. Improvements to infusion and infusion-related technology, education standards, clinical best practice guidelines, hospital policies, and unit work practices are required to reduce the risk potential. This report makes several recommendations to Ontario hospitals so that they can develop an awareness of the issues highlighted in this report and minimize some of the risks. Further investigation of mitigating strategies is required and will be undertaken in Phase 2 of this research. Plain Language Summary Patients, particularly in critical care environments, often require multiple intravenous (IV) medications via large volumetric or syringe infusion pumps. The infusion of multiple IV medications is not without risk; unintended errors during these complex procedures have resulted in patient harm. However, the range of associated risks and the factors contributing to these risks are not well understood. Health Quality Ontario’s Ontario Health Technology Advisory Committee commissioned the Health Technology Safety Research Team at the University Health Network to conduct a multi-phase study to identify and mitigate the risks associated with multiple IV infusions. Some of the questions addressed by the team were as follows: What is needed to reduce the risk of errors for individuals who are receiving a lot of medications? What strategies work best? The initial report, Multiple Intravenous Infusions Phase 1a: Situation Scan Summary Report, summarizes the interim findings based on a literature review, an incident database review, and a technology scan. The Health Technology Safety Research Team worked in close collaboration with the Institute for Safe Medication Practices Canada on an exploratory study to understand the risks associated with multiple IV infusions and the degree to which nurses are educated to help mitigate them. The current report, Multiple Intravenous Infusions Phase 1b: Practice and Training Scan, presents the findings of a field study of 12 hospital clinical units across Ontario, as well as 13 interviews with educators from baccalaureate-level nursing degree programs and postgraduate Critical Care Nursing Certificate programs. It makes 9 recommendations that emphasize best practices for the administration of multiple IV infusions and pertain to secondary infusions, line identification, line set-up and removal, and administering IV bolus medications. The Health Technology Safety Research Team has also produced an associated report for hospitals entitled Mitigating the Risks Associated With Multiple IV Infusions: Recommendations Based on a Field Study of Twelve Ontario Hospitals, which highlights the 9 interim recommendations and provides a brief rationale for each one. PMID:23074426

Putting the public (back) into public health: leadership, evidence and action.

PubMed

South, J; Connolly, A M; Stansfield, J A; Johnstone, P; Henderson, G; Fenton, K A

2018-03-13

There is a strong evidence-based rationale for community capacity building and community empowerment as part of a strategic response to reduce health inequalities. Within the current UK policy context, there are calls for increased public engagement in prevention and local decision-making in order to give people greater control over the conditions that determine health. With reference to the challenges and opportunities within the English public health system, this essay seeks to open debate about what is required to mainstream community-centred approaches and ensure that the public is central to public health. The essay sets out the case for a reorientation of public health practice in order to build impactful action with communities at scale leading to a reduction in the health gap. National frameworks that support local practice are described. Four areas of challenge that could potentially drive an implementation gap are discussed: (i) achieving integration and scale, (ii) effective community mobilization, (iii) evidencing impact and (iv) achieving a shift in power. The essay concludes with a call to action for developing a contemporary public health practice that is rooted in communities and offers local leadership to strengthen local assets, increase community control and reduce health inequalities.

Major depressive disorder in DSM-5: implications for clinical practice and research of changes from DSM-IV.

PubMed

Uher, Rudolf; Payne, Jennifer L; Pavlova, Barbara; Perlis, Roy H

2014-06-01

The changes in diagnostic criteria for major depressive disorder (MDD) from the fourth to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) may appear small but have important consequences for how the diagnosis is used. In DSM-5, MDD is part of the new "Depressive disorders" section, which is separate from "Bipolar disorders", marking a division in what had been known as "Mood disorders". A small wording change has expanded the core mood criterion to include hopelessness, potentially broadening the diagnosis. The replacement of an operationalized bereavement exclusion with a call for clinical judgment in distinguishing normal reactions to significant loss from a disorder in need of clinical attention makes the diagnosis less objective and complicates investigations of the relationship between adversity and depression. A new persistent depressive disorder category is intended to encompass both dysthymia and chronic depression, but its relationship to MDD is ambiguous with conflicting statements on whether the two diagnoses should be concurrent if both sets of criteria are fulfilled. Clarification is also needed on whether MDD can be concurrent with the new broad "other specified bipolar and related disorders". New specifiers of MDD "with anxious distress" and "with mixed features" allow characterization of additional symptoms. The specifier "with perinatal onset" expands on the DSM-IV "postnatal onset" to include onset during pregnancy. We review the changes in MDD definition, provide guidance on their implementation and discuss their implications for clinical practice and research. © 2013 Wiley Periodicals, Inc.

The Role of Independent V&V in Upstream Software Development Processes

NASA Technical Reports Server (NTRS)

Easterbrook, Steve

1996-01-01

This paper describes the role of Verification and Validation (V&V) during the requirements and high level design processes, and in particular the role of Independent V&V (IV&V). The job of IV&V during these phases is to ensure that the requirements are complete, consistent and valid, and to ensure that the high level design meets the requirements. This contrasts with the role of Quality Assurance (QA), which ensures that appropriate standards and process models are defined and applied. This paper describes the current state of practice for IV&V, concentrating on the process model used in NASA projects. We describe a case study, showing the processes by which problem reporting and tracking takes place, and how IV&V feeds into decision making by the development team. We then describe the problems faced in implementing IV&V. We conclude that despite a well defined process model, and tools to support it, IV&V is still beset by communication and coordination problems.

Virological Surveillance of Influenza A Subtypes Isolated in 2014 from Clinical Outbreaks in Canadian Swine

PubMed Central

Grgić, Helena; Gallant, Jackie; Poljak, Zvonimir

2017-01-01

Influenza A viruses (IAVs) are respiratory pathogens associated with an acute respiratory disease that occurs year-round in swine production. It is currently one of the most important pathogens in swine populations, with the potential to infect other host species including humans. Ongoing research indicates that the three major subtypes of IAV—H1N1, H1N2, and H3N2—continue to expand in their genetic and antigenic diversity. In this study, we conducted a comprehensive genomic analysis of 16 IAVs isolated from different clinical outbreaks in Alberta, Manitoba, Ontario, and Saskatchewan in 2014. We also examined the genetic basis for probable antigenic differences among sequenced viruses. On the basis of phylogenetic analysis, all 13 Canadian H3N2 viruses belonged to cluster IV, eight H3N2 viruses were part of the IV-C cluster, and one virus belonged to the IV-B and one to the IV-D cluster. Based on standards used in this study, three H3N2 viruses could not be clearly classified into any currently established group within cluster IV (A to F). Three H1N2 viruses were part of the H1α cluster. PMID:28335552

Independent verification and validation for Space Shuttle flight software

NASA Technical Reports Server (NTRS)

1992-01-01

The Committee for Review of Oversight Mechanisms for Space Shuttle Software was asked by the National Aeronautics and Space Administration's (NASA) Office of Space Flight to determine the need to continue independent verification and validation (IV&V) for Space Shuttle flight software. The Committee found that the current IV&V process is necessary to maintain NASA's stringent safety and quality requirements for man-rated vehicles. Therefore, the Committee does not support NASA's plan to eliminate funding for the IV&V effort in fiscal year 1993. The Committee believes that the Space Shuttle software development process is not adequate without IV&V and that elimination of IV&V as currently practiced will adversely affect the overall quality and safety of the software, both now and in the future. Furthermore, the Committee was told that no organization within NASA has the expertise or the manpower to replace the current IV&V function in a timely fashion, nor will building this expertise elsewhere necessarily reduce cost. Thus, the Committee does not recommend moving IV&V functions to other organizations within NASA unless the current IV&V is maintained for as long as it takes to build comparable expertise in the replacing organization.

45 CFR 305.61 - Penalty for failure to meet IV-D requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HEALTH AND HUMAN SERVICES PROGRAM PERFORMANCE MEASURES, STANDARDS, FINANCIAL INCENTIVES, AND PENALTIES § 305.61 Penalty for failure to meet IV-D requirements. (a) A State will be subject to a financial... order establishment and current collections performance measures as set forth in § 305.40 of this part...

20 CFR 410.702 - Definitions and terms.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., TITLE IV-BLACK LUNG BENEFITS (1969- ) Rules for the Review of Denied and Pending Claims Under the Black... shall apply with regard to review under this subpart G. (a) Denied claim defined. Denied claim means: (1) Any claim that was filed with the Social Security Administration under part B of title IV of the Act...

20 CFR 410.702 - Definitions and terms.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., TITLE IV-BLACK LUNG BENEFITS (1969- ) Rules for the Review of Denied and Pending Claims Under the Black... shall apply with regard to review under this subpart G. (a) Denied claim defined. Denied claim means: (1) Any claim that was filed with the Social Security Administration under part B of title IV of the Act...

Review of Prescribing Practices for Intermittent Bolus Administration of Morphine

PubMed Central

Sine, Keith; Vaillancourt, Régis; Pascuet, Elena; Martelli, Brenda; Lamontagne, Christine; Ellis, Jacqueline; Wong, Elaine; Gaboury, Isabelle

2011-01-01

Background: Several changes to medication safety practices were proposed in a pediatric hospital, including changing the period of patient observation after administration of opioids and limiting the availability of various concentrations of morphine in the patient care unit. Objective: To document and review postoperative pain management for children on a surgical ward, specifically with regard to intermittent IV bolus administration of morphine, to help in assessing the impact of the proposed nursing practice changes. Methods: Data were collected from records for narcotics and controlled drugs for the surgical ward over a 3-month period (April to June 2006). For each patient, data had been recorded for up to 7 consecutive days after surgery. A patient’s data were included in the review if he or she had received at least 2 doses of morphine by IV bolus, except for the review of weight-based dosing pattern (mg/kg), for which all patients who had received at least one dose of IV morphine were included. Results: Charts for 193 patients were audited. Of these, 163 patients (84.5%) had recieved up to 0.1 mg/kg per dose, and 53 (27.5%) had received only one dose of morphine. Among patients who received more than one dose, the median dose was 0.080 mg/kg on day 1, with a decrease by day 5 to 0.065 mg/kg. Most patients received morphine over the first 2 days after surgery. The median time elapsed between doses was 4.3 h on day 1 and 6.2 h on day 2. Of the 1020 doses included in the analysis, most (801 [78.5%]) were 4 mg or less. Conclusion: The intermittent administration of IV bolus doses of morphine at the study hospital followed common standards for the treatment of postoperative pain. Most doses were no more than 4 mg. On the basis of this information, only 2-mg vials of morphine are now stocked on the ward. The hospital’s change in monitoring practices will increase the surveillance of patients receiving IV bolus doses of morphine. PMID:22479025

Intravenous Therapy.

ERIC Educational Resources Information Center

Galliart, Barbara

Intended for teaching licensed practical nurses, this curriculum guide provides information related to the equipment and skills required for nursing care of patients needing intravenous (IV) therapy. It also explains the roles and responsibilities of the licensed practical nurse with regard to intravenous therapy. Each of the 15 instructional…

Identifying and applying psychological theory to setting and achieving rehabilitation goals.

PubMed

Scobbie, Lesley; Wyke, Sally; Dixon, Diane

2009-04-01

Goal setting is considered to be a fundamental part of rehabilitation; however, theories of behaviour change relevant to goal-setting practice have not been comprehensively reviewed. (i) To identify and discuss specific theories of behaviour change relevant to goal-setting practice in the rehabilitation setting. (ii) To identify 'candidate' theories that that offer most potential to inform clinical practice. The rehabilitation and self-management literature was systematically searched to identify review papers or empirical studies that proposed a specific theory of behaviour change relevant to setting and/or achieving goals in a clinical context. Data from included papers were extracted under the headings of: key constructs, clinical application and empirical support. Twenty-four papers were included in the review which proposed a total of five theories: (i) social cognitive theory, (ii) goal setting theory, (iii) health action process approach, (iv) proactive coping theory, and (v) the self-regulatory model of illness behaviour. The first three of these theories demonstrated most potential to inform clinical practice, on the basis of their capacity to inform interventions that resulted in improved patient outcomes. Social cognitive theory, goal setting theory and the health action process approach are theories of behaviour change that can inform clinicians in the process of setting and achieving goals in the rehabilitation setting. Overlapping constructs within these theories have been identified, and can be applied in clinical practice through the development and evaluation of a goal-setting practice framework.

The Planning of Change. Third Edition.

ERIC Educational Resources Information Center

Bennis, Warren G., Ed.; And Others

This collection of essays discusses some of the models employed in the analysis of change processes. Part I provides a history of strategies for social change. Part II explores the meaning and use of systems models used to diagnose change situations. Part III deals with the intervention modes, and Part IV explores the dilemmas confronted by agents…

Neurons of human nucleus accumbens.

PubMed

Sazdanović, Maja; Sazdanović, Predrag; Zivanović-Macuzić, Ivana; Jakovljević, Vladimir; Jeremić, Dejan; Peljto, Amir; Tosevski, Jovo

2011-08-01

Nucleus accumbens is a part of the ventral striatum also known as a drug active brain region, especially related with drug addiction. The aim of the study was to investigate the Golgi morphology of the nucleus accumbens neurons. The study was performed on the frontal and sagittal sections of 15 human brains by the Golgi Kopsch method. We classified neurons in the human nucleus accumbens according to their morphology and size into four types: type I--fusiform neurons; type II--fusiform neurons with lateral dendrite, arising from a part of the cell body; type III--pyramidal-like neuron; type IV--multipolar neuron. The medium spiny neurons, which are mostly noted regarding to the drug addictive conditions of the brain, correspond to the type IV--multipolar neurons. Two regions of human nucleus accumbens could be clearly recognized on Nissl and Golgi preparations each containing different predominant neuronal types. Central part of nucleus accumbens, core region, has a low density of impregnated neurons with predominant type III, pyramidal-like neurons, with spines on secondary branches and rare type IV, multipolar neurons. Contrary to the core, peripheral region, shell of nucleus, has a high density of impregnated neurons predominantly contained of type I and type IV--multipolar neurons, which all are rich in spines on secondary and tertiary dendritic branches. Our results indicate great morphological variability of human nucleus accumbens neurons. This requires further investigations and clarifying clinical significance of this important brain region.

Assessing the Impact of Drug Use on Hospital Costs

PubMed Central

Stuart, Bruce C; Doshi, Jalpa A; Terza, Joseph V

2009-01-01

Objective To assess whether outpatient prescription drug utilization produces offsets in the cost of hospitalization for Medicare beneficiaries. Data Sources/Study Setting The study analyzed a sample (N=3,101) of community-dwelling fee-for-service U.S. Medicare beneficiaries drawn from the 1999 and 2000 Medicare Current Beneficiary Surveys. Study Design Using a two-part model specification, we regressed any hospital admission (part 1: probit) and hospital spending by those with one or more admissions (part 2: nonlinear least squares regression) on drug use in a standard model with strong covariate controls and a residual inclusion instrumental variable (IV) model using an exogenous measure of drug coverage as the instrument. Principal Findings The covariate control model predicted that each additional prescription drug used (mean=30) raised hospital spending by $16 (p<.001). The residual inclusion IV model prediction was that each additional prescription fill reduced hospital spending by $104 (p<.001). Conclusions The findings indicate that drug use is associated with cost offsets in hospitalization among Medicare beneficiaries, once omitted variable bias is corrected using an IV technique appropriate for nonlinear applications. PMID:18783453

Math anxiety differentially affects WAIS-IV arithmetic performance in undergraduates.

PubMed

Buelow, Melissa T; Frakey, Laura L

2013-06-01

Previous research has shown that math anxiety can influence the math performance level; however, to date, it is unknown whether math anxiety influences performance on working memory tasks during neuropsychological evaluation. In the present study, 172 undergraduate students completed measures of math achievement (the Math Computation subtest from the Wide Range Achievement Test-IV), math anxiety (the Math Anxiety Rating Scale-Revised), general test anxiety (from the Adult Manifest Anxiety Scale-College version), and the three Working Memory Index tasks from the Wechsler Adult Intelligence Scale-IV Edition (WAIS-IV; Digit Span [DS], Arithmetic, Letter-Number Sequencing [LNS]). Results indicated that math anxiety predicted performance on Arithmetic, but not DS or LNS, above and beyond the effects of gender, general test anxiety, and math performance level. Our findings suggest that math anxiety can negatively influence WAIS-IV working memory subtest scores. Implications for clinical practice include the utilization of LNS in individuals expressing high math anxiety.

Break-even analysis of Medicaid vs fee for service in orthodontic practice: North Carolina as a case study.

PubMed

Murdock, John E; Phillips, Ceib; Beane, Richard; Quinonez, Rocio

2010-03-01

Access to orthodontic services for children enrolled in Medicaid is limited nationwide. Orthodontists cite low fee reimbursement as a significant barrier to Medicaid participation. The purpose of this study was to examine, under a specific set of practice assumptions, the simulated effect on profitability of treating patients covered by Medicaid in orthodontic practices in North Carolina by using a break-even analysis for the 2005 fiscal year. Questionnaires were mailed to 154 orthodontists in active practice in North Carolina. The response rate was 58%. Seventy respondents met the eligibility criteria. Respondents were categorized into 4 groups based on the number of 2005 Medicaid case starts (I, 0; II, 1-5; III, 6-12; IV, 13 or more). By using the aggregated responses for treatment fees, treatment times, and overhead percentages for each group, average per-patient costs were calculated for each group and used in a break-even analysis. Group I accounted for 60% of respondents; group II, 20%; group III, 9%; and group IV, 11%. Assuming that the break-even point had not been reached, the group I practice would have an average estimated loss of $164 per patient whereas groups II, III, and IV would realize average profits from $98 to $256. The break-even point increased slightly in groups I, II, and III after the total number of patients in the patient pool was increased by 5%, assuming that additional patients were enrolled in Medicaid: group I, 203 to 210; group II, 220 to 226; group III, 158 to 160. The break-even point for group IV was 234 patients. Assuming that the break-even point had been reached, all groups were estimated to realize average per-patient profits of $1483 to $1897. Break-even analysis is a basic economic concept applicable to orthodontic practices. Under the specific conditions of this study, the inclusion of 5% of patients enrolled in Medicaid in the active patient pool had minimal effect on the financial break-even point and, assuming that the break-even point had been reached, was unlikely to have a negative financial impact on the practice. 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Exporting simulation technology to the Philippines: a comparative study of traditional versus simulation methods for teaching intravenous cannulation.

PubMed

Sotto, Juan Alejandro R; Ayuste, Eduardo C; Bowyer, Mark W; Almonte, Josefina R; Dofitas, Rodney B; Lapitan, Marie C M; Pimentel, Elisabeth A; Ritter, E Matthew; Wherry, David C

2009-01-01

This study examines effectiveness of a donated Laerdal Virtual I.V. simulator when compared with traditional methods of teaching intravenous (IV) cannulation to third year medical students in the Philippines. Forty novice Filipino medical students viewed an instructional video on how to start intravenous lines and were then randomly divided into two groups of twenty. The "Traditional" group observed an IV insertion on an actual patient performed by an experienced practitioner, and then subsequently performed an IV on an actual patient which was videotaped. The "Simulation" group practiced the Virtual I.V. simulator until they successfully completed level three using the "doctor" setting. These students then performed an IV on an actual patient which was videotaped. The videotapes for both groups were reviewed by two pre-trained (Inter-rater reliability of > or =0.84) observers who were blinded to the group using a previously validated checklist for IV insertion. Students trained on the Virtual I.V. showed significantly greater success in successfully starting an IV on an actual patient (40% VS. 15%, p<0.05), decreased constrictive band time (p<.05), increased raw score on the check list (p<.03), and decreased overall time to start an IV (p<.05). The technology was well received but wider application in the non western world is limited by lack of in country company support and the relative expense.

A Study of Mandarin Loanwords: Lexical Stratification, Adaptation and Factors

ERIC Educational Resources Information Center

Kim, Tae Eun

2012-01-01

This dissertation is about Chinese loanwords. It is mainly divided into two parts. Part I is a general discussion about loanwords in Chinese; Chapter I and II belong to the first part. Part II is a discussion about the analyses of Mandarin loanwords originating from English. Chapter III, IV, and V are all related to the second part. Chapter VI is…

Effects of practice on the Wechsler Adult Intelligence Scale-IV across 3- and 6-month intervals.

PubMed

Estevis, Eduardo; Basso, Michael R; Combs, Dennis

2012-01-01

A total of 54 participants (age M = 20.9; education M = 14.9; initial Full Scale IQ M = 111.6) were administered the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) at baseline and again either 3 or 6 months later. Scores on the Full Scale IQ, Verbal Comprehension, Working Memory, Perceptual Reasoning, Processing Speed, and General Ability Indices improved approximately 7, 5, 4, 5, 9, and 6 points, respectively, and increases were similar regardless of whether the re-examination occurred over 3- or 6-month intervals. Reliable change indices (RCI) were computed using the simple difference and bivariate regression methods, providing estimated base rates of change across time. The regression method provided more accurate estimates of reliable change than did the simple difference between baseline and follow-up scores. These findings suggest that prior exposure to the WAIS-IV results in significant score increments. These gains reflect practice effects instead of genuine intellectual changes, which may lead to errors in clinical judgment.

45 CFR 301.0 - Scope and applicability of this part.

Code of Federal Regulations, 2011 CFR

2011-10-01

.... This part deals with the administration of title IV-D of the Social Security Act by the Federal... under the approved plan; review and audit of State and local expenditures; and reconsideration of...

Instrumental variables analysis using multiple databases: an example of antidepressant use and risk of hip fracture.

PubMed

Uddin, Md Jamal; Groenwold, Rolf H H; de Boer, Anthonius; Gardarsdottir, Helga; Martin, Elisa; Candore, Gianmario; Belitser, Svetlana V; Hoes, Arno W; Roes, Kit C B; Klungel, Olaf H

2016-03-01

Instrumental variable (IV) analysis can control for unmeasured confounding, yet it has not been widely used in pharmacoepidemiology. We aimed to assess the performance of IV analysis using different IVs in multiple databases in a study of antidepressant use and hip fracture. Information on adults with at least one prescription of a selective serotonin reuptake inhibitor (SSRI) or tricyclic antidepressant (TCA) during 2001-2009 was extracted from the THIN (UK), BIFAP (Spain), and Mondriaan (Netherlands) databases. IVs were created using the proportion of SSRI prescriptions per practice or using the one, five, or ten previous prescriptions by a physician. Data were analysed using conventional Cox regression and two-stage IV models. In the conventional analysis, SSRI (vs. TCA) was associated with an increased risk of hip fracture, which was consistently found across databases: the adjusted hazard ratio (HR) was approximately 1.35 for time-fixed and 1.50 to 2.49 for time-varying SSRI use, while the IV analysis based on the IVs that appeared to satisfy the IV assumptions showed conflicting results, e.g. the adjusted HRs ranged from 0.55 to 2.75 for time-fixed exposure. IVs for time-varying exposure violated at least one IV assumption and were therefore invalid. This multiple database study shows that the performance of IV analysis varied across the databases for time-fixed and time-varying exposures and strongly depends on the definition of IVs. It remains challenging to obtain valid IVs in pharmacoepidemiological studies, particularly for time-varying exposure, and IV analysis should therefore be interpreted cautiously. Copyright © 2016 John Wiley & Sons, Ltd.

Ideas for Refining Children's Savings Account Proposals. Creating a Financial Stake in College: Report IV of IV

ERIC Educational Resources Information Center

Elliott, William, III

2012-01-01

"Creating a Financial Stake in College" is a four-part series of reports that focuses on the relationship between children's savings and improving college success. This series examines: (1) why policymakers should care about savings, (2) the relationship between inequality and bank account ownership, (3) the connections between savings…

45 CFR 309.145 - What costs are allowable for Tribal IV-D programs carried out under § 309.65(a) of this part?

Code of Federal Regulations, 2010 CFR

2010-10-01

.... (h) Automated data processing computer systems, including: (1) Planning efforts in the identification, evaluation, and selection of an automated data processing computer system solution meeting the program... existing automated data processing computer system to support Tribal IV-D program operations, and...

45 CFR 309.145 - What costs are allowable for Tribal IV-D programs carried out under § 309.65(a) of this part?

Code of Federal Regulations, 2013 CFR

2013-10-01

.... (h) Automated data processing computer systems, including: (1) Planning efforts in the identification, evaluation, and selection of an automated data processing computer system solution meeting the program... existing automated data processing computer system to support Tribal IV-D program operations, and...

45 CFR 309.145 - What costs are allowable for Tribal IV-D programs carried out under § 309.65(a) of this part?

Code of Federal Regulations, 2014 CFR

2014-10-01

.... (h) Automated data processing computer systems, including: (1) Planning efforts in the identification, evaluation, and selection of an automated data processing computer system solution meeting the program... existing automated data processing computer system to support Tribal IV-D program operations, and...

45 CFR 309.145 - What costs are allowable for Tribal IV-D programs carried out under § 309.65(a) of this part?

Code of Federal Regulations, 2012 CFR

2012-10-01

.... (h) Automated data processing computer systems, including: (1) Planning efforts in the identification, evaluation, and selection of an automated data processing computer system solution meeting the program... existing automated data processing computer system to support Tribal IV-D program operations, and...

45 CFR 309.145 - What costs are allowable for Tribal IV-D programs carried out under § 309.65(a) of this part?

Code of Federal Regulations, 2011 CFR

2011-10-01

.... (h) Automated data processing computer systems, including: (1) Planning efforts in the identification, evaluation, and selection of an automated data processing computer system solution meeting the program... existing automated data processing computer system to support Tribal IV-D program operations, and...

14 CFR Appendix A to Part 43 - Major Alterations, Major Repairs, and Preventive Maintenance

Code of Federal Regulations, 2013 CFR

2013-01-01

... hub design. (iii) Changes in the governor or control design. (iv) Installation of a propeller governor.... (iv) Engine mounts. (v) Control system. (vi) Landing gear. (vii) Hull or floats. (viii) Elements of an... of gravity limits of the aircraft. (xii) Changes to the basic design of the fuel, oil, cooling...

Printed-Circuit-Board Soldering Training for Group IV Personnel.

ERIC Educational Resources Information Center

Hooprich, E. A.; Matlock, E. W.

As part of a larger program to determine which Navy skills can be learned by lower aptitude personnel, and which methods and techniques would be most effective, an experimental course in printed circuit board soldering was given to 186 Group IV students in 13 classes. Two different training approaches--one stressing instructor guidance and the…

Cost identification of Nordic FLIRI, Nordic FLOX, XELIRI and XELOX in first-line treatment of advanced colorectal cancer in Sweden -- a clinical practice model approach.

PubMed

Pettersson, Karin; Carlsson, Göran; Holmberg, Christoffer; Sporrong, Sofia Kälvemark

2012-09-01

The role of health-related economy is crucial due to the finite healthcare resources. Intravenous (i.v.) regimes Nordic FLOX and Nordic FLIRI, and the partly oral alternatives XELIRI and XELOX are four commonly used chemotherapies in the first-line treatment of advanced colorectal cancer (CRC) in the Scandinavian countries, all with different costs. To describe and compare costs associated with four commonly used treatments for advanced CRC in clinical routine practice. An additional aim was to evaluate the theoretical cost impact of adverse effects associated with the therapies. The retrospective study was carried out using observations and a clinical quality database of CRC patients treated with Nordic FLOX, Nordic FLIRI, XELIRI and XELOX as first line at an oncology clinic in Gothenburg, Sweden. The treatments are used in parallel in clinical practice. All patients treated from 2003 to 2009 were included. The clinical outcome of the therapies was equivalent; mean treatment time was 5.9-7.7 months. A clinical economic evaluation model was designed. All direct costs associated with the baseline treatment, administration of chemotherapy and drug costs were collected and evaluated. The maximum cost for the four treatments was estimated to be 72 000-75 000 SEK per patient for six months, of this approximately 8000 SEK was linked to treatment of toxicity. During six months the i.v. treatments could include 17 more outpatient visits per patient compared to the oral alternatives. During treatment at the clinic around 20% of the patients were hospitalised (XELOX excluded, because of few included patients). The results indicate that the four regimens are similar in terms of treatment costs. Different costs affect the total cost. The oral alternative makes it possible to treat additional patients with the same labour force resources. Treatment of adverse effects contributes to extensive resource use at the hospital.

Feature Extraction and Classification of Magnetic and EMI Data, Camp Beale, CA

DTIC Science & Technology

2012-05-01

and non-specialists. However, as part of ESTCP 1004 we are presently working on transitioning our inversion algorithms to an API that will be...10 0 Time (ms) Cell 663 - Target 1965 - Model 1 (SOI) ISO IVS 0.001 0.005 10 0 Time (ms) Cell 1104 - Target 2532 - Model 1 (SOI) ISO IVS...0.0 1 0.005 10 0 Time (ms) Cell 663 - Target 1965 - Model 1 (SOI) ISO IVS 0.0 1 0.005 10 0 Time (ms) Cell 1104 - Target 2532 - Model 1 (SOI

Managing type II and type IV Lauge-Hansen supination external rotation ankle fractures: current orthopaedic practice.

PubMed

Kosuge, D D; Mahadevan, D; Chandrasenan, J; Pugh, H

2010-11-01

Differentiating supination external rotation (SER) type II and IV ankle injuries is challenging in the absence of a medial malleolar fracture or talar shift on radiographs. The accurate differentiation between a stable SER-II from an unstable SER-IV injury would allow implementation of the appropriate management plan from diagnosis. The aim of this study was to ascertain the practice of orthopaedic surgeons in dealing with these injuries. A postal survey was undertaken on 216 orthopaedic consultants from three regions. In the presence of medial-sided clinical signs (tenderness, swelling, ecchymosis), 22% of consultants would perform surgical fixation. 53% would choose non-operative treatment and the majority would monitor these fractures through serial radiographs. The remaining 25% of consultants would perform an examination under anaesthesia (EUA; 15%), request stress radiographs (9%) or an MRI scan (1%). Without medial-sided signs, 85% would advocate non-operative treatment and, of these, 74% would perform weekly radiographs. Interestingly, 6% would perform immediate surgical fixation. Stress radiographs (6%) and EUAs (2%) were advocated in the remaining group of consultants. Foot and ankle surgeons utilised stress radiographs more frequently and were more likely to proceed to surgical fixation should talar shift be demonstrated. Clinical practice is varied amongst the orthopaedic community. This may lead to unnecessary surgery in SER-II injuries and delay in diagnosis and operative management of SER-IV injuries. We have highlighted the various investigative modalities available that may be used in conjunction with clinical signs to make a more accurate diagnosis.

Analysis of effectiveness, safety and optimization of tocilizumab in a cohort of patients with rheumatoid arthritis in clinical practice.

PubMed

Mena-Vázquez, Natalia; Manrique-Arija, Sara; Rojas-Giménez, Marta; Ureña-Garnica, Inmaculada; Jiménez-Núñez, Francisco G; Fernández-Nebro, Antonio

2017-07-01

To evaluate the effectiveness and safety of tocilizumab (TCZ) in patients with rheumatoid arthritis (RA) in clinical practice, establishing the optimized regimen and switching from intravenous (IV) to subcutaneous (SC) therapy. Retrospective observational study. We included 53 RA patients treated with TCZ. The main outcome was TCZ effectiveness at week 24. Secondary outcome variables included effectiveness at week 52, therapeutic maintenance, physical function and safety. The effectiveness of optimization and the switch from IV to SC was evaluated at 3 and 6 months. The efficacy was measured with the Disease Activity Score. Paired t-tests or Wilcoxon were used to evaluate effectiveness and survival time using Kaplan-Meier. The proportion of patients who achieved remission or low disease activity at weeks 24 and 52 was 75.5% and 87.3%, respectively. The mean retention time (95% confidence interval [95% CI] was 81.7 months [76.6-86.7]). Twenty-one of 53 patients (39.6%) optimized the TCZ dose and 35 patients switched from IV TCZ to SC, with no changes in effectiveness. The adverse event rate was 13.6 events/100 patient-years. Tocilizumab appears to be effective and safe in RA in clinical practice. The optimized regimen appears to be effective in most patients in remission, even when they change from IV to SC. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Global megatrends and their implications for environmental assessment practice

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

Retief, Francois, E-mail: francois.retief@nwu.ac.za; Bond, Alan; Research Unit for Environmental Sciences and Management, North-West University

This paper addresses the future of environmental assessment (EA) practice in light of a rapidly changing world. We apply a literature review-based methodology to firstly identify key global megatrends and then reflect upon the implications for EA practice based on some known challenges. The key megatrends identified are synthesised into six categories: i) demographics, ii) urbanization, iii) technological innovation, iv) power shifts, v) resource scarcity and vi) climate change. We then discuss the implications of these megatrends for EA practice against four known EA challenges namely: dealing with i) complexity and uncertainty, ii) efficiency, iii) significance and iv) communication andmore » participation. Our analysis suggests important implications for EA practice such as: increased difficulties with accuracy of prediction; the need for facilitative adaptation; an increase in the occurrence of unexpected events; higher expectations for procedural efficiency; challenges with information and communication management; dealing with significance judgements; and mitigation amidst resource scarcity and increasing pressures on earth systems. The megatrends underscore the need for continued evolution of EA thinking and practice, especially moving away from seeking a predictable single future or outcome towards the possibility of multiple scenarios with associated adaptability and enhanced system resilience capable of responding to rapid change.« less

Concordances and discrepancies between ICD-10 and DSM-IV criteria for anxiety disorders in childhood and adolescence

PubMed Central

2012-01-01

Background Mental disorders are classified by two major nosological systems, the ICD-10 and the DSM-IV-TR, consisting of different diagnostic criteria. The present study investigated the diagnostic concordance between the two systems for anxiety disorders in childhood and adolescence, in particular for separation anxiety disorder (SAD), specific phobia, social phobia, and generalized anxiety disorder (GAD). Methods A structured clinical interview, the Kinder-DIPS, was administered to 210 children and 258 parents. The percentage of agreement, kappa, and Yule’s Y coefficients were calculated for all diagnoses. Specific criteria causing discrepancies between the two classification systems were identified. Results DSM-IV-TR consistently classified more children than ICD-10 with an anxiety disorder, with a higher concordance between DSM-IV-TR and the ICD-10 child section (F9) than with the adult section (F4) of the ICD-10. This result was found for all four investigated anxiety disorders. The results revealed low to high levels of concordance and poor to good agreement between the classification systems, depending on the anxiety disorder. Conclusions The two classification systems identify different children with an anxiety disorder. However, it remains an open question, whether the research results can be generalized to clinical practice since DSM-IV-TR is mainly used in research while ICD-10 is widely established in clinical practice in Europe. Therefore, the population investigated by the DSM (research population) is not identical with the population examined using the ICD (clinical population). PMID:23267678

Primary Education in Pakistan. Part IV. Annexes to the Analysis.

ERIC Educational Resources Information Center

Development Associates, Inc., Arlington, VA.

The fourth part of a four-part analysis and assessment of Pakistan's system of primary education presents annexes to the analysis that was reported in the second part of the overall report. Five annexes are included: (A) Acronyms; (B) Scope of Work; (C) Persons Interviewed; (D) Chapter Annexes; and (E) Bibliography. A number of charts and diagrams…

Rapid Intravenous Rehydration Therapy in Children With Acute Gastroenteritis: A Systematic Review.

PubMed

Toaimah, Fatihi Hassan Soliman; Mohammad, Hala Mohammad Fathi

2016-02-01

Rapid intravenous (IV) rehydration is commonly used for the management of pediatric gastroenteritis in the emergency department. The current practice shows wide variation in the volume and rate of rapid IV hydration. The aim of this review was to assess the efficacy of rapid IV rehydration compared with standard method in children with gastroenteritis. MEDLINE (1946-2014), EMBASE (1974-2014), and CENTRAL via the Cochrane Library (Issue 8, 2014) were systematically searched to identify eligible studies. Inclusion criteria were randomized controlled trials of rapid IV rehydration in children with gastroenteritis. A total of 1513 articles were retrieved, and our inclusion criteria were met by 3 studies, with a total of 464 participants. The percentage of children who were successfully rehydrated and tolerated oral fluids at 2 to 4 hours after starting IV fluid therapy ranged from 69% to 100% in both rapid IV rehydration and standard method. Time to discharge ranged from 2 to 6 hours (rapid rehydration) versus 2 to 5 hours (standard rehydration). Emergency department revisits ranged from 3% to 16% (rapid rehydration) versus 5% to 14% (standard). Summarized results suggested that rapid IV rehydration may be associated with longer time-to-discharge and higher readmission rates. The new evidence fails to demonstrate superiority of large-volume (60 mL/kg/h) over standard (20 mL/kg/h) IV rehydration. Standard volume IV rehydration for 1 to 4 hours followed by oral hydration or maintenance IV fluids seems sufficient for most children with gastroenteritis requiring IV fluid administration. However, more evidence is needed to establish an optimal IV rehydration regimen.

17 CFR 201.102 - Appearance and practice before the Commission.

Code of Federal Regulations, 2012 CFR

2012-04-01

..., opinion or other paper by any attorney, accountant, engineer or other professional or expert, filed with... rules and regulations thereunder. (iv) With respect to persons licensed to practice as accountants... accountant knows, or should know, that heightened scrutiny is warranted. (2) Repeated instances of...

17 CFR 201.102 - Appearance and practice before the Commission.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., opinion or other paper by any attorney, accountant, engineer or other professional or expert, filed with... rules and regulations thereunder. (iv) With respect to persons licensed to practice as accountants... accountant knows, or should know, that heightened scrutiny is warranted. (2) Repeated instances of...

17 CFR 201.102 - Appearance and practice before the Commission.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., opinion or other paper by any attorney, accountant, engineer or other professional or expert, filed with... rules and regulations thereunder. (iv) With respect to persons licensed to practice as accountants... accountant knows, or should know, that heightened scrutiny is warranted. (2) Repeated instances of...

17 CFR 201.102 - Appearance and practice before the Commission.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., opinion or other paper by any attorney, accountant, engineer or other professional or expert, filed with... rules and regulations thereunder. (iv) With respect to persons licensed to practice as accountants... accountant knows, or should know, that heightened scrutiny is warranted. (2) Repeated instances of...

17 CFR 201.102 - Appearance and practice before the Commission.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., opinion or other paper by any attorney, accountant, engineer or other professional or expert, filed with... rules and regulations thereunder. (iv) With respect to persons licensed to practice as accountants... accountant knows, or should know, that heightened scrutiny is warranted. (2) Repeated instances of...

Contribution of alpha3(IV)alpha4(IV)alpha5(IV) Collagen IV to the Mechanical Properties of the Glomerular Basement Membrane

NASA Astrophysics Data System (ADS)

Gyoneva, Lazarina

The glomerular basement membrane (GBM) is a vital part of the blood-urine filtration barrier in the kidneys. In healthy GBMs, the main tension-resisting component is alpha3(IV)alpha4(IV)alpha5(IV) type IV collagen, but in some diseases it is replaced by other collagen IV isoforms. As a result, the GBM becomes leaky and disorganized, ultimately resulting in kidney failure. Our goal is to understanding the biomechanical aspects of the alpha3(IV)alpha4(IV)alpha5(IV) chains and how their absence could be responsible for (1) the initial injury to the GBM and (2) progression to kidney failure. A combination of experiments and computational models were designed for that purpose. A model basement membrane was used to compare experimentally the distensibility of tissues with the alpha3(IV)alpha4(IV)alpha5(IV) chains present and missing. The experiments showed basement membranes containing alpha3(IV)alpha4(IV)alpha5(IV) chains were less distensible. It has been postulated that the higher level of lateral cross-linking (supercoiling) in the alpha3(IV)alpha4(IV)alpha5(IV) networks contributes additional strength/stability to basement membranes. In a computational model of supercoiled networks, we found that supercoiling greatly increased the stiffness of collagen IV networks but only minimally decreased the permeability, which is well suited for the needs of the GBM. It is also known that the alpha3(IV)alpha4(IV)alpha5(IV) networks are more protected from enzymatic degradation, and we explored their significance in GBM remodeling. Our simulations showed that the more protected network was needed to prevent the system from entering a dangerous feedback cycle due to autoregulation mechanisms in the kidneys. Overall, the work adds to the evidence of biomechanical differences between the alpha3(IV)alpha4(IV)alpha5(IV) networks and other collagen IV networks, points to supercoiling as the main source of biomechanical differences, discusses the suitability of alpha3(IV)alpha4(IV)alpha5(IV) networks to meet the mechanics and permeability needs of the GBM, and explores the role of biomechanics and enzymatic digestion in GBM remodeling.

40 CFR 63.11494 - What are the applicability requirements and compliance dates?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Copolymers Production, subject to subpart DDDDDD of this part. (iv) Acrylic and Modacrylic Fibers Production, subject to subpart LLLLLL of this part. (v) Carbon Black Production, subject to subpart MMMMMM of this...

40 CFR 63.11494 - What are the applicability requirements and compliance dates?

Code of Federal Regulations, 2011 CFR

2011-07-01

... Copolymers Production, subject to subpart DDDDDD of this part. (iv) Acrylic and Modacrylic Fibers Production, subject to subpart LLLLLL of this part. (v) Carbon Black Production, subject to subpart MMMMMM of this...

40 CFR 261.6 - Requirements for recyclable materials.

Code of Federal Regulations, 2010 CFR

2010-07-01

... CFR part 266, subpart F); (iv) Spent lead-acid batteries that are being reclaimed (40 CFR part 266... recycling process itself is exempt from regulation except as provided in § 261.6(d).) (2) Owners or...

40 CFR 261.6 - Requirements for recyclable materials.

Code of Federal Regulations, 2011 CFR

2011-07-01

... CFR part 266, subpart F); (iv) Spent lead-acid batteries that are being reclaimed (40 CFR part 266... recycling process itself is exempt from regulation except as provided in § 261.6(d).) (2) Owners or...

Can we improve C IV-based single epoch black hole mass estimations?

NASA Astrophysics Data System (ADS)

Mejía-Restrepo, J. E.; Trakhtenbrot, B.; Lira, P.; Netzer, H.

2018-05-01

In large optical surveys at high redshifts (z > 2), the C IV broad emission line is the most practical alternative to estimate the mass (MBH) of active super-massive black holes (SMBHs). However, mass determinations obtained with this line are known to be highly uncertain. In this work we use the Sloan Digital Sky Survey Data Release 7 and 12 quasar catalogues to statistically test three alternative methods put forward in the literature to improve C IV-based MBH estimations. These methods are constructed from correlations between the ratio of the C IV line-width to the low ionization line-widths (Hα, Hβ and Mg II) and several other properties of rest-frame UV emission lines. Our analysis suggests that these correction methods are of limited applicability, mostly because all of them depend on correlations that are driven by the linewidth of the C IV profile itself and not by an interconnection between the linewidth of the C IV line with the linewidth of the low ionization lines. Our results show that optical C IV-based mass estimates at high redshift cannot be a proper replacement for estimates based on IR spectroscopy of low ionization lines like Hα, Hβ and Mg II.

Metronidazole stewardship initiative at Christchurch hospitals-achievable with immediate benefits.

PubMed

Gardiner, Sharon J; Metcalf, Sarah Cl; Chin, Paul Kl; Doogue, Matthew P; Dalton, Simon C; Chambers, Stephen T

2018-04-13

To evaluate an antimicrobial stewardship (AMS) initiative to change hospital prescribing practice for metronidazole. In October 2015, the Canterbury District Health Board (CDHB) AMS committee changed advice for metronidazole to promote two times daily dosing for most indications, prioritisation of the oral route and avoidance of double anaerobic cover. Adoption of the initiative was facilitated via change in prescribing guidelines, education and ongoing pharmacy support. Usage and expenditure on metronidazole for adult inpatients were compared for the five years pre- and two years post-change. Other district health boards (DHBs) were surveyed to determine their dosing recommendation for metronidazole IV. Mean annual metronidazole IV use, as defined daily doses per 1,000 occupied bed days, decreased by 43% post-initiative. Use of non-IV (oral or rectal) formulations increased by 104%. Total savings associated with the initiative were approximately $33,400 in drug costs plus $78,200 per annum in IV giving sets and post-dose flushes. Twelve of 20 (60%) DHBs (including CDHB) endorse twice daily IV dosing. In addition to financial savings, reduction in IV doses has potential benefits, including avoidance of IV catheter-associated complications such as bloodstream infections. Approaches to metronidazole dosing vary across DHBs and could benefit from national coordination.

Lupin alkaloids Part IV. The influence of some structural factors on the conformational equilibrium in bis-quinolizidine systems

NASA Astrophysics Data System (ADS)

Wysocka, Waleria; Brukwicki, Tadeusz

1992-01-01

13C NMR and IR spectra of minor alkaloids of Lupinus albus such as multiflorine ( I), 13α-hydroxymultiflorine ( IV) and their monoperchlorates, 13α-hydroxy-5-dehydromultiflorine ( V) and 5-dehydromultiflorine ( VI) were taken. I and IV in CDCl 3, their monoperchlorates in CD 3CN and V in CD 3OD solution occur in conformational equilibrium. The share of the conformation with a boat ring C in I is about 74%, in IV 67%, in I · HClO 4 20%, in IV·HClO 43% and in V 3%. The change in conformational preference results mainly from a decreasing destabilization of the conformation with a chair ring C caused by an increase in the distance between the interacting hydrogen atom pairs 5α-17α, 8β-12β, 12β-17β and 14β-17β, due to protonation induced lengthening of the N (16)-C α bonds. VI and most of the molecules of V remain in solution in conformation with a chair ring C. This conformation in V and VI is less destabilized than in I and IV because of a lower steric hindrance for the chair ring C, as a consequence of the planarity of ring A and a part of fragment B and because of the absence of the 5α-17α interaction.

How Is the Practice of Yoga Related to Weight Status? Population-Based Findings From Project EAT-IV.

PubMed

Neumark-Sztainer, Dianne; MacLehose, Richard F; Watts, Allison W; Eisenberg, Marla E; Laska, Melissa N; Larson, Nicole

2017-12-01

Yoga may provide a strategy for healthy weight management in young adults. This study examined prevalence and characteristics of young adults' yoga practice and associations with changes in body mass index. Surveys were completed by 1830 young adults (31.1 ± 1.6 y) participating in Project EAT-IV. Cross-sectional and 5-year longitudinal analyses were conducted stratified by initial weight status. Two-thirds (66.5%) of nonoverweight women and 48.9% of overweight women reported ever doing yoga, while 27.2% of nonoverweight women and 16.4% of overweight women practiced regularly (≥30 min/wk). Fewer men practiced yoga. Among young adults practicing regularly (n = 294), differences were identified in intensity, type, and location of yoga practice across weight status. Young adults who were overweight and practiced yoga regularly showed a nonsignificant 5-year decrease in their body mass index (-0.60 kg/m 2 ; P = .49), whereas those not practicing regularly had significant increases in their body mass index (+1.37 kg/m 2 ; P < .01). Frequency of yoga was inversely associated with weight gain among both overweight and nonoverweight young adults practicing yoga regularly. Young adults of different body sizes practice yoga. Yoga was associated with less weight gain over time, particularly in overweight young adults. Practicing yoga on a regular basis may help with weight gain prevention.

Independent examination of the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV): what does the WAIS-IV measure?

PubMed

Benson, Nicholas; Hulac, David M; Kranzler, John H

2010-03-01

Published empirical evidence for the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) does not address some essential questions pertaining to the applied practice of intellectual assessment. In this study, the structure and cross-age invariance of the latest WAIS-IV revision were examined to (a) elucidate the nature of the constructs measured and (b) determine whether the same constructs are measured across ages. Results suggest that a Cattell-Horn-Carroll (CHC)-inspired structure provides a better description of test performance than the published scoring structure does. Broad CHC abilities measured by the WAIS-IV include crystallized ability (Gc), fluid reasoning (Gf), visual processing (Gv), short-term memory (Gsm), and processing speed (Gs), although some of these abilities are measured more comprehensively than are others. Additionally, the WAIS-IV provides a measure of quantitative reasoning (QR). Results also suggest a lack of cross-age invariance resulting from age-related differences in factor loadings. Formulas for calculating CHC indexes and suggestions for interpretation are provided. PsycINFO Database Record (c) 2010 APA, all rights reserved.

How to Retain Postgraduate Students in Engineering Programmes: A Practical Perspective

ERIC Educational Resources Information Center

Le, Khoa N.; Tam, Vivian W. Y.

2008-01-01

Six factors for pursuing an engineering postgraduate programme at Griffith University including (i) programme quality; (ii) employment prospects; (iii) practicality; (iv) personal interest; (v) popularity; and (vi) reputation; and 11 factors for not pursuing this engineering programme including (i) employment prospects; (ii) degree of difficulty;…

75 FR 62759 - Notice of Proposed Change to Section IV of the Virginia State Technical Guide

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-13

..., Roof Runoff Structure; 600, Terrace; 620, Underground Outlet; 313, Waste Storage Facility; 359, Waste Treatment Lagoon; 633, Waste Utilization; 638, Water and Sediment Control Basin. These practices will be used to plan and install conservation practices on cropland, pastureland, woodland, and wildlife land...

Utilisation of prehospital intravenous access.

PubMed

Bester, B H; Sobuwa, Simpiwe

2014-07-22

To describe the use of intravenous (IV) therapy in the South African (SA) prehopsital setting, and to determine the proportion of prehopsital cannulations considered unnecessary when graded against the South African Triage Score (SATS) chart. The study was conducted in the prehospital emergency medical care setting in the Western Cape Province, SA. Using a descriptive research design, we looked at the report forms of patients treated and transported by personnel currently employed in the public sector, serving the urban and rural areas stipulated by the municipal boundaries. All medical and trauma cases in which establishment of IV access was documented for the month of April 2013 were included. Interhospital transfers, unsuccessful attempts at IV access and intraosseous cannulation were excluded. When graded against the SATS, prophylactic IV access was not justified in 42.3% of the total number of cases (N=149) in which it was established, and therefore added no direct benefit to the continuum of patient care. It is worth noting that 18.8% (n=39) of the IV lines were utilised for fluid administration, as opposed to 9.2% (n=19) for the administration of IV medications. In view of the paucity of studies indicating a direct benefit of out-of-hospital IV intervention, the practice of precautionary, protocol-driven prophylactic establishment of IV access should be evaluated. Current data suggest that in the absence of scientific evidence, IV access should only be initiated when it will benefit the patient immediately, and precautionary IV access, especially in non-injured patients, should be re-evaluated.

Implementing smart infusion pumps with dose-error reduction software: real-world experiences.

PubMed

Heron, Claire

2017-04-27

Intravenous (IV) drug administration, especially with 'smart pumps', is complex and susceptible to errors. Although errors can occur at any stage of the IV medication process, most errors occur during reconstitution and administration. Dose-error reduction software (DERS) loaded on to infusion pumps incorporates a drug library with predefined upper and lower drug dose limits and infusion rates, which can reduce IV infusion errors. Although this is an important advance for patient safety at the point of care, uptake is still relatively low. This article discuses the challenges and benefits of implementing DERS in clinical practice as experienced by three UK trusts.

DSM-V Changes for Autism Spectrum Disorder (ASD): Implications for Diagnosis, Management, and Care Coordination for Children With ASDs.

PubMed

Lobar, Sandra L

2016-01-01

The purpose of this article is to highlight issues about diagnosis and management of autism spectrum disorders (ASDs) in all settings, along with care coordination for all children with ASDs. The article outlines differences between the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 4th edition, revised (DSM-IV-TR) and the newer version (DSM-V) for ASDs. These changes may limit the eligibility of some children for services in school, leading to poorer social/academic outcomes, lower rates of employment, and decreased assistance in eventual independent living. Primary care providers identified a lack of knowledge regarding ASDs before the DSM-V was published, describing difficulty in making ASD diagnoses, recognizing early symptoms of developmental concern, and managing care. Care coordination is part of the role of the advanced practice nurse, and lack of understanding of ASD changes in the DSM-V may diminish the ability of advanced practice nurses to screen for ASDs and make the appropriate referrals. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

An Application of the PMI Model at the Project Level Evaluation of ESEA Title IV-C Projects.

ERIC Educational Resources Information Center

McBeath, Marcia

All of the papers presented as part of a symposium concerned the application of the Planning, Monitoring, and Implementation Model (PMI) to the evaluation of the District of Columbia Public Schools' programs supported by the Elementary Secondary Education Act (ESEA) Title IV-C. PMI was developed to provide a model for systematic evaluation of…

The Development and Evaluation of Training Methods for Group IV Personnel. 1. Orientation and Implementation of the Training Methods Development School (TMDS).

ERIC Educational Resources Information Center

Steinemann, John H.

The investigation is part of continuing Navy research on the Trainability of Group IV (low ability) personnel intended to maximize the utilization and integration of marginal personnel in the fleet. An experimental Training Methods Development School (TMDS) was initiated to provide an experimental training program, with research controls, for…

Beyond the Classroom: International Education and the Community College. Volume IV. Working with Local Business To Enhance Asian-Pacific Understanding.

ERIC Educational Resources Information Center

Franco, Robert W., Ed.; Shimabukuro, James N., Ed.

Part of a four-volume set in which community college educators discuss their efforts to internationalize the educational experience of the students and communities they serve, volume IV in this series focuses on the growing importance of community colleges in providing short-term, intensive training in international business and intercultural…

49 CFR Appendix E to Part 227 - Use of Insert Earphones for Audiometric Testing

Code of Federal Regulations, 2011 CFR

2011-10-01

... audiometer. IV. Background Noise Levels Testing shall be conducted in a room where the background ambient noise octave-band sound pressures levels meet appendix D to this part. V. Conversion From Supra Aural...

I-V Curves from Photovoltaic Modules Deployed in Tucson

NASA Astrophysics Data System (ADS)

Kopp, Emily; Brooks, Adria; Lonij, Vincent; Cronin, Alex

2011-10-01

More than 30 Mega Watts of photo-voltaic (PV) modules are connected to the electric power grid in Tucson, AZ. However, predictions of PV system electrical yields are uncertain, in part because PV modules degrade at various rates (observed typically in the range 0% to 3 %/yr). We present I-V curves (PV output current as a function of PV output voltage) as a means to study PV module efficiency, de-ratings, and degradation. A student-made I-V curve tracer for 100-Watt modules will be described. We present I-V curves for several different PV technologies operated at an outdoor test yard, and we compare new modules to modules that have been operated in the field for 10 years.

FY 2002 Report on Software Visualization Techniques for IV and V

NASA Technical Reports Server (NTRS)

Fotta, Michael E.

2002-01-01

One of the major challenges software engineers often face in performing IV&V is developing an understanding of a system created by a development team they have not been part of. As budgets shrink and software increases in complexity, this challenge will become even greater as these software engineers face increased time and resource constraints. This research will determine which current aspects of providing this understanding (e.g., code inspections, use of control graphs, use of adjacency matrices, requirements traceability) are critical to the performing IV&V and amenable to visualization techniques. We will then develop state-of-the-art software visualization techniques to facilitate the use of these aspects to understand software and perform IV&V.

Land-Grant College Education 1910 to 1920 Part IV: Engineering and Mechanic Arts. Bulletin, 1925, No. 5

ERIC Educational Resources Information Center

Walton, C. John, Ed.

1925-01-01

This is the fourth part of a 5-part survey of land-grant college education. Other parts are: (1) History and Educational Objectives of Land-Grant College Education; (2) The Liberal Arts and Sciences and Miscellaneous Subjects in Land-Grant Colleges (3) Agricultural Education in Land-Grant Colleges (including agricultural engineering)(4); and Home…

Eliminating the use of intravenous glass bottles using a FOCUS-PDCA model and providing a practical stability reference guide.

PubMed

Maraiki, Fatma; Farooq, Faiyaz; Ahmed, Mohamed

2016-08-01

To identify the intravenous (IV) medications that are prepared in glass bottles at the institution and establish which of these medications can be prepared in flexible IV bags such as polyvinyl chloride (PVC) or non-PVC instead of glass bottles. The cost implication of switching from glass bottles to flexible IV bags was calculated. A study using FOCUS-PDCA model to identify IV medications prepared in glass bottles and establish which of these medications could be prepared in IV bags (PVC or non-PVC). The cost impact of switching from glass bottles to IV plastic bags (including PVC or non-PVC) was calculated. The stability data obtained were used as a reference for updating pharmacy internal IV preparation charts. A total of 17 IV medications were found to be prepared in IV glass bottles. Of these 17 medications, only 8 (47%) were prepared in IV glass bottles due to incompatibility with PVC bags. For 7 (41%) of the medications, of which 6 were monoclonal antibodies (MABs), the reason for preparation in glass bottles was unclear as these medications are compatible with either PVC or non-PVC or both. The potential cost savings associated with switching all of the identified medications to IV plastic bags (either non-PVC or PVC) exceeded $200 000. The elimination of glass bottles within the institution resulted in a significant cost saving. The use of FOCUS-PDCA model can help healthcare institution achieve significant improvements in process and realize significant cost savings. © 2016 Royal Pharmaceutical Society.

Comparison of Intraabdominal and Trocar Site Local Anaesthetic Infiltration on Postoperative Analgesia After Laparoscopic Cholecystectomy.

PubMed

Altuntaş, Gülsüm; Akkaya, Ömer Taylan; Özkan, Derya; Sayın, Mehmet Murat; Balas, Şener; Özlü, Elif

2016-12-01

This study aimed to compare the efficacy of local anaesthetic infiltration to trocar wounds and intraperitoneally on postoperative pain as a part of a multimodal analgesia method after laparoscopic cholecystectomies. The study was performed on 90 ASA I-III patients aged between 20 and 70 years who underwent elective laparoscopic cholecystectomy. All patients had the same general anaesthesia drug regimen. Patients were randomized into three groups by a closed envelope method: group I (n=30), trocar site local anaesthetic infiltration (20 mL of 0.5% bupivacaine); group II (n=30), intraperitoneal local anaesthetic instillation (20 mL of 0.5%) and group III (n=30), saline infiltration both trocar sites and intraperitoneally. Postoperative i.v. patient controlled analgesia was initiated for 24 h. In total, 4 mg of i.v. ondansetron was administered to all patients. Visual analogue scale (VAS), nausea and vomiting and shoulder pain were evaluated at 1., 2., 4., 8., 12., 24. hours. An i.v. nonsteroidal anti-inflammatory drug (NSAID) (50 mg of dexketoprofen) as a rescue analgesic was given if the VAS was ≥5. There were no statistical significant differences between the clinical and demographic properties among the three groups (p≥0.005). During all periods, VAS in group I was significantly lower than that in groups II and III (p<0.001). Among the groups, although there was no significant difference in nausea and vomiting (p=0.058), there was a significant difference in shoulder pain. Group III (p<0.05) had more frequent shoulder pain than groups I and II. The total morphine consumption was higher in groups II and III (p<0.001 vs p<0.001) than in group I. The requirement for a rescue analgesic was significantly higher in group III (p<0.05). Trocar site local anaesthetic infiltration is more effective for postoperative analgesia, easier to apply and safer than other analgesia methods. Morphine consumption is lesser and side effects are fewer; therefore, this method can be used as a part of common practice.

Small potent ligands to the insulin-regulated aminopeptidase (IRAP)/AT(4) receptor.

PubMed

Axén, Andreas; Andersson, Hanna; Lindeberg, Gunnar; Rönnholm, Harriet; Kortesmaa, Jarkko; Demaegdt, Heidi; Vauquelin, Georges; Karlén, Anders; Hallberg, Mathias

2007-07-01

Angiotensin IV analogs encompassing aromatic scaffolds replacing parts of the backbone of angiotensin IV have been synthesized and evaluated in biological assays. Several of the ligands displayed high affinities to the insulin-regulated aminopeptidase (IRAP)/AT(4) receptor. Displacement of the C-terminal of angiotensin IV with an o-substituted aryl acetic acid derivative delivered the ligand 4, which exhibited the highest binding affinity (K(i) = 1.9 nM). The high affinity of this ligand provides support to the hypothesis that angiotensin IV adopts a gamma-turn in the C-terminal of its bioactive conformation. Ligand (4) inhibits both human IRAP and aminopeptidase N-activity and induces proliferation of adult neural stem cells at low concentrations. Furthermore, ligand 4 is degraded considerably more slowly in membrane preparations than angiotensin IV. Hence, it might constitute a suitable research tool for biological studies of the (IRAP)/AT(4) receptor.

12 CFR Appendix C to Part 707 - Official Staff Interpretations

Code of Federal Regulations, 2010 CFR

2010-01-01

.... Messages promoting an account that are provided along with information about the member's existing account... account. iv. For purposes of § 707.8(b) of this part through § 707.8(e) of this part, information given to... automatically renewable time account sent before renewal. v. Information about a particular transaction in an...

Curriculum Development--Post-Secondary Electro-Mechanical Technology. Parts I-IV.

ERIC Educational Resources Information Center

Texas State Technical Inst., Sweetwater.

This curriculum guide consists of materials for use in teaching a four-part course in electromechanical technical technology. The first part contains nine units dealing with hydraulics and nine units on pneumatics. Addressed in the individual units are the following topics: an introduction to hydraulics; control of hydraulic energy; check valves…

Meta-analysis of screening and case finding tools for depression in cancer: evidence based recommendations for clinical practice on behalf of the Depression in Cancer Care consensus group.

PubMed

Mitchell, Alex J; Meader, Nick; Davies, Evan; Clover, Kerrie; Carter, Gregory L; Loscalzo, Matthew J; Linden, Wolfgang; Grassi, Luigi; Johansen, Christoffer; Carlson, Linda E; Zabora, James

2012-10-01

To examine the validity of screening and case-finding tools used in the identification of depression as defined by an ICD10/DSM-IV criterion standard. We identified 63 studies involving 19 tools (in 33 publications) designed to help clinicians identify depression in cancer settings. We used a standardized rating system. We excluded 11 tools without at least two independent studies, leaving 8 tools for comparison. Across all cancer stages there were 56 diagnostic validity studies (n=10,009). For case-finding, one stem question, two stem questions and the BDI-II all had level 2 evidence (2a, 2b and 2c respectively) and given their better acceptability we gave the stem questions a grade B recommendation. For screening, two stem questions had level 1b evidence (with high acceptability) and the BDI-II had level 2c evidence. For every 100 people screened in advanced cancer, the two questions would accurately detect 18 cases, while missing only 1 and correctly reassure 74 with 7 falsely identified. For every 100 people screened in non-palliative settings the BDI-II would accurately detect 17 cases, missing 2 and correctly re-assure 70, with 11 falsely identified as cases. The main cautions are the reliance on DSM-IV definitions of major depression, the large number of small studies and the paucity of data for many tools in specific settings. Although no single tool could be offered unqualified support, several tools are likely to improve upon unassisted clinical recognition. In clinical practice, all tools should form part of an integrated approach involving further follow-up, clinical assessment and evidence based therapy. Copyright © 2012 Elsevier B.V. All rights reserved.

Impact of climate change on freshwater resources in a heterogeneous coastal aquifer of Bremerhaven, Germany: A three-dimensional modeling study.

PubMed

Yang, Jie; Graf, Thomas; Ptak, Thomas

2015-01-01

Climate change is expected to induce sea level rise in the German Bight, which is part of the North Sea, Germany. Climate change may also modify river discharge of the river Weser flowing into the German Bight, which will alter both pressure and salinity distributions in the river Weser estuary. To study the long-term interaction between sea level rise, discharge variations, a storm surge and coastal aquifer flow dynamics, a 3D seawater intrusion model was designed using the fully coupled surface-subsurface numerical model HydroGeoSphere. The model simulates the coastal aquifer as an integral system considering complexities such as variable-density flow, variably saturated flow, irregular boundary conditions, irregular land surface and anthropogenic structures (e.g., dyke, drainage canals, water gates). The simulated steady-state groundwater flow of the year 2009 is calibrated using PEST. In addition, four climate change scenarios are simulated based on the calibrated model: (i) sea level rise of 1m, (ii) the salinity of the seaside boundary increases by 4 PSU (Practical Salinity Units), (iii) the salinity of the seaside boundary decreases by 12 PSU, and (iv) a storm surge with partial dyke failure. Under scenarios (i) and (iv), the salinized area expands several kilometers further inland during several years. Natural remediation can take up to 20 years. However, sudden short-term salinity changes in the river Weser estuary do not influence the salinized area in the coastal aquifer. The obtained results are useful for coastal engineering practices and drinking water resource management. Copyright © 2015 Elsevier B.V. All rights reserved.

Intravenous Chemotherapy Compounding Errors in a Follow-Up Pan-Canadian Observational Study.

PubMed

Gilbert, Rachel E; Kozak, Melissa C; Dobish, Roxanne B; Bourrier, Venetia C; Koke, Paul M; Kukreti, Vishal; Logan, Heather A; Easty, Anthony C; Trbovich, Patricia L

2018-05-01

Intravenous (IV) compounding safety has garnered recent attention as a result of high-profile incidents, awareness efforts from the safety community, and increasingly stringent practice standards. New research with more-sensitive error detection techniques continues to reinforce that error rates with manual IV compounding are unacceptably high. In 2014, our team published an observational study that described three types of previously unrecognized and potentially catastrophic latent chemotherapy preparation errors in Canadian oncology pharmacies that would otherwise be undetectable. We expand on this research and explore whether additional potential human failures are yet to be addressed by practice standards. Field observations were conducted in four cancer center pharmacies in four Canadian provinces from January 2013 to February 2015. Human factors specialists observed and interviewed pharmacy managers, oncology pharmacists, pharmacy technicians, and pharmacy assistants as they carried out their work. Emphasis was on latent errors (potential human failures) that could lead to outcomes such as wrong drug, dose, or diluent. Given the relatively short observational period, no active failures or actual errors were observed. However, 11 latent errors in chemotherapy compounding were identified. In terms of severity, all 11 errors create the potential for a patient to receive the wrong drug or dose, which in the context of cancer care, could lead to death or permanent loss of function. Three of the 11 practices were observed in our previous study, but eight were new. Applicable Canadian and international standards and guidelines do not explicitly address many of the potentially error-prone practices observed. We observed a significant degree of risk for error in manual mixing practice. These latent errors may exist in other regions where manual compounding of IV chemotherapy takes place. Continued efforts to advance standards, guidelines, technological innovation, and chemical quality testing are needed.

[Irritable bowel syndrome with constipation and functional constipation in adults: Treatment (Part 2 of 2)].

PubMed

Mearin, F; Ciriza, C; Mínguez, M; Rey, E; Mascort, J J; Peña, E; Cañones, P; Júdez, J

2017-03-01

In this Clinical practice guide we examine the diagnostic and therapeutic management of adult patients with constipation and abdominal discomfort, at the confluence of the spectrum of irritable bowel syndrome and functional constipation. Both fall within the framework of functional intestinal disorders and have major personal, health and social impact, altering the quality of life of the patients affected. The former is a subtype of irritable bowel syndrome in which constipation and altered bowel habit predominate, often along with recurring abdominal pain, bloating and abdominal distension. Constipation is characterised by infrequent or hard-to-pass bowel movements, often accompanied by straining during defecation or the sensation of incomplete evacuation. There is no underlying organic cause in the majority of cases; it being considered a functional bowel disorder. There are many clinical and pathophysiological similarities between the two conditions, the constipation responds in a similar way to commonly used drugs, the fundamental difference being the presence or absence of pain, but not in an "all or nothing" way. The severity of these disorders depends not only on the intensity of the intestinal symptoms but also on other biopsychosocial factors: association of gastrointestinal and extraintestinal symptoms, degree of involvement, forms of perception and behaviour. Functional bowel disorders are diagnosed using the Rome criteria. This Clinical practice guide adapts to the Rome IV criteria published at the end of May 2016. The first part (96, 97, 98) examined the conceptual and pathophysiological aspects, alarm criteria, diagnostic test and referral criteria between Primary Care and Gastroenterology. This second part reviews all the available treatment alternatives (exercise, fluid ingestion, diet with soluble fibre-rich foods, fibre supplements, other dietary components, osmotic or stimulating laxatives, probiotics, antibiotics, spasmolytics, peppermint essence, prucalopride, linaclotide, lubiprostone, biofeedback, antdepressants, psychological treatment, acupuncture, enemas, sacral root neurostimulation and surgery), and practical recommendations are made for each. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Australian Staphylococcus aureus Sepsis Outcome Programme annual report, 2013.

PubMed

Coombs, Geoffrey W; Nimmo, Graeme R; Daly, Denise A; Le, Tam T; Pearson, Julie C; Tan, Hui-Leen; Robinson, James O; Collignon, Peter J; McLaws, Mary-Louise; Turnidge, John D

2014-12-31

From 1 January to 31 December 2013, around Australia 26 institutions around Australia participated in the Australian Staphylococcal Sepsis Outcome Programme (ASSOP). The aim of ASSOP 2013 was to determine the proportion of Staphylococcus aureus bacteraemia (SAB) isolates in Australia that are antimicrobial resistant, (with particular emphasis on susceptibility to methicillin) and to characterise the molecular epidemiology of the isolates. Overall 19.1% of the 2,010 SAB episodes were methicillin resistant, which is significantly higher than that reported in most European countries. Although the SAB 30-day all cause mortality appears to be decreasing in Australia, methicillin-resistant SAB associated mortality remains high (20.1%) and was significantly higher than methicillin-sensitive SAB associated mortality (13%) (P< 0.0001). With the exception of the ß-lactams and erythromycin, antimicrobial resistance in methicillin sensitive S. aureus remains rare. However, in addition to the ß-lactams, approximately 50% of methicillin-resistant S. aureus (MRSA) were resistant to erythromycin and ciprofloxacin and approximately 20% were resistant to co-trimoxazole, tetracycline and gentamicin. Linezolid, daptomycin and teicoplanin resistance was detected in a small number of S. aureus isolates. Resistance to vancomycin was not detected. Resistance was largely attributable to 2 healthcare associated MRSA clones; ST22-IV [2B] (EMRSA-15) and ST239-III [3A] (Aus-2/3 EMRSA). ST22-IV [2B] (EMRSA-15) has now become the predominant healthcare associated clone in Australia. Approximately 60% of methicillin-resistant SAB were due to community associated clones. Although polyclonal, almost 50% of community associated clones were characterised as ST93-IV [2B] (Queensland CA-MRSA) and ST1-IV [2B] (WA1). CA-MRSA, in particular the ST45-V [5C2&5] (WA84) clone, has acquired multiple antimicrobial resistance determinants including ciprofloxacin, erythromycin, clindamycin, gentamicin and tetracycline. As CA-MRSA is well established in the Australian community, it is important antimicrobial resistance patterns in community and healthcare associated SAB is monitored as this information will guide therapeutic practices in treating S. aureus sepsis. This work is copyright. You may download, display, print and reproduce the whole or part of this work in unaltered form for your own personal use or, if you are part of an organisation, for internal use within your organisation, but only if you or your organisation do not use the reproduction for any commercial purpose and retain this copyright notice and all disclaimer notices as part of that reproduction. Apart from rights to use as permitted by the Copyright Act 1968 or allowed by this copyright notice, all other rights are reserved and you are not allowed to reproduce the whole or any part of this work in any way (electronic or otherwise) without first being given the specific written permission from the Commonwealth to do so. Requests and inquiries concerning reproduction and rights are to be sent to the Online, Services and External Relations Branch, Department of Health, GPO Box 9848, Canberra ACT 2601, or by email to copyright@health.gov.au.

An overview of intravenous-related medication administration errors as reported to MEDMARX, a national medication error-reporting program.

PubMed

Hicks, Rodney W; Becker, Shawn C

2006-01-01

Medication errors can be harmful, especially if they involve the intravenous (IV) route of administration. A mixed-methodology study using a 5-year review of 73,769 IV-related medication errors from a national medication error reporting program indicates that between 3% and 5% of these errors were harmful. The leading type of error was omission, and the leading cause of error involved clinician performance deficit. Using content analysis, three themes-product shortage, calculation errors, and tubing interconnectivity-emerge and appear to predispose patients to harm. Nurses often participate in IV therapy, and these findings have implications for practice and patient safety. Voluntary medication error-reporting programs afford an opportunity to improve patient care and to further understanding about the nature of IV-related medication errors.

Dielectric Constant and Loss Data. Part 4

DTIC Science & Technology

1980-12-01

Fluorinated ethers, Organic Chemicals Dept., P.R.-194Dow Chemical "Dowtherm" A, P.R.-194 T ORg C a p - Dew Corning Corp., IV-26, 27, 41, 42, "HVITON...Esso "Teresso" oil, V-78; P.R.-195 and MFl16, V-15 "Estawax", IV-57 "Eccosorb" MFll7, V-15, 242 Ethers, fluorinated , P.R.-194 Eggwhite. P.R.-202 "Ethocel...PPG, 8-20 Flourglas laminate, 9-33 "Gafite" cast polymer, IV-34 Fluorinated ethers, P.R.-194 Gasoline, aviation, 100 and 91 octane, Fluorcarbon

A Genetic Selection for dinB Mutants Reveals an Interaction between DNA Polymerase IV and the Replicative Polymerase That Is Required for Translesion Synthesis.

PubMed

Scotland, Michelle K; Heltzel, Justin M H; Kath, James E; Choi, Jung-Suk; Berdis, Anthony J; Loparo, Joseph J; Sutton, Mark D

2015-09-01

Translesion DNA synthesis (TLS) by specialized DNA polymerases (Pols) is a conserved mechanism for tolerating replication blocking DNA lesions. The actions of TLS Pols are managed in part by ring-shaped sliding clamp proteins. In addition to catalyzing TLS, altered expression of TLS Pols impedes cellular growth. The goal of this study was to define the relationship between the physiological function of Escherichia coli Pol IV in TLS and its ability to impede growth when overproduced. To this end, 13 novel Pol IV mutants were identified that failed to impede growth. Subsequent analysis of these mutants suggest that overproduced levels of Pol IV inhibit E. coli growth by gaining inappropriate access to the replication fork via a Pol III-Pol IV switch that is mechanistically similar to that used under physiological conditions to coordinate Pol IV-catalyzed TLS with Pol III-catalyzed replication. Detailed analysis of one mutant, Pol IV-T120P, and two previously described Pol IV mutants impaired for interaction with either the rim (Pol IVR) or the cleft (Pol IVC) of the β sliding clamp revealed novel insights into the mechanism of the Pol III-Pol IV switch. Specifically, Pol IV-T120P retained complete catalytic activity in vitro but, like Pol IVR and Pol IVC, failed to support Pol IV TLS function in vivo. Notably, the T120P mutation abrogated a biochemical interaction of Pol IV with Pol III that was required for Pol III-Pol IV switching. Taken together, these results support a model in which Pol III-Pol IV switching involves interaction of Pol IV with Pol III, as well as the β clamp rim and cleft. Moreover, they provide strong support for the view that Pol III-Pol IV switching represents a vitally important mechanism for regulating TLS in vivo by managing access of Pol IV to the DNA.

Dollar$ & $en$e. Part VI: Knowledge management: the state of the art.

PubMed

Wilkinson, I

2001-01-01

In Part I of this series, I introduced the concept of memes (1). Memes are ideas or concepts--the information world equivalent of genes. The goal of this series of articles is to infect you with memes so you will assimilate, translate, and express them. No matter what our area of expertise or "-ology," we all are in the information business. Our goal is to be in the wisdom business. In the previous articles in this series, I showed that when we convert raw data into wisdom, we are moving along a value chain. Each step in the chain adds a different amount of value to the final product: timely, relevant, accurate, and precise knowledge that then can be applied to create the ultimate product in the value chain--wisdom. In part II of this series, I introduced a set of memes for measuring the cost of adding value (2). In part III of this series, I presented a new set of memes for measuring the added value of knowledge, i.e., intellectual capital (3). In part IV of this series, I discussed practical knowledge management tools for measuring the value of people, structural, and customer capital (4). In part V of this series, I applied intellectual capital and knowledge management concepts at the individual level, to help answer a fundamental question: what is my added value (5)? In the final part of this series, I will review the state of intellectual capital and knowledge management development to date and outline the direction of current knowledge management initiatives and research projects.

Eighteenth annual report of the United States Geological Survey to the Secretary of the Interior, 1896-1897: Part IV - Hydrography

USGS Publications Warehouse

Davis, Arthur Powell; Leverett, Frank; Darton, N.H.; Schuyler, J.D.

1897-01-01

The completion of this volume marks the revival of extended systematic investigation of the hydrography of the United State. This book is, in effect, the ninth annual report of what has been known as the Irrigation Survey. Its preparation and publication has been made possible by the act of June 11, 1896 (Stat. L., vol. 29, p. 436), which enlarged the scope of the work and authorized the preparation of reports upon the best methods of utilizing the water resources of arid and semiarid sections. For some years before this date the sums available for hydrographic work were so small that it was practicable merely to continue observations at previously established stations, compute discharges, and compile for publication the data accumulated in the office.

Interventional radiology in infancy.

PubMed

Barnacle, Alex M

2014-11-01

Interventional radiology (IR) is an emerging sub-speciality within paediatric medicine. In adult care, IR is largely centred on the management of vascular disease but in paediatric practice, IR applications are varied and increasingly innovative, making this an exciting field to be a part of. IR has a central role both in the day to day care of sick children, from long term IV access provision to feeding tube insertions, and in the acute management of critically ill infants, such as those with overwhelming liver disease, neonatal tumours and vascular malformations. Paediatric IR faces a unique set of challenges, developing or modifying techniques and equipment for use in very small patients, training professionals to take the speciality forward and, most importantly, convincing paediatricians and healthcare institutions to create opportunities for IR to make a difference. Copyright © 2014 Elsevier Ltd. All rights reserved.

33 CFR Appendix B to Part 155 - Determining and Evaluating Required Response Resources for Vessel Response Plans

Code of Federal Regulations, 2011 CFR

2011-07-01

... carried [persistent (groups II, III, and IV) or non-persistent (group I)]; and the geographic area(s) in... type of petroleum oil carried [persistent (groups II, III, and IV) or non-persistent (group I)]; and... Petroleum Oil Cargo Groups Non-persistent oil 72 G: Group I 1.0 Persistent oil: Group II 1.8 Group III 2.0...

33 CFR Appendix B to Part 155 - Determining and Evaluating Required Response Resources for Vessel Response Plans

Code of Federal Regulations, 2010 CFR

2010-07-01

... carried [persistent (groups II, III, and IV) or non-persistent (group I)]; and the geographic area(s) in... type of petroleum oil carried [persistent (groups II, III, and IV) or non-persistent (group I)]; and... Petroleum Oil Cargo Groups Non-persistent oil 72 G: Group I 1.0 Persistent oil: Group II 1.8 Group III 2.0...

33 CFR Appendix B to Part 155 - Determining and Evaluating Required Response Resources for Vessel Response Plans

Code of Federal Regulations, 2013 CFR

2013-07-01

... carried [persistent (groups II, III, and IV) or non-persistent (group I)]; and the geographic area(s) in... type of petroleum oil carried [persistent (groups II, III, and IV) or non-persistent (group I)]; and... Petroleum Oil Cargo Groups Non-persistent oil 72 G: Group I 1.0 Persistent oil: Group II 1.8 Group III 2.0...

[Maintenance of Pure Lines and Hybridization.] Student Materials. V.A. III. [IV-A-1 through IV-A-2].

ERIC Educational Resources Information Center

Texas A and M Univ., College Station. Vocational Instructional Services.

Part of a series of eight student learning modules in vocational agriculture, this booklet deals with plant reproduction. Topics covered include the pure line theory and its history, pure line selection, the effect of inbreeding on vitality, the definition of and reasons for hybridization in plants, and techniques for producing hybirds; a list of…

Auxiliary subprograms for calculating the navigational parameters of artificial Earth satellites. FORTRAN IV

NASA Technical Reports Server (NTRS)

Prokhorenko, V. I.

1981-01-01

Subprograms for transforming coordinates and time, for determining the position of the Moon and Sun, and for calculating the atmosphere and disturbances, which are specified by anomalies of the Earth's gravitational field are described. The subprograms are written in FORTRAN IV and form a major part of the package of applied programs for calculating the navigational parameters of artificial Earth satellites.

Student Perceptions of Elementary School Climates in the Louisiana School Effectiveness Study: A Comparison of Phase III and Phase IV.

ERIC Educational Resources Information Center

Roberts, Sharon Pol; Heroman, Deborah S.

A 5-year study examined third-graders' perceptions of school climate in 16 Louisiana schools. Part of the Louisiana School Effectiveness Study (LSES), Phase III and IV examined student perceptions in 1984-85 and 1989-90, respectively, and also gathered demographic data and multiple measures of student outcomes through student surveys and classroom…

40 CFR 63.11148 - What are the standards and compliance requirements for existing sources using batch copper...

Code of Federal Regulations, 2013 CFR

2013-07-01

... acid plant prior to discharge to the atmosphere. (iv) For each secondary capture system that is used to... practicable, maintain and operate any affected source, including associated air pollution control equipment, in a manner consistent with good air pollution control practice for minimizing emissions...

40 CFR 63.11148 - What are the standards and compliance requirements for existing sources using batch copper...

Code of Federal Regulations, 2014 CFR

2014-07-01

... acid plant prior to discharge to the atmosphere. (iv) For each secondary capture system that is used to... practicable, maintain and operate any affected source, including associated air pollution control equipment, in a manner consistent with good air pollution control practice for minimizing emissions...

40 CFR 63.11148 - What are the standards and compliance requirements for existing sources using batch copper...

Code of Federal Regulations, 2011 CFR

2011-07-01

... acid plant prior to discharge to the atmosphere. (iv) For each secondary capture system that is used to... practicable, maintain and operate any affected source, including associated air pollution control equipment, in a manner consistent with good air pollution control practice for minimizing emissions...

40 CFR 63.11148 - What are the standards and compliance requirements for existing sources using batch copper...

Code of Federal Regulations, 2010 CFR

2010-07-01

... acid plant prior to discharge to the atmosphere. (iv) For each secondary capture system that is used to... practicable, maintain and operate any affected source, including associated air pollution control equipment, in a manner consistent with good air pollution control practice for minimizing emissions...

40 CFR 63.11148 - What are the standards and compliance requirements for existing sources using batch copper...

Code of Federal Regulations, 2012 CFR

2012-07-01

... acid plant prior to discharge to the atmosphere. (iv) For each secondary capture system that is used to... practicable, maintain and operate any affected source, including associated air pollution control equipment, in a manner consistent with good air pollution control practice for minimizing emissions...

22 CFR 129.7 - Prior approval (license).

Code of Federal Regulations, 2010 CFR

2010-04-01

...; (ii) Nuclear weapons strategic delivery systems and all components, parts, accessories, attachments specifically designed for such systems and associated equipment; (iii) Nuclear weapons design and test equipment of a nature described by Category XVI of Part 121; (iv) Naval nuclear propulsion equipment of a...

22 CFR 129.7 - Prior approval (license).

Code of Federal Regulations, 2011 CFR

2011-04-01

...; (ii) Nuclear weapons strategic delivery systems and all components, parts, accessories, attachments specifically designed for such systems and associated equipment; (iii) Nuclear weapons design and test equipment of a nature described by Category XVI of part 121; (iv) Naval nuclear propulsion equipment of a...

75 FR 82489 - Process for Submissions for Review of Security-Based Swaps for Mandatory Clearing and Notice...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-30

... Part IV Securities and Exchange Commission 17 CFR Parts 240 and 249 Process for Submissions for Review of Security-Based Swaps for Mandatory Clearing and Notice Filing Requirements for Clearing...;#0; [[Page 82490

45 CFR Appendix B to Part 1356 - NYTD Youth Outcome Survey

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false NYTD Youth Outcome Survey B Appendix B to Part... APPLICABLE TO TITLE IV-E Pt. 1356, App. B Appendix B to Part 1356—NYTD Youth Outcome Survey Topic/element # Question to youth and response options Definition INFORMATION TO COLLECT FROM ALL YOUTH SURVEYED FOR...

45 CFR Appendix B to Part 1356 - NYTD Youth Outcome Survey

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false NYTD Youth Outcome Survey B Appendix B to Part... APPLICABLE TO TITLE IV-E Pt. 1356, App. B Appendix B to Part 1356—NYTD Youth Outcome Survey Topic/element # Question to youth and response options Definition INFORMATION TO COLLECT FROM ALL YOUTH SURVEYED FOR...

DSM-IV: a nosology sold before its time?

PubMed

Zimmerman, M; Jampala, V C; Sierles, F S; Taylor, M A

1991-04-01

The purpose of this study was to determine whether American psychiatrists believe that DSM-IV is being published too soon after DSM-III-R. The authors conducted a mail survey of the attitudes of practicing psychiatrists (N = 454), residency program directors (N = 128), residents (N = 1,331), and researchers (N = 196) toward the scheduled publication of DSM-IV in the early 1990s. They found that the majority of all four groups believed that DSM-IV is being published prematurely. In contrast to respondents who believed that the timing of DSM-IV is appropriate, those who indicated that it is being published too soon had more recently completed their residency training and also believed that DSM-III-R was published prematurely. There was no association between the psychiatrists' responses and their theoretical orientation, Board certification status, ownership of the DSM manuals, the length of time they had used DSM-III, and the diagnostic manual (DSM-III or DSM-III-R) they were currently using. The belief that DSM-IV is being published too soon could contribute to underuse of DSM-IV by substantial numbers of psychiatrists. Thus, to foster compliance with it, APA must preserve in its efforts to demonstrate that the advantages of publishing it in 1993 outweigh the disadvantages of adopting yet another manual.

Selenoamino Acid-Enriched Green Pea as a Value-Added Plant Protein Source for Humans and Livestock.

PubMed

Garousi, Farzaneh; Domokos-Szabolcsy, Éva; Jánószky, Mihály; Kovács, Andrea Balláné; Veres, Szilvia; Soós, Áron; Kovács, Béla

2017-06-01

Selenium deficiency in various degrees affects around 15% of the world's population, contributing to a variety of health problems. In this study, we examined the accumulation and biotransformation of soil applied Se-supplementation (sodium selenite and sodium selenate forms) at different concentrations, along with growth and yield formation of green pea, in a greenhouse experiment. Biotransformation of inorganic Se was evaluated using HPLC-ICP-MS for Se-species separation in the above ground parts of green pea. Results showed 3 mg kg -1 Se IV increased green pea growth biomarkers and also caused an increase in protein content in leaves by 17%. Selenomethionine represented 65% of the total selenium content in shoots, but was lower in pods and seeds (54 and 38%, respectively). Selenomethionine was the major species in all plant parts and the only organic selenium form in the lower Se IV concentration range. Elevating the dose of Se IV (≥30 mg kg -1 ) triggered detrimental effects on growth and protein content and caused higher accumulation of inorganic Se in forms of Se VI and Se IV . Selenocysteine, another organic form of proteinogenic amino acid, was determined when Se IV (≥10 mg kg -1 ) was applied in higher concentrations. Thus, agronomic biofortification using the appropriate chemical form and concentration of Se will have positive effects on green pea growth and its enriched shoots and seeds provide a value-added protein source for livestock and humans with significant increased selenomethionine.

Undue industry influences that distort healthcare research, strategy, expenditure and practice: a review.

PubMed

Stamatakis, Emmanuel; Weiler, Richard; Ioannidis, John P A

2013-05-01

Expenditure on industry products (mostly drugs and devices) has spiraled over the last 15 years and accounts for substantial part of healthcare expenditure. The enormous financial interests involved in the development and marketing of drugs and devices may have given excessive power to these industries to influence medical research, policy, and practice. Review of the literature and analysis of the multiple pathways through which the industry has directly or indirectly infiltrated the broader healthcare systems. We present the analysis of the industry influences at the following levels: (i) evidence base production, (ii) evidence synthesis, (iii) understanding of safety and harms issues, (iv) cost-effectiveness evaluation, (v) clinical practice guidelines formation, (vi) healthcare professional education, (vii) healthcare practice, (viii) healthcare consumer's decisions. We located abundance of consistent evidence demonstrating that the industry has created means to intervene in all steps of the processes that determine healthcare research, strategy, expenditure, practice and education. As a result of these interferences, the benefits of drugs and other products are often exaggerated and their potential harms are downplayed, and clinical guidelines, medical practice, and healthcare expenditure decisions are biased. To serve its interests, the industry masterfully influences evidence base production, evidence synthesis, understanding of harms issues, cost-effectiveness evaluations, clinical practice guidelines and healthcare professional education and also exerts direct influences on professional decisions and health consumers. There is an urgent need for regulation and other action towards redefining the mission of medicine towards a more objective and patient-, population- and society-benefit direction that is free from conflict of interests. © 2013 Stichting European Society for Clinical Investigation Journal Foundation. Published by Blackwell Publishing Ltd.

Improving Efficiency using a Hybrid Approach: Revising an IV/Blood Workshop in a Clinical Research Environment

PubMed Central

Parchen, Debra A.; Phelps, Sandra E.; Johnson, Eunice M.; Fisher, Cheryl A.

2016-01-01

Orienting to a new job can be overwhelming, especially if the nurse is required to develop or refine new skills, such as intravenous (IV) therapy or blood administration. At the National Institutes of Health Clinical Center Nursing Department, a group of nurse educators redesigned the IV/Blood Workshop to prepare nurses with skills needed when caring for patients on protocol in a research intensive environment. Innovative teaching strategies and a hybrid instructional approach were utilized along with a pre-workshop activity, skills lab practice, and follow up skill validation at the unit level to provide a comprehensive curriculum while decreasing resource utilization. PMID:27187829

Development of Methodologies for IV and V of Neural Networks

NASA Technical Reports Server (NTRS)

Taylor, Brian; Darrah, Marjorie

2003-01-01

Non-deterministic systems often rely upon neural network (NN) technology to "lean" to manage flight systems under controlled conditions using carefully chosen training sets. How can these adaptive systems be certified to ensure that they will become increasingly efficient and behave appropriately in real-time situations? The bulk of Independent Verification and Validation (IV&V) research of non-deterministic software control systems such as Adaptive Flight Controllers (AFC's) addresses NNs in well-behaved and constrained environments such as simulations and strict process control. However, neither substantive research, nor effective IV&V techniques have been found to address AFC's learning in real-time and adapting to live flight conditions. Adaptive flight control systems offer good extensibility into commercial aviation as well as military aviation and transportation. Consequently, this area of IV&V represents an area of growing interest and urgency. ISR proposes to further the current body of knowledge to meet two objectives: Research the current IV&V methods and assess where these methods may be applied toward a methodology for the V&V of Neural Network; and identify effective methods for IV&V of NNs that learn in real-time, including developing a prototype test bed for IV&V of AFC's. Currently. no practical method exists. lSR will meet these objectives through the tasks identified and described below. First, ISR will conduct a literature review of current IV&V technology. TO do this, ISR will collect the existing body of research on IV&V of non-deterministic systems and neural network. ISR will also develop the framework for disseminating this information through specialized training. This effort will focus on developing NASA's capability to conduct IV&V of neural network systems and to provide training to meet the increasing need for IV&V expertise in such systems.

Continuing education for maternal child health nurses: a means to improve the health care of mothers and children.

PubMed Central

Bolte, I M; Presler, E P

1983-01-01

The University of Kentucky College of Nursing is in the 7th year of implementing a 7-year federally funded continuing education project. The major goal of MCH (maternal child health) Project 969, which is scheduled to terminate Sept. 30, 1984, is to develop and offer a series of quality continuing education courses for three distinct populations--practicing maternal child health nurses, State nurse consultants, and nurse supervisors at county or district levels. The purpose of these courses is to improve the practice of the participating nurses and thereby ultimately to improve the health status of mothers and children in Region IV of the Department of Health and Human Services. Evaluation of the project by its staff after its first 5 years showed that (a) it has provided a series of continuing education courses of high quality; (b) met its goals and objectives; (c) provided continuing education for practicing maternal child health nurses that has improved MCH nursing practice in Region IV; (d) provided continuing education for State nurse consultants that has enabled them to become more effective leaders in their respective States; (e) used previously untapped resources in Region IV to make the concept of regional continuing education in maternal child health nursing a reality; and (f) generated a networking system among State nurse consultants, nurse educators, and nurse leaders in other service-oriented Title V programs that has been most effective in meeting the learning needs of the three distinct populations it serves. PMID:6419272

Implementation of a protocol for the prevention and management of extravasation injuries in the neonatal intensive care patient.

PubMed

Warren, Diane

2011-06-01

This project sought to determine nurses' understanding and management of infants with intravenous (IV) therapy. There were three specific aims: • To improve identification and management of extravasation injuries in neonates • To ensure management of extravasation injuries in neonates is classified according to IV extravasation staging guidelines • To develop a protocol that outlined actions required to manage extravasation injuries. This project utilised a pre- and post-implementation audit strategy using the Joanna Briggs Institute (JBI) Getting Research into Practice (GRIP) program. This method has been used to improve clinical practice by utilising an audit, feedback and re-audit sequence. The project was implemented in four stages over a 7-month period from 21 October 2009 to 30 May 2010. Initially, there was poor compliance with all four criteria, ranging from zero to 63%. The GRIP phase of the project identified five barriers which were addressed throughout this project. These related to education of staff and the development of a protocol for the prevention and management of extravasation injuries in the neonatal population. Following implementation of best practice, the second audit showed a marked improvement in all four criteria, ranging from 70 to 100% compliance. Overall, this project has led to improvements in clinical practice in line with current evidence. This has resulted in enhanced awareness of the risks associated with IV therapy and of measures to prevent an injury occurring within this clinical setting. © 2011 The Author. International Journal of Evidence-Based Healthcare © 2011 The Joanna Briggs Institute.

The Generation in Between: A Perspective from the Keystone IV Conference.

PubMed

Chen, Frederick M; Bliss, Erika; Dunn, Aaron; Edgoose, Jennifer; Elliott, Tricia C; Maxwell, Lisa C; Morris, Carl G; Phillips, Robert L

2016-01-01

Keystone IV affirmed the value of relationships in family medicine, but each generation of family physicians took away different impressions and lessons. "Generation III," between the Baby Boomers and Millennials, reported conflict between their professional ideal of family medicine and the realities of current practice. But the Keystone conference also helped them appreciate core values of family medicine, their shared experience, and new opportunities for leadership. © Copyright 2016 by the American Board of Family Medicine.

Prescribing Patterns of Intravenous Golimumab for Rheumatoid Arthritis.

PubMed

Brady, Brenna L; Tkacz, Joseph P; Lofland, Jennifer; Meyer, Roxanne; Bolge, Susan C

2015-09-01

The use of intravenous golimumab (GLM-IV), in combination with methotrexate, was approved by the US Food and Drug Administration in July 2013 for the treatment of moderate to severe, active rheumatoid arthritis (RA). GLM-IV is available in 50-mg vials, and the prescribing information specifies a dosing regimen of 2 mg/kg at 0 and 4 weeks and then every 8 weeks thereafter. The purpose of this study was to examine the patterns of prescribing and administration of GLM-IV, including the demographic, clinical, and utilization characteristics of patients with RA newly treated with GLM-IV. Rheumatology practices across the continental United States were solicited for a chart-review study. Inclusion criteria were: (1) diagnosis of RA; (2) current treatment with GLM-IV; (3) age ≥18 years; and (4) lack of pregnancy (in female patients). Physicians were offered a monetary incentive for each eligible chart provided. An electronic case-report form was developed to aid in the chart data extraction and included fields for demographic characteristics, available comorbid diagnoses, prior RA treatments, and doses and dates of GLM-IV administration. A total of 117 eligible patient charts from 15 rheumatologist practices were reviewed. The patient sample was predominantly female (81.2%), with a mean (SD) age of 55.4 (14.5) years. A total of 55.6% of patients had evidence of biologic treatment before receiving GLM-IV, and 53% had at least 1 comorbid condition. In total, 300 individual GLM-IV infusions from this sample were reviewed. Due to the relatively recent approval of GLM-IV use by the US Food and Drug Administration, the majority of patients in this sample (69.2%) had received only between 2 and 4 infusions at the time of the review. For infusion records with valid dose data, the mean number of administered vials was 3.6 (0.8) (total dose, 180 mg); the majority of patients received a dose consistent with the prescribed dose of 2 mg/kg. Combination therapy with methotrexate was observed in the charts of a minority of patients (27.4%). The mean interval between induction and the first follow-up infusion was 32.9 (11.4) days, with a mean maintenance interval of 56.5 (13.3) days. This analysis provides an early glimpse of the patterns of prescribing GLM-IV. Overall, patients appeared to have been receiving GLM-IV in accordance with Food and Drug Administration labeling; although the rate of prescribing methotrexate was low, dosages and administration intervals were within the expected ranges. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

The incidence of phlebitis with intravenous amiodarone at guideline dose recommendations.

PubMed

Slim, Ahmad M; Roth, Jason E; Duffy, Benjamin; Boyd, Sheri Y N; Rubal, Bernard J

2007-12-01

Postoperative atrial fibrillation following cardiothoracic surgery is common and frequently managed with intravenous (IV) amiodarone. Phlebitis is the most common complication with peripheral infusion of this agent. Current practice guidelines for peripheral IV administration of <2 mg/mL amiodarone were established to reduce the risk of phlebitis. The present study examines the incidence of phlebitis in a postoperative patient population given current dose recommendations. A total of 273 patient charts were reviewed. The incidence of phlebitis in patients given IV amiodarone (n = 36) was 13.9% (95% confidence interval, 2.6-25.2%; p = 0.001). Logistic regression analysis with backward elimination of other therapeutic risk factors suggests that the odds ratio for phlebitis using current dose regimens without IV filters is 19-fold greater than baseline risk in this population. Phlebitis remains a significant complication associated with peripheral infusion of amiodarone within recommended dosing limits.

Career paths and contributions of four cohorts of IV-E funded MSW child welfare graduates.

PubMed

Robin, Sandra C; Hollister, C David

2002-01-01

For the last decade the federal government has provided financial support through Title IV-E of the Social Security Act to schools of social work to provide professional education in child welfare. This study looks at the first four cohorts of graduates who received IV-E funding from one school of social work. Data on MSW graduates from 1993-1996 (N = 73), as well as survey responses (N = 32), were analyzed to ascertain dimensions of their career development in, and contributions to, child welfare social work. Results indicate that the vast majority of graduates funded by IV-E dollars became employed in and stayed in child welfare focused social work, with a strong percentage in public child welfare services, and that these social work-educated social workers are actively involved in shaping the practice, policies and administration of child welfare services.

Properties of the highly ionized disk and halo gas toward two distant high-latitude stars

NASA Technical Reports Server (NTRS)

Savage, Blair D.; Sembach, K. R.

1994-01-01

Goddard High Resolution Spectrograph (GHRS) intermediate -resolution observations of S III, Si III, Al III, Si IV, C IV, and N V absorption along the sight lines to HD 18100 (l = 217.9 deg, b = -62.7, d = 3.1 kpc, z = -2.8 kpc) and HD 100340 (l = 258.9 deg, b = +61.2 deg, d = 5.3 kpc, z = 4.6 kpc) are presented. These small science aperture spectra have resolutions ranging from 11 to 20 km/s full width at half maximum (FWHM) and S/N from 30 to 65 per diode substep. Strong absorption by moderately and highly ionized gas is seen in each direction. The absorption in the direction of the south Galactic polar region (HD 18100) is kinematically simple, while the absorption in the direction of north Galactic polar region (HD 100304) is kinematically complex. In each case the absorption by the highly ionized gas lies within the velocity range of absorption by neutral and weakly ionized gas. Along each sight line, the velocity dispersion determined from the unsaturated absorption lines increases with the energy required to create each ion. The logarithmic column densities for Al III, Si IV, C IV, and N V are log N(atoms/sq cm = 12.71, 13.10, 13.58, and 12.75 toward HD 18100 and log N = 12.88, 13.31, 13.83, and 13.04 toward HD 100340. Average ionic ratios among these species are very similar along the two sight lines. Differences in profile shape between the absorption for AL II, Si IV, C IV, and N V provide additional support for the claim of Savage, Sembach, & Cardelli (1994) that there exists two types of highly ionized gas in the interstellar medium. One type of highly ionized gas is responsible for the structured Si IV absorption and part of the C IV absorption. In this gas N(C IV)/N(Si IV) approximately 3.0 and N(C IV)/N(N V) greater than 6. The absorption by this gas seems to be associated with some type of self-regulating interface or mixing layer between the warm and hot interstellar medium. The other type of highly ionized gas is responsible for most of the N V absorption, part of the C IV absorption, and has very little associated Si IV absorption. In this gas N(C IV)/N(N V) is approximately 1 to 3. This gas is hot (T greater than 2 x 10(exp 5) K) and may be tracing the cooling gas of supernova (SN) bubbles or a Galactic fountain. The relative mixture of these two types of highly ionized gas varies from one sight line to the next. The two sight lines in this study sample halo gas in the solar neighborhood and have a smaller percentage of the more highly ionized gas than inner Galaxy sight lines.

Age 60 study, part IV : experimental evaluation of pilot performance.

DOT National Transportation Integrated Search

1994-10-01

This document is one of four products completed as a part of the Age 60 Rule Research Contract monitored by Pam Della Rocco, Civil Aerospace Medical Institute. This report was a deliverable from the research contract with Hilton Systems, Inc. on the ...

Technology transfer by means of fault tree synthesis

NASA Astrophysics Data System (ADS)

Batzias, Dimitris F.

2012-12-01

Since Fault Tree Analysis (FTA) attempts to model and analyze failure processes of engineering, it forms a common technique for good industrial practice. On the contrary, fault tree synthesis (FTS) refers to the methodology of constructing complex trees either from dentritic modules built ad hoc or from fault tress already used and stored in a Knowledge Base. In both cases, technology transfer takes place in a quasi-inductive mode, from partial to holistic knowledge. In this work, an algorithmic procedure, including 9 activity steps and 3 decision nodes is developed for performing effectively this transfer when the fault under investigation occurs within one of the latter stages of an industrial procedure with several stages in series. The main parts of the algorithmic procedure are: (i) the construction of a local fault tree within the corresponding production stage, where the fault has been detected, (ii) the formation of an interface made of input faults that might occur upstream, (iii) the fuzzy (to count for uncertainty) multicriteria ranking of these faults according to their significance, and (iv) the synthesis of an extended fault tree based on the construction of part (i) and on the local fault tree of the first-ranked fault in part (iii). An implementation is presented, referring to 'uneven sealing of Al anodic film', thus proving the functionality of the developed methodology.

Distance-Learning, ADHD Quality Improvement in Primary Care: A Cluster-Randomized Trial.

PubMed

Fiks, Alexander G; Mayne, Stephanie L; Michel, Jeremy J; Miller, Jeffrey; Abraham, Manju; Suh, Andrew; Jawad, Abbas F; Guevara, James P; Grundmeier, Robert W; Blum, Nathan J; Power, Thomas J

2017-10-01

To evaluate a distance-learning, quality improvement intervention to improve pediatric primary care provider use of attention-deficit/hyperactivity disorder (ADHD) rating scales. Primary care practices were cluster randomized to a 3-part distance-learning, quality improvement intervention (web-based education, collaborative consultation with ADHD experts, and performance feedback reports/calls), qualifying for Maintenance of Certification (MOC) Part IV credit, or wait-list control. We compared changes relative to a baseline period in rating scale use by study arm using logistic regression clustered by practice (primary analysis) and examined effect modification by level of clinician participation. An electronic health record-linked system for gathering ADHD rating scales from parents and teachers was implemented before the intervention period at all sites. Rating scale use was ascertained by manual chart review. One hundred five clinicians at 19 sites participated. Differences between arms were not significant. From the baseline to intervention period and after implementation of the electronic system, clinicians in both study arms were significantly more likely to administer and receive parent and teacher rating scales. Among intervention clinicians, those who participated in at least 1 feedback call or qualified for MOC credit were more likely to give parents rating scales with differences of 14.2 (95% confidence interval [CI], 0.6-27.7) and 18.8 (95% CI, 1.9-35.7) percentage points, respectively. A 3-part clinician-focused distance-learning, quality improvement intervention did not improve rating scale use. Complementary strategies that support workflows and more fully engage clinicians may be needed to bolster care. Electronic systems that gather rating scales may help achieve this goal. Index terms: ADHD, primary care, quality improvement, clinical decision support.

Circadian Rhythm Sleep Disorders: Part I, Basic Principles, Shift Work and Jet Lag DisordersAn American Academy of Sleep Medicine Review

PubMed Central

Sack, Robert L; Auckley, Dennis; Auger, R. Robert; Carskadon, Mary A.; Wright, Kenneth P.; Vitiello, Michael V.; Zhdanova, Irina V.

2007-01-01

Objective: This the first of two articles reviewing the scientific literature on the evaluation and treatment of circadian rhythm sleep disorders (CRSDs), employing the methodology of evidence-based medicine. In this first part of this paper, the general principles of circadian biology that underlie clinical evaluation and treatment are reviewed. We then report on the accumulated evidence regarding the evaluation and treatment of shift work disorder (SWD) and jet lag disorder (JLD). Methods: A set of specific questions relevant to clinical practice were formulated, a systematic literature search was performed, and relevant articles were abstracted and graded. Results: A substantial body of literature has accumulated that provides a rational basis the evaluation and treatment of SWD and JLD. Physiological assessment has involved determination of circadian phase using core body temperature and the timing of melatonin secretion. Behavioral assessment has involved sleep logs, actigraphy and the Morningness-Eveningness Questionnaire (MEQ). Treatment interventions fall into three broad categories: 1) prescribed sleep scheduling, 2) circadian phase shifting (“resetting the clock”), and 3) symptomatic treatment using hypnotic and stimulant medications. Conclusion: Circadian rhythm science has also pointed the way to rational interventions for the SWD and JLD, and these treatments have been introduced into the practice of sleep medicine with varying degrees of success. More translational research is needed using subjects who meet current diagnostic criteria. Citation: Sack RL; Auckley D; Auger RR; Carskadon MA; Wright KP; Vitiello MV; Zhdanova IV. Circadian rhythm sleep disorders: Part I, basic principles, shift work and jet lag disorders. SLEEP 2007;30(11):1460-1483. PMID:18041480

Microbial oxidation of elemental selenium in soil slurries and bacterial cultures

USGS Publications Warehouse

Dowdle, P.R.; Oremland, R.S.

1998-01-01

The microbial oxidation of elemental selenium [Se(O)] was studied by employing 75Se(O) as a tracer. Live, oxic soil slurries demonstrated a linear production of mostly Se(IV), with the formation of smaller quantities of Se(VI). Production of both Se(IV) and Se(VI) was inhibited by autoclaving, formalin, antibiotics, azide, and 2,4-dinitrophenol, thereby indicating the involvement of microbes. Oxidation of Se(O) in slurries was enhanced by addition of acetate, glucose, or sulfide, which implied involvement of chemoheterotrophs as well as chemoautotrophic thiobacilli. Cultures of Thiobacillus ASN-1, Leptothrix MnB1, and a heterotrophic soil enrichment all oxidized Se(O) with Se(VI) observed as the major product rather than Se(IV). This indicated that microbial oxidation in soils is partly constrained by the adsorption of Se(IV) onto soil surfaces. Rate constants for unamended soil slurry Se(O) oxidation ranged from 0.0009 to 0.0117 day-1 which were 3-4 orders of magnitude lower than those reported for dissimilatory Se(VI) reduction in organic-rich, anoxic sediments.The microbial oxidation of elemental selenium [Se(0)] was studied by employing 75Se(0) as a tracer. Live, oxic soil slurries demonstrated a linear production of mostly Se(IV), with the formation of smaller quantities of Se(VI). Production of both Se(IV) and Se(VI) was inhibited by autoclaving, formalin, antibiotics, azide, and 2,4-dinitrophenol, thereby indicating the involvement of microbes. Oxidation of Se(O) in slurries was enhanced by addition of acetate, glucose, or sulfide, which implied involvement of chemoheterotrophs as well as chemoautotrophic thiobacilli. Cultures of Thiobacillus ASN-1, Leptothrix MnB1, and a heterotrophic soil enrichment all oxidized Se(O) with Se(VI) observed as the major product rather than Se(IV). This indicated that microbial oxidation in soils is partly constrained by the adsorption of Se(IV) onto soil surfaces. Rate constants for unamended soil slurry Se(O) oxidation ranged from 0.0009 to 0.0117 day-1 which were 3-4 orders of magnitude lower than those reported for dissimilatory Se(VI) reduction in organic-rich, anoxic sediments.

46 CFR 160.151-21 - Equipment required for SOLAS A and SOLAS B inflatable liferafts.

Code of Federal Regulations, 2012 CFR

2012-10-01

...), Chapter IV/4.1.5.1.7 and ISO 18813). Each sharp part of a tin-opener must have a guard. (h) First-aid kit... approval series 160.061. (r) Food rations (IMO LSA Code, as amended by Resolution MSC.293(87), Chapter IV/4.1.5.1.18) The food rations must be approved by the Commandant under approval series 160.046. (s...

46 CFR 160.151-21 - Equipment required for SOLAS A and SOLAS B inflatable liferafts.

Code of Federal Regulations, 2013 CFR

2013-10-01

...), Chapter IV/4.1.5.1.7 and ISO 18813). Each sharp part of a tin-opener must have a guard. (h) First-aid kit... approval series 160.061. (r) Food rations (IMO LSA Code, as amended by Resolution MSC.293(87), Chapter IV/4.1.5.1.18) The food rations must be approved by the Commandant under approval series 160.046. (s...

46 CFR 160.151-21 - Equipment required for SOLAS A and SOLAS B inflatable liferafts.

Code of Federal Regulations, 2014 CFR

2014-10-01

...), Chapter IV/4.1.5.1.7 and ISO 18813). Each sharp part of a tin-opener must have a guard. (h) First-aid kit... approval series 160.061. (r) Food rations (IMO LSA Code, as amended by Resolution MSC.293(87), Chapter IV/4.1.5.1.18) The food rations must be approved by the Commandant under approval series 160.046. (s...

Gen IV Materials Handbook Beta Release for Structural and Functional Evaluation

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

Ren, Weiju; Luttrell, Claire

2006-09-12

Development of the Gen IV Materials Handbook is briefly summarized up to date. Current status of the Handbook website construction is described. The developed Handbook components and access control of the beta version are discussed for the present evaluation release. Detailed instructions and examples are given to provide guidance for evaluators to browse the constructed parts and use all the currently developed functionalities of the Handbook in evaluation.

Method for separating actinides. [Patent application; stripping of Np from organic extractant

DOEpatents

Friedman, H.A.; Toth, L.M.

1980-11-10

An organic solution used for processing spent nuclear reactor fuels is contacted with an aqueous nitric acid solution to strip Np(VI), U(VI), and Pu(IV) from the organic solution into the acid solution. The acid solution is exposed to ultraviolet light, which reduces Np(VI) to Np(V) without reducing U(VI) and Pu(IV). Since the solubility of Np(V) in the organic solution is much lower than that of Np(VI), U(VI), and Pu(IV), a major part of the Np is stripped from the organic solution while leaving most of the U and Pu therein.

Adherence to AIOM (Italian Association of Medical Oncology) lung cancer guidelines in Italian clinical practice: Results from the RIGHT-3 (research for the identification of the most effective and highly accepted clinical guidelines for cancer treatment) study.

PubMed

Barni, Sandro; Maiello, Evaristo; Di Maio, Massimo; Ardizzoni, Andrea; Cappuzzo, Federico; Maranzano, Ernesto; Novello, Silvia; Bennati, Chiara; Ori, Alessandra; Rizzoli, Sara; Crinò, Lucio

2015-11-01

Clinical practice guidelines represent a key tool to improve quality and reduce variability of cancer care. In 2004, Italian Association of Medical Oncology (AIOM) launched the RIGHT (research for the identification of the most effective and highly accepted clinical guidelines for cancer treatment) program. The third step, RIGHT-3, evaluated the concordance between AIOM lung cancer guidelines and Italian clinical practice. RIGHT-3 was a retrospective observational study, conducted in 53 Italian centers treating lung cancer. Sampling from AIOM database of 230 centers was stratified by presence of thoracic surgery and geographic distribution. To describe the adherence to AIOM guidelines (2009 edition), 11 indicators regarding diagnostic and treatment procedures were identified. Patients with non-small-cell lung cancer (NSCLC) diagnosis who had first visit in 2010 were divided into 3 groups, based on TNM stage: I-II-IIIA (5 indicators), IIIB (3 indicators) and IV (3 indicators). 708 patients were enrolled; 680 were eligible: 225 patients in stage I-II-IIIA; 156 patients in stage IIIB; 299 patients in stage IV. Cyto-histological diagnosis was available in 96%, 97%, 96% of stage I-II-IIIA, IIIB, IV respectively. Positron-emission tomography was performed in 64% of stage I-II-IIIA and 46% of stage IIIB. 88% of stage I-II patients eligible for surgery underwent lobectomy; after surgery, 61% of stage II and 57% of stage IIIA patients received adjuvant chemotherapy. Among stage IIIB patients who received combined chemo- radiotherapy, sequential approach was more common than concomitant treatment (86% vs. 14%). Among stage IV patients, 87% received platinum-based first-line treatment, and 70% received second-line. The RIGHT-3 study showed that, in 2010, adherence to Italian NSCLC guidelines was high for many indicators (including those related to treatment of stage IV patients), but lower for some diagnostic procedures. Guidelines adherence monitoring can be useful to reduce variability in cancer care. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

45 CFR Appendix B to Part 1356 - NYTD Youth Outcome Survey

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false NYTD Youth Outcome Survey B Appendix B to Part... APPLICABLE TO TITLE IV-E Pt. 1356, App. B Appendix B to Part 1356—NYTD Youth Outcome Survey Topic/element No. Question to youth and response options Definition INFORMATION TO COLLECT FROM ALL YOUTH SURVEYED FOR...

45 CFR Appendix B to Part 1356 - NYTD Youth Outcome Survey

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false NYTD Youth Outcome Survey B Appendix B to Part... APPLICABLE TO TITLE IV-E Pt. 1356, App. B Appendix B to Part 1356—NYTD Youth Outcome Survey Topic/element No. Question to youth and response options Definition INFORMATION TO COLLECT FROM ALL YOUTH SURVEYED FOR...

45 CFR Appendix B to Part 1356 - NYTD Youth Outcome Survey

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false NYTD Youth Outcome Survey B Appendix B to Part... APPLICABLE TO TITLE IV-E Pt. 1356, App. B Appendix B to Part 1356—NYTD Youth Outcome Survey Topic/element No. Question to youth and response options Definition INFORMATION TO COLLECT FROM ALL YOUTH SURVEYED FOR...

Pilot Judgment Training and Evaluation. Volume 3.

DTIC Science & Technology

1982-06-01

Information Manual. 3-1 8. Flight computer . _ 9. Basic navigation: aeronautical charts (sectional and world 4- aeronautical charts); airspace... clouds , traffic, etc., when you needed to and still maintained the course. 4-13 I___________________ -- -I ~ =~- I- -- INSTRUCTOR LESSON PLAN PART I...maintain basic VFR. PART III Observable Behavior Sought: The student will make proper diversions from clouds to maintain basic VFR. PART IV Reinforcements

45 CFR Appendix C to Part 1356 - Calculating Sample Size for NYTD Follow-Up Populations

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false Calculating Sample Size for NYTD Follow-Up Populations C Appendix C to Part 1356 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE... REQUIREMENTS APPLICABLE TO TITLE IV-E Pt. 1356, App. C Appendix C to Part 1356—Calculating Sample Size for NYTD...

Ultraviolet continuum absorption /less than about 1000 A/ above the quiet sun transition region

NASA Technical Reports Server (NTRS)

Doschek, G. A.; Feldman, U.

1982-01-01

Lyman continuum absorption shortward of 912 A in the quiet sun solar transition region is investigated by combining spectra obtained from the Apollo Telescope Mount experiments on Skylab. The most recent atomic data are used to compute line intensities for lines that fall on both sides of the Lyman limit. Lines of O III, O IV, O V, and S IV are considered. The computed intensity ratios of most lines from O IV, O V, and S IV agree with the experimental ratios to within a factor of 2. However, the discrepancies show no apparent wavelength dependence. From this fact, it is concluded that at least part of the discrepancy between theory and observation for lines of these ions can be accounted for by uncertainties in instrumental calibration and atomic data. However, difficulties remain in reconciling observation and theory, particularly for lines of O III, and one line of S IV. The other recent results of Schmahl and Orrall (1979) are also discussed in terms of newer atomic data.

48 CFR 252.246-7003 - Notification of Potential Safety Issues.

Code of Federal Regulations, 2013 CFR

2013-10-01

.... Critical safety item means a part, subassembly, assembly, subsystem, installation equipment, or support... impact for systems, or subsystems, assemblies, subassemblies, or parts integral to a system, acquired by... the extent known at the time of notification; (iv) A point of contact to coordinate problem analysis...

48 CFR 252.246-7003 - Notification of Potential Safety Issues.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... Critical safety item means a part, subassembly, assembly, subsystem, installation equipment, or support... impact for systems, or subsystems, assemblies, subassemblies, or parts integral to a system, acquired by... the extent known at the time of notification; (iv) A point of contact to coordinate problem analysis...

48 CFR 252.246-7003 - Notification of Potential Safety Issues.

Code of Federal Regulations, 2011 CFR

2011-10-01

.... Critical safety item means a part, subassembly, assembly, subsystem, installation equipment, or support... impact for systems, or subsystems, assemblies, subassemblies, or parts integral to a system, acquired by... the extent known at the time of notification; (iv) A point of contact to coordinate problem analysis...

48 CFR 252.246-7003 - Notification of Potential Safety Issues.

Code of Federal Regulations, 2012 CFR

2012-10-01

.... Critical safety item means a part, subassembly, assembly, subsystem, installation equipment, or support... impact for systems, or subsystems, assemblies, subassemblies, or parts integral to a system, acquired by... the extent known at the time of notification; (iv) A point of contact to coordinate problem analysis...

48 CFR 252.246-7003 - Notification of Potential Safety Issues.

Code of Federal Regulations, 2014 CFR

2014-10-01

.... Critical safety item means a part, subassembly, assembly, subsystem, installation equipment, or support... impact for systems, or subsystems, assemblies, subassemblies, or parts integral to a system, acquired by... the extent known at the time of notification; (iv) A point of contact to coordinate problem analysis...

45 CFR 286.35 - What are proper uses of Tribal Family Assistance Grant funds?

Code of Federal Regulations, 2014 CFR

2014-10-01

... AND HUMAN SERVICES TRIBAL TANF PROVISIONS Tribal TANF Funding § 286.35 What are proper uses of Tribal... State plans for Parts A or F of title IV of the Social Security Act, as such parts were in effect on...

45 CFR 286.35 - What are proper uses of Tribal Family Assistance Grant funds?

Code of Federal Regulations, 2011 CFR

2011-10-01

... AND HUMAN SERVICES TRIBAL TANF PROVISIONS Tribal TANF Funding § 286.35 What are proper uses of Tribal... State plans for Parts A or F of title IV of the Social Security Act, as such parts were in effect on...

76 FR 34541 - Child and Adult Care Food Program Improving Management and Program Integrity

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-13

... Vol. 76 Monday, No. 113 June 13, 2011 Part IV Department of Agriculture Food and Nutrition Service 7 CFR Parts 210, 215, 220 et al. Child and Adult Care Food Program Improving Management and Program... Regulations#0;#0; [[Page 34542

48 CFR 1436.270-5 - Part IV-Representations and instructions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... for award. Identify all factors that will be considered in awarding the contract (See, for example... THE INTERIOR SPECIAL CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Special Aspects of Contracting for Construction 1436.270-5 Part IV—Representations and instructions. The CO shall...

48 CFR 1436.270-5 - Part IV-Representations and instructions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... for award. Identify all factors that will be considered in awarding the contract (See, for example... THE INTERIOR SPECIAL CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Special Aspects of Contracting for Construction 1436.270-5 Part IV—Representations and instructions. The CO shall...

(Docket A-93-02) Category IV-G: Post-Hearing Comments

EPA Pesticide Factsheets

This Index lists comments received after scheduled hearings related to the decision to certify that the Department of Energy had met the compliance criteria established by EPA in 40 CFR Part 194 and the disposal regulations set by EPA in 40 CFR Part 191.

Considerations of Alloy 617 Application in the Gen IV Nuclear Reactor Systems - Part II: Metallurgical Property Challenges

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

Ren, Weiju

2010-01-01

Alloy 617 is currently considered as a leading candidate material for high temperature components in the Gen IV Nuclear Reactor Systems. Because of the unprecedented severe working conditions beyond its commercial service experience required by the Gen IV systems, the alloy faces various challenges in both mechanical and metallurgical properties. Following a previous paper discussing the mechanical property challenges, this paper is focused on the challenges and issues in metallurgical properties of the alloy for the intended nuclear application. Considerations are given in details about its metallurgical stability and aging evolution, aging effects on mechanical properties, potential Co hazard, andmore » internal oxidation. Some research and development activities are suggested with discussions on viability to satisfy the Gen IV Nuclear Reactor System needs.« less

Clinical utility of the Wechsler Memory Scale--Fourth Edition (WMS-IV) in predicting laterality of temporal lobe epilepsy among surgical candidates.

PubMed

Soble, Jason R; Eichstaedt, Katie E; Waseem, Hena; Mattingly, Michelle L; Benbadis, Selim R; Bozorg, Ali M; Vale, Fernando L; Schoenberg, Mike R

2014-12-01

This study evaluated the accuracy of the Wechsler Memory Scale--Fourth Edition (WMS-IV) in identifying functional cognitive deficits associated with seizure laterality in localization-related temporal lobe epilepsy (TLE) relative to a previously established measure, the Rey Auditory Verbal Learning Test (RAVLT). Emerging WMS-IV studies have highlighted psychometric improvements that may enhance its ability to identify lateralized memory deficits. Data from 57 patients with video-EEG-confirmed unilateral TLE who were administered the WMS-IV and RAVLT as part of a comprehensive presurgical neuropsychological evaluation for temporal resection were retrospectively reviewed. We examined the predictive accuracy of the WMS-IV not only in terms of verbal versus visual composite scores but also using individual subtests. A series of hierarchal logistic regression models were developed, including the RAVLT, WMS-IV delayed subtests (Logical Memory, Verbal Paired Associates, Designs, Visual Reproduction), and a WMS-IV verbal-visual memory difference score. Analyses showed that the RAVLT significantly predicted laterality with overall classification rates of 69.6% to 70.2%, whereas neither the individual WMS-IV subtests nor the verbal-visual memory difference score accounted for additional significant variance. Similar to previous versions of the WMS, findings cast doubt as to whether the WMS-IV offers significant incremental validity in discriminating seizure laterality in TLE beyond what can be obtained from the RAVLT. Copyright © 2014 Elsevier Inc. All rights reserved.

An outbreak of post-partum breast abscesses in Mumbai, India caused by ST22-MRSA-IV: genetic characteristics and epidemiological implications

PubMed Central

MANOHARAN, A.; ZHANG, L.; POOJARY, A.; BHANDARKAR, L.; KOPPIKAR, G.; ROBINSON, D. A.

2012-01-01

SUMMARY A cluster of methicillin-resistant Staphylococcus aureus (MRSA) breast abscesses in women who had given birth at a hospital in Mumbai, India was investigated retrospectively. Nineteen of twenty cases were caused by a single clone: pvl-positive, spa type 648 (Ridom t852), ccrB:dru subtype 3:0, ST22-MRSA-IV. Despite the presence of pvl and SCCmec type IV, which are common genetic markers among community-associated MRSA, this outbreak was caused by a healthcare-associated, community-onset MRSA that was common in the hospital environment. Thus, infection control practices may have an important role in limiting the spread of this virulent clone. PMID:22475374

Inter-rater agreement of comorbid DSM-IV personality disorders in substance abusers.

PubMed

Hesse, Morten; Thylstrup, Birgitte

2008-05-17

Little is known about the inter-rater agreement of personality disorders in clinical settings. Clinicians rated 75 patients with substance use disorders on the DSM-IV criteria of personality disorders in random order, and on rating scales representing the severity of each. Convergent validity agreement was moderate (range for r = 0.55, 0.67) for cluster B disorders rated with DSM-IV criteria, and discriminant validity was moderate for eight of the ten personality disorders. Convergent validity of the rating scales was only moderate for antisocial and narcissistic personality disorder. Dimensional ratings may be used in research studies and clinical practice with some caution, and may be collected as one of several sources of information to describe the personality of a patient.

Interactive Macroeconomics

NASA Astrophysics Data System (ADS)

Di Guilmi, Corrado; Gallegati, Mauro; Landini, Simone

2017-04-01

Preface; List of tables; List of figures, 1. Introduction; Part I. Methodological Notes and Tools: 2. The state space notion; 3. The master equation; Part II. Applications to HIA Based Models: 4. Financial fragility and macroeconomic dynamics I: heterogeneity and interaction; 5. Financial fragility and macroeconomic Dynamics II: learning; Part III. Conclusions: 6. Conclusive remarks; Part IV. Appendices and Complements: Appendix A: Complements to Chapter 3; Appendix B: Solving the ME to solve the ABM; Appendix C: Specifying transition rates; Index.

Regulation of COX-2–mediated signaling by α3 type IV noncollagenous domain in tumor angiogenesis

PubMed Central

Boosani, Chandra Shekhar; Mannam, Arjuna P.; Cosgrove, Dominic; Silva, Rita; Hodivala-Dilke, Kairbaan M.; Keshamouni, Venkateshwar G.

2007-01-01

Human α3 chain, a noncollagenous domain of type IV collagen [α3(IV)NC1], inhibits angiogenesis and tumor growth. These biologic functions are partly attributed to the binding of α3(IV)NC1 to αVβ3 and α3β1 integrins. α3(IV)NC1 binds αVβ3 integrin, leading to translation inhibition by inhibiting focal adhesion kinase/phosphatidylinositol 3-kinase/Akt/mTOR/4E-BP1 pathways. In the present study, we evaluated the role of α3β1 and αVβ3 integrins in tube formation and regulation of cyclooxygenase-2 (COX-2) on α3(IV)NC1 stimulation. We found that although both integrins were required for the inhibition of tube formation by α3(IV)NC1 in endothelial cells, only α3β1 integrin was sufficient to regulate COX-2 in hypoxic endothelial cells. We show that binding of α3(IV)NC1 to α3β1 integrin leads to inhibition of COX-2–mediated pro-angiogenic factors, vascular endothelial growth factor, and basic fibroblast growth factor by regulating IκBα/NFκB axis, and is independent of αVβ3 integrin. Furthermore, β3 integrin–null endothelial cells, when treated with α3(IV)NC1, inhibited hypoxia-mediated COX-2 expression, whereas COX-2 inhibition was not observed in α3 integrin–null endothelial cells, indicating that regulation of COX-2 by α3(IV)NC1 is mediated by integrin α3β1. Our in vitro and in vivo findings demonstrate that α3β1 integrin is critical for α3(IV)NC1-mediated inhibition of COX-2–dependent angiogenic signaling and inhibition of tumor progression. PMID:17426256

5 CFR 890.805 - Application time limitations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Benefits for Former Spouses § 890.805...) and (v) of this part, former spouses must apply for health benefits coverage— (1) Within 60 days after... spouses who meet the requirements in § 890.803(a)(3)(iv) of this part must apply for health benefits...

5 CFR 890.805 - Application time limitations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Benefits for Former Spouses § 890.805...) and (v) of this part, former spouses must apply for health benefits coverage— (1) Within 60 days after... spouses who meet the requirements in § 890.803(a)(3)(iv) of this part must apply for health benefits...

5 CFR 890.805 - Application time limitations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Benefits for Former Spouses § 890.805...) and (v) of this part, former spouses must apply for health benefits coverage— (1) Within 60 days after... spouses who meet the requirements in § 890.803(a)(3)(iv) of this part must apply for health benefits...

5 CFR 890.805 - Application time limitations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Benefits for Former Spouses § 890.805...) and (v) of this part, former spouses must apply for health benefits coverage— (1) Within 60 days after... spouses who meet the requirements in § 890.803(a)(3)(iv) of this part must apply for health benefits...

48 CFR 315.204-5 - Part IV-Representations and instructions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... submit them to the Contracting Officer as part of the acquisition plan or other acquisition request...) Only a formal amendment to a solicitation can change the evaluation factors. Evaluation of proposals... Contracting Officer shall review evaluation factors to ensure they are consistent with the SOW/PWS. This...

48 CFR 315.204-5 - Part IV-Representations and instructions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... submit them to the Contracting Officer as part of the acquisition plan or other acquisition request...) Only a formal amendment to a solicitation can change the evaluation factors. Evaluation of proposals... Contracting Officer shall review evaluation factors to ensure they are consistent with the SOW/PWS. This...

46 CFR 164.019-7 - Non-standard components; acceptance criteria and procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) Inner Envelope Fabric; (iv) Closure (including zippers) or Adjustment Hardware; (v) Body Strap; (vi... in detail and including the unique style, part, or model number, the identification data required by the applicable subpart of this part, and any other manufacturer's identifying data. No two components...

46 CFR 164.019-7 - Non-standard components; acceptance criteria and procedures.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) Inner Envelope Fabric; (iv) Closure (including zippers) or Adjustment Hardware; (v) Body Strap; (vi... in detail and including the unique style, part, or model number, the identification data required by the applicable subpart of this part, and any other manufacturer's identifying data. No two components...

46 CFR 164.019-7 - Non-standard components; acceptance criteria and procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) Inner Envelope Fabric; (iv) Closure (including zippers) or Adjustment Hardware; (v) Body Strap; (vi... in detail and including the unique style, part, or model number, the identification data required by the applicable subpart of this part, and any other manufacturer's identifying data. No two components...

Basic Electricity. Part 2.

ERIC Educational Resources Information Center

Kilmer, Donald C.

This guide, the second (part 2) in a set of four guides, is designed for the student interested in a vocation in electrical work, and includes two units: Unit IV--Electrical Theory, covering thirteen lessons (matter, the atom, electrical charges in the atom, rules of electric charges, electricity, atoms in an electrical conductor, electrical…

76 FR 1213 - Core Principles and Other Requirements for Swap Execution Facilities

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-07

... Part II Commodity Futures Trading Commission 17 CFR Part 37 Core Principles and Other Requirements... RIN Number 3038-AD18 Core Principles and Other Requirements for Swap Execution Facilities AGENCY... Compliance With the Core Principles III. Effective Date and Transition Period IV. Related Matters A...

45 CFR 301.0 - Scope and applicability of this part.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Section 301.0 Public Welfare Regulations Relating to Public Welfare OFFICE OF CHILD SUPPORT ENFORCEMENT (CHILD SUPPORT ENFORCEMENT PROGRAM), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND.... This part deals with the administration of title IV-D of the Social Security Act by the Federal...

Investigation of Two Insect Species for Control of Eurasian Watermilfoil.

DTIC Science & Technology

1981-02-01

accidentally introduced European moth, Agnt~J.g nivea . (Olivier), whose larvae feed on the leaves and stems. The biology of J1. leycogaster was studied... nivea (Olivier) .................... 15 PART ILI: RESULTS AND DISCUSSION ............................. 19 Studies with Litodactylus leucogaster...19 Studies with Acentria nivea .............................. 38 PART IV: CONCLUSIONS ......................................... 47

The Use of Office-Based Sedation and General Anesthesia by Board Certified Pediatric Dentists Practicing in the United States

PubMed Central

Olabi, Nassim F.; Jones, James E.; Saxen, Mark A.; Sanders, Brian J.; Walker, LaQuia A.; Weddell, James A.; Schrader, Stuart M.; Tomlin, Angela M.

2012-01-01

The purpose of this study is to explore the use of office-based sedation by board-certified pediatric dentists practicing in the United States. Pediatric dentists have traditionally relied upon self-administered sedation techniques to provide office-based sedation. The use of dentist anesthesiologists to provide office-based sedation is an emerging trend. This study examines and compares these two models of office-based sedations. A survey evaluating office-based sedation of diplomates of the American Board of Pediatric Dentistry (ABPD) based on gender, age, years in practice, practice types, regions, and years as a diplomate of the ABPD was completed by 494 active members. The results were summarized using frequencies and percentages. Relationships of dentist age, gender, and number of years in practice with the use of intravenous (IV) sedation was completed using two-way contingency tables and Mantel-Haenszel tests for ordered categorical data. Relationships of office-based sedation use and the type of one's practice were examined using Pearson chi-square tests. Of the 1917 surveys e-mailed, 494 completed the survey for a response rate of 26%. Over 70% of board-certified US pediatric dentists use some form of sedation in their offices. Less than 20% administer IV sedation, 20 to 40% use a dentist anesthesiologist, and 60 to 70% would use dentist anesthesiologists if one were available. PMID:22428969

The use of office-based sedation and general anesthesia by board certified pediatric dentists practicing in the United States.

PubMed

Olabi, Nassim F; Jones, James E; Saxen, Mark A; Sanders, Brian J; Walker, Laquia A; Weddell, James A; Schrader, Stuart M; Tomlin, Angela M

2012-01-01

The purpose of this study is to explore the use of office-based sedation by board-certified pediatric dentists practicing in the United States. Pediatric dentists have traditionally relied upon self-administered sedation techniques to provide office-based sedation. The use of dentist anesthesiologists to provide office-based sedation is an emerging trend. This study examines and compares these two models of office-based sedations. A survey evaluating office-based sedation of diplomates of the American Board of Pediatric Dentistry (ABPD) based on gender, age, years in practice, practice types, regions, and years as a diplomate of the ABPD was completed by 494 active members. The results were summarized using frequencies and percentages. Relationships of dentist age, gender, and number of years in practice with the use of intravenous (IV) sedation was completed using two-way contingency tables and Mantel-Haenszel tests for ordered categorical data. Relationships of office-based sedation use and the type of one's practice were examined using Pearson chi-square tests. Of the 1917 surveys e-mailed, 494 completed the survey for a response rate of 26%. Over 70% of board-certified US pediatric dentists use some form of sedation in their offices. Less than 20% administer IV sedation, 20 to 40% use a dentist anesthesiologist, and 60 to 70% would use dentist anesthesiologists if one were available.

Cancer cervix: Establishing an evidence-based strategy, an experience of a tertiary care centre in India.

PubMed

Shrivastava, Shyam Kishore; Lewis, Shirley; Sastri, Supriya Chopra; Lavanya, G; Mahantshetty, Umesh; Engineer, Reena

2018-01-12

Carcinoma cervix is a common cancer among Indian women. Evidence based management is essential for best practice in treatment of carcinoma cervix for its effective control. The current imaging system like CT, MRI and PET CT scans have contributed in identifying the patients for optimal treatment and delivering treatment accurately. For stages IB2 to IV, concurrent chemoradiation is advocated with improvement in overall survival proven with randomized trials. Brachytherapy is an integral part in the radiation treatment. Imaged-guided brachytherapy using MRI is desirable, however less expensive imaging modalities such as CT and ultrasonography has been evaluated. In special situation such as for HIV positive patients and patients with neuroendocrine tumors have role of radiotherapy. For further improvement in control of cancer, it is required to integrate basic research to answer clinically relevant questions. Copyright © 2018 Elsevier Inc. All rights reserved.

"… but if you're afraid of things, how are you meant to belong?" What belonging means to people with intellectual disabilities?

PubMed

Strnadová, Iva; Johnson, Kelley; Walmsley, Jan

2018-05-15

A policy commitment to social inclusion has brought about some positive changes in the lives of people with intellectual disabilities; yet many also continue to experience social isolation, poverty and abuse. The authors introduce a framework for belonging from the literature and then present a study exploring the views of people with intellectual disabilities about belonging. These are discussed in relation to the framework identified from the literature. Three focus groups with 24 participants with intellectual disabilities were conducted in New South Wales and Victoria (Australia). The authors used inductive content analysis to identify four meanings of belonging: (i) belonging in relation to place, (ii) as being part of a community, (iii) as having relationships and (iv) as identity. Also discussed are commonly experienced barriers to belonging identified by participants. Implications for policy, service provision and practice are discussed. © 2018 John Wiley & Sons Ltd.

Tourette's: syndrome, disorder or spectrum? Classificatory challenges and an appraisal of the DSM criteria.

PubMed

Robertson, Mary May; Eapen, Valsamma

2014-10-01

The fifth version of the Diagnostic and statistical manual of mental disorders (DSM-5) was released in May 2013 after 14 years of development and almost two decades after the last edition DSM-IV was published in 1994. We review the DSM journey with regards to Tourette Syndrome from the original publication of DSM 1 in 1952 till date. In terms of changes in DSM 5, the major shift has come in the placement of Tourette Syndrome under the 'Neurodevelopmental Disorders' alongside other disorders with a developmental origin. This review provides an overview of the changes in DSM-5 highlighting key points for clinical practice and research along with a snap shot of the current use of DSM as a classificatory system in different parts of the world and suggestions for improving the subtyping and the diagnostic confidence. Copyright © 2014 Elsevier B.V. All rights reserved.

New treatment policy of malaria as a part of malaria control program in Indonesia.

PubMed

Kusriastuti, Rita; Surya, Asik

2012-07-01

Malaria control program is one of the oldest program in the Ministry of Health (MoH) Republic of Indonesia. Started with effort to eradicate malaria in 1959 through Malaria Eradication Command well known as KOPEM (Komando Pembasmian Malaria) then it evolves to Malaria Control Program, Roll Back Malaria Program, and the current Malaria Elimination Program. In terms of diagnostic and treatment, the policy has formulated by strictly follow evidence-based principles as well as technical guided from World Health Organization (WHO). In 2004, based on numerous researches conducted in Indonesia the use of chloroquine was stopped and artemisinin-based combination therapy (ACT) was then initiated. For severe cases the use of intravenous (iv) Artesunate for cases treated in hospitals and intramuscular (im) Arthemeter for cases treated in the primary care setting were also introduced. ACT, Artesunate iv, and Artemether im, all are provided nationwide through the procurement system. For radical treatment, the recommendation in Indonesia is to add primaquine (PQ) to ACT for Plasmodium vivax and Plasmodium ovale infections to prevent relapses and for Plasmodium Falciparum infection to kill the gametocytes. These recommendations put hope to reduce malaria mortality to zero and eventually with other interventions will eliminate malaria from the country by 2030. The dissemination of this information is important for the policy to apply in practice across the country.

European best practice guidelines for renal transplantation. Section IV: Long-term management of the transplant recipient. IV.6.2. Cancer risk after renal transplantation. Skin cancers: prevention and treatment.

PubMed

2002-01-01

D. Due to the high prevalence of skin cancers after organ transplantation, it is highly recommended to inform patients about self-awareness. E. Primary prevention should include the avoidance of sun exposure, use of protective clothing and use of an effective sunscreen (protection factor >15) for unclothed body parts (head, neck, hands and arms) in order to prevent the occurrence of squamous-cell carcinoma. This is the most frequent skin tumour in transplant recipients, and its preferential location is the head. F. Recipients with pre-malignant skin lesions (warts, epidermodysplasia verruciformis or actinic keratoses) should be referred early to a dermatologist for active treatment and close follow-up. G. All skin cancers should be completely removed by a dermatologist with appropriate techniques, such as electro-desiccation with curettage, cryotherapy or surgical excision. H. Secondary prevention for recipients should include close follow-up by a dermatologist (at least every 6 months), the use of topical retinoids to control actinic keratoses and to diminish squamous-cell carcinoma recurrence, and reduction of immunosuppression whenever possible. I. In recipients with multiple and/or recurrent skin cancers, the use of systemic retinoids, such as low-dose acitretin, could be recommended for months/years, if well tolerated, in addition to further reduction in immunosuppression whenever possible.

Validity of the WISC-IV Spanish for a clinically referred sample of Hispanic children.

PubMed

San Miguel Montes, Liza E; Allen, Daniel N; Puente, Antonio E; Neblina, Cris

2010-06-01

The Wechsler Intelligence Scale for Children (WISC) is the most commonly used intelligence test for children. Five years ago, a Spanish version of the WISC-IV was published (WISC-IV Spanish; Wechsler, 2005), but a limited amount of published information is available regarding its utility when assessing clinical samples. The current study included 107 children who were Spanish speaking and of Puerto Rican descent that had been administered the WISC-IV Spanish. They were subdivided into a clinical sample of 35 children with diagnoses of various forms of brain dysfunction (primarily learning disability, attention-deficit/hyperactivity disorder, and epilepsy) and a comparison group made up of 72 normal children who were part of the WISC-IV Spanish version standardization sample. Comparisons between these groups and the standardization sample were performed for the WISC-IV Spanish index and subtest scores. Results indicated that the clinical sample performed worse than the comparison samples on the Working Memory and Processing Speed Indexes, although findings varied to some extent depending on whether the clinical group was compared with the normal comparison group or the standardization sample. These findings provide support for the criterion validity of the WISC-IV Spanish when it is used to assess a clinically referred sample with brain dysfunction.

Student Assistance General Provisions; Federal Pell Grant Program; Academic Competitiveness Grant Program; and National Science and Mathematics Access to Retain Talent Grant Program. Final Rule. Federal Register, Part IV, Department of Education, 34 CFR Parts 668, 690, and 691

ERIC Educational Resources Information Center

National Archives and Records Administration, 2006

2006-01-01

The Secretary is adopting as final, with changes, interim final regulations in: 34 CFR part 691 for the Academic Competitiveness Grant (ACG) and National Science and Mathematics Access to Retain Talent Grant (National SMART Grant) programs; 34 CFR part 668 (Student Assistance General Provisions); and 34 CFR part 690 (Federal Pell Grant Program).…

Self-Reported Long-Term Benefits of Mindfulness-Based Cognitive Therapy in Patients with Bipolar Disorder.

PubMed

Weber, Béatrice; Sala, Loretta; Gex-Fabry, Marianne; Docteur, Aurélie; Gorwood, Philip; Cordera, Paolo; Bondolfi, Guido; Jermann, Françoise; Aubry, Jean-Michel; Mirabel-Sarron, Christine

2017-07-01

This study focused on patients with bipolar disorder (BD), several years after their participation in mindfulness-based cognitive therapy (MBCT). It aimed at documenting sustained mindfulness practice, perceived long-term benefit from the program, and changes regarded as direct consequences of the intervention. This cross-sectional survey took place at least 2 years after MBCT for 70.4% of participants. It was conducted in two specialized outpatient units for BDs that are part of the Geneva University Hospitals (Switzerland) and the Sainte-Anne Hospital in Paris (France). Eligibility criteria were a diagnosis of BD according to DSM-IV and participation in at least four MBCT sessions. Response rate was 66.4%. The final sample included 71 outpatients (71.8% bipolar I, 28.2% bipolar II). A questionnaire retrospectively assessed patient-perceived change, benefit from MBCT, and current mindfulness practice. Proportions of respondents who practiced mindfulness at least once a week were 54.9% for formal practice (body scan, sitting meditation, mindful walking, or movements) and 57.7% for informal practice (mindful daily activities). Perceived benefit for the prevention of relapse was moderate, but patients acknowledged long-lasting effects and persistent changes in their way of life. Formal mindfulness practice at least once a week tended to be associated with increased long-lasting effects (p = 0.052), whereas regular informal practice and mindful breathing were significantly associated with persistent changes in daily life (p = 0.038) and better prevention of depressive relapse (p = 0.035), respectively. The most frequently reported positive change was increased awareness of being able to improve one's health. Despite methodological limitations, this survey allowed documenting mindfulness practice and perceived sustained benefit from MBCT in patients with BD. Participants particularly valued increased awareness that they can influence their own health. Both informal and formal practices, when sustained in the long term, might promote long-lasting changes.

Part H of the Individuals with Disabilities Education Act (IDEA) for Infants, Toddlers, and Their Families Annual Performance Report, Year IV (1990-1992).

ERIC Educational Resources Information Center

McNulty, Brian A.; And Others

This report on the fourth year of Colorado's participation in Part H of the Individuals with Disabilities Education Act describes major accomplishments in preparing for full implementation of Part H in Year 5. Accomplishments in the following areas are discussed: state definition of developmental delay, central directory, timetables for serving…

The six most essential questions in psychiatric diagnosis: a pluralogue part 3: issues of utility and alternative approaches in psychiatric diagnosis

PubMed Central

2012-01-01

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM – whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part 1 of this article took up the first two questions. Part 2 took up the second two questions. Part 3 now deals with Questions 5 & 6. Question 5 confronts the issue of utility, whether the manual design of DSM-III and IV favors clinicians or researchers, and what that means for DSM-5. Our final question, Question 6, takes up a concluding issue, whether the acknowledged problems with the earlier DSMs warrants a significant overhaul of DSM-5 and future manuals. As in Parts 1 & 2 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. PMID:22621419

Barriers to administering intravenous tissue plasminogen activator (tPA) for acute ischemic stroke in the emergency department: A cross-sectional survey of stroke centers.

PubMed

Hargis, Mitch; Shah, Jharna N; Mazabob, Janine; Rao, Chethan Venkatasubba; Suarez, Jose I; Bershad, Eric M

2015-08-01

The logistics involved in administration of IV tPA for acute ischemic stroke patients are complex, and may contribute to variability in door-to-needle times between different hospitals. We sought to identify practice patterns in stroke centers related to IV tPA use. We hypothesized that there would be significant variability in logistics related to ancillary staff (i.e. nursing, pharmacists) processes in the emergency room setting. A 21 question survey was distributed to attendees of the AHA/ASA Southwest Affiliate Stroke Coordinators Conference to evaluate potential barriers and delays with regards to thrombolysis for acute strokes patients in the Emergency Department setting. Answers were anonymous and aggregated to examine trends in responses. Responses were obtained from 37 of 67 (55%) stroke centers, which were located mainly in the Southwest United States. Logistical processes differed between facilities. Nursing and pharmacy carried stroke pagers in only 19% of the centers, and pharmacy responded to stroke alerts only one-third of centers. Insertion of Foley catheters and nasogastric tubes prior to tPA was routine in some of the sites. Other barriers to IV tPA administration included physician reluctance and inadequate communication between health care providers. Practices regarding logistics for giving IV tPA may be variable amongst different stroke centers. Given this potential variability, prospective evaluation to confirm these preliminary findings is warranted. Copyright © 2015 Elsevier B.V. All rights reserved.

What Happens to the Farm? Australian Farmers' Experiences after a Serious Farm Injury.

PubMed

Beattie, Jessica; McLeod, Candis; Murray, Meg; Pedler, Daryl; Brumby, Susan; Gabbe, Belinda

2018-01-01

To investigate the experiences of farmers on returning to farming following a serious farm-related injury. Patients who had sustained major trauma on a farm in Victoria, Australia, were identified using the Victorian State Trauma Registry (VSTR). In depth, semistructured phone interviews were conducted with 31 participants. Interview data were subjected to thematic analysis to identify important recurring themes. Interviews continued until data saturation was achieved. Interviewees included self-employed full-time farmers, part-time farmers with a supplementary income, and agricultural employees. Analysis of participant responses connected to returning to farming after a serious farm-related injury identified five major interconnected themes: (i) effect on farm work, (ii) farming future, (iii) safety advocacy, (iv) changes to farming practices, and (v) financial ramifications. Farmers who have sustained a serious farm-related injury are an important resource; their experiences and perspectives could assist in the development of educational and transitional support services from recovery back to working at a preinjury level, while ensuring farming production is sustainable during this period. Furthermore, farm safety programs can be enhanced by the engagement of farmers, such as participants in this study as advocates for improved farm safety practices.

A cross-cultural analysis of posthumous reproduction: The significance of the gender and margins-of-life perspectives.

PubMed

Hashiloni-Dolev, Yael; Schicktanz, Silke

2017-06-01

The scholarly discussion of posthumous reproduction (PHR) focuses on informed consent and the welfare of the future child, for the most part overlooking cultural differences between societies. Based on a cross-cultural comparison of legal and regulatory documents, analysis of pivotal cases and study of scholarly and media discussions in Israel and Germany, this paper analyses the relevant ethical and policy issues, and questions how cultural differences shape the practice of PHR. The findings challenge the common classifications of PHR by highlighting the gender perspective and adding brain-dead pregnant women to the debate. Based on this study's findings, four neglected cultural factors affecting social attitudes towards PHR are identified: (i) the relationship between the pregnant woman and her future child; (ii) what constitutes the beginning of life; (iii) what constitutes dying; and (iv) the social agent(s) seeking to have the future child. The paper argues that PHR can be better understood by adding the gender and margins-of-life perspectives, and that future ethical and practical discussions of this issue could benefit from the criteria emerging from this cross-cultural analysis.

Perceived preparedness for physiatric specialization and future career goals of graduating postgraduate year IV residents during the 2004-2005 academic year.

PubMed

Raj, Vishwa S; Rintala, Diana H

2007-12-01

The purpose of this study was to evaluate trends among postgraduate year (PGY) IV physiatry residents, at the time of graduation from residency, in terms of their perceived experiences in the core clinical areas, confidence with procedural subspecialization, choice in career specialization, and desire to pursue clinical fellowship. Surveys were distributed to 386 PGY IV residents in physiatry at the end of the 2004-2005 academic year. Ninety-three residents (24%) completed responses in a confidential manner. Residents who were generally more confident in core clinical areas, as defined by the Self-Assessment Examination, and specialty prescription writing also believed themselves to be more prepared to practice these topics in their careers. Overall levels of confidence and perceived preparedness correlated positively with months of training and negatively with the belief in the need for postresidency fellowship training to incorporate these areas into clinical practice. Positive correlations also existed among perceived levels of preparedness in performing various physiatric procedures. Statistically significant differences in levels of confidence and preparedness existed among geographic regions when evaluating core physiatric subject matter. Fifty-six percent of residents who responded planned to pursue fellowship training, and a majority of residents intended to perform interventional procedures and musculoskeletal medicine in their practices. These results provide insight into how trainees perceive their current clinical education. With validation of measures for confidence and preparedness, this survey may be useful as an adjunct resource for residency programs to evaluate their trainees.

Impact of heavy soiling on the power output of PV modules

NASA Astrophysics Data System (ADS)

Schill, Christian; Brachmann, Stefan; Heck, Markus; Weiss, Karl-Anders; Koehl, Michael

2011-09-01

Fraunhofer ISE is running a PV-module outdoor testing set-up on the Gran Canaria island, one of the Canary Island located west of Morroco in the Atlantic Ocean. The performance of the modules is assessed by IV-curve monitoring every 10 minutes. The electronic set-up of the monitoring system - consisting of individual electronic loads for each module which go into an MPP-tracking mode between the IV-measurements - will be described in detail. Soiling of the exposed modules happened because of building constructions nearby. We decided not to clean the modules, but the radiation sensors and recorded the decrease of the power output and the efficiency over time. The efficiency dropped to 20 % within 5 months before a heavy rain and subsequently the service personnel on site cleaned the modules. A smaller rain-fall in between washed the dust partly away and accumulated it at the lower part of the module, what could be concluded from the shape of the IV-curves, which were similar to partial shading by hot-spot-tests and by partial snow cover.

Survey of pain specialists regarding conversion of high-dose intravenous to neuraxial opioids

PubMed Central

Gorlin, Andrew W; Rosenfeld, David M; Maloney, Jillian; Wie, Christopher S; McGarvey, Johnathan; Trentman, Terrence L

2016-01-01

The conversion of high-dose intravenous (IV) opioids to an equianalgesic epidural (EP) or intrathecal (IT) dose is a common clinical dilemma for which there is little evidence to guide practice. Expert opinion varies, though a 100 IV:10:EP:1 IT conversion ratio is commonly cited in the literature, especially for morphine. In this study, the authors surveyed 724 pain specialists to elucidate the ratios that respondents apply to convert high-dose IV morphine, hydromorphone, and fentanyl to both EP and IT routes. Eighty-three respondents completed the survey. Conversion ratios were calculated and entered into graphical scatter plots. The data suggest that there is wide variation in how pain specialists convert high-dose IV opioids to EP and IT routes. The 100 IV:10 EP:1 IT ratio was the most common answer of survey respondent, especially for morphine, though also for hydromorphone and fentanyl. Furthermore, more respondents applied a more aggressive conversion strategy for hydromorphone and fentanyl, likely reflecting less spinal selectivity of those opioids compared with morphine. The authors conclude that there is little consensus on this issue and suggest that in the absence of better data, a conservative approach to opioid conversion between IV and neuraxial routes is warranted. PMID:27703394

From Cholera to Burns: A Role for Oral Rehydration Therapy

PubMed Central

Green, W.B.; Asuku, M.E.; Feldman, M.; Makam, R.; Noppenberger, D.; Price, L.A.; Prosciak, M.; van Loon, I.N.

2011-01-01

According to the practice guidelines of the American Burn Association on burn shock resuscitation, intravenous (IV) fluid therapy is the standard of care for the replacement of fluid and electrolyte losses in burn injury of ≥20% of the total body surface area. However, in mass burn casualties, IV fluid resuscitation may be delayed or unavailable. Oral rehydration therapy (ORT), which has been shown to be highly effective in the treatment of dehydration in epidemics of cholera, could be an alternate way to replace fluid losses in burns. A prospective case series of three patients was carried out as an initial step to establish whether oral Ceralyte®90 could replace fluid losses requiring IV fluid therapy in thermal injury. The requirement of the continuing IV fluid therapy was reduced by an average of 58% in the first 24 hours after the injury (range 37-78%). ORT may be a feasible alternative to IV fluid therapy in the resuscitation of burns. It could also potentially save many lives in mass casualty situations or in resource-poor settings where IV fluid therapy is not immediately available. Further studies are needed to assess the efficacy of this treatment and to determine whether the present formulations of ORT for cholera need modification. PMID:22283039

Wechsler Intelligence Scale for Children 4th edition-Chinese version index scores in Taiwanese children with attention-deficit/hyperactivity disorder.

PubMed

Yang, Pinchen; Cheng, Chung-Ping; Chang, Chen-Lin; Liu, Tai-Ling; Hsu, Hsiu-Yi; Yen, Cheng-Fang

2013-02-01

The Wechsler Intelligence Scale for Children 4th edition-Chinese version (WISC-IV-Chinese) has been in clinical use in Taiwan since 2007. Research is needed to determine how the WISC-IV, modified from its earlier version, will affect its interpretation in clinical practice in a Mandarin-speaking context. We attempted to use WISC-IV-Chinese scores to identify the cognitive strengths and weaknesses in 334 Taiwanese children with attention-deficit/hyperactivity disorder (ADHD). Comparison of cognitive profiles of WISC-IV-Chinese scores between subtypes of ADHD was also performed. The results indicated that the four-factor model of the WISC-IV-Chinese fitted well for Taiwanese children with ADHD. The profiles showed that performance in the index score of the Processing Speed Index was the weakness domain for the Taiwanese children with ADHD, as confirmed by two different kinds of analytic methods. Cognitive profile analysis of ADHD subtypes revealed children with inattentive subtypes to have a greater weakness in processing speed performance. The implications of the profiles of the index scores on the WISC-IV-Chinese version for Taiwanese children with ADHD were explored. © 2013 The Authors. Psychiatry and Clinical Neurosciences © 2013 Japanese Society of Psychiatry and Neurology.

An upper limit on interstellar C IV in the spectrum of gamma-2 Velorum

NASA Technical Reports Server (NTRS)

Lengyel-Frey, D.; Stecher, T. P.; West, D. K.

1975-01-01

An upper limit on the column density of C IV along the line of sight to gamma-2 Vel is derived from upper limits placed on the equivalent widths of the interstellar C IV doublet with rest wavelengths at 1548.20 A and 1550.77 A. A lower limit of 250,000 K is calculated for the electron temperature of O VI emitting regions by combining the C IV results with a measurement of the column density of interstellar O VI for the same star and using calculations for the relative ionization of some abundant elements as a function of electron temperature in a low-density plasma. Since gamma-2 Vel is in the central part of the Gum Nebula, the high temperature suggested by these results is shown to support the idea that a high-temperature phase of the interstellar medium, possibly maintained by supernova explosions, may exist.-

The Two-Wavelength Method of Microspectrophotometry

PubMed Central

Mendelsohn, Mortimer L.

1958-01-01

In spite of a number of examples of the apparently successful application of the two-wavelength method of microspectrophotometry to biological materials, a demonstration of the effective transition from the theoretical to the practical aspects of the method has never been given. The following tests were carried out on model systems in order to confirm the practical validity of the method: (1) Spherical droplets of Sudan blue or Sudan IV (varying in volume by as much as 400 times) were measured with the surrounding blank field included and were found to have amounts of chromophore which conformed to the estimated droplet volume to within 3 to 6 per cent. (2) Repeated determinations on the same isolated nucleus gave results which did not vary in spite of wide variations in the area of the photometric field. (3) The results of repeated determinations on the same droplet of dye were unaffected by gross changes in the focus of the objective. The microspectrophotometer on which these measurements were made has been briefly described; it was designed specifically for the two-wavelength method. Some of the details of instrumentation have been discussed, in particular, the effects of non-uniform illumination and the contrasting demands of the two integral parts of this type of photometry. Although it has certain limitations, the two-wavelength method conforms to its theoretical promise and is a practical method of measuring light absorption in complex objects. PMID:13563548

Indian Vacuum Society: The Indian Vacuum Society

NASA Astrophysics Data System (ADS)

Saha, T. K.

2008-03-01

The Indian Vacuum Society (IVS) was established in 1970. It has over 800 members including many from Industry and R & D Institutions spread throughout India. The society has an active chapter at Kolkata. The society was formed with the main aim to promote, encourage and develop the growth of Vacuum Science, Techniques and Applications in India. In order to achieve this aim it has conducted a number of short term courses at graduate and technician levels on vacuum science and technology on topics ranging from low vacuum to ultrahigh vacuum So far it has conducted 39 such courses at different parts of the country and imparted training to more than 1200 persons in the field. Some of these courses were in-plant training courses conducted on the premises of the establishment and designed to take care of the special needs of the establishment. IVS also regularly conducts national and international seminars and symposia on vacuum science and technology with special emphasis on some theme related to applications of vacuum. A large number of delegates from all over India take part in the deliberations of such seminars and symposia and present their work. IVS also arranges technical visits to different industries and research institutes. The society also helped in the UNESCO sponsored post-graduate level courses in vacuum science, technology and applications conducted by Mumbai University. The society has also designed a certificate and diploma course for graduate level students studying vacuum science and technology and has submitted a syllabus to the academic council of the University of Mumbai for their approval, we hope that some colleges affiliated to the university will start this course from the coming academic year. IVS extended its support in standardizing many of the vacuum instruments and played a vital role in helping to set up a Regional Testing Centre along with BARC. As part of the development of vacuum education, the society arranges the participation of expert members on the subject to deliver lectures and take part in devising courses in the universities. IVS publishes a quarterly called the `Bulletin of Indian Vacuum Society' since its inception, in which articles on vacuum and related topics are published. NIRVAT, news, announcements, and reports are the other features of the Bulletin. The articles in the Bulletin are internationally abstracted. The Bulletin is distributed free to all the members of the society. The society also publishes proceedings of national/international symposia and seminars, manuals, lecture notes etc. It has published a `Vacuum Directory' containing very useful information on vacuum technology. IVS has also set up its own website http://www.ivsnet.org in January 2002. The website contains information about IVS, list of members, list of EC members, events and news, abstracts of articles published in the `Bulletin of Indian Vacuum Society', utilities, announcements, reports, membership and other forms which can be completed online and also gives links to other vacuum societies. Our Society has been a member of the executive council of the International Union of Vacuum Science, Techniques and Applications (IUVSTA) and its various committees since 1970. In 1983 IVS conducted an International Symposium on Vacuum Technology and Nuclear Applications in BARC, Mumbai, under the sponsorship of IUVSTA. In 1987 IVS arranged the Triennial International Conference on Thin Films in New Delhi, where more than 200 foreign delegates participated. IVS also hosted the IUVSTA Executive Council Meeting along with the conference. The society organized yet again an International Conference on Vacuum Science and Technology and SRS Vacuum Systems at CAT, Indore in1995. IVS arranges the prestigious Professor Balakrishnan Memorial Lecture in memory of its founder vice-president. Leading scientists from India and abroad in the field are invited to deliver the talks. So far 23 lectures have been held in this series. IVS has instituted the `IVS- Professor D Y Phadke Memorial Prize' in memory of our founder president, the late Professor D Y Phadke at the University of Mumbai. The prize is given every year to the student ranked top in the MSc (PHY.) examination conducted by the university. The IVS Kolkata Chapter has established the Dr A S Divatia Memorial Trust with the objective of organizing the Dr A S Divatia Memorial Lecture and a seminar once a year and to set up a vacuum testing and calibration facility. IVS has instituted an award in memory of the late Shri C Ambasankaran, its past president and pioneer of vacuum technology in India. This award is given to one of the best papers presented in the national symposium conducted by IVS. One more best paper award `Smt. Shakuntalabai Vyawahare Memorial Prize' is established from a donation given by Shri Mohan R Vyawahare, a life member and a present EC member of the society, in memory of his mother. During the symposia, IVS felicitates two of its members, one from Industry and one from an R & D Institution for their lifetime contribution to vacuum science and technology. Dr A K Gupta, Ex BARC, Ex Generla Manager, IBP, Head, Energy Group, Shapoorji Pallonji & Co Ltd (Industry), and Dr S R Gowariker, Ex BARC, Ex Director, CSIO, Chandigarh, Director, Tolani Education Foundation (R & D) are being honoured this year. T K Saha Geneneral Secretary, IVS

Physics Meets Philosophy at the Planck Scale

NASA Astrophysics Data System (ADS)

Callender, Craig; Huggett, Nick

2001-04-01

Preface; 1. Introduction Craig Callendar and Nick Huggett; Part I. Theories of Quantum Gravity and their Philosophical Dimensions: 2. Spacetime and the philosophical challenge of quantum gravity Jeremy Butterfield and Christopher Isham; 3. Naive quantum gravity Steven Weinstein; 4. Quantum spacetime: what do we know? Carlo Rovelli; Part II. Strings: 5. Reflections on the fate of spacetime Edward Witten; 6. A philosopher looks at string theory Robert Weingard; 7. Black holes, dumb holes, and entropy William G. Unruh; Part III. Topological Quantum Field Theory: 8. Higher-dimensional algebra and Planck scale physics John C. Baez; Part IV. Quantum Gravity and the Interpretation of General Relativity: 9. On general covariance and best matching Julian B. Barbour; 10. Pre-Socratic quantum gravity Gordon Belot and John Earman; 11. The origin of the spacetime metric: Bell's 'Lorentzian Pedagogy' and its significance in general relativity Harvey R. Brown and Oliver Pooley; Part IV. Quantum Gravity and the Interpretation of Quantum Mechanics: 12. Quantum spacetime without observers: ontological clarity and the conceptual foundations of quantum gravity Sheldon Goldstein and Stefan Teufel; 13. On gravity's role in quantum state reduction Roger Penrose; 14. Why the quantum must yield to gravity Joy Christian.

Dollar$ & $en$e. Part IV: Measuring the value of people, structural, and customer capital.

PubMed

Wilkinson, I

2001-01-01

In Part I of this series, I introduced the concept of memes (1). Memes are ideas or concepts, the information world equivalent of genes. The goal of this series of articles is to infect you with my memes, so that you will assimilate, translate, and express them. We discovered that no matter what our area of expertise or "-ology," we all are in the information business. Our goal is to be in the wisdom business. We saw that when we convert raw data into wisdom we are moving along a value chain. Each step in the chain adds a different amount of value to the final product: timely, relevant, accurate, and precise knowledge which can then be applied to create the ultimate product in the value chain: wisdom. In Part II of this series, I infected you with a set of memes for measuring the cost of adding value (2). In Part III of this series, I infected you with a new set of memes for measuring the added value of knowledge, i.e., intellectual capital (3). In Part IV of this series, I will infect you with memes for measuring the value of people, structural, and customer capital.

Usefulness of high-dose intravenous human immunoglobulins treatment for refractory recurrent pericarditis.

PubMed

Moretti, Michele; Buiatti, Alessandra; Merlo, Marco; Massa, Laura; Fabris, Enrico; Pinamonti, Bruno; Sinagra, Gianfranco

2013-11-01

The management of refractory recurrent pericarditis is challenging. Previous clinical reports have noted a beneficial effect of high-dose intravenous human immunoglobulins (IvIgs) in isolated and systemic inflammatory disease-related forms. In this article, we analyzed retrospectively our clinical experience with IvIg therapy in a series of clinical cases of pericarditis refractory to conventional treatment. We retrospectively analyzed 9 patients (1994 to 2010) with refractory recurrent pericarditis, who received high-dose IvIg as a part of their medical treatment. Nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, or colchicine treatment was not discontinued during IvIg treatment. No patients had a history of autoimmune or connective tissue diseases. During an average period of 11 months from the first recurrence, patients had experienced a mean of 5 relapses before the first IvIg treatment. In 4 cases, patients showed complete clinical remission with no further relapse after the first IvIg cycle. Two patients experienced a single minor relapse, responsive to short-term nonsteroidal anti-inflammatory drugs. In 2 patients, we performed a second cycle of IvIg after a recurrence of pericarditis, with subsequent complete remission. One patient did not respond to 3 cycles of IvIg and subsequently underwent pericardial window and long-term immunosuppressive treatment. No major adverse effect was observed in consequence of IvIg administration in all the cases. In conclusion, although IvIg mode of action is still poorly understood in this setting, this treatment can be considered as an option in patients with recurrent pericarditis refractory to conventional medical treatment and, in our small series, has proved to be effective in 8 of 9 cases. Copyright © 2013 Elsevier Inc. All rights reserved.

Synergistic Instance-Level Subspace Alignment for Fine-Grained Sketch-Based Image Retrieval.

PubMed

Li, Ke; Pang, Kaiyue; Song, Yi-Zhe; Hospedales, Timothy M; Xiang, Tao; Zhang, Honggang

2017-08-25

We study the problem of fine-grained sketch-based image retrieval. By performing instance-level (rather than category-level) retrieval, it embodies a timely and practical application, particularly with the ubiquitous availability of touchscreens. Three factors contribute to the challenging nature of the problem: (i) free-hand sketches are inherently abstract and iconic, making visual comparisons with photos difficult, (ii) sketches and photos are in two different visual domains, i.e. black and white lines vs. color pixels, and (iii) fine-grained distinctions are especially challenging when executed across domain and abstraction-level. To address these challenges, we propose to bridge the image-sketch gap both at the high-level via parts and attributes, as well as at the low-level, via introducing a new domain alignment method. More specifically, (i) we contribute a dataset with 304 photos and 912 sketches, where each sketch and image is annotated with its semantic parts and associated part-level attributes. With the help of this dataset, we investigate (ii) how strongly-supervised deformable part-based models can be learned that subsequently enable automatic detection of part-level attributes, and provide pose-aligned sketch-image comparisons. To reduce the sketch-image gap when comparing low-level features, we also (iii) propose a novel method for instance-level domain-alignment, that exploits both subspace and instance-level cues to better align the domains. Finally (iv) these are combined in a matching framework integrating aligned low-level features, mid-level geometric structure and high-level semantic attributes. Extensive experiments conducted on our new dataset demonstrate effectiveness of the proposed method.

76 FR 38050 - Defense Federal Acquisition Regulation Supplement; Management of Manufacturing Risk in Major...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-29

...-readiness processes of potential contractors and subcontractors as a part of the source selection process... Supplement (DFARS) subpart 215.3, Source Selection. It amends DFARS 215.304(c) by adding paragraph (iv) to... and subcontractors shall be considered as a part of the source selection process for major defense...

Executive Summary and Policy Recommendations. Part IV. The Work of Nets.

ERIC Educational Resources Information Center

Scherer, Jacqueline

This summary, the last of a four-part study of social networks in Pontiac, Michigan, presents highlights from the three previous volumes and advocates the use of network research for understanding the dissemination process in educational innovation. Based on the conclusion that social networks provide a metaphor for understanding complex social…

42 CFR 431.625 - Coordination of Medicaid with Medicare part B.

Code of Federal Regulations, 2012 CFR

2012-10-01

...-living increases under title II of the Act; (iv) Beneficiaries of foster care maintenance payments or... 42 Public Health 4 2012-10-01 2012-10-01 false Coordination of Medicaid with Medicare part B. 431.625 Section 431.625 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND...

42 CFR 431.625 - Coordination of Medicaid with Medicare part B.

Code of Federal Regulations, 2014 CFR

2014-10-01

...-living increases under title II of the Act; (iv) Beneficiaries of foster care maintenance payments or... 42 Public Health 4 2014-10-01 2014-10-01 false Coordination of Medicaid with Medicare part B. 431.625 Section 431.625 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND...

42 CFR 431.625 - Coordination of Medicaid with Medicare part B.

Code of Federal Regulations, 2013 CFR

2013-10-01

...-living increases under title II of the Act; (iv) Beneficiaries of foster care maintenance payments or... 42 Public Health 4 2013-10-01 2013-10-01 false Coordination of Medicaid with Medicare part B. 431.625 Section 431.625 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND...

AB 1725, IV: Part-Time Faculty.

ERIC Educational Resources Information Center

California Community Colleges, Sacramento. Board of Governors.

An overview is provided of issues related to the use of part-time faculty in community colleges in California and elsewhere in the nation. First, background information is provided on the major relevant issues. This section: (1) lists the teaching functions which are best carried out by full-time instructors as argued by those who favor employing…

45 CFR 301.0 - Scope and applicability of this part.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 2 2014-10-01 2012-10-01 true Scope and applicability of this part. 301.0 Section 301.0 Public Welfare Regulations Relating to Public Welfare OFFICE OF CHILD SUPPORT ENFORCEMENT (CHILD... deals with the administration of title IV-D of the Social Security Act by the Federal Government...

76 FR 39788 - Regulations Governing Fees for Services

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-07

... DEPARTMENT OF TRANSPORTATION Surface Transportation Board 49 CFR Part 1002 [Docket No. EP 542 (Sub... governing user fees for services performed, 49 CFR 1002.2(f), Part V, by lowering the fee for sub-item 56(iv... complaint to the Board. For example, over the past 10 years, our Rail Consumer and Public Assistance unit...

46 CFR 10.227 - Requirements for renewal.

Code of Federal Regulations, 2010 CFR

2010-10-01

... part 5 of this chapter or if facts that would render a renewal improper have come to the attention of... this part; (C) Complete an approved refresher training course; or (D) Present evidence of employment in... renewal of an officer endorsement as first-class pilot are contained in § 11.713 of this chapter. (iv) An...

Environmental Sentinel Biomonitor (ESB) System Technology Assessment

DTIC Science & Technology

2007-02-01

Andersson M, Barile FA, et al. 1996. MEIC evaluation of acute systemic toxicity Part I. Methodology of 68 in vitro toxicity assays used to test the first...30 reference chemicals. ATLA 24:251-272. Clemedson C, Andersson M, Aoki Y, Barile FA, et al. 1998. MEIC evaluation of acute systemic toxicity Part IV

75 FR 10121 - Milk in the Northeast and Other Marketing Areas; Final Decision on Proposed Amendments to...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-04

... Part IV Department of Agriculture Agricultural Marketing Service 7 CFR Parts 1000, 1001, 1005, et al. Milk in the Northeast and Other Marketing Areas; Final Decision on Proposed Amendments to Tentative Marketing Agreements and Orders; Proposed Rule #0;#0;Federal Register / Vol. 75, No. 42 / Thursday...

Soviet Political Perspectives on Power Projection.

DTIC Science & Technology

1987-03-01

justified by the recognition on the part of many Soviet economists that the traditional Soviet development model does not work. Rapid nationalization...37 Models of Economic Development................................43 IV. ARMED STRUGGLE AND REVOLUTIONARY CHANGE...Soviets always describe revolutionary change in ~.~ the Third World as merely the product of local social and political forces, part of an inevitable

O-Pu-U (Oxygen-Plutonium-Uranium)

NASA Astrophysics Data System (ADS)

Materials Science International Team MSIT

This document is part of Subvolume C4 'Non-Ferrous Metal Systems. Part 4: Selected Nuclear Materials and Engineering Systems' of Volume 11 'Ternary Alloy Systems - Phase Diagrams, Crystallographic and Thermodynamic Data critically evaluated by MSIT®' of Landolt-Börnstein - Group IV 'Physical Chemistry'. It provides data of the ternary system Oxygen-Plutonium-Uranium.

V&V of Fault Management: Challenges and Successes

NASA Technical Reports Server (NTRS)

Fesq, Lorraine M.; Costello, Ken; Ohi, Don; Lu, Tiffany; Newhouse, Marilyn

2013-01-01

This paper describes the results of a special breakout session of the NASA Independent Verification and Validation (IV&V) Workshop held in the fall of 2012 entitled "V&V of Fault Management: Challenges and Successes." The NASA IV&V Program is in a unique position to interact with projects across all of the NASA development domains. Using this unique opportunity, the IV&V program convened a breakout session to enable IV&V teams to share their challenges and successes with respect to the V&V of Fault Management (FM) architectures and software. The presentations and discussions provided practical examples of pitfalls encountered while performing V&V of FM including the lack of consistent designs for implementing faults monitors and the fact that FM information is not centralized but scattered among many diverse project artifacts. The discussions also solidified the need for an early commitment to developing FM in parallel with the spacecraft systems as well as clearly defining FM terminology within a project.

Vented spikes improve delivery from intravenous bags with no air headspace.

PubMed

Galush, William J; Horst, Travis A

2015-07-01

Flexible plastic bags are the container of choice for most intravenous (i.v.) infusions. Under certain circumstances, however, the air-liquid interface present in these i.v. bags can lead to physical instability of protein biopharmaceuticals, resulting in product aggregation. In principle, the air headspace present in the bags can be removed to increase drug stability, but experiments described here show that this can result in incomplete draining of solution from the bag using gravity delivery, or generation of negative pressure in the bag when an infusion pump is used. It is expected that these issues could lead to incomplete delivery of medication to patients or pump-related problems, respectively. However, here it is shown that contrary to the standard pharmacy practice of using nonvented spikes with i.v. bags, the use of vented spikes with i.v. bags that lack air headspace allows complete delivery of the dose solution without impacting the physical stability of a protein-based drug. © 2015 Wiley Periodicals, Inc. and the American Pharmacists Association.

Ultrathin inorganic molecular nanowire based on polyoxometalates

PubMed Central

Zhang, Zhenxin; Murayama, Toru; Sadakane, Masahiro; Ariga, Hiroko; Yasuda, Nobuhiro; Sakaguchi, Norihito; Asakura, Kiyotaka; Ueda, Wataru

2015-01-01

The development of metal oxide-based molecular wires is important for fundamental research and potential practical applications. However, examples of these materials are rare. Here we report an all-inorganic transition metal oxide molecular wire prepared by disassembly of larger crystals. The wires are comprised of molybdenum(VI) with either tellurium(IV) or selenium(IV): {(NH4)2[XMo6O21]}n (X=tellurium(IV) or selenium(IV)). The ultrathin molecular nanowires with widths of 1.2 nm grow to micrometre-scale crystals and are characterized by single-crystal X-ray analysis, Rietveld analysis, scanning electron microscopy, X-ray photoelectron spectroscopy, ultraviolet–visible spectroscopy, thermal analysis and elemental analysis. The crystals can be disassembled into individual molecular wires through cation exchange and subsequent ultrasound treatment, as visualized by atomic force microscopy and transmission electron microscopy. The ultrathin molecular wire-based material exhibits high activity as an acid catalyst, and the band gap of the molecular wire-based crystal is tunable by heat treatment. PMID:26139011

Simultaneous spectrophotometric determination of trace amounts of uranium, thorium, and zirconium using the partial least squares method after their preconcentration by alpha-benzoin oxime modified Amberlite XAD-2000 resin.

PubMed

Ghasemi, Jahan B; Zolfonoun, E

2010-01-15

A new solid phase extraction method for separation and preconcentration of trace amounts of uranium, thorium, and zirconium in water samples is proposed. The procedure is based on the adsorption of U(VI), Th(IV) and Zr(IV) ions on a column of Amberlite XAD-2000 resin loaded with alpha-benzoin oxime prior to their simultaneous spectrophotometric determination with Arsenazo III using orthogonal signal correction partial least squares method. The enrichment factor for preconcentration of uranium, thorium, and zirconium was found to be 100. The detection limits for U(VI), Th(IV) and Zr(IV) were 0.50, 0.54, and 0.48microgL(-1), respectively. The precision of the method, evaluated as the relative standard deviation obtained by analyzing a series of 10 replicates, was below 4% for all elements. The practical applicability of the developed sorbent was examined using synthetic seawater, natural waters and ceramic samples.

Consensus in controversy: The modified Delphi method applied to Gynecologic Oncology practice.

PubMed

Cohn, David E; Havrilesky, Laura J; Osann, Kathryn; Lipscomb, Joseph; Hsieh, Susie; Walker, Joan L; Wright, Alexi A; Alvarez, Ronald D; Karlan, Beth Y; Bristow, Robert E; DiSilvestro, Paul A; Wakabayashi, Mark T; Morgan, Robert; Mukamel, Dana B; Wenzel, Lari

2015-09-01

To determine the degree of consensus regarding the probabilities of outcomes associated with IP/IV and IV chemotherapy. A survey was administered to an expert panel using the Delphi method. Ten ovarian cancer experts were asked to estimate outcomes for patients receiving IP/IV or IV chemotherapy. The clinical estimates were: 1) probability of completing six cycles of chemotherapy, 2) probability of surviving five years, 3) median survival, and 4) probability of ER/hospital visits during treatment. Estimates for two patients, one with a low comorbidity index (patient 1) and the other with a moderate index (patient 2), were included. The survey was administered in three rounds, and panelists could revise their subsequent responses based on review of the anonymous opinions of their peers. The ranges were smaller for IV compared with IP/IV therapy. Ranges decreased with each round. Consensus converged around outcomes related to IP/IV chemotherapy for: 1) completion of 6 cycles of therapy (type 1 patient, 62%, type 2 patient, 43%); 2) percentage of patients surviving 5 years (type 1 patient, 66%, type 2 patient, 47%); and 3) median survival (type 1 patient, 83 months, type 2 patient, 58 months). The group required three rounds to achieve consensus on the probabilities of ER/hospital visits (type 1 patient, 24%, type 2 patient, 35%). Initial estimates of survival and adverse events associated with IP/IV chemotherapy differ among experts. The Delphi process works to build consensus and may be a pragmatic tool to inform patients of their expected outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

Astragaloside IV attenuates injury caused by myocardial ischemia/reperfusion in rats via regulation of toll-like receptor 4/nuclear factor-κB signaling pathway.

PubMed

Lu, Meili; Tang, Futian; Zhang, Jing; Luan, Aina; Mei, Meng; Xu, Chonghua; Zhang, Suping; Wang, Hongxin; Maslov, Leonid N

2015-04-01

Myocardial ischemia/reperfusion (MI/R) injury, in which inflammatory response and cell apoptosis play a vital role, is frequently encountered in clinical practice. Astragaloside IV (AsIV), a small molecular saponin of Astragalus membranaceus, has been shown to confer protective effects against many cardiovascular diseases. The present study was aimed to investigate the antiinflammatory and antiapoptotic effects and the possible mechanism of AsIV on MI/R injury in rats. Rats were randomly divided into sham operation group, MI/R group and groups with combinations of MI/R and different doses of AsIV. The results showed that the expressions of myocardial toll-like receptor 4 (TLR4) and nuclear factor-κB (NF-κB) were significantly increased, and apoptosis of cardiomyocytes was induced in MI/R group compared with that in sham operation group. Administration of AsIV attenuated MI/R injury, downregulated the expressions of TLR4 and NF-κB and inhibited cell apoptosis as evidenced by decreased terminal deoxynucleotidyl transferase dUTP nick end labeling positive cells, B-cell lymphoma-2 associated X protein and caspase-3 expressions and increased B-cell lymphoma-2 expression compared with that in MI/R group. In addition, AsIV treatment reduced levels of inflammatory cytokines induced by MI/R injury. In conclusion, our results demonstrated that AsIV downregulates TLR4/NF-κB signaling pathway and inhibits cell apoptosis, subsequently attenuating MI/R injury in rats. Copyright © 2015 John Wiley & Sons, Ltd.

Health physics division annual progress report for period ending June 30, 1977

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

Not Available

1978-07-01

This annual progress report follows, as in the past, the organizational structure of the Health Physics Division. Each part is a report of work done by a section of the division: Assessment and Technology Section (Part I), headed by H.W. Dickson; Biological and Radiation Physics Section (Part II), H.A. Wright; Chemical Physics and Spectroscopy Section (Part III), W.R. Garrett; Emergency Technology Section (Part IV), C.V. Chester, Medical Physics and Internal Dosimetry Section (Part V), K.E. Cowser; and the Analytic Dosimetry and Education Group (Part VI), J.E. Turner.

44 CFR 9.9 - Analysis and reevaluation of practicable alternatives.

Code of Federal Regulations, 2010 CFR

2010-10-01

...; (ii) Reduce the risk of flood loss; (iii) Minimize the impact of floods on human safety, health and... wetlands; (iii) Minimize the destruction, loss or degradation of wetlands; and (iv) Preserve and enhance...

30 CFR 250.916 - What are the CVA's primary duties during the design phase?

Code of Federal Regulations, 2014 CFR

2014-07-01

... the design phase? (a) The CVA must use good engineering judgment and practices in conducting an...; (iv) Load determinations; (v) Stress analyses; (vi) Material designations; (vii) Soil and foundation...

30 CFR 250.916 - What are the CVA's primary duties during the design phase?

Code of Federal Regulations, 2012 CFR

2012-07-01

... the design phase? (a) The CVA must use good engineering judgment and practices in conducting an...; (iv) Load determinations; (v) Stress analyses; (vi) Material designations; (vii) Soil and foundation...

30 CFR 250.916 - What are the CVA's primary duties during the design phase?

Code of Federal Regulations, 2013 CFR

2013-07-01

... the design phase? (a) The CVA must use good engineering judgment and practices in conducting an...; (iv) Load determinations; (v) Stress analyses; (vi) Material designations; (vii) Soil and foundation...

AGARD Index of Publications (1952-1970). Part III: Author Index, Part IV: Addendum to Part I,

DTIC Science & Technology

When the AGARD Index of Publications 1952-1970 was published in June 1972, no Author Index was provided. Experience with the basic document has...therefore contains both an Author Index of all publications and papers from 1952-1970 and, in addition, an Addendum containing a listing of the titles of all individual papers that were omitted from the basic document.

SOF Language Transformation Strategy Needs Assessment Project: SOF Operator Survey Report

DTIC Science & Technology

2004-10-01

CAT III/IV Language More difficult languages to acquire for native English speakers. Examples: Cantonese , Japanese, Arabic, Dari, Pashto, Turkish...simple conversations on familiar topics (M = 68.4) and less confident in their ability participate in informal conversations on practical, social , and...familiar topics (M = 59.6), and to participate in informal conversations on practical, social , and professional topics (M = 40.3) than personnel

Absorption spectroscopic studies of Np(IV) complexes

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

Reed, D. T.

2004-01-01

The complexation of neptunium (IV) with selected inorganic and organic ligands was studied as part of an investigation to establish key subsurface interactions between neptunium and biological systems. The prevalence of reducing environments in most subsurface migation scenarios, which are in many cases induced by biological activity, has increased the role and importance of Np(IV) as a key subsurface neptunium oxidation state. The biodegradation of larger organics that often coexist with actinides in the subsurface leads to the formation of many organic acids as transient products that, by complexation, play a key role in defining the fate and speciation ofmore » neptunium in biologically active systems. These often compete with inorganic complexes e.g. hydrolysis and phosphate. Herein we report the results of a series of complexation studies based on new band formation of the characteristic 960 nm band for Np(IV). Formation constants for Np(IV) complexes with phosphate, hydrolysis, succinate, acetohydroxamic acid, and acetate were determined. These results show the 960 nm absorption band to be very amenable to these types of complexation studies.« less

Evaluation of the effectiveness of an intravenous line and fluid bottle fixation design.

PubMed

Chiou, Piao-Yi; Chien, Chih-Yin; Shiu, Ting-Ru; Lin, Pei-Jiun; Lin, Wan-Yu; Jiang, Yi-Rung

2015-01-01

It's important to improve the stability of intravenous (IV) lines and bottles during patient activity and nursing care. We developed an intravenous line and fluid bottle fixation design (ILFBFD) which includes a bottle retaining clip and line fixation kit. We randomly assigned 60 participants each to the experimental and control groups. Participants were asked to push an IV stand without and with ILFBFD 11 meters on uneven pavement and a sloping floor. The distance the IV bottle moved was recorded. Self-administered questionnaires were used to collect the opinions of the participants. Use of ILFBFD, resulted in less movement in the anteroposterior and left/right directions (differences of 46.98 cm2, t= 12.80, p < 0.000 and 39.24 cm2, t= 8.01, p< 0.000, respectively) compared with not using ILFBFD. The average scores for bottle movement when participants walked on a flat floor, uneven pavement and sloping floor, IV line tangling and dropping, and organization of Liv lines were significantly better in those using than not using ILFBFD. The results can be used in clinical practice to reduce knotting of IV lines, and to enhance the safety and quality of patient care.

Methods of Contemporary Gauge Theory

NASA Astrophysics Data System (ADS)

Makeenko, Yuri

2002-08-01

Preface; Part I. Path Integrals: 1. Operator calculus; 2. Second quantization; 3. Quantum anomalies from path integral; 4. Instantons in quantum mechanics; Part II. Lattice Gauge Theories: 5. Observables in gauge theories; 6. Gauge fields on a lattice; 7. Lattice methods; 8. Fermions on a lattice; 9. Finite temperatures; Part III. 1/N Expansion: 10. O(N) vector models; 11. Multicolor QCD; 12. QCD in loop space; 13. Matrix models; Part IV. Reduced Models: 14. Eguchi-Kawai model; 15. Twisted reduced models; 16. Non-commutative gauge theories.

Methods of Contemporary Gauge Theory

NASA Astrophysics Data System (ADS)

Makeenko, Yuri

2005-11-01

Preface; Part I. Path Integrals: 1. Operator calculus; 2. Second quantization; 3. Quantum anomalies from path integral; 4. Instantons in quantum mechanics; Part II. Lattice Gauge Theories: 5. Observables in gauge theories; 6. Gauge fields on a lattice; 7. Lattice methods; 8. Fermions on a lattice; 9. Finite temperatures; Part III. 1/N Expansion: 10. O(N) vector models; 11. Multicolor QCD; 12. QCD in loop space; 13. Matrix models; Part IV. Reduced Models: 14. Eguchi-Kawai model; 15. Twisted reduced models; 16. Non-commutative gauge theories.

Arab oil: a bibliography of materials in the Library of Congress

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

Selim, G.M.

1982-01-01

This bibliography draws attention to materials on Arab oil in the collections of the Library of Congress that were available through 1980. It cites articles, books, dissertations, maps, papers, periodicals, reports, and audiovisual materials in Western languages that use the Roman alphabet. The bibliography is divided into four parts: Part I covers the Arab world and the Middle East as a whole; Part II covers political and geographical entities; Part III deals with OPEC; and Part IV lists dictionaries which relate to the Arab oil industry.

[Irritable bowel syndrome with constipation and functional constipation in adults: Treatment (Part 2 of 2)].

PubMed

Mearin, F; Ciriza, C; Mínguez, M; Rey, E; Mascort, J J; Peña, E; Cañones, P; Júdez, J

2017-03-01

In this Clinical practice guide we examine the diagnostic and therapeutic management of adult patients with constipation and abdominal discomfort, at the confluence of the spectrum of irritable bowel syndrome and functional constipation. Both fall within the framework of functional intestinal disorders and have major personal, health and social impact, altering the quality of life of the patients affected. The former is a subtype of irritable bowel syndrome in which constipation and altered bowel habit predominate, often along with recurring abdominal pain, bloating and abdominal distension. Constipation is characterised by infrequent or hard-to-pass bowel movements, often accompanied by straining during defecation or the sensation of incomplete evacuation. There is no underlying organic cause in the majority of cases; it being considered a functional bowel disorder. There are many clinical and pathophysiological similarities between the two conditions, the constipation responds in a similar way to commonly used drugs, the fundamental difference being the presence or absence of pain, but not in an "all or nothing" way. The severity of these disorders depends not only on the intensity of the intestinal symptoms but also on other biopsychosocial factors: association of gastrointestinal and extraintestinal symptoms, degree of involvement, forms of perception and behaviour. Functional bowel disorders are diagnosed using the Rome criteria. This Clinical practice guide adapts to the Rome IV criteria published at the end of May 2016. The first part (96, 97, 98) examined the conceptual and pathophysiological aspects, alarm criteria, diagnostic test and referral criteria between Primary Care and Gastroenterology. This second part reviews all the available treatment alternatives (exercise, fluid ingestion, diet with soluble fibre-rich foods, fibre supplements, other dietary components, osmotic or stimulating laxatives, probiotics, antibiotics, spasmolytics, peppermint essence, prucalopride, linaclotide, lubiprostone, biofeedback, antdepressants, psychological treatment, acupuncture, enemas, sacral root neurostimulation and surgery), and practical recommendations are made for each. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Interactive Visualization of National Airspace Data in 4D (IV4D)

DTIC Science & Technology

2010-08-01

Research Laboratory) JView graphics engine. All of the software, IV4D/Viewer/JView, is written in Java and is platform independent, meaning that it...both parts. 11 3.3.1.1 Airspace Volumes Once appropriate CSV or ACES XML airspace boundary files are selected from a standard Java File Chooser...persistence mechanism, Hibernate , was replaced with JDBC specific code and, over time, quite a bit of JDBC support code was added to the Viewer and to

7 CFR 1781.6 - Loan purposes.

Code of Federal Regulations, 2011 CFR

2011-01-01

... conservation and water control facilities such as dikes, terraces, detention reservoirs, stream channels... vegetative measures to stabilize stream channels and gullies. (iv) Basic farm conservation practices to control runoff, erosion, and sedimentation. (6) Installing, repairing, and improving water storage...

Site Environmental Report for Calendar Year 2005. DOE Operations at The Boeing Company, Santa Susana Field Laboratory, Area IV

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

None

2006-09-30

This annual report describes the environmental monitoring programs related to the Department of Energy’s (DOE) activities at the Santa Susana Field Laboratory (SSFL) facility located in Ventura County, California during 2005. Part of the SSFL facility, known as Area IV, had been used for DOE’s activities since the 1950s. A broad range of energy related research and development (R&D) projects, including nuclear technologies projects, was conducted at the site. All the nuclear R&D operations in Area IV ceased in 1988. Current efforts are directed toward decontamination and decommissioning (D&D) of the former nuclear facilities and closure of facilities used formore » liquid metal research.« less

Effectiveness of IV Cannulation Skills Laboratory Training and Its Transfer into Clinical Practice: A Randomized, Controlled Trial

PubMed Central

Lund, Frederike; Schultz, Jobst-Hendrik; Maatouk, Imad; Krautter, Markus; Möltner, Andreas; Werner, Anne; Weyrich, Peter; Jünger, Jana; Nikendei, Christoph

2012-01-01

Background The effectiveness of skills laboratory training is widely recognized. Yet, the transfer of procedural skills acquired in skills laboratories into clinical practice has rarely been investigated. We conducted a prospective, randomised, double-blind, controlled trial to evaluate, if students having trained intravenous (IV) cannulation in a skills laboratory are rated as more professional regarding technical and communication skills compared to students who underwent bedside teaching when assessed objectively by independent video assessors and subjectively by patients. Methodology and Principal Findings 84 volunteer first-year medical students were randomly assigned to one of two groups. Three drop-outs occurred. The intervention group (IG; n = 41) trained IV cannulation in a skills laboratory receiving instruction after Peyton's ‘Four-Step Approach’. The control group (CG; n = 40) received a bedside teaching session with volunteer students acting as patients. Afterwards, performance of IV cannulation of both groups in a clinical setting with students acting as patients was video-recorded. Two independent, blinded video assessors scored students' performance using binary checklists (BC) and the Integrated Procedural Protocol Instrument (IPPI). Patients assessed students' performance with the Communication Assessment Tool (CAT) and a modified IPPI. IG required significantly shorter time needed for the performance on a patient (IG: 595.4 SD(188.1)s; CG: 692.7 SD(247.8)s; 95%CI 23.5 s to 45.1 s; p = 0.049) and completed significantly more single steps of the procedure correctly (IG: 64% SD(14) for BC items; CG: 53% SD(18); 95%CI 10.25% to 11.75%; p = 0.004). IG also scored significantly better on IPPI ratings (median: IG: 3.1; CG: 3.6; p = 0.015;). Rated by patients, students' performance and patient-physician communication did not significantly differ between groups. Conclusions Transfer of IV cannulation-related skills acquired in a skills laboratory is superior to bedside teaching when rated by independent video raters by means of IPPI and BC. It enables students to perform IV cannulation more professionally on volunteer students acting as patients. PMID:22427895

Expressing yourself: a feminist analysis of talk around expressing breast milk.

PubMed

Johnson, Sally; Williamson, Iain; Lyttle, Steven; Leeming, Dawn

2009-09-01

Recent feminist analyses, particularly from those working within a poststructuralist framework, have highlighted a number of historically located and contradictory socio-cultural constructions and practices which women are faced with when negotiating infant feeding, especially breastfeeding, within contemporary western contexts. However, there has been little explicit analysis of the practice of expressing breast milk. The aim of this article is to explore the embodied practice of expressing breast milk. This is done by analysing, from a feminist poststructuralist perspective, discourse surrounding expressing breast milk in sixteen first time mothers' accounts of early infant feeding. Participants were recruited from a hospital in the South Midlands of England. The data are drawn from the first phase of a larger longitudinal study, during which mothers kept an audio diary about their breastfeeding experiences for seven days following discharge from hospital, and then took part in a follow-up interview. Key themes identified are expressing breast milk as (i) a way of managing pain whilst still feeding breast milk; (ii) a solution to the inefficiencies of the maternal body; (iii) enhancing or disrupting the 'bonding process'; (iv) a way of managing feeding in public; and (v) a way to negotiate some independence and manage the demands of breastfeeding. Links between these and broader historical and socio-cultural constructions and practices are discussed. This analysis expands current feminist theorising around how women actively create the 'good maternal body'. As constructed by the participants, expressing breast milk appears to be largely a way of aligning subjectivity with cultural ideologies of motherhood. Moreover, breastfeeding discourses and practices available to mothers are not limitless and processes of power restrict the possibilities for women in relation to infant feeding.

The behaviour of health care providers in managing diarrheal disease in Palembang City, south Sumatera, Indonesia.

PubMed

Ismail, R; Bakri, A; Nazir, M; Pardede, N

1991-01-01

A study on knowledge, attitude and practice of health care providers in Palembang had been conducted at the end of 1989 and beginning of 1990. Four approaches were carried out: (1) by recording the help obtained by cases who consulted researchers for further help for the same diarrheal diseases (DD) episode, (2) by studying the medical records of DD cases admitted to three hospitals, (3) by studying prescriptions dispensed by three pharmacies and (4) by focus group discussions. The findings were analysed to evaluate the achievement of the Indonesian Diarrheal Diseases Control Program (CDD). ORT, avoiding antimotility drugs and appropriated feeding have been accepted and practiced by the providers in Palembang. The target of promotion now is to support the acquisition of these behaviours to be implemented as a routine habit of the providers and as a part of the ongoing system of health care delivery system. Specifically the danger of loperamide promotion to the policy on antimotility must be stressed. Rapid iv rehydration and avoiding surface precipitating agents have been accepted, but are not practiced consistently yet due to practical considerations. It seems that there is no impact at all of CDD towards the rate of antibiotic therapy in DD. Besides intensifying the campaign, enforcing group pressure, may be we have to elaborate more the perception of health care provider as a practitioner, and conforming the strategy of the CDD campaign towards the findings. Health education had not been practiced effectively yet. Morale and value system of the providers are important for the success of this program. In general the medical-technic aspect of the CDD has been accepted by the providers, but there is still a lot to do in communicating them to be adopted as an effective behaviour.

Circadian Rhythm Sleep Disorders: Part II, Advanced Sleep Phase Disorder, Delayed Sleep Phase Disorder, Free-Running Disorder, and Irregular Sleep-Wake Rhythm

PubMed Central

Sack, Robert L; Auckley, Dennis; Auger, R. Robert; Carskadon, Mary A.; Wright, Kenneth P.; Vitiello, Michael V.; Zhdanova, Irina V.

2007-01-01

Objective: This the second of two articles reviewing the scientific literature on the evaluation and treatment of circadian rhythm sleep disorders (CRSDs), employing the methodology of evidence-based medicine. We herein report on the accumulated evidence regarding the evaluation and treatment of Advamced Sleep Phase Disorder (ASPD), Delayed Sleep Phase Disorder (DSPD), Free-Running Disorder (FRD) and Irregular Sleep-Wake Rhythm ISWR). Methods: A set of specific questions relevant to clinical practice were formulated, a systematic literature search was performed, and relevant articles were abstracted and graded. Results: A substantial body of literature has accumulated that provides a rational basis the evaluation and treatment of CRSDs. Physiological assessment has involved determination of circadian phase using core body temperature and the timing of melatonin secretion. Behavioral assessment has involved sleep logs, actigraphy and the Morningness-Eveningness Questionnaire (MEQ). Treatment interventions fall into three broad categories: 1) prescribed sleep scheduling, 2) circadian phase shifting (“resetting the clock”), and 3) symptomatic treatment using hypnotic and stimulant medications. Conclusion: Circadian rhythm science has also pointed the way to rational interventions for CRSDs and these treatments have been introduced into the practice of sleep medicine with varying degrees of success. More translational research is needed using subjects who meet current diagnostic criteria. Citation: Sack R; Auckley D; Auger RR; Carskadon MA; Wright KP; Vitiello MV; Zhdanova IV. Circadian rhythm sleep disorders: Part II, advanced sleep phase disorder, delayed sleep phase disorder, free-running disorder, and irregular sleep-wake rhythm. SLEEP 2007;30(11):1484-1501. PMID:18041481

77 FR 45307 - Approval and Promulgation of Air Quality Implementation Plans: Georgia; Control Techniques...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-31

... October 7, 2008 (73 FR 58481), EPA updated the 1977 CTG, as part of Group IV CTG, addressing the control... Group III CTG, addressing control of VOC emissions from metal furniture coating operations. On January 3..., as part of Group III CTG, addressing the control of VOC emissions from large appliance surface...

75 FR 69446 - Proposed Information Collection Activity; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-12

... (CFS-101). OMB No.: 0980-0047. Description: Under title IV-B, subparts 1 and 2, of the Social Security... report called the CFS-101. The APSR is a Yearly report that discusses progress made by a State, Territory...-year plan period. The CFS-101 has three parts. Part I is an annual budget request for the upcoming...

77 FR 23370 - Federal Acquisition Regulation; Technical Amendments

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-18

... CONTRACT CLAUSES 52.212-5 [Amended] 0 2. Amend section 52.212-5 by removing from paragraph (b)(7) ``(Jan... ADMINISTRATION 48 CFR Parts 1 and 52 [FAC 2005-58; Item IV; Docket 2012-0079; Sequence 2] Federal Acquisition... update certain elements in 48 CFR parts 1 and 52, this document makes editorial changes to the FAR. List...

Diffusion of pent-1-ene (1); air (2)

NASA Astrophysics Data System (ADS)

Winkelmann, J.

This document is part of Subvolume A `Gases in Gases, Liquids and their Mixtures' of Volume 15 `Diffusion in Gases, Liquids and Electrolytes' of Landolt-Börnstein Group IV `Physical Chemistry'. It is part of the chapter of the chapter `Diffusion in Pure Gases' and contains data on diffusion of (1) pent-1-ene; (2) air

Thermally activated ("thermal") battery technology. Part IV. Anode materials

NASA Astrophysics Data System (ADS)

Guidotti, Ronald A.; Masset, Patrick J.

In this paper, the history of anode materials developed for use in thermally activated ("thermal") batteries is presented. The chemistries (phases) and electrochemical characteristics (discharge mechanisms) of these materials are described, along with general thermodynamic properties, where available. This paper is the last of a five-part series that presents a general review of thermal-battery technology.

78 FR 9247 - Milk in the Northeast and Other Marketing Areas; Final Decision on Proposed Amendments to...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-07

... Vol. 78 Thursday, No. 26 February 7, 2013 Part IV Department of Agriculture Agricultural Marketing Service 7 CFR Part 1000 Milk in the Northeast and Other Marketing Areas; Final Decision on Proposed Amendments to Marketing Agreements and Orders and Termination of a Portion of the Proceeding; Proposed Rule...

Report of material and equipment section`s activities at New York Shipbuilding Corporation during fabrication of AXC 167 1/2 starting May 18, 1951. Part 7, Section 3

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

Stewart, J.R.

1954-04-28

This document provides Part VII, Section III and Section IV of the report of the Material and Equipment Section`s activities at the New York Shipbuilding Corporation. The fabrication, inspection, and testing of reactor components is detailed.

Clustering Methods; Part IV of Scientific Report No. ISR-18, Information Storage and Retrieval...

ERIC Educational Resources Information Center

Cornell Univ., Ithaca, NY. Dept. of Computer Science.

Two papers are included as Part Four of this report on Salton's Magical Automatic Retriever of Texts (SMART) project report. The first paper: "A Controlled Single Pass Classification Algorithm with Application to Multilevel Clustering" by D. B. Johnson and J. M. Laferente presents a single pass clustering method which compares favorably…

DSU Repair Parts Stockouts

DTIC Science & Technology

1976-06-01

37 7. Training of Class IX Suppl- Personnel ----------- 2-40 8. Training of Division PLL Clerks ----------------- 2-42 iv *m1 PAGE 9. Essentiality of...Requisition Followups ---------------------------- 2-78 9. Forecasting Production Leadtimes ----------------- 2-79 10. Repair Parts Essentiality ... essentiality coding are discussed. xi SUMMARY 1. !NTRODUCTION. It has been observed on repeated occasions that major items of equipment are deadlined for

14 CFR 121.583 - Carriage of persons without compliance with the passenger-carrying requirements of this part.

Code of Federal Regulations, 2010 CFR

2010-01-01

... is governed by regulations in 49 CFR part 175; (iv) The security of valuable or confidential cargo; (v) The preservation of fragile or perishable cargo; (vi) Experiments on, or testing of, cargo containers or cargo handling devices; (vii) The operation of special equipment for loading or unloading cargo...

14 CFR 121.583 - Carriage of persons without compliance with the passenger-carrying requirements of this part.

Code of Federal Regulations, 2012 CFR

2012-01-01

... is governed by regulations in 49 CFR part 175; (iv) The security of valuable or confidential cargo; (v) The preservation of fragile or perishable cargo; (vi) Experiments on, or testing of, cargo containers or cargo handling devices; (vii) The operation of special equipment for loading or unloading cargo...

14 CFR 121.583 - Carriage of persons without compliance with the passenger-carrying requirements of this part.

Code of Federal Regulations, 2011 CFR

2011-01-01

... is governed by regulations in 49 CFR part 175; (iv) The security of valuable or confidential cargo; (v) The preservation of fragile or perishable cargo; (vi) Experiments on, or testing of, cargo containers or cargo handling devices; (vii) The operation of special equipment for loading or unloading cargo...

Highly ionized gas in the Gum nebula and elsewhere - A comparison of IUE and Copernicus satellite results

NASA Technical Reports Server (NTRS)

Edgar, Richard J.; Savage, Blair D.

1992-01-01

The data from six high-dispersion IUE echelle spectra are averaged in order to obtain an interstellar absorption line spectrum with an S/N of about 30 and a resolution of about 25 km/s. The interstellar lines of C IV and Si IV are very strong and broad and N V is detected. The profiles for these species and Al III are compared to the Copernicus satellite profiles for O VI. The high ionization lines toward HD 64760 are much stronger and broader than those recorded toward Zeta Pup and Gamma super 2 Vel, the two exciting stars of the Gum nebula. The profiles for Al III and Si IV are similar and considerably narrower than the O VI profile. An origin in photoionized Gum nebula gas is suggested as the most likely explanation for Al III and Si IV. The C IV profile has a high positive velocity wing extending to approximately +80 km/s, which is similar in appearance to the positive velocity portion of the O VI profile. It is inferred that a substantial part of the observed C IV has an origin in the collisionally ionized gas most likely rsponsible for the O VI.

Beyond signal functions in global obstetric care: Using a clinical cascade to measure emergency obstetric readiness

PubMed Central

Dettinger, Julia; Calkins, Kimberly; Kibore, Minnie; Gachuno, Onesmus; Walker, Dilys

2018-01-01

Background Globally, the rate of reduction in delivery-associated maternal and perinatal mortality has been slow compared to improvements in post-delivery mortality in children under five. Improving clinical readiness for basic obstetric emergencies is crucial for reducing facility-based maternal deaths. Emergency readiness is commonly assessed using tracers derived from the maternal signal functions model. Objective-method We compare emergency readiness using the signal functions model and a novel clinical cascade. The cascades model readiness as the proportion of facilities with resources to identify the emergency (stage 1), treat it (stage 2) and monitor-modify therapy (stage 3). Data were collected from 44 Kenyan clinics as part of an implementation trial. Findings Although most facilities (77.0%) stock maternal signal function tracer drugs, far fewer have resources to practically identify and treat emergencies. In hypertensive emergencies for example, 38.6% of facilities have resources to identify the emergency (Stage 1 readiness, including sphygmomanometer, stethoscope, urine collection device, protein test). 6.8% have the resources to treat the emergency (Stage 2, consumables (IV Kit, fluids), durable goods (IV pole) and drugs (magnesium sulfate and hydralazine). No facilities could monitor or modify therapy (Stage 3). Across five maternal emergencies, the signal functions overestimate readiness by 54.5%. A consistent, step-wise pattern of readiness loss across signal functions and care stage emerged and was profoundly consistent at 33.0%. Significance Comparing estimates from the maternal signal functions and cascades illustrates four themes. First, signal functions overestimate practical readiness by 55%. Second, the cascade’s intuitive indicators can support cross-sector health system or program planners to more precisely measure and improve emergency care. Third, adding few variables to existing readiness inventories permits step-wise modeling of readiness loss and can inform more precise interventions. Fourth, the novel aggregate readiness loss indicator provides an innovative and intuitive approach for modeling health system emergency readiness. Additional testing in diverse contexts is warranted. PMID:29474397

Exploring the challenges and successes of the Lecturer Practitioner role using a stakeholder evaluation approach.

PubMed

Hancock, Helen; Lloyd, Hilary; Campbell, Steve; Turnock, Chris; Craig, Stephen

2007-10-01

Plans for NHS reform include strategies to reduce the gap between theory and the realities of clinical practice, with the aim of improving patient care. The role of Lecturer Practitioners (LPs) as educators for nurses who 'bridge' the theory-practice gap forms a central part of this strategy. Given the amount of investment in the role and its potential, this study sought to evaluate the impact of the LP role within the education and practice setting from the perspective of key stakeholders. The study, which included five LPs from a range of backgrounds, followed the principles of stakeholder evaluation. Each LP and their line manager identified six informants who were familiar with the LP's role. The total sample consisted of 36 participants. Semi-structured interviews were used to gain the perceptions of stakeholders about the LP role. The emerging themes were then discussed, consensus reached, and a collaborative project report produced. The findings were derived from the perceptions of the stakeholders. Minimally interpretive analysis of the data resulted in identification of five themes: (i) general overview of LP's individual qualities; (ii) preconceived notions of the post; (iii) reality of the post; (iv) areas of concern; and (v) developing the role. The findings indicated that the LP role provides a credible and valuable link between theory and practice and, as such, is an important contribution to the modernization agenda of the NHS. It was apparent, however, that there are a number of areas in which developments are needed, and that organizational and individual actions are necessary in order to achieve the most from these posts.

Mutational Analysis of the QRRQ Motif in the Yeast Hig1 Type 2 Protein Rcf1 Reveals a Regulatory Role for the Cytochrome c Oxidase Complex*

PubMed Central

Garlich, Joshua; Strecker, Valentina; Wittig, Ilka; Stuart, Rosemary A.

2017-01-01

The yeast Rcf1 protein is a member of the conserved family of proteins termed the hypoxia-induced gene (domain) 1 (Hig1 or HIGD1) family. Rcf1 interacts with components of the mitochondrial oxidative phosphorylation system, in particular the cytochrome bc1 (complex III)-cytochrome c oxidase (complex IV) supercomplex (termed III-IV) and the ADP/ATP carrier proteins. Rcf1 plays a role in the assembly and modulation of the activity of complex IV; however, the molecular basis for how Rcf1 influences the activity of complex IV is currently unknown. Hig1 type 2 isoforms, which include the Rcf1 protein, are characterized in part by the presence of a conserved motif, (Q/I)X3(R/H)XRX3Q, termed here the QRRQ motif. We show that mutation of conserved residues within the Rcf1 QRRQ motif alters the interactions between Rcf1 and partner proteins and results in the destabilization of complex IV and alteration of its enzymatic properties. Our findings indicate that Rcf1 does not serve as a stoichiometric component, i.e. as a subunit of complex IV, to support its activity. Rather, we propose that Rcf1 serves to dynamically interact with complex IV during its assembly process and, in doing so, regulates a late maturation step of complex IV. We speculate that the Rcf1/Hig1 proteins play a role in the incorporation and/or remodeling of lipids, in particular cardiolipin, into complex IV and. possibly, other mitochondrial proteins such as ADP/ATP carrier proteins. PMID:28167530

Osteomyelitis

MedlinePlus

... to need IV or oral (taken by mouth) antibiotics at home for several more weeks. Most teens recover completely from osteomyelitis. Can I Prevent Osteomyelitis? The easiest way to prevent yourself from getting osteomyelitis is to practice good hygiene. If you get a cut or a ...

The Role of the Urologist in Treating Patients with Hormone-Refractory Prostate Cancer

PubMed Central

Crawford, E. David

2003-01-01

Objectives: To ascertain what percentage of urologists’ oncology practice is dedicated to the care of prostate cancer patients and to determine urologists’ attitudes towards the treatment of patients with metastatic and hormone-refractory prostate cancer (HRPC). An additional objective is to determine urologists’ interest in administering various types of chemotherapy in HRPC patients. Materials and Methods: The American Urological Association (AUA) directory of practicing urologists was obtained, and 3000 randomly selected members of the AUA, as well as the complete list of 168 Society of Urologic Oncology (SUO) members, were chosen for the mailing of a 16-item questionnaire. The urologists were asked about how many of their patients have prostate cancer, how many have metastatic disease, and how many have HRPC and are currently receiving intravenous (IV) chemotherapy. In addition, the urologists were queried regarding their level of interest in learning about chemotherapy options as well as learning how to administer chemotherapy. Results: A total of 654 survey questionnaires were completed and returned for tabulation, resulting in a 21% effective response rate. Sixty-four percent of the responding urologists’ cancer patients had prostate cancer, 21% had metastatic disease, and 19% had HRPC; only 4% of the urologists currently administer IV chemotherapy themselves. When asked to describe their interest in learning how to deliver and be reimbursed for IV chemotherapy, 26% expressed an extremely low level of interest, 23% a low level of interest, 31% a high level of interest, and 17% an extremely high level of interest. The results of other questions are presented and correlated with the number of years the urologists have been in practice and other demographic data. Conclusions: The management of prostate cancer comprises a major portion of urologists’ practices. Almost one half (48%) of the urologists in this survey were interested in administering and being reimbursed for IV chemotherapy. Several chemotherapy regimens have been shown to improve quality of life in patients with HRPC, yet only about 30% of these patients were referred for chemotherapy. If more urologists were able to deliver these drugs, then the number of patients referred for chemotherapy would likely increase, as would accrual to important clinical trials in HRPC. The results of this survey suggest that methods to implement the training and reimbursement of urologists in the use of chemotherapy regimens should be investigated. PMID:16986047

Promising ferroelectricity in 2D group IV tellurides: a first-principles study

NASA Astrophysics Data System (ADS)

Wan, Wenhui; Liu, Chang; Xiao, Wende; Yao, Yugui

2017-09-01

Based on the first-principles calculations, we investigated the ferroelectric properties of two-dimensional (2D) Group-IV tellurides XTe (X = Si, Ge, and Sn), with a focus on GeTe. 2D Group-IV tellurides energetically prefer an orthorhombic phase with a hinge-like structure and an in-plane spontaneous polarization. The intrinsic Curie temperature Tc of monolayer GeTe is as high as 570 K and can be raised quickly by applying a tensile strain. An out-of-plane electric field can effectively decrease the coercive field for the reversal of polarization, extending its potential for regulating the polarization switching kinetics. Moreover, for bilayer GeTe, the ferroelectric phase is still the ground state. Combined with these advantages, 2D GeTe is a promising candidate material for practical integrated ferroelectric applications.

[Ultraviolet spectroscopic study on the fine structures in the solar polar hole].

PubMed

Zhang, Min; Wang, Dong; Liu, Guo-Hong

2014-07-01

Fine structures in the south solar polar coronal hole were observed by N IV line of SOHO/SUMER spectrograph. The scales of the fine structures range spatially range from 1 arcsec to several arcsecs, temporally from 1 min to several minutes, and parts of them are in strip shape along the slit direction. The line-of-sight velocity of them is up to tens of km x s(-1) with red and blue shift intercrossed occasionally, which appear periodically as long as 100 minutes in some regions. Part of the fine structures can be clearly observed at the Ne V III line with higher formation temperature in the same spectral window. The time and location of some fine structures with high velocity in the Ne V III spectrum are almost the same as that in N IV spectrum, but they are extended and diffused in the Ne V III spectrum. Some fine structures have non-Gaussian profiles with the line-of-sight Doppler velocities up to 150 km x s(-1) in the N IV blue/red wings, which is similar with the explosive events in the transition region. In the past, explosive events are small-scale dynamic phenomena often observed in the quiet-sun (QS) region, while their properties in coronal holes (CHs) remain unclear. Here, we find the EE-like events with strong dynamics in the south solar polar coronal hole by N IV line of SOHO/SUMER spectrograph.

75 FR 70217 - Defense Transportation Regulation, Part IV

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-17

... comments received in connection with the Defense Personal Property Program (DP3), Phase III Final-Draft.... Any subsequent changes will be published in a Federal Register Announcement and incorporated into the...

45 CFR 303.0 - Scope and applicability of this part.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CHILD SUPPORT ENFORCEMENT PROGRAM), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND... prescribes: (a) The minimum organizational and staffing requirements the State IV-D agency must meet in...

41 CFR 61-250.2 - What definitions apply to this part?

Code of Federal Regulations, 2013 CFR

2013-07-01

... institutes and junior colleges, or through equivalent on-the-job training. Includes: Computer programmers and... (medical, dental, electronic, physical science), and kindred workers. (iv) Sales means occupations engaging...

41 CFR 61-250.2 - What definitions apply to this part?

Code of Federal Regulations, 2010 CFR

2010-07-01

... institutes and junior colleges, or through equivalent on-the-job training. Includes: Computer programmers and... (medical, dental, electronic, physical science), and kindred workers. (iv) Sales means occupations engaging...

41 CFR 61-250.2 - What definitions apply to this part?

Code of Federal Regulations, 2014 CFR

2014-07-01

... institutes and junior colleges, or through equivalent on-the-job training. Includes: Computer programmers and... (medical, dental, electronic, physical science), and kindred workers. (iv) Sales means occupations engaging...

41 CFR 61-250.2 - What definitions apply to this part?

Code of Federal Regulations, 2012 CFR

2012-07-01

... institutes and junior colleges, or through equivalent on-the-job training. Includes: Computer programmers and... (medical, dental, electronic, physical science), and kindred workers. (iv) Sales means occupations engaging...

41 CFR 61-250.2 - What definitions apply to this part?

Code of Federal Regulations, 2011 CFR

2011-07-01

... institutes and junior colleges, or through equivalent on-the-job training. Includes: Computer programmers and... (medical, dental, electronic, physical science), and kindred workers. (iv) Sales means occupations engaging...

Handling missing values in the MDS-UPDRS.

PubMed

Goetz, Christopher G; Luo, Sheng; Wang, Lu; Tilley, Barbara C; LaPelle, Nancy R; Stebbins, Glenn T

2015-10-01

This study was undertaken to define the number of missing values permissible to render valid total scores for each Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part. To handle missing values, imputation strategies serve as guidelines to reject an incomplete rating or create a surrogate score. We tested a rigorous, scale-specific, data-based approach to handling missing values for the MDS-UPDRS. From two large MDS-UPDRS datasets, we sequentially deleted item scores, either consistently (same items) or randomly (different items) across all subjects. Lin's Concordance Correlation Coefficient (CCC) compared scores calculated without missing values with prorated scores based on sequentially increasing missing values. The maximal number of missing values retaining a CCC greater than 0.95 determined the threshold for rendering a valid prorated score. A second confirmatory sample was selected from the MDS-UPDRS international translation program. To provide valid part scores applicable across all Hoehn and Yahr (H&Y) stages when the same items are consistently missing, one missing item from Part I, one from Part II, three from Part III, but none from Part IV can be allowed. To provide valid part scores applicable across all H&Y stages when random item entries are missing, one missing item from Part I, two from Part II, seven from Part III, but none from Part IV can be allowed. All cutoff values were confirmed in the validation sample. These analyses are useful for constructing valid surrogate part scores for MDS-UPDRS when missing items fall within the identified threshold and give scientific justification for rejecting partially completed ratings that fall below the threshold. © 2015 International Parkinson and Movement Disorder Society.

The Handbook of Medical Image Perception and Techniques

NASA Astrophysics Data System (ADS)

Samei, Ehsan; Krupinski, Elizabeth

2014-07-01

1. Medical image perception Ehsan Samei and Elizabeth Krupinski; Part I. Historical Reflections and Theoretical Foundations: 2. A short history of image perception in medical radiology Harold Kundel and Calvin Nodine; 3. Spatial vision research without noise Arthur Burgess; 4. Signal detection theory, a brief history Arthur Burgess; 5. Signal detection in radiology Arthur Burgess; 6. Lessons from dinners with the giants of modern image science Robert Wagner; Part II. Science of Image Perception: 7. Perceptual factors in reading medical images Elizabeth Krupinski; 8. Cognitive factors in reading medical images David Manning; 9. Satisfaction of search in traditional radiographic imaging Kevin Berbaum, Edmund Franken, Robert Caldwell and Kevin Schartz; 10. The role of expertise in radiologic image interpretation Calvin Nodine and Claudia Mello-Thoms; 11. A primer of image quality and its perceptual relevance Robert Saunders and Ehsan Samei; 12. Beyond the limitations of human vision Maria Petrou; Part III. Perception Metrology: 13. Logistical issues in designing perception experiments Ehsan Samei and Xiang Li; 14. ROC analysis: basic concepts and practical applications Georgia Tourassi; 15. Multi-reader ROC Steve Hillis; 16. Recent developments in FROC methodology Dev Chakraborty; 17. Observer models as a surrogate to perception experiments Craig Abbey and Miguel Eckstein; 18. Implementation of observer models Matthew Kupinski; Part IV. Decision Support and Computer Aided Detection: 19. CAD: an image perception perspective Maryellen Giger and Weijie Chen; 20. Common designs of CAD studies Yulei Jiang; 21. Perceptual effect of CAD in reading chest images Matthew Freedman and Teresa Osicka; 22. Perceptual issues in mammography and CAD Michael Ulissey; 23. How perceptual factors affect the use and accuracy of CAD for interpretation of CT images Ronald Summers; 24. CAD: risks and benefits for radiologists' decisions Eugenio Alberdi, Andrey Povyakalo, Lorenzo Strigini and Peter Ayton; Part V. Optimization and Practical Issues: 25. Optimization of 2D and 3D radiographic systems Jeff Siewerdson; 26. Applications of AFC methodology in optimization of CT imaging systems Kent Ogden and Walter Huda; 27. Perceptual issues in reading mammograms Margarita Zuley; 28. Perceptual optimization of display processing techniques Richard Van Metter; 29. Optimization of display systems Elizabeth Krupinski and Hans Roehrig; 30. Ergonomic radiologist workplaces in the PACS environment Carl Zylack; Part VI. Epilogue: 31. Future prospects of medical image perception Ehsan Samei and Elizabeth Krupinski; Index.

The Handbook of Medical Image Perception and Techniques

NASA Astrophysics Data System (ADS)

Samei, Ehsan; Krupinski, Elizabeth

2009-12-01

1. Medical image perception Ehsan Samei and Elizabeth Krupinski; Part I. Historical Reflections and Theoretical Foundations: 2. A short history of image perception in medical radiology Harold Kundel and Calvin Nodine; 3. Spatial vision research without noise Arthur Burgess; 4. Signal detection theory, a brief history Arthur Burgess; 5. Signal detection in radiology Arthur Burgess; 6. Lessons from dinners with the giants of modern image science Robert Wagner; Part II. Science of Image Perception: 7. Perceptual factors in reading medical images Elizabeth Krupinski; 8. Cognitive factors in reading medical images David Manning; 9. Satisfaction of search in traditional radiographic imaging Kevin Berbaum, Edmund Franken, Robert Caldwell and Kevin Schartz; 10. The role of expertise in radiologic image interpretation Calvin Nodine and Claudia Mello-Thoms; 11. A primer of image quality and its perceptual relevance Robert Saunders and Ehsan Samei; 12. Beyond the limitations of human vision Maria Petrou; Part III. Perception Metrology: 13. Logistical issues in designing perception experiments Ehsan Samei and Xiang Li; 14. ROC analysis: basic concepts and practical applications Georgia Tourassi; 15. Multi-reader ROC Steve Hillis; 16. Recent developments in FROC methodology Dev Chakraborty; 17. Observer models as a surrogate to perception experiments Craig Abbey and Miguel Eckstein; 18. Implementation of observer models Matthew Kupinski; Part IV. Decision Support and Computer Aided Detection: 19. CAD: an image perception perspective Maryellen Giger and Weijie Chen; 20. Common designs of CAD studies Yulei Jiang; 21. Perceptual effect of CAD in reading chest images Matthew Freedman and Teresa Osicka; 22. Perceptual issues in mammography and CAD Michael Ulissey; 23. How perceptual factors affect the use and accuracy of CAD for interpretation of CT images Ronald Summers; 24. CAD: risks and benefits for radiologists' decisions Eugenio Alberdi, Andrey Povyakalo, Lorenzo Strigini and Peter Ayton; Part V. Optimization and Practical Issues: 25. Optimization of 2D and 3D radiographic systems Jeff Siewerdson; 26. Applications of AFC methodology in optimization of CT imaging systems Kent Ogden and Walter Huda; 27. Perceptual issues in reading mammograms Margarita Zuley; 28. Perceptual optimization of display processing techniques Richard Van Metter; 29. Optimization of display systems Elizabeth Krupinski and Hans Roehrig; 30. Ergonomic radiologist workplaces in the PACS environment Carl Zylack; Part VI. Epilogue: 31. Future prospects of medical image perception Ehsan Samei and Elizabeth Krupinski; Index.

GENETIC AND ENVIRONMENTAL CONTRIBUTIONS TO THE CO-OCCURRENCE OF DEPRESSIVE PERSONALITY DISORDER AND DSM-IV PERSONALITY DISORDERS

PubMed Central

Ørstavik, Ragnhild E.; Kendler, Kenneth S.; Røysamb, Espen; Czajkowski, Nikolai; Tambs, Kristian; Reichborn-Kjennerud, Ted

2012-01-01

One of the main controversies with regard to depressive personality disorder (DPD) concerns the co-occurrence with the established DSM-IV personality disorders (PDs). The main aim of this study was to examine to what extent DPD and the DSM-IV PDs share genetic and environmental risk factors, using multivariate twin modeling. The DSM-IV Structured Interview for Personality was applied to 2,794 young adult twins. Paranoid PD from Cluster A, borderline PD from Cluster B, and all three PDs from Cluster C were independently and significantly associated with DPD in multiple regression analysis. The genetic correlations between DPD and the other PDs were strong (.53–.83), while the environmental correlations were moderate (.36–.40). Close to 50% of the total variance in DPD was disorder specific. However, only 5% was due to disorder-specific genetic factors, indicating that a substantial part of the genetic vulnerability to DPD also increases the vulnerability to other PDs. PMID:22686231

Genetic and environmental contributions to the co-occurrence of depressive personality disorder and DSM-IV personality disorders.

PubMed

Ørstavik, Ragnhild E; Kendler, Kenneth S; Røysamb, Espen; Czajkowski, Nikolai; Tambs, Kristian; Reichborn-Kjennerud, Ted

2012-06-01

One of the main controversies with regard to depressive personality disorder (DPD) concerns the co-occurrence with the established DSM-IV personality disorders (PDs). The main aim of this study was to examine to what extent DPD and the DSM-IV PDs share genetic and environmental risk factors, using multivariate twin modeling. The DSM-IV Structured Interview for Personality was applied to 2,794 young adult twins. Paranoid PD from Cluster A, borderline PD from Cluster B, and all three PDs from Cluster C were independently and significantly associated with DPD in multiple regression analysis. The genetic correlations between DPD and the other PDs were strong (.53-.83), while the environmental correlations were moderate (.36-.40). Close to 50% of the total variance in DPD was disorder specific. However, only 5% was due to disorder-specific genetic factors, indicating that a substantial part of the genetic vulnerability to DPD also increases the vulnerability to other PDs.

Standards for Clinical Trials in Male and Female Sexual Dysfunction: I. Phase I to Phase IV Clinical Trial Design.

PubMed

Fisher, William A; Gruenwald, Ilan; Jannini, Emmanuele A; Lev-Sagie, Ahinoam; Lowenstein, Lior; Pyke, Robert E; Reisman, Yakov; Revicki, Dennis A; Rubio-Aurioles, Eusebio

2016-12-01

This series of articles outlines standards for clinical trials of treatments for male and female sexual dysfunctions, with a focus on research design and patient-reported outcome assessment. These articles consist of revision, updating, and integration of articles on standards for clinical trials in male and female sexual dysfunction from the 2010 International Consultation on Sexual Medicine developed by the authors as part of the 2015 International Consultation on Sexual Medicine. We are guided in this effort by several principles. In contrast to previous versions of these guidelines, we merge discussion of standards for clinical trials in male and female sexual dysfunction in an integrated approach that emphasizes the common foundational practices that underlie clinical trials in the two settings. We present a common expected standard for clinical trial design in male and female sexual dysfunction, a common rationale for the design of phase I to IV clinical trials, and common considerations for selection of study population and study duration in male and female sexual dysfunction. We present a focused discussion of fundamental principles in patient- (and partner-) reported outcome assessment and complete this series of articles with specific discussions of selected aspects of clinical trials that are unique to male and to female sexual dysfunction. Our consideration of standards for clinical trials in male and female sexual dysfunction attempts to embody sensitivity to existing and new regulatory guidance and to address implications of the evolution of the diagnosis of sexual dysfunction that have been brought forward in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. The first article in this series focuses on phase I to phase IV clinical trial design considerations. Subsequent articles in this series focus on the measurement of patient-reported outcomes, unique aspects of clinical trial design for men, and unique aspects of clinical trial design for women. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Distinguishing bipolar II depression from major depressive disorder with comorbid borderline personality disorder: demographic, clinical, and family history differences.

PubMed

Zimmerman, Mark; Martinez, Jennifer H; Morgan, Theresa A; Young, Diane; Chelminski, Iwona; Dalrymple, Kristy

2013-09-01

Because of the potential treatment implications, it is clinically important to distinguish between bipolar II depression and major depressive disorder with comorbid borderline personality disorder. The high frequency of diagnostic co-occurrence and resemblance of phenomenological features has led some authors to suggest that borderline personality disorder is part of the bipolar spectrum. Few studies have directly compared patients with bipolar disorder and borderline personality disorder. In the present study from the Rhode Island Methods to Improve Diagnostic Assessment and Services project, we compared these 2 groups of patients on demographic, clinical, and family history variables. From December 1995 to May 2012, 3,600 psychiatric patients presenting to the outpatient practice at Rhode Island Hospital (Providence, Rhode Island) were evaluated with semistructured diagnostic interviews for DSM-IV Axis I and Axis II disorders. The focus of the present study is the 206 patients with DSM-IV major depressive disorder and borderline personality disorder (MDD-BPD) and 62 patients with DSM-IV bipolar II depression without borderline personality disorder. The patients with MDD-BPD were significantly more often diagnosed with posttraumatic stress disorder (P < .001), a current substance use disorder (P < .01), somatoform disorder (P < .05), and other nonborderline personality disorder (P < .05). Clinical ratings of anger, anxiety, paranoid ideation, and somatization were significantly higher in the MDD-BPD group (all P < .01). The MDD-BPD patients were rated significantly lower on the Global Assessment of Functioning (P < .001), their current social functioning was poorer (P < .01), and they made significantly more suicide attempts (P < .01). The patients with bipolar II depression had a significantly higher morbid risk for bipolar disorder in their first-degree relatives than the MDD-BPD patients (P < .05). Patients diagnosed with bipolar II depression and major depressive disorder with comorbid borderline personality disorder differed on a number of clinical and family history variables, thereby supporting the validity of this distinction. © Copyright 2013 Physicians Postgraduate Press, Inc.

Chemical modification of group IV graphene analogs

PubMed Central

Nakano, Hideyuki; Tetsuka, Hiroyuki; Spencer, Michelle J. S.; Morishita, Tetsuya

2018-01-01

Abstract Mono-elemental two-dimensional (2D) crystals (graphene, silicene, germanene, stanene, and so on), termed 2D-Xenes, have been brought to the forefront of scientific research. The stability and electronic properties of 2D-Xenes are main challenges in developing practical devices. Therefore, in this review, we focus on 2D free-standing group-IV graphene analogs (graphene quantum dots, silicane, and germanane) and the functionalization of these sheets with organic moieties, which could be handled under ambient conditions. We highlight the present results and future opportunities, functions and applications, and novel device concepts. PMID:29410713

Does Expert Advice Improve Educational Choice?

PubMed Central

2015-01-01

This paper reports evidence that an individual meeting with a study counselor at high school significantly improves the quality of choice of tertiary educational field, as self-assessed 18 months after graduation from college. To address endogeneity, we explore the variation in study counseling practices between schools as an instrumental variable (IV). Following careful scrutiny of the validity of the IV, our results indicate a significant and positive influence of study counseling on the quality of educational choice, foremost among males and those with low educated parents. The overall result is stable across a number of robustness checks. PMID:26692388

Effect of closed-loop order processing on the time to initial antimicrobial therapy.

PubMed

Panosh, Nicole; Rew, Richardd; Sharpe, Michelle

2012-08-15

The results of a study comparing the average time to initiation of i.v. antimicrobial therapy with closed-versus open-loop order entry and processing are reported. A retrospective cohort study was performed to compare order-to-administration times for initial doses of i.v. antimicrobials before and after a closed-loop order-processing system including computerized prescriber order entry (CPOE) was implemented at a large medical center. A total of 741 i.v. antimicrobial administrations to adult patients during designated five-month preimplementation and postimplementation study periods were assessed. Drug-use reports generated by the pharmacy database were used to identify order-entry times, and medication administration records were reviewed to determine times of i.v. antimicrobial administration. The mean ± S.D. order-to-administration times before and after the implementation of the CPOE system and closed-loop order processing were 3.18 ± 2.60 and 2.00 ± 1.89 hours, respectively, a reduction of 1.18 hours (p < 0.0001). Closed-loop order processing was associated with significant reductions in the average time to initiation of i.v. therapy in all patient care areas evaluated (cardiology, general medicine, and oncology). The study results suggest that CPOE-based closed-loop order processing can play an important role in achieving compliance with current practice guidelines calling for increased efforts to ensure the prompt initiation of i.v. antimicrobials for severe infections (e.g., sepsis, meningitis). Implementation of a closed-loop order-processing system resulted in a significant decrease in order-to-administration times for i.v. antimicrobial therapy.

Plasma and cerebrospinal fluid pharmacokinetic parameters after single-dose administration of intravenous, oral, or rectal acetaminophen.

PubMed

Singla, Neil K; Parulan, Cherri; Samson, Roselle; Hutchinson, Joel; Bushnell, Rick; Beja, Evelyn G; Ang, Robert; Royal, Mike A

2012-09-01

This is the first study to compare plasma and cerebrospinal fluid (CSF) pharmacokinetics of intravenous (IV), oral (PO), or rectal (PR) formulations of acetaminophen. Healthy male subjects (N = 6) were randomized to receive a single dose of IV (OFIRMEV(®) ; Cadence) 1,000 mg (15 minute infusion), PO (2 Tylenol(®) 500 mg caplets; McNeil Consumer Healthcare), or PR acetaminophen (2 Feverall(®) 650 mg suppositories; Actavis) with a 1-day washout period between doses. The 1,300 mg PR concentrations were standardized to 1,000 mg. Acetaminophen plasma and CSF levels were obtained at T0, 0.25, 0.5, 0.75, 1, 2, 3, 4, and 6 hours. IV acetaminophen showed earlier and higher plasma and CSF levels compared with PO or PR administration. CSF bioavailability over 6 hours (AUC(0-6)) for IV, PO, and PR 1 g was 24.9, 14.2, and 10.3 μg·h/mL, respectively. No treatment-related adverse events were reported. One subject was replaced because of premature failure of his lumbar spinal catheter. The mean CSF level in the IV group was similar to plasma from 3 to 4 hours and higher from 4 hours on. Absorption phase, variability in plasma, and CSF were greater in PO and PR groups than variability with IV administration. These results demonstrate that earlier and greater CSF penetration occurs as a result of the earlier and higher plasma peak with IV administration compared with PO or PR. © 2012 Lotus Clinical Research, LLC. Pain Practice © 2012 World Institute of Pain.

Intravenous Infiltration Risk by Catheter Dwell Time Among Hospitalized Children.

PubMed

Jeong, Ihn Sook; Jeon, Gey Rok; Lee, Man Seop; Shin, Bum Joo; Kim, Yong-Jin; Park, Soon Mi; Hyun, Sookyung

This study was aimed to examine the cumulative risk for infiltration over IV catheter dwell time by general or catheterization-specific characteristics of pediatric patients with IV therapy. This secondary data analysis was done with the data of 1596 children who received peripheral IV therapy at least once during their hospital stay between August 1st and October 30th, 2011 and in June, 2013 in an academic medical center, Yangsan, Republic of Korea. The survival functions of infiltration were determined by using the Kaplan-Meier analysis. The cumulative risk for infiltration had rapidly increased from 1.5% after 24 hours of catheter dwell time to 17.3% after 96 hours. The survival functions were significantly different in the medical than in the surgical department (p=.005), lower extremities than upper ones (p=.001), and use of 10% dextrose (p=.001), ampicillin/sulbactam (p<.001), vancomycin (p=.024), high-concentration electrolytes (p=.001), and phenytoin (p<.001). When catheter dwell times are similar, the cumulative risk for infiltration was higher in cases wherein the patient had a risk factor. The cumulative risk for infiltration has rapidly increased after 24 hours in patients who have 10% dextrose, high-concentration electrolytes, and phenytoin. The results suggest that nurses are required to assess the IV site every hour after 24 hours of catheter dwell time for the infusion of irritants for a safer practice of IV therapy. However, this monitoring time may be modified by the age of child, previous IV complications, and/or hemodynamic issues which may impact IV integrity. Copyright © 2016 Elsevier Inc. All rights reserved.

Sfg

NASA Astrophysics Data System (ADS)

Fischer, R. X.; Baur, W. H.

This document is part of Subvolume E `Zeolite-Type Crystal Structures and their Chemistry. Framework Type Codes RON to STI' of Volume 14 `Microporous and other Framework Materials with Zeolite-Type Structures' of Landolt-Börnstein Group IV `Physical Chemistry'.

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2010-10-01

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Vet

NASA Astrophysics Data System (ADS)

Fischer, R. X.; Baur, W. H.

This document is part of Subvolume F 'Zeolite-Type Crystal Structures and their Chemistry. Framework Type Codes STO to ZON' of Volume 14 'Microporous and other Framework Materials with Zeolite-Type Structures' of Landolt-Börnstein Group IV 'Physical Chemistry'.

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2010-04-01

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Reviews.

ERIC Educational Resources Information Center

Science Teacher, 1989

1989-01-01

Describes two software programs for the Apple II series and TRS-80 Models III and IV: (1) "Personal Energy Inventory" (grades 9-12, records and manages data, not considered user friendly); (2) "Energy Conservation" (grades 7-12, aids in converting and problem solving, uses drill and practice). (MVL)

5 CFR 900.706 - Employment practices.

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2012-01-01

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2014-01-01

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2013-01-01

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Talking about Life

NASA Astrophysics Data System (ADS)

Impey, Chris

2010-08-01

Preface; Part I. Introduction Timothy Ferris, Iris Fry, Steven Dick, Ann Druyan, Pinky Nelson, Neil Tyson, Steve Benner and William Bains; Part II. Earth Roger Buick, Lynn Rothschild, John Baross, Joe Kirschvink, Andrew Knoll, Simon Conway Morris, Roger Hanlon and Lori Marino; Part III. Solar System Chris McKay, David Grinspoon, Jonathan Lunine, Carolyn Porco, Laurie Leshin, Guy Consolmagno and Peter Smith; Part IV. Exoplanets Alan Boss, Geoff Marcy, Debra Fischer, Sara Seager, David Charbonneau and Vikki Meadows; Part V. Frontiers Jill Tarter, Seth Shostak, Ray Kurzweil, Nick Bostrom, Paul Davies, Martin Rees, Ben Bova and Jennifer Michael Hecht; Reading list; Glossary; Index.

10 CFR 1800.14 - Modification to and enforcement of the rules in this part.

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2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Modification to and enforcement of the rules in this part. 1800.14 Section 1800.14 Energy NORTHEAST INTERSTATE LOW-LEVEL RADIOACTIVE WASTE COMMISSION DECLARATION... rescinded after a public hearing held pursuant to Article IV.i.(6) of the Compact and Article V.F.1. of the...

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... requirement, which are not part of the calculation process. Expenditures for which the increased FMAP is not... paid at a rate of 100 percent and therefore not subject to increase), and expenditures that are paid at an enhanced FMAP rate. The increased FMAP is available for expenditures under part E of title IV of...