10 CFR 435.305 - Alternative compliance procedure.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 3 2012-01-01 2012-01-01 false Alternative compliance procedure. 435.305 Section 435.305... Alternative compliance procedure. (a) If a proposed building design includes unusual or innovative energy... estimated unit energy cost on the compliance forms, on the basis of selecting the optimum levels on the...

10 CFR 435.305 - Alternative compliance procedure.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 3 2013-01-01 2013-01-01 false Alternative compliance procedure. 435.305 Section 435.305... Alternative compliance procedure. (a) If a proposed building design includes unusual or innovative energy... estimated unit energy cost on the compliance forms, on the basis of selecting the optimum levels on the...

10 CFR 435.305 - Alternative compliance procedure.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 3 2014-01-01 2014-01-01 false Alternative compliance procedure. 435.305 Section 435.305... Alternative compliance procedure. (a) If a proposed building design includes unusual or innovative energy... estimated unit energy cost on the compliance forms, on the basis of selecting the optimum levels on the...

Outcome of appendicectomy in children performed in paediatric surgery units compared with general surgery units.

PubMed

Tiboni, S; Bhangu, A; Hall, N J

2014-05-01

Appendicectomy for acute appendicitis in children may be performed in specialist centres by paediatric surgeons or in general surgery units. Service provision and outcome of appendicectomy in children may differ between such units. This multicentre observational study included all children (aged less than 16 years) who had an appendicectomy at either a paediatric surgery unit or general surgery unit. The primary outcome was normal appendicectomy rate (NAR). Secondary outcomes included 30-day adverse events, use of ultrasound imaging and laparoscopy, and consultant involvement in procedures. Appendicectomies performed in 19 paediatric surgery units (242 children) and 54 general surgery units (461 children) were included. Children treated in paediatric surgery units were younger and more likely to have a preoperative ultrasound examination, a laparoscopic procedure, a consultant present at the procedure, and histologically advanced appendicitis than children treated in general surgery units. The unadjusted NAR was significantly lower in paediatric surgery units (odds ratio (OR) 0.37, 95 per cent confidence interval 0.23 to 0.59; P < 0.001), and the difference persisted after adjusting for age, sex and use of preoperative ultrasound imaging (OR 0.34, 0.21 to 0.57; P < 0.001). Female sex and preoperative ultrasonography, but not age, were significantly associated with normal appendicectomy in general surgery units but not in paediatric surgery units in this adjusted model. The unadjusted 30-day adverse event rate was higher in paediatric surgery units than in general surgery units (OR 1.90, 1.18 to 3.06; P = 0.011). When adjusted for case mix and consultant presence at surgery, no statistically significant relationship between centre type and 30-day adverse event rate existed (OR 1.59, 0.93 to 2.73; P = 0.091). The NAR in general surgery units was over twice that in paediatric surgery units. Despite a more severe case mix, paediatric surgery units had a similar 30-day adverse event rate to general surgery units. Service provision differs between paediatric and general surgery units. © 2014 BJS Society Ltd. Published by John Wiley & Sons Ltd.

Why and How We Made a Problem Oriented AV Teaching Unit for Chemistry Students.

ERIC Educational Resources Information Center

Mulder, T. H. M.; Verdonk, A. H.

1984-01-01

Describes an audiovisual teaching unit on the chemical laboratory technique of recrystallization which was developed along problem-solving lines and based on observation of student laboratory behavior. Discussion includes usual procedures for developing such units, how this unit solves problems typically associated with teaching, and its general…

LACIE large area acreage estimation. [United States of America

NASA Technical Reports Server (NTRS)

Chhikara, R. S.; Feiveson, A. H. (Principal Investigator)

1979-01-01

A sample wheat acreage for a large area is obtained by multiplying its small grains acreage estimate as computed by the classification and mensuration subsystem by the best available ratio of wheat to small grains acreages obtained from historical data. In the United States, as in other countries with detailed historical data, an additional level of aggregation was required because sample allocation was made at the substratum level. The essential features of the estimation procedure for LACIE countries are included along with procedures for estimating wheat acreage in the United States.

Development of a diagnosis- and procedure-based risk model for 30-day outcome after pediatric cardiac surgery.

PubMed

Crowe, Sonya; Brown, Kate L; Pagel, Christina; Muthialu, Nagarajan; Cunningham, David; Gibbs, John; Bull, Catherine; Franklin, Rodney; Utley, Martin; Tsang, Victor T

2013-05-01

The study objective was to develop a risk model incorporating diagnostic information to adjust for case-mix severity during routine monitoring of outcomes for pediatric cardiac surgery. Data from the Central Cardiac Audit Database for all pediatric cardiac surgery procedures performed in the United Kingdom between 2000 and 2010 were included: 70% for model development and 30% for validation. Units of analysis were 30-day episodes after the first surgical procedure. We used logistic regression for 30-day mortality. Risk factors considered included procedural information based on Central Cardiac Audit Database "specific procedures," diagnostic information defined by 24 "primary" cardiac diagnoses and "univentricular" status, and other patient characteristics. Of the 27,140 30-day episodes in the development set, 25,613 were survivals, 834 were deaths, and 693 were of unknown status (mortality, 3.2%). The risk model includes procedure, cardiac diagnosis, univentricular status, age band (neonate, infant, child), continuous age, continuous weight, presence of non-Down syndrome comorbidity, bypass, and year of operation 2007 or later (because of decreasing mortality). A risk score was calculated for 95% of cases in the validation set (weight missing in 5%). The model discriminated well; the C-index for validation set was 0.77 (0.81 for post-2007 data). Removal of all but procedural information gave a reduced C-index of 0.72. The model performed well across the spectrum of predicted risk, but there was evidence of underestimation of mortality risk in neonates undergoing operation from 2007. The risk model performs well. Diagnostic information added useful discriminatory power. A future application is risk adjustment during routine monitoring of outcomes in the United Kingdom to assist quality assurance. Copyright © 2013 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Large Area Crop Inventory Experiment (LACIE). Second-generation sampling strategy evaluation report. [Kansas, North Dakota, and U.S.S.R.

NASA Technical Reports Server (NTRS)

Basu, J. P. (Principal Investigator); Dragich, S. M.; Mcguigan, D. P.

1978-01-01

The author has identified the following significant results. The stratification procedure in the new sampling strategy for LACIE included: (1) correlation test results indicating that an agrophysical stratum may be homogeneous with respect to agricultural density, but not with respect to wheat density; and (2) agrophysical unit homogeneity test results indicating that with respect to agricultural density many agrophysical units are not homogeneous, but removal of one or more refined strata from any such current agrophysical unit can make the strata homogeneous. The apportioning procedure results indicated that the current procedure is not performing well and that the apportioned estimates of refined strata wheat area are often unreliable.

Nuclear Proliferation: A Unit for Study.

ERIC Educational Resources Information Center

Fernekes, William R.

1990-01-01

Using Argentina as a sample case study, presents a classroom unit designed to explain the implications for world peace of nuclear weapons development. Employs a policy analysis model to make an indepth examination of the values underlying all government policy decisions. Includes unit topics and procedures for the exercise. (NL)

Management of cystinuric patients: an observational, retrospective, single-centre analysis.

PubMed

Ahmed, Kamran; Khan, Mohammad Shamim; Thomas, Kay; Challacombe, Ben; Bultitude, Matthew; Glass, Jonathan; Tiptaft, Richard; Dasgupta, Prokar

2008-01-01

A critical appraisal of the management of patients with cystine stones treated in our unit in the past 6 years and to analyze the outcome of multimodality therapies. An observational, single-centre retrospective study. We reviewed the records of all patients with stones referred to our centre over a 6-year period from 1998 to 2005. Data recorded included demographic details, medical therapies received/prescribed, compliance with medical therapies, mode of treatment, stone clearance and any recurrence during this period of study. A total of 30 cystinuric patients were treated in our institution over the period of 6 years from 1998 to early 2005. Of these 16 were males and 14 females with an average age at last follow-up of 39 years (range 15-70). Two patients were successfully managed medically. The remaining patients (n = 28) underwent a total of 237 procedures (pre- and postreferral to our unit), with an average of 7.9 procedures per patient for 126 stone episodes (4.2 episodes/patient). The modes of treatment included extracorporeal shockwave lithotripsy (n = 143), ureterorenoscopy and intracorporeal lithotripsy (n = 50), percutaneous nephrolithotomy (n = 28) and open procedures (n = 16). Two patients needed open surgery at our unit. Prior to referral to our dedicated unit, patients had received treatment with extracorporeal shockwave lithotripsy (multiple sessions), ureteroscopy (n = 14), percutaneous nephrolithotomy (n = 4) and open stone removal (n = 14). Most of the stones at our unit were managed using minimally invasive therapies. Compliance of cystinuric patients with medical treatment is often poor and patients experience recurrent stone episodes requiring multiple interventions. Modern management of cystine calculi should be with staged minimally invasive procedures to avoid the complications of multiple open procedures wherever possible along with appropriate medical prophylaxis.

40 CFR 61.355 - Test methods, procedures, and compliance provisions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... entering an enhanced biodegradation unit, as defined in § 61.348(b)(2)(ii)(B), shall not be included in the... are met: (i) The benzene concentration for each waste stream entering the enhanced biodegradation unit...

40 CFR 61.355 - Test methods, procedures, and compliance provisions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... entering an enhanced biodegradation unit, as defined in § 61.348(b)(2)(ii)(B), shall not be included in the... are met: (i) The benzene concentration for each waste stream entering the enhanced biodegradation unit...

40 CFR 61.355 - Test methods, procedures, and compliance provisions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... entering an enhanced biodegradation unit, as defined in § 61.348(b)(2)(ii)(B), shall not be included in the... are met: (i) The benzene concentration for each waste stream entering the enhanced biodegradation unit...

40 CFR 61.355 - Test methods, procedures, and compliance provisions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... entering an enhanced biodegradation unit, as defined in § 61.348(b)(2)(ii)(B), shall not be included in the... are met: (i) The benzene concentration for each waste stream entering the enhanced biodegradation unit...

40 CFR 61.355 - Test methods, procedures, and compliance provisions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... entering an enhanced biodegradation unit, as defined in § 61.348(b)(2)(ii)(B), shall not be included in the... are met: (i) The benzene concentration for each waste stream entering the enhanced biodegradation unit...

Modern Problems: Sociology Units. An Experimental Program for Grade 12.

ERIC Educational Resources Information Center

Carlson, Marshall; Fennig, Lois

GRADES OR AGES: Grade 12. SUBJECT MATTER: Sociology; modern problems. ORGANIZATION AND PHYSICAL APPEARANCE: The guide contains two units, one on the problems of minority groups and the other on social pathology. Sub-sections of unit 2 include crime and criminals, criminal investigation, gun control, U.S. criminal law, criminal procedure,…

A real world analysis of payment per unit time in a Maryland Vascular Practice.

PubMed

Martin, John D; Warble, Patricia B; Hupp, Jon A; Mapes, Jerry E; Stanziale, Stephen F; Weiss, Linda L; Schiller, Toni B; Hanson, Louise A

2010-10-01

In 1992, Centers for Medicare and Medicaid Services instituted the Resource Based Relative Value Scale (RBRVS) system to determine physician reimbursement. Relative value units (RVU) were assigned to each Current Procedure Terminology (CPT) code and intended to reflect the time and intensity of work. Little data exist correlating actual procedural and clinical time with respect to reimbursement within the RVU value system. The purpose of this study was to determine how well this system distributes payments per hour for hospital-based procedures in a single vascular practice in the state of Maryland between July 1, 2008 and June 30, 2009. As part of an ongoing prospective outcomes program, procedural times for all vascular procedures (time into until time out of room) were recorded. Fifteen minutes were added for administrative functions on procedural day, each hospital day, and office visits during the global period. The combination of all times was reflected in the total care time (TCT) for each procedure. We recorded all physician fees collected for each procedure. This total fee collected for each procedure was then divided by the TCT to determine the procedure-specific payment per unit time. All similar procedures were grouped together and the average reimbursement per procedure was reported. Data was collected on all 1103 procedures performed during this period. Insurance carrier distribution was 75% Medicare and 25% private insurance. The average reimbursement was $316/hour for open procedures and $556/hour for endovascular. Higher reimbursing procedures included visceral endovascular procedures ($701/hour) and caval filters ($751/hour). Lower reimbursing procedures included lower extremity bypass ($292/hour), dialysis access ($268/hour) and lower extremity amputations ($223/hour). Striking was the difference between payment based on approach for similar conditions. Reimbursement for carotid stent vs carotid endarterectomy was $643/hour vs $383/hour, endovascular abdominal aortic aneurysm (AAA) repair vs open $593/hour vs $359/hour. This unique study demonstrates a "real world" experience of reimbursement per unit time and raises questions as to the validity of the RBRVS process. The disparity between payments for open and endovascular repair of similar conditions are typical of this inequality. These data do not reflect the intangible time of operative planning, administrative matters, or overhead, and these factors must be considered when interpreting this data. Regardless, this study suggests that capturing detailed financial data is possible and is a more accurate source for future discussions on reimbursement. Copyright © 2010 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

21 CFR 211.160 - General requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... drafted by the appropriate organizational unit and reviewed and approved by the quality control unit. The...: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS Laboratory Controls § 211.160... procedures, or other laboratory control mechanisms required by this subpart, including any change in such...

47 CFR 1.917 - Who may sign applications.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Wireless Radio Services... territories of the United States, their political subdivisions, the District of Columbia, and units of local... administrative sanctions, including revocation of station license pursuant to 312(a)(1) of the Communications Act...

Epidemiology and management of painful procedures in children in Canadian hospitals

PubMed Central

Stevens, Bonnie J.; Abbott, Laura K.; Yamada, Janet; Harrison, Denise; Stinson, Jennifer; Taddio, Anna; Barwick, Melanie; Latimer, Margot; Scott, Shannon D.; Rashotte, Judith; Campbell, Fiona; Finley, G. Allen

2011-01-01

Background Children being cared for in hospital undergo multiple painful procedures daily. However, little is known about the frequency of these procedures and associated interventions to manage the pain. We undertook this study to determine, for children in Canadian hospitals, the frequency of painful procedures, the types of pain management interventions associated with painful procedures and the influence of the type of hospital unit on procedural pain management. Methods We reviewed medical charts for infants and children up to 18 years of age who had been admitted to 32 inpatient units at eight Canadian pediatric hospitals between October 2007 and April 2008. We recorded all of the painful procedures performed and the pain management interventions that had been implemented in the 24-hour period preceding data collection. We performed descriptive and comparative (analysis of variance, χ2) analyses. Results Of the 3822 children included in the study, 2987 (78.2%) had undergone at least one painful procedure in the 24-hour period preceding data collection, for a total of 18 929 painful procedures (mean 6.3 per child who had any painful procedure). For 2334 (78.1%) of the 2987 children who had a painful procedure, a pain management intervention in the previous 24 hours was documented in the chart: 1980 (84.8%) had a pharmacologic intervention, 609 (26.1%) a physical intervention, 584 (25.0%) a psychologic intervention and 753 (32.3%) a combination of interventions. However, for only 844 (28.3%) of the 2987 children was one or more pain management interventions administered and documented specifically for a painful procedure. Pediatric intensive care units reported the highest proportion of painful procedures and analgesics administered. Interpretation For less than one-third of painful procedures was there documentation of one or more specific pain management interventions. Strategies for implementing changes in pain management must be tailored to the type of hospital unit. PMID:21464171

Periscopic Spine Surgery.

DTIC Science & Technology

2000-02-01

radiation medicine, the neurosurgery intensive care unit (ICU), and the pediatrics ICU [Geary 1999a]. The major procedures impacted are spine tumor...radiation medicine, and the pediatric intensive care unit . Hardware and software problems addressed included modifications of patient positioning...planning. Attempts have been made to link mechanical tissue properties to cellular interaction through electrical impedance [7] and to Hounsfield units

Health Occupations Education. Units of Instruction. Teacher's Guide. Volume II.

ERIC Educational Resources Information Center

Williams, Catherine

This manual is the second part of a two-volume teacher's guide to a series of instructional units for use in health occupations education programs in Texas. Covered in the 10 units included in this volume are the following topics: special procedures (administering oxygen to patients; using elastic bandages; assisting with postural drainage; and…

UNIT 10.7 Electroblotting from Polyacrylamide Gels

PubMed Central

Goldman, Aaron; Speicher, David W.

2015-01-01

Transferring proteins from polyacrylamide gels onto retentive membranes is now primarily used for immunoblotting. A second application that was quite common up to about a decade ago was electroblotting of proteins for N-terminal and internal sequencing using Edman chemistry. This unit contains procedures for electroblotting proteins from polyacrylamide gels onto a variety of membranes, including polyvinylidene difluoride (PVDF) and nitrocellulose. In addition to the commonly used tank or wet transfer system, protocols are provided for electroblotting using semidry and dry systems. This unit also describes procedures for eluting proteins from membranes using detergents or acidic extraction with organic solvents for specialized applications. PMID:26521711

Stationary Engineering, Environmental Control, Refrigeration. Science Manual I.

ERIC Educational Resources Information Center

Steingress, Frederick M.; And Others

The student materials present lessons about occupations related to environmental control, stationary engineering, and refrigeration. Included are 18 units organized by objective, information, reference, procedure, and assignment. Each lesson involves concrete trade experience where science is applied. Unit titles are: safety and housekeeping,…

Australia: An Instructional Unit for Elementary Grades.

ERIC Educational Resources Information Center

Duea, Joan; And Others

Designed to provide elementary teachers with materials for the study of Australia, this unit contains 19 lessons that include objectives, materials, procedures, suggested extension activities, and answer keys where needed. Following the 19 lessons are blackline masters for teacher transparencies, student worksheets, and extension activities. A…

76 FR 39843 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-07

...: National Institute of Standards and Technology (NIST). Title: Usage of Elevators for Occupant Evacuation...- story buildings in the United States during fire emergencies. This research aims to summarize emergency... emergency procedures for multi-story buildings) from existing buildings in the United States, including...

National Interim Energy-Consumption Survey. Part VI. Energy assessment

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

Not Available

The goal of energy assessment of the housing unit is to obtain physical information which can be combined with other survey results to give a more complete picture of the residential environment. A limited pretest of an energy assessment procedure was carried out in April-June 1979 with a subsample of 44 households that had been originally interviewed in the National Interim Energy Consumption Survey. In order to gain experience under a variety of environmental conditions, the pretest sites included locations in the Northeast, North Central, and South regions. As developed for the pretest, the energy assessment was a 90-minute inspectionmore » of the housing unit by a trained technician. Data collected during the inspection included square footage of the unit; age, make, and characteristics of appliances; insulation characteristics, characteristics of siting and apertures; and detailed information on the heating and cooling systems in the unit. The report describes the data collection procedures for the pretest.« less

Housekeeping Management Assistant Manual for Training of the Mentally Retarded.

ERIC Educational Resources Information Center

Texas Tech Univ., Lubbock. Research and Training Center in Mental Retardation.

Presented is an instructional guide for teaching mentally retarded persons to become housekeeping assistants. Listed are tasks, objectives, and background information for the following six units: general safety procedures; daily duties (general cleaning, use of supply carts, and bathroom cleaning); laundry procedures (including use of washer and…

PURIFICATION OF RAT LEYDIG CELLS: INCREASED YIELDS AFTER UNIT-GRAVITY SEDIMENTATION OF COLLAGENASE-DISPERSED INTERSTITIAL CELLS

EPA Science Inventory

Abstract

Procedures for purification of Leydig cells have facilitated studies of their regulatory biology. A multistep procedure, that includes a filtration with nylon mesh (100 micron pore size) to separate interstitial cells from the seminiferous tubules, combining centr...

Postprocedural pain in shoulder arthrography: differences between using preservative-free normal saline and normal saline with benzyl alcohol as an intraarticular contrast diluent.

PubMed

Storey, Troy F; Gilbride, George; Clifford, Kelly

2014-11-01

The purpose of this study was to prospectively evaluate the effect of benzyl alcohol, a common preservative in normal saline, on postprocedural pain after intraarticular injection for direct shoulder MR arthrography. From April 2011 through January 2013, 138 patients underwent direct shoulder MR arthrography. Using the Wong-Baker Faces Pain Scale, patients were asked to report their shoulder pain level immediately before and immediately after the procedure and then were contacted by telephone 6, 24, and 48 hours after the procedure. Fourteen patients did not receive the prescribed amount of contrast agent for diagnostic reasons or did not complete follow-up. Sixty-two patients received an intraarticular solution including preservative-free normal saline (control group) and 62 patients received an intraarticular solution including normal saline with 0.9% benzyl alcohol as a contrast diluent (test group). Patients were randomized as to which intraarticular diluent they received. Fluoroscopic and MR images were reviewed for extracapsular contrast agent administration or extravasation, full-thickness rotator cuff tears, and adhesive capsulitis. The effect of preservative versus control on pain level was estimated with multiple regression, which included time after procedure as the covariate and accounted for repeated measures over patients. Pain scale scores were significantly (p = 0.0382) higher (0.79 units; 95% CI, 0.034-1.154) with benzyl alcohol preservative compared with control (saline). In both study arms, the pain scale scores decreased slightly after the procedure, increased by roughly 1 unit over baseline for the test group and 0.3 unit over baseline for the control group by 6 hours after the procedure, were 0.50 unit over baseline for the test group and 0.12 unit over baseline for the control group at 24 hours, then fell to be slightly greater than baseline at 48 hours with benzyl alcohol and slightly less than baseline without benzyl alcohol. These trends over time were highly significant (p < 0.0001). Shoulder arthrography is often associated with postprocedural discomfort that begins immediately after the procedure and resolves by 48 hours. There is significantly increased patient discomfort at 6 and 48 hours when using normal saline preserved with benzyl alcohol as a diluent compared with using normal saline without preservative as a diluent.

30 CFR 33.6 - Application procedures and requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) Written evidence of the laboratory's independence and current recognition by a laboratory accrediting... the electrical parts of units designed to operate as face equipment (see § 33.38) in accordance with... combination unit that includes electrical parts, and is designed to operate as electric face equipment, as...

30 CFR 33.6 - Application procedures and requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) Written evidence of the laboratory's independence and current recognition by a laboratory accrediting... the electrical parts of units designed to operate as face equipment (see § 33.38) in accordance with... combination unit that includes electrical parts, and is designed to operate as electric face equipment, as...

30 CFR 33.6 - Application procedures and requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) Written evidence of the laboratory's independence and current recognition by a laboratory accrediting... the electrical parts of units designed to operate as face equipment (see § 33.38) in accordance with... combination unit that includes electrical parts, and is designed to operate as electric face equipment, as...

30 CFR 33.6 - Application procedures and requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) Written evidence of the laboratory's independence and current recognition by a laboratory accrediting... the electrical parts of units designed to operate as face equipment (see § 33.38) in accordance with... combination unit that includes electrical parts, and is designed to operate as electric face equipment, as...

An audit of bronchoscopy practice in the United Kingdom: a survey of adherence to national guidelines

PubMed Central

Honeybourne, D.; Neumann, C. S.

1997-01-01

BACKGROUND: Both patient and staff safety are of major importance during the procedure of fibreoptic bronchoscopy. Patient safety depends partly on adequate disinfection of instruments and accessories used as well as careful monitoring during the procedure. Adequate facilities, manpower and training are also essential. Staff safety depends partly on adequate procedures to minimise any risks of sensitisation to agents such as glutaraldehyde. An audit was carried out of bronchoscopy procedures in hospitals in the UK and the findings were compared with published guidelines on good practice and clinical consensus. METHODS: A postal questionnaire was sent to 218 bronchoscopy units in the UK. Findings were then compared with published evidence of good practice in the areas of disinfection, including the use of glutaraldehyde, patient monitoring, manpower, facilities, and training. RESULTS: A 73% response rate was obtained. Recommended minimum disinfection times before and after routine bronchoscopies were not achieved by 35% of units. No disinfection was carried out in 34% of units before emergency bronchoscopies and in 19% of units after suspected cases of tuberculosis. Adequate rinsing of the bronchoscope with sterile or filtered water was not carried out by 43% of units. Contrary to recommendations, 31% of departments were still using glutaraldehyde in the patient examination room and inadequate room ventilation was common. Protective clothing was often not worn by staff during bronchoscopy. Inadequate intravenous access and use of supplementary oxygen were found in many units. Practice standards were higher in departments where dedicated bronchoscopy/endoscopy units of the hospital were used, and also where staff had been on external training courses. CONCLUSIONS: This audit has shown that many units do not adhere to guidelines on disinfection procedures and patient monitoring. Unnecessary potential risks due to staff exposure to glutaraldehyde were apparent. National guidelines on good practice are not being followed in areas which may potentially affect patient and staff safety. 


 PMID:9337830

30 CFR 33.6 - Application procedures and requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... Department of Labor, Mine Safety and Health Administration, Approval and Certification Center, 765 Technology... the electrical parts of units designed to operate as face equipment (see § 33.38) in accordance with... combination unit that includes electrical parts, and is designed to operate as electric face equipment, as...

Project Physics Teacher Guide 3, The Triumph of Mechanics.

ERIC Educational Resources Information Center

Harvard Univ., Cambridge, MA. Harvard Project Physics.

Teaching procedures of Project Physics Unit 3 are presented to help teachers make effective use of learning materials. Unit contents are discussed in connection with teaching aid perspective, multi-media schedules, schedule blocks, and resource charts. Brief analyses are made for transparencies, 16mm films, and reader articles. Included is…

Project Physics Teacher Guide 2, Motion in the Heavens.

ERIC Educational Resources Information Center

Harvard Univ., Cambridge, MA. Harvard Project Physics.

Teaching procedures of Project Physics Unit 2 are presented to help teachers make effective use of learning materials. The unit contents are discussed in connection with teaching aid perspectives, multi-media schedules, schedule blocks, and resource charts. Analyses are made for transparencies, 16mm films, and reader articles. Included is…

Project Physics Teacher Guide 6, The Nucleus.

ERIC Educational Resources Information Center

Harvard Univ., Cambridge, MA. Harvard Project Physics.

Teaching procedures of Project Physics Unit 6 are presented to help teachers make effective use of learning materials. Unit contents are discussed in connection with teaching aid lists, multi-media schedules, schedule blocks, and resource charts. Brief summaries are made for transparencies, 16mm films, and reader articles. Included is information…

40 CFR 86.1838-01 - Small volume manufacturer certification procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... aggregated relationship, then each manufacturer may certify whole test groups whose total aggregated sales... sales in all states and territories of the United States, including all vehicles and engines imported... the aggregated sales in all states and territories of the United States of the manufacturer, as...

40 CFR 86.1838-01 - Small volume manufacturer certification procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... aggregated relationship, then each manufacturer may certify whole test groups whose total aggregated sales... sales in all states and territories of the United States, including all vehicles and engines imported... the aggregated sales in all states and territories of the United States of the manufacturer, as...

Project Physics Teacher Guide 4, Light and Electromagnetism.

ERIC Educational Resources Information Center

Harvard Univ., Cambridge, MA. Harvard Project Physics.

Teaching procedures of Project Physics Unit 4 are presented to help teachers make effective use of learning materials. Unit contents are discussed in connection with teaching aid lists, multi-media schedules, schedule blocks, and resources charts. Brief summaries are made for transparencies, 16mm films, and reader articles. Included is information…

Marine Flora and Fauna of the Northeastern United States. Echinodermata: Holothuroidea.

ERIC Educational Resources Information Center

Pawson, David L.

This report is part of a subseries entitled "Marine Flora and Fauna of the Northeastern United States" which is designed for use by biology students, biologists, biological oceanographers and informed laymen. Contents of this report include: (1) Introduction; (2) Morphology; (3) Systematic Characters; (4) Examination Procedures; (5)…

Elections: An Instructional Unit for Elementary Grades.

ERIC Educational Resources Information Center

McClain, Janet; And Others

In order to increase students' awareness of their place in the nation's political life, this unit introduces young children to the electoral process. Each lesson includes objectives, materials, procedures, and supplementary materials that can be duplicated for student use. The first five lessons are designed to improve student awareness of…

Topics in Mathematics.

ERIC Educational Resources Information Center

Posey, Johnsie Jo, Ed.; And Others

This manual is a collection of materials and teaching strategies to motivate the development of mathematical ideas in secondary school mathematics programs or in beginning college mathematics programs. The unit is written for the instructor with step-by-step procedures including lists of needed materials. The exercises in this unit also appear in…

GUIDE FOR SOCIAL STUDIES AND SCIENCE-HEALTH, FIRST YEAR. JUNIOR HIGH SCHOOL SPECIAL CURRICULUM.

ERIC Educational Resources Information Center

STINCHCOMB, KOMA D.; AND OTHERS

THIS CURRICULUM GUIDE FOR JUNIOR HIGH EDUCABLE MENTALLY HANDICAPPED STUDENTS PROVIDES INFORMATION ON TEACHING PROCEDURES, SUGGESTIONS FOR PLANNING SUPPLEMENTAL UNITS, TYPES OF LESSONS, AND EVALUATION. INDIVIDUAL UNITS INCLUDE THE INFORMATION CONTENT, SUGGESTIONS FOR BACKGROUND STUDY, SPECIFIC TEACHING PLANS, DISCUSSION QUESTIONS, ASSIGNMENTS,…

Federal standards and procedures for the National Watershed Boundary Dataset (WBD)

USGS Publications Warehouse

,; ,; ,

2013-01-01

The Watershed Boundary Dataset (WBD) is a comprehensive aggregated collection of hydrologic unit data consistent with the national criteria for delineation and resolution. This document establishes Federal standards and procedures for creating the WBD as seamless and hierarchical hydrologic unit data, based on topographic and hydrologic features at a 1:24,000 scale in the United States, except for Alaska at 1:63,360 scale, and 1:25,000 scale in the Caribbean. The data within the WBD have been reviewed for certification through the 12-digit hydrologic unit for compliance with the criteria outlined in this document. Any edits to certified data will be reviewed against this standard prior to inclusion. Although not required as part of the framework WBD, the guidelines contain details for compiling and delineating the boundaries of two additional levels, the 14- and 16-digit hydrologic units, as well as the use of higher resolution base information to improve delineations. The guidelines presented herein are designed to enable local, regional, and national partners to delineate hydrologic units consistently and accurately. Such consistency improves watershed management through efficient sharing of information and resources and by ensuring that digital geographic data are usable with other related Geographic Information System (GIS) data.Terminology, definitions, and procedural information are provided to ensure uniformity in hydrologic unit boundaries, names, and numerical codes. Detailed standards and specifications for data are included. The document also includes discussion of objectives, communications required for revising the data resolution in the United States and the Caribbean, as well as final review and data-quality criteria. Instances of unusual landforms or artificial features that affect the hydrologic units are described with metadata standards. Up-to-date information and availability of the hydrologic units are listed at http:// www.nrcs.usda.gov/wps/portal/nrcs/detail/national/technical/ nra/dma/?&cid=nrcs143_021630/.

Federal standards and procedures for the National Watershed Boundary Dataset (WBD)

USGS Publications Warehouse

U.S. Geological Survey and U.S. Department of Agriculture, Natural Resources Conservation Service

2012-01-01

The Watershed Boundary Dataset (WBD) is a comprehensive aggregated collection of hydrologic unit data consistent with the national criteria for delineation and resolution. This document establishes Federal standards and procedures for creating the WBD as seamless and hierarchical hydrologic unit data, based on topographic and hydrologic features at a 1:24,000 scale in the United States, except for Alaska at 1:63,360 scale, and 1:25,000 scale in the Caribbean. The data within the WBD have been reviewed for certification through the 12-digit hydrologic unit for compliance with the criteria outlined in this document. Any edits to certified data will be reviewed against this standard prior to inclusion. Although not required as part of the framework WBD, the guidelines contain details for compiling and delineating the boundaries of two additional levels, the 14- and 16-digit hydrologic units, as well as the use of higher resolution base information to improve delineations. The guidelines presented herein are designed to enable local, regional, and national partners to delineate hydrologic units consistently and accurately. Such consistency improves watershed management through efficient sharing of information and resources and by ensuring that digital geographic data are usable with other related Geographic Information System (GIS) data. Terminology, definitions, and procedural information are provided to ensure uniformity in hydrologic unit boundaries, names, and numerical codes. Detailed standards and specifications for data are included. The document also includes discussion of objectives, communications required for revising the data resolution in the United States and the Caribbean, as well as final review and data-quality criteria. Instances of unusual landforms or artificial features that affect the hydrologic units are described with metadata standards. Up-to-date information and availability of the hydrologic units are listed at http://www.nrcs.usda.gov/wps/portal/nrcs/detail/national/water/watersheds/?cid=nrcs143_021630/.

HIPPO Unit Commitment Version 1

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

2017-01-17

Developed for the Midcontinent Independent System Operator, Inc. (MISO), HIPPO-Unit Commitment Version 1 is for solving security constrained unit commitment problem. The model was developed to solve MISO's cases. This version of codes includes I/O module to read in MISO's csv files, modules to create a state-based mixed integer programming formulation for solving MIP, and modules to test basic procedures to solve MIP via HPC.

Handwashing with soap or alcoholic solutions? A randomized clinical trial of its effectiveness.

PubMed

Zaragoza, M; Sallés, M; Gomez, J; Bayas, J M; Trilla, A

1999-06-01

The effectiveness of an alcoholic solution compared with the standard hygienic handwashing procedure during regular work in clinical wards and intensive care units of a large public university hospital in Barcelona was assessed. A prospective, randomized clinical trial with crossover design, paired data, and blind evaluation was done. Eligible health care workers (HCWs) included permanent and temporary HCWs of wards and intensive care units. From each category, a random sample of persons was selected. HCWs were randomly assigned to regular handwashing (liquid soap and water) or handwashing with the alcoholic solution by using a crossover design. The number of colony-forming units on agar plates from hands printing in 3 different samples was counted. A total of 47 HCWs were included. The average reduction in the number of colony-forming units from samples before handwashing to samples after handwashing was 49.6% for soap and water and 88.2% for the alcoholic solution. When both methods were compared, the average number of colony-forming units recovered after the procedure showed a statistically significant difference in favor of the alcoholic solution (P <.001). The alcoholic solution was well tolerated by HCWs. Overall acceptance rate was classified as "good" by 72% of HCWs after 2 weeks use. Of all HCWs included, 9.3% stated that the use of the alcoholic solution worsened minor pre-existing skin conditions. Although the regular use of hygienic soap and water handwashing procedures is the gold standard, the use of alcoholic solutions is effective and safe and deserves more attention, especially in situations in which the handwashing compliance rate is hampered by architectural problems (lack of sinks) or nursing work overload.

Chapter 2. Surge capacity and infrastructure considerations for mass critical care. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster.

PubMed

Hick, John L; Christian, Michael D; Sprung, Charles L

2010-04-01

To provide recommendations and standard operating procedures for intensive care unit (ICU) and hospital preparations for a mass disaster or influenza epidemic with a specific focus on surge capacity and infrastructure considerations. Based on a literature review and expert opinion, a Delphi process was used to define the essential topics including surge capacity and infrastructure considerations. Key recommendations include: (1) hospitals should increase their ICU beds to the maximal extent by expanding ICU capacity and expanding ICUs into other areas; (2) hospitals should have appropriate beds and monitors for these expansion areas; hospitals should develop contingency plans at the facility and government (local, state, provincial, national) levels to provide additional ventilators; (3) hospitals should develop a phased staffing plan (nursing and physician) for ICUs that provides sufficient patient care supervision during contingency and crisis situations; (4) hospitals should provide expert input to the emergency management personnel at the hospital both during planning for surge capacity as well as during response; (5) hospitals should assure that adequate infrastructure support is present to support critical care activities; (6) hospitals should prioritize locations for expansion by expanding existing ICUs, using postanesthesia care units and emergency departments to capacity, then step-down units, large procedure suites, telemetry units and finally hospital wards. Judicious planning and adoption of protocols for surge capacity and infrastructure considerations are necessary to optimize outcomes during a pandemic.

Procedural Pain: Systematic Review of Parent Experiences and Information Needs.

PubMed

Gates, Allison; Shave, Kassi; Featherstone, Robin; Buckreus, Kelli; Ali, Samina; Scott, Shannon D; Hartling, Lisa

2018-06-01

Parents wish to reduce their child's pain during medical procedures but may not know how to do so. We systematically reviewed the literature on parents' experiences and information needs related to managing their child's pain for common medical procedures. Of 2678 records retrieved through database searching, 5 were included. Three additional records were identified by scanning reference lists. Five studies were qualitative, and 3 were quantitative. Most took place in North America or Europe (n = 7) and described neonatal intensive care unit experiences (n = 5). Procedures included needle-related medical procedures (eg, venipuncture, phlebotomy, intravenous insertion), sutures, and wound repair and treatment, among others. Generally, parents desired being present during procedures, wanted to remain stoic for their child, and thought that information would be empowering and relieve stress but felt unsupported in taking an active role. Supporting and educating parents may empower them to lessen pain for their children while undergoing medical procedures.

NASA three-laser airborne differential absorption lidar system electronics

NASA Technical Reports Server (NTRS)

Allen, R. J.; Copeland, G. D.

1984-01-01

The system control and signal conditioning electronics of the NASA three laser airborne differential absorption lidar (DIAL) system are described. The multipurpose DIAL system was developed for the remote measurement of gas and aerosol profiles in the troposphere and lower stratosphere. A brief description and photographs of the majority of electronics units developed under this contract are presented. The precision control system; which includes a master control unit, three combined NASA laser control interface/quantel control units, and three noise pulse discriminator/pockels cell pulser units; is described in detail. The need and design considerations for precision timing and control are discussed. Calibration procedures are included.

Celebrating the Constitution: An Instructional Unit for Elementary Grades.

ERIC Educational Resources Information Center

McClain, Janet; And Others

Because attaining citizenship skills remains the principal goal of social studies, this unit was designed to highlight the founding of the U.S. Constitution and the Bill of Rights in a manner appropriate to both primary and intermediate elementary children. Each lesson includes objectives, materials, and procedures, as well as supplementary…

Modules in Agricultural Education for Agricultural Production.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Bureau of Occupational and Career Curriculum Development.

Each of the 61 modules in this packet contains a brief description of the module contents, a list of the major division of units, the overall objectives, objectives by units, content outline, and suggested teaching method, student application activities, and evaluation procedures. A list of resource materials is also included for each. Some of the…

Project Physics Teacher Guide 5, Models of the Atom.

ERIC Educational Resources Information Center

Harvard Univ., Cambridge, MA. Harvard Project Physics.

Teaching procedures of Project Physics Unit 5 are presented to help teachers make effective use of learning materials. Unit contents are discussed in connection with teaching aid lists, multi-media schedules, schedule blocks, and resource charts. Brief summaries are made for transparencies, 16mm films, and reader articles. Included is information…

Process Design Manual for Land Treatment of Municipal Wastewater.

ERIC Educational Resources Information Center

Crites, R.; And Others

This manual presents a procedure for the design of land treatment systems. Slow rate, rapid infiltration, and overland flow processes for the treatment of municipal wastewaters are given emphasis. The basic unit operations and unit processes are discussed in detail, and the design concepts and criteria are presented. The manual includes design…

Differences and Similarities between School Principals in Costa Rica and the United States

ERIC Educational Resources Information Center

Ballestero, Victor; Wright, Sam

2008-01-01

The need for effective school leadership is a global concern. This paper provides a comparison of the school principal in Costa Rica to the United States. Differences and similarities are described for principals in both nations. Major differences for principals in Costa Rica include administrative salaries, selection procedures, induction, no…

Processing United Nations Documents in the University of Michigan Library.

ERIC Educational Resources Information Center

Stolper, Gertrude

This guide provides detailed instructions for recording documents in the United Nations (UN) card catalog which provides access to the UN depository collection in the Harlan Hatcher Graduate Library at the University of Michigan. Procedures for handling documents when they are received include stamping, counting, and sorting into five categories:…

Purification of NAD glycohydrolase from Agkistrodon acutus venom.

PubMed

Wu, Shuang Ding; Liu, Yanli; Xu, Xiaolong; Zhu, Zhengang

2002-07-01

NAD glycohydrolase (NADase) from Agkistrodon acutus venom was purified to electrophoretic homogeneity by a fast, reproducible 3-step procedure including Q Sepharose Fast Flow, Superdex 75, and Mono S column chromatography. This new procedure gave a 15.6-fold purification with a recovery yield of 7.9% and a specific activity of 12.8 units/mg.

Guia para su incorporacion a los Estados Unidos de America (A Guide to Resettlement in the United States. Spanish).

ERIC Educational Resources Information Center

Center for Applied Linguistics, Washington, DC. Refugee Service Center.

This resettlement guide, entirely in Spanish, describes the initial stage of resettlement and the processes that refugees undergo as new arrivals. Subjects covered in this guide include pre-arrival procedures, admissions criteria, immigrant's statement of understanding, travel costs and U.S. Customs; resettlement procedures, immigrants'…

Law Enforcement Officer Training, Basic Course. A Unit of the Ohio Law Enforcement Officers' Training Program. Instructor's Manual.

ERIC Educational Resources Information Center

Ohio State Dept. of Education, Columbus. Trade and Industrial Education Service.

Developed by the State Division of Vocational Education with the help of qualified consultants, this instructor's manual is for use in teaching the fundamental law enforcement procedures. Suggested time allotment, teaching guides, and presentation methods are included for each of the training procedures. Line drawings and photographs supplement…

78 FR 12365 - License Amendment Request for United Nuclear Corporation, Church Rock Mill-License No. SUA-1475

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-22

.... Electronic Submissions (E-Filing) All documents filed in NRC adjudicatory proceedings, including a request... NRC E-Filing rule (72 FR 49139; August 28, 2007). The E-Filing process requires participants to submit... accordance with the procedures described below. To comply with the procedural requirements of E-Filing, at...

A Kid Like Me across the Sea: A Look into the World of a German Child. Social Studies, Grades Kindergarten-Grade 3. Update 2002.

ERIC Educational Resources Information Center

Blankenship, Glen

This instructional unit about Germany is designed for primary students and may be integrated into the existing curriculum or used as a stand-alone unit. Each lesson begins with an outline for teaching that includes instructional objectives, a list of needed materials, and a sequenced list of procedures for implementing the lesson. The unit is…

Let's Explore Aviation

ERIC Educational Resources Information Center

Arvin, Jean

1977-01-01

Presents an intermediate level social studies unit dealing with air education, social aspects of aviation, and the importance of aviation to industry and transportation. Includes objectives, twelve activities, and evaluative procedures. (SL)

21 CFR 876.4300 - Endoscopic electrosurgical unit and accessories.

Code of Federal Regulations, 2011 CFR

2011-04-01

... accessories is a device used to perform electrosurgical procedures through an endoscope. This generic type of device includes the electrosurgical generator, patient plate, electric biopsy forceps, electrode...

System Testing of Ground Cooling System Components

NASA Technical Reports Server (NTRS)

Ensey, Tyler Steven

2014-01-01

This internship focused primarily upon software unit testing of Ground Cooling System (GCS) components, one of the three types of tests (unit, integrated, and COTS/regression) utilized in software verification. Unit tests are used to test the software of necessary components before it is implemented into the hardware. A unit test determines that the control data, usage procedures, and operating procedures of a particular component are tested to determine if the program is fit for use. Three different files are used to make and complete an efficient unit test. These files include the following: Model Test file (.mdl), Simulink SystemTest (.test), and autotest (.m). The Model Test file includes the component that is being tested with the appropriate Discrete Physical Interface (DPI) for testing. The Simulink SystemTest is a program used to test all of the requirements of the component. The autotest tests that the component passes Model Advisor and System Testing, and puts the results into proper files. Once unit testing is completed on the GCS components they can then be implemented into the GCS Schematic and the software of the GCS model as a whole can be tested using integrated testing. Unit testing is a critical part of software verification; it allows for the testing of more basic components before a model of higher fidelity is tested, making the process of testing flow in an orderly manner.

7 CFR 271.6 - Complaint procedure.

Code of Federal Regulations, 2010 CFR

2010-01-01

... concerned individuals or groups. This shall not include complaints alleging discrimination on the basis of..., Pennsylvania, Puerto Rico, Virginia, the Virgin Islands of the United States, and West Virginia: Mid-Atlantic...

8 CFR 252.3 - Great Lakes vessels and tugboats arriving in the United States from Canada; special procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... in the United States from Canada; special procedures. 252.3 Section 252.3 Aliens and Nationality... and tugboats arriving in the United States from Canada; special procedures. (a) United States vessels... vessel of United States registry or a tugboat of United States registry arriving from Canada at a port of...

75 FR 15715 - Filing Procedures and Automatic Extension of Employment Authorization and Related Documentation...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-30

... resided in Liberia) who are physically present in the United States and who held TPS on September 30, 2007... resided in Liberia) who were covered by DED through March 31, 2010. Such individuals include only... United States; Who has voluntarily returned to Liberia or his or her country of last habitual residence...

The Essentials of Proper Wine Service.

ERIC Educational Resources Information Center

Manago, Gary H.

This instructional unit was designed to assist the food services instructor and/or the restaurant manager in training students and/or staff in the proper procedure for serving wines to guests. The lesson plans included in this unit focus on: (1) the different types of wine glasses and their uses; (2) the parts of a wine glass; (3) the proper…

Annual Forest Inventories for the North Central Region of the United States

Treesearch

Ronald E. McRoberts; Mark H. Hansen

1999-01-01

The primary objective in developing procedures for annual forest inventories for the north central region of the United States is to establish the capability of producing standard forest inventory and analysis estimates on an annual basis. The inventory system developed to accomplish this objective features several primary functions, including (1) an annual sample of...

Metrication of the United States Lumber Industry and Its Effects on Wood Consuming Industrial Education Courses.

ERIC Educational Resources Information Center

Craemer, Peter J.

A study investigated the direction United States lumber industries are moving concerning the implementation of the metric system and what implications this has concerning wood consuming industrial education courses. The procedure included a literature review and investigating the major producers of softwood dimensional lumber by a detailed survey…

21 CFR 104.20 - Statement of purpose.

Code of Federal Regulations, 2014 CFR

2014-04-01

... handling procedures cannot prevent the loss of such nutrient(s), (3) All nutrients, including protein... standard: Nutrient Unit of measurement DRV or RDI 1 Amount per 100 calories Protein grams (g) 50 2.5 Vitamin A International Unit (IU) 5,000 250 Vitamin C milligrams (mg) 60 3 Calcium g 1 0.05 Iron mg 18 0.9...

21 CFR 104.20 - Statement of purpose.

Code of Federal Regulations, 2011 CFR

2011-04-01

... handling procedures cannot prevent the loss of such nutrient(s), (3) All nutrients, including protein... standard: Nutrient Unit of measurement DRV or RDI 1 Amount per 100 calories Protein grams (g) 50 2.5 Vitamin A International Unit (IU) 5,000 250 Vitamin C milligrams (mg) 60 3 Calcium g 1 0.05 Iron mg 18 0.9...

21 CFR 104.20 - Statement of purpose.

Code of Federal Regulations, 2010 CFR

2010-04-01

... handling procedures cannot prevent the loss of such nutrient(s), (3) All nutrients, including protein... standard: Nutrient Unit of measurement DRV or RDI 1 Amount per 100 calories Protein grams (g) 50 2.5 Vitamin A International Unit (IU) 5,000 250 Vitamin C milligrams (mg) 60 3 Calcium g 1 0.05 Iron mg 18 0.9...

21 CFR 104.20 - Statement of purpose.

Code of Federal Regulations, 2013 CFR

2013-04-01

... handling procedures cannot prevent the loss of such nutrient(s), (3) All nutrients, including protein... standard: Nutrient Unit of measurement DRV or RDI 1 Amount per 100 calories Protein grams (g) 50 2.5 Vitamin A International Unit (IU) 5,000 250 Vitamin C milligrams (mg) 60 3 Calcium g 1 0.05 Iron mg 18 0.9...

21 CFR 104.20 - Statement of purpose.

Code of Federal Regulations, 2012 CFR

2012-04-01

... handling procedures cannot prevent the loss of such nutrient(s), (3) All nutrients, including protein... standard: Nutrient Unit of measurement DRV or RDI 1 Amount per 100 calories Protein grams (g) 50 2.5 Vitamin A International Unit (IU) 5,000 250 Vitamin C milligrams (mg) 60 3 Calcium g 1 0.05 Iron mg 18 0.9...

Residual Strength Characterization of Unitized Structures Fabricated Using Different Manufacturing Technologies

NASA Technical Reports Server (NTRS)

Seshadri, B. R.; Smith, S. W.; Johnston, W. M.

2008-01-01

This viewgraph presentation describes residual strength analysis of integral structures fabricated using different manufacturing procedures. The topics include: 1) Built-up and Integral Structures; 2) Development of Prediction Methodology for Integral Structures Fabricated using different Manufacturing Procedures; 3) Testing Facility; 4) Fracture Parameters Definition; 5) Crack Branching in Integral Structures; 6) Results and Discussion; and 7) Concluding Remarks.

Sampling protocol, estimation, and analysis procedures for the down woody materials indicator of the FIA program

Treesearch

Christopher W. Woodall; Vicente J. Monleon

2008-01-01

The USDA Forest Service's Forest Inventory and Analysis program conducts an inventory of forests of the United States including down woody materials (DWM). In this report we provide the rationale and context for a national inventory of DWM, describe the components sampled, discuss the sampling protocol used and corresponding estimation procedures, and provide...

28 CFR 77.5 - No private remedies.

Code of Federal Regulations, 2010 CFR

2010-07-01

... procedural, enforceable at law by a party to litigation with the United States, including criminal defendants, targets or subjects of criminal investigations, witnesses in criminal or civil cases (including civil law enforcement proceedings), or plaintiffs or defendants in civil investigations or litigation; or any other...

28 CFR 77.5 - No private remedies.

Code of Federal Regulations, 2012 CFR

2012-07-01

... procedural, enforceable at law by a party to litigation with the United States, including criminal defendants, targets or subjects of criminal investigations, witnesses in criminal or civil cases (including civil law enforcement proceedings), or plaintiffs or defendants in civil investigations or litigation; or any other...

28 CFR 77.5 - No private remedies.

Code of Federal Regulations, 2014 CFR

2014-07-01

... procedural, enforceable at law by a party to litigation with the United States, including criminal defendants, targets or subjects of criminal investigations, witnesses in criminal or civil cases (including civil law enforcement proceedings), or plaintiffs or defendants in civil investigations or litigation; or any other...

28 CFR 77.5 - No private remedies.

Code of Federal Regulations, 2013 CFR

2013-07-01

... procedural, enforceable at law by a party to litigation with the United States, including criminal defendants, targets or subjects of criminal investigations, witnesses in criminal or civil cases (including civil law enforcement proceedings), or plaintiffs or defendants in civil investigations or litigation; or any other...

28 CFR 77.5 - No private remedies.

Code of Federal Regulations, 2011 CFR

2011-07-01

... procedural, enforceable at law by a party to litigation with the United States, including criminal defendants, targets or subjects of criminal investigations, witnesses in criminal or civil cases (including civil law enforcement proceedings), or plaintiffs or defendants in civil investigations or litigation; or any other...

32 CFR 182.1 - Purpose.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Department of Defense OFFICE OF THE SECRETARY OF DEFENSE CIVIL DEFENSE DEFENSE SUPPORT OF CIVILIAN LAW... provides procedures for DoD support to Federal, State, Tribal, and local civilian law enforcement agencies, including responses to civil disturbances within the United States, including the District of Columbia, the...

Is medical perspective on clinical governance practices associated with clinical units' performance and mortality? A cross-sectional study through a record-linkage procedure.

PubMed

Sarchielli, Guido; De Plato, Giovanni; Cavalli, Mario; Albertini, Stefano; Nonni, Ilaria; Bencivenni, Lucia; Montali, Arianna; Ventura, Antonio; Montali, Francesca

2016-01-01

Assessment of the knowledge and application as well as perceived utility by doctors of clinical governance tools in order to explore their impact on clinical units' performance measured through mortality rates and efficiency indicators. This research is a cross-sectional study with a deterministic record-linkage procedure. The sample includes n = 1250 doctors (n = 249 chiefs of clinical units; n = 1001 physicians) working in six public hospitals located in the Emilia-Romagna Region in Italy. Survey instruments include a checklist and a research-made questionnaire which were used for data collection about doctors' knowledge and application as well as perceived utility of clinical governance tools. The analysis was based on clinical units' performance indicators which include patients' mortality, extra-region active mobility rate, average hospital stay, bed occupancy, rotation and turnover rates, and the comparative performance index as efficiency indicators. The clinical governance tools are known and applied differently in all the considered clinical units. Significant differences emerged between roles and organizational levels at which the medical leadership is carried out. The levels of knowledge and application of clinical governance practices are correlated with the clinical units' efficiency indicators (bed occupancy rate, bed turnover interval, and extra-region mobility). These multiple linear regression analyses highlighted that the clinical governance knowledge and application is correlated with clinical units' mortality rates (odds ratio, -8.677; 95% confidence interval, -16.654, -0.700). The knowledge and application, as well as perceived utility by medical professionals of clinical governance tools, are associated with the mortality rates of their units and with some efficiency indicators. However, the medical frontline staff seems to not consider homogeneously useful the clinical governance tools application on its own clinical practice.

Location identifiers

DOT National Transportation Integrated Search

1997-01-30

This order lists the location identifiers authorized by the Federal Aviation Administration, Department of the Navy, and Transport Canada. It lists United States airspace fixes and procedure codes. The order also includes guidelines for requesting id...

Percutaneous nephrolithotomy for complete staghorn renal stones.

PubMed

Koko, Abdelmoniem H; Onuora, Vincent C; Al-Turkey, Mohamamed A; Al Moss, Mohammed; Meabed, Ahmed H; Al Jawani, Nasser A

2007-03-01

To evaluate the effectiveness of percutaneous nephrolithotomy (PNL) in the management of patients with complete staghorn stones, a retrospective study was conducted on 110 patients at the Riyadh Medical Complex, Riyadh, Kingdom of Saudi Arabia. The study was performed between September 1990 and September 1999. 144 procedures were performed on 119 renal units including 22 units (18.5%) that needed more than one sitting. Of them, 85 units (71.4%) were completely cleared after PNL and 11 units (9.2%) were left with insignificant residual fragments (< 4 mm). This gives a success rate of 78.6% for PNL as a monotherapy. Twelve patients with significant residual fragments required Extracorporal Shock Wave Lithotripsy (SWL) in addition to PNL. The overall success rate after PNL and SWL in 108 renal units was 89.4%. We found PNL useful in the management of patients with complete staghorn stones, either as monotherapy or in combination with SWL. It was associated with little morbidity and the procedure can be instituted even in centers with limited facilities.

77 FR 32645 - Revision of Performance Standards for State Medicaid Fraud Control Units

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-01

... Procedures A Unit establishes written policies and procedures for its operations and ensures that staff are familiar with, and adhere to, policies and procedures. To determine whether a Unit meets this standard, OIG... contain current policies and procedures, consistent with these performance standards, for the...

Let's Make Metric Ice Cream

ERIC Educational Resources Information Center

Zimmerman, Marianna

1975-01-01

Describes a classroom activity which involved sixth grade students in a learning situation including making ice cream, safety procedures in a science laboratory, calibrating a thermometer, using metric units of volume and mass. (EB)

High-level neutron coincidence counter maintenance manual

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

Swansen, J.; Collinsworth, P.

1983-05-01

High-level neutron coincidence counter operational (field) calibration and usage is well known. This manual makes explicit basic (shop) check-out, calibration, and testing of new units and is a guide for repair of failed in-service units. Operational criteria for the major electronic functions are detailed, as are adjustments and calibration procedures, and recurrent mechanical/electromechanical problems are addressed. Some system tests are included for quality assurance. Data on nonstandard large-scale integrated (circuit) components and a schematic set are also included.

Electroblotting from Polyacrylamide Gels.

PubMed

Goldman, Aaron; Ursitti, Jeanine A; Mozdzanowski, Jacek; Speicher, David W

2015-11-02

Transferring proteins from polyacrylamide gels onto retentive membranes is now primarily used for immunoblotting. A second application that was quite common up to about a decade ago was electroblotting of proteins for N-terminal and internal sequencing using Edman chemistry. This unit contains procedures for electroblotting proteins from polyacrylamide gels onto a variety of membranes, including polyvinylidene difluoride (PVDF) and nitrocellulose. In addition to the commonly used tank or wet transfer system, protocols are provided for electroblotting using semidry and dry systems. This unit also describes procedures for eluting proteins from membranes using detergents or acidic extraction with organic solvents for specialized applications. Copyright © 2015 John Wiley & Sons, Inc.

Relationships between stratospheric clear air turbulence and synoptic meteorological parameters over the western United States between 12-20 km altitude

NASA Technical Reports Server (NTRS)

Scoggins, J. R.; Clark, T. L.; Possiel, N. C.

1975-01-01

Procedures for forecasting clear air turbulence in the stratosphere over the western United States from rawinsonde data are described and results presented. Approaches taken to relate meteorological parameters to regions of turbulence and nonturbulence encountered by the XB-70 during 46 flights at altitudes between 12-20 km include: empirical probabilities, discriminant function analysis, and mountainwave theory. Results from these techniques were combined into a procedure to forecast regions of clear air turbulence with an accuracy of 70-80 percent. A computer program was developed to provide an objective forecast directly from the rawinsonde sounding data.

Interval Female Sterilization.

PubMed

Stuart, Gretchen S; Ramesh, Shanthi S

2018-01-01

Female sterilization is relied on by nearly one in three women aged 35-44 years in the United States. Sterilization procedures are among the most common procedures that obstetrician-gynecologists perform. The most frequent sterilization procedures include postpartum tubal ligation, laparoscopic tubal disruption or salpingectomy, and hysteroscopic tubal occlusion. The informed consent process for sterilization is crucial and requires shared decision-making between the patient and the health care provider. Counseling should include the specific risks and benefits of the specific surgical approaches. Additionally, women should be counseled on the alternatives to sterilization, including intrauterine contraceptives and subdermal contraceptive implants. Complications, including unplanned pregnancy after successful female sterilization, are rare. The objectives of this Clinical Expert Series are to describe the epidemiology of female sterilization, access to postpartum sterilization, advances in interval sterilization techniques, and clinical considerations in caring for women requesting sterilization.

Screening Workers: An Examination and Analysis of Practice and Public Policy.

ERIC Educational Resources Information Center

Greenfield, Patricia A.; And Others

1989-01-01

Discusses methods of screening job applicants and issues raised by screening procedures.. Includes legal ramifications, current practices in Britain and the United States, future directions, and the employment interview. (JOW)

The implementation of a postoperative care process on a neurosurgical unit.

PubMed

Douglas, Mary; Rowed, Sheila

2005-12-01

The postoperative phase is a critical time for any neurosurgical patient. Historically, certain patients having neurosurgical procedures, such as craniotomies and other more complex surgeries, have been nursed postoperatively in the intensive care unit (ICU) for an overnight stay, prior to transfer to a neurosurgical floor. At the Hospital for Sick Children in Toronto, because of challenges with access to ICU beds and the cancellation of surgeries because of lack of available nurses for the ICU setting, this practice was reexamined. A set of criteria was developed to identify which postoperative patients should come directly to the neurosurgical unit immediately following their anesthetic recovery. The criteria were based on patient diagnosis, preoperative condition, comorbidities, the surgical procedure, intraoperative complications, and postoperative status. A detailed process was then outlined that allowed the optimum patients to be selected for this process to ensure patient safety. Included in this process was a postoperative protocol addressing details such as standard physician orders and the levels of monitoring required. Outcomes of this new process include fewer surgical cancellations for patients and families, equally safe, or better patient care, and the conservation of limited ICU resources. The program has currently been expanded to include patients who have undergone endovascular therapies.

Adaptive Units of Learning and Educational Videogames

ERIC Educational Resources Information Center

Moreno-Ger, Pablo; Thomas, Pilar Sancho; Martinez-Ortiz, Ivan; Sierra, Jose Luis; Fernandez-Manjon, Baltasar

2007-01-01

In this paper, we propose three different ways of using IMS Learning Design to support online adaptive learning modules that include educational videogames. The first approach relies on IMS LD to support adaptation procedures where the educational games are considered as Learning Objects. These games can be included instead of traditional content…

15 CFR 23.7 - Notice to Department of Commerce organizational units of implementation and procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... organizational units of implementation and procedures. 23.7 Section 23.7 Commerce and Foreign Trade Office of the... Department of Commerce organizational units of implementation and procedures. Following are roles and...) Otherwise determine and control the use of missing children materials and information by the Operating Unit...

Are oral and maxillofacial surgery residents being adequately trained to care for pediatric patients?

PubMed

Abramowicz, Shelly; Kaban, Leonard B; Wurtzel, Andrew S; Roser, Steven M

2017-09-01

To evaluate whether current oral and maxillofacial surgery (OMS) residents are receiving adequate training and experience to perform specific surgical procedures and anesthesia for pediatric patients. A 17-question survey was sent electronically to fellows of the American Academy of Craniomaxillofacial Surgeons. Descriptive data for individual surgeons, their associated residency programs, and the quantity of specific pediatric procedures they performed were collected. Resident case load for inpatient and outpatient procedures and overall experience in medical, surgical, and anesthetic management of pediatric OMS patients were explored. Surveys were sent to 110 active fellows; 64 completed the questionnaire (58%). There were 59 male fellows and 5 female fellows, with a mean age of 50.4 years. Of those, 68.8% practice in an academic setting. Specifically, 93.8% take after-hours emergency calls covering adult and pediatric patients and 98.4% have admitting privileges at a children's hospital or a pediatric unit in an adult hospital. Their affiliated residency programs include required rotations in pediatrics or pediatric subspecialties. In their opinion, >90% of graduating OMS residents have the appropriate skill set to perform dentoalveolar procedures, outpatient anesthesia, orthognathic procedures, and alveolar bone grafts. However, residents have limited ability to reconstruct pediatric ramus-condyle unit with a costochondral graft. Results of this study indicate that, in the opinion of the respondents, graduates of OMS residency programs have adequate training to perform dentoalveolar procedures, outpatient anesthesia, orthognathic surgery, and alveolar bone grafts in pediatric procedures, but have limited experience with reconstruction of pediatric ramus-condyle unit via costochondral graft. Copyright © 2017 Elsevier Inc. All rights reserved.

Gelatin-thrombin hemostatic matrix in neurosurgical procedures: hemostasis effectiveness and economic value of clinical and surgical procedure-related benefits.

PubMed

Esposito, Felice; Cappabianca, Paolo; Angileri, Filippo F; Cavallo, Luigi M; Priola, Stefano M; Crimi, Salvatore; Solari, Domenico; Germanò, Antonino F; Tomasello, Francesco

2016-07-26

Gelatin-thrombin hemostatic matrix (FloSeal®) use is associated with shorter surgical times and less blood loss, parameters that are highly valued in neurosurgical procedures. We aimed to assess the effectiveness of gelatin-thrombin in neurosurgical procedures and estimate its economic value. In a 6-month retrospective evaluation at 2 hospitals, intraoperative and postoperative information were collected from patients undergoing neurosurgical procedures where bleeding was controlled with gelatin-thrombin matrix or according to local bleeding control guidelines (control group). Study endpoints were: length of surgery, estimated blood loss, hospitalization duration, blood units utilized, intensive care unit days, postoperative complications, and time-to-recovery. Statistical methods compared endpoints between the gelatin-thrombin and control groups and resource utilization costs were estimated. Seventy-eight patients (38 gelatin-thrombin; 40 control) were included. Gelatin-thrombin was associated with a shorter surgery duration than control 166±40 versus 185±55, p=0.0839); a lower estimated blood loss (185±80 versus 250±95ml; p=0.0017); a shorter hospital stay (10±3 versus 13±3 days; p<0.001); fewer intensive care unit days (10 days/3 patients and 20 days/4 patients); and shorter time-to-recovery (3±2.2 versus 4±2.8 weeks; p=0861). Fewer gelatin-thrombin patients experienced postoperative complications (3 minor) than the control group (5 minor; 3 major). No gelatin-thrombin patient required blood transfusion; 5 units were administered in the control group. The cost of gelatin-thrombin (€268.40/unit) was offset by the shorter surgery duration (difference of 19 minutes at €858 per hour) and the economic value of improved the other endpoint outcomes (ie, shorter hospital stay, less blood loss/lack of need for transfusion, fewer intensive care unit days, and complications). Gelatin-thrombin hemostatic matrix use in patients undergoing neurosurgical procedures was associated with better intra- and post-operative parameters than conventional hemostasis methods, with these parameters having substantial economic benefits.

Sandy Hook Traveler Information System

DOT National Transportation Integrated Search

2010-09-01

This report focuses on equipment and procedural solutions for gathering and disseminating a wide range of visitor information, including real-time traveler information data relating to traffic and parking at the Sandy Hook Unit of the Gateway Recreat...

Impact of medical tourism on cosmetic surgery in the United States.

PubMed

Franzblau, Lauren E; Chung, Kevin C

2013-10-01

Developing countries have been attracting more international patients by building state-of-the-art facilities and offering sought-after healthcare services at a fraction of the cost of the US healthcare system. These price differentials matter most for elective procedures, including cosmetic surgeries, which are paid for out of pocket. It is unclear how this rise in medical tourism will affect the practice of plastic surgery, which encompasses a uniquely large number of elective procedures. By examining trends in the globalization of the cosmetic surgery market, we can better understand the current situation and what plastic surgeons in the United States can expect. In this article, we explore both domestic and foreign factors that affect surgical tourism and the current state of this industry. We also discuss how it may affect the practice of cosmetic surgery within the United States.

A procedure for rapid issue of red cells for emergency use.

PubMed

Weiskopf, Richard B; Webb, Mary; Stangle, Deena; Klinbergs, Gunter; Toy, Pearl

2005-04-01

A College of American Pathologists Q-Probe revealed that the median turnaround times for emergency requests for red blood cells from the operating room were 30 minutes to release of cells from the blood bank and 34 minutes to delivery to the operating room. These times may not be adequate to permit the red cells to provide sufficiently rapid delivery of oxygen in massively bleeding patients. To improve the time from emergency request for red cells to delivery to the operating room. A new emergency issue program was implemented for only the operating rooms; emergency issue to all other hospital locations remained unchanged. Six units of group O Rh-negative red blood cells (RBCs) are maintained in the blood bank in a separate basket with transfusion forms containing the unit numbers and expiration dates and a bag with one blood tubing segment from each unit. The times to issue and to delivery to the operating room suite were compared with time to issue of 2 group O Rh-negative RBCs for other hospital locations using the older system during the same time period and with the time to issue of 2 units to all other hospital locations during the preceding 2 years. A university hospital. Time between emergency request for red cells and delivery to the operating room. The time between blood bank notification and arrival in the operating room of the 6 units of RBCs was significantly shorter than the time required to just issue (not including delivery time) 2 units of RBCs to other hospital locations. With the new procedure, 82% of units issued reached the operating room within 2 minutes of request, 91% arrived within 3 minutes, and 100% arrived within 4 minutes. These percentages are significantly higher than those for only issue of blood (without delivery) using the older issuing procedure for all hospital locations during the previous 2 years (37%, 49%, and 66%, respectively; P = .007, .009, and .02, respectively) and for other locations during the same 7-month period (29%, 46%, and 73%, respectively; P = .004, .01, and .09, respectively). Time (mean [95% confidence interval]) from blood bank notification to delivery of RBCs to the operating room suite (2.1 [1.6-2.6] minutes, of which approximately 50-60 seconds is attributable to delivery time) was less than issue times (not including delivery times) using the older issuing procedure for other hospital locations during the same period (4.1 [3.1-5.0] minutes; P = .007). An emergency issue procedure can be used to issue several units of RBCs within 1 minute and have them delivered to the operating room within 2 minutes while maintaining sufficient controls and providing required information to satisfy patient and blood bank requirements.

Martins Creek S. E. S. 800-MW Units 3 and 4: design and operating experience with axial-flow FD and ID fans

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

Curley, C.C.; Overas, A.J.

1976-01-01

The design and performance of the variable-pitch axial-flow forced-draft and induced-draft fans used in two 820MW generating units at the Martins Creek Power Plant are described. Information is included on fan design; silencers; mechanical and metallurgical testing; insulation; performance testing; start-up and shutdown procedures; and maintenance. (LCL)

A united event grand canonical Monte Carlo study of partially doped polyaniline

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

Byshkin, M. S., E-mail: mbyshkin@unisa.it, E-mail: gmilano@unisa.it; Correa, A.; Buonocore, F.

2013-12-28

A Grand Canonical Monte Carlo scheme, based on united events combining protonation/deprotonation and insertion/deletion of HCl molecules is proposed for the generation of polyaniline structures at intermediate doping levels between 0% (PANI EB) and 100% (PANI ES). A procedure based on this scheme and subsequent structure relaxations using molecular dynamics is described and validated. Using the proposed scheme and the corresponding procedure, atomistic models of amorphous PANI-HCl structures were generated and studied at different doping levels. Density, structure factors, and solubility parameters were calculated. Their values agree well with available experimental data. The interactions of HCl with PANI have beenmore » studied and distribution of their energies has been analyzed. The procedure has also been extended to the generation of PANI models including adsorbed water and the effect of inclusion of water molecules on PANI properties has also been modeled and discussed. The protocol described here is general and the proposed United Event Grand Canonical Monte Carlo scheme can be easily extended to similar polymeric materials used in gas sensing and to other systems involving adsorption and chemical reactions steps.« less

40 CFR 270.300 - What container information must I keep at my facility?

Code of Federal Regulations, 2011 CFR

2011-07-01

... RCRA Standardized Permits for Storage and Treatment Units Information That Must Be Kept at Your...), including: (1) Test procedures and results or other documentation or information to show that the wastes do...

40 CFR 270.300 - What container information must I keep at my facility?

Code of Federal Regulations, 2012 CFR

2012-07-01

... RCRA Standardized Permits for Storage and Treatment Units Information That Must Be Kept at Your...), including: (1) Test procedures and results or other documentation or information to show that the wastes do...

Urban transportation planning in the United States : an historical overview

DOT National Transportation Integrated Search

1997-09-01

The report focuses on key events in the evolution of urban transportation planning including developments in technical procedures, philosophy, processes and institutions. But, planners must also be aware of changes in legislation, policy, regulations...

Transfusion medicine management for reconstructive spinal repair in a patient with von Willebrand's disease and a history of heavy surgical bleeding.

PubMed

Bolan, C D; Rick, M E; Polly, D W

2001-12-01

A case report of a multidisciplinary approach to a second reconstructive back surgery in a patient with von Willebrand's disease, flatback syndrome, and a history of heavy surgical bleeding is presented. To review the perioperative planning and assessment of hemostasis and transfusion medicine management, including administration of Humate P, a Factor VIII preparation with high von Willebrand factor content. Reconstructive spinal procedures may require significant transfusion support even in patients with normal preoperative hemostasis. In addition to the hemostatic problem caused by von Willebrand's disease, the reported patient requested minimal exposure to allogeneic blood products because of hepatitis C infection acquired from previous transfusions. The multidisciplinary team included the patient, hematologist, blood bank medical director, anesthesiologist, and operating surgeon. Preoperative assessment showed a Type 2A von Willebrand's disease variant. A careful planning process included a test infusion of desmopressin and extensive autologous donations of red cells, plasma, and platelets, which were collected before the procedure. Anterior and posterior spine fusions were performed during a 14-hour procedure. Hemostasis and clinical response were excellent. Humate P was administered perioperatively as assessed by the baseline Factor VIII and von Willebrand's disease levels, the plasma volume, the half-life of infused Humate P, and the anticipated risk and tolerance for bleeding. The estimated blood loss was 5 L. Replacement included 9 units of autologous red cells, 6 units of autologous plasma, 2 autologous plateletpheresis collections, a single allogeneic plateletpheresis product, and 17,000 units of Humate P administered over the perioperative period. Using a careful multidisciplinary approach, excellent hemostasis can be achieved with minimal exposure to untreated allogeneic blood products during aggressive spinal surgery in a patient with a clinically significant congenital coagulopathy.

Use of National Burden to Define Operative Emergency General Surgery.

PubMed

Scott, John W; Olufajo, Olubode A; Brat, Gabriel A; Rose, John A; Zogg, Cheryl K; Haider, Adil H; Salim, Ali; Havens, Joaquim M

2016-06-15

Emergency general surgery (EGS) represents 11% of surgical admissions and 50% of surgical mortality in the United States. However, there is currently no established definition of the EGS procedures. To define a set of procedures accounting for at least 80% of the national burden of operative EGS. A retrospective review was conducted using data from the 2008-2011 National Inpatient Sample. Adults (age, ≥18 years) with primary EGS diagnoses consistent with the American Association for the Surgery of Trauma definition, admitted urgently or emergently, who underwent an operative procedure within 2 days of admission were included in the analyses. Procedures were ranked to account for national mortality and complication burden. Among ranked procedures, contributions to total EGS frequency, mortality, and hospital costs were assessed. The data query and analysis were performed between November 15, 2015, and February 16, 2016. Overall procedure frequency, in-hospital mortality, major complications, and inpatient costs calculated per 3-digit International Classification of Diseases, Ninth Revision, Clinical Modification procedure codes. The study identified 421 476 patient encounters associated with operative EGS, weighted to represent 2.1 million nationally over the 4-year study period. The overall mortality rate was 1.23% (95% CI, 1.18%-1.28%), the complication rate was 15.0% (95% CI, 14.6%-15.3%), and mean cost per admission was $13 241 (95% CI, $12 957-$13 525). After ranking the 35 procedure groups by contribution to EGS mortality and morbidity burden, a final set of 7 operative EGS procedures were identified, which collectively accounted for 80.0% of procedures, 80.3% of deaths, 78.9% of complications, and 80.2% of inpatient costs nationwide. These 7 procedures included partial colectomy, small-bowel resection, cholecystectomy, operative management of peptic ulcer disease, lysis of peritoneal adhesions, appendectomy, and laparotomy. Only 7 procedures account for most admissions, deaths, complications, and inpatient costs attributable to the 512 079 EGS procedures performed in the United States each year. National quality benchmarks and cost reduction efforts should focus on these common, complicated, and costly EGS procedures.

Commentary: recent reforms in the British National Health Service--lessons for the United States.

PubMed Central

Holland, W W; Graham, C

1994-01-01

President Clinton recently announced his reform plan for health care in the United States. The United Kingdom, along with other countries, has already enacted reforms in an effort to overcome the basic problem of having insufficient funds to provide a health service to meet modern demands. This paper briefly describes the recent health reforms in the United Kingdom and highlights some lessons for the United States, which include the need to choose procedures that should be universally provided. Health reforms that involve some fundamental restructuring need to be evaluated everywhere and agreed to by the staff in advance. PMID:8296937

The Effect of Geographic Units of Analysis on Measuring Geographic Variation in Medical Services Utilization.

PubMed

Kim, Agnus M; Park, Jong Heon; Kang, Sungchan; Hwang, Kyosang; Lee, Taesik; Kim, Yoon

2016-07-01

We aimed to evaluate the effect of geographic units of analysis on measuring geographic variation in medical services utilization. For this purpose, we compared geographic variations in the rates of eight major procedures in administrative units (districts) and new areal units organized based on the actual health care use of the population in Korea. To compare geographic variation in geographic units of analysis, we calculated the age-sex standardized rates of eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee-replacement surgery, caesarean section, hysterectomy, computed tomography scan, and magnetic resonance imaging scan) from the National Health Insurance database in Korea for the 2013 period. Using the coefficient of variation, the extremal quotient, and the systematic component of variation, we measured geographic variation for these eight procedures in districts and new areal units. Compared with districts, new areal units showed a reduction in geographic variation. Extremal quotients and inter-decile ratios for the eight procedures were lower in new areal units. While the coefficient of variation was lower for most procedures in new areal units, the pattern of change of the systematic component of variation between districts and new areal units differed among procedures. Geographic variation in medical service utilization could vary according to the geographic unit of analysis. To determine how geographic characteristics such as population size and number of geographic units affect geographic variation, further studies are needed.

Integrated Advanced Microwave Sounding Unit-A (AMSU-A. Engineering Report: Electromagnetic Interface (EMI)/Electromagnetic Radiation (EMR) and Electromagnetic Compatibility (EMC), for the METSAT/METOP AMSU-A1

NASA Technical Reports Server (NTRS)

Valdez, A.

1999-01-01

This document contains the procedure and the test results of the Advanced Microwave Sounding Unit-A (AMSU-A) Electromagnetic Interference (EMI), Electromagnetic Susceptibility, and Electromagnetic Compatibility (EMC) qualification test for the Meteorological Satellite (METSAT) and the Meteorological Operation Platform (METOP) projects. The test was conducted in accordance with the approved EMI/EMC Test Plan/Procedure, Specification number AE-26151/5D. This document describes the EMI/EMC test performed by Aerojet and it is presented in the following manner: Section-1 contains introductory material and a brief summary of the test results. Section 2 contains more detailed descriptions of the test plan, test procedure, and test results for each type of EMI/EMC test conducted. Section 3 contains supplementary information that includes test data sheets, plots, and calculations collected during the qualification testing.

Efficiency of endoscopy units can be improved with use of discrete event simulation modeling.

PubMed

Sauer, Bryan G; Singh, Kanwar P; Wagner, Barry L; Vanden Hoek, Matthew S; Twilley, Katherine; Cohn, Steven M; Shami, Vanessa M; Wang, Andrew Y

2016-11-01

Background and study aims: The projected increased demand for health services obligates healthcare organizations to operate efficiently. Discrete event simulation (DES) is a modeling method that allows for optimization of systems through virtual testing of different configurations before implementation. The objective of this study was to identify strategies to improve the daily efficiencies of an endoscopy center with the use of DES. Methods: We built a DES model of a five procedure room endoscopy unit at a tertiary-care university medical center. After validating the baseline model, we tested alternate configurations to run the endoscopy suite and evaluated outcomes associated with each change. The main outcome measures included adequate number of preparation and recovery rooms, blocked inflow, delay times, blocked outflows, and patient cycle time. Results: Based on a sensitivity analysis, the adequate number of preparation rooms is eight and recovery rooms is nine for a five procedure room unit (total 3.4 preparation and recovery rooms per procedure room). Simple changes to procedure scheduling and patient arrival times led to a modest improvement in efficiency. Increasing the preparation/recovery rooms based on the sensitivity analysis led to significant improvements in efficiency. Conclusions: By applying tools such as DES, we can model changes in an environment with complex interactions and find ways to improve the medical care we provide. DES is applicable to any endoscopy unit and would be particularly valuable to those who are trying to improve on the efficiency of care and patient experience.

Efficiency of endoscopy units can be improved with use of discrete event simulation modeling

PubMed Central

Sauer, Bryan G.; Singh, Kanwar P.; Wagner, Barry L.; Vanden Hoek, Matthew S.; Twilley, Katherine; Cohn, Steven M.; Shami, Vanessa M.; Wang, Andrew Y.

2016-01-01

Background and study aims: The projected increased demand for health services obligates healthcare organizations to operate efficiently. Discrete event simulation (DES) is a modeling method that allows for optimization of systems through virtual testing of different configurations before implementation. The objective of this study was to identify strategies to improve the daily efficiencies of an endoscopy center with the use of DES. Methods: We built a DES model of a five procedure room endoscopy unit at a tertiary-care university medical center. After validating the baseline model, we tested alternate configurations to run the endoscopy suite and evaluated outcomes associated with each change. The main outcome measures included adequate number of preparation and recovery rooms, blocked inflow, delay times, blocked outflows, and patient cycle time. Results: Based on a sensitivity analysis, the adequate number of preparation rooms is eight and recovery rooms is nine for a five procedure room unit (total 3.4 preparation and recovery rooms per procedure room). Simple changes to procedure scheduling and patient arrival times led to a modest improvement in efficiency. Increasing the preparation/recovery rooms based on the sensitivity analysis led to significant improvements in efficiency. Conclusions: By applying tools such as DES, we can model changes in an environment with complex interactions and find ways to improve the medical care we provide. DES is applicable to any endoscopy unit and would be particularly valuable to those who are trying to improve on the efficiency of care and patient experience. PMID:27853739

12 CFR 621.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... accepted accounting principles means that body of conventions, rules, and procedures necessary to define accepted accounting practices at a particular time, as promulgated by the Financial Accounting Standards... profession in the United States. Generally accepted accounting principles include not only broad guidelines...

Insights into Pupils' Responses to Practical Investigations from the APU.

ERIC Educational Resources Information Center

Murphy, Patricia

1988-01-01

Describes the Assessment of Performance Unit (APU) Science project. Discusses the findings including perceptions of problems, procedural understanding, control of variables, and measurement strategies. Suggests a change from traditional learning strategies to more student-centered ones. (YP)

Physics Notes.

ERIC Educational Resources Information Center

School Science Review, 1982

1982-01-01

Demonstrations, procedures, games, teaching suggestions and information on a variety of physics topics are presented, including hydraulic rams, units and formulae, static electric motors, a computer graphics program, diffraction, adaptation of a basic meter, photoelasticity, photo-diodes, radioactive decay, and analog-digital conversions. (DC)

7 CFR 1205.23 - United States.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 10 2011-01-01 2011-01-01 false United States. 1205.23 Section 1205.23 Agriculture... Procedures for Conduct of Sign-up Period Definitions § 1205.23 United States. The term United States means the 50 states of the United States of America. Procedures ...

7 CFR 1205.23 - United States.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 10 2014-01-01 2014-01-01 false United States. 1205.23 Section 1205.23 Agriculture... Procedures for Conduct of Sign-up Period Definitions § 1205.23 United States. The term United States means the 50 states of the United States of America. Procedures ...

7 CFR 1205.23 - United States.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 10 2012-01-01 2012-01-01 false United States. 1205.23 Section 1205.23 Agriculture... Procedures for Conduct of Sign-up Period Definitions § 1205.23 United States. The term United States means the 50 states of the United States of America. Procedures ...

7 CFR 1205.23 - United States.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 10 2013-01-01 2013-01-01 false United States. 1205.23 Section 1205.23 Agriculture... Procedures for Conduct of Sign-up Period Definitions § 1205.23 United States. The term United States means the 50 states of the United States of America. Procedures ...

7 CFR 1205.23 - United States.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Procedures for Conduct of Sign-up Period Definitions § 1205.23 United States. The term United States means the 50 states of the United States of America. Procedures ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1205.23 Section 1205.23 Agriculture...

A Comparative Assessment of Knowledge Management Education Across the United States Department of Defense

DTIC Science & Technology

2007-03-01

portal, AKO. The Army is also creating Battle Command Knowledge Cells staffed with Knowledge Management Officers ( KMO ) to facilitate KM within...battle commands. To increase their effectiveness, the Army has a draft Standard Operation Procedures (SOP) document to assist KMOs in establishing and...cultivating KM programs. This draft document includes instruction on implementing a KM program in a unit, worksheets to assist KMOs with knowledge

The Multi-County Regional Educational Service Agency in Iowa. Part I, Section 1 (Chapters I-IV), The Intermediate Unit of School Administration in the United States. Final Report.

ERIC Educational Resources Information Center

Stephens, E. Robert; And Others

An extensive study, reported in three separately published sections, was made to determine primary aspects of the current consolidation and redistricting of local school districts. Basic procedures used to gather information included a survey of related literature, visitations to county and intermediate educational agencies in Iowa and other…

Global Perspective for Protecting Intellectual Property - Patenting in USA and Poland

NASA Astrophysics Data System (ADS)

Grebski, Michalene Eva; Wolniak, Radosław

2018-06-01

Paper addresses the different methods for protecting intellectual property in modern knowledge-based economies. The focus of the paper is a comparison between the procedures for applying for patents in Poland and the United States. The comparison has been made from the perspective of the cost of obtaining and maintaining a patent in Poland, the United States and some other countries. The comparison has also been made from the perspective of the procedures for applying for a patent in different countries based on the Patent Cooperation Treaty. The paper also includes a comparison of the time needed for processing the patent application. Low cost provisional twelve-month patent pending protection available in the United States is also being discussed. The paper also provides some guidance and recommendations for conducting a patent search in order to validate the originality of the invention.

Impact of Medical Tourism on Cosmetic Surgery in the United States

PubMed Central

Franzblau, Lauren E.

2013-01-01

Summary: Developing countries have been attracting more international patients by building state-of-the-art facilities and offering sought-after healthcare services at a fraction of the cost of the US healthcare system. These price differentials matter most for elective procedures, including cosmetic surgeries, which are paid for out of pocket. It is unclear how this rise in medical tourism will affect the practice of plastic surgery, which encompasses a uniquely large number of elective procedures. By examining trends in the globalization of the cosmetic surgery market, we can better understand the current situation and what plastic surgeons in the United States can expect. In this article, we explore both domestic and foreign factors that affect surgical tourism and the current state of this industry. We also discuss how it may affect the practice of cosmetic surgery within the United States. PMID:25289258

10 CFR 35.610 - Safety procedures and instructions for remote afterloader units, teletherapy units, and gamma...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Safety procedures and instructions for remote afterloader units, teletherapy units, and gamma stereotactic radiosurgery units. 35.610 Section 35.610 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units...

10 CFR 35.610 - Safety procedures and instructions for remote afterloader units, teletherapy units, and gamma...

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Safety procedures and instructions for remote afterloader units, teletherapy units, and gamma stereotactic radiosurgery units. 35.610 Section 35.610 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units...

10 CFR 35.610 - Safety procedures and instructions for remote afterloader units, teletherapy units, and gamma...

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Safety procedures and instructions for remote afterloader units, teletherapy units, and gamma stereotactic radiosurgery units. 35.610 Section 35.610 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units...

10 CFR 35.610 - Safety procedures and instructions for remote afterloader units, teletherapy units, and gamma...

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Safety procedures and instructions for remote afterloader units, teletherapy units, and gamma stereotactic radiosurgery units. 35.610 Section 35.610 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units...

10 CFR 35.610 - Safety procedures and instructions for remote afterloader units, teletherapy units, and gamma...

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Safety procedures and instructions for remote afterloader units, teletherapy units, and gamma stereotactic radiosurgery units. 35.610 Section 35.610 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units...

22 CFR 94.6 - Procedures for children abducted to the United States.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Procedures for children abducted to the United... CHILD ABDUCTION § 94.6 Procedures for children abducted to the United States. The U.S. Central Authority... to all Hague Convention applications seeking the return of children wrongfully removed to or retained...

22 CFR 94.7 - Procedures for children abducted from the United States.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Procedures for children abducted from the United States. 94.7 Section 94.7 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED SERVICES INTERNATIONAL CHILD ABDUCTION § 94.7 Procedures for children abducted from the United States. Upon receipt of an...

14 CFR 183.43 - Application.

Code of Federal Regulations, 2010 CFR

2010-01-01

... REGULATIONS REPRESENTATIVES OF THE ADMINISTRATOR Organization Designation Authorization § 183.43 Application... structure, including a description of the proposed ODA Unit as it relates to the applicant's organizational structure; and (d) A proposed procedures manual as described in § 183.53 of this part. ...

Epidemiologic Analysis of Elective Operative Procedures in Infants Less Than 6 Months of Age in the United States.

PubMed

Einhorn, Lisa M; Young, Brian J; Routh, Jonathan C; Allori, Alexander C; Tracy, Elisabeth T; Greene, Nathaniel H

2017-11-01

This study uses publicly available data to analyze the total number of elective, potentially deferrable operative procedures involving infants <6 months of age in the United States. We investigated the factors associated with the performance of these procedures in this population. The State Ambulatory Surgery Database was used to identify patients in California, North Carolina, New York, and Utah during the years of 2007-2010 who were younger than 6 months of age at the time that they underwent outpatient (ambulatory) surgery. Operations that could reasonably be postponed until 6 months of age were classified as potentially deferrable procedures. Hernia repairs were analyzed separately from other deferrable procedures. Primary outcomes included the total number of elective procedures and the number and rates of potentially deferrable procedures per state per year in this population. Over the study period, a total of 27,540 procedures were identified as meeting inclusion criteria; of those, 7832 (28%) were classified as potentially deferrable, 4315 of which were hernia repairs. The average rates of potentially deferrable nonhernia procedures in California, North Carolina, New York, and Utah were 8.3, 43.8, 30.0, and 11.7 per 10,000 person-years, respectively. In multivariable analysis, private insurance (odds ratio [OR] = 1.36), self-pay status (OR = 1.50), and treatment in a different state (OR = 0.48-3.16) were independent predictors of a potentially deferrable procedure being performed on an infant younger than 6 months. Potentially deferrable procedures are still performed in infants <6 months of age. There appears to be significant variation in timing of these procedures among states. Insurance status and geography may be independent predictors of a procedure being potentially deferrable.

The management of failed ankle replacement.

PubMed

Kotnis, R; Pasapula, C; Anwar, F; Cooke, P H; Sharp, R J

2006-08-01

Advances in the design of the components for total ankle replacement have led to a resurgence of interest in this procedure. Between January 1999 and December 2004, 16 patients with a failed total ankle replacement were referred to our unit. In the presence of infection, a two-stage salvage procedure was planned. The first involved the removal of the components and the insertion of a cement spacer. Definitive treatment options included hindfoot fusion with a circular frame or amputation. When there was no infection, a one-stage salvage procedure was planned. Options included hindfoot fusion with an intramedullary nail or revision total ankle replacement. When there was suspicion of infection, a percutaneous biopsy was performed. The patients were followed up for a minimum of 12 months. Of the 16 patients, 14 had aseptic loosening, five of whom underwent a revision total ankle replacement and nine a hindfoot fusion. Of the two with infection, one underwent fusion and the other a below-knee amputation. There were no cases of wound breakdown, nonunion or malunion. Management of the failed total ankle replacement should be performed by experienced surgeons and ideally in units where multidisciplinary support is available. Currently, a hindfoot fusion appears to be preferable to a revision total ankle replacement.

Fresh-Frozen Plasma: Ordering Patterns and Utilization in the Operating Rooms of a Tertiary Referral Hospital.

PubMed

Meyer, Matthew J; Dzik, Walter H; Levine, Wilton C

2017-02-01

Blood product transfusion is the most commonly performed hospital procedure. Intraoperative blood product utilization varies between institutions and anesthesiologists. In the United States in 2011, nearly 4 million plasma units were transfused. A retrospective analysis of intraoperative plasma ordering patterns and utilization (thawing and transfusing) was performed at a tertiary, academic hospital between January 2015 and March 2016. Over 15 months, 46,002 operative procedures were performed. In 1540 of them, plasma was thawed or transfused: 8297 plasma units were thawed and 3306 of those units were transfused. These 3306 plasma units were transfused in 749 cases with a median of 2 plasma units (interquartile range, 2-4) transfused. The percentage of average monthly procedures with plasma thawed and none transfused was 51.3% (confidence interval, 49.0%-53.6%). The cardiac surgery service requested the greatest number of plasma units to be thawed (2143) but only transfused 712 (33.2%) of them. Of all plasma units not transfused, 45% were generated by procedures with 1 to 4 units of plasma thawed; 95.7% of these units were thawed as even integers (ie, 2, 4). For operative procedures, far more plasma was thawed than was transfused and this practice occurred across surgical specialties and anesthesiologists. Considering the plasma that was not transfused, 45% occurred in procedures with 4 or fewer units of plasma requested suggesting these low-volume requests were a primary source of potential waste. Further studies are needed to examine associations between plasma utilization and clinical outcomes.

The effect of intensive care unit environments on nurse perceptions of family presence during resuscitation and invasive procedures.

PubMed

Carroll, Diane L

2014-01-01

In a growing number of requests, family members are asking for proximity to their family member during resuscitation and invasive procedures. The objective of this study was to measure the impact of intensive care unit environments on nurse perception of family presence during resuscitation and invasive procedures. The study used a descriptive survey design with nurses from 9 intensive care units using the Family Presence Self-confidence Scale for resuscitation/invasive procedures that measures nurses' perception of self-confidence and Family Presence Risk-Benefit Scale for resuscitation and invasive procedures that measures nurses' perception of risks/benefits related to managing resuscitation and invasive procedures with family present. There were 207 nurses who responded: 14 male and 184 female nurses (9 missing data), with mean age of 41 ± 11 years, with a mean of 15 years in critical care practice. The environments were defined as surgical (n = 68), medical (n = 43), pediatric/neonatal (n = 34), and mixed adult medical/surgical (n = 36) intensive care units. There were significant differences in self-confidence, with medical and pediatric intensive care unit nurses rating more self-confidence for family presence during resuscitation (F = 7.73, P < .000) and invasive procedures (F = 6.41, P < .000). There were significant differences in risks/benefits with medical and pediatric intensive care unit nurses rating lower risk and higher benefit for resuscitation (F = 7.73, P < .000). Perceptions of family presence were significantly higher for pediatric and medical intensive care unit nurses. Further education and support may be needed in the surgical and mixed intensive care units. Evidence-based practice guidelines that are family centered can define the procedures and resources for family presence, to ultimately promote professional practice.

Environmental impact of minimally invasive surgery in the United States: an estimate of the carbon dioxide footprint.

PubMed

Power, Nicholas E; Silberstein, Jonathan L; Ghoneim, Tarek P; Guillonneau, Bertrand; Touijer, Karim A

2012-12-01

To attempt to quantitate the carbon footprint of minimally invasive surgery (MIS) through approximated scope 1 to 3 CO(2) emissions to identify its potential role in global warming. To estimate national usage, we determined the number of inpatient and outpatient MIS procedures using International Classification of Diseases, ninth revision-clinical modification codes for all MIS procedures in a 2009 sample collected in national databases. Need for surgery was considered essential, and therefore traditional open surgery was used as the comparator. Scope 1 (direct) CO(2) emissions resulting from CO(2) gas used for insufflation were based on both escaping procedural CO(2) and metabolic CO(2) eliminated via respiration. Scopes 2 and 3 (indirect) emissions related to capture, compression, and transportation of CO(2) to hospitals and the disposal of single-use equipment not used in open surgery were calculated. The total CO(2) emissions were calculated to be 355,924 tonnes/year. For perspective, if MIS in the United States was considered a country, it would rank 189 th on the United Nations 2008 list of countries' carbon emissions per year. Limitations include the inability to account for uncertainty using the various models and tools for approximating CO(2) emissions. CO(2) emission of MIS in the United States may have a significant environmental impact. This is the first attempt to quantify CO(2) emissions related to MIS in the United States. Strategies for reduction, while maintaining high quality medical care, should be considered.

Primary Astronomy.

ERIC Educational Resources Information Center

Greenstone, Sid; Smith, Murray

Selected materials needed to teach an astronomy unit as well as suggested procedures, activities, ideas, and astronomy fact sheets published by the Manitoba Planetarium are provided. Subjects of the fact sheets include: publications and classroom picture sets available from the National Aeronautics and Space Administration and facts and statistics…

Astronomy.

ERIC Educational Resources Information Center

Greenstone, Sid; Smith, Murray

Selected materials needed to teach an astronomy unit as well as suggested procedures, activities, ideas, and astronomy fact sheets published by the Manitoba Planetarium are provided. Subjects of the fact sheets include: publications and classroom picture sets available from the National Aeronautics and Space Administration and facts and statistics…

Intermediate Astronomy.

ERIC Educational Resources Information Center

Greenstone, Sid; Smith, Murray

Selected materials needed to teach an astronomy unit as well as suggested procedures, activities, ideas, and astronomy fact sheets published by the Manitoba Planetarium are provided. Subjects of the fact sheets include: publications and classroom picture sets available from the National Aeronautics and Space Administration and facts and statistics…

20 CFR 655.183 - Less than substantial violations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... EMPLOYMENT OF FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process for Temporary Agricultural... otherwise negative effect on the recruitment, employment, and retention of U.S. workers, the OFLC... certification determination. These special procedures may include special on-site positive recruitment and...

Cross-Sectional Time Series Designs: A General Transformation Approach.

ERIC Educational Resources Information Center

Velicer, Wayne F.; McDonald, Roderick P.

1991-01-01

The general transformation approach to time series analysis is extended to the analysis of multiple unit data by the development of a patterned transformation matrix. The procedure includes alternatives for special cases and requires only minor revisions in existing computer software. (SLD)

Into the Curriculum.

ERIC Educational Resources Information Center

School Library Media Activities Monthly, 1996

1996-01-01

Provides five fully developed library media activities designed for use with specific curriculum units in art, health and nutrition, mathematics, science, and social studies. Library media skills, objectives, grade levels, instructional roles, procedures, evaluation, and follow-up are described for each activity. Specific topics include aardvarks,…

View from My Classroom: A Spectrophotometry Unit for Advanced Chemistry Students.

ERIC Educational Resources Information Center

Diehl-Jones, Susan M.

1983-01-01

Rationale, objectives, and instructional strategies for a directed study course on spectrophotometry are provided. Descriptions of three experiments and four student research projects are also provided. Objectives, laboratory procedures, advantages, and disadvantages for the experiments and projects are included. (JN)

32 CFR 809a.11 - Procedures outside the United States.

Code of Federal Regulations, 2011 CFR

2011-07-01

... ADMINISTRATION INSTALLATION ENTRY POLICY, CIVIL DISTURBANCE INTERVENTION AND DISASTER ASSISTANCE Civil Disturbance Intervention and Disaster Assistance § 809a.11 Procedures outside the United States. It is Air.... Intervention by United States military personnel outside the United States is governed by international law...

The epidemiology of blood component transfusion in Catalonia, Northeastern Spain.

PubMed

Bosch, M Alba; Contreras, Enric; Madoz, Pedro; Ortiz, Pilar; Pereira, Arturo; Pujol, M Mar

2011-01-01

Epidemiologic information on blood component usage can help improve the utilization of transfusion resources. Crosssectional survey in 2007 that included every hospital in Catalonia. Clinical data of blood recipients, including the four-digit International Classification of Diseases, 9th Revision, Clinical Modification codes and the indication for transfusion, were prospectively collected according to an established protocol. In total, 19,148 red blood cell (RBC) units, 1812 platelet (PLT) doses, and 3070 plasma units, transfused into 8019 patients (median age, 71 years; 52% males), were surveyed. Half the RBC units were used by patients older than 70 years. Specific diagnosis and procedures with the highest RBC use were lower limb orthopedic surgery (10.6% of all units) and gastrointestinal hemorrhage (6%). Therapeutic plasmapheresis (8.1%) and heart valve surgery (7.2%) were the procedures with the highest plasma use. Oncohematology patients accounted for 73% of transfused PLTs, more that two-thirds being administered for hemorrhage prophylaxis. Acute hemorrhage was the most common indication for RBC and plasma transfusion. Among all blood recipients, 80% received only RBCs and 6.9% received only plasma and/or PLTs, without concomitant RBCs. The population transfusion incidence rates were 35 RBC units, three PLT doses, and 6 plasma units per 1000 population-year. Demographic changes anticipate a 30% increase in RBC transfusion by year 2030. These results allow for identification of blood uses that are susceptible to improvement, help appraise the expected yield of blood safety measures, and will assist in planning the future blood supply. © 2010 American Association of Blood Banks.

Temporal Trends in Gender-Affirming Surgery Among Transgender Patients in the United States.

PubMed

Canner, Joseph K; Harfouch, Omar; Kodadek, Lisa M; Pelaez, Danielle; Coon, Devin; Offodile, Anaeze C; Haider, Adil H; Lau, Brandyn D

2018-02-28

Little is known about the incidence of gender-affirming surgical procedures for transgender patients in the United States. To investigate the incidence and trends over time of gender-affirming surgical procedures and to analyze characteristics and payer status of transgender patients seeking these operations. In this descriptive observational study from 2000 to 2014, data were analyzed from the National Inpatient Sample, a representative pool of inpatient visits across the United States. The initial analyses were done from June to August 2015. Patients of interest were identified by International Classification of Diseases, Ninth Revision, diagnosis codes for transsexualism or gender identity disorder. Subanalysis focused on patients with procedure codes for surgery related to gender affirmation. Demographics, health insurance plan, and type of surgery for patients who sought gender-affirming surgery were compared between 2000-2005 and 2006-2011, as well as annually from 2012 to 2014. This study included 37 827 encounters (median [interquartile range] patient age, 38 [26-49] years) identified by a diagnosis code of transsexualism or gender identity disorder. Of all encounters, 4118 (10.9%) involved gender-affirming surgery. The incidence of genital surgery increased over time: in 2000-2005, 72.0% of patients who underwent gender-affirming procedures had genital surgery; in 2006-2011, 83.9% of patients who underwent gender-affirming procedures had genital surgery. Most patients (2319 of 4118 [56.3%]) undergoing these procedures were not covered by any health insurance plan. The number of patients seeking these procedures who were covered by Medicare or Medicaid increased by 3-fold in 2014 (to 70) compared with 2012-2013 (from 25). No patients who underwent inpatient gender-affirming surgery died in the hospital. Most transgender patients in this national sample undergoing inpatient gender-affirming surgery were classified as self-pay; however, an increasing number of transgender patients are being covered by private insurance, Medicare, or Medicaid. As coverage for these procedures increases, likely so will demand for qualified surgeons to perform them.

22 CFR 46.4 - Procedure in case of alien prevented from departing from the United States.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Procedure in case of alien prevented from departing from the United States. 46.4 Section 46.4 Foreign Relations DEPARTMENT OF STATE VISAS CONTROL OF ALIENS DEPARTING FROM THE UNITED STATES § 46.4 Procedure in case of alien prevented from departing from...

22 CFR 46.4 - Procedure in case of alien prevented from departing from the United States.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Procedure in case of alien prevented from departing from the United States. 46.4 Section 46.4 Foreign Relations DEPARTMENT OF STATE VISAS CONTROL OF ALIENS DEPARTING FROM THE UNITED STATES § 46.4 Procedure in case of alien prevented from departing from...

22 CFR 46.4 - Procedure in case of alien prevented from departing from the United States.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Procedure in case of alien prevented from departing from the United States. 46.4 Section 46.4 Foreign Relations DEPARTMENT OF STATE VISAS CONTROL OF ALIENS DEPARTING FROM THE UNITED STATES § 46.4 Procedure in case of alien prevented from departing from...

22 CFR 46.4 - Procedure in case of alien prevented from departing from the United States.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Procedure in case of alien prevented from departing from the United States. 46.4 Section 46.4 Foreign Relations DEPARTMENT OF STATE VISAS CONTROL OF ALIENS DEPARTING FROM THE UNITED STATES § 46.4 Procedure in case of alien prevented from departing from...

Trends in Shoulder Stabilization Techniques Used in the United States Based on a Large Private-Payer Database.

PubMed

Riff, Andrew J; Frank, Rachel M; Sumner, Shelby; Friel, Nicole; Bach, Bernard R; Verma, Nikhil N; Romeo, Anthony A

2017-12-01

Arthroscopic stabilization is the most broadly used surgical procedure in the United States for management of recurrent shoulder instability. Latarjet coracoid transfer has been considered a salvage surgical procedure for failed arthroscopic repairs or cases of significant glenoid bone loss; however, with recent literature suggesting reduced risk of recurrent instability with Latarjet, several surgeons have advocated its broader utilization as a primary operation for treatment of shoulder instability. To determine trends in shoulder stabilization techniques used in the United States. Cross-sectional study. A retrospective analysis of a publicly available national insurance database was performed to identify shoulder stabilization procedures performed over 9 years (2007-2015). The following Current Procedural Terminology codes were searched: 29806 (arthroscopic stabilization), 23455 (open capsulolabral repair), 23466 (open capsular shift), 23462 (Latarjet coracoid transfer), and 23460 (open anterior capsulorrhaphy with other bone block augmentation). Outcomes of interest included (1) trends in the use of each technique throughout the study interval, (2) age and sex distributions of patients undergoing each technique, and (3) regional predilections for the use of each technique. Arthroscopic stabilization was the most broadly used shoulder stabilization procedure in the database (87%), followed by open Bankart (7%), Latarjet (3.2%), open capsular shift (2.6%), and alternative bone block procedure (0.8%). Throughout the study period, the incidence of arthroscopic stabilization and Latarjet increased (8% and 15% per year, respectively); the incidence of open capsular shift remained relatively constant; and the incidence of open Bankart decreased (9% per year). Arthroscopic stabilization, open Bankart, and Latarjet each had similar sex-based distributions (roughly 70% male), while open capsular shift and alternative bone block were relatively more common in females (54% and 50% male, respectively). The incidence of arthroscopic stabilization and Latarjet were greatest in the South and lowest in the Northeast. Arthroscopic stabilization remains the most commonly utilized stabilization technique in the United States. The use of the Latarjet procedure is steadily increasing and now rivals open Bankart stabilization among the most commonly used open stabilization techniques.

Your Paycheck. Cooperative Work Experience Learning Activity Packet: Series on Job Entry and Adjustment; Packet Five.

ERIC Educational Resources Information Center

Herschbach, Dennis R.; And Others

This student booklet is fifth in an illustrated series of eleven learning activity packets for use in teaching job hunting and application procedures and the management of wages to secondary students. Two units are included in this packet: the first describing the various ways of being paid: salary (including overtime and compensatory time),…

4 CFR 28.115 - Processing petitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 4 Accounts 1 2010-01-01 2010-01-01 false Processing petitions. 28.115 Section 28.115 Accounts... Special Procedures; Representation Proceedings § 28.115 Processing petitions. (a) Upon the expiration of... their consultations including an agreement on the appropriate units, on the withdrawal of the petition...

Earth Observing System (EOS) Advanced Microwave Sounding Unit-A (AMSU-A) schedule plan

NASA Technical Reports Server (NTRS)

1994-01-01

This report describes Aerojet's methods and procedures used to control and administer contractual schedules for the EOS/AMSU-A program. Included are the following: the master, intermediate, and detail schedules; critical path analysis; and the total program logic network diagrams.

Junior High Astronomy.

ERIC Educational Resources Information Center

Greenstone, Sid; Smith, Murray

Selected materials needed to teach an astronomy unit as well as suggested procedures, activities, ideas, and astronomy fact sheets published by the Manitoba Planetarium are provided. Subjects of the fact sheets include: publications and classroom picture sets available from the National Aeronautics and Space Administration and facts and statistics…

40 CFR 75.1 - Purpose and scope.

Code of Federal Regulations, 2014 CFR

2014-07-01

... monitoring systems and provisions to account for missing data from certified continuous emission monitoring... estimation procedures for missing data are included in appendix C to this part. Optional protocols for...), and carbon dioxide (CO2) emissions, volumetric flow, and opacity data from affected units under the...

40 CFR 75.1 - Purpose and scope.

Code of Federal Regulations, 2011 CFR

2011-07-01

... monitoring systems and provisions to account for missing data from certified continuous emission monitoring... estimation procedures for missing data are included in appendix C to this part. Optional protocols for...), and carbon dioxide (CO2) emissions, volumetric flow, and opacity data from affected units under the...

40 CFR 75.1 - Purpose and scope.

Code of Federal Regulations, 2013 CFR

2013-07-01

... monitoring systems and provisions to account for missing data from certified continuous emission monitoring... estimation procedures for missing data are included in appendix C to this part. Optional protocols for...), and carbon dioxide (CO2) emissions, volumetric flow, and opacity data from affected units under the...

STS-5 Columbia, OV-102, middeck documentation

NASA Technical Reports Server (NTRS)

1982-01-01

Items stowed temporarily on forward middeck lockers include (left to right) field sequential (FS) crew cabin camera, procedural notebook, communications kit assembly (assy) headset (HDST) interface unit (HIU), personal hygiene kit, personal hygiene mirror assy, meal tray assemblies, towels, and Vestibular Study Experiment headset and antenna.

Biographical Study and Hypothesis Testing. Instructional Technology.

ERIC Educational Resources Information Center

Little, Timothy H.

1995-01-01

Asserts that the story of Amelia Earhart holds an ongoing fascination for students. Presents an instructional unit using a spreadsheet to create a database about Earhart's final flight. Includes student objectives, step-by-step instructional procedures, and eight graphics of student information or teacher examples. (CFR)

Emergency contraceptive pill (ECP) use and experiences at college health centers in the mid-Atlantic United States: changes since ECP went over-the-counter.

PubMed

Miller, Laura M

2011-01-01

To investigate the availability of emergency contraceptive pills (ECPs) at college health centers since ECP went over-the-counter (OTC) in 2006. Related issues, such as distribution procedure, existence of a written protocol, personnel involved, contraindications, follow-up procedures, methods of advertising, and staff attitudes, were examined. The sample included 135 college and university health centers in the mid-Atlantic region of the United States. Data were collected via telephone survey with the use of a 42-item survey instrument. Forty-three percent of schools reported distributing ECPs, for an average of 10.6 years. Major changes in ECP distribution and usage since ECP went OTC related primarily to protocol in ECP distribution, advertising for ECP services, and ECP accessibility to university students. College health centers are responding to the OTC status of ECP in a number of ways, primarily relating to their distribution procedures and advertising techniques.

An evaluation of strategies to control noise from air conditioning and refrigeration condensing units

NASA Astrophysics Data System (ADS)

Durden, G. L.; Myers, J. O.; Towers, T. A.; Dickman, D. M.

1981-12-01

Noise from air conditioning and refrigeration condensing units is investigated. The practical aspects of attempting to implement innovative approaches are emphasized. These included: (1) sample selection, (2) noise measurement survey, (3) implementation of aggressive abatement procedures, (4) development and use of a screening graph for determining acceptability of sound rated outdoor unitary equipment, (5) incorporation of noise control considerations, (6) exploration of an operatinal curfew, and (7) development of an incentive/information program.

Abortion-Related Mortality in the United States 1998–2010

PubMed Central

Zane, Suzanne; Creanga, Andreea A.; Berg, Cynthia J.; Pazol, Karen; Suchdev, Danielle B.; Jamieson, Denise J.; Callaghan, William M.

2015-01-01

OBJECTIVE To examine characteristics and causes of legal induced abortion–related deaths in the United States between 1998 and 2010. METHODS Abortion-related deaths were identified through the national Pregnancy Mortality Surveillance System with enhanced case-finding. We calculated the abortion mortality rate by race, maternal age, and gestational age and the distribution of causes of death by gestational age and procedure. RESULTS During the period from 1998–2010, of approximately 16.1 million abortion procedures, 108 women died, for a mortality rate of 0.7 deaths per 100,000 procedures overall, 0.4 deaths for non-Hispanic white women, 0.5 deaths for Hispanic women, and 1.1 deaths for black women. The mortality rate increased with gestational age, from 0.3 to 6.7 deaths for procedures performed at 8 weeks or less and at 18 weeks or greater, respectively. A majority of abortion-related deaths at 13 weeks of gestation or less were associated with anesthesia complications and infection, whereas a majority of abortion-related deaths at more than 13 weeks of gestation were associated with infection and hemorrhage. In 20 of the 108 cases, the abortion was performed as a result of a severe medical condition where continuation of the pregnancy threatened the woman’s life. CONCLUSION Deaths associated with legal induced abortion continue to be rare events—less than 1 per 100,000 procedures. Primary prevention of unintended pregnancy, including those in women with serious pre-existing medical conditions, and increased access to abortion services at early gestational ages may help to further decrease abortion-related mortality in the United States. PMID:26241413

Claus sulfur recovery unit startups

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

Parnell, D.C.

1973-08-01

Because of the recent emphasis on reducing sulfur emissions to the atmosphere, Claus-type sulfur recovery units are becoming more prevalent throughout the industry. Many plants, including refinery, chemical, and natural gasoline units, are being required to install Claus sulfur recovery facilities to meet pollution requirements. Although Claus units in some cases cannot alone meet the most rigid air pollution codes currently being enforced, they are still the most economical and practical method for recovering about 94 to 97% of the sulfur from hydrogen sulfide rich gases. For best operation and longer service life, proper startup and shutdown procedures for thesemore » sulfur recovery units should be followed. On all startups and shutdowns, these units require considerable operator attention; improper operation during these critical phases can affect overall plant efficiency.« less

Human Factors Considerations for Performance-Based Navigation

NASA Technical Reports Server (NTRS)

Barhydt, Richard; Adams, Catherine A.

2006-01-01

A transition toward a performance-based navigation system is currently underway in both the United States and around the world. Performance-based navigation incorporates Area Navigation (RNAV) and Required Navigation Performance (RNP) procedures that do not rely on the location of ground-based navigation aids. These procedures offer significant benefits to both operators and air traffic managers. Under sponsorship from the Federal Aviation Administration (FAA), the National Aeronautics and Space Administration (NASA) has undertaken a project to document human factors issues that have emerged during RNAV and RNP operations and propose areas for further consideration. Issues were found to include aspects of air traffic control and airline procedures, aircraft systems, and procedure design. Major findings suggest the need for human factors-specific instrument procedure design guidelines. Ongoing industry and government activities to address air-ground communication terminology, procedure design improvements, and chart-database commonality are strongly encouraged.

Field methods to evaluate effects of pesticides on wildlife of the northwestern United States

USGS Publications Warehouse

Henny, C.J.

1987-01-01

Field .methods used to evaluate the impact of organochlorine and organophosphate pesticides on wildlife populations in the Pacific Northwest are reviewed. Five field studies, presented in a CASE HISTORY format, illustrate study designs .and thetypes of information collected. The pesticides investigated included DDT, heptachlor, endr1n, and famphur, and the species studied included the American kestrel (Falco sparverius), Canada goose (Branta canadensis}, black--crowned night-heron (Nycticorax nycticorac), and black-billed magpie (Pica pica). Wildlife biologists conducting field studies of pesticides encounter a variety of design and logistics problems. However, a number of procedures are now available to the researcher for field evaluations. The three principa1 types of insecticides (organochlorines (OC's), organophosphates (OP's) and carbamates (CB's) require different field approaches. In this paper, five field studies, conducted by my colleagues and me between 1974 and 1982, in the northwestern portion of the United States (Washington, Oregon, Idaho, and northern Nevada), are reviewed to illustrate procedures for evaluating the effects of these insecticides.on wildlife populations. Althought most OC pesticides were banned in the United States during the 1970's (.for review, see F1eming et al. 1983), we studied several OC applications, including the last major DDT spray project in 1974. Use of OP's and CB's increased during the 1970's and 1980s as the OC's were phased out.

A proposed procedure for derivation of regulatory values for carcinogenic airborne polycyclic aromatic hydrocarbons (PAHs) based on coal tar pitch (CTP) volatiles.

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

Foureman, G.L.; Smith, R.L.

A procedure for estimating upper bound lifetime human cancer risk from air levels of six common carcinogenic polycyclic aromatic hydrocarbons (PAHs), termed APAHs of concern, is proposed. These PAHs are benzo(a)pyrene, benz(a)anthracene, benzo(b)fluoranthene, benzo(k)fluoranthene, indeno(1,2,3-c,d)pyrene, and chrysene. In application, this proposed procedure would regard any given air level obtained for a APAH of concern to originate from a standard mixture of coal tar pitch (CTP). The given air level for the APAHs of concern is then related to a corresponding air level of CTP and thence, to an inhalation unit cancer risk calculated for CTP. Reference values for the proceduremore » are the relative and absolute PAH composition of a CTP standard (SRM-1597) and the inhalation unit cancer risk. Qualitative characterization of the results are a vital part of the procedure especially when more than one APAH of concern{at} is being considered. Toxic equivalency factors (TEFs) may be used as an evaluative tool in characterization of the procedure and outcome. Limitations of this proposed procedure include the uneven database for the reference values and the inability to consider air samples inclusive of another common carcinogenic PAH, dibenz(a,h)anthracene, due to its lack of documentation in CTP and high TEF« less

Tornado and extreme wind design criteria for nuclear power plants

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

None

1973-12-01

Nuclear power plant design criteria for tornadoes and extreme winds are presented. Data, formulas, and procedures for determining maximum wind loading on structures and parts of structures are included. Extreme wind loading is applied to structures using methods and procedures consistent with ANSI Building Code A58.1- 1972. The design wind velocities specified generally exceed 100-year recurrent interval winds. Tornado wind loading is applied to structures using procedures paralleling those for extrene winds with additional criteria resulting from the atmospheric pressure change accompanying tornadoes and tornado missile inipact effects. Tornado loading for the 48 contiguous United States is specified for twomore » major zones separated by the Continental Divide. A cross reference listing items related to Atomic Energy Commission Safety Analysis Report format is provided. Development supporting tornado criteria is included. (auth)« less

Family presence during cardiopulmonary resuscitation and invasive procedures in children

PubMed Central

Ferreira, Cristiana Araújo G.; Balbino, Flávia Simphronio; Balieiro, Maria Magda F. G.; Mandetta, Myriam Aparecida

2014-01-01

Objective: To identify literature evidences related to actions to promote family's presence during cardiopulmonary resuscitation and invasive procedures in children hospitalized in pediatric and neonatal critical care units. Data sources : Integrative literature review in PubMed, SciELO and Lilacs databases, from 2002 to 2012, with the following inclusion criteria: research article in Medicine, or Nursing, published in Portuguese, English or Spanish, using the keywords "family", "invasive procedures", "cardiopulmonary resuscitation", "health staff", and "Pediatrics". Articles that did not refer to the presence of the family in cardiopulmonary resuscitation and invasive procedures were excluded. Therefore, 15 articles were analyzed. Data synthesis : Most articles were published in the United States (80%), in Medicine and Nursing (46%), and were surveys (72%) with healthcare team members (67%) as participants. From the critical analysis, four themes related to the actions to promote family's presence in invasive procedures and cardiopulmonary resuscitation were obtained: a) to develop a sensitizing program for healthcare team; b) to educate the healthcare team to include the family in these circumstances; c) to develop a written institutional policy; d) to ensure the attendance of family's needs. Conclusions: Researches on these issues must be encouraged in order to help healthcare team to modify their practice, implementing the principles of the Patient and Family Centered Care model, especially during critical episodes. PMID:24676198

Physical Education: Tennis, Physical Fitness, Body-Building.

ERIC Educational Resources Information Center

Veilleux, Dave

This unit plan for introducing high school students to the game of tennis is divided into objectives and suggested activities. A listing of resource outlets and retail prices for equipment and audiovisual materials is included. Student evaluation procedures are outlined, and a sample evaluation checklist is provided. (LH)

37 CFR 102.24 - Procedures for making requests for records.

Code of Federal Regulations, 2010 CFR

2010-07-01

... TRADEMARK OFFICE, DEPARTMENT OF COMMERCE ADMINISTRATION DISCLOSURE OF GOVERNMENT INFORMATION Privacy Act... Privacy Officer, United States Patent and Trademark Office, P.O. Box 1450, Alexandria, Virginia 22313-1450. (b) Requests submitted by mail should include the words “PRIVACY ACT REQUEST” in capital letters at...

37 CFR 102.24 - Procedures for making requests for records.

Code of Federal Regulations, 2011 CFR

2011-07-01

... TRADEMARK OFFICE, DEPARTMENT OF COMMERCE ADMINISTRATION DISCLOSURE OF GOVERNMENT INFORMATION Privacy Act... Privacy Officer, United States Patent and Trademark Office, P.O. Box 1450, Alexandria, Virginia 22313-1450. (b) Requests submitted by mail should include the words “PRIVACY ACT REQUEST” in capital letters at...

19 CFR 10.450 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United States-Chile Free Trade Agreement Rules of Origin § 10.450 Definitions. For purposes of §§ 10.450 through 10.463 of this subpart: (a..., rules, and procedures, including both broad and specific guidelines, that define the accounting...

75 FR 27387 - Sentencing Guidelines for United States Courts

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-14

... Practice and Procedure 4.1. William K. Sessions III, Chair. 1. Amendment: Chapter Five, Part A, is amended... scholarly literature, current federal and state practices, and feedback in various forms from federal judges... to prevent further similar criminal conduct, including assessing the compliance and ethics program...

Low Budget Biology: Genetics Unit.

ERIC Educational Resources Information Center

Wartski, Bert; Wartski, Lynn Marie

Some concepts in genetics are difficult for many students to understand. This document provides hands-on, cost efficient, fun activities for students to help them better understand abstract concepts in genetics. Each activity includes: purpose, introduction, materials, procedures, results and conclusion. Some of the topics explored are: (1)…

Seventh Grade Interdisciplinary Packet (Science-Social Studies).

ERIC Educational Resources Information Center

Madison Public Schools, WI. Dept. of Curriculum Development.

GRADES OR AGES: Grade 7. SUBJECT MATTER: Science and Social Studies. ORGANIZATION AND PHYSICAL APPEARANCE: This guide presents a series of earth sciences units which would have interdisciplinary potential specifically in the area of social studies. Introductory material includes a rationale, evaluation procedures, 44 "key" environmental concepts,…

Bank-a-Budget

ERIC Educational Resources Information Center

Karls, Doris; Jordan, Elaine

1978-01-01

The article gives procedures for consumer foods teachers to use to actively involve students in making independent food purchasing decisions according to the school foods lab budget and food buying principles. Included are forms used to keep records for each lab: unit bank account, meat lab evaluation, and market order. (MF)

Interactive boundary delineation of agricultural lands using graphics workstations

NASA Technical Reports Server (NTRS)

Cheng, Thomas D.; Angelici, Gary L.; Slye, Robert E.; Ma, Matt

1992-01-01

A review is presented of the computer-assisted stratification and sampling (CASS) system developed to delineate the boundaries of sample units for survey procedures. CASS stratifies the sampling units by land-cover and land-use type, employing image-processing software and hardware. This procedure generates coverage areas and the boundaries of stratified sampling units that are utilized for subsequent sampling procedures from which agricultural statistics are developed.

Crew Procedures for Continuous Descent Arrivals Using Conventional Guidance

NASA Technical Reports Server (NTRS)

Oseguera-Lohr, Rosa M.; Williams, David H.; Lewis, Elliot T,

2007-01-01

This paper presents results from a simulation study which investigated the use of Continuous Descent Arrival (CDA) procedures for conducting a descent through a busy terminal area, using conventional transport-category automation. This research was part of the Low Noise Flight Procedures (LNFP) element within the Quiet Aircraft Technology (QAT) Project, that addressed development of flight guidance, and supporting pilot and Air Traffic Control (ATC) procedures for low noise operations. The procedures and chart were designed to be easy to understand, and to make it easy for the crew to make changes via the Flight Management Computer Control-Display Unit (FMC-CDU) to accommodate changes from ATC. The test runs were intended to represent situations typical of what exists in many of today's terminal areas, including interruptions to the descent in the form of clearances issued by ATC.

22 CFR 50.7 - Consular Report of Birth Abroad of a Citizen of the United States of America.

Code of Federal Regulations, 2012 CFR

2012-04-01

... PASSPORTS NATIONALITY PROCEDURES Procedures for Determination of United States Nationality of a Person... United States of America may be issued by the Department of State's Passport Office upon written request...

22 CFR 50.7 - Consular Report of Birth Abroad of a Citizen of the United States of America.

Code of Federal Regulations, 2011 CFR

2011-04-01

... PASSPORTS NATIONALITY PROCEDURES Procedures for Determination of United States Nationality of a Person... United States of America may be issued by the Department of State's Passport Office upon written request...

22 CFR 50.7 - Consular Report of Birth Abroad of a Citizen of the United States of America.

Code of Federal Regulations, 2014 CFR

2014-04-01

... PASSPORTS NATIONALITY PROCEDURES Procedures for Determination of United States Nationality of a Person... United States of America may be issued by the Department of State's Passport Office upon written request...

22 CFR 50.7 - Consular Report of Birth Abroad of a Citizen of the United States of America.

Code of Federal Regulations, 2013 CFR

2013-04-01

... PASSPORTS NATIONALITY PROCEDURES Procedures for Determination of United States Nationality of a Person... United States of America may be issued by the Department of State's Passport Office upon written request...

22 CFR 50.7 - Consular Report of Birth Abroad of a Citizen of the United States of America.

Code of Federal Regulations, 2010 CFR

2010-04-01

... PASSPORTS NATIONALITY PROCEDURES Procedures for Determination of United States Nationality of a Person... United States of America may be issued by the Department of State's Passport Office upon written request...

Does intraoperative fluid management in spine surgery predict intensive care unit length of stay?

PubMed

Nahtomi-Shick, O; Kostuik, J P; Winters, B D; Breder, C D; Sieber, A N; Sieber, F E

2001-05-01

To determine whether intraoperative fluid management in spine surgery predicts postoperative intensive care unit length of stay (ICU LOS). Retrospective case series. University-affiliated medical center. 103 adult ASA physical status I, II, and III patients undergoing spine surgery. Patients were divided into three LOS groups: no ICU stay (LOS0) (n = 26), 1 day ICU stay (LOS1) (n = 48), and ICU stay > 1 day (LOS2) (n = 29). Measurements were analyzed by groups using the Kruskal-Wallis and Mann-Whitney tests, and linear regression. Demographics, comorbidity, length of surgery, surgical procedure, and intraoperative fluids were recorded. The important differences in perioperative fluid management among the three groups included estimated blood loss (612 +/- 480 mL, 1853 +/- 1175 mL, 2702 +/- 1771 mL, means +/- SD); total crystalloid administration (2715 +/- 1396 mL, 5717 +/- 2574 mL, 7281 +/- 3417 mL); and total blood administration (92 +/- 279 mL, 935 +/- 757 mL, 1542 +/- 1230 mL) in LOS0, LOS1, and LOS2, respectively. The mixture of surgical procedures was similar in LOS1 and LOS2; and differed from LOS0. Predictors of ICU LOS included age, ASA physical status, surgical procedure, total crystalloid administration, and platelet administration. Surgical procedure and total crystalloid administration correlated (Pearson correlation coefficient = 0.441; p = 0.000) and were not related to age or ASA physical status. Total crystalloid administration during spine surgery does predict ICU LOS. In addition, total crystalloid administration is closely related to the surgical procedure. Given that the mixture of surgical procedures was similar in LOS1 and LOS2, but differed in estimated blood loss, total crystalloid administration, and total blood administration; intraoperative fluid management during spine surgery only predicts ICU LOS insofar as total crystalloid administration is related to the surgical procedure.

Gastrointestinal endoscopy in pregnancy

PubMed Central

Savas, Nurten

2014-01-01

Gastrointestinal endoscopy has a major diagnostic and therapeutic role in most gastrointestinal disorders; however, limited information is available about clinical efficacy and safety in pregnant patients. The major risks of endoscopy during pregnancy include potential harm to the fetus because of hypoxia, premature labor, trauma and teratogenesis. In some cases, endoscopic procedures may be postponed until after delivery. When emergency or urgent indications are present, endoscopic procedures may be considered with some precautions. United States Food and Drug Administration category B drugs may be used in low doses. Endoscopic procedures during pregnancy may include upper gastrointestinal endoscopy, percutaneous endoscopic gastrostomy, sigmoidoscopy, colonoscopy, enteroscopy of the small bowel or video capsule endoscopy, endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography. All gastrointestinal endoscopic procedures in pregnant patients should be performed in hospitals by expert endoscopists and an obstetrician should be informed about all endoscopic procedures. The endoscopy and flexible sigmoidoscopy may be safe for the fetus and pregnant patient, and may be performed during pregnancy when strong indications are present. Colonoscopy for pregnant patients may be considered for strong indications during the second trimester. Although therapeutic endoscopic retrograde cholangiopancreatography may be considered during pregnancy, this procedure should be performed only for strong indications and attempts should be made to minimize radiation exposure. PMID:25386072

The effect of tablet computers with a mobile patient portal application on hospitalized patients' knowledge and activation.

PubMed

O'Leary, Kevin J; Lohman, Mary E; Culver, Eckford; Killarney, Audrey; Randy Smith, G; Liebovitz, David M

2016-01-01

To assess the effect of tablet computers with a mobile patient portal application on hospitalized patients' knowledge and activation. We developed a mobile patient portal application including pictures, names, and role descriptions of team members, scheduled tests and procedures, and a list of active medications. We evaluated the effect of the application using a controlled trial involving 2 similar units in a large teaching hospital. Patients on the intervention unit were offered use of tablet computers with the portal application during their hospitalization. We assessed patients' ability to correctly name their nurse, primary service physicians, physician roles, planned tests and procedures, medications started, and medications stopped since admission. We also administered the Short Form of the Patient Activation Measure. Overall, 100 intervention- and 102 control-unit patients participated. A higher percentage of intervention-unit patients correctly named ≥1 physician (56% vs 29.4%; P < .001) and ≥1 physician role (47% vs 15.7%; P < .001). Knowledge of nurses' names, planned tests, planned procedures, and medication changes was generally low and not significantly different between the study units. The Short Form of the Patient Activation Measure mean (SD) score was also not significantly different at 64.1 (13.4) vs 62.7 (12.8); P = .46. Additional research is needed to identify optimal methods to engage and inform patients during their hospitalization, which will improve preparation for self- management after discharge. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Recovering activity and illusion: the nephrology day care unit.

PubMed

Remón Rodríguez, C; Quirós Ganga, P L; González-Outón, J; del Castillo Gámez, R; García Herrera, A L; Sánchez Márquez, M G

2011-01-01

Day Care Units are an alternative to hospital care that improves more efficiency. The Nephrology, by its technical characteristics, would be benefit greatly from further development of this care modality. The objectives of this study are to present the process we have developed the Nephrology Day Care Unit in the Puerto Real University Hospital (Cádiz, Spain). For this project we followed the Deming Management Method of Quality improvement, selecting opportunities, analyzing causes, select interventions, implement and monitor results. The intervention plan includes the following points: 1) Define the place of the Day Care Unit in the organization of our Clinical Department of Nephrology, 2) Define the Manual of organization, 3) Define the structural and equipment resources, 4) Define the Catalogue of services and procedures, 5) Standards of Care Processes. Protocols and Clinical Pathways; and 6) Information and Registration System. In the first 8 months we have been performed nearly 2000 procedures, which corresponds to an average of about 10 procedures per day, and essentially related to Hemodialysis in critical or acute patients, the Interventional Nephrology, the Clinical Nephrology and Peritoneal Dialysis. The development of the Nephrology Day Care Units can help to increase our autonomy, our presence in Hospitals, recover the progressive loss of clinical activity (diagnostic and therapeutic skills) in the past to the benefit of other Specialties. It also contributes to: Promote and develop the Diagnostic and Interventional Nephrology; improve the clinical management of patients with Primary Health Level, promote the Health Education and Investigation, collaborate in the Resources Management, and finally, to make more attractive and exciting our Specialty, both for nephrologists to training specialists.

Environmental Impact of Minimally Invasive Surgery in the United States: An Estimate of the Carbon Dioxide Footprint

PubMed Central

Power, Nicholas E.; Silberstein, Jonathan L.; Ghoneim, Tarek P.; Guillonneau, Bertrand

2012-01-01

Abstract Purpose To attempt to quantitate the carbon footprint of minimally invasive surgery (MIS) through approximated scope 1 to 3 CO2 emissions to identify its potential role in global warming. Patients and Methods To estimate national usage, we determined the number of inpatient and outpatient MIS procedures using International Classification of Diseases, ninth revision-clinical modification codes for all MIS procedures in a 2009 sample collected in national databases. Need for surgery was considered essential, and therefore traditional open surgery was used as the comparator. Scope 1 (direct) CO2 emissions resulting from CO2 gas used for insufflation were based on both escaping procedural CO2 and metabolic CO2 eliminated via respiration. Scopes 2 and 3 (indirect) emissions related to capture, compression, and transportation of CO2 to hospitals and the disposal of single-use equipment not used in open surgery were calculated. Results The total CO2 emissions were calculated to be 355,924 tonnes/year. For perspective, if MIS in the United States was considered a country, it would rank 189th on the United Nations 2008 list of countries' carbon emissions per year. Limitations include the inability to account for uncertainty using the various models and tools for approximating CO2 emissions. Conclusion CO2 emission of MIS in the United States may have a significant environmental impact. This is the first attempt to quantify CO2 emissions related to MIS in the United States. Strategies for reduction, while maintaining high quality medical care, should be considered. PMID:22845049

Validation of a New Method to Automatically Select Cases With Intraoperative Red Blood Cell Transfusion for Audit.

PubMed

Dexter, Franklin; Epstein, Richard H; Ledolter, Johannes; Dasovich, Susan M; Herman, Jay H; Maga, Joni M; Schwenk, Eric S

2018-05-01

Hospitals review allogeneic red blood cell (RBC) transfusions for appropriateness. Audit criteria have been published that apply to 5 common procedures. We expanded on this work to study the management decision of selecting which cases involving transfusion of at least 1 RBC unit to audit (review) among all surgical procedures, including those previously studied. This retrospective, observational study included 400,000 cases among 1891 different procedures over an 11-year period. There were 12,616 cases with RBC transfusion. We studied the proportions of cases that would be audited based on criteria of nadir hemoglobin (Hb) greater than the hospital's selected transfusion threshold, or absent Hb or missing estimated blood loss (EBL) among procedures with median EBL <500 mL. This threshold EBL was selected because it is approximately the volume removed during the donation of a single unit of whole blood at a blood bank. Missing EBL is important to the audit decision for cases in which the procedures' median EBL is <500 mL because, without an indication of the extent of bleeding, there are insufficient data to assume that there was sufficient blood loss to justify the transfusion. Most cases (>50%) that would be audited and most cases (>50%) with transfusion were among procedures with median EBL <500 mL (P < .0001). Among cases with transfusion and nadir Hb >9 g/dL, the procedure's median EBL was <500 mL for 3.0 times more cases than for procedures having a median EBL ≥500 mL. A greater percentage of cases would be recommended for audit based on missing values for Hb and/or EBL than based on exceeding the Hb threshold among cases of procedures with median EBL ≥500 mL (P < .0001). There were 3.7 times as many cases with transfusion that had missing values for Hb and/or EBL than had a nadir Hb >9 g/dL and median EBL for the procedure ≥500 mL. An automated process to select cases for audit of intraoperative transfusion of RBC needs to consider the median EBL of the procedure, whether the nadir Hb is below the hospital's Hb transfusion threshold for surgical cases, and the absence of either a Hb or entry of the EBL for the case. This conclusion applies to all surgical cases and procedures.

20 CFR 655.3 - Special procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process and Enforcement of Attestations for Temporary Employment in Occupations Other Than Agriculture or Registered Nursing in the United States (H-2B Workers) § 655.3 Special procedures. (a) Systematic process. This subpart provides procedures for the...

Plated wire memory subsystem

NASA Technical Reports Server (NTRS)

Carpenter, K. H.

1974-01-01

The design, construction, and test history of a 4096 word by 18 bit random access NDRO Plated Wire Memory for use in conjunction with a spacecraft input/output and central processing unit is reported. A technical and functional description is given along with diagrams illustrating layout and systems operation. Test data is shown on the procedures and results of system level and memory stack testing, and hybrid circuit screening. A comparison of the most significant physical and performance characteristics of the memory unit versus the specified requirements is also included.

Audit of transfusion procedures in 660 hospitals. A College of American Pathologists Q-Probes study of patient identification and vital sign monitoring frequencies in 16494 transfusions.

PubMed

Novis, David A; Miller, Karen A; Howanitz, Peter J; Renner, Stephen W; Walsh, Molly K

2003-05-01

Hemolytic transfusion reactions are often the result of failure to follow established identification and monitoring procedures. To measure the frequencies with which health care workers completed specific transfusion procedures required for laboratory and blood bank accreditation. In 2 separate studies, participants in the College of American Pathologists Q-Probes laboratory quality improvement program audited nonemergent red blood cell transfusions prospectively and completed questionnaires profiling their institutions' transfusion policies. A total of 660 institutions, predominantly in the United States, at which transfusion medicine services are provided. The percentages of transfusions for which participants completed 4 specific components of patient and blood unit identifications, and for which participants monitored vital signs at 3 specific intervals during transfusions. In the first study, all components of patient identification procedures were performed in 62.3%, and all required patient vital sign monitoring was performed in 81.6% of 12 448 transfusions audited. The median frequencies with which institutions participating in the first study performed all patient identification and monitoring procedures were 69.0% and 90.2%, respectively. In the second study, all components of patient identification were performed in 25.4% and all patient vital sign monitoring was performed in 88.3% of 4046 transfusions audited. The median frequencies with which institutions participating in the second study performed all patient identification and monitoring procedures were 10.0% and 95.0%, respectively. Individual practices and/or institutional policies associated with greater frequencies of patient identification and/or vital sign monitoring included transporting units of blood directly to patient bedsides, having no more than 1 individual handle blood units in route, checking unit labels against physicians' orders, having patients wear identification tags (wristbands), reading identification information aloud when 2 or more transfusionists participated, using written checklists to guide the administration of blood, instructing health care personnel in transfusion practices, and routinely auditing the administration of transfusions. In many hospitals, the functions of identification and vital sign monitoring of patients receiving blood transfusions do not meet laboratory and blood bank accreditation standards. Differences in hospital transfusion policies influence how well health care workers comply with standard practices. We would expect that efforts designed to perfect transfusion policies might also improve performance in those hospitals in which practice compliance is substandard.

First U.S. near-total human face transplantation: a paradigm shift for massive complex injuries.

PubMed

Siemionow, Maria Z; Papay, Frank; Djohan, Risal; Bernard, Steven; Gordon, Chad R; Alam, Daniel; Hendrickson, Mark; Lohman, Robert; Eghtesad, Bijan; Fung, John

2010-01-01

Severe complex facial injuries are difficult to reconstruct and require multiple surgical procedures. The potential of performing complex craniofacial reconstruction in one surgical procedure is appealing, and composite face allograft transplantation may be considered an alternative option. The authors describe establishment of the Cleveland Clinic face transplantation program that led them to perform the first U.S. near-total face transplantation. In November of 2004, the authors received the world's first institutional review board approval to perform a face transplant in humans. In December of 2008, after a 22-hour operation, the authors performed the first near-total face transplantation in the United States, replacing 80 percent of the patient's traumatic facial deficit with a composite allograft from a brain-dead donor. This largest, and most complex, face allograft in the world included over 535 cm2 of facial skin; functional units of full nose with nasal lining and bony skeleton; lower eyelids and upper lip; underlying muscles and bones, including orbital floor, zygoma, maxilla, alveolus with teeth, hard palate, and parotid glands; and pertinent nerves, arteries, and veins. Immunosuppressive treatment consisted of thymoglobulin, tacrolimus, mycophenolate mofetil, and prednisone. The patient tolerated the procedure and immunosuppression well. At day 47 after transplantation, routine biopsy showed rejection of the graft mucosa without clinical evidence of skin or graft rejection. The patient's physical and psychological recovery went well. The functional outcome has been excellent, including optimal return of breathing through the nose, smelling, tasting, speaking, drinking from a cup, and eating solid foods. The functional outcome thus far at 8 months is rewarding and confirms the feasibility of performing complex reconstruction of severely disfigured patients in a single surgical procedure of facial allotransplantation.

The Rise of Post-Grant Proceedings

PubMed Central

2016-01-01

This viewpoint provides a brief overview of the procedures for initiating post-grant proceedings before the United States Patent Trial and Appeal Board, including a discussion of why companies are now commonly electing to use those proceedings, both as part of an overall litigation strategy and outside of the litigation context. PMID:28105262

Food Production, Management and Services: Service. Teacher Edition. Second Edition.

ERIC Educational Resources Information Center

Palan, Earl

This food production, management, and services teacher guide contains nine units: (1) orientation; (2) types of service; (3) table settings; (4) dining room personnel; (5) dining room procedures; (6) side work; (7) guest/employee relationships; (8) sales techniques; and (9) safety and sanitation. Suggestions are included to increase reinforcement…

7 CFR 2.65 - Administrator, Agricultural Research Service.

Code of Federal Regulations, 2014 CFR

2014-01-01

... groups; and (iii) Design and carry out methodological research studies to develop improved procedures for... designed to reduce the cost of producing upland cotton in the United States (7 U.S.C. 1441 note). (16... Research Program. Included in this delegation is the authority to: (i) Design and carry out periodic...

7 CFR 2.65 - Administrator, Agricultural Research Service.

Code of Federal Regulations, 2012 CFR

2012-01-01

... groups; and (iii) Design and carry out methodological research studies to develop improved procedures for... designed to reduce the cost of producing upland cotton in the United States (7 U.S.C. 1441 note). (16... Research Program. Included in this delegation is the authority to: (i) Design and carry out periodic...

7 CFR 2.65 - Administrator, Agricultural Research Service.

Code of Federal Regulations, 2013 CFR

2013-01-01

... groups; and (iii) Design and carry out methodological research studies to develop improved procedures for... designed to reduce the cost of producing upland cotton in the United States (7 U.S.C. 1441 note). (16... Research Program. Included in this delegation is the authority to: (i) Design and carry out periodic...

A Primer on Sampling for Statewide Assessment.

ERIC Educational Resources Information Center

Jaeger, Richard M.

This paper is a primer on sampling procedures for statewide assessment. The careful reader should gain substantial knowledge about the promises and pitfalls of sampling for assessment. The primer has three basic objectives: (1) to define terms and concepts basic to sampling theory and its application, including population, sampling unit, sampling…

Building America's Industrial Revolution: The Boott Cotton Mills of Lowell, Massachusetts. Teaching with Historic Places.

ERIC Educational Resources Information Center

Stowell, Stephen

1995-01-01

Presents a high school unit about the U.S. Industrial Revolution featuring the Boott Cotton Mills of Lowell, Massachusetts. Includes student objectives, step-by-step instructional procedures, and discussion questions. Provides two maps, five illustrations, one photograph, and three student readings. (ACM)

Project Earth, A Curriculum Guide, Kindergarten-Primary-Intermediate.

ERIC Educational Resources Information Center

Rogers, Arnold R., Ed.

This conservation curriculum guide contains units on the air, water, soil, plants, and animals. The guide is organized by grade levels--kindergarten, primary, intermediate. Objectives and concepts are listed and suggested activities are complete with a statement of procedure and necessary materials. A resource appendix includes books, films, and…

Some Models for Interpreting the History of Compulsory Schooling.

ERIC Educational Resources Information Center

Tyack, David B.

Five models are postulated for interpreting the three historical stages in the development of compulsory schooling in the United States. These three stages include (1) a symbolic stage where compulsory public school education began to gain strength but lacked enforcement procedures, (2) a bureaucratic phase beginning around 1900 where new…

34 CFR 674.50 - Assignment of defaulted loans to the United States.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION FEDERAL PERKINS LOAN PROGRAM Due Diligence... to collect on the loan despite complying with the diligence procedures, including at least a first... all of the due diligence requirements described in paragraph (a)(1) of this section if the institution...

40 CFR 1612.1 - Purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-07-01

... litigants; (4) Avoid spending the time and money of the United States for private purposes; and (5) To... requesting material for use in legal proceedings (including administrative proceedings) in which the Chemical Safety and Hazard Investigation Board (CSB) is not a party, and procedures to be followed by the employee...

Methods in Teaching Basic Business Subjects.

ERIC Educational Resources Information Center

Musselman, Vernon A.

The textbook is intended for use in college methods classes in business education, is self-teachable, written informally, and includes two complete teaching units in detail. On the premise that classroom procedures utilized in teaching the basic business subjects differ considerably from those employed in teaching the skill subjects, the book…

75 FR 61572 - Change to “Procedures To Qualify for Bulk Purchase of Silver Bullion Coins”

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-05

... effective immediately. Significant modifications include the addition of the America the Beautiful Silver... ``Marketing Support'' section, and adjustments to the ``Experienced Market-Maker in Silver Bullion Coins... FURTHER INFORMATION CONTACT: B. B. Craig, Associate Director for Sales and Marketing; United States Mint...

75 FR 53024 - Change to “Procedures To Qualify for Bulk Purchase of Gold Bullion Coins”

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-30

....usmint.gov/consumer/index.cfm?action=AmericanEagles ) These changes apply to new applications effective immediately. Significant modifications include clarifications to the ``Purpose'' section and ``Marketing... FURTHER INFORMATION CONTACT: B. B. Craig, Associate Director for Sales and Marketing; United States Mint...

Ozone: Does It Affect Me?

ERIC Educational Resources Information Center

Wilson, Karla G.

This curriculum unit on the ozone is intended for high school students and contains sections on environmental science and chemistry. It has been structured according to a learning cycle model and contains numerous activities, some of which are in a cooperative learning format. Skills emphasized include laboratory procedures, experimental design,…

Occupational Exploration at Ontario Junior High School: 8th Grade.

ERIC Educational Resources Information Center

Bates, Gene; And Others

The document contains 47 activities for Grade 8. The contents include the following areas: questionnaires; work vocabularies; employment seeking procedures--employment ads, application forms, resumes, job interviews, and resume preparation advice; a 24-page unit presenting occupational information in relation to career choice and job application…

Mountain Plains Learning Experience Guide: Carpentry. Course: Finish.

ERIC Educational Resources Information Center

Leland, Lyle

One of two individualized courses included in a carpentry curriculum, this course is structured to provide the information, procedures, and experiences to complete the carpentry requirements following the framing operation. The course is comprised of five units: (1) Machine Processes, (2) Exterior Wall Coverings and Cornice, (3) Windows and Trim,…

INTERLABORATORY VALIDATION OF USEPA METHOD 1680: FECAL COLIFORMS IN BIOSOLIDS BY MULTIPLE-TUBE FERMENTATION PROCEDURES

EPA Science Inventory

In the United States, the use and disposal of biosolids (including domestic septage) are regulated under 40 CFR Part 503. Subpart D of this regulation protects public health and the environment through requirements designed to reduce the potential for contact with pathogens in bi...

Teaching Grammar: What Really Works

ERIC Educational Resources Information Center

Benjamin, Amy; Berger, Joan

2010-01-01

In this book, the authors share procedures for teaching grammar effectively and dynamically, in ways that appeal to students and teachers alike. Ideal for teachers just beginning their work in grammar instruction, this book includes day-by-day units and reproducibles to help them embed grammar lessons into writing instruction. Using visuals,…

Classwide Functional Analysis and Treatment of Preschoolers' Disruptive Behavior

ERIC Educational Resources Information Center

Poole, Veena Y.; Dufrene, Brad A.; Sterling, Heather E.; Tingstrom, Daniel H.; Hardy, Christina M.

2012-01-01

Relatively few functional assessment and intervention studies have been conducted in preschool classrooms with children of typical development who engage in high incidence problem behaviors. Moreover, limited studies have used functional assessment procedures with the class as the unit of analysis. This study included functional analyses and a…

Developing Competency in Payroll Procedures

ERIC Educational Resources Information Center

Jackson, Allen L.

1975-01-01

The author describes a sequence of units that provides for competency in payroll procedures. The units could be the basis for a four to six week minicourse and are adaptable, so that the student, upon completion, will be able to apply his learning to any payroll procedures system. (Author/AJ)

Carpentry and Finishing Procedures. Building Maintenance. Module II. Instructor's Guide.

ERIC Educational Resources Information Center

Hawk, Sam; Brunk, Art

This curriculum guide, keyed to the building maintenance competency profile developed by industry and education professionals, provides three units on carpentry and finishing procedures. The first unit, Exterior Carpentry, contains the following lessons: carpentry safety procedures, ladder and scaffolding safety, door installation/repair,…

21 CFR 211.100 - Written procedures; deviations.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Process Controls § 211.100 Written procedures; deviations. (a) There shall be written procedures for production and process control designed to assure that the drug products have the identity, strength, quality... approved by the appropriate organizational units and reviewed and approved by the quality control unit. (b...

21 CFR 211.100 - Written procedures; deviations.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Process Controls § 211.100 Written procedures; deviations. (a) There shall be written procedures for production and process control designed to assure that the drug products have the identity, strength, quality... approved by the appropriate organizational units and reviewed and approved by the quality control unit. (b...

21 CFR 211.100 - Written procedures; deviations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Process Controls § 211.100 Written procedures; deviations. (a) There shall be written procedures for production and process control designed to assure that the drug products have the identity, strength, quality... approved by the appropriate organizational units and reviewed and approved by the quality control unit. (b...

21 CFR 211.100 - Written procedures; deviations.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Process Controls § 211.100 Written procedures; deviations. (a) There shall be written procedures for production and process control designed to assure that the drug products have the identity, strength, quality... approved by the appropriate organizational units and reviewed and approved by the quality control unit. (b...

21 CFR 211.100 - Written procedures; deviations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Process Controls § 211.100 Written procedures; deviations. (a) There shall be written procedures for production and process control designed to assure that the drug products have the identity, strength, quality... approved by the appropriate organizational units and reviewed and approved by the quality control unit. (b...

Efficiency of performing pulmonary procedures in a shared endoscopy unit: procedure time, turnaround time, delays, and procedure waiting time.

PubMed

Verma, Akash; Lee, Mui Yok; Wang, Chunhong; Hussein, Nurmalah B M; Selvi, Kalai; Tee, Augustine

2014-04-01

The purpose of this study was to assess the efficiency of performing pulmonary procedures in the endoscopy unit in a large teaching hospital. A prospective study from May 20 to July 19, 2013, was designed. The main outcome measures were procedure delays and their reasons, duration of procedural steps starting from patient's arrival to endoscopy unit, turnaround time, total case durations, and procedure wait time. A total of 65 procedures were observed. The most common procedure was BAL (61%) followed by TBLB (31%). Overall procedures for 35 (53.8%) of 65 patients were delayed by ≥ 30 minutes, 21/35 (60%) because of "spillover" of the gastrointestinal and surgical cases into the time block of pulmonary procedure. Time elapsed between end of pulmonary procedure and start of the next procedure was ≥ 30 minutes in 8/51 (16%) of cases. In 18/51 (35%) patients there was no next case in the room after completion of the pulmonary procedure. The average idle time of the room after the end of pulmonary procedure and start of next case or end of shift at 5:00 PM if no next case was 58 ± 53 minutes. In 17/51 (33%) patients the room's idle time was >60 minutes. A total of 52.3% of patients had the wait time >2 days and 11% had it ≥ 6 days, reason in 15/21 (71%) being unavailability of the slot. Most pulmonary procedures were delayed due to spillover of the gastrointestinal and surgical cases into the block time allocated to pulmonary procedures. The most common reason for difficulty encountered in scheduling the pulmonary procedure was slot unavailability. This caused increased procedure waiting time. The strategies to reduce procedure delays and turnaround times, along with improved scheduling methods, may have a favorable impact on the volume of procedures performed in the unit thereby optimizing the existing resources.

Revised Methods for Characterizing Stream Habitat in the National Water-Quality Assessment Program

USGS Publications Warehouse

Fitzpatrick, Faith A.; Waite, Ian R.; D'Arconte, Patricia J.; Meador, Michael R.; Maupin, Molly A.; Gurtz, Martin E.

1998-01-01

Stream habitat is characterized in the U.S. Geological Survey's National Water-Quality Assessment (NAWQA) Program as part of an integrated physical, chemical, and biological assessment of the Nation's water quality. The goal of stream habitat characterization is to relate habitat to other physical, chemical, and biological factors that describe water-quality conditions. To accomplish this goal, environmental settings are described at sites selected for water-quality assessment. In addition, spatial and temporal patterns in habitat are examined at local, regional, and national scales. This habitat protocol contains updated methods for evaluating habitat in NAWQA Study Units. Revisions are based on lessons learned after 6 years of applying the original NAWQA habitat protocol to NAWQA Study Unit ecological surveys. Similar to the original protocol, these revised methods for evaluating stream habitat are based on a spatially hierarchical framework that incorporates habitat data at basin, segment, reach, and microhabitat scales. This framework provides a basis for national consistency in collection techniques while allowing flexibility in habitat assessment within individual Study Units. Procedures are described for collecting habitat data at basin and segment scales; these procedures include use of geographic information system data bases, topographic maps, and aerial photographs. Data collected at the reach scale include channel, bank, and riparian characteristics.

Surgical wound infection rates in Spain: data summary, January 1997 through June 2012.

PubMed

Díaz-Agero Pérez, Cristina; Robustillo Rodela, Ana; Pita López, María José; López Fresneña, Nieves; Monge Jodrá, Vicente

2014-05-01

The Indicadores Clínicos de Mejora Continua de la Calidad (INCLIMECC) program was established in Spain in 1997. INCLIMECC is a prospective system of health care-associated infection (HAI) surveillance that collects incidence data in surgical and intensive care unit patients. The protocol is based on the National Healthcare Safety Network (NHSN) surveillance system, formerly known as the National Nosocomial Infection Surveillance (NNIS) system, and uses standard infection definitions from the US Centers for Disease Control and Prevention. Each hospital takes part voluntarily and selects the units and surgical procedures to be surveyed. This report is a summary of the data collected between January 1997 and June 2012. A total of 370,015 patients were included, and the overall incidence of surgical wound infection (SWI) was 4.51%. SWI rates are provided by NHSN operating procedure category and NNIS risk index category. More than 27% of the patients received inadequate antibiotic prophylaxis, the main reason being unsuitable duration (57.05% of cases). Today, the INCLIMECC network includes 64 Spanish hospitals. We believe that an HAI surveillance system with trained personnel external to the surveyed unit is a key component not only in infection control and prevention, but also in a quality improvement system. Copyright © 2014. Published by Mosby, Inc.

Academic medical libraries' policies and procedures for notifying library users of retracted scientific publications.

PubMed

Hughes, C

1998-01-01

Academic medical libraries have a responsibility to inform library users regarding retracted publications. Many have created policies and procedures that identify flawed journal articles. A questionnaire was sent to the 129 academic medical libraries in the United States and Canada to find out how many had policies and procedures for identifying retracted publications. Of the returned questionnaires, 59% had no policy and no practice for calling the attention of the library user to retracted publications. Forty-one percent of the libraries called attention to retractions with or without a formal policy for doing so. Several responding libraries included their policy statement with the survey. The increasing number of academic medical libraries that realize the importance of having policies and practices in place highlights the necessity for this procedure.

77 FR 72885 - Meeting of the Judicial Conference Committee on Rules of Practice and Procedure

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-06

... Procedure AGENCY: Judicial Conference of the United States Advisory Committee on Rules of Civil Procedure... Timberdell Road, Norman, OK 73019. FOR FURTHER INFORMATION CONTACT: Jonathan C. Rose, Secretary and Chief Rules Officer, Rules Committee Support Office, Administrative Office of the United States Courts...

76 FR 62074 - Proposed Revision of Performance Standards for State Medicaid Fraud Control Units

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-06

... volume of case referrals and workload for each location. Performance Standard 3--Policies and Procedures A Unit establishes written policies and procedures for its operations and ensures that staff are familiar with, and adhere to, policies and procedures. In meeting this standard, the following performance...

Connectionist Learning Procedures.

ERIC Educational Resources Information Center

Hinton, Geoffrey E.

A major goal of research on networks of neuron-like processing units is to discover efficient learning procedures that allow these networks to construct complex internal representations of their environment. The learning procedures must be capable of modifying the connection strengths in such a way that internal units which are not part of the…

Implementation of multidimensional knowledge translation strategies to improve procedural pain in hospitalized children.

PubMed

Stevens, Bonnie J; Yamada, Janet; Promislow, Sara; Stinson, Jennifer; Harrison, Denise; Victor, J Charles

2014-11-25

Despite extensive research, institutional policies, and practice guidelines, procedural pain remains undertreated in hospitalized children. Knowledge translation (KT) strategies have been employed to bridge the research to practice gap with varying success. The most effective single or combination of KT strategies has not been found. A multifaceted KT intervention, Evidence-based Practice for Improving Quality (EPIQ), that included tailored KT strategies was effective in improving pain practices and clinical outcomes at the unit level in a prospective comparative cohort study in 32 hospital units (16 EPIQ intervention and 16 Standard Care), in eight pediatric hospitals in Canada. In a study of the 16 EPIQ units (two at each hospital) only, the objectives were to: determine the effectiveness of evidence-based KT strategies implemented to achieve unit aims; describe the KT strategies implemented and their influence on pain assessment and management across unit types; and identify facilitators and barriers to their implementation. Data were collected from each EPIQ intervention unit on targeted pain practices and KT strategies implemented, through chart review and a process evaluation checklist, following four intervention cycles over a 15-month period. Following the completion of the four cycle intervention, 78% of 23 targeted pain practice aims across units were achieved within 80% of the stated aims. A statistically significant improvement was found in the proportion of children receiving pain assessment and management, regardless of pre-determined aims (p < 0.001). The median number of KT strategies implemented was 35 and included reminders, educational outreach and materials, and audit and feedback. Units successful in achieving their aims implemented more KT strategies than units that did not. No specific type of single or combination of KT strategies was more effective in improving pain assessment and management outcomes. Tailoring KT strategies to unit context, support from unit leadership, staff engagement, and dedicated time and resources were identified as facilitating effective implementation of the strategies. Further research is required to better understand implementation outcomes, such as feasibility and fidelity, how context influences the effectiveness of multifaceted KT strategies, and the sustainability of improved pain practices and outcomes over time.

Use of topical tranexamic acid or aminocaproic acid to prevent bleeding after major surgical procedures.

PubMed

Ipema, Heather J; Tanzi, Maria G

2012-01-01

To evaluate the literature describing topical use of tranexamic acid or aminocaproic acid for prevention of postoperative bleeding after major surgical procedures. Literature was retrieved through MEDLINE (1946-September 2011) and International Pharmaceutical Abstracts (1970-September 2011) using the terms tranexamic acid, aminocaproic acid, antifibrinolytic, topical, and surgical. In addition, reference citations from publications identified were reviewed. All identified articles in English were evaluated. Clinical trials, case reports, and meta-analyses describing topical use of tranexamic acid or aminocaproic acid to prevent postoperative bleeding were included. A total of 16 publications in the setting of major surgical procedures were included; the majority of data were for tranexamic acid. For cardiac surgery, 4 trials used solutions containing tranexamic acid (1-2.5 g in 100-250 mL of 0.9% NaCl), and 1 trial assessed a solution containing aminocaproic acid (24 g in 250 mL of 0.9% NaCl). These solutions were poured into the chest cavity before sternotomy closure. For orthopedic procedures, all of the data were for topical irrigation solutions containing tranexamic acid (500 mg-3 g in 50-100 mL of 0.9% NaCl) or for intraarticular injections of tranexamic acid (250 mg to 2 g in 20-50 mL of 0.9% sodium chloride, with or without carbazochrome sodium sulfate). Overall, use of topical tranexamic acid or aminocaproic acid reduced postoperative blood loss; however, few studies reported a significant reduction in the number of packed red blood cell transfusions or units given, intensive care unit stay, or length of hospitalization. Topical application of tranexamic acid and aminocaproic acid to decrease postsurgical bleeding after major surgical procedures is a promising strategy. Further data are needed regarding the safety of this hemostatic approach.

Unplanned admissions in day-case surgery as a clinical indicator for quality assurance.

PubMed

Margovsky, A

2000-03-01

Day surgery is a modern, effective and economical way to treat patients while maintaining the same level of quality of patient care. Quality improvement in day surgery units, however, continues to be an issue due to high rates of unplanned admissions. The aim of the present retrospective study was to investigate reasons for and methods of preventing unplanned postoperative admissions in a day surgical unit over a 12-month period in respect to different surgical specialties. The study was based on an audit from the Endoscopy and Day Surgery Unit (EDSU) at Launceston General Hospital, which provides health care to a population of more than 120000. For the accounted period 920 outpatients had elective day surgical procedures. Overall the unplanned admission rate was 4.7%, and surgical, anaesthetic and social reasons accounted for 58.2, 37.2 and 4.6% of the unplanned admissions, respectively. The highest rate of unplanned admissions was for plastic and reconstructive surgery (12.8%) and orthopaedic surgery (7.5%) despite the relatively small number of patients who underwent such procedures in the day surgery unit. The results also showed a correlation between age group, pre-operative medical status of the patients found suitable for the day surgical procedure and unplanned admissions. Strategies to reduce the unplanned admission rate which include patient selection and pre-operative assessment, patient waiting time and education, pre-operative anaesthesia, follow-up with nursing care and postoperative analgesia are discussed.

Complications Following Common Inpatient Urological Procedures: Temporal Trend Analysis from 2000 to 2010.

PubMed

Meyer, Christian P; Hollis, Michael; Cole, Alexander P; Hanske, Julian; O'Leary, James; Gupta, Soham; Löppenberg, Björn; Zavaski, Mike E; Sun, Maxine; Sammon, Jesse D; Kibel, Adam S; Fisch, Margit; Chun, Felix K H; Trinh, Quoc-Dien

2016-04-01

Measuring procedure-specific complication-rate trends allows for benchmarking and improvement in quality of care but must be done in a standardized fashion. Using the Nationwide Inpatient Sample, we identified all instances of eight common inpatient urologic procedures performed in the United States between 2000 and 2010. This yielded 327218 cases including both oncologic and benign diseases. Complications were identified by International Classification of Diseases, Ninth Revision codes. Each complication was cross-referenced to the procedure code and graded according to the standardized Clavien system. The Mann-Whitney and chi-square were used to assess the statistical significance of medians and proportions, respectively. We assessed temporal variability in the rates of overall complications (Clavien grade 1-4), length of hospital stay, and in-hospital mortality using the estimated annual percent change (EAPC) linear regression methodology. We observed an overall reduction in length of stay (EAPC: -1.59; p<0.001), whereas mortality rates remained negligible and unchanged (EAPC: -0.32; p=0.83). Patient comorbidities increased significantly over the study period (EAPC: 2.09; p<0.001), as did the rates of complications. Procedure-specific trends showed a significant increase in complications for inpatient ureterorenoscopy (EAPC: 5.53; p<0.001), percutaneous nephrolithotomy (EAPC: 3.75; p<0.001), radical cystectomy (EAPC: 1.37; p<0.001), radical nephrectomy (EAPC: 1.35; p<0.001), and partial nephrectomy (EAPC: 1.22; p=0.006). Limitations include lack of postdischarge follow-up data, lack of pathologic characteristics, and inability to adjust for secular changes in administrative coding. In the context of urologic care in the United States, our findings suggest a shift toward more complex oncologic procedures in the inpatient setting, with same-day procedures most likely shifted to the outpatient setting. Consequently, complications have increased for the majority of examined procedures; however, no change in mortality was found. This report evaluated the trends of urologic procedures and their complications. A significant shift toward sicker patients and more complex procedures in the inpatient setting was found, but this did not result in higher mortality. These results are indicators of the high quality of care for urologic procedures in the inpatient setting. Copyright © 2015 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Installation guidelines for solar heating system, single-family residence at William OBrien State Park, Stillwater, Minnesota

NASA Technical Reports Server (NTRS)

1980-01-01

Installation procedures for the single family residential solar heating system at the William O'Brien State Park, Stillwater, Minnesota, are presented. The system is a solar-assisted, hydronic-to-warm-air system with solar-assisted domestic water heating. It is composed of the following major components: liquid cooled flat plate collectors; water storage tank; passive solar-fired domestic water preheater; electric hot water heater; heat pump with electric backup; solar hot water coil unit; tube-and-shell heat exchanger, three pumps, and associated pipes and valving in an energy transport module; control system; and air-cooled heat purge unit. Installer guidelines are provided for each subsystem and includes testing and filling the system. Information is also given on the operating procedures, controls, caution requirements and routine and schedule maintenance.

78 FR 49768 - Hearings of the Judicial Conference Advisory Committees on Rules of Bankruptcy and Civil Procedure

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-15

... JUDICIAL CONFERENCE OF THE UNITED STATES Hearings of the Judicial Conference Advisory Committees... Civil Procedure, Judicial Conference of the United States. ACTION: Notice of proposed amendments and... Judicial Conference of the United States, Thurgood Marshall Federal Judiciary Building, Washington, DC...

40 CFR 63.1282 - Test methods, compliance procedures, and compliance demonstrations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... compliance demonstrations. (a) Determination of glycol dehydration unit flowrate, benzene emissions, or BTEX... dehydration unit natural gas flowrate, benzene emissions, or BTEX emissions. (1) The determination of actual flowrate of natural gas to a glycol dehydration unit shall be made using the procedures of either paragraph...

40 CFR 63.1282 - Test methods, compliance procedures, and compliance demonstrations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... compliance demonstrations. (a) Determination of glycol dehydration unit flowrate, benzene emissions, or BTEX... dehydration unit natural gas flowrate, benzene emissions, or BTEX emissions. (1) The determination of actual flowrate of natural gas to a glycol dehydration unit shall be made using the procedures of either paragraph...

Adequacy of Fixed-Dose Heparin Infusions for Venous Thromboembolism Prevention after Microsurgical Procedures.

PubMed

Bertolaccini, Corinne M; Prazak, Ann Marie B; Agarwal, Jayant; Goodwin, Isak A; Rockwell, W Bradford; Pannucci, Christopher J

2018-05-22

 In microvascular surgery, patients often receive unfractionated heparin infusions to minimize risk for microvascular thrombosis. Patients who receive intravenous (IV) heparin are believed to have adequate prophylaxis against venous thromboembolism (VTE). Whether a fixed dose of IV heparin provides detectable levels of anticoagulation, or whether the "one size fits all" approach provides adequate prophylaxis against VTE remains unknown. This study examined the pharmacodynamics of fixed-dose heparin infusions and the effects of real-time, anti-factor Xa (aFXa) level driven heparin dose adjustments.  This prospective clinical trial recruited adult microvascular surgery patients placed on a fixed-dose (500 units/h) unfractionated heparin infusion during their initial microsurgical procedure. Steady-state aFXa levels, a marker of unfractionated heparin efficacy and safety, were monitored. Patients with out-of-range aFXa levels received protocol-driven real-time dose adjustments. Outcomes of interest included aFXa levels in response to heparin 500 units/h, number of dose adjustments required to achieve goal aFXa levels, time to reach goal aFXa level, and 90-day clinically relevant bleeding and VTE.  Twenty patients were recruited prospectively. None of 20 patients had any detectable level of anticoagulation in response to heparin infusions at 500 units/h. The median number of dose adjustments required to reach goal level was five, and median weight-based dose to reach goal level was 11.8 units/kg/h. Real-time dose adjustments significantly increased the proportion of patients with in-range levels (60 vs. 0%, p  = 0.0001). The 90-day VTE rate was 5% and 90-day clinically relevant bleeding rate was 5%.  Fixed-dose heparin infusions at a rate of 500 units/h do not provide a detectable level of anticoagulation after microsurgical procedures and are insufficient for the majority of patients who require VTE prophylaxis. Weight-based heparin infusions at 10 to 12 units/kg/h deserve future study in patients undergoing microsurgical procedures to increase the proportion of patients receiving adequate VTE prophylaxis. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

7 CFR 1726.204 - Multiparty unit price quotations.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., DEPARTMENT OF AGRICULTURE ELECTRIC SYSTEM CONSTRUCTION POLICIES AND PROCEDURES Procurement Procedures § 1726.204 Multiparty unit price quotations. The borrower or its engineer must contact a sufficient number of...

7 CFR 1726.204 - Multiparty unit price quotations.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., DEPARTMENT OF AGRICULTURE ELECTRIC SYSTEM CONSTRUCTION POLICIES AND PROCEDURES Procurement Procedures § 1726.204 Multiparty unit price quotations. The borrower or its engineer must contact a sufficient number of...

7 CFR 1726.204 - Multiparty unit price quotations.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., DEPARTMENT OF AGRICULTURE ELECTRIC SYSTEM CONSTRUCTION POLICIES AND PROCEDURES Procurement Procedures § 1726.204 Multiparty unit price quotations. The borrower or its engineer must contact a sufficient number of...

7 CFR 1726.204 - Multiparty unit price quotations.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., DEPARTMENT OF AGRICULTURE ELECTRIC SYSTEM CONSTRUCTION POLICIES AND PROCEDURES Procurement Procedures § 1726.204 Multiparty unit price quotations. The borrower or its engineer must contact a sufficient number of...

7 CFR 1726.204 - Multiparty unit price quotations.

Code of Federal Regulations, 2014 CFR

2014-01-01

..., DEPARTMENT OF AGRICULTURE ELECTRIC SYSTEM CONSTRUCTION POLICIES AND PROCEDURES Procurement Procedures § 1726.204 Multiparty unit price quotations. The borrower or its engineer must contact a sufficient number of...

[Duties of institutions and heads of health care centers in the area of infection control, information, assessment, registration and financing of benefits provided to TB patients].

PubMed

Zielonka, Tadeusz M

2015-01-01

The Act on preventing and counteracting infections and infectious diseases in humans effective in Poland requires the heads of health care outlets and institutions to counteract spreading of TB in units under their management. They are, by all means, responsible for monitoring infections in their respective units, including development, implementation and monitoring of the implementation of procedures into practice, aiming at limiting the dissemination of TB in hospitals and outpatient clinics. Medical service unit managers are also responsible for providing members of their staff with means of individual protection against infection with Mycobacterium tuberculosis bacillus. Their duties also include reporting all of the recognized TB cases in their respective units. TB is an infectious diseases included in the occupational disease list. Assessment of TB as an occupational disease is the responsibility of provincial TB prevention clinics. The Act also provides principles of financing of individual benefits available for the insured TB patients as well as those not insured.

Closure of hazardous and mixed radioactive waste management units at DOE facilities. [Contains glossary

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

Not Available

This is document addresses the Federal regulations governing the closure of hazardous and mixed waste units subject to Resource Conservation and Recovery Act (RCRA) requirements. It provides a brief overview of the RCRA permitting program and the extensive RCRA facility design and operating standards. It provides detailed guidance on the procedural requirements for closure and post-closure care of hazardous and mixed waste management units, including guidance on the preparation of closure and post-closure plans that must be submitted with facility permit applications. This document also provides guidance on technical activities that must be conducted both during and after closure ofmore » each of the following hazardous waste management units regulated under RCRA.« less

Who do you prefer? A study of public preferences for health care provider type in performing cutaneous surgery and cosmetic procedures in the United States.

PubMed

Bangash, Haider K; Ibrahimi, Omar A; Green, Lawrence J; Alam, Murad; Eisen, Daniel B; Armstrong, April W

2014-06-01

The public preference for provider type in performing cutaneous surgery and cosmetic procedures is unknown in the United States. An internet-based survey was administered to the lay public. Respondents were asked to select the health care provider (dermatologist, plastic surgeon, primary care physician, general surgeon, and nurse practitioner/physician's assistant) they mostly prefer to perform different cutaneous cosmetic and surgical procedures. Three hundred fifty-four respondents undertook the survey. Dermatologists were identified as the most preferable health care provider to evaluate and biopsy worrisome lesions on the face (69.8%), perform skin cancer surgery on the back (73.4%), perform skin cancer surgery on the face (62.7%), and perform laser procedures (56.3%) by most of the respondents. For filler injections, the responders similarly identified plastic surgeons and dermatologists (47.3% vs 44.6%, respectively) as the most preferred health care provider. For botulinum toxin injections, there was a slight preference for plastic surgeons followed by dermatologists (50.6% vs 38.4%). Plastic surgeons were the preferred health care provider for procedures such as liposuction (74.4%) and face-lift surgery (96.1%) by most of the respondents. Dermatologists are recognized as the preferred health care providers over plastic surgeons, primary care physicians, general surgeons, and nurse practitioners/physician's assistants to perform a variety of cutaneous cosmetic and surgical procedures including skin cancer surgery, on the face and body, and laser procedures. The general public expressed similar preferences for dermatologists and plastic surgeons regarding filler injections.

22 CFR 1102.3 - Procedures for requesting access to records or information.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Procedures for requesting access to records or information. 1102.3 Section 1102.3 Foreign Relations INTERNATIONAL BOUNDARY AND WATER COMMISSION, UNITED STATES AND MEXICO, UNITED STATES SECTION FREEDOM OF INFORMATION ACT § 1102.3 Procedures for requesting...

mizuRoute version 1: A river network routing tool for a continental domain water resources applications

USGS Publications Warehouse

Mizukami, Naoki; Clark, Martyn P.; Sampson, Kevin; Nijssen, Bart; Mao, Yixin; McMillan, Hilary; Viger, Roland; Markstrom, Steven; Hay, Lauren E.; Woods, Ross; Arnold, Jeffrey R.; Brekke, Levi D.

2016-01-01

This paper describes the first version of a stand-alone runoff routing tool, mizuRoute. The mizuRoute tool post-processes runoff outputs from any distributed hydrologic model or land surface model to produce spatially distributed streamflow at various spatial scales from headwater basins to continental-wide river systems. The tool can utilize both traditional grid-based river network and vector-based river network data. Both types of river network include river segment lines and the associated drainage basin polygons, but the vector-based river network can represent finer-scale river lines than the grid-based network. Streamflow estimates at any desired location in the river network can be easily extracted from the output of mizuRoute. The routing process is simulated as two separate steps. First, hillslope routing is performed with a gamma-distribution-based unit-hydrograph to transport runoff from a hillslope to a catchment outlet. The second step is river channel routing, which is performed with one of two routing scheme options: (1) a kinematic wave tracking (KWT) routing procedure; and (2) an impulse response function – unit-hydrograph (IRF-UH) routing procedure. The mizuRoute tool also includes scripts (python, NetCDF operators) to pre-process spatial river network data. This paper demonstrates mizuRoute's capabilities to produce spatially distributed streamflow simulations based on river networks from the United States Geological Survey (USGS) Geospatial Fabric (GF) data set in which over 54 000 river segments and their contributing areas are mapped across the contiguous United States (CONUS). A brief analysis of model parameter sensitivity is also provided. The mizuRoute tool can assist model-based water resources assessments including studies of the impacts of climate change on streamflow.

Assessment of the safety of injection practices and injection-related procedures in family health units and centers in Alexandria.

PubMed

Elhoseeny, Taghareed A; Mourad, Juidan K

2014-08-01

The Safe Injection Global Network (SIGN) developed an intervention strategy for reducing overuse of injections and promoting the administration of safe injections. Tool C--Revised is designed to assess the safety of the most common procedures that puncture the skin within health services. The aim of the study was to assess injection safety within the primary healthcare facilities in Alexandria using Tool C--Revised. A total of 45 family health units and centers in Alexandria were selected by proportional allocation from the eight regions of Alexandria. The Tool C--Revised of the WHO was used for observation of the entire facility, injection practices and injection-related procedures, and sterilization practices. Interview of different health providers and immediate supervisor of injections was carried out. Indicators that reflect risk included: deficiency of alcohol-based hand rub for cleansing hands (13.3%), compliance with hand wash before preparing a procedure (56.9% before injection practices, 61.3% before phlebotomy, and 67.6% before lancet puncture), and wearing a new pair of gloves before new procedures (48.6% before injection practices, 9.7% for phlebotomy, 11.8% for lancet puncture, and 80% for both intravenous injections and infusions). Enough disposable equipment in all facilities for at least 2 weeks dependent on the statement of the average numbers of procedures per week was shown. Only 38% of the providers had received training regarding injection safety in the last 2 years and 62.5% had completed their three doses of hepatitis B vaccine. Only 42.2% of staffs who handled healthcare waste had access to heavy gloves. Indicators related to injection and injection-related practices that reflect risk to patients include deficiency of alcohol-based hand rub tools, nonadherence to hand hygiene before preparing an injection, and inadequate adherence to using a clean barrier when opening a glass ampule and use of gloves. Indicators that may reflect risk to patients and providers include inadequate injection safety training and incomplete hepatitis B vaccination of healthcare providers. Indicators that may reflect risk to providers include nonadherence to safety precautions related to injection practices, such as inadequate access to heavy gloves by staff handling healthcare waste.

Black History: African Heritage, American Heritage.

ERIC Educational Resources Information Center

Duea, Joan; And Others

Providing elementary school teachers with materials to enhance student awareness of black heritage is the goal of this unit. Each of the 10 lessons includes objectives, materials, and procedures as well as supplementary materials that may be duplicated for student use. The land and people of Africa are studied in lessons one through three. Games,…

Introduction of Electronic Book Ordering with EDIFACT in a Special Library: A Case Study.

ERIC Educational Resources Information Center

Stadler, Peter; Thomas, Martin; Mernke, Ernst

1999-01-01

Describes book ordering procedures at a German pharmaceutical library using the Electronic Data Interchange for Administration, Commerce and Transport (EDIFACT) guidelines developed by the United Nations. Topics include advantages for libraries and for the book trade, changes needed in software, productivity gains, and EDIFACT versus the Internet.…

Tire Production and Pollution Control. Environmental Education Curriculum. Revised.

ERIC Educational Resources Information Center

Topeka Public Schools, KS.

This unit was developed to introduce secondary students to the many facets of a typical, large manufacturing plant - the Topeka Goodyear Tire and Rubber Company - in an effort to increase awareness of sound environmental practices in industry. Its five major foci include the production of tires and quality control procedures; applications of…

Letter Proposing Candidates for the First UN Assembly. Teaching with Documents.

ERIC Educational Resources Information Center

Haverkamp, Beth; Schamel, Wynell

1994-01-01

Presents a secondary school lesson plan on the selection of delegates to the first United Nations Assembly meeting. Discusses the esteem of Eleanor Roosevelt at that time and how President Truman requested that she be one of five U.S. representatives. Includes two primary source letters and instructional procedures. (CFR)

75 FR 27225 - Hass Avocados from Mexico; Importation into the Commonwealth of Puerto Rico and Other Changes

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-14

... development of procedures to determine the competency of designees, to perform system audits and review, to... systems approach currently required for the importation of Hass avocados into all States of the United States from Michoac[aacute]n, Mexico. The systems approach requirements include trapping, orchard...

Evaluating the Spatial Distributions of Ethnic Populations: A Quantitative Exercise for Undergraduates.

ERIC Educational Resources Information Center

Rivizzigno, Victoria L.

This exercise teaches undergraduate geography students to use the Lorenz Curve and the Index of Dissimilarity to assess the spatial distributions of the White, Black, and American Indian populations of the United States in 1980. Specific procedures for implementing the exercise are provided; solutions to the exercise are also included. Students…

Teaching Pediatric Nursing Concepts to Non-Pediatric Nurses Using an Advance Organizer

ERIC Educational Resources Information Center

Bell, Julie Ann

2013-01-01

Non-pediatric nurses in rural areas often care for children in adult units, emergency departments, and procedural areas. A half-day program about pediatric nursing using constructivist teaching strategies including an advance organizer, case studies, and simulation was offered at a community hospital in Western North Carolina. Nurses reported a…

75 FR 52781 - Virginia Electric and Power Company, North Anna Power Station, Unit Nos. 1 and 2, Surry Power...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-27

... participant (or its counsel or representative) to digitally sign documents and access the E- Submittal server... Order Imposing Procedures for Document Access to Sensitive Unclassified Non-Safeguards Information... respond to this notice must request document access by September 7, 2010. ADDRESSES: Please include Docket...

76 FR 59050 - Changes To Implement the Prioritized Examination Track (Track I) of the Enhanced Examination...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-23

... Enhanced Examination Timing Control Procedures Under the Leahy- Smith America Invents Act AGENCY: United...-Smith America Invents Act includes provisions for prioritized examination that emulate the requirements... provisions of section 11(h) of the Leahy-Smith America Invents Act. DATES: Effective Date: The changes in...

Agricultural Marketing. Instructor's Guide. Volume 12, Number 9. Agdex 810, Catalog Number AG-81-I.

ERIC Educational Resources Information Center

Missouri Univ., Columbia. Instructional Materials Lab.

This instructor's guide contains twenty lessons for teaching a curriculum unit in agricultural marketing. Each lesson includes the following instructional elements: objectives, study questions, references, teaching procedures, transparency masters, exams, and answer keys. The lessons cover the following questions: (1) What is marketing? (2) What…

Air drying of lumber.

Treesearch

1999-01-01

This report describes how lumber can be air-dried most effectively under outdoor conditions and illustrates the principles and procedures of air-drying lumber that were developed through field investigations and observations of industrial practices. Particular emphasis is placed on the yarding of lumber in unit packages. Included are topics such as why lumber is dried...

75 FR 8177 - WTO Dispute Settlement Proceeding Regarding United States-Anti-Dumping Measures on Certain Shrimp...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-23

... of certain frozen warmwater shrimp from Vietnam (Investigation A-552-801), and various U.S. laws, regulations, administrative procedures, practices, and methodologies. That request may be found at http://www..., practices, and methodologies, including (1) the Tariff Act of 1930, as amended, in particular sections 736...

Veterinary Forensics: Firearms and Investigation of Projectile Injury.

PubMed

Bradley-Siemens, N; Brower, A I

2016-09-01

Projectile injury represents an estimated 14% of reported animal cruelty cases in the United States. Cases involving projectiles are complicated by gross similarities to other common types of injury, including bite wounds and motor vehicle injuries, by weapons and ammunition not commonly recognized or understood by veterinary medical professionals, and by required expertise beyond that employed in routine postmortem examination. This review describes the common types of projectile injuries encountered within the United States, as well as firearms and ammunition associated with this form of injury. The 3 stages of ballistics-internal, external, and terminal-and wounding capacity are discussed. A general understanding of firearms, ammunition, and ballistics is necessary before pursuing forensic projectile cases. The forensic necropsy is described, including gunshot wound examination, projectile trajectories, different imaging procedures, collection and storage of projectile evidence, and potential advanced techniques for gunpowder analysis. This review presents aspects of projectile injury investigation that must be considered in tandem with standard postmortem practices and procedures to ensure reliable conclusions are reached for medicolegal as well as diagnostic purposes. © The Author(s) 2016.

Chapter 6. Protection of patients and staff during a pandemic. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster.

PubMed

Taylor, Bruce L; Montgomery, Hugh E; Rhodes, Andrew; Sprung, Charles L

2010-04-01

To provide recommendations and standard operating procedures (SOPs) for intensive care unit (ICU) and hospital preparations for an influenza pandemic or mass disaster with a specific focus on protection of patients and staff. Based on a literature review and expert opinion, a Delphi process was used to define the essential topics including protection of patients and staff. Key recommendations include: (1) prepare infection control and occupational health policies for clinical risks relating to potential disease transmission; (2) decrease clinical risks and provide adequate facilities through advanced planning to maximise capacity by increasing essential equipment, drugs, supplies and encouraging staff availability; (3) create robust systems to maintain staff confidence and safety by minimising non-clinical risks and maintaining or escalating essential services; (4) prepare formal reassurance plans for legal protection; (5) provide assistance to staff working outside their normal domains. Judicious planning and adoption of protocols for protection of patients and staff are necessary to optimise outcomes during a pandemic.

Initial experience with hysteroscopic tubal occlusion (Essure®)

PubMed Central

Depes, Daniella De Batista; Pereira, Ana Maria Gomes; Lippi, Umberto Gazi; Martins, João Alfredo; Lopes, Reginaldo Guedes Coelho

2016-01-01

ABSTRACT Objective To evaluate results of early tubal occlusions performed by hysteroscopy (Essure®). Methods This prospective study included 38 patients, 73.7% of them were white, mean age 34.5 years, they have had on average 3 pregnancies and 2.7 of deliveries. A total of 86.8% of patients previously prepared the endometrium. All procedures were carried out at outpatient unit without anesthesia. Results Insertion rate of the device was 100% at a mean time of 4 minutes and 50 seconds. Based on the analogical visual scale, average pain reported was three, and 55.3% of women did not report pain after the procedure. After 3 months, 89.5% of patients were very satisfied with the method. Simple radiographs of the pelvis showed 92.1% of topical devices, and one case of unilateral expulsion had occurred. A four years follow-up did not show failure in the method. Conclusions Tubal occlusion through hysteroscopy at outpatient unit and without anesthesia was a quickly and well-tolerated procedure. No serious complications were seen, the success rate was high, and patients were satisfied. PMID:27462885

Plasma exchange in the intensive care unit: Technical aspects and complications.

PubMed

Lemaire, Aurélie; Parquet, Nathalie; Galicier, Lionel; Boutboul, David; Bertinchamp, Rémi; Malphettes, Marion; Dumas, Guillaume; Mariotte, Eric; Peraldi, Marie-Noëlle; Souppart, Virginie; Schlemmer, Benoit; Azoulay, Elie; Canet, Emmanuel

2017-12-01

Data on plasma exchange therapy in the intensive care unit (ICU) setting are scarce. We aimed to describe the technical aspects and the adverse events associated with the procedure in critically ill patients. All adult patients treated by plasma exchange in the medical ICU of the Saint-Louis university hospital between January 1, 2013 and March 31, 2015 were prospectively included. We report on 260 plasma exchange procedures performed in 50 patients. The centrifugation technique was used for 159 (61%) procedures and the filtration technique for the other 101 (39%) procedures. Both techniques had similar efficacy to treat hyperviscosity syndrome (n = 18). Seventy (26.9%) of the 260 plasma exchange procedures were reported with at least one adverse reaction. Centrifugation and filtration techniques had similar rates of adverse reactions (23.9 vs. 31.7%, P = .19). Hypotension was the most reported (n = 21, 8%) and correlates with a low hematocrit before therapy. Most complications were related to allergic reactions to the replacement fluids. Coagulation disorders depended on the type of replacement fluid. The post-exchange fibrinogen level was decreased by 54% [48;66] with albumin 5%, and 4% [-5;17] with plasma frozen within 24 h. Twenty-three (22.8%) of the 101 filtration procedures experienced filter clotting. Filter clotting was associated with a higher volume exchange prescribed when compared to procedures without filter clotting (4600 [4000;5000] ml vs. 3900 [3600;4800] ml, P < .01). Plasma exchange is a relatively safe and generally well-tolerated procedure in the ICU setting. Most adverse events are unpredictable and related to minor allergic reactions. © 2017 Wiley Periodicals, Inc.

Effect of mobile laminar airflow units on airborne bacterial contamination during neurosurgical procedures.

PubMed

von Vogelsang, A-C; Förander, P; Arvidsson, M; Löwenhielm, P

2018-03-24

Surgical site infections (SSIs) after neurosurgery are potentially life-threatening and entail great costs. SSIs may occur from airborne bacteria in the operating room, and ultraclean air is desired during infection-prone cleaning procedures. Door openings and the number of persons present in the operating room affect the air quality. Mobile laminar airflow (MLAF) units, with horizontal laminar airflow, have previously been shown to reduce airborne bacterial contamination. To assess the effect of MLAF units on airborne bacterial contamination during neurosurgical procedures. In a quasi-experimental design, bacteria-carrying particles (colony-forming units: cfu) during neurosurgical procedures were measured with active air-sampling in operating rooms with conventional turbulent ventilation, and with additional MLAF units. The MLAF units were shifted between operating rooms monthly. Colony-forming unit count and bacterial species detection were conducted after incubation. Data was collected for a period of 18 months. A total of 233 samples were collected during 45 neurosurgical procedures. The use of MLAF units significantly reduced the numbers of cfu in the surgical site area (P < 0.001) and above the instrument table (P < 0.001). Logistic regression showed that the only significant predictor affecting cfu count was the use of MLAF units (odds ratio: 41.6; 95% confidence interval: 11.3-152.8; P < 0.001). The most frequently detected bacteria were coagulase-negative staphylococci. MLAF successfully reduces cfu during neurosurgery to ultraclean air levels. MLAF units are valuable when the main operating room ventilation system is unable to produce ultraclean air in infection-prone clean neurosurgery. Copyright © 2018 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

40 CFR 63.1282 - Test methods, compliance procedures, and compliance demonstrations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... demonstrations. (a) Determination of glycol dehydration unit flowrate or benzene emissions. The procedures of this paragraph shall be used by an owner or operator to determine glycol dehydration unit natural gas....1274(d). (1) The determination of actual flowrate of natural gas to a glycol dehydration unit shall be...

40 CFR 63.1282 - Test methods, compliance procedures, and compliance demonstrations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... demonstrations. (a) Determination of glycol dehydration unit flowrate or benzene emissions. The procedures of this paragraph shall be used by an owner or operator to determine glycol dehydration unit natural gas....1274(d). (1) The determination of actual flowrate of natural gas to a glycol dehydration unit shall be...

Evaluation of five antibiotic resistance genes in wastewater treatment systems of swine farms by real-time PCR.

PubMed

Tao, Chi-Wei; Hsu, Bing-Mu; Ji, Wen-Tsai; Hsu, Tsui-Kang; Kao, Po-Min; Hsu, Chun-Po; Shen, Shu-Min; Shen, Tzung-Yu; Wan, Terng-Jou; Huang, Yu-Li

2014-10-15

Antibiotics are widely used in livestock for infection treatment and growth promotion. Wastes from animal husbandry are a potential environmental source of antibiotic-insensitive pathogens, and the removal efficiency of the resistance genotypes in current wastewater treatment plants (WWTPs) is unknown. In this study, quantitative PCR was used for evaluating antibiotic resistance genes in wastewater treatment processes. Six wastewater treatment plants in different swine farms were included in this study, and five antibiotic resistance genes (ARGs) were tested for each treatment procedure. All of the tested ARGs including tetA, tetW, sulI, sulII, and blaTEM genes were detected in six swine farms with considerable amounts. The results showed that antibiotic resistance is prevalent in livestock farming. The ARG levels were varied by wastewater treatment procedure, frequently with the highest level at anaerobic treatment tank and lowest in the activated sludge unit and the effluents. After normalizing the ARG levels to 16S rRNA gene copies, the results showed that ARGs in WWTP units fluctuated partly with the quantity of bacteria. Regardless of its importance in biodegradation, the anaerobic procedure may facilitate bacterial growth thus increasing the sustainability of the antibiotic resistance genotypes. After comparing the copy numbers in influx and efflux samples, the mean removal efficiency of ARGs ranged between 33.30 and 97.56%. The results suggested that treatments in the WWTP could partially reduce the spread of antibiotic-resistant bacteria, and additional procedures such as sedimentation may not critically affect the removal efficiency. Copyright © 2014 Elsevier B.V. All rights reserved.

Identifying Nonprovider Factors Affecting Pediatric Emergency Medicine Provider Efficiency.

PubMed

Saleh, Fareed; Breslin, Kristen; Mullan, Paul C; Tillett, Zachary; Chamberlain, James M

2017-10-31

The aim of this study was to create a multivariable model of standardized relative value units per hour by adjusting for nonprovider factors that influence efficiency. We obtained productivity data based on billing records measured in emergency relative value units for (1) both evaluation and management of visits and (2) procedures for 16 pediatric emergency medicine providers with more than 750 hours worked per year. Eligible shifts were in an urban, academic pediatric emergency department (ED) with 2 sites: a tertiary care main campus and a satellite community site. We used multivariable linear regression to adjust for the impact of shift and pediatric ED characteristics on individual-provider efficiency and then removed variables from the model with minimal effect on productivity. There were 2998 eligible shifts for the 16 providers during a 3-year period. The resulting model included 4 variables when looking at both ED sites combined. These variables include the following: (1) number of procedures billed by provider, (2) season of the year, (3) shift start time, and (4) day of week. Results were improved when we separately modeled each ED location. A 3-variable model using procedures billed by provider, shift start time, and season explained 23% of the variation in provider efficiency at the academic ED site. A 3-variable model using procedures billed by provider, patient arrivals per hour, and shift start time explained 45% of the variation in provider efficiency at the satellite ED site. Several nonprovider factors affect provider efficiency. These factors should be considered when designing productivity-based incentives.

Assisted Reproductive Technology Surveillance - United States, 2015.

PubMed

Sunderam, Saswati; Kissin, Dmitry M; Crawford, Sara B; Folger, Suzanne G; Boulet, Sheree L; Warner, Lee; Barfield, Wanda D

2018-02-16

Since the first U.S. infant conceived with assisted reproductive technology (ART) was born in 1981, both the use of ART and the number of fertility clinics providing ART services have increased steadily in the United States. ART includes fertility treatments in which eggs or embryos are handled in the laboratory (i.e., in vitro fertilization [IVF] and related procedures). Although the majority of infants conceived through ART are singletons, women who undergo ART procedures are more likely than women who conceive naturally to deliver multiple-birth infants. Multiple births pose substantial risks for both mothers and infants, including obstetric complications, preterm delivery (<37 weeks), and low birthweight (<2,500 g) infants. This report provides state-specific information for the United States (including the District of Columbia and Puerto Rico) on ART procedures performed in 2015 and compares birth outcomes that occurred in 2015 (resulting from ART procedures performed in 2014 and 2015) with outcomes for all infants born in the United States in 2015. 2015. In 1995, CDC began collecting data on ART procedures performed in fertility clinics in the United States as mandated by the Fertility Clinic Success Rate and Certification Act of 1992 (FCSRCA) (Public Law 102-493 [October 24, 1992]). Data are collected through the National ART Surveillance System, a web-based data collection system developed by CDC. This report includes data from 52 reporting areas (the 50 states, the District of Columbia, and Puerto Rico). In 2015, a total of 182,111 ART procedures (range: 135 in Alaska to 23,198 in California) with the intent to transfer at least one embryo were performed in 464 U.S. fertility clinics and reported to CDC. These procedures resulted in 59,334 live-birth deliveries (range: 55 in Wyoming to 7,802 in California) and 71,152 infants born (range: 68 in Wyoming to 9,176 in California). Nationally, the number of ART procedures performed per 1 million women of reproductive age (15-44 years), a proxy measure of the ART utilization rate, was 2,832. ART use exceeded the national rate in 13 reporting areas (California, Connecticut, Delaware, the District of Columbia, Hawaii, Illinois, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Rhode Island, and Virginia). Nationally, among ART transfer procedures in patients using fresh embryos from their own eggs, the average number of embryos transferred increased with increasing age of the woman (1.6 among women aged <35 years, 1.8 among women aged 35-37 years, and 2.3 among women aged >37 years). Among women aged <35 years, the national elective single-embryo transfer (eSET) rate was 34.7% (range: 11.3% in Puerto Rico to 88.1% in Delaware). In 2015, ART contributed to 1.7% of all infants born in the United States (range: 0.3% in Puerto Rico to 4.5% in Massachusetts). ART also contributed to 17.0% of all multiple-birth infants, 16.8% of all twin infants, and 22.2% of all triplets and higher-order infants. The percentage of multiple-birth infants was higher among infants conceived with ART (35.3%) than among all infants born in the total birth population (3.4%). Approximately 34.0% of ART-conceived infants were twins and 1.0% were triplets and higher-order infants. Nationally, infants conceived with ART contributed to 5.1% of all low birthweight infants. Among ART-conceived infants, 25.5% had low birthweight, compared with 8.1% among all infants. ART-conceived infants contributed to 5.3% of all preterm (gestational age <37 weeks) infants. The percentage of preterm births was higher among infants conceived with ART (31.2%) than among all infants born in the total birth population (9.7%). Among singletons, the percentage of ART-conceived infants who had low birthweight was 8.7% compared with 6.4% among all infants born. The percentage of ART-conceived infants who were born preterm was 13.4% among singletons compared with 7.9% among all infants. Multiple births from ART contributed to a substantial proportion of all twins, triplets, and higher-order infants born in the United States. For women aged <35 years, who are typically considered good candidates for eSET, the national average of 1.6 embryos was transferred per ART procedure. Of the four states (Illinois, Massachusetts, New Jersey, and Rhode Island) with comprehensive mandated health insurance coverage for ART procedures (i.e., coverage for at least four cycles of IVF), three (Illinois, Massachusetts, and New Jersey) had rates of ART use exceeding 1.5 times the national rate. This type of mandated insurance coverage has been associated with greater use of ART and likely accounts for some of the difference in per capita ART use observed among states. Twins account for the majority of ART-conceived multiple births. Reducing the number of embryos transferred and increasing use of eSET when clinically appropriate could help reduce multiple births and related adverse health consequences for both mothers and infants. State-based surveillance of ART might be useful for monitoring and evaluating maternal and infant health outcomes of ART in states with high ART use.

Assisted Reproductive Technology Surveillance — United States, 2015

PubMed Central

Kissin, Dmitry M.; Crawford, Sara B.; Folger, Suzanne G.; Boulet, Sheree L.; Warner, Lee; Barfield, Wanda D.

2018-01-01

Problem/Condition Since the first U.S. infant conceived with assisted reproductive technology (ART) was born in 1981, both the use of ART and the number of fertility clinics providing ART services have increased steadily in the United States. ART includes fertility treatments in which eggs or embryos are handled in the laboratory (i.e., in vitro fertilization [IVF] and related procedures). Although the majority of infants conceived through ART are singletons, women who undergo ART procedures are more likely than women who conceive naturally to deliver multiple-birth infants. Multiple births pose substantial risks for both mothers and infants, including obstetric complications, preterm delivery (<37 weeks), and low birthweight (<2,500 g) infants. This report provides state-specific information for the United States (including the District of Columbia and Puerto Rico) on ART procedures performed in 2015 and compares birth outcomes that occurred in 2015 (resulting from ART procedures performed in 2014 and 2015) with outcomes for all infants born in the United States in 2015. Period Covered 2015. Description of System In 1995, CDC began collecting data on ART procedures performed in fertility clinics in the United States as mandated by the Fertility Clinic Success Rate and Certification Act of 1992 (FCSRCA) (Public Law 102–493 [October 24, 1992]). Data are collected through the National ART Surveillance System, a web-based data collection system developed by CDC. This report includes data from 52 reporting areas (the 50 states, the District of Columbia, and Puerto Rico). Results In 2015, a total of 182,111 ART procedures (range: 135 in Alaska to 23,198 in California) with the intent to transfer at least one embryo were performed in 464 U.S. fertility clinics and reported to CDC. These procedures resulted in 59,334 live-birth deliveries (range: 55 in Wyoming to 7,802 in California) and 71,152 infants born (range: 68 in Wyoming to 9,176 in California). Nationally, the number of ART procedures performed per 1 million women of reproductive age (15–44 years), a proxy measure of the ART utilization rate, was 2,832. ART use exceeded the national rate in 13 reporting areas (California, Connecticut, Delaware, the District of Columbia, Hawaii, Illinois, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Rhode Island, and Virginia). Nationally, among ART transfer procedures in patients using fresh embryos from their own eggs, the average number of embryos transferred increased with increasing age of the woman (1.6 among women aged <35 years, 1.8 among women aged 35–37 years, and 2.3 among women aged >37 years). Among women aged <35 years, the national elective single-embryo transfer (eSET) rate was 34.7% (range: 11.3% in Puerto Rico to 88.1% in Delaware). In 2015, ART contributed to 1.7% of all infants born in the United States (range: 0.3% in Puerto Rico to 4.5% in Massachusetts). ART also contributed to 17.0% of all multiple-birth infants, 16.8% of all twin infants, and 22.2% of all triplets and higher-order infants. The percentage of multiple-birth infants was higher among infants conceived with ART (35.3%) than among all infants born in the total birth population (3.4%). Approximately 34.0% of ART-conceived infants were twins and 1.0% were triplets and higher-order infants. Nationally, infants conceived with ART contributed to 5.1% of all low birthweight infants. Among ART-conceived infants, 25.5% had low birthweight, compared with 8.1% among all infants. ART-conceived infants contributed to 5.3% of all preterm (gestational age <37 weeks) infants. The percentage of preterm births was higher among infants conceived with ART (31.2%) than among all infants born in the total birth population (9.7%). Among singletons, the percentage of ART-conceived infants who had low birthweight was 8.7% compared with 6.4% among all infants born. The percentage of ART-conceived infants who were born preterm was 13.4% among singletons compared with 7.9% among all infants. Interpretation Multiple births from ART contributed to a substantial proportion of all twins, triplets, and higher-order infants born in the United States. For women aged <35 years, who are typically considered good candidates for eSET, the national average of 1.6 embryos was transferred per ART procedure. Of the four states (Illinois, Massachusetts, New Jersey, and Rhode Island) with comprehensive mandated health insurance coverage for ART procedures (i.e., coverage for at least four cycles of IVF), three (Illinois, Massachusetts, and New Jersey) had rates of ART use exceeding 1.5 times the national rate. This type of mandated insurance coverage has been associated with greater use of ART and likely accounts for some of the difference in per capita ART use observed among states. Public Health Action Twins account for the majority of ART-conceived multiple births. Reducing the number of embryos transferred and increasing use of eSET when clinically appropriate could help reduce multiple births and related adverse health consequences for both mothers and infants. State-based surveillance of ART might be useful for monitoring and evaluating maternal and infant health outcomes of ART in states with high ART use. PMID:29447147

Particulate Matter Stack Emission Compliance Test Procedure for Fuel Burning Units.

ERIC Educational Resources Information Center

West Virginia Air Pollution Control Commission, Charleston.

This publication details the particulate matter emissions test procedure that is applicable for conducting compliance tests for fuel burning units required to be tested under Sub-section 7 of Regulation II (1972) as established by the state of West Virginia Air Pollution Control Commission. The testing procedure is divided into five parts:…

14 CFR 1263.102 - Procedure when a demand is issued in a legal proceeding involving the United States.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Procedure when a demand is issued in a legal proceeding involving the United States. 1263.102 Section 1263.102 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION DEMAND FOR INFORMATION OR TESTIMONY SERVED ON AGENCY EMPLOYEES; PROCEDURES...

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR HARVARD PM IMPACTOR CALIBRATION AND LEAK TESTING (UA-L-7.1)

EPA Science Inventory

The purpose of this SOP is to describe the procedures for the periodic calibration and leak testing of Harvard particulate matter (PM) impactor units. This procedure applies directly to the calibration and leak testing of Harvard PM impactor units used during the Arizona NHEXAS ...

22 CFR 1102.7 - The Section's determination and appeal procedures.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 2 2011-04-01 2009-04-01 true The Section's determination and appeal procedures. 1102.7 Section 1102.7 Foreign Relations INTERNATIONAL BOUNDARY AND WATER COMMISSION, UNITED STATES AND MEXICO, UNITED STATES SECTION FREEDOM OF INFORMATION ACT § 1102.7 The Section's determination and appeal procedures. Upon receipt of any reques...

22 CFR 1102.3 - Procedures for requesting access to records or information.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Procedures for requesting access to records or information. 1102.3 Section 1102.3 Foreign Relations INTERNATIONAL BOUNDARY AND WATER COMMISSION, UNITED STATES AND MEXICO, UNITED STATES SECTION FREEDOM OF INFORMATION ACT § 1102.3 Procedures for requesting access to records or information. (a) A...

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR HARVARD PM IMPACTOR CALIBRATION AND LEAK TESTING (UA-L-7.1)

EPA Science Inventory

The purpose of this SOP is to describe the procedures for the periodic calibration and leak testing of Harvard particulate matter (PM) impactor units. This procedure applies directly to the calibration and leak testing of Harvard PM impactor units used during the Arizona NHEXAS ...

[Duties of institutions and heads of health care centers in the area of infection control, information, assessment, registration and financing of benefits provided to TB patients].

PubMed

Zielonka, Tadeusz M

2011-01-01

The Act on preventing and counteracting infections and infectious diseases in humans effective in Poland provides for the duty of the heads of health care outlets and institutions to counteract spreading of TB in units under their management. They are, by all means, responsible for monitoring infections in their respective units, involving development, implementation and monitoring of practical implementation of procedures aiming at limiting dissemination of TB in hospitals and outpatient clinics. Medical service unit managers are also responsible for providing members of their staffs with means of individual protection against infection with Mycobacterium tuberculosis bacillus. Their duties also include notification of all recognized TB cases in their respective units. TB is an infectious diseases included in the occupational disease list. Assessment of TB as occupational disease is the responsibility of provincial TB prevention clinics. The Act also provides for principles of financing of individual benefits available for the insured TB patients and those not insured.

Basics of compounding: considerations for implementing United States pharmacopeia chapter 797 pharmaceutical compounding-sterile preparations, part 16: suggested standard operating procedures.

PubMed

Okeke, Claudia C; Allen, Loyd V

2009-01-01

The standard operating procedures suggested in this article are presented to compounding pharmacies to ensure the quality of the environment in which a CSP is prepared. Since United States Pharmacopeia Chapter 797 provides minimum standards, each facility should aim for best practice gold standard. The standard operating procedures should be tailored to meet the expectations and design of each facility. Compounding personnel are expected to know and understand each standard operating procedure to allow for complete execution of the procedures.

Battery Test Manual For Electric Vehicles, Revision 3

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

Christophersen, Jon P.

2015-06-01

This battery test procedure manual was prepared for the United States Department of Energy (DOE), Office of Energy Efficiency and Renewable Energy (EERE), Vehicle Technologies Office. It is based on technical targets for commercial viability established for energy storage development projects aimed at meeting system level DOE goals for Electric Vehicles (EV). The specific procedures defined in this manual support the performance and life characterization of advanced battery devices under development for EVs. However, it does share some methods described in the previously published battery test manual for plug-in hybrid electric vehicles. Due to the complexity of some of themore » procedures and supporting analysis, future revisions including some modifications and clarifications of these procedures are expected. As in previous battery and capacitor test manuals, this version of the manual defines testing methods for full-size battery systems, along with provisions for scaling these tests for modules, cells or other subscale level devices. The DOE-United States Advanced Battery Consortium (USABC), Technical Advisory Committee (TAC) supported the development of the manual. Technical Team points of contact responsible for its development and revision are Chul Bae of Ford Motor Company and Jon P. Christophersen of the Idaho National Laboratory. The development of this manual was funded by the Unites States Department of Energy, Office of Energy Efficiency and Renewable Energy, Vehicle Technologies Office. Technical direction from DOE was provided by David Howell, Energy Storage R&D Manager and Hybrid Electric Systems Team Leader. Comments and questions regarding the manual should be directed to Jon P. Christophersen at the Idaho National Laboratory (jon.christophersen@inl.gov).« less

Current practice and recommendations in UK epilepsy monitoring units. Report of a national survey and workshop.

PubMed

Hamandi, Khalid; Beniczky, Sandor; Diehl, Beate; Kandler, Rosalind H; Pressler, Ronit M; Sen, Arjune; Solomon, Juliet; Walker, Matthew C; Bagary, Manny

2017-08-01

Inpatient video-EEG monitoring (VEM) is an important investigation in patients with seizures or blackouts, and in the pre-surgical workup of patients with epilepsy. There has been an expansion in the number of Epilepsy Monitoring Units (EMU) in the UK offering VEM with a necessary increase in attention on quality and safety. Previous surveys have shown variation across centres on issues including consent and patient monitoring. In an effort to bring together healthcare professionals in the UK managing patients on EMU, we conducted an online survey of current VEM practice and held a one-day workshop convened under the auspices of the British Chapter of the ILAE. The survey and workshop aimed to cover all aspects of VEM, including pre-admission, consent procedures, patient safety, drug reduction and reinstatement, seizure management, staffing levels, ictal testing and good data recording practice. This paper reports on the findings of the survey, the workshop presentations and workshop discussions. 32 centres took part in the survey and there were representatives from 22 centres at the workshop. There was variation in protocols, procedures and consent processes between units, and levels of observation of monitored patients. Nevertheless, the workshop discussion found broad areas of agreement on points. A survey and workshop of UK epilepsy monitoring units found that some variability in practice is inevitable due to different local arrangements and patient groups under investigation. However, there were areas of clear consensus particularly in relation to consent and patient safety that can be applied to most units and form a basis for setting minimum standards. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Transmission of hepatitis C from a midwife to a patient through non-exposure prone procedures.

PubMed

Muir, David; Chow, Yimmy; Tedder, Richard; Smith, Donald; Harrison, John; Holmes, Alison

2014-02-01

A woman developed acute hepatitis C (HCV) infection 2 months after delivering her baby at a London Hospital. The other patients who had been on the unit at the same time all had negative HCV serology antenatally. Testing of the healthcare workers who had been involved in this patient's care revealed that one of the midwives who only worked on the postnatal unit was chronically infected with the same viral genotype. Sequencing and phylogenetic analysis revealed close identity between the viruses from the two individuals. Although, the midwife had only performed non-exposure prone procedures including venepuncture and cannulation, our findings indicate that transmission of the virus had occurred from the healthcare worker to the patient. The potential implications of this case within the setting of national policy on blood borne viruses and healthcare workers are discussed. © 2013 Wiley Periodicals, Inc.

Guidelines for testing and release procedures

NASA Technical Reports Server (NTRS)

Molari, R.; Conway, M.

1984-01-01

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

77 FR 72884 - Meeting of the Judicial Conference Committee on Rules of Practice and Procedure

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-06

... JUDICIAL CONFERENCE OF THE UNITED STATES Meeting of the Judicial Conference Committee on Rules of Practice and Procedure AGENCY: Judicial Conference of the United States Advisory Committee on Rules of... but not participation. DATES: April 2-3, 2013. Time: 8:30 a.m. to 5:00 p.m. ADDRESSES: United States...

22 CFR 50.11 - Certificate of identity for travel to the United States to apply for admission.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Certificate of identity for travel to the United States to apply for admission. 50.11 Section 50.11 Foreign Relations DEPARTMENT OF STATE NATIONALITY AND PASSPORTS NATIONALITY PROCEDURES Procedures for Determination of United States Nationality of...

22 CFR 50.11 - Certificate of identity for travel to the United States to apply for admission.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Certificate of identity for travel to the United States to apply for admission. 50.11 Section 50.11 Foreign Relations DEPARTMENT OF STATE NATIONALITY AND PASSPORTS NATIONALITY PROCEDURES Procedures for Determination of United States Nationality of...

22 CFR 50.11 - Certificate of identity for travel to the United States to apply for admission.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Certificate of identity for travel to the United States to apply for admission. 50.11 Section 50.11 Foreign Relations DEPARTMENT OF STATE NATIONALITY AND PASSPORTS NATIONALITY PROCEDURES Procedures for Determination of United States Nationality of...

22 CFR 50.11 - Certificate of identity for travel to the United States to apply for admission.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Certificate of identity for travel to the United States to apply for admission. 50.11 Section 50.11 Foreign Relations DEPARTMENT OF STATE NATIONALITY AND PASSPORTS NATIONALITY PROCEDURES Procedures for Determination of United States Nationality of...

22 CFR 50.11 - Certificate of identity for travel to the United States to apply for admission.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Certificate of identity for travel to the United States to apply for admission. 50.11 Section 50.11 Foreign Relations DEPARTMENT OF STATE NATIONALITY AND PASSPORTS NATIONALITY PROCEDURES Procedures for Determination of United States Nationality of...

The unique contribution of the nursing intervention pain management on length of stay in older patients undergoing hip procedures.

PubMed

Kerr, Peg; Shever, Leah; Titler, Marita G; Qin, Rui; Kim, Taikyoung; Picone, Debra M

2010-02-01

The purpose of this study was to examine the unique contribution of the nursing intervention pain management on length of stay (LOS) for 568 older patients hospitalized for hip procedures. Propensity-score-adjusted analysis was used to determine the effect of pain management on LOS. The LOS for hospitalizations that received pain management was 0.78 day longer than that for hospitalizations that did not receive pain management. Other variables that were predictors of LOS included several context-of-care variables (e.g., time spent in the intensive care unit, registered nurse skill mix, etc.), number of medical procedures and unique medications, and several other nursing interventions. Copyright 2010 Elsevier Inc. All rights reserved.

Reduction of catheter-associated bloodstream infections through procedures in newborn babies admitted in a university hospital intensive care unit in Brazil.

PubMed

Resende, Daiane Silva; Ó, Jacqueline Moreira do; Brito, Denise von Dolinger de; Abdallah, Vânia Olivetti Steffen; Gontijo Filho, Paulo Pinto

2011-01-01

Catheter-associated bloodstream infection (CA-BSI) is the most common nosocomial infection in neonatal intensive care units. There is evidence that care bundles to reduce CA-BSI are effective in the adult literature. The aim of this study was to reduce CA-BSI in a Brazilian neonatal intensive care unit by means of a care bundle including few strategies or procedures of prevention and control of these infections. An intervention designed to reduce CA-BSI with five evidence-based procedures was conducted. A total of sixty-seven (26.7%) CA-BSIs were observed. There were 46 (32%) episodes of culture-proven sepsis in group preintervention (24.1 per 1,000 catheter days [CVC days]). Neonates in the group after implementation of the intervention had 21 (19.6%) episodes of CA-BSI (14.9 per 1,000 CVC days). The incidence of CA-BSI decreased significantly after the intervention from the group preintervention and postintervention (32% to 19.6%, 24.1 per 1,000 CVC days to 14.9 per 1,000 CVC days, p=0.04). In the multiple logistic regression analysis, the use of more than 3 antibiotics and length of stay >8 days were independent risk factors for BSI. A stepwise introduction of evidence-based intervention and intensive and continuous education of all healthcare workers are effective in reducing CA-BSI.

Computer-aided boundary delineation of agricultural lands

NASA Technical Reports Server (NTRS)

Cheng, Thomas D.; Angelici, Gary L.; Slye, Robert E.; Ma, Matt

1989-01-01

The National Agricultural Statistics Service of the United States Department of Agriculture (USDA) presently uses labor-intensive aerial photographic interpretation techniques to divide large geographical areas into manageable-sized units for estimating domestic crop and livestock production. Prototype software, the computer-aided stratification (CAS) system, was developed to automate the procedure, and currently runs on a Sun-based image processing system. With a background display of LANDSAT Thematic Mapper and United States Geological Survey Digital Line Graph data, the operator uses a cursor to delineate agricultural areas, called sampling units, which are assigned to strata of land-use and land-cover types. The resultant stratified sampling units are used as input into subsequent USDA sampling procedures. As a test, three counties in Missouri were chosen for application of the CAS procedures. Subsequent analysis indicates that CAS was five times faster in creating sampling units than the manual techniques were.

Human Factors Considerations for Area Navigation Departure and Arrival Procedures

NASA Technical Reports Server (NTRS)

Barhydt, Richard; Adams, Catherine A.

2006-01-01

Area navigation (RNAV) procedures are being implemented in the United States and around the world as part of a transition to a performance-based navigation system. These procedures are providing significant benefits and have also caused some human factors issues to emerge. Under sponsorship from the Federal Aviation Administration (FAA), the National Aeronautics and Space Administration (NASA) has undertaken a project to document RNAV-related human factors issues and propose areas for further consideration. The component focusing on RNAV Departure and Arrival Procedures involved discussions with expert users, a literature review, and a focused review of the NASA Aviation Safety Reporting System (ASRS) database. Issues were found to include aspects of air traffic control and airline procedures, aircraft systems, and procedure design. Major findings suggest the need for specific instrument procedure design guidelines that consider the effects of human performance. Ongoing industry and government activities to address air-ground communication terminology, design improvements, and chart-database commonality are strongly encouraged. A review of factors contributing to RNAV in-service errors would likely lead to improved system design and operational performance.

26 CFR 301.7214-1 - Offenses by officers and employees of the United States.

Code of Federal Regulations, 2010 CFR

2010-04-01

... TREASURY (CONTINUED) PROCEDURE AND ADMINISTRATION PROCEDURE AND ADMINISTRATION Crimes, Other Offenses, and Forfeitures Crimes § 301.7214-1 Offenses by officers and employees of the United States. Any officer or...

Congenital heart surgery: surgical performance according to the Aristotle complexity score.

PubMed

Arenz, Claudia; Asfour, Boulos; Hraska, Viktor; Photiadis, Joachim; Haun, Christoph; Schindler, Ehrenfried; Sinzobahamvya, Nicodème

2011-04-01

Aristotle score methodology defines surgical performance as 'complexity score times hospital survival'. We analysed how this performance evolved over time and in correlation with case volume. Aristotle basic and comprehensive complexity scores and corresponding basic and comprehensive surgical performances were determined for primary (main) procedures carried out from 2006 to 2009. Surgical case volume performance described as unit performance was estimated as 'surgical performance times the number of primary procedures'. Basic and comprehensive complexity scores for the whole cohort of procedures (n=1828) were 7.74±2.66 and 9.89±3.91, respectively. With an early survival of 97.5% (1783/1828), mean basic and comprehensive surgical performances reached 7.54±2.54 and 9.64±3.81, respectively. Basic surgical performance varied little over the years: 7.46±2.48 in 2006, 7.43±2.58 in 2007, 7.50±2.76 in 2008 and 7.79±2.54 in 2009. Comprehensive surgical performance decreased from 9.56±3.91 (2006) to 9.22±3.94 (2007), and then to 9.13±3.77 (2008), thereafter increasing up to 10.62±3.67 (2009). No significant change of performance was observed for low comprehensive complexity levels 1-3. Variation concerned level 4 (p=0.048) which involved the majority of procedures (746, or 41% of cases) and level 6 (p<0.0001) which included a few cases (20, or 1%), whereas for level 5, statistical significance was almost attained: p=0.079. With a mean annual number of procedures of 457, mean basic and comprehensive unit performance was estimated at 3447±362 and 4405±577, respectively. Basic unit performance increased year to year from 3036 (2006, 100%) to 3254 (2007, 107.2%), then 3720 (2008, 122.5%), up to 3793 (2009, 124.9%). Comprehensive unit performance also increased: from 3891 (2006, 100%) to 4038 (2007, 103.8%), 4528 (2008, 116.4%) and 5172 (2009, 132.9%). Aristotle scoring of surgical performance allows quality assessment of surgical management of congenital heart disease over time. The newly defined unit performance appears to well reflect the trend of activity and efficiency of a congenital heart surgery department. Copyright © 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

Is routine ultrasound guidance for central line placement beneficial? A prospective analysis.

PubMed

Martin, Matthew J; Husain, Farah A; Piesman, Michael; Mullenix, Philip S; Steele, Scott R; Andersen, Charles A; Giacoppe, George N

2004-01-01

Portable ultrasound devices have become more readily available in the intensive care unit setting, but their utility outside of controlled trials remains unproven. We sought to determine how the availability of ultrasound guidance affected the types and number of complications during central line placement. Review of a prospectively maintained database in a 20-bed combined intensive care unit. Procedure notes from all attempts at internal jugular vein access from 1996 to 2001 were recorded, and selected patient records were reviewed. Ultrasound guidance was available beginning in March 1998. From 1996 to 2001, there were 484 documented attempts at internal jugular central line placement. Most procedures (83%) were performed by first- or second-year residents. During this period, there were 47 complications for an overall complication rate of 10%. These included 1 pneumothorax (2%), 6 carotid punctures (13%), 2 hematomas (4%), and 34 unsuccessful attempts (72%). There was no significant difference in age, sex, body-mass index, or intubation status between those with and without complications or between the ultrasound and anatomic landmark groups. Ultrasound was used in 179 (37%) attempts. The overall complication rate with ultrasound was 11% versus 9% using anatomic landmarks (p = NS). The complication rate prior to the availability of ultrasound was 15 of 114 attempts (13%) versus 32 of 370 attempts (9%) after the introduction of ultrasound in our intensive care unit (p = NS). Analysis of the 370 procedures performed since ultrasound became available demonstrated a complication rate of 11% with ultrasound guidance versus 6% without (p = 0.09). There was no significant difference in complication rates by resident year group or department (surgery vs. other). However, procedures performed after-hours (1800 to 0800) were associated with a 15% complication rate versus 6% for procedures performed during the workday (p < 0.05). The availability and use of ultrasound guidance for central line placement by junior residents has not resulted in an improvement in procedure-related complications. The complication profile was not affected by ultrasound use, patient factors, or resident year in training. There was a higher complication rate associated with procedures performed at night that may be caused by resident fatigue or unavailability of senior supervision.

A System Approach to Navy Medical Education and Training. Appendix 44. Competency Curriculum for Dental Assistant.

DTIC Science & Technology

1974-08-31

Prosthodontic Appliances - Partial Dentures .... ....... ....... .... 59 2. Removable Prosthodontic Appliances - Full Dentures ..... ........... . 60 3...PROCEDURES I This unit includes the following Modules: Number Title Page 1 Removable Prosthodontic Appliances - Partial Dentures 59. ......... ...... 2...Removable Prostbodontic Appliances - Full Dentures ..... ...... a .. .. .. . 60 3 Fixed Prosthodontic Appliances - Fixed Bridge. . 61 4 Mouthquard

The Dig: A Study in Archaeology. Profiles of Promise 6.

ERIC Educational Resources Information Center

Risinger, C. Frederick; And Others

The activity described in this profile is based on the simulation Dig. Although designed primarily for use by social studies classes, Dig was expanded by Glen Ellyn teachers to include language arts, mathematics, and science. The objectives of the one-month unit were to: 1) teach techniques and procedures of archaeologists; 2) introduce students…

Terra II--A Spaceship Earth Simulation for the Middle Grades

ERIC Educational Resources Information Center

Mastrude, Peggy

1972-01-01

The unit of study consists of four lessons based on the concept that the earth is a large system made up of many small systems (air, food, water, man, etc.). Complete procedures are included to study the environment, examine developing countries, determine interaction between peoples and nations. The problem solving excercise is an inquiry…

Field sampling and data analysis methods for development of ecological land classifications: an application on the Manistee National Forest.

Treesearch

George E. Host; Carl W. Ramm; Eunice A. Padley; Kurt S. Pregitzer; James B. Hart; David T. Cleland

1992-01-01

Presents technical documentation for development of an Ecological Classification System for the Manistee National Forest in northwest Lower Michigan, and suggests procedures applicable to other ecological land classification projects. Includes discussion of sampling design, field data collection, data summarization and analyses, development of classification units,...

40 CFR 98.172 - GHGs to report.

Code of Federal Regulations, 2014 CFR

2014-07-01

... combustion units include, but are not limited to, by-product recovery coke oven battery combustion stacks... flares that burn blast furnace gas or coke oven gas according to the procedures in § 98.253(b)(1) of...)(B) and § 98.253(b)(1)(iii)(C), you must use the default CO2 emission factors for coke oven gas and...

40 CFR 98.172 - GHGs to report.

Code of Federal Regulations, 2012 CFR

2012-07-01

... combustion units include, but are not limited to, by-product recovery coke oven battery combustion stacks... flares that burn blast furnace gas or coke oven gas according to the procedures in § 98.253(b)(1) of...)(B) and § 98.253(b)(1)(iii)(C), you must use the default CO2 emission factors for coke oven gas and...

40 CFR 98.172 - GHGs to report.

Code of Federal Regulations, 2013 CFR

2013-07-01

... combustion units include, but are not limited to, by-product recovery coke oven battery combustion stacks... flares that burn blast furnace gas or coke oven gas according to the procedures in § 98.253(b)(1) of...)(B) and § 98.253(b)(1)(iii)(C), you must use the default CO2 emission factors for coke oven gas and...

40 CFR 98.172 - GHGs to report.

Code of Federal Regulations, 2011 CFR

2011-07-01

... combustion units include, but are not limited to, by-product recovery coke oven battery combustion stacks... flares that burn blast furnace gas or coke oven gas according to the procedures in § 98.253(b)(1) of...)(B) and § 98.253(b)(1)(iii)(C), you must use the default CO2 emission factors for coke oven gas and...

40 CFR 60.2210 - What information must I include in my annual report?

Code of Federal Regulations, 2012 CFR

2012-07-01

... Performance for Commercial and Industrial Solid Waste Incineration Units for Which Construction Is Commenced..., time, and duration that each CMS was inoperative, except for zero (low-level) and high-level checks. (3... procedure in 40 CFR part 60, appendix F of this part, as if any of the following occur. (1) The zero (low...

40 CFR 60.2210 - What information must I include in my annual report?

Code of Federal Regulations, 2011 CFR

2011-07-01

... Performance for Commercial and Industrial Solid Waste Incineration Units for Which Construction Is Commenced..., time, and duration that each CMS was inoperative, except for zero (low-level) and high-level checks. (3... procedure in 40 CFR part 60, appendix F of this part, as if any of the following occur. (1) The zero (low...

Proceedings of the Speech Communication Association Summer Conference: Mini Courses in Speech Communication (7th, Chicago, July 8-10, 1971).

ERIC Educational Resources Information Center

Jeffrey, Robert C., Ed.

The Speech Communication Association's 1971 summer conference provided instruction in the application of basic research and innovative practices in communication. It was designed to assist elementary, secondary, and college teachers in the enrichment of content and procedures. The proceedings include syllabi, course units, and bibliographic…

A Survey of the Practices, Procedures, and Techniques in Undergraduate Organic Chemistry Teaching Laboratories

ERIC Educational Resources Information Center

Martin, Christopher B.; Schmidt, Monica; Soniat, Michael

2011-01-01

A survey was conducted of four-year institutions that teach undergraduate organic chemistry laboratories in the United States. The data include results from over 130 schools, describes the current practices at these institutions, and discusses the statistical results such as the scale of the laboratories performed, the chemical techniques applied,…

Cook's Helper. DOT No. 317.687-010. Restaurant Occupations. Coordinator's Guide. First Edition.

ERIC Educational Resources Information Center

Hohhertz, Durwin

This coordinator's guide for a module on cook's helpers, one of seven individualized units about restaurant occupations, has been developed for students enrolled in cooperative part-time training and employed in a commercial restaurant. Included in the first part of the guide are a progress chart, suggested teaching procedures, answers to the…

Mountain Plains Learning Experience Guide: Radio and T.V. Repair. Course: Television Repair.

ERIC Educational Resources Information Center

Arneson, R.; And Others

One of four individualized courses included in a radio and television repair, curriculum, this course focuses on trouble-shooting procedures for both black and white and color television equipment. The course is comprised of ten units: (1) Introduction to/and Block Diagrams of Television, (2) Television Audio Section Troubles, (3) Television Video…

A Description of a Student-Staffed, Competency-Based Laboratory for the Assessment of Interpersonal Communication Skills.

ERIC Educational Resources Information Center

Ratliffe, Sharon A.; Hudson, David D.

A competency-based skill development and assessment procedure is used in an interpersonal communication course (SpCom 100) at Golden West College in California. SpCom 100, which offers 18 to 24 sections each semester, includes eight units: the interpersonal process, conversation, self-concept and disclosure, perception, verbal language, nonverbal…

Cyber Terrorism: A Study of the Extent of Coverage in Computer Security Textbooks

ERIC Educational Resources Information Center

Prichard, Janet J.; MacDonald, Laurie E.

2004-01-01

On September 11th, 2001 the United States experienced the largest terrorist attack in its history. This event caused many government agencies to review their security practices and procedures. It also has raised awareness of other avenues that terrorists might pursue to achieve their goals, including cyber terrorism. Cyber terrorism can be…

Kitchen Helper. DOT No. 318.687-010. Restaurant Occupations. Coordinator's Guide. First Edition.

ERIC Educational Resources Information Center

Hohhertz, Durwin

This coordinator's guide for a module on kitchen helpers, one of seven individualized units about restaurant occupations, has been developed for students enrolled in cooperative part-time training and employed in a commercial restaurant. Included in the first part of the guide are a progress chart, suggested teaching procedures, answers to the…

Space shuttle navigation analysis. Volume 2: Baseline system navigation

NASA Technical Reports Server (NTRS)

Jones, H. L.; Luders, G.; Matchett, G. A.; Rains, R. G.

1980-01-01

Studies related to the baseline navigation system for the orbiter are presented. The baseline navigation system studies include a covariance analysis of the Inertial Measurement Unit calibration and alignment procedures, postflight IMU error recovery for the approach and landing phases, on-orbit calibration of IMU instrument biases, and a covariance analysis of entry and prelaunch navigation system performance.

Sampling and estimation procedures for the vegetation diversity and structure indicator

Treesearch

Bethany K. Schulz; William A. Bechtold; Stanley J. Zarnoch

2009-01-01

The Vegetation Diversity and Structure Indicator (VEG) is an extensive inventory of vascular plants in the forests of the United States. The VEG indicator provides baseline data to assess trends in forest vascular plant species richness and composition, and the relative abundance and spatial distribution of those species, including invasive and introduced species. The...

Municipal Wastewater Processes. Instructor Guide. Working for Clean Water: An Information Program for Advisory Groups.

ERIC Educational Resources Information Center

Stoltzfus, Lorna

Described is a one-hour overview of the unit processes which comprise a municipal wastewater treatment system. Topics covered in this instructor's guide include types of pollutants encountered, treatment methods, and procedures by which wastewater treatment processes are selected. A slide-tape program is available to supplement this component of…

Conceptual design and feasibility evaluation model of a 10 to the 8th power bit oligatomic mass memory. Volume 3: Operation manual

NASA Technical Reports Server (NTRS)

Horst, R. L.; Nordstrom, M. J.

1972-01-01

An operation manual is presented for the oligatomic mass memory feasibility model. It includes a brief description of the memory and exerciser units, a description of the controls and their functions, the operating procedures, the test points and adjustments, and the circuit diagram.

Balloon mitral valvuloplasty in the United States: a 13-year perspective.

PubMed

Badheka, Apurva O; Shah, Neeraj; Ghatak, Abhijit; Patel, Nileshkumar J; Chothani, Ankit; Mehta, Kathan; Singh, Vikas; Patel, Nilay; Grover, Peeyush; Deshmukh, Abhishek; Panaich, Sidakpal S; Savani, Ghanshyambhai T; Bhalara, Vipulkumar; Arora, Shilpkumar; Rathod, Ankit; Desai, Harit; Kar, Saibal; Alfonso, Carlos; Palacios, Igor F; Grines, Cindy; Schreiber, Theodore; Rihal, Charanjit S; Makkar, Raj; Cohen, Mauricio G; O'Neill, William; de Marchena, Eduardo

2014-11-01

Incidence and prevalence of mitral stenosis is declining in the US. We performed this study to determine recent trends in utilization, complications, mortality, length of stay, and cost associated with balloon mitral valvuloplasty. Utilizing the nationwide inpatient sample database from 1998 to 2010, we identified patients using the International Classification of Diseases, 9th Revision, Clinical Modification procedure code for "percutaneous valvuloplasty." Patients ≥18 years of age with mitral stenosis were included. Patients with concomitant aortic, tricuspid, or pulmonic stenosis were excluded. Primary outcome included death and procedural complications. A total of 1308 balloon mitral valvuloplasties (weighted n = 6540) were analyzed. There was a 7.5% decrease in utilization of the procedure from 24.6 procedures/10 million population in 1998-2001 to 22.7 procedures/10 million population in 2008-2010 (P for trend = .098). We observed a 15.9% overall procedural complication rate and 1.7% mortality rate. The procedural complication rates have increased in recent years (P = .001), corresponding to increasing age and burden of comorbidities in patients. The mean cost per admission for balloon mitral valvuloplasty has gone up significantly over the 10 years, from $11,668 ± 1046 in 2001 to $23,651 ± 301 in 2010 (P <.001). In a large cross-sectional study of balloon mitral valvuloplasty in the US, we have reported trends of decreasing overall utilization and increasing procedural complication rates and cost over a period of 13 years. Copyright © 2014 Elsevier Inc. All rights reserved.

EVA manipulation and assembly of space structure columns

NASA Technical Reports Server (NTRS)

Loughead, T. E.; Pruett, E. C.

1980-01-01

Assembly techniques and hardware configurations used in assembly of the basic tetrahedral cell by A7LB pressure-suited subjects in a neutral bouyancy simulator were studied. Eleven subjects participated in assembly procedures which investigated two types of structural members and two configurations of attachment hardware. The assembly was accomplished through extra-vehicular activity (EVA) only, EVA with simulated manned maneuvering unit (MMU), and EVA with simulated MMU and simulated remote manipulator system (RMS). Assembly times as low as 10.20 minutes per tetrahedron were achieved. Task element data, as well as assembly procedures, are included.

Improving patient handover between teams using a business improvement model: PDSA cycle.

PubMed

Luther, Vishal; Hammersley, Daniel; Chekairi, Ahmed

2014-01-01

Medical admission units are continuously under pressure to move patients off the unit to outlying medical wards and allow for new admissions. In a typical district general hospital, doctors working in these medical wards reported that, on average, three patients each week arrived from the medical admission unit before any handover was received, and a further two patients arrived without any handover at all. A quality improvement project was therefore conducted using a 'Plan, Do, Study, Act' cycle model for improvement to address this issue. P - Plan: as there was no framework to support doctors with handover, a series of standard handover procedures were designed. D - Do: the procedures were disseminated to all staff, and championed by key stakeholders, including the clinical director and matron of the medical admission unit. S - STUDY: Measurements were repeated 3 months later and showed no change in the primary end points. A - ACT: The post take ward round sheet was redesigned, creating a checkbox for a medical admission unit doctor to document that handover had occurred. Nursing staff were prohibited from moving the patient off the ward until this had been completed. This later evolved into a separate handover sheet. Six months later, a repeat study revealed that only one patient each week was arriving before or without a verbal handover. Using a 'Plan, Do, Study, Act' business improvement tool helped to improve patient care.

Chapter 9. Educational process. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster.

PubMed

Richards, Guy A; Sprung, Charles L

2010-04-01

To provide recommendations and standard operating procedures (SOPs) for intensive care unit (ICU) and hospital preparations for an influenza pandemic or mass disaster with focus on education of all stakeholders, specifically the emergency executive control groups, ICU staff and staff co-opted to assist with patient management. Based on a literature review and expert opinion, a Delphi process was used to define the essential topics, including staff education. Key recommendations include: (1) define functional roles and responsibilities of the internal personnel and interface agencies or sectors; (2) determine logistic support and requirements necessary for the effective implementation of the SOPs; (3) determine what is required to maintain the SOPs; (4) recommended training and activities include: (a) personal protection techniques; (b) environmental contamination; (c) medical management; (d) laboratory specimens; (e) alert lists; (f) training of recruited staff; (g) ethical issues; (h) psychosocial issues; (i) dealing with the deceased; (j) policies for restricting visitors; (k) mechanisms for enforcing policies; (5) Training should begin as soon as possible with daily demonstrations followed by supervised practice; (6) identify the staff to participate in training programs, verify that they have participated and evaluate their knowledge subsequently. Judicious planning and adoption of protocols for staff education are necessary to optimize outcomes during a pandemic.

Chapter 3. Coordination and collaboration with interface units. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster.

PubMed

Joynt, Gavin M; Loo, Shi; Taylor, Bruce L; Margalit, Gila; Christian, Michael D; Sandrock, Christian; Danis, Marion; Leoniv, Yuval; Sprung, Charles L

2010-04-01

To provide recommendations and standard operating procedures (SOPs) for intensive care unit (ICU) and hospital preparations for an influenza pandemic or mass disaster with a specific focus on enhancing coordination and collaboration between the ICU and other key stakeholders. Based on a literature review and expert opinion, a Delphi process was used to define the essential topics including coordination and collaboration. Key recommendations include: (1) establish an Incident Management System with Emergency Executive Control Groups at facility, local, regional/state or national levels to exercise authority and direction over resource use and communications; (2) develop a system of communication, coordination and collaboration between the ICU and key interface departments within the hospital; (3) identify key functions or processes requiring coordination and collaboration, the most important of these being manpower and resources utilization (surge capacity) and re-allocation of personnel, equipment and physical space; (4) develop processes to allow smooth inter-departmental patient transfers; (5) creating systems and guidelines is not sufficient, it is important to: (a) identify the roles and responsibilities of key individuals necessary for the implementation of the guidelines; (b) ensure that these individuals are adequately trained and prepared to perform their roles; (c) ensure adequate equipment to allow key coordination and collaboration activities; (d) ensure an adequate physical environment to allow staff to properly implement guidelines; (6) trigger events for determining a crisis should be defined. Judicious planning and adoption of protocols for coordination and collaboration with interface units are necessary to optimize outcomes during a pandemic.

Economic cost of initial attack and large-fire suppression

Treesearch

Armando González-Cabán

1983-01-01

A procedure has been developed for estimating the economic cost of initial attack and large-fire suppression. The procedure uses a per-unit approach to estimate total attack and suppression costs on an input-by-input basis. Fire management inputs (FMIs) are the production units used. All direct and indirect costs are charged to the FMIs. With the unit approach, all...

Multiple Hollow Cathode Wear Testing for the Space Station Plasma Contactor

NASA Technical Reports Server (NTRS)

Soulas, George C.

1994-01-01

A wear test of four hollow cathodes was conducted to resolve issues associated with the Space Station plasma contactor. The objectives of this test were to evaluate unit-to-unit dispersions, verify the transportability of contamination control protocols developed by the project, and to evaluate cathode contamination control and activation procedures to enable simplification of the gas feed system and heater power processor. These objectives were achieved by wear testing four cathodes concurrently to 2000 hours. Test results showed maximum unit-to-unit deviations for discharge voltages and cathode tip temperatures to be +/-3 percent and +/-2 percent, respectively, of the nominal values. Cathodes utilizing contamination control procedures known to increase cathode lifetime showed no trends in their monitored parameters that would indicate a possible failure, demonstrating that contamination control procedures had been successfully transferred. Comparisons of cathodes utilizing and not utilizing a purifier or simplified activation procedure showed similar behavior during wear testing and pre- and post-test performance characterizations. This behavior indicates that use of simplified cathode systems and procedures is consistent with long cathode lifetimes.

Rainwater Wildlife Area Habitat Evaluation Procedures Report; A Columbia Basin Wildlife Mitigation Project.

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

Childs, Allen B.

The 8,768 acre Rainwater Wildlife Area was acquired in September 1998 by the Confederated Tribes of the Umatilla Indian Reservation (CTUIR) through an agreement with Bonneville Power Administration (BPA) to partially offset habitat losses associated with construction of the John Day and McNary hydroelectric facilities on the mainstem Columbia River. U.S. Fish and Wildlife Service (USFWS) Habitat Evaluation Procedures (HEP) were used to determine the number of habitat units credited to BPA for acquired lands. Upland and riparian forest, upland and riparian shrub, and grassland cover types are evaluated in this study. Targeted wildlife species include downy woodpecker (Picoides pubescens),more » black-capped chickadee (Parus atricopillus), blue grouse (Dendragapus obscurus), great blue heron (Ardea herodias), yellow warbler (Dendroica petechia), mink (Mustela vison), and Western meadowlark (Sturnella neglecta). Habitat surveys were conducted in 1998 and 1999 in accordance with published HEP protocols and included 65,300, 594m{sup 2}2 plots, and 112 one-tenth-acre plots. Between 153.3 and 7,187.46 acres were evaluated for each target wildlife mitigation species. Derived habitat suitability indices were multiplied by corresponding cover-type acreages to determine the number of habitat units for each species. The total baseline habitat units credited to BPA for the Rainwater Wildlife Area and its seven target species is 5,185.3 habitat units. Factors limiting habitat suitability are related to the direct, indirect, and cumulative effects of past livestock grazing, road construction, and timber harvest which have simplified the structure, composition, and diversity of native plant communities. Alternatives for protecting and improving habitat suitability include exclusion of livestock grazing, road de-commissioning/obliteration, reforestation and thinning, control of competing and unwanted vegetation (including noxious weeds), reestablishing displaced or reduced native vegetation species, allowance of normative processes such as fire occurrence, and facilitating development of natural stable stream channels and associated floodplains. Implementation of habitat enhancement and restoration activities could generate an additional 1,850 habitat units in 10 years. Baseline and estimated future habitat units total 7,035.3 for the Rainwater Wildlife Area. Habitat protection, enhancement and restoration will require long-term commitments from managers to increase probabilities of success and meet the goals and objectives of the Northwest Power Planning Council's Fish and Wildlife Mitigation Program.« less

Habitat Evaluation Procedures (HEP) Report : Rainwater Wildlife Area, 1998-2001 Technical Report.

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

Childs, Allen

The 8,768 acre Rainwater Wildlife Area was acquired in September 1998 by the Confederated Tribes of the Umatilla Indian Reservation (CTUIR) through an agreement with Bonneville Power Administration (BPA) to partially offset habitat losses associated with construction of the John Day and McNary hydroelectric facilities on the mainstem Columbia River. U.S. Fish and Wildlife Service (USFWS) Habitat Evaluation Procedures (HEP) were used to determine the number of habitat units credited to BPA for acquired lands. Upland and riparian forest, upland and riparian shrub, and grassland rover types are evaluated in this study. Targeted wildlife species include downy woodpecker (Picoides pubescens),more » black-capped chickadee (Parus atricopillus), blue grouse (Dendragapus obscurus), great blue heron (Ardea herodias), yellow warbler (Dendroica petechia), mink (Mustela vison), and Western meadowlark (Sturnella neglects). Habitat surveys were conducted in 1998 and 1999 in accordance with published HEP protocols and included 65,300, 594m{sup 2} plots, and 112 one-tenth-acre plots. Between 153.3 and 7,187.46 acres were evaluated for each target wildlife mitigation species. Derived habitat suitability indices were multiplied by corresponding cover-type acreages to determine the number of habitat units for each species. The total baseline habitat units credited to BPA for the Rainwater Wildlife Area and its seven target species is 5,185.3 habitat units. Factors limiting habitat suitability are related to the direct, indirect, and cumulative effects of past livestock grazing, road construction, and timber harvest which have simplified the structure, composition, and diversity of native plant communities. Alternatives for protecting and improving habitat suitability include exclusion of livestock grazing, road de-commissioning/obliteration, reforestation and thinning, control of competing and unwanted vegetation (including noxious weeds), reestablishing displaced or reduced native vegetation species, allowance of normative processes such as fire occurrence, and facilitating development of natural stable stream channels and associated floodplains. Implementation of habitat enhancement and restoration activities could generate an additional 1,850 habitat units in 10 years. Baseline and estimated future habitat units total 7,035.3 for the Rainwater Wildlife Area. Habitat protection, enhancement and restoration will require long-term commitments from managers to increase probabilities of success and meet the goals and objectives of the Northwest Power Planning Council's Fish and Wildlife Mitigation Program. Longer-term benefits of protection and enhancement activities include increases in native species diversity and plant community resiliency in all cover types. Watershed conditions, including floodplain/riparian, and instream habitat quality should improve as well providing multiple benefits for terrestrial and aquatic resources. While such benefits are not necessarily recognized by HEP models and reflected in the number of habitat units generated, they are consistent with the NPPC Fish and Wildlife Program.« less

Pesticide-sampling equipment, sample-collection and processing procedures, and water-quality data at Chicod Creek, North Carolina, 1992

USGS Publications Warehouse

Manning, T.K.; Smith, K.E.; Wood, C.D.; Williams, J.B.

1994-01-01

Water-quality samples were collected from Chicod Creek in the Coastal Plain Province of North Carolina during the summer of 1992 as part of the U.S. Geological Survey's National Water-Quality Assessment Program. Chicod Creek is in the Albemarle-Pamlico drainage area, one of four study units designated to test equipment and procedures for collecting and processing samples for the solid-phase extraction of selected pesticides, The equipment and procedures were used to isolate 47 pesticides, including organonitrogen, carbamate, organochlorine, organophosphate, and other compounds, targeted to be analyzed by gas chromatography/mass spectrometry. Sample-collection and processing equipment equipment cleaning and set-up procedures, methods pertaining to collecting, splitting, and solid-phase extraction of samples, and water-quality data resulting from the field test are presented in this report Most problems encountered during this intensive sampling exercise were operational difficulties relating to equipment used to process samples.

7 CFR 1220.209 - Procedure.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE SOYBEAN PROMOTION, RESEARCH, AND CONSUMER INFORMATION Soybean Promotion and Research Order United Soybean Board § 1220.209 Procedure. (a) At... on annual average soybean production of the three previous years. If a unit is represented by more...

7 CFR 1220.209 - Procedure.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE SOYBEAN PROMOTION, RESEARCH, AND CONSUMER INFORMATION Soybean Promotion and Research Order United Soybean Board § 1220.209 Procedure. (a) At... on annual average soybean production of the three previous years. If a unit is represented by more...

Practical Procedures for Internationalizing an Academic Unit.

ERIC Educational Resources Information Center

Hughes, Gail

Procedures for internationalizing a college academic unit are examined. The approach centers around eight key steps in organizational development: developing organizational support groups; assessing the international/intercultural needs of the organization; making maximum use of existing strengths and international resources; developing programs…

10 CFR 205.300 - Who shall apply.

Code of Federal Regulations, 2011 CFR

2011-01-01

... OF ENERGY OIL ADMINISTRATIVE PROCEDURES AND SANCTIONS Electric Power System Permits and Reports; Applications; Administrative Procedures and Sanctions Application for Authorization to Transmit Electric Energy... borders of the United States, of facilities for the transmission of electric energy between the United...

Procedure and information displays in advanced nuclear control rooms: experimental evaluation of an integrated design.

PubMed

Chen, Yue; Gao, Qin; Song, Fei; Li, Zhizhong; Wang, Yufan

2017-08-01

In the main control rooms of nuclear power plants, operators frequently have to switch between procedure displays and system information displays. In this study, we proposed an operation-unit-based integrated design, which combines the two displays to facilitate the synthesis of information. We grouped actions that complete a single goal into operation units and showed these operation units on the displays of system states. In addition, we used different levels of visual salience to highlight the current unit and provided a list of execution history records. A laboratory experiment, with 42 students performing a simulated procedure to deal with unexpected high pressuriser level, was conducted to compare this design against an action-based integrated design and the existing separated-displays design. The results indicate that our operation-unit-based integrated design yields the best performance in terms of time and completion rate and helped more participants to detect unexpected system failures. Practitioner Summary: In current nuclear control rooms, operators frequently have to switch between procedure and system information displays. We developed an integrated design that incorporates procedure information into system displays. A laboratory study showed that the proposed design significantly improved participants' performance and increased the probability of detecting unexpected system failures.

Comparisons of Patient Demographics in Prospective Sports, Shoulder, and National Database Initiatives.

PubMed

Saltzman, Bryan M; Cvetanovich, Gregory L; Bohl, Daniel D; Cole, Brian J; Bach, Bernard R; Romeo, Anthony A

2016-09-01

There has been increased emphasis in orthopaedics on high-quality prospective research to provide evidence-based treatment guidelines, particularly in sports medicine/shoulder surgery. The external validity of these studies has not been established, and the generalizability of the results to clinical practice in the United States is unknown. Comparison of patient demographics in major prospective studies of arthroscopic sports and shoulder surgeries to patients undergoing the same procedures in the National Surgical Quality Improvement Program (NSQIP) database will show substantial differences to question the generalizability and external validity of those studies. Cross-sectional study; Level of evidence, 3. This study utilized patients undergoing arthroscopic anterior cruciate ligament reconstruction (ACLR), meniscectomy (MX), rotator cuff repair (RCR), and shoulder stabilization (SS) from the NSQIP database (2005-2013). Two prospective studies (either randomized controlled trials or, in 1 case, a major cohort study) were identified for each of the 4 procedures for comparison. Demographic variables available for comparison in both the identified prospective studies and the NSQIP included age, sex, and body mass index (BMI). From the NSQIP database, 5576 ACLR patients, 18,882 MX patients, 7282 RCR patients, and 993 SS patients were identified. The comparison clinical studies included cohort sizes as follows: ACLR, n = 121 and 2683; MX, n = 146 and 330; RCR, n = 90 and 103; SS, n = 88 and 196. Age differed significantly between the NSQIP and the patients in 6 of the 8 prospective clinical studies. Sex differed significantly between the NSQIP and the patients in 7 of the 8 prospective clinical studies. BMI differed significantly between the NSQIP and the patients of all 4 of the prospective clinical studies that reported this demographic variable. Significant differences exist for patient age, sex, and BMI between patients included in major sports medicine/shoulder prospective studies and corresponding patients undergoing the same procedures in a nationwide database of academic and community centers in the United States. Future work is needed to understand whether major prospective clinical studies-frequently performed in high-volume, specialized practices-are truly indicative of the types of patients treated and expected results in the general orthopaedic practice. This study additionally argues for the importance of initiating a national registry dedicated to patients undergoing orthopaedic procedures in the United States.

Management of the patient with a total joint replacement: the primary care practitioner's role.

PubMed

Palmer, L M

1999-01-01

The primary care practitioner assumes chief responsibility for patients with arthritis. More than 40 million Americans experience some form of arthritis. Management of the patient with arthritis may include a referral to an orthopedic surgeon for surgical intervention. As estimated, up to 500,000 total joint replacement procedures are performed by orthopedic surgeons each year in the United States. Presurgical evaluation for a total joint replacement is imperative to ensure that the patient can safely undergo this surgical procedure. Postsurgical care of a patient with total joint replacement involves coordinating care with the physical therapist and orthopedic surgeon to ensure adequate follow-through with the recommended rehabilitation program, prophylactic antibiotic coverage, and observation for any complications including infection, deep-vein thrombosis, or loosening of the total-joint prosthesis.

New procedure speeds cold start, protects turbine

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

Mallard, R.E.; Jordan, C.A.

1995-09-01

System dispatch from today`s power plants must consider availability of purchase power (buy and sell), fuel prices, and unit availability and efficiency. To gain the best combination of these factors, steam units must be capable of quick removal and return to service. However, unit startups are expensive, time consuming nd operationally demanding. For example, excessive thermal stresses can be catastrophic to a unit. With those factors in mind, Jacksonville Electric Authority (JEA) developed the ``valve open start`` procedure described here.

[Handling modern imaging procedures in a high-tech operating room].

PubMed

Hüfner, T; Citak, M; Imrecke, J; Krettek, C; Stübig, T

2012-03-01

Operating rooms are the central unit in the hospital network in trauma centers. In this area, high costs but also high revenues are generated. Modern operating theater concepts as an integrated model have been offered by different companies since the early 2000s. Our hypothesis is that integrative concepts for operating rooms, in addition to improved operating room ergonomics, have the potential for measurable time and cost savings. In our clinic, an integrated operating room concept (I-Suite, Stryker, Duisburg) was implemented after analysis of the problems. In addition to the ceiling-mounted arrangement, the system includes an endoscopy unit, a navigation system, and a voice control system. In the first 6 months (9/2005 to 2/2006), 112 procedures were performed in the integrated operating room: 34 total knee arthroplasties, 12 endoscopic spine surgeries, and 66 inpatient arthroscopic procedures (28 shoulder and 38 knee reconstructions). The analysis showed a daily saving of 22-45 min, corresponding to 15-30% of the daily changeover times, calculated to account for potential savings in the internal cost allocation of 225-450 EUR. A commercial operating room concept was evaluated in a pilot phase in terms of hard data, including time and cost factors. Besides the described effects further savings might be achieved through the effective use of voice control and the benefit of the sterile handle on the navigation camera, since waiting times for an additional nurse are minimized. The time of the procedure of intraoperative imaging is also reduced due to the ceiling-mounted concept, as the C-arm can be moved freely in the operating theater without hindering cables. By these measures and ensuing improved efficiency, the initial high costs for the implementation of the system may be cushioned over time.

Forest growth of Mississippi's north unit - A case study of the Southern Forest surveys growth estimation procedures

Treesearch

Dennis M. May

1988-01-01

This report presents the procedures by which the Southern Forest Inventory and Analysis unit estimates forest growth from permanent horizontal point samples. Inventory data from the 1977-87 survey of Mississippi's north unit were used to demonstrate how trees on the horizontal point samples are classified into one of eight components of growth and, in turn, how...

32 CFR Appendix F to Part 197 - Procedures for Copying of Documents for the Foreign Relations of the United States Series

Code of Federal Regulations, 2010 CFR

2010-07-01

... Foreign Relations of the United States Series F Appendix F to Part 197 National Defense Department of...—Procedures for Copying of Documents for the Foreign Relations of the United States Series 1. The records will.../declassification and historical research branch staff member must be present at all times. 4. OSD will supply the...

32 CFR Appendix F to Part 197 - Procedures for Copying of Documents for the Foreign Relations of the United States Series

Code of Federal Regulations, 2011 CFR

2011-07-01

... Foreign Relations of the United States Series F Appendix F to Part 197 National Defense Department of...—Procedures for Copying of Documents for the Foreign Relations of the United States Series 1. The records will.../declassification and historical research branch staff member must be present at all times. 4. OSD will supply the...

20 CFR 655.102 - Special procedures.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR TEMPORARY EMPLOYMENT OF FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process for Temporary Agricultural Employment in the United States (H-2A Workers) § 655.102 Special procedures. To provide for a limited degree of...

19 CFR 201.170 - Compliance procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF GENERAL APPLICATION.... International Trade Commission § 201.170 Compliance procedures. (a) Except as provided in paragraph (b) of this..., United States International Trade Commission, 500 E Street SW., Washington, DC 20436. (d) The agency...

19 CFR 201.170 - Compliance procedures.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF GENERAL APPLICATION.... International Trade Commission § 201.170 Compliance procedures. (a) Except as provided in paragraph (b) of this..., United States International Trade Commission, 500 E Street SW., Washington, DC 20436. (d) The agency...

19 CFR 201.170 - Compliance procedures.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF GENERAL APPLICATION.... International Trade Commission § 201.170 Compliance procedures. (a) Except as provided in paragraph (b) of this..., United States International Trade Commission, 500 E Street SW., Washington, DC 20436. (d) The agency...

19 CFR 201.170 - Compliance procedures.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF GENERAL APPLICATION.... International Trade Commission § 201.170 Compliance procedures. (a) Except as provided in paragraph (b) of this..., United States International Trade Commission, 500 E Street SW., Washington, DC 20436. (d) The agency...

19 CFR 201.170 - Compliance procedures.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF GENERAL APPLICATION.... International Trade Commission § 201.170 Compliance procedures. (a) Except as provided in paragraph (b) of this..., United States International Trade Commission, 500 E Street SW., Washington, DC 20436. (d) The agency...

Outcomes of transcatheter aortic valve replacement using a minimalist approach.

PubMed

Gurevich, Sergey; Oestreich, Brett; Kelly, Rosemary F; Mbai, Mackenzie; Bertog, Stefan; Ringsred, Karen; Lawton, Annette; Thooft, Brenda; Wagner, Julie; Garcia, Santiago

2018-03-01

Transcatheter Aortic Valve Replacement (TAVR) is increasingly performed using a minimalist approach under monitored anesthesia care (MAC). The safety of this approach remains controversial and adoption has been low in the US. The study cohort was comprised of 130 patients (98% male) who underwent TAVR between 4/2015 and 4/2017 at the Minneapolis VA. We compared the outcomes of 81 patients who underwent TAVR using a standard approach (standard TAVR) and 49 who underwent TAVR using a minimalist approach (minimalist TAVR). Outcome measures included device and procedural success, procedural efficiency, length of intensive care unit (ICU) and hospital stay, procedural complications and hospital readmissions. Mean age was 80 (±9) years and median (IQR) STS score was 5 (4-6). Access included transfemoral (n = 111, 85%) and alternative (n = 19, 15%). Minimalist TAVR was associated with reduced procedural time: median 101 min (IQR: 78-135) versus 127 min (IQR: 97-182, p = 0.03), fluoroscopy time: median 18 min (IQR: 12-26) versus 24 min (IQR: 16-38), p = 0.001), contrast volume 90 ml (IQR: 70-120 ml) versus 140 ml (IQR: 86-213 ml, p < 0.001). A minimalistic approach to TAVR is associated with improved procedural efficiency and reduced length of stay without compromising procedural success or clinical outcomes. Published by Elsevier Inc.

U.S. Department of Energy Vehicle Technologies Program: Battery Test Manual For Plug-In Hybrid Electric Vehicles

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

Christophersen, Jon P.

2014-09-01

This battery test procedure manual was prepared for the United States Department of Energy (DOE), Office of Energy Efficiency and Renewable Energy (EERE), Vehicle Technologies Office. It is based on technical targets for commercial viability established for energy storage development projects aimed at meeting system level DOE goals for Plug-in Hybrid Electric Vehicles (PHEV). The specific procedures defined in this manual support the performance and life characterization of advanced battery devices under development for PHEV’s. However, it does share some methods described in the previously published battery test manual for power-assist hybrid electric vehicles. Due to the complexity of somemore » of the procedures and supporting analysis, future revisions including some modifications and clarifications of these procedures are expected. As in previous battery and capacitor test manuals, this version of the manual defines testing methods for full-size battery systems, along with provisions for scaling these tests for modules, cells or other subscale level devices. The DOE-United States Advanced Battery Consortium (USABC), Technical Advisory Committee (TAC) supported the development of the manual. Technical Team points of contact responsible for its development and revision are Renata M. Arsenault of Ford Motor Company and Jon P. Christophersen of the Idaho National Laboratory. The development of this manual was funded by the Unites States Department of Energy, Office of Energy Efficiency and Renewable Energy, Vehicle Technologies Office. Technical direction from DOE was provided by David Howell, Energy Storage R&D Manager and Hybrid Electric Systems Team Leader. Comments and questions regarding the manual should be directed to Jon P. Christophersen at the Idaho National Laboratory (jon.christophersen@inl.gov).« less

[Current situation of the organisation, resources and activity in paediatric cardiology in Spain].

PubMed

Sánchez Ferrer, Francisco; Castro García, Francisco José; Pérez-Lescure Picarzo, Javier; Roses Noguer, Ferrán; Centeno Malfaz, Fernándo; Grima Murcia, María Dolores; Brotons, Dimpna Albert

2018-04-26

The results are presented on the «current situation of the organisation, resources and activity in paediatric cardiology in Spain». It was promoted by the Spanish Society of Paediatric Cardiology and Congenital Heart disease. An analysis was carried out on the results obtained from a specifically designed questionnaire, prepared by the Spanish Society of Paediatric Cardiology and Congenital Heart disease, that was sent to all hospitals around the country that offer the speciality of paediatric cardiology. A total of 86 questionnaires were obtained, including 14 hospitals that perform cardiac surgery on children. A total of 190 paediatric cardiology consultants, 40 cardiac surgeons, and 27 middle grade doctors performing their paediatric residency (MIR program) were identified. All hospitals had adequate equipment to perform an optimal initial evaluation of any child with a possible cardiac abnormality, but only tertiary centres could perform complex diagnostic procedures, interventional cardiology, and cardiac surgery. In almost all units around the country, paediatric cardiology consultants were responsible for outpatient clinics and hospital admissions, whereas foetal cardiology units were still mainly managed by obstetricians. The number of diagnostic and therapeutic procedures was similar to those reported in the first survey, except for a slight decrease in the total number of closed cardiac surgery procedures, and a proportional increase in the number of therapeutic catheterisations. Paediatric Cardiology in Spain is performed by paediatric cardiology consultants that were trained initially as general paediatricians, and then completed a paediatric cardiology training period. Almost all units have adequate means for diagnosis and treatment. Efforts should be directed to create a national registry that would not only allow a prospective quantification of diagnostic and therapeutic procedures, but also focus on their clinical outcomes. Copyright © 2018. Publicado por Elsevier España, S.L.U.

Ethnic and Gender Considerations in the Use of Facial Injectables: African-American Patients.

PubMed

Burgess, Cheryl; Awosika, Olabola

2015-11-01

The United States is becoming increasingly more diverse as the nonwhite population continues to rise faster than ever. By 2044, the US Census Bureau projects that greater than 50% of the US population will be of nonwhite descent. Ethnic patients are the quickest growing portion of the cosmetic procedures market, with African-Americans comprising 7.1% of the 22% of ethnic minorities who received cosmetic procedures in the United States in 2014. The cosmetic concerns and natural features of this ethnic population are unique and guided by differing structural and aging processes than their white counterparts. As people of color increasingly seek nonsurgical cosmetic procedures, dermatologists and cosmetic surgeons must become aware that the Westernized look does not necessarily constitute beauty in these diverse people. The use of specialized aesthetic approaches and understanding of cultural and ethnic-specific features are warranted in the treatment of these patients. This article will review the key principles to consider when treating African-American patients, including the average facial structure of African-Americans, the impact of their ethnicity on aging and structure of face, and soft-tissue augmentation strategies specific to African-American skin.

Building SAWE Capability as an ANSI Accredited Standards Developer

NASA Technical Reports Server (NTRS)

Cerro, Jeffrey A.; Davis, Ed; Peterson, Eric; Griffiths, William T.; Brooks, Andy; Stratton, Bonnie; Attar, Jose

2014-01-01

This paper presents a 2014 status of the Society of Allied Weight Engineers' process towards becoming an Accredited Standards Developer (ASD) under certification by the United States American National Standards Institute (ANSI). Included is material from the committee's 2013 International presentation, current status, and additional general background material. The document strives to serve as a reference point to assist SAWE Recommended Practice and Standards developers in negotiating United States Standards Strategy, international standards strategy, and the association of SAWE standards and recommended practices to those efforts. Required procedures for SAWE to develop and maintain Recommended Practices and ANSI/SAWE Standards are reviewed.

Outbreaks in Health Care Settings.

PubMed

Sood, Geeta; Perl, Trish M

2016-09-01

Outbreaks and pseudo-outbreaks in health care settings can be complex and should be evaluated systematically using epidemiologic tools. Laboratory testing is an important part of an outbreak evaluation. Health care personnel, equipment, supplies, water, ventilation systems, and the hospital environment have been associated with health care outbreaks. Settings including the neonatal intensive care unit, endoscopy, oncology, and transplant units are areas that have specific issues which impact the approach to outbreak investigation and control. Certain organisms have a predilection for health care settings because of the illnesses of patients, the procedures performed, and the care provided. Copyright © 2016 Elsevier Inc. All rights reserved.

Getting a Raise. Cooperative Work Experience Learning Activity Packet: Series on Job Entry and Adjustment; Packet Seven.

ERIC Educational Resources Information Center

Herschbach, Dennis R.; And Others

This student booklet is seventh in an illustrated series of eleven learning activity packets for use in teaching job hunting and application procedures and the management of wages to secondary students. Two units are included in this packet, one explaining the differences between periodic and merit pay increases and between flat amount and…

40 CFR 60.2210 - What information must I include in my annual report?

Code of Federal Regulations, 2013 CFR

2013-07-01

... Performance for Commercial and Industrial Solid Waste Incineration Units Recordkeeping and Reporting § 60.2210..., time, and duration that each CMS was inoperative, except for zero (low-level) and high-level checks. (3... procedure in 40 CFR part 60, appendix F of this part, as if any of the following occur. (1) The zero (low...

Bullying Victimisation and Social Support of Adolescent Male Dance Students: An Analysis of Findings

ERIC Educational Resources Information Center

Risner, Doug

2014-01-01

This analysis (n?=?33), drawn from the findings of the author's larger mixed method research study, investigated bullying and harassment of adolescent male students (ages 13-18) pursuing dance study at the pre-professional level in the United States. Procedures for this analysis included review of primary and secondary sources from the…

Global Distribution of Businesses Marketing Stem Cell-Based Interventions.

PubMed

Berger, Israel; Ahmad, Amina; Bansal, Akhil; Kapoor, Tanvir; Sipp, Douglas; Rasko, John E J

2016-08-04

A structured search reveals that online marketing of stem-cell-based interventions is skewed toward developed economies including the United States, Ireland, Australia, and Germany. Websites made broad, imprecise therapeutic claims and frequently failed to detail procedures. Widespread marketing poses challenges to regulators, bioethicists, and those seeking realistic hope from therapies. Copyright © 2016 Elsevier Inc. All rights reserved.

The Sea of Simulation: Improving Naval Shiphandling Training and Readiness through Game-Based Learning

DTIC Science & Technology

2012-03-01

Officer SWOI Surface Warfare Officer Introduction SWOS Surface Warfare Officers School xvii TFT Thin Film Transistor ULTRA Unit Level Training...designed the experiment , including participants, procedures, facilities selection, and materials. Chapter IV: Results and Discussion. This chapter...contains the results of experimentation and an interpretation of those results . Chapter V: Conclusions. This chapter provides an overall assessment

Training apartment upkeep skills to rehabilitation clients: a comparison of task analytic strategies.

PubMed Central

Williams, G E; Cuvo, A J

1986-01-01

The research was designed to validate procedures to teach apartment upkeep skills to severely handicapped clients with various categorical disabilities. Methodological features of this research included performance comparisons between general and specific task analyses, effect of an impasse correction baseline procedure, social validation of training goals, natural environment assessments and contingencies, as well as long-term follow-up. Subjects were taught to perform upkeep responses on their air conditioner-heating unit, electric range, refrigerator, and electrical appliances within the context of a multiple-probe across subjects experimental design. The results showed acquisition, long-term maintenance, and generalization of the upkeep skills to a nontraining apartment. General task analyses were recommended for assessment and specific task analyses for training. The impasse correction procedure generally did not produce acquisition. PMID:3710947

Preliminary digital geologic maps of the Mariposa, Kingman, Trona, and Death Valley Sheets, California

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

D`Agnese, F.A.; Faunt, C.C.; Turner, A.K.

1995-10-01

Parts of four 1:250,000-scale geologic maps by the California Department of Natural Resources, Division of Mines and Geology have been digitized for use in hydrogeologic characterization. These maps include the area of California between lat. 35{degree}N; Long. 115{degree}W and lat. 38{degree}N, long. 118{degree}W of the Kingman Sheet (Jennings, 1961), Trona Sheet (Jennings and others, 1962), Mariposa Sheet (Strand, 1967), and Death Valley Sheet (Streitz and Stinson, 1974). These digital maps are being released by the US Geological Survey in the ARC/INFO Version 6.1 Export format. The digitized data include geologic unit boundaries, fault traces, and identity of geologic units. Themore » procedure outlined in US Geological Survey Circular 1054 (Soller and others, 1990) was sued during the map construction. The procedure involves transferring hard-copy data into digital format by scanning manuscript maps, manipulating the digital map data, and outputting the data. Most of the work was done using Environmental Systems Research Institute`s ARC/INFO software. The digital maps are available in ARC/INFO Rev. 6.1 Export format, from the USGS, Yucca Mountain Project, in Denver, Colorado.« less

Future of operating rooms.

PubMed

Reijnen, Michel M P J; Zeebregts, Clark J; Meijerink, Wilhelmus J H J

2005-01-01

Operating-room design has not changed significantly since the modern era of surgery began. Minimal invasive, endoscopic, procedures, and evolution of technology will affect operating-room design in the near future. Poor ergonomics has always been one of the major drawbacks of endoscopic surgery. Use of retractable arms and monitors will improve ergonomics of the operating team. Developments in telecommunication will allow surgeons to communicate with colleagues and experts during the procedure in virtually any location around the world, which increases teaching possibilities and procedural safety. Introduction and further development of intraoperative imaging, including real-time, three-dimensional (3-D) reconstructions of patient, and computer-aided surgery offer surgeons the opportunity to train the planned surgical procedure. Moreover, they will improve control and supervision of the procedure in learning situations. The last decade's robotics have made their introduction into the operating rooms. They improve control over the operating-room environment and will facilitate the performance of more complex procedures. However, high costs and lack of force feedback remain its major drawbacks. Improvements of robotic techniques and its implementation into the operating rooms will further guide their design into highly specialized operating units.

N-gram support vector machines for scalable procedure and diagnosis classification, with applications to clinical free text data from the intensive care unit.

PubMed

Marafino, Ben J; Davies, Jason M; Bardach, Naomi S; Dean, Mitzi L; Dudley, R Adams

2014-01-01

Existing risk adjustment models for intensive care unit (ICU) outcomes rely on manual abstraction of patient-level predictors from medical charts. Developing an automated method for abstracting these data from free text might reduce cost and data collection times. To develop a support vector machine (SVM) classifier capable of identifying a range of procedures and diagnoses in ICU clinical notes for use in risk adjustment. We selected notes from 2001-2008 for 4191 neonatal ICU (NICU) and 2198 adult ICU patients from the MIMIC-II database from the Beth Israel Deaconess Medical Center. Using these notes, we developed an implementation of the SVM classifier to identify procedures (mechanical ventilation and phototherapy in NICU notes) and diagnoses (jaundice in NICU and intracranial hemorrhage (ICH) in adult ICU). On the jaundice classification task, we also compared classifier performance using n-gram features to unigrams with application of a negation algorithm (NegEx). Our classifier accurately identified mechanical ventilation (accuracy=0.982, F1=0.954) and phototherapy use (accuracy=0.940, F1=0.912), as well as jaundice (accuracy=0.898, F1=0.884) and ICH diagnoses (accuracy=0.938, F1=0.943). Including bigram features improved performance on the jaundice (accuracy=0.898 vs 0.865) and ICH (0.938 vs 0.927) tasks, and outperformed NegEx-derived unigram features (accuracy=0.898 vs 0.863) on the jaundice task. Overall, a classifier using n-gram support vectors displayed excellent performance characteristics. The classifier generalizes to diverse patient populations, diagnoses, and procedures. SVM-based classifiers can accurately identify procedure status and diagnoses among ICU patients, and including n-gram features improves performance, compared to existing methods. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Infection control in delivery care units, Gujarat state, India: A needs assessment

PubMed Central

2011-01-01

Background Increasingly, women in India attend health facilities for childbirth, partly due to incentives paid under government programs. Increased use of health facilities can alleviate the risks of infections contracted in unhygienic home deliveries, but poor infection control practices in labour and delivery units also cause puerperal sepsis and other infections of childbirth. A needs assessment was conducted to provide information on procedures and practices related to infection control in labour and delivery units in Gujarat state, India. Methods Twenty health care facilities, including private and public primary health centres and referral hospitals, were sampled from two districts in Gujarat state, India. Three pre-tested tools for interviewing and for observation were used. Data collection was based on existing infection control guidelines for clean practices, clean equipment, clean environment and availability of diagnostics and treatment. The study was carried out from April to May 2009. Results Seventy percent of respondents said that standard infection control procedures were followed, but a written procedure was only available in 5% of facilities. Alcohol rubs were not used for hand cleaning and surgical gloves were reused in over 70% of facilities, especially for vaginal examinations in the labour room. Most types of equipment and supplies were available but a third of facilities did not have wash basins with "hands-free" taps. Only 15% of facilities reported that wiping of surfaces was done immediately after each delivery in labour rooms. Blood culture services were available in 25% of facilities and antibiotics are widely given to women after normal delivery. A few facilities had data on infections and reported rates of 3% to 5%. Conclusions This study of current infection control procedures and practices during labour and delivery in health facilities in Gujarat revealed a need for improved information systems, protocols and procedures, and for training and research. Simply incentivizing the behaviour of women to use health facilities for childbirth via government schemes may not guarantee safe delivery. PMID:21599924

[Management of chemical burns and inhalation poisonings in acute medical care procedures of the State Fire Service].

PubMed

Chomoncik, Mariusz; Nitecki, Jacek; Ogonowska, Dorota; Cisoń-Apanasewicz, Urszula; Potok, Halina

2013-01-01

Emergency Medical Services (EMS) were founded by the government to perform tasks aimed at providing people with help in life-threatening conditions. The system comprises two constituent parts. The first one is public administrative bodies which are to organise, plan, coordinate and supervise the completion of the tasks. The other constituent is EMS units which keep people, resources and units in readiness. Supportive services, which include: the State Fire Service (SFS) and the National Firefighting and Rescue System (NFRS), are of great importance for EMS because they are eligible for providing acute medical care (professional first aid). Acute medical care covers actions performed by rescue workers to help people in life-threatening conditions. Rescue workers provide acute medical care in situations when EMS are not present on the spot and the injured party can be accessed only with the use of professional equipment by trained workers of NFRS. Whenever necessary, workers of supportive services can assist paramedics' actions. Cooperation of all units of EMS and NFRS is very important for rescue operations in the integrated rescue system. Time is a key aspect in delivering first aid to a person in life-threatening conditions. Fast and efficient first aid given by the accident's witness, as well as acute medical care performed by a rescue worker can prevent death and minimise negative effects of an injury or intoxication. It is essential that people delivering first aid and acute medical care should act according to acknowledged and standardised procedures because only in this way can the process of decision making be sped up and consequently, the number of possible complications following accidents decreased. The present paper presents an analysis of legal regulations concerning the management of chemical burn and inhalant intoxication in acute medical care procedures of the State Fire Service. It was observed that the procedures for rescue workers entitled to provide acute medical care should be correlated with the procedures for emergency medical teams.

Hidden Anemias in the Critically Ill.

PubMed

O'Malley, Patricia

2017-09-01

With increasing knowledge of the risks associated with receiving blood transfusions, a new paradigm of bloodless medicine is needed. Principles of bloodless medicine include careful monitoring for obvious and hidden anemias, rapid intervention, minimizing blood losses from laboratory testing and procedures, and careful management of bleeding diatheses. As evidence is revealed and refined, standard treatment of anemia in the intensive care unit will include erythropoietin-stimulating agents, iron, folate, and vitamin B12, which will reduce risks associated with blood transfusions. Copyright © 2017 Elsevier Inc. All rights reserved.

[Prompt control of an imported carbapenem-resistant Acinetobacter baumanii outbreak in a French intensive care unit].

PubMed

Guth, C; Cavalli, Z; Pernod, C; Lhopital, C; Wey, Pf; Gerome, P; Turc, J

2016-01-01

to describe the management and control of a limited outbreak of carbapenem-resistant Acinetobacter baumanii (CRAB) outbreak in a French intensive care unit. Careful review of the contact's and carrier's files and outbreak management procedures. An undiagnosed CRAB carrier was admitted to our intensive care unit after medical evacuation from Turkey. Despite preventive isolation and contact precautions, a secondary case was diagnosed 5 days after admission of the index case and resulted in the creation of a crisis unit. Prompt management included an epidemiologic investigation with contact screening and follow-up, environmental screening, and additional restrictive measures: isolation room, closure of adjacent rooms, patient cohorting with designated nurses, and reinforcement of contact precautions. restrictive management of CRAB outbreaks may allow prompt outbreak control and avoid prolonged room closures.

Mortality of induced abortion, other outpatient surgical procedures and common activities in the United States.

PubMed

Raymond, Elizabeth G; Grossman, Daniel; Weaver, Mark A; Toti, Stephanie; Winikoff, Beverly

2014-11-01

The recent surge of new legislation regulating induced abortion in the United States is ostensibly motivated by the desire to protect women's health. To provide context for interpreting the risk of abortion, we compared abortion-related mortality to mortality associated with other outpatient surgical procedures and selected nonmedical activities. We calculated the abortion-related mortality rate during 2000-2009 using national data. We searched PubMed and other sources for contemporaneous data on mortality associated with other outpatient procedures commonly performed on healthy young women, marathon running, bicycling and driving. The abortion-related mortality rate in 2000-2009 in the United States was 0.7 per 100,000 abortions. Studies in approximately the same years found mortality rates of 0.8-1.7 deaths per 100,000 plastic surgery procedures, 0-1.7deaths per 100,000 dental procedures, 0.6-1.2 deaths per 100,000 marathons run and at least 4 deaths among 100,000 cyclists in a large annual bicycling event. The traffic fatality rate per 758 vehicle miles traveled by passenger cars in the United States in 2007-2011 was about equal to the abortion-related mortality rate. The safety of induced abortion as practiced in the United States for the past decade met or exceeded expectations for outpatient surgical procedures and compared favorably to that of two common nonmedical voluntary activities. The new legislation restricting abortion is unnecessary; indeed, by reducing the geographic distribution of abortion providers and requiring women to travel farther for the procedure, these laws are potentially detrimental to women's health. Copyright © 2014 Elsevier Inc. All rights reserved.

Family needs and involvement in the intensive care unit: a literature review.

PubMed

Al-Mutair, Abbas Saleh; Plummer, Virginia; O'Brien, Anthony; Clerehan, Rosemary

2013-07-01

To understand the needs of critically ill patient families', seeking to meet those needs and explore the process and patterns of involving family members during routine care and resuscitation and other invasive procedures. A structured literature review using Cumulative Index to Nursing and Allied Health Literature, Pubmed, Proquest, Google scholar, Meditext database and a hand search of critical care journals via identified search terms for relevant articles published between 2000 and 2010. Thirty studies were included in the review either undertaken in the Intensive Care Unit or conducted with critical care staff using different methods of inquiry. The studies were related to family needs; family involvement in routine care; and family involvement during resuscitation and other invasive procedures. The studies revealed that family members ranked both the need for assurance and the need for information as the most important. They also perceived their important needs as being unmet, and identified the nurses as the best staff to meet these needs, followed by the doctors. The studies demonstrate that both family members and healthcare providers have positive attitudes towards family involvement in routine care. However, family members and healthcare providers had significantly different views of family involvement during resuscitation and other invasive procedures. Meeting Intensive Care Unit family needs can be achieved by supporting and involving families in the care of the critically ill family member. More emphasis should be placed on identifying the family needs in relation to the influence of cultural values and religion held by the family members and the organisational climate and culture of the working area in the Intensive Care Unit. © 2013 Blackwell Publishing Ltd.

Compiling and editing agricultural strata boundaries with remotely sensed imagery and map attribute data using graphics workstations

NASA Technical Reports Server (NTRS)

Cheng, Thomas D.; Angelici, Gary L.; Slye, Robert E.; Ma, Matt

1991-01-01

The USDA presently uses labor-intensive photographic interpretation procedures to delineate large geographical areas into manageable size sampling units for the estimation of domestic crop and livestock production. Computer software to automate the boundary delineation procedure, called the computer-assisted stratification and sampling (CASS) system, was developed using a Hewlett Packard color-graphics workstation. The CASS procedures display Thematic Mapper (TM) satellite digital imagery on a graphics display workstation as the backdrop for the onscreen delineation of sampling units. USGS Digital Line Graph (DLG) data for roads and waterways are displayed over the TM imagery to aid in identifying potential sample unit boundaries. Initial analysis conducted with three Missouri counties indicated that CASS was six times faster than the manual techniques in delineating sampling units.

Effects of selection and training on unit-level performance over time: a latent growth modeling approach.

PubMed

Van Iddekinge, Chad H; Ferris, Gerald R; Perrewé, Pamela L; Blass, Fred R; Heetderks, Thomas D; Perryman, Alexa A

2009-07-01

Surprisingly few data exist concerning whether and how utilization of job-related selection and training procedures affects different aspects of unit or organizational performance over time. The authors used longitudinal data from a large fast-food organization (N = 861 units) to examine how change in use of selection and training relates to change in unit performance. Latent growth modeling analyses revealed significant variation in both the use and the change in use of selection and training across units. Change in selection and training was related to change in 2 proximal unit outcomes: customer service performance and retention. Change in service performance, in turn, was related to change in the more distal outcome of unit financial performance (i.e., profits). Selection and training also affected financial performance, both directly and indirectly (e.g., through service performance). Finally, results of a cross-lagged panel analysis suggested the existence of a reciprocal causal relationship between the utilization of the human resources practices and unit performance. However, there was some evidence to suggest that selection and training may be associated with different causal sequences, such that use of the training procedure appeared to lead to unit performance, whereas unit performance appeared to lead to use of the selection procedure.

WEO position statement on hygiene in digestive endoscopy: Focus on endoscopy units in Asia and the Middle East.

PubMed

Murdani, Abdullah; Kumar, Ajay; Chiu, Han-Mo; Goh, Khean-Lee; Jang, Byung Ik; Khor, Christopher J L; Lau, James; Mostafa, Ibrahim; Ramchandani, Mohan; Ratanalert, Siriporn; Tajiri, Hisao; Yuen, Minghwa; Zhang, Shu Tian; Duforest-Rey, Dianelle; Rey, Jean-Francois

2017-01-01

The aim of this position statement is to reinforce the key points of hygiene in digestive endoscopy. The present article details the minimum hygiene requirements for reprocessing of endoscopes and endoscopic devices, regardless of the reprocessing method (automated washer-disinfector or manual cleaning) and the endoscopy setting (endoscopy suite, operating room, elective or emergency procedures). These minimum requirements are mandatory for patient safety. Both advanced diagnostic and therapeutic endoscopies should be carried out in an environment that is safe for patients and staff. Particular attention is given to contaminants. Procedural errors in decontamination, defective equipment, and failure to follow disinfection guidelines are major factors contributing to transmission of infection during endoscopy. Other important risk factors include inadequate cleaning, use of older endoscopes with surface and working channel irregularities, and contamination of water bottles or irrigating solutions. Infections by multidrug-resistant organisms have become an increasing problem in health-care systems worldwide. Since 2010, outbreaks of multidrug-resistant bacteria associated with endoscopic retrograde cholangiopancreatography have been reported from the USA, France, Germany, and The Netherlands. In many endoscopy units in Asia and the Middle East, reprocessing procedures have lagged behind those of Western countries for cultural reasons or lack of financial resources. This inconsistency in standards is now being addressed, and the World Endoscopy Organization has prepared this position statement to highlight key points for quality assurance in any endoscopy unit in any country. © 2016 Japan Gastroenterological Endoscopy Society.

Systems workplace for endoscopic surgery.

PubMed

Irion, K M; Novak, P

2000-01-01

With the advent of minimally invasive surgery (MIS) a decade ago, the requirements for operating rooms (OR) and their equipment have been increased. Compared with conventional open surgery, the new endoscopic techniques require additional tools. Television systems, for video-assisted image acquisition and visualisation, including cameras, monitors and light systems, as well as insufflators, pumps, high-frequency units, lasers and motorised therapy units, are nowadays usually made available on carts during endoscopic surgery. In conjunction with a set of endoscopic instruments, these high-tech units allow new operating techniques to be performed. The benefit for patients has become clear in recent years; however, the technical complexity of OR has also increased considerably. To minimise this problem for the OR personnel, the MIS concept 'OR1' (Operating Room 1) was developed and implemented. OR1 is a fully functional and integrated multi-speciality surgical suite for MIS. The centrepieces of the OR1 are the Storz Communication Bus (SCB) and the advanced image and data archiving system (Aida) from Karl Storz, Tuttlingen, Germany. Both components allow monitoring, access and networking of the MIS equipment and other OR facilities, as well as the acquisition, storage and display of image, patient and equipment data during the endoscopic procedure. A central user interface allows efficient, simplified operation and online clinical images. Due to the system integration, the handling of complex equipment is considerably simplified, logistical procedures in the OR are improved, procedure times are shorter and, particularly noteworthy, operative risk can be reduced through simplified device operation.

Improving conceptual and procedural knowledge: The impact of instructional content within a mathematics lesson.

PubMed

Rittle-Johnson, Bethany; Fyfe, Emily R; Loehr, Abbey M

2016-12-01

Students, parents, teachers, and theorists often advocate for direct instruction on both concepts and procedures, but some theorists suggest that including instruction on procedures in combination with concepts may limit learning opportunities and student understanding. This study evaluated the effect of instruction on a math concept and procedure within the same lesson relative to a comparable amount of instruction on the concept alone. Direct instruction was provided before or after solving problems to evaluate whether the type of instruction interacted with the timing of instruction within a lesson. We worked with 180 second-grade children in the United States. In a randomized experiment, children received a classroom lesson on mathematical equivalence in one of four conditions that varied in instruction type (conceptual or combined conceptual and procedural) and in instruction order (instruction before or after solving problems). Children who received two iterations of conceptual instruction had better retention of conceptual and procedural knowledge than children who received both conceptual and procedural instruction in the same lesson. Order of instruction did not impact outcomes. Findings suggest that within a single lesson, spending more time on conceptual instruction may be more beneficial than time spent teaching a procedure when the goal is to promote more robust understanding of target concepts and procedures. © 2016 The British Psychological Society.

Procedure to establish inspection intervals of regularity maintained in-service units subject to failure

DOT National Transportation Integrated Search

1996-05-01

Procedures have been developed for determining the period between regular inspections that is required to ensure, with a : specified level of confidence, that no more than a certain percentage of the units of a population that is in service is : fail...

Rodent models of depression: learned helplessness induced in mice.

PubMed

Anisman, H; Merali, Z

2001-05-01

Uncontrollable stressors induce a variety of behavioral disturbances that are in many ways reminiscent of the symptoms that characterize clinical depression. These deficits are evident across a range of species, including mice. Given the increasing focus on genetic techniques involving mice to identify the mechanisms subserving these behavioral disturbances (e.g., recombinant, knockout, and transgenic strains), it is of particular interest to provide a detailed description of the method to induce behavioral deficits in response to uncontrollable stressors. This unit describes the procedure used to assess the effects of controllable and uncontrollable shock on subsequent shock escape performance in mice using an escape-delay procedure.

Petroleum supply monthly, February 1991. [Glossary included

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

Not Available

1991-02-01

Data presented in the Petroleum Supply Monthly (PSM) describe the supply and disposition of petroleum products in the United States and major US geographic regions. The data series describe production, imports and exports, inter-Petroleum Administration for Defense (PAD) District movements, and inventories by the primary suppliers of petroleum products in the United States (50 States and the District of Columbia). The reporting universe includes those petroleum sectors in Primary Supply. Included are: petroleum refiners, motor gasoline blenders, operators of natural gas processing plants and fractionators, inter-PAD transporters, importers, and major inventory holders of petroleum products and crude oil. When aggregated,more » the data reported by these sectors approximately represent the consumption of petroleum products in the United States. Data presented in the PSM are divided into two sections (1) the Summary Statistics and (2) the Detailed Statistics. Explanatory Notes, located at the end of this publication, present information describing data collection, sources, estimation methodology, data quality control procedures, modifications to reporting requirements and interpretation of tables. Industry terminology and product definitions are listed alphabetically in the Glossary. 12 figs., 54 tabs.« less

Chimpanzees' (Pan troglodytes) use of gaze cues in object-choice tasks: different methods yield different results.

PubMed

Barth, Jochen; Reaux, James E; Povinelli, Daniel J

2005-04-01

To assess the influence of different procedures on chimpanzees' performance in object-choice tasks, five adult chimpanzees were tested using three experimenter-given cues to food location: gazing, glancing, and pointing. These cues were delivered to the subjects in an identical fashion but were deployed within the context of two distinct meta-procedures that have been previously employed with this species with conflicting results. In one procedure, the subjects entered the test unit and approached the experimenter (who had already established the cue) on each trial. In the other procedure, the subjects stayed in the test unit throughout a session, witnessed the hiding procedure, and waited for a delay of 10 s during which the cue was provided. The subjects scored at high levels far exceeding chance in response to the gaze cue only when they approached the experimenter for each trial. They performed at chance levels when they stayed inside the test unit throughout the session. They scored at chance levels on all other cues irrespective of the procedure. These findings imply that (a) chimpanzees can immediately exploit social gaze cues, and (b) previous conflicting findings were likely due to the different meta-procedures that were used.

76 FR 62092 - Filing Procedures

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-06

... INTERNATIONAL TRADE COMMISSION Filing Procedures AGENCY: International Trade Commission. ACTION: Notice of issuance of Handbook on Filing Procedures. SUMMARY: The United States International Trade Commission (``Commission'') is issuing a Handbook on Filing Procedures to replace its Handbook on Electronic...

Quality Assurance in Breast Health Care and Requirement for Accreditation in Specialized Units

PubMed Central

Güler, Sertaç Ata; Güllüoğlu, Bahadır M.

2014-01-01

Breast health is a subject of increasing importance. The statistical increase in the frequency of breast cancer and the consequent increase in death rate increase the importance of quality of services to be provided for breast health. For these reasons, the minimum standards and optimum quality metrics of breast care provided to the community are determined. The quality parameters for breast care service include the results, the structure and the operation of services. Within this group, the results of breast health services are determined according to clinical results, patient satisfaction and financial condition. The structure of quality services should include interdisciplinary meetings, written standards for specific procedures and the existence of standardized reporting systems. Establishing breast centers that adopt integrated multidisciplinary working principles and their cost-effective maintenance are important in terms of operation of breast health services. The importance of using a “reviewing/auditing” procedure that checks if all of these functions existing in the health system are carried out at the desired level and an “accreditation” system indicating that the working breast units/centers provide minimum quality adequacy in all aspects, is undeniable. Currently, the accreditation system for breast centers is being used in the European Union and the United States for the last 5–10 years. This system is thought to provide standardization in breast care services, and is accepted as one of the important factors that resulted in reduction in mortality associated with breast cancer. PMID:28331658

Quality Assurance in Breast Health Care and Requirement for Accreditation in Specialized Units.

PubMed

Güler, Sertaç Ata; Güllüoğlu, Bahadır M

2014-07-01

Breast health is a subject of increasing importance. The statistical increase in the frequency of breast cancer and the consequent increase in death rate increase the importance of quality of services to be provided for breast health. For these reasons, the minimum standards and optimum quality metrics of breast care provided to the community are determined. The quality parameters for breast care service include the results, the structure and the operation of services. Within this group, the results of breast health services are determined according to clinical results, patient satisfaction and financial condition. The structure of quality services should include interdisciplinary meetings, written standards for specific procedures and the existence of standardized reporting systems. Establishing breast centers that adopt integrated multidisciplinary working principles and their cost-effective maintenance are important in terms of operation of breast health services. The importance of using a "reviewing/auditing" procedure that checks if all of these functions existing in the health system are carried out at the desired level and an "accreditation" system indicating that the working breast units/centers provide minimum quality adequacy in all aspects, is undeniable. Currently, the accreditation system for breast centers is being used in the European Union and the United States for the last 5-10 years. This system is thought to provide standardization in breast care services, and is accepted as one of the important factors that resulted in reduction in mortality associated with breast cancer.

Procedural Guide for International Gauging Stations on Boundary Waters Between Canada and the United States of America

USGS Publications Warehouse

Huberman, S.; Slater, James; Condes, A.

1985-01-01

INTRODUCTION Since 1909, the United States of America (U.S.A.) and Canada have employed a system of monitoring stream-flow and water levels for shared waters based upon professionalism, trust and goodwill. This document has been prepared in considerable detail for use by managers and field officers at all levels of government in Canada and the United States. Its purpose is to serve as a guide in attaining uniform procedures in the designation and operation of International Gauging Stations. For special situations where these procedures do not apply, specific mention is made in appropriate sections of the guide. This guide supersedes that of November 4, 1969, and the guide entitled 'The Procedural Guide for Operation of International Gauging Stations, St. Mary- Milk Rivers,' dated March 12, 1979.

39 CFR 912.11 - Exclusiveness of remedy.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Exclusiveness of remedy. 912.11 Section 912.11 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES PROCEDURES TO ADJUDICATE CLAIMS FOR PERSONAL... of remedy. The provisions of 28 U.S.C. 2679(b) provide that the remedy against the United States, as...

39 CFR 912.11 - Exclusiveness of remedy.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Exclusiveness of remedy. 912.11 Section 912.11 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES PROCEDURES TO ADJUDICATE CLAIMS FOR PERSONAL... of remedy. The provisions of 28 U.S.C. 2679(b) provide that the remedy against the United States, as...

Unit Method of Accounting for Investments.

ERIC Educational Resources Information Center

Jones, Leigh A.

1971-01-01

The unit method of accounting for investments, also called the market-value method, is defined as a procedure for accurately allocating income and investment gains and losses, both realized and unrealized, between component funds of an investment pool. This procedure provides a data base for the calculation of investment performance. Advantages of…

77 FR 59397 - Economic Impact Policy

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-27

... EXPORT-IMPORT BANK OF THE UNITED STATES Economic Impact Policy This notice is to inform the public that the Export-Import Bank of the United States is in the process of reviewing its economic impact procedures. A draft of the proposed economic impact procedures can be accessed at the following location...

78 FR 77492 - Hearings of the Judicial Conference Advisory Committee on Rules of Bankruptcy Procedure; Federal...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-23

... JUDICIAL CONFERENCE OF THE UNITED STATES Hearings of the Judicial Conference Advisory Committee on...: Advisory Committee on Rules of Bankruptcy Procedure, Judicial Conference of the United States. ACTION..., 2014, Chicago, IL. FOR FURTHER INFORMATION CONTACT: Jonathan C. Rose, Secretary and Chief Rules Officer...

77 FR 72885 - Meeting of the Judicial Conference Committee on Rules of Practice and Procedure

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-06

... JUDICIAL CONFERENCE OF THE UNITED STATES Meeting of the Judicial Conference Committee on Rules of Practice and Procedure AGENCY: Judicial Conference of the United States Advisory Committee on Rules of... CONTACT: Jonathan C. Rose, Secretary and Chief Rules Officer, Rules Committee Support Office...

77 FR 66481 - Hearings of the Judicial Conference Advisory Committee on Rules of Civil Procedure

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-05

... JUDICIAL CONFERENCE OF THE UNITED STATES Hearings of the Judicial Conference Advisory Committee on Rules of Civil Procedure AGENCY: Judicial Conference of the United States, Advisory Committee on Rules... Circle NE., Washington, DC 20544. FOR FURTHER INFORMATION CONTACT: Jonathan C. Rose, Chief Rules Officer...

78 FR 76177 - Meeting of the Judicial Conference Committee on Rules of Practice and Procedure

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-16

... JUDICIAL CONFERENCE OF THE UNITED STATES Meeting of the Judicial Conference Committee on Rules of Practice and Procedure AGENCY: Judicial Conference of the United States Advisory Committee on Rules of..., Phoenix, Arizona 85003. FOR FURTHER INFORMATION CONTACT: Jonathan C. Rose, Secretary and Chief Rules...

ILLINOIS VOCATIONAL EDUCATION OCCUPATIONAL RESEARCH AND DEVELOPMENT COORDINATING UNIT FINAL REPORT.

ERIC Educational Resources Information Center

BURGENER, V.E.

AN OCCUPATIONAL RESEARCH AND DEVELOPMENT UNIT WAS CREATED TO PROVIDE ASSISTANCE IN A STATEWIDE PROGRAM OF VOCATIONAL RESEARCH TO DEVELOP RESEARCH PERSONNEL, TO EVALUATE EXPERIMENTAL CURRICULUM AND INSTRUCTIONAL PROCEDURES, TO DEVELOP AN OVERVIEW OF SURVEY PROCEDURES RELATED TO OCCUPATIONAL OPPORTUNITIES AND TRAINING NEEDS, TO REFINE THE OPERATING…

A COMPARISON OF MAPPED ESTIMATES OF LONG-TERM RUNOFF IN THE NORTHEAST UNITED STATES

EPA Science Inventory

We evaluated the relative accuracy of four methods of producing maps of long-term runoff for part of the northeast United States: MAN, a manual procedure that incorporates expert opinion in contour placement; RPRIS, an automated procedure based on water balance considerations, Pn...

8 CFR 301.1 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... STATES AT BIRTH § 301.1 Procedures. (a) Application. (1) A person residing in the United States who... evidence essential to establish the claimed citizenship, such as birth, marriage, death, and divorce.... The person shall be considered a United States citizen as of the date of his or her birth. [62 FR...

28 CFR 19.6 - Responsibility of DOJ organizational units for program implementation and implementation procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... consent to use the photograph and biographical information. See 28 CFR 0.1, Organizational Structure of... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Responsibility of DOJ organizational... Responsibility of DOJ organizational units for program implementation and implementation procedures. (a) The...

Evaluating environmental impact caused by industrial activities - Implementation of the WTP-WTA approach

NASA Astrophysics Data System (ADS)

Kopsidas, Odysseas; Batzias, Fragiskos

2012-12-01

In this work, a methodological framework under the form of an algorithmic procedure, including 28 activity stages and 6 decision nodes, has been developed for evaluating environmental impact caused by industrial activities. The main part of this procedure is a modification of the Contingent Valuation Method (CVM), which is heavily relied on survey-based estimation of WTP-WTA (willingness to pay/accept, respectively). The survey may take place either under a strictly controlled environment or in situ and as-is ('laboratory conditions' or 'field conditions', respectively, in the terminology of experimental economics). Implementation of this methodology is presented, referring to three cases of industrial pollution (in three different sites) caused by (i) a cement producing units, (ii) an oil refinery complex, and (iii) an industrialized small city with an intensively polluted port, where several industrial units co-exist, all of them located in the vicinity of Athens, Greece. The results are interpreted/discussed and conclusions are drawn.

Physical Property Analysis and Report for Sediments at 100-BC-5 Operable Unit, Boreholes C7505, C7506, C7507, and C7665

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

Lindberg, Michael J.

2010-09-28

Between October 14, 2009 and February 22, 2010 sediment samples were received from 100-BC Decision Unit for geochemical studies. This is an analytical data report for sediments received from CHPRC at the 100 BC 5 OU. The analyses for this project were performed at the 325 building located in the 300 Area of the Hanford Site. The analyses were performed according to Pacific Northwest National Laboratory (PNNL) approved procedures and/or nationally recognized test procedures. The data sets include the sample identification numbers, analytical results, estimated quantification limits (EQL), and quality control data. The preparatory and analytical quality control requirements, calibrationmore » requirements, acceptance criteria, and failure actions are defined in the on-line QA plan 'Conducting Analytical Work in Support of Regulatory Programs' (CAW). This QA plan implements the Hanford Analytical Services Quality Assurance Requirements Documents (HASQARD) for PNNL.« less

Effect of support flexibilty and damping on the dynamic response of a single mass flexible rotor in elastic bearings

NASA Technical Reports Server (NTRS)

Kirk, R. G.; Gunter, E. J.

1972-01-01

A steady state analysis of the shaft and the bearing housing motion was made by assuming synchronous precession of the system. The conditions under which the support system would act as a dynamic vibration absorber at the rotor critical speed were studied; plots of the rotor and support amplitudes, phase angles, and forces transmitted were evaluated by the computer, and the performance curves were automatically plotted by a CalComp plotter unit. Curves are presented on the optimization of the support housing characteristics to attenuate the rotor unbalance response over the entire rotor speed range. The complete transient motion including rotor unbalance was examined by integrating the equations of motion numerically using a modified fourth order Runge-Kutta procedure, and the resulting whirl orbits were plotted by the CalComp plotter unit. The results of the transient analysis are discussed with regards to the design optimization procedure derived from the steady-state analysis.

Extremity movements help occupational therapists identify stress responses in preterm infants in the neonatal intensive care unit: a systematic review.

PubMed

Holsti, Liisa; Grunau, Ruth E

2007-06-01

Accurate assessment and treatment of pain and stress in preterm infants in neonatal intensive care units (NICU) is vital because pain and stress responses have been linked to long-term alterations in development in this population. To review the evidence of specific extremity movements in preterm infants as observed during stressful procedures. Five on-line databases were searched for relevant studies. For each study, levels of evidence were determined and effect size estimates were calculated. Each study was also evaluated for specific factors that presented potential threats to its validity. Eighteen studies were identified and seven comprised the review. The combined sample included 359 preterm infants. Six specific movements were associated with painful and intrusive procedures. A set of specific extremity movements, when combined with other reliable biobehavioural measures of pain and stress, can form the basis for future research and development of a clinical stress scale for preterm infants.

Approach to a case of multiple irregular red cell antibodies in a liver transplant recipient: Need for developing competence

PubMed Central

Dara, Ravi C.; Tiwari, Aseem K.; Pandey, Prashant; Arora, Dinesh

2015-01-01

Liver transplant procedure acts as a challenge for transfusion services in terms of specialized blood components, serologic problems, and immunologic effects of transfusion. Red cell alloimmunization in patients awaiting a liver transplant complicate the process by undue delay or unavailability of compatible red blood cell units. Compatible blood units can be provided by well-equipped immunohematology laboratory, which has expertise in resolving these serological problems. This report illustrates resolution of a case with multiple alloantibodies using standard techniques, particularly rare antisera. Our case re-emphasizes the need for universal antibody screening in all patients as part of pretransfusion testing, which helps to identify atypical antibodies and plan for appropriate transfusion support well in time. We recommend that the centers, especially the ones that perform complex procedures like solid organ transplants and hematological transplants should have the necessary immunohematological reagents including rare antisera to resolve complex cases of multiple antibodies as illustrated in this case. PMID:25722585

Chapter 5. Essential equipment, pharmaceuticals and supplies. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster.

PubMed

Sprung, Charles L; Kesecioglu, Jozef

2010-04-01

To provide recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza pandemic or mass disaster with a specific focus on essential equipment, pharmaceuticals and supplies. Based on a literature review and expert opinion, a Delphi process was used to define the essential topics including essential equipment, pharmaceuticals and supplies. Key recommendations include: (1) ensure that adequate essential medical equipment, pharmaceuticals and important supplies are available during a disaster; (2) develop a communication and coordination system between health care facilities and local/regional/state/country governmental authorities for the provision of additional support; (3) determine the required resources, order and stockpile adequate resources, and judiciously distribute them; (4) acquire additional mechanical ventilators that are portable, provide adequate gas exchange for a range of clinical conditions, function with low-flow oxygen and without high pressure, and are safe for patients and staff; (5) provide advanced ventilatory support and rescue therapies including high levels of inspired oxygen and positive end-expiratory pressure, volume and pressure control ventilation, inhaled nitric oxide, high-frequency ventilation, prone positioning ventilation and extracorporeal membrane oxygenation; (6) triage scarce resources including equipment, pharmaceuticals and supplies based on those who are likely to benefit most or on a 'first come, first served' basis. Judicious planning and adoption of protocols for providing adequate equipment, pharmaceuticals and supplies are necessary to optimize outcomes during a pandemic.

Chapter 4. Manpower. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster.

PubMed

Sandrock, Christian

2010-04-01

To provide recommendations and standard operating procedures (SOPs) for intensive care unit (ICU) and hospital preparations for an influenza pandemic or mass disaster with a specific focus on manpower. Based on a literature review and expert opinion, a Delphi process was used to define the essential topics including manpower. Key recommendations include: (1) plan to access, coordinate and increase labor resources for continued and expanded ICU care including increasing critical care specialists and expanded practice for non-critical care personnel; (2) develop an education, awareness, preparation and communication program to ensure a well-protected and prepared workforce with coordinated rapid manpower expansion; (3) maintain a central inventory of all clinical and non-clinical staff with their current roles along with possible emergency re-training possibilities; (4) coordinate all clinical and non-clinical staffing requirements and determine the hospital's daily needs including a sick and no-show list together with ICU requirements; (5) provide clinical care to patients only with clinical staff and not with non-clinical staff; (6) delegate duties not within the scope of workers' practice under crisis conditions with proper supervision and support from experienced clinicians to ensure patient safety; (7) intensivists should supervise nonintensivist physicians to expand the workforce if patient surge exceeds the number of available ICU-trained specialists. Judicious planning and adoption of protocols for providing adequate manpower are necessary to optimize outcomes during a pandemic.

78 FR 64234 - 30-Day Notice of Proposed Information Collection: Environmental Review Procedures for Entities...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-28

... Information Collection: Environmental Review Procedures for Entities Assuming HUD Environmental... Information Collection: Environmental Review Procedures for Entities Assuming HUD Environmental..., ``Environmental Review Procedures for Entities Assuming HUD Environmental Responsibilities'' requires units of...

Prescription Drugs: Comparison of DOD, Medicaid, and Medicare Part D Retail Reimbursement Prices

DTIC Science & Technology

2014-06-01

information, including suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215...Medicaid Services DIR direct and indirect remuneration DOD Department of Defense FCP federal ceiling price HCPCS Healthcare Common Procedure...prices, we used PDTS data from DOD; unit rebate amount (URA) and CMS-64 data from Medicaid; and the 2010 Direct and Indirect Remuneration (DIR

40 CFR 63.1574 - What notifications must I submit and when?

Code of Federal Regulations, 2010 CFR

2010-07-01

... catalytic reforming unit when you use a colormetric tube sampling system, including procedures for..., you must submit all of the notifications in §§ 63.6(h), 63.7(b) and (c), 63.8(e), 63.8(f)(4), 63.8(f)(6), and 63.9(b) through (h) that apply to you by the dates specified. (1) You must submit the...

Techniques of Water-Resources Investigations of the United States Geological Survey. Book 5, Laboratory Analysis. Chapter A5, Methods for Determination of Radioactive Substances in Water and Fluvial Sediments.

ERIC Educational Resources Information Center

Thatcher, L. L.; And Others

Analytical methods for determining important components of fission and natural radioactivity found in water are reported. The discussion of each method includes conditions for application of the method, a summary of the method, interferences, required apparatus, procedures, calculations and estimation of precision. Isotopes considered are…

28 CFR Appendix E to Part 61 - United States Marshals Service Procedures Relating to the Implementation of the National...

Code of Federal Regulations, 2010 CFR

2010-07-01

... disposal of equipment or property, (3) Leases or entitlement for use, including donation or exchange, (4... facility is a site-specific determination based on the extent to which an entire project will be within the... decisions based on it, will or will not achieve the goals of NEPA to prevent damage to the environment and...

Patrol force allocation for law enforcement: An introductory planning guide

NASA Technical Reports Server (NTRS)

Sohn, R. L.; Kennedy, R. D.

1976-01-01

Previous and current methods for analyzing police patrol forces are reviewed and discussed. The steps in developing an allocation analysis procedure are defined, including the prediction of the rate of calls for service, determination of the number of patrol units needed, designing sectors, and analyzing dispatch strategies. Existing computer programs used for this purpose are briefly described, and some results of their application are given.

Design and manufacture of the integrated field unit for the NIRSpec spectrometer on JWST

NASA Astrophysics Data System (ADS)

Lobb, Daniel; Robertson, David; Closs, Martin; Barnes, Andy

2008-09-01

The NIRSpec imaging spectrometer, which forms part of the James Webb Space Telescope instrumentation, will include an integrated field unit (IFU). The IFU will be tasked specifically with efficient analysis of extended objects, including galaxies; it will accept a square image area at the spectrometer entrance field, dissect this area into 30 parallel sub-slits, and image the sub-slits end-to-end, forming a single virtual entrance slit. The IFU, uses all-mirror optics to operate over the spectral range 700nm to 5000nm. 95 mirrors and the main support structure are made in a common aluminium alloy, to achieve athermal performance down to an operating temperature of around 30K. Relatively complex mirror surface shapes are produced by diamond machining. The IFU has been designed and constructed by SSTL, with optics produced by CfAI; the unit is currently undergoing performance tests. This paper describes the IFU optical design and performance, and outlines the mirror manufacturing methods and alignment procedures.

Effect of infection control strategy on knowledge, attitude and practice towards hepatitis B transmission and prevention in vulnerable populations.

PubMed

Al-Tawil, M M; El-Gohary, E E; El-Sayed, M H

2013-01-01

Health care workers (HCWs) and hematological patients needing blood/ blood product transfusion are particularly vulnerable to blood born infections (BBI) including viral hepatitis. To evaluate knowledge, attitude and practice (KAP) of these target groups regarding viral hepatitis B (HBV) transmission and its change with implementing infection control policy and procedures. An anonymous questionnaire with closed questions was used to evaluate KAP including vaccination status in 2 target groups, in Children Hospital, Ain Shams University, Cairo, Egypt: 184 nurses and 210 children and adolescents with blood diseases. One year after instituting infection control as a part of hospital procedures, the same questionnaire was reused to evaluate KAP towards HBV. Baseline knowledge regarding HBV transmission, sequelae and preventive measures, was poor in both groups. Among nurses, only 62% wore gloves on withdrawing or giving blood to patients, 43.5% routinely washed hands between patients and 37.5% reported exposure after sharp injury. Only 38% of patients and 40% of nurses received HBV vaccination. Targeted infection control policy and procedures significantly improved KAP regarding HBV in both groups. Vaccination coverage significantly increased and reached 88.7% for nurses and 72% for patients. Hospital based infection control units with established policy and procedures against BBI significantly improved KAP towards HBV including a significant increase in vaccination intake.

50 CFR 11.21 - Commencement of hearing procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... PLANTS CIVIL PROCEDURES Hearing and Appeal Procedures § 11.21 Commencement of hearing procedures... 50 Wildlife and Fisheries 1 2010-10-01 2010-10-01 false Commencement of hearing procedures. 11.21 Section 11.21 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR...

50 CFR 11.21 - Commencement of hearing procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... PLANTS CIVIL PROCEDURES Hearing and Appeal Procedures § 11.21 Commencement of hearing procedures... 50 Wildlife and Fisheries 1 2011-10-01 2011-10-01 false Commencement of hearing procedures. 11.21 Section 11.21 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR...

A programmable and portable NMES device for drop foot correction and blood flow assist applications.

PubMed

Breen, Paul P; Corley, Gavin J; O'Keeffe, Derek T; Conway, Richard; Olaighin, Gearóid

2009-04-01

The Duo-STIM, a new, programmable and portable neuromuscular stimulation system for drop foot correction and blood flow assist applications is presented. The system consists of a programmer unit and a portable, programmable stimulator unit. The portable stimulator features fully programmable, sensor-controlled, constant-voltage, dual-channel stimulation and accommodates a range of customized stimulation profiles. Trapezoidal and free-form adaptive stimulation intensity envelope algorithms are provided for drop foot correction applications, while time dependent and activity dependent algorithms are provided for blood flow assist applications. A variety of sensor types can be used with the portable unit, including force sensitive resistor-based foot switches and MEMS-based accelerometer and gyroscope devices. The paper provides a detailed description of the hardware and block-level system design for both units. The programming and operating procedures for the system are also presented. Finally, functional bench test results for the system are presented.

A programmable and portable NMES device for drop foot correction and blood flow assist applications.

PubMed

Breen, Paul P; Corley, Gavin J; O'Keeffe, Derek T; Conway, Richard; OLaighin, Gearoid

2007-01-01

The Duo-STIM, a new, programmable and portable neuromuscular stimulation system for drop foot correction and blood flow assist applications is presented. The system consists of a programmer unit and a portable, programmable stimulator unit. The portable stimulator features fully programmable, sensor-controlled, constant-voltage, dual-channel stimulation and accommodates a range of customized stimulation profiles. Trapezoidal and free-form adaptive stimulation intensity envelope algorithms are provided for drop foot correction applications, while time dependent and activity dependent algorithms are provided for blood flow assist applications. A variety of sensor types can be used with the portable unit, including force sensitive resistor based foot switches and NMES based accelerometer and gyroscope devices. The paper provides a detailed description of the hardware and block-level system design for both units. The programming and operating procedures for the system are also presented. Finally, functional bench test results for the system are presented.

Does neonatal pain management in intensive care units differ between night and day? An observational study.

PubMed

Guedj, Romain; Danan, Claude; Daoud, Patrick; Zupan, Véronique; Renolleau, Sylvain; Zana, Elodie; Aizenfisz, Sophie; Lapillonne, Alexandre; de Saint Blanquat, Laure; Granier, Michèle; Durand, Philippe; Castela, Florence; Coursol, Anne; Hubert, Philippe; Cimerman, Patricia; Anand, K J S; Khoshnood, Babak; Carbajal, Ricardo

2014-02-20

To determine whether analgesic use for painful procedures performed in neonates in the neonatal intensive care unit (NICU) differs during nights and days and during each of the 6 h period of the day. Conducted as part of the prospective observational Epidemiology of Painful Procedures in Neonates study which was designed to collect in real time and around-the-clock bedside data on all painful or stressful procedures. 13 NICUs and paediatric intensive care units in the Paris Region, France. All 430 neonates admitted to the participating units during a 6-week period between September 2005 and January 2006. During the first 14 days of admission, data were collected on all painful procedures and analgesic therapy. The five most frequent procedures representing 38 012 of all 42 413 (90%) painful procedures were analysed. Observational study. We compared the use of specific analgesic for procedures performed during each of the 6 h period of a day: morning (7:00 to 12:59), afternoon, early night and late night and during daytime (morning+afternoon) and night-time (early night+late night). 7724 of 38 012 (20.3%) painful procedures were carried out with a specific analgesic treatment. For morning, afternoon, early night and late night, respectively, the use of analgesic was 25.8%, 18.9%, 18.3% and 18%. The relative reduction of analgesia was 18.3%, p<0.01, between daytime and night-time and 28.8%, p<0.001, between morning and the rest of the day. Parental presence, nurses on 8 h shifts and written protocols for analgesia were associated with a decrease in this difference. The substantial differences in the use of analgesics around-the-clock may be questioned on quality of care grounds.

77 FR 39895 - New Analytic Methods and Sampling Procedures for the United States National Residue Program for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-06

... Analytic Methods and Sampling Procedures for the United States National Residue Program for Meat, Poultry... implementing several multi-residue methods for analyzing samples of meat, poultry, and egg products for animal.... These modern, high-efficiency methods will conserve resources and provide useful and reliable results...

76 FR 70957 - Foreign-Trade Zone 277-Western Maricopa County, AZ; Application for Manufacturing Authority, Sub...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-16

..., and wine storage units for export and the domestic market. Components and materials sourced from... entry procedures that applies to refrigerators, freezers, and wine storage units (duty rate--free) for... realize logistical benefits through the use of weekly customs entry procedures. Customs duties also could...

Investigating Conceptual, Procedural, and Intuitive Aspects of Area Measurement with Non-Square Area Units

ERIC Educational Resources Information Center

Miller, Amanda L.

2013-01-01

This dissertation reports the results of a qualitative research project on area measurement. The study utilized structured, task-based interviews with students to (a) investigate the ways students enumerate and structure two-dimensional space with a variety of area units; (b) identify conceptual, procedural, and intuitive aspects of area…

77 FR 72885 - Meeting of the Judicial Conference Committee on Rules of Practice and Procedure

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-06

... JUDICIAL CONFERENCE OF THE UNITED STATES Meeting of the Judicial Conference Committee on Rules of Practice and Procedure AGENCY: Judicial Conference of the United States Advisory Committee on Rules of... Science Drive, Durham, NC 27708. FOR FURTHER INFORMATION CONTACT: Jonathan C. Rose, Secretary and Chief...

78 FR 64012 - Meeting of the Judicial Conference Committee on Rules of Practice and Procedure

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-25

... JUDICIAL CONFERENCE OF THE UNITED STATES Meeting of the Judicial Conference Committee on Rules of Practice and Procedure AGENCY: Judicial Conference of the United States Advisory Committee on Rules of... Columbus Circle NE., Washington, DC 20544. FOR FURTHER INFORMATION CONTACT: Jonathan C. Rose, Secretary and...

78 FR 45564 - Meeting of the Judicial Conference Committee on Rules of Practice and Procedure

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-29

... States Courts, Washington, DC 20544, telephone (202) 502- 1820. Dated: July 24, 2013. Jonathan C. Rose... JUDICIAL CONFERENCE OF THE UNITED STATES Meeting of the Judicial Conference Committee on Rules of Practice and Procedure AGENCY: Judicial Conference of the United States Advisory Committee on Rules of...

77 FR 72885 - Meeting of the Judicial Conference Committee on Rules of Practice and Procedure

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-06

... JUDICIAL CONFERENCE OF THE UNITED STATES Meeting of the Judicial Conference Committee on Rules of Practice and Procedure AGENCY: Judicial Conference of the United States Advisory Committee on Rules of..., Coral Gables, FL 33146. FOR FURTHER INFORMATION CONTACT: Jonathan C. Rose, Secretary and Chief Rules...

75 FR 62411 - Notice of Submission of Proposed Information Collection to OMB; Policies and Procedures for the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-08

... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5380-N-42] Notice of Submission of Proposed Information Collection to OMB; Policies and Procedures for the Conversion of Efficiencies Units to One Bedroom Units AGENCY: Office of the Assistant Secretary for Housing, HUD. ACTION: Notice. SUMMARY...

40 CFR 75.34 - Units with add-on emission controls.

Code of Federal Regulations, 2013 CFR

2013-07-01

... PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Missing Data Substitution Procedures § 75.34 Units with... monitoring system(s) are not obtained. (1) The owner or operator may use the missing data substitution procedures specified in §§ 75.31 through 75.33 to provide substitute data for any missing data hour(s) in...

40 CFR 75.34 - Units with add-on emission controls.

Code of Federal Regulations, 2011 CFR

2011-07-01

... PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Missing Data Substitution Procedures § 75.34 Units with... monitoring system(s) are not obtained. (1) The owner or operator may use the missing data substitution procedures specified in §§ 75.31 through 75.33 to provide substitute data for any missing data hour(s) in...

40 CFR 75.34 - Units with add-on emission controls.

Code of Federal Regulations, 2014 CFR

2014-07-01

... PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Missing Data Substitution Procedures § 75.34 Units with... monitoring system(s) are not obtained. (1) The owner or operator may use the missing data substitution procedures specified in §§ 75.31 through 75.33 to provide substitute data for any missing data hour(s) in...

40 CFR 75.34 - Units with add-on emission controls.

Code of Federal Regulations, 2012 CFR

2012-07-01

... PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Missing Data Substitution Procedures § 75.34 Units with... monitoring system(s) are not obtained. (1) The owner or operator may use the missing data substitution procedures specified in §§ 75.31 through 75.33 to provide substitute data for any missing data hour(s) in...

40 CFR 75.34 - Units with add-on emission controls.

Code of Federal Regulations, 2010 CFR

2010-07-01

... PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Missing Data Substitution Procedures § 75.34 Units with... monitoring system(s) are not obtained. (1) The owner or operator may use the missing data substitution procedures specified in §§ 75.31 through 75.33 to provide substitute data for any missing data hour(s) in...

Experiments on Learning by Back Propagation.

ERIC Educational Resources Information Center

Plaut, David C.; And Others

This paper describes further research on a learning procedure for layered networks of deterministic, neuron-like units, described by Rumelhart et al. The units, the way they are connected, the learning procedure, and the extension to iterative networks are presented. In one experiment, a network learns a set of filters, enabling it to discriminate…

Isolation of zymogen granules from rat pancreas.

PubMed

Rindler, Michael J

2006-01-01

This unit describes methods for preparing zymogen granules from rat pancreas. Zymogen granules are storage organelles in pancreatic acinar cells containing digestive enzymes that are released into the pancreatic duct. The protocols in this unit take advantage of the large size (up to 1 microm diameter) and high density (>1.20 g/cm(3) on sucrose gradients) of the granules as compared to other cellular organelles. They use a combination of differential sedimentation and density gradient separation to accomplish the purification. Similar procedures can be used to isolate zymogen granules from mouse pancreas and canine pancreas. A protocol for preparing zymogen granules from dog pancreas is also included.

The history behind successful uterine transplantation in humans

PubMed Central

Castellón, Luis Arturo Ruvalcaba; Amador, Martha Isolina García; González, Roberto Enrique Díaz; Eduardo, Montoya Sarmiento Jorge; Díaz-García, César; Kvarnström, Niclas; Bränström, Mats

2017-01-01

This paper aimed to describe the basic aspects of uterine transplant (UTx) research in humans, including preliminary experiences in rodents and domestic species. Studies in rats, domestic species, and non-human primates validated and optimized the UTx procedure in terms of its surgical aspects, immunosuppression, rejection diagnosis, peculiarities of pregnancy in immunosuppressed patients, and patients with special uterine conditions. In animal species, the first live birth from UTx was achieved in a syngeneic mouse model in 2003. Twenty-five UTx procedures have been performed in humans. The first two cases were unsuccessful, but established the need for rigorous research to improve success rates. As a result of a controlled clinical study under a strictly designed research protocol, nine subsequent UTx procedures have resulted in six healthy live births, the first of them in 2014. Further failed UTx procedures have been performed in China, Czech Republic, Brazil, Germany, and the United States, most of which using living donors. Albeit still an experimental procedure in, UTx is the first potential alternative for the treatment of absolute uterine factor infertility (AUFI). PMID:28609280

47 CFR 36.2 - Fundamental principles underlying procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Fundamental principles underlying procedures... Fundamental principles underlying procedures. (a) The following general principles underlie the procedures... operating forces on a unit basis (e.g., conversation-minute-kilometers per message, weighted standard work...

Promoting clinical and laboratory interaction by harmonization.

PubMed

Plebani, Mario; Panteghini, Mauro

2014-05-15

The lack of interchangeable results in current practice among clinical laboratories has underpinned greater attention to standardization and harmonization projects. Although the focus was mainly on the standardization and harmonization of measurement procedures and their results, the scope of harmonization goes beyond method and analytical results: it includes all other aspects of laboratory testing, including terminology and units, report formats, reference limits and decision thresholds, as well as test profiles and criteria for the interpretation of results. In particular, as evidence collected in last decades demonstrates that pre-pre- and post-post-analytical steps are more vulnerable to errors, harmonization initiatives should be performed to improve procedures and processes at the laboratory-clinical interface. Managing upstream demand, down-stream interpretation of laboratory results, and subsequent appropriate action through close relationships between laboratorians and clinicians remains a crucial issue of the laboratory testing process. Therefore, initiatives to improve test demand management from one hand and to harmonize procedures to improve physicians' acknowledgment of laboratory data and their interpretation from the other hand are needed in order to assure quality and safety in the total testing process. © 2013.

The Kaiser Permanente shoulder arthroplasty registry: results from 6,336 primary shoulder arthroplasties.

PubMed

Dillon, Mark T; Ake, Christopher F; Burke, Mary F; Singh, Anshuman; Yian, Edward H; Paxton, Elizabeth W; Navarro, Ronald A

2015-06-01

Shoulder arthroplasty is being performed in the United States with increasing frequency. We describe the medium-term findings from a large integrated healthcare system shoulder arthroplasty registry. Shoulder arthroplasty cases registered between January 2005 and June 2013 were included for analysis. The registry included patient characteristics, surgical information, implant data, attrition, and patient outcomes such as surgical site infections, venous thromboembolism, and revision procedures. During the study period, 6,336 primary cases were registered. Median follow-up time for all primaries was 3.3 years; 461 cases were lost to follow-up by ending of health plan membership. Primary cases were predominantly female (56%) and white (81%), with an average age of 70 years. The most common reason for surgery was osteoarthritis in 60% of cases, followed by acute fracture (17%) and rotator cuff tear arthropathy (15%). In elective shoulder arthroplasty procedures, 200 all-cause revisions (4%) were reported, with glenoid wear being the most common reason. Most arthroplasties were elective procedures: over half performed for osteoarthritis. Glenoid wear was the most common reason for revision of primary shoulder arthroplasty in elective cases.

Cost containment and mechanical ventilation in the United States.

PubMed

Cohen, I L; Booth, F V

1994-08-01

In many ICUs, admission and discharge hinge on the need for intubation and ventilatory support. As few as 5% to 10% of ICU patients require prolonged mechanical ventilation, and this patient group consumes > or = 50% of ICU patient days and ICU resources. Prolonged ventilatory support and chronic ventilator dependency, both in the ICU and non-ICU settings, have a significant and growing impact on healthcare economics. In the United States, the need for prolonged mechanical ventilation is increasingly recognized as separate and distinct from the initial diagnosis and/or procedure that leads to hospitalization. This distinction has led to improved reimbursement under the prospective diagnosis-related group (DRG) system, and demands more precise accounting from healthcare providers responsible for these patients. Using both published and theoretical examples, mechanical ventilation in the United States is discussed, with a focus on cost containment. Included in the discussion are ventilator teams, standards of care, management protocols, stepdown units, rehabilitation units, and home care. The expanding role of total quality management (TQM) is also presented.

TU-D-201-07: Severity Indication in High Dose Rate Brachytherapy Emergency Response Procedure

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

Li, K; Rustad, F

Purpose: Understanding the corresponding dose to different staff during the High Dose Rate (HDR) Brachytherapy emergency response procedure could help to develop a strategy in efficiency and effective action. In this study, the variation and risk analysis methodology was developed to simulation the HDR emergency response procedure based on severity indicator. Methods: A GammaMedplus iX HDR unit from Varian Medical System was used for this simulation. The emergency response procedure was decomposed based on risk management methods. Severity indexes were used to identify the impact of a risk occurrence on the step including dose to patient and dose to operationmore » staff by varying the time, HDR source activity, distance from the source to patient and staff and the actions. These actions in 7 steps were to press the interrupt button, press emergency shutoff switch, press emergency button on the afterloader keypad, turn emergency hand-crank, remove applicator from the patient, disconnect transfer tube and move afterloader from the patient, and execute emergency surgical recovery. Results: Given the accumulated time in second at the assumed 7 steps were 15, 5, 30, 15, 180, 120, 1800, and the dose rate of HDR source is 10 Ci, the accumulated dose in cGy to patient at 1cm distance were 188, 250, 625, 813, 3063, 4563 and 27063, and the accumulated exposure in rem to operator at outside the vault, 1m and 10cm distance were 0.0, 0.0, 0.1, 0.1, 22.6, 37.6 and 262.6. The variation was determined by the operators in action at different time and distance from the HDR source. Conclusion: The time and dose were estimated for a HDR unit emergency response procedure. It provided information in making optimal decision during the emergency procedure. Further investigation would be to optimize and standardize the responses for other emergency procedure by time-spatial-dose severity function.« less

SU-D-209-03: Radiation Dose Reduction Using Real-Time Image Processing in Interventional Radiology

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

Kanal, K; Moirano, J; Zamora, D

Purpose: To characterize changes in radiation dose after introducing a new real-time image processing technology in interventional radiology systems. Methods: Interventional radiology (IR) procedures are increasingly complex, at times requiring substantial time and radiation dose. The risk of inducing tissue reactions as well as long-term stochastic effects such as radiation-induced cancer is not trivial. To reduce this risk, IR systems are increasingly equipped with dose reduction technologies.Recently, ClarityIQ (Philips Healthcare) technology was installed in our existing neuroradiology IR (NIR) and vascular IR (VIR) suites respectively. ClarityIQ includes real-time image processing that reduces noise/artifacts, enhances images, and sharpens edges while alsomore » reducing radiation dose rates. We reviewed 412 NIR (175 pre- and 237 post-ClarityIQ) procedures and 329 VIR (156 preand 173 post-ClarityIQ) procedures performed at our institution pre- and post-ClarityIQ implementation. NIR procedures were primarily classified as interventional or diagnostic. VIR procedures included drain port, drain placement, tube change, mesenteric, and implanted venous procedures. Air Kerma (AK in units of mGy) was documented for all the cases using a commercial radiation exposure management system. Results: When considering all NIR procedures, median AK decreased from 1194 mGy to 561 mGy. When considering all VIR procedures, median AK decreased from 49 to 14 mGy. Both NIR and VIR exhibited a decrease in AK exceeding 50% after ClarityIQ implementation, a statistically significant (p<0.05) difference. Of the 5 most common VIR procedures, all median AK values decreased, but significance (p<0.05) was only reached in venous access (N=53), angio mesenteric (N=41), and drain placement procedures (N=31). Conclusion: ClarityIQ can reduce dose significantly for both NIR and VIR procedures. Image quality was not assessed in conjunction with the dose reduction.« less

Left Atrial Appendage Closure for Stroke Prevention: Devices, Techniques, and Efficacy.

PubMed

Iskandar, Sandia; Vacek, James; Lavu, Madhav; Lakkireddy, Dhanunjaya

2016-05-01

Left atrial appendage closure can be performed either surgically or percutaneously. Surgical approaches include direct suture, excision and suture, stapling, and clipping. Percutaneous approaches include endocardial, epicardial, and hybrid endocardial-epicardial techniques. Left atrial appendage anatomy is highly variable and complex; therefore, preprocedural imaging is crucial to determine device selection and sizing, which contribute to procedural success and reduction of complications. Currently, the WATCHMAN is the only device that is approved for left atrial appendage closure in the United States. Copyright © 2016 Elsevier Inc. All rights reserved.

How to set up a robotic-assisted laparoscopic surgery center and training of staff.

PubMed

Lenihan, John P

2017-11-01

The use of computers to assist surgeons in the operating room has been an inevitable evolution in the modern practice of surgery. Robotic-assisted surgery has been evolving now for over two decades and has finally matured into a technology that has caused a monumental shift in the way gynecologic surgeries are performed. Prior to robotics, the only minimally invasive options for most Gynecologic (GYN) procedures including hysterectomies were either vaginal or laparoscopic approaches. However, even with over 100 years of vaginal surgery experience and more than 20 years of laparoscopic advancements, most gynecologic surgeries in the United States were still performed through an open incision. However, this changed in 2005 when the FDA approved the da Vinci Surgical Robotic System tm for use in gynecologic surgery. Over the last decade, the trend for gynecologic surgeries has now dramatically shifted to less open and more minimally invasive procedures. Robotic-assisted surgeries now include not only hysterectomy but also most all other commonly performed gynecologic procedures including myomectomies, pelvic support procedures, and reproductive surgeries. This success, however, has not been without controversies, particularly around costs and complications. The evolution of computers to assist surgeons and make minimally invasive procedures more common is clearly a trend that is not going away. It is now incumbent on surgeons, hospitals, and medical societies to determine the most cost-efficient and productive use for this technology. This process is best accomplished by developing a Robotics Program in each hospital that utilizes robotic surgery. Copyright © 2017. Published by Elsevier Ltd.

[National survey of preoperative management and patient selection in ambulatory surgery centers].

PubMed

Papaceit, J; Olona, M; Ramón, C; García-Aguado, R; Rodríguez, R; Rull, M

2003-01-01

The objective of this study was to determine both the selection and preparation criteria in patients in various Spanish ambulatory surgery centers, as well as the impact of these criteria on their results. The results were compared according to the type of functional structure of the units (autonomous or integrated). We performed a cross sectional, descriptive study through postal survey. The survey contained the following items: type of unit, surgical procedures, selection criteria, preoperative assessment and management, and qualitative and quantitative indexes of the activity performed in 2000. A total of 123 units were included with a response rate of 39%. The selection criteria showed a high degree of consensus. The outpatient anesthesia clinic was used for preoperative assessment by 97.9% of the units. Most units routinely requested preoperative tests (hemostasis and hemogram by 89%; biochemical parameters by 72.9%) and to a lesser extent chest X-ray (33.3%) and electrocardiogram (35.4%). The introduction of procedures for the management of coexisting diseases was scarce (25-64.6%). Units using the outpatient anesthesia clinic in all patients had a lower cancellation rate (1.5% vs 4.4%). Autonomous units were significantly more likely to accept patients with high surgical-anesthetic risk than integrated units. Autonomous units also showed a significantly lower number of admissions (1.2% vs 1.9%, p = 0.003), mean stay (240 min vs 367 min, p = 0.002), and recovery time (150 min vs 212 min, p = 0.001) than integrated units. No statistically significant differences were found in the remaining parameters. Scientifically based protocols for patient selection, preoperative assessment and perioperative management of distinct processes and for the rational use of laboratory tests should be more widely used. The need for an outpatient anesthesia clinic for preoperative assessment was notable. The results of our survey indicate that better results in performance indexes are achieved in autonomous ambulatory surgery units than in integrated units. Given the possibility of defining and validating quality standards, further multicenter studies should be performed.

Indications and Effects of Plasma Transfusions in Critically Ill Children.

PubMed

Karam, Oliver; Demaret, Pierre; Shefler, Alison; Leteurtre, Stéphane; Spinella, Philip C; Stanworth, Simon J; Tucci, Marisa

2015-06-15

Plasma transfusions are frequently prescribed for critically ill children, although their indications lack a strong evidence base. Plasma transfusions are largely driven by physician conceptions of need, and these are poorly documented in pediatric intensive care patients. To identify patient characteristics and to characterize indications leading to plasma transfusions in critically ill children, and to assess the effect of plasma transfusions on coagulation tests. Point-prevalence study in 101 pediatric intensive care units in 21 countries, on 6 predefined weeks. All critically ill children admitted to a participating unit were included if they received at least one plasma transfusion. During the 6 study weeks, 13,192 children were eligible. Among these, 443 (3.4%) received at least one plasma transfusion and were included. The primary indications for plasma transfusion were critical bleeding in 22.3%, minor bleeding in 21.2%, planned surgery or procedure in 11.7%, and high risk of postoperative bleeding in 10.6%. No bleeding or planned procedures were reported in 34.1%. Before plasma transfusion, the median international normalized ratio (INR) and activated partial thromboplastin time (aPTT) values were 1.5 and 48, respectively. After plasma transfusion, the median INR and aPTT changes were -0.2 and -5, respectively. Plasma transfusion significantly improved INR only in patients with a baseline INR greater than 2.5. One-third of transfused patients were not bleeding and had no planned procedure. In addition, in most patients, coagulation tests are not sensitive to increases in coagulation factors resulting from plasma transfusion. Studies assessing appropriate plasma transfusion strategies are urgently needed.

Radiologists' Variation of Time to Read Across Different Procedure Types.

PubMed

Forsberg, Daniel; Rosipko, Beverly; Sunshine, Jeffrey L

2017-02-01

The workload of US radiologists has increased over the past two decades as measured through total annual relative value units (RVUs). This increase in RVUs generated suggests that radiologists' productivity has increased. However, true productivity (output unit per input unit; RVU per time) is at large unknown since actual time required to interpret and report a case is rarely recorded. In this study, we analyzed how the time to read a case varies between radiologists over a set of different procedure types by retrospectively extracting reading times from PACS usage logs. Specifically, we tested two hypotheses that; i) relative variation in time to read per procedure type increases as the median time to read a procedure type increases, and ii) relative rankings in terms of median reading speed for individual radiologists are consistent across different procedure types. The results that, i) a correlation of -0.25 between the coefficient of variation and median time to read and ii) that only 12 out of 46 radiologists had consistent rankings in terms of time to read across different procedure types, show both hypotheses to be without support. The results show that workload distribution will not follow any general rule for a radiologist across all procedures or a general rule for a specific procedure across many readers. Rather the findings suggest that improved overall practice efficiency can be achieved only by taking into account radiologists' individual productivity per procedure type when distributing unread cases.

Outcomes for Gestational Carriers Versus Traditional Surrogates in the United States.

PubMed

Fuchs, Erika L; Berenson, Abbey B

2018-05-01

Little is known about the obstetric and procedural outcomes of traditional surrogates and gestational carriers. Participants included 222 women living in the United States who completed a brief online survey between November 2015 and February 2016. Differences between gestational carriers (n = 204) and traditional surrogates (n = 18) in demographic characteristics, pregnancy outcomes, and procedural outcomes were examined using chi-squared tests, Fisher's exact tests, and t-tests. Out of 248 eligible respondents, 222 surveys were complete, for a response rate of 89.5%. Overall, obstetric outcomes were similar among gestational carriers and traditional surrogates. Traditional surrogates were more likely than gestational carriers to have a Center for Epidemiologic Studies Depression Scale Revised score of 16 or higher (37.5% vs. 4.0%). Gestational carriers reported higher mean compensation ($27,162.80 vs. $17,070.07) and were more likely to travel over 400 miles (46.0% vs. 0.0%) than traditional surrogates. Procedural differences, but not differences in obstetric outcomes, emerged between gestational carriers and traditional surrogates. To ensure that both traditional surrogates and gestational carriers receive optimal medical care, it may be necessary to extend practice guidelines to ensure that traditional surrogates are offered the same level of care offered to gestational carriers.

Children's orthodontic utilization in the United States: Socioeconomic and surveillance considerations.

PubMed

Laniado, Nadia; Oliva, Stephanie; Matthews, Gregory J

2017-11-01

There has been no epidemiologic study of malocclusion prevalence and treatment need in the United States since the Third National Health and Nutrition Examination Survey, conducted from 1988 to 1991. In this descriptive study, the authors sought to estimate orthodontic treatment prevalence by examining a nationally representative survey to assess current pediatric dental and orthodontic utilization. The 2009 and 2013 Medical Expenditure Panel Surveys were used to categorize and compare all types of pediatric dental and orthodontic procedures in children and adolescents up to 20 years old. Descriptive variables included dental insurance, poverty level, and racial/ethnic background. Visits for orthodontic procedures constituted the third largest treatment category (14.5%) and were greatest among the uninsured and higher income populations. Children with public insurance had the fewest orthodontic visits (9.4%). Racial/ethnic disparities were most pronounced among orthodontic visits, with black and Hispanic children receiving the fewest orthodontic procedures (8.89% and 10.56%, respectively). Orthodontic treatment prevalence data suggest that significant disparities exist in orthodontic utilization based on race/ethnicity, poverty level, and insurance status. To establish the burden of malocclusion, describe populations in greatest need of interventions, and craft appropriate programs and policies, an active orthodontic surveillance system is essential. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

22 CFR 1103.170 - Compliance procedures.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Foreign Relations INTERNATIONAL BOUNDARY AND WATER COMMISSION, UNITED STATES AND MEXICO, UNITED STATES... INTERNATIONAL BOUNDARY AND WATER COMMISSION, UNITED STATES AND MEXICO, UNITED STATES SECTION § 1103.170... Mexico, United States Section, The Commons, Building C, Suite 310, 4171 North Mesa, El Paso, Texas 79902...

Involving Children in the Design and Development of Research Instruments and Data Collection Procedures: A Case Study in Primary Schools in Northern Ireland

ERIC Educational Resources Information Center

Turtle, Kellie; McElearney, Aisling; Scott, Joanne

2010-01-01

Children's right to participate as enshrined in Article 12 of the United Nations Convention on the Rights of the Child is increasingly evident in the rhetoric of policy documents as well as in practice and research with children and young people. Children's participation in research is being facilitated in a range of creative ways, including as…

Nutrition Labeling and Education Act of 1989. Hearing before the Committee on Labor and Human Resources. United States Senate, One Hundred First Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.

This hearing on the Nutrition Labeling and Education Act of 1989, S. 1425, which requires mandatory nutrition labels on all food products regulated by the Food and Drug Administration, covered specific details on labeling procedures which will enable consumers to make intelligent choices on food selection. Prepared statements are included from…

Evacuation Planning in the TMI Accident

DTIC Science & Technology

1980-01-01

their scientific counterparts (for a particular hazard) can arrange planned and systematic procedures for handling the "translation" of a technical hazard...conditions is combined with a limited number of jurisdictions which can be integrated in a state-wide or large area disaster-response operation. These...should include not only the expansion of communications available locally but also their augmentation by mobile radio units and other additions which can

A unique challenge: Emergency egress and life support equipment at KSC

NASA Technical Reports Server (NTRS)

Waddell, H. M., Jr.

1975-01-01

As a result of the investigation following the January 1967 fire, which took the lives of three astronauts, materials were developed, flight hardware was modified, and test procedures were rewritten in order to establish the framework within which a more effective rescue concept could be developed. Topics discussed include breathing units, improved life support equipment, miniresuscitators, and hazardous tasks during space shuttle launch and landing operations.

Spending Analysis of Government Purchase Card Buys for United States Navy Destroyers

DTIC Science & Technology

2009-12-01

1). By utilizing Simplified 2 Acquisition Procedures (SAP) and Electronic Funds Transfer ( EFT ), governmental entities including the Department...policy or regulation is unclear. While this is in essence no different from the relationship as it exists regarding stock -numbered supply system...invoice cited the purchased material only using a local stock number, e.g., 3ea Item 32-4405N $75, purchase card requests and amplifying

Single-Incision Laparoscopic Total Colectomy

PubMed Central

Ojo, Oluwatosin J.; Carne, David; Guyton, Daniel

2012-01-01

Background and Objectives: To present our experience with a single-incision laparoscopic total colectomy, along with a literature review of all published cases on single-incision laparoscopic total colectomy. Methods: A total of 22 cases were published between 2010 and 2011, with our patient being case 23. These procedures were performed in the United States and United Kingdom. Surgical procedures included total colectomy with end ileostomy, proctocolectomy with ileorectal anastomosis, and total proctocolectomy with ileopouch-anal anastomosis. Intraoperative and postoperative data are analyzed. Results: Twenty-two of the 23 cases were performed for benign cases including Crohns, ulcerative colitis, and familial adenomatous polyposis. One case was performed for adenocarcinoma of the cecum. The mean age was 35.3 years (range, 13 to 64), the mean body mass index was 20.1 (range, 19 to 25), mean operative time was 175.9 minutes (range, 139 to 216), mean blood loss was 95.3mL (range, 59 to 200), mean incision length was 2.61cm (range, 2 to 3). Average follow-up was 4.6 months with 2 reported complications. Conclusions: Single-incision laparoscopic total colectomy is feasible and safe in the hands of an experienced surgeon. It has been performed for both benign and malignant cases. It is comparable to the conventional multi-port laparoscopic total colectomy. PMID:22906326

Stratification of a cityscape using census and land use variables for inventory of building materials

USGS Publications Warehouse

Rosenfield, G.H.; Fitzpatrick-Lins, K.; Johnson, T.L.

1987-01-01

A cityscape (or any landscape) can be stratified into environmental units using multiple variables of information. For the purposes of sampling building materials, census and land use variables were used to identify similar strata. In the Metropolitan Statistical Area of a cityscape, the census tract is the smallest unit for which census data are summarized and digitized boundaries are available. For purposes of this analysis, census data on total population, total number of housing units, and number of singleunit dwellings were aggregated into variables of persons per square kilometer and proportion of housing units in single-unit dwellings. The level 2 categories of the U.S. Geological Survey's land use and land cover data base were aggregated into variables of proportion of residential land with buildings, proportion of nonresidential land with buildings, and proportion of open land. The cityscape was stratified, from these variables, into environmental strata of Urban Central Business District, Urban Livelihood Industrial Commercial, Urban Multi-Family Residential, Urban Single Family Residential, Non-Urban Suburbanizing, and Non-Urban Rural. The New England region was chosen as a region with commonality of building materials, and a procedure developed for trial classification of census tracts into one of the strata. Final stratification was performed by discriminant analysis using the trial classification and prior probabilities as weights. The procedure was applied to several cities, and the results analyzed by correlation analysis from a field sample of building materials. The methodology developed for stratification of a cityscape using multiple variables has application to many other types of environmental studies, including forest inventory, hydrologic unit management, waste disposal, transportation studies, and other urban studies. Multivariate analysis techniques have recently been used for urban stratification in England. ?? 1987 Annals of Regional Science.

Oral glucose efficacy on neonate's pain responses at the NICU: A quasi experimental trial of two clinical procedures.

PubMed

Matar, Eman M; Arabiat, Diana H; Foster, Mandie J

2016-11-01

This research was undertaken with the purpose of testing two research hypotheses regarding the efficacy of 10% oral glucose solution on procedural pain associated with venepuncture and nasopharyngeal suctioning within three neonatal intensive care units (NICU). The hypotheses were formulated from previous conclusions reached by other researchers highlighting the efficacy of sucrose solutions on neonates' pain responses during minor painful procedures. A quasi-experimental trial utilising a time series design with one group was used. Data from a total of 90 neonates included 60 neonates who underwent a venepuncture and 30 neonates who underwent a nasopharyngeal suctioning procedure for clinical purposes. The neonate's pain response for each procedure was scored using the Neonatal Pain Assessment Scale (NPAS) on two separate occasions over three time periods. The pre-procedural score (T 0 ) when the neonate received no sucrose, the inter-procedural score (T 1 ) when the neonate was given 2ml of 10% glucose solution two minutes before the procedure (intervention group) or where oral glucose was withheld (control group) and the post-procedural score (T 2 ) being at the end of the procedure. The results showed the mean NPAS scores in response to venepuncture or nasopharyngeal suctioning were significantly lower in the intervention group than the control group. This showed that oral glucose (10%) had a positive effect on the pain response during venepuncture and nasopharyngeal suctioning procedures. Copyright © 2015 Elsevier Inc. All rights reserved.

14 CFR 1263.102 - Procedure when a demand is issued in a legal proceeding involving the United States.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Procedure when a demand is issued in a legal proceeding involving the United States. 1263.102 Section 1263.102 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION DEMAND FOR INFORMATION OR TESTIMONY SERVED ON AGENCY EMPLOYEES...

40 CFR Appendix I to Subpart V of... - Recommended Test Procedures and Test Criteria and Recommended Durability Procedures To...

Code of Federal Regulations, 2013 CFR

2013-07-01

... to the vacuum unit to achieve full diaphragm displacement. Seal vacuum source to unit. There shall be no visible loss of diaphragm displacement or drop in vacuum gauge reading after a 15 second observation. Vacuum purge system and diaphragm displacement adjusting screw holes should be temporarily sealed...

40 CFR Appendix I to Subpart V of... - Recommended Test Procedures and Test Criteria and Recommended Durability Procedures To...

Code of Federal Regulations, 2011 CFR

2011-07-01

... to the vacuum unit to achieve full diaphragm displacement. Seal vacuum source to unit. There shall be no visible loss of diaphragm displacement or drop in vacuum gauge reading after a 15 second observation. Vacuum purge system and diaphragm displacement adjusting screw holes should be temporarily sealed...

40 CFR Appendix I to Subpart V of... - Recommended Test Procedures and Test Criteria and Recommended Durability Procedures To...

Code of Federal Regulations, 2012 CFR

2012-07-01

... to the vacuum unit to achieve full diaphragm displacement. Seal vacuum source to unit. There shall be no visible loss of diaphragm displacement or drop in vacuum gauge reading after a 15 second observation. Vacuum purge system and diaphragm displacement adjusting screw holes should be temporarily sealed...

40 CFR Appendix I to Subpart V of... - Recommended Test Procedures and Test Criteria and Recommended Durability Procedures To...

Code of Federal Regulations, 2014 CFR

2014-07-01

... to the vacuum unit to achieve full diaphragm displacement. Seal vacuum source to unit. There shall be no visible loss of diaphragm displacement or drop in vacuum gauge reading after a 15 second observation. Vacuum purge system and diaphragm displacement adjusting screw holes should be temporarily sealed...

40 CFR Appendix I to Subpart V of... - Recommended Test Procedures and Test Criteria and Recommended Durability Procedures To...

Code of Federal Regulations, 2010 CFR

2010-07-01

... to the vacuum unit to achieve full diaphragm displacement. Seal vacuum source to unit. There shall be no visible loss of diaphragm displacement or drop in vacuum gauge reading after a 15 second observation. Vacuum purge system and diaphragm displacement adjusting screw holes should be temporarily sealed...

Habitat Evaluation Procedures (HEP) Report; Iskuulpa Wildlife Mitigation and Watershed Project, Technical Report 1998-2003.

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

Quaempts, Eric

U.S. Fish and Wildlife Service (USFWS) Habitat Evaluation Procedures (HEP) were used to determine the number of habitat units credited to evaluate lands acquired and leased in Eskuulpa Watershed, a Confederated Tribes of the Umatilla Indian Reservation watershed and wildlife mitigation project. The project is designed to partially credit habitat losses incurred by BPA for the construction of the John Day and McNary hydroelectric facilities on the Columbia River. Upland and riparian forest, upland and riparian shrub, and grasslands cover types were included in the evaluation. Indicator species included downy woodpecker (Picuides puhescens), black-capped chickadee (Pams atricopillus), blue grouse (Beadragapusmore » obscurus), great blue heron (Ardea herodias), yellow warbler (Dendroica petschia), mink (Mustela vison), and Western meadowlark (Sturnello neglects). Habitat surveys were conducted in 1998 and 1999 in accordance with published HEP protocols and included 55,500 feet of transects, 678 m2 plots, and 243 one-tenth-acre plots. Between 123.9 and f 0,794.4 acres were evaluated for each indicator species. Derived habitat suitability indices were multiplied by corresponding cover-type acreages to determine the number of habitat units for each species. The total habitat units credited to BPA for the Iskuulpa Watershed Project and its seven indicator species is 4,567.8 habitat units. Factors limiting habitat suitability are related to the direct, indirect, and cumulative effects of past livestock grazing, road construction, and timber harvest, which have simplified the structure, composition, and diversity of native plant communities. Alternatives for protecting and improving habitat suitability include exclusion of livestock grazing or implementation of restoration grazing schemes, road de-commissioning, reforestation, large woody debris additions to floodplains, control of competing and unwanted vegetation, reestablishing displaced or reduced native vegetation species, and the allowance of normative processes such as fire occurrence. Implementation of these alternatives could generate an estimated minimum of 393 enhancement credits in 10 years. Longer-term benefits of protection and enhancement activities include increases in native species diversity and structural complexity in all cover types. While such benefits are not readily recognized by HEP models and reflected in the number of habitat units generated, they also provide dual benefits for fisheries resources. Implementation of the alternatives will require long-term commitments from managers to increase probabilities of success and meet the goals and objectives of the Northwest Power Planning Council's Fish and Wildlife Mitigation Program.« less

Holmium:YAG surgical lasers.

PubMed

1995-03-01

"Holmium:YAG (Ho:YAG)" is the shorthand name for a family of solid-state lasers that use the doping element holmium in a laser crystal (e.g., YAG [yttrium-aluminum-garnet]) and that emit energy at approximately 2.1 microns. This wavelength is relatively new to medicine and has been used in laser surgery for only about the last six years. Like the carbon dioxide (CO2) laser when it was first used clinically, the Ho:YAG laser is poised for rapid and wide-spread use. Ho:YAG lasers, like CO2 lasers, offer precise cutting with minimal damage to adjacent tissue; however, unlike CO2 lasers, they also offer fiberoptic delivery (which is ideal for endoscopic use) and the ability to treat tissue in a liquid-filled environment (e.g., saline, blood). The initial specialty for which the Ho:YAG laser was used was arthroscopic surgery, especially diskectomy. Today, it is effectively used in many surgical specialties, including general surgery, urology, laparoscopy, neurosurgery, lithotripsy, angioplasty, orthopedic surgery (which includes procedures such as meniscectomy, bone sculpting [may also be performed in plastic surgery], and some experimental surgery, such as cartilage shrinking to tighten loose joints), and dentistry. Because of its broad range of potential applications, it has been called the "Swiss Army Knife" of lasers. High-powered Ho:YAG lasers, which enable surgeons to work more quickly and cut more smoothly, have been made available only within the last three years (units offering > 20 W) to 18 months (units offering > 60 W). Because of this rapid increase, high-powered units are still relatively expensive, and it is not yet clear whether maximum power outputs will continue to increase or whether the cost of higher-power units will begin to come down. Although low-power and high-power Ho:YAG lasers can be used for the same procedures, their different ranges of possible clinical techniques make them better suited to different applications: low-power units are preferable for small-joint and some head-and-neck surgeries or for office use, and high-power units are more suitable for use in major surgery, such as gastrointestinal surgery or surgery in large joints. This evaluation includes two units at both ends of the Ho:YAG power spectrum--one 10 W and one 60 W--and thus provides a guide to evaluating other Ho:YAG lasers that are currently available or that will be entering the market.(ABSTRACT TRUNCATED AT 400 WORDS)

Thoracoscopy: medical versus surgical—in the management of pleural diseases

PubMed Central

2015-01-01

Diseases of the pleura continue to affect a large population of patients worldwide and in the United States. Pleural fluid analysis and accompanying imaging of the pleura including chest X-rays, chest computed tomography (CT) scan and chest ultrasonography are among the first steps in the management of pleural effusions. When further diagnostic or therapeutic work up is necessary, open thoracotomy and thoracoscopy come to mind. However, given the significant morbidity and mortality associated with open thoracotomy, and the advances in medicine and medical instruments, thoracoscopy has now become a routine procedure in the management of the disease of the chest including pleura. Debates about surgical vs. medical thoracoscopy (MT) are ongoing. In the following pages we review the literature and discuss the similarities and differences between the two procedures, as well as their indications, contraindications, complications and efficacy in the management of pleural diseases. PMID:26807282

Overview of Facial Plastic Surgery and Current Developments

PubMed Central

Chuang, Jessica; Barnes, Christian; Wong, Brian J. F.

2016-01-01

Facial plastic surgery is a multidisciplinary specialty largely driven by otolaryngology but includes oral maxillary surgery, dermatology, ophthalmology, and plastic surgery. It encompasses both reconstructive and cosmetic components. The scope of practice for facial plastic surgeons in the United States may include rhinoplasty, browlifts, blepharoplasty, facelifts, microvascular reconstruction of the head and neck, craniomaxillofacial trauma reconstruction, and correction of defects in the face after skin cancer resection. Facial plastic surgery also encompasses the use of injectable fillers, neural modulators (e.g., BOTOX Cosmetic, Allergan Pharmaceuticals, Westport, Ireland), lasers, and other devices aimed at rejuvenating skin. Facial plastic surgery is a constantly evolving field with continuing innovative advances in surgical techniques and cosmetic adjunctive technologies. This article aims to give an overview of the various procedures that encompass the field of facial plastic surgery and to highlight the recent advances and trends in procedures and surgical techniques. PMID:28824978

The US Experiments Flown on the Soviet Biosatellite Cosmos 1887

NASA Technical Reports Server (NTRS)

Connolly, James P. (Editor); Grindeland, Richard E. (Editor); Ballard, Rodney W. (Editor)

1990-01-01

Cosmos 1887, a biosatellite containing biological and radiation experiments from the Soviet Union, the United States and seven other countries, was launched on September 29, 1987. One Rhesus monkey's feeder stopped working two days into the flight and a decision was made to terminate the mission after 12 1/2 days. The biosatellite returned to Earth on October 12, 1987. A system malfunction, during the reentry procedure, caused the Cosmos 1887 spacecraft to land approximately 1800 miles beyond the intended landing site and delayed the start of the postflight procedures by approximately 44 hours. Further information on the conditions at landing and postflight activities is included in the Mission Operations portion of this document. U.S. and U.S.S.R. specialists jointly conducted 26 experiments on this mission, including the postflight transfer of data, hardware and biosamples to the U.S.

The analysis of tensegrity structures for the design of a morphing wing

NASA Astrophysics Data System (ADS)

Moored, Keith W., III; Bart-Smith, Hilary

2005-05-01

Tensegrity structures have become of engineering interest in recent years, but very few have found practical use. This lack of integration is attributed to the lack of a well formulated design procedure. In this paper, a preliminary procedure is presented for developing morphing tensegrity structures that include actuating elements. To do this, the virtual work method has been modified to allow for individual actuation of struts and cables. A generalized connectivity matrix for a cantilever beam constructed from either a single 4-strut cell or multiple 4-strut cells has been developed. Global deflections resulting from actuation of specific elements have been calculated. Furthermore, the force density method is expanded to include a necessary upper bound condition such that a physically feasible structure can be designed. Finally, the importance of relative force density values on the overall shape of a structure comprising of multiple unit cells is discussed.

Efficacy of Negative Pressure Wound Treatment in Preventing Surgical Site Infections after Whipple Procedures.

PubMed

Gupta, Ryan; Darby, Geoffrey C; Imagawa, David K

2017-10-01

Surgical site infections (SSIs) occur at an average rate of 21.1 per cent after Whipple procedures per NSQIP data. In the setting of adherence to standard National Surgery Quality Improvement Program (NSQIP) Hepatopancreatobiliary recommendations including wound protector use and glove change before closing, this study seeks to evaluate the efficacy of using negative pressure wound treatment (NPWT) over closed incision sites after a Whipple procedure to prevent SSI formation. We retrospectively examined consecutive patients from January 2014 to July 2016 who met criteria of completing Whipple procedures with full primary incision closure performed by a single surgeon at a single institution. Sixty-one patients were included in the study between two cohorts: traditional dressing (TD) (n = 36) and NPWT dressing (n = 25). There was a statistically significant difference (P = 0.01) in SSI formation between the TD cohort (n = 15, SSI rate = 0.41) and the NPWT cohort (n = 3, SSI rate = 0.12). The adjusted odds ratio (OR) of SSI formation was significant for NPWT use [OR = 0.15, P = 0.036] and for hospital length of stay [OR = 1.21, P = 0.024]. Operative length, operative blood loss, units of perioperative blood transfusion, intraoperative gastrojejunal tube placement, preoperative stent placement, and postoperative antibiotic duration did not significantly impact SSI formation (P > 0.05).

Skin and Soft Tissue Surgery in the Office Versus Operating Room Setting: An Analysis Based on Individual-Level Medicare Data.

PubMed

Kantor, Jonathan

2018-03-23

The relative volume of skin and soft tissue excision and reconstructive procedures performed in the outpatient office versus facility (ambulatory surgical center or hospital) differs by specialty, and has major implications for quality of care, outcomes, development of guidelines, resident education, health care economics, and patient perception. To assess the relative volume of surgical procedures performed in each setting (office vs ambulatory surgery center [ASC]/hospital) by dermatologists and nondermatologists. A cross-sectional analytical study was performed using the Medicare public use file (PUF) for 2014, which includes every patient seen in an office, ASC, or hospital in the United States billed to Medicare part B. Data were divided by physician specialty and setting. A total of 9,316,307 individual encounters were included in the Medicare PUF. Dermatologists account for 195,001 (2.1%) of the total. Dermatologists were more likely to perform surgical procedures in an office setting only (odds ratio 5.48 [95% confidence interval 5.05-5.95], p < .0001) than other specialists in aggregate. More than 90% of surgical procedures are performed in an office setting, and dermatologists are more than 5 times as likely as other specialists to operate in an office setting.

Does Bedside Sonography Effectively Identify Nasogastric Tube Placements in Pediatric Critical Care Patients?

PubMed

Atalay, Yunus Oktay; Aydin, Ramazan; Ertugrul, Omer; Gul, Selim Baris; Polat, Ahmet Veysel; Paksu, Muhammet Sukru

2016-12-01

A nasogastric tube (NGT) insertion is a common procedure in intensive care units, with some serious complications that result from the malposition of the NGT tip. This pilot study was designed to investigate the efficiency of ultrasound in verifying correct NGT placement and to compare these results with radiographic findings. This was a single-center, double-blind prospective study of patients who had received an NGT in the pediatric critical care unit. Twenty-one patients aged 1 month to 18 years were included in this study. All NGTs were inserted by the same critical care physician. After insertion, the physician first confirmed NGT placement by the auscultation of the epigastrium following the insufflation of air. Confirmation was supplemented with an abdominal radiograph. A radiologist who was unaware of the radiographic findings performed bedside sonography on all patients and verified the location of the NGTs. The findings from these 2 physicians were then compared. NGTs were inserted without any complications, and none of the NGTs were positioned in the respiratory tract in any of the patients. All NGT tips were visualized by radiography and sonography with a sensitivity of 100%. Bedside sonography performed by a radiologist is an effective and sensitive diagnostic procedure for confirming the correct NGT position in patients in the pediatric critical care unit.

Requirements to the procedure and stages of innovative fuel development

NASA Astrophysics Data System (ADS)

Troyanov, V.; Zabudko, L.; Grachyov, A.; Zhdanova, O.

2016-04-01

According to the accepted current understanding under the nuclear fuel we will consider the assembled active zone unit (Fuel assembly) with its structural elements, fuel rods, pellet column, structural materials of fuel rods and fuel assemblies. The licensing process includes justification of safe application of the proposed modifications, including design-basis and experimental justification of the modified items under normal operating conditions and in violation of normal conditions, including accidents as well. Besides the justification of modified units itself, it is required to show the influence of modifications on the performance and safety of the other Reactor Unit’ and Nuclear Plant’ elements (e.g. burst can detection system, transportation and processing operations during fuel handling), as well as to justify the new standards of fuel storage etc. Finally, the modified fuel should comply with the applicable regulations, which often becomes a very difficult task, if only because those regulations, such as the NP-082-07, are not covered modification issues. Making amendments into regulations can be considered as the only solution, but the process is complicated and requires deep grounds for amendments. Some aspects of licensing new nuclear fuel are considered the example of mixed nitride uranium -plutonium fuel application for the BREST reactor unit.

A review of ride comfort studies in the United Kingdom

NASA Technical Reports Server (NTRS)

Griffin, M. J.

1975-01-01

United Kingdom research which is relevant to the assessment of vehicle ride comfort was reviewed. The findings reported in approximately 80 research papers are outlined, and an index to the areas of application of these studies is provided. The data obtained by different research groups are compared, and it is concluded that, while there are some areas of general agreement, the findings obtained from previous United Kingdom research are insufficient to define a general purpose ride comfort evaluation procedure. The degree to which United Kingdom research supports the vibration evaluation procedure defined in the current International Standard on the evaluation of human exposure to whole-body vibration is discussed.

47 CFR 1.19 - Use of metric units required.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Procedure General § 1.19 Use of metric units required. Where parenthesized English units accompany metric... currently required, and compliance with the English unit shall be considered sufficient when the Commission form requests that data showing compliance with that particular standard be submitted in English units...

20 CFR 361.14 - Procedures for salary offset: Imposition of interest, penalties and administrative costs.

Code of Federal Regulations, 2010 CFR

2010-04-01

... BOARD INTERNAL ADMINISTRATION, POLICY AND PROCEDURES RECOVERY OF DEBTS OWED TO THE UNITED STATES GOVERNMENT BY GOVERNMENT EMPLOYEES § 361.14 Procedures for salary offset: Imposition of interest, penalties...

Cost Utility Analysis of Cervical Therapeutic Medial Branch Blocks in Managing Chronic Neck Pain

PubMed Central

Manchikanti, Laxmaiah; Pampati, Vidyasagar; Kaye, Alan D.; Hirsch, Joshua A.

2017-01-01

Background:Controlled diagnostic studies have established the prevalence of cervical facet joint pain to range from 36% to 67% based on the criterion standard of ≥ 80% pain relief. Treatment of cervical facet joint pain has been described with Level II evidence of effectiveness for therapeutic facet joint nerve blocks and radiofrequency neurotomy and with no significant evidence for intraarticular injections. However, there have not been any cost effectiveness or cost utility analysis studies performed in managing chronic neck pain with or without headaches with cervical facet joint interventions. Study Design:Cost utility analysis based on the results of a double-blind, randomized, controlled trial of cervical therapeutic medial branch blocks in managing chronic neck pain. Objectives:To assess cost utility of therapeutic cervical medial branch blocks in managing chronic neck pain. Methods: A randomized trial was conducted in a specialty referral private practice interventional pain management center in the United States. This trial assessed the clinical effectiveness of therapeutic cervical medial branch blocks with or without steroids for an established diagnosis of cervical facet joint pain by means of controlled diagnostic blocks. Cost utility analysis was performed with direct payment data for the procedures for a total of 120 patients over a period of 2 years from this trial based on reimbursement rates of 2016. The payment data provided direct procedural costs without inclusion of drug treatments. An additional 40% was added to procedural costs with multiplication of a factor of 1.67 to provide estimated total costs including direct and indirect costs, based on highly regarded surgical literature. Outcome measures included significant improvement defined as at least a 50% improvement with reduction in pain and disability status with a combined 50% or more reduction in pain in Neck Disability Index (NDI) scores. Results:The results showed direct procedural costs per one-year improvement in quality adjusted life year (QALY) of United States Dollar (USD) of $2,552, and overall costs of USD $4,261. Overall, each patient on average received 5.7 ± 2.2 procedures over a period of 2 years. Average significant improvement per procedure was 15.6 ± 12.3 weeks and average significant improvement in 2 years per patient was 86.0 ± 24.6 weeks. Limitations:The limitations of this cost utility analysis are that data are based on a single center evaluation. Only costs of therapeutic interventional procedures and physician visits were included, with extrapolation of indirect costs. Conclusion:The cost utility analysis of therapeutic cervical medial branch blocks in the treatment of chronic neck pain non-responsive to conservative management demonstrated clinical effectiveness and cost utility at USD $4,261 per one year of QALY. PMID:29200944

Cost Utility Analysis of Cervical Therapeutic Medial Branch Blocks in Managing Chronic Neck Pain.

PubMed

Manchikanti, Laxmaiah; Pampati, Vidyasagar; Kaye, Alan D; Hirsch, Joshua A

2017-01-01

Background: Controlled diagnostic studies have established the prevalence of cervical facet joint pain to range from 36% to 67% based on the criterion standard of ≥ 80% pain relief. Treatment of cervical facet joint pain has been described with Level II evidence of effectiveness for therapeutic facet joint nerve blocks and radiofrequency neurotomy and with no significant evidence for intraarticular injections. However, there have not been any cost effectiveness or cost utility analysis studies performed in managing chronic neck pain with or without headaches with cervical facet joint interventions. Study Design: Cost utility analysis based on the results of a double-blind, randomized, controlled trial of cervical therapeutic medial branch blocks in managing chronic neck pain. Objectives: To assess cost utility of therapeutic cervical medial branch blocks in managing chronic neck pain. Methods: A randomized trial was conducted in a specialty referral private practice interventional pain management center in the United States. This trial assessed the clinical effectiveness of therapeutic cervical medial branch blocks with or without steroids for an established diagnosis of cervical facet joint pain by means of controlled diagnostic blocks. Cost utility analysis was performed with direct payment data for the procedures for a total of 120 patients over a period of 2 years from this trial based on reimbursement rates of 2016. The payment data provided direct procedural costs without inclusion of drug treatments. An additional 40% was added to procedural costs with multiplication of a factor of 1.67 to provide estimated total costs including direct and indirect costs, based on highly regarded surgical literature. Outcome measures included significant improvement defined as at least a 50% improvement with reduction in pain and disability status with a combined 50% or more reduction in pain in Neck Disability Index (NDI) scores. Results: The results showed direct procedural costs per one-year improvement in quality adjusted life year (QALY) of United States Dollar (USD) of $2,552, and overall costs of USD $4,261. Overall, each patient on average received 5.7 ± 2.2 procedures over a period of 2 years. Average significant improvement per procedure was 15.6 ± 12.3 weeks and average significant improvement in 2 years per patient was 86.0 ± 24.6 weeks. Limitations: The limitations of this cost utility analysis are that data are based on a single center evaluation. Only costs of therapeutic interventional procedures and physician visits were included, with extrapolation of indirect costs. Conclusion: The cost utility analysis of therapeutic cervical medial branch blocks in the treatment of chronic neck pain non-responsive to conservative management demonstrated clinical effectiveness and cost utility at USD $4,261 per one year of QALY.

77 FR 30241 - Representation Procedures and Rulemaking Authority

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-22

... the informal rulemaking procedures in the Administrative Procedure Act (APA), 5 U.S.C. 553, and... stricter requirements in sections 556 and 557 of the APA, this hearing will comply with those informal rulemaking procedures under the APA. See, e.g. United States v. Allegheny-Ludlum Steel Corp., 406 US 742...

32 CFR 516.16 - Individual and supervisory procedures upon commencement of legal proceedings.

Code of Federal Regulations, 2013 CFR

2013-07-01

... litigation. (b) Supervisory procedures. When supervisors learn that legal proceedings in which the United... 32 National Defense 3 2013-07-01 2013-07-01 false Individual and supervisory procedures upon... to HQDA § 516.16 Individual and supervisory procedures upon commencement of legal proceedings. (a...

32 CFR 516.16 - Individual and supervisory procedures upon commencement of legal proceedings.

Code of Federal Regulations, 2012 CFR

2012-07-01

... litigation. (b) Supervisory procedures. When supervisors learn that legal proceedings in which the United... 32 National Defense 3 2012-07-01 2009-07-01 true Individual and supervisory procedures upon... to HQDA § 516.16 Individual and supervisory procedures upon commencement of legal proceedings. (a...

32 CFR 516.16 - Individual and supervisory procedures upon commencement of legal proceedings.

Code of Federal Regulations, 2014 CFR

2014-07-01

... litigation. (b) Supervisory procedures. When supervisors learn that legal proceedings in which the United... 32 National Defense 3 2014-07-01 2014-07-01 false Individual and supervisory procedures upon... to HQDA § 516.16 Individual and supervisory procedures upon commencement of legal proceedings. (a...

Integrated Advanced Microwave Sounding Unit-A (AMSU-A). Performance Verification Report: Initial Comprehensive Performance Test Report, P/N 1331200-2-IT, S/N 105/A2

NASA Technical Reports Server (NTRS)

Platt, R.

1999-01-01

This is the Performance Verification Report, Initial Comprehensive Performance Test Report, P/N 1331200-2-IT, S/N 105/A2, for the Integrated Advanced Microwave Sounding Unit-A (AMSU-A). The specification establishes the requirements for the Comprehensive Performance Test (CPT) and Limited Performance Test (LPT) of the Advanced Microwave Sounding, Unit-A2 (AMSU-A2), referred to herein as the unit. The unit is defined on Drawing 1331200. 1.2 Test procedure sequence. The sequence in which the several phases of this test procedure shall take place is shown in Figure 1, but the sequence can be in any order.