75 FR 71448 - Notice of Intent To Provide Supplemental Funding

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-23

... award to include direct Medicare fraud prevention intervention activities in high risk areas. Funding... direct intervention activities in South Florida, especially Miami and Dade counties. Intervention... and adequately describe the targeted population and document the need for intervention? B. Approach...

Pre-Career Curriculum Guide for Deaf-Blind. Parts I-III.

ERIC Educational Resources Information Center

Carr, LaVernya K.; And Others

The two-volume document provides a pre-career curriculum guide for professionals and teachers working with deaf-blind students. Part 1 contains professionals and teachers working with deaf-blind students. Part I contains introductory information. Pointed out is the void in providing adequate programs for deaf-blind students over the age of 10.…

Reducing Stressful Aspects of Information Technology in Public Services.

ERIC Educational Resources Information Center

Quinn, Brian

1995-01-01

Identifies sources of technological stress for public services librarians and patrons and proposes ways to reduce stress, including communicating with staff, implementing a system gradually, providing adequate training, creating proper documentation, planning, considering ergonomics in hardware and software selection, selecting a good interface,…

RECOMMENDED PRACTICE FOR THE USE OF ELECTROMAGNETIC FLOWMETERS IN WASTEWATER TREATMENT PLANTS

EPA Science Inventory

Electromagnetic flowmeters that conform to the guidelines described in this document can be used to measure the volumetric flowrate of all liquids and sludges normally encountered in wastewater treatment plants, provided that adequate inspection and maintenance are performed as r...

40 CFR 35.970 - Contract enforcement.

Code of Federal Regulations, 2010 CFR

2010-07-01

... authorized to provide technical and legal assistance in the administration and enforcement of any contract... matters at issue. (b) Grantee request. The grantee's request for technical or legal assistance should be submitted in writing and be accompained by documentation adequate to inform the Regional Administrator of...

Region 9: California Los Angeles - San Bernadino Counties Adequate Letter Enclosure (5/20/2008)

EPA Pesticide Factsheets

This document is the enclosure to the April 16, 2008, letter from EPA provides adequacy finding for transportation conformity purposes the motor vehicle emissions budgets in the Antelope Valley-Western Mojave Desert 8-hour Ozone Early Progress Plan.

"You Can See the Quality in Front of Your Eyes": Grounding Academic Standards between Rationality and Interpretation

ERIC Educational Resources Information Center

Bloxham, Sue

2012-01-01

This article considers the failure of theory to provide a workable model for academic standards in use. Examining the contrast between theoretical perspectives, it argues that there are four dimensions for which the academy has failed to provide an adequate theoretical account of standards: documented or tacit knowledge of standards; norm or…

36 CFR 1223.1 - What are the authorities for part 1223?

Code of Federal Regulations, 2010 CFR

2010-07-01

... authorities for this part are 44 U.S.C. 3101; Executive Orders 12656, Assignment of Emergency Preparedness... adequate and proper documentation of the organization and to perform national security emergency preparedness functions. (b) These regulations are in conformance with guidance provided in Federal Continuity...

Development of Methodologic Tools for Planning and Managing Library Services: II. Measuring a Library's Capability for Providing Documents *

PubMed Central

Orr, Richard H.; Pings, Vern M.; Pizer, Irwin H.; Olson, Edwin E.; Spencer, Carol C.

1968-01-01

A method of measuring a library's capability for providing the documents its users need has been developed. The library is tested with a representative sample of such documents to determine how long would be required for users to obtain these documents. Test results are expressed in terms of a Capability Index, which has a maximal value of 100 only if all the sample documents are found “on shelf.” Specific tests employing samples of 300 documents have been developed that are appropriate for academic and for “reservoir” biomedical libraries. Realistic field trials have demonstrated that these two tests are practical to administer and that test results are adequately reproducible. When strict comparability is not important, a library can test itself. In assessing a reservoir library, test results are supplemented by data on its typical processing time for interlibrary loan requests. Currently these tests are being used in a national survey. The general method is applicable to other types of libraries, provided appropriate test samples are established. If their limitations are clearly understood, these “Document Delivery Tests” can be valuable tools for planning and managing library services. PMID:5665969

U.S. Air Force Doctrine: A Perspective

DTIC Science & Technology

1990-01-01

of Air Power." This document provided the independence long desired by proponents of a separate air force. It recognized the role of air superiority...guidance. First, AFM 1-1 fails to adequately address the corduct of war across the spectrum of conflict. The document tails to address the Vietnam war...have made it possible--in deed necessary-to update the doctrine;" "Air Force puts 3-2 in a class by itself and has given it superstar status billing

Using Reflection Documents to Assess Student Learning

ERIC Educational Resources Information Center

Powell, Larkin A.

2009-01-01

Traditional assessment methods such as tests and essays may not be adequate to evaluate students' ability to solve problems and think critically. I developed a qualitative assessment technique for a junior-level Wildlife Management Techniques course that incorporated written responses in a pre- and post-course reflection exercise. I provided the…

Schools and the Law: Legal Trouble Spots and How To Avoid Them.

ERIC Educational Resources Information Center

Jones, Rebecca

2000-01-01

To reduce liability risks, there are no substitutes for knowing law and policies, consulting with an attorney beforehand, providing adequate staff training, and documenting efforts. School law hot spots include negligence, religion, discipline policies, sexual harassment, magnet school diversity policies, and high-stakes testing. (MLH)

Clear Purpose...Complete Commitment. A Long-Range Program To Provide Louisianians with Library and Information Services Adequate to Their Needs 1996-2000.

ERIC Educational Resources Information Center

Jaques, Thomas F.

This document provides the 5-year (1996-2000) library plan for public libraries in Louisiana. It identifies specific inadequacies in public library services, resources, facilities, and personnel. It identifies the people who are to be served, and reveals the geographical, sociological, economic, and educational barriers to the expanded use of…

Seismology software: state of the practice

NASA Astrophysics Data System (ADS)

Smith, W. Spencer; Zeng, Zheng; Carette, Jacques

2018-05-01

We analyzed the state of practice for software development in the seismology domain by comparing 30 software packages on four aspects: product, implementation, design, and process. We found room for improvement in most seismology software packages. The principal areas of concern include a lack of adequate requirements and design specification documents, a lack of test data to assess reliability, a lack of examples to get new users started, and a lack of technological tools to assist with managing the development process. To assist going forward, we provide recommendations for a document-driven development process that includes a problem statement, development plan, requirement specification, verification and validation (V&V) plan, design specification, code, V&V report, and a user manual. We also provide advice on tool use, including issue tracking, version control, code documentation, and testing tools.

Seismology software: state of the practice

NASA Astrophysics Data System (ADS)

Smith, W. Spencer; Zeng, Zheng; Carette, Jacques

2018-02-01

We analyzed the state of practice for software development in the seismology domain by comparing 30 software packages on four aspects: product, implementation, design, and process. We found room for improvement in most seismology software packages. The principal areas of concern include a lack of adequate requirements and design specification documents, a lack of test data to assess reliability, a lack of examples to get new users started, and a lack of technological tools to assist with managing the development process. To assist going forward, we provide recommendations for a document-driven development process that includes a problem statement, development plan, requirement specification, verification and validation (V&V) plan, design specification, code, V&V report, and a user manual. We also provide advice on tool use, including issue tracking, version control, code documentation, and testing tools.

[Problems encountered during the installation of an automated anesthesia documentation system (AIMS)].

PubMed

Müller, H; Naujoks, F; Dietz, S

2002-08-01

Problems encountered during the installation and introduction of an automated anaesthesia documentation system are discussed. Difficulties have to be expected in the area of staff training because of heterogeneous experience in computer usage and in the field of online documentation of vital signs. Moreover the areas of net administration and hardware configuration as well as general administrative issues also represent possible sources of drawbacks. System administration and reliable support provided by personnel of the department of anaesthesiology assuring staff motivation and reducing time of system failures require adequately staffed departments. Based on our own experiences, we recommend that anaesthesiology departments considering the future installation and use of an automated anaesthesia documentation system should verify sufficient personnel capacities prior to their decision.

29 CFR 516.1 - Form of records; scope of regulations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 3 2010-07-01 2010-07-01 false Form of records; scope of regulations. 516.1 Section 516.1 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR REGULATIONS... other basic source document of an automatic word or data processing memory provided that adequate...

Master Plan for Tennessee Schools, 1995: Preparing for the 21st Century.

ERIC Educational Resources Information Center

Tennessee State Board of Education, Nashville.

The Tennessee State Legislature passed the Education Improvement Act (EIA) in 1992, which established the Basic Education Program (BEP) as the funding formula for providing adequate, equitable, and sustainable school funding. This document presents the 1995 Master Plan for Tennessee Schools, which focuses on the priority issues that must be…

7 CFR 1717.860 - Lien accommodations and subordinations under section 306E of the RE Act.

Code of Federal Regulations, 2012 CFR

2012-01-01

... these documents itself; (v) A copy of the loan agreement, loan note, bond or other financing instrument..., provided that the outstanding balance of all such loans lien subordinated under this paragraph (d), after... reasonably adequate after granting the lien subordination. Investments lien subordinated under this paragraph...

7 CFR 1717.860 - Lien accommodations and subordinations under section 306E of the RE Act.

Code of Federal Regulations, 2013 CFR

2013-01-01

... these documents itself; (v) A copy of the loan agreement, loan note, bond or other financing instrument..., provided that the outstanding balance of all such loans lien subordinated under this paragraph (d), after... reasonably adequate after granting the lien subordination. Investments lien subordinated under this paragraph...

The Risk of Reaching.

ERIC Educational Resources Information Center

Barfield, Kenny D.

One of three related documents exploring the problems inherent to current high school forensic coaching, this paper explores the issue of risk in debate and how this risk can be reduced. The paper first examines how the 'risk of losing' affects coaches and debaters alike, noting that in providing adequate direction by helping to test the evidence…

32 CFR 701.114 - PA enforcement actions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... adequately addressed, the individual may contact CNO (DNS-36) or CMC (ARSF), for assistance. (b) Civil court... employee, the responsible DON activity shall promptly apprise CNO (DNS-36)) and provide a copy of all relevant documents. CNO (DNS-36) will in turn apprise the DPO, who will apprise the DOJ. When a court...

32 CFR 701.114 - PA enforcement actions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... adequately addressed, the individual may contact CNO (DNS-36) or CMC (ARSF), for assistance. (b) Civil court... employee, the responsible DON activity shall promptly apprise CNO (DNS-36)) and provide a copy of all relevant documents. CNO (DNS-36) will in turn apprise the DPO, who will apprise the DOJ. When a court...

32 CFR 701.114 - PA enforcement actions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... adequately addressed, the individual may contact CNO (DNS-36) or CMC (ARSF), for assistance. (b) Civil court... employee, the responsible DON activity shall promptly apprise CNO (DNS-36)) and provide a copy of all relevant documents. CNO (DNS-36) will in turn apprise the DPO, who will apprise the DOJ. When a court...

32 CFR 701.114 - PA enforcement actions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... adequately addressed, the individual may contact CNO (DNS-36) or CMC (ARSF), for assistance. (b) Civil court... employee, the responsible DON activity shall promptly apprise CNO (DNS-36)) and provide a copy of all relevant documents. CNO (DNS-36) will in turn apprise the DPO, who will apprise the DOJ. When a court...

32 CFR 701.114 - PA enforcement actions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... adequately addressed, the individual may contact CNO (DNS-36) or CMC (ARSF), for assistance. (b) Civil court... employee, the responsible DON activity shall promptly apprise CNO (DNS-36)) and provide a copy of all relevant documents. CNO (DNS-36) will in turn apprise the DPO, who will apprise the DOJ. When a court...

The Alabama Long Range Program for Library Development, 1995-1999.

ERIC Educational Resources Information Center

Alabama Public Library Service, Montgomery.

This document contains the long range plan of the Alabama public libraries. The purpose of presenting this long range program is to meet the requirements of the Library Services and Construction Act (LSCA) and to assess, prioritize, and communicate library needs to librarians, officials, and the public to provide adequate library service to the…

The Alabama Long Range Program for Library Development 1994-1998.

ERIC Educational Resources Information Center

Alabama Public Library Service, Montgomery.

This document contains the long range plan of the Alabama public libraries. The purpose of presenting this program is to meet the requirements of the Library Services and Construction Act (LSCA) and to assess, prioritize, and communicate library needs to librarians, officials, and the public to provide adequate library service to the citizens of…

Adult Literacy in the United States Today.

ERIC Educational Resources Information Center

Forlizzi, Lori A.

This document addresses issues related to the problem that many U.S. citizens do not have literacy skills adequate to meet their needs and ambitions. The first section of the paper provides an overview of the problem, discussing how to define literacy, how it has been measured, some estimates of how many people are illiterate, who they are and…

Effectiveness guidance document (EGD) for Chinese medicine trials: a consensus document

PubMed Central

2014-01-01

Background There is a need for more Comparative Effectiveness Research (CER) on Chinese medicine (CM) to inform clinical and policy decision-making. This document aims to provide consensus advice for the design of CER trials on CM for researchers. It broadly aims to ensure more adequate design and optimal use of resources in generating evidence for CM to inform stakeholder decision-making. Methods The Effectiveness Guidance Document (EGD) development was based on multiple consensus procedures (survey, written Delphi rounds, interactive consensus workshop, international expert review). To balance aspects of internal and external validity, multiple stakeholders, including patients, clinicians, researchers and payers were involved in creating this document. Results Recommendations were developed for “using available data” and “future clinical studies”. The recommendations for future trials focus on randomized trials and cover the following areas: designing CER studies, treatments, expertise and setting, outcomes, study design and statistical analyses, economic evaluation, and publication. Conclusion The present EGD provides the first systematic methodological guidance for future CER trials on CM and can be applied to single or multi-component treatments. While CONSORT statements provide guidelines for reporting studies, EGDs provide recommendations for the design of future studies and can contribute to a more strategic use of limited research resources, as well as greater consistency in trial design. PMID:24885146

40 CFR 310.16 - What kind of cost documentation is necessary?

Code of Federal Regulations, 2010 CFR

2010-07-01

...) SUPERFUND, EMERGENCY PLANNING, AND COMMUNITY RIGHT-TO-KNOW PROGRAMS REIMBURSEMENT TO LOCAL GOVERNMENTS FOR... cost documentation is necessary? Cost documentation must be adequate for an audit. At a minimum, you...

Clear Purpose...Complete Commitment: A Long-Range Program To Provide Louisianians with Library and Information Services Adequate to Their Needs, 1995-1999.

ERIC Educational Resources Information Center

Jaques, Thomas F.

This document presents the five year library plan for public libraries in Louisiana. It identifies the specific inadequacies in public library services, resources, facilities, and personnel; identifies the people who are to be served; reveals the geographical, sociological, economic, and educational barriers to the expanded use of libraries; and…

"Standards" on the Bench: Do Standards for Technological Literacy Render an Adequate Image of Technology?

ERIC Educational Resources Information Center

Nia, Mahdi G.; de Vries, Marc J.

2016-01-01

The technological literacy of students has recently become one of the primary goals of education in countries such as the USA, England, New Zealand, Australia, and so forth. However the question here is whether these educations--their long-term policy documents as well as the standards they provide in particular--address sufficient learning about…

System Guidelines for EMC Safety-Critical Circuits: Design, Selection, and Margin Demonstration

NASA Technical Reports Server (NTRS)

Lawton, R. M.

1996-01-01

Demonstration of safety margins for critical points (circuits) has traditionally been required since it first became a part of systems-level Electromagnetic Compatibility (EMC) requirements of MIL-E-6051C. The goal of this document is to present cost-effective guidelines for ensuring adequate Electromagnetic Effects (EME) safety margins on spacecraft critical circuits. It is for the use of NASA and other government agencies and their contractors to prevent loss of life, loss of spacecraft, or unacceptable degradation. This document provides practical definition and treatment guidance to contain costs within affordable limits.

Hanford waste-form release and sediment interaction: A status report with rationale and recommendations for additional studies

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

Serne, R.J.; Wood, M.I.

1990-05-01

This report documents the currently available geochemical data base for release and retardation for actual Hanford Site materials (wastes and/or sediments). The report also recommends specific laboratory tests and presents the rationale for the recommendations. The purpose of this document is threefold: to summarize currently available information, to provide a strategy for generating additional data, and to provide recommendations on specific data collection methods and tests matrices. This report outlines a data collection approach that relies on feedback from performance analyses to ascertain when adequate data have been collected. The data collection scheme emphasizes laboratory testing based on empiricism. 196more » refs., 4 figs., 36 tabs.« less

The valuation of nursing begins with identifying value drivers.

PubMed

Rutherford, Marcella M

2010-03-01

Adequate investment in a profession links to its ability to define and document its value. This requires identifying those elements or value drivers that demonstrate its worth. To completely identify nursing's value drivers requires meshing the economic, technical, and caring aspects of its profession. Nursing's valuation includes assessing nursing's tangible and intangible assets and documenting these assets. This information communicates nursing's worth and ensures adequate economic investment in its services.

Planning guidance for the Chemical Stockpile Emergency Preparedness Program

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

Shumpert, B.L.; Watson, A.P.; Sorensen, J.H.

1995-02-01

This planning guide was developed under the direction of the U.S. Army and the Federal Emergency Management Agency (FEMA) which jointly coordinate and direct the development of the Chemical Stockpile Emergency Preparedness Program (CSEPP). It was produced to assist state, local, and Army installation planners in formulating and coordinating plans for chemical events that may occur at the chemical agent stockpile storage locations in the continental United States. This document provides broad planning guidance for use by both on-post and off-post agencies and organizations in the development of a coordinated plan for responding to chemical events. It contains checklists tomore » assist in assuring that all important aspects are included in the plans and procedures developed at each Chemical Stockpile Disposal Program (CSDP) location. The checklists are supplemented by planning guidelines in the appendices which provide more detailed guidance regarding some issues. The planning guidance contained in this document will help ensure that adequate coordination between on-post and off-post planners occurs during the planning process. This planning guide broadly describes an adequate emergency planning base that assures that critical planning decisions will be made consistently at every chemical agent stockpile location. This planning guide includes material drawn from other documents developed by the FEMA, the Army, and other federal agencies with emergency preparedness program responsibilities. Some of this material has been developed specifically to meet the unique requirements of the CSEPP. In addition to this guidance, other location-specific documents, technical studies, and support studies should be used as needed to assist in the planning at each of the chemical agent stockpile locations to address the specific hazards and conditions at each location.« less

Controls Over Ministry of Interior Fuel Contracts Could be Improved

DTIC Science & Technology

2016-01-20

Fiscal Year 1395 Commitment Letter improved reporting requirements designed to specify adequate documentation of the Afghan Ministry of Interior fuel...1395 Commitment Letter improved reporting requirements designed to specify adequate documentation of the Afghan Ministry of Interior fuel consumption...of Defense F r a u d , W a s t e & A b u s e FOR OFFICIAL USE ONLY FOR OFFICIAL USE ONLY Results in Brief Controls Over Ministry of Interior Fuel

DOD Business Systems Modernization: Further Actions Needed to Address Challenges and Improve Accountability

DTIC Science & Technology

2013-05-01

to Lack Adequate Validation Page 35 GAO-13-557 DOD Business Systems Modernization provided a compliance dashboard to document BEA...campaigns, execute marketing campaigns, and measure and evaluate the performance of marketing campaigns. Order-to- Cash Accept and process customer... dashboards reflected related GAO reports. In addition, the department’s fiscal year 2014 investment management guidance issued by the Office of the

EIA model documentation: Petroleum market model of the national energy modeling system

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

NONE

1995-12-28

The purpose of this report is to define the objectives of the Petroleum Market Model (PMM), describe its basic approach, and provide detail on how it works. This report is intended as a reference document for model analysts, users, and the public. Documentation of the model is in accordance with EIA`s legal obligation to provide adequate documentation in support of its models. The PMM models petroleum refining activities, the marketing of petroleum products to consumption regions, the production of natural gas liquids in gas processing plants, and domestic methanol production. The PMM projects petroleum product prices and sources of supplymore » for meeting petroleum product demand. The sources of supply include crude oil, both domestic and imported; other inputs including alcohols and ethers; natural gas plant liquids production; petroleum product imports; and refinery processing gain. In addition, the PMM estimates domestic refinery capacity expansion and fuel consumption. Product prices are estimated at the Census division level and much of the refining activity information is at the Petroleum Administration for Defense (PAD) District level.« less

Computer program CDCID: an automated quality control program using CDC update

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

Singer, G.L.; Aguilar, F.

1984-04-01

A computer program, CDCID, has been developed in coordination with a quality control program to provide a highly automated method of documenting changes to computer codes at EG and G Idaho, Inc. The method uses the standard CDC UPDATE program in such a manner that updates and their associated documentation are easily made and retrieved in various formats. The method allows each card image of a source program to point to the document which describes it, who created the card, and when it was created. The method described is applicable to the quality control of computer programs in general. Themore » computer program described is executable only on CDC computing systems, but the program could be modified and applied to any computing system with an adequate updating program.« less

Reactive documentation system

NASA Astrophysics Data System (ADS)

Boehnlein, Thomas R.; Kramb, Victoria

2018-04-01

Proper formal documentation of computer acquired NDE experimental data generated during research is critical to the longevity and usefulness of the data. Without documentation describing how and why the data was acquired, NDE research teams lose capability such as their ability to generate new information from previously collected data or provide adequate information so that their work can be replicated by others seeking to validate their research. Despite the critical nature of this issue, NDE data is still being generated in research labs without appropriate documentation. By generating documentation in series with data, equal priority is given to both activities during the research process. One way to achieve this is to use a reactive documentation system (RDS). RDS prompts an operator to document the data as it is generated rather than relying on the operator to decide when and what to document. This paper discusses how such a system can be implemented in a dynamic environment made up of in-house and third party NDE data acquisition systems without creating additional burden on the operator. The reactive documentation approach presented here is agnostic enough that the principles can be applied to any operator controlled, computer based, data acquisition system.

Multisource data fusion for documenting archaeological sites

NASA Astrophysics Data System (ADS)

Knyaz, Vladimir; Chibunichev, Alexander; Zhuravlev, Denis

2017-10-01

The quality of archaeological sites documenting is of great importance for cultural heritage preserving and investigating. The progress in developing new techniques and systems for data acquisition and processing creates an excellent basis for achieving a new quality of archaeological sites documenting and visualization. archaeological data has some specific features which have to be taken into account when acquiring, processing and managing. First of all, it is a needed to gather as full as possible information about findings providing no loss of information and no damage to artifacts. Remote sensing technologies are the most adequate and powerful means which satisfy this requirement. An approach to archaeological data acquiring and fusion based on remote sensing is proposed. It combines a set of photogrammetric techniques for obtaining geometrical and visual information at different scales and detailing and a pipeline for archaeological data documenting, structuring, fusion, and analysis. The proposed approach is applied for documenting of Bosporus archaeological expedition of Russian State Historical Museum.

A standardized, uniform and universal dental chart for documenting state of dentition before anaesthesia.

PubMed

Gatt, S P; Aurisch, J; Wong, K

2001-02-01

It is vital to have adequate and precise documentation of the condition of a patient's dentition before commencing an anaesthetic. The incidence of dental damage during anaesthesia is not low. To the authors' knowledge, there is no standardized method used by anaesthetists to document the state of a patient's dentition. We propose the introduction of a standardized uniform dental chart to enable anaesthetists to accurately document the condition of their patients' teeth. This vital information can be easily obtained during the preanaesthetic assessment. With the increase in medical litigation and demands for adequate documentation, we believe this chart can become an invaluable part of every hospital's preanaesthetic assessment form. The dental chart is to be offered as a service to anaesthetists in the form of a copyright-free "Freeware" computer diskette or adhesive sticker and will be downloadable from the internet.

23 CFR 635.120 - Changes and extra work.

Code of Federal Regulations, 2014 CFR

2014-04-01

... STD should establish and document with the Division Administrator's concurrence specific parameters as... STD shall perform and adequately document a cost analysis of each negotiated contract change or...

23 CFR 635.120 - Changes and extra work.

Code of Federal Regulations, 2013 CFR

2013-04-01

... STD should establish and document with the Division Administrator's concurrence specific parameters as... STD shall perform and adequately document a cost analysis of each negotiated contract change or...

23 CFR 635.120 - Changes and extra work.

Code of Federal Regulations, 2011 CFR

2011-04-01

... STD should establish and document with the Division Administrator's concurrence specific parameters as... STD shall perform and adequately document a cost analysis of each negotiated contract change or...

23 CFR 635.120 - Changes and extra work.

Code of Federal Regulations, 2012 CFR

2012-04-01

... STD should establish and document with the Division Administrator's concurrence specific parameters as... STD shall perform and adequately document a cost analysis of each negotiated contract change or...

The Indian Elder, A Forgotten American. Final Report on the National Indian Conference on Aging (1st, Phoenix, Arizona, June 15-17, 1976) Including Supplemental Documentation.

ERIC Educational Resources Information Center

Lyon, Juana P., Comp.

A culmination of the efforts of many Indian and concerned non-Indian people, the conference, attended by almost 1,500 American Indians and Alaska Natives representing 171 tribes, aimed to promote effective and adequate services needed by the Indian elderly. Based on input from the Indian community and service providers, five concurrent workshops…

76 FR 33780 - Assessments for Mismatched Payments or Inadequate Payment Information for Geothermal, Solid...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-09

...Regulations for geothermal, solid minerals, and Indian oil and gas leases authorize the Office of Natural Resources Revenue (ONRR) to assess payors for failure to submit payments of the same amount as the royalty or bill document, or to provide adequate information. The amount assessed for each mismatched or inadequately identified payment will be $214.00, effective on the date stated below.

Region 9: California Adequate / Inadequate Letter Attachment (5/30/2008)

EPA Pesticide Factsheets

This is a document that states that it has been found adequate for transportation conformitypurposes certain 8-hour ozone and PM2.5 motor vehicleemissions budgets in the 2007 South Coast StateImplementation Plan.

41 CFR 51-7.3 - Ensuring environmental documents are actually considered in agency determinations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... contains requirements to ensure adequate consideration of environmental documents in agency decision-making... environmental documents as a part of their decision-making: (1) Action: Request. (2) Start of NEPA process: Upon... Property Management Other Provisions Relating to Public Contracts COMMITTEE FOR PURCHASE FROM PEOPLE WHO...

[Development of a computerized system using standard nursing language for creation of a nursing minimum data set].

PubMed

D'Agostino, Fabio; Vellone, Ercole; Tontini, Francesco; Zega, Maurizio; Alvaro, Rosaria

2012-01-01

The aim of a nursing data set is to provide useful information for assessing the level of care and the state of health of the population. Currently, both in Italy and in other countries, this data is incomplete due to the lack of a structured nursing documentation , making it indispensible to develop a Nursing Minimum Data Set (NMDS) using standard nursing language to evaluate care, costs and health requirements. The aim of the project described , is to create a computer system using standard nursing terms with a dedicated software which will aid the decision-making process and provide the relative documentation. This will make it possible to monitor nursing activity and costs and their impact on patients' health : adequate training and involvement of nursing staff will play a fundamental role.

25 CFR 101.13 - Security.

Code of Federal Regulations, 2010 CFR

2010-04-01

... income will be adequate to pay all expenses and the loan principal and interest payments, indicating... will be adequate to pay all expenses and the loan principal and interest payments, indicating... constitutions and bylaws, corporate charters, or other organizational documents when mortgaging tribal property...

Loads Prediction Program for Accidental Explosions in Underground Munitions Storage Facilities

DTIC Science & Technology

1990-08-01

1 Loads All parameters that significantly 1417 Report Documentation Page Form ApprovedOMB No . 0704-0188 Public reporting burden for the collection...other provision of law, no person shall be subject to a penalty for failing to comply with a collection of information if it does not display a...and cost of real estate to provide an adequate cushion of space around above-ground facilities. Although many governments and industries need to

Report on SARS backfit evaluation, Exxon Donor Solvent Plant, Baytown, Texas

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

Meyer, A.F. Jr.

1980-07-02

This report provides information on observations, findings, and conclusions arising from a site visit to the Exxon Donor Solvent Plant, Baytown, Texas. That visit was to provide technical assistance and professional services to the DOE/ASFE/OPTA Project Officer regarding verification of his initial determination that this pilot plant is exempt from the SARS backfit requirement (DOE Order 5481.1). A secondary purpose was to obtain further information regarding the occupational safety and health plans and procedures at this new pilot plant facility. It is concluded that a well planned and implemented occupational safety and health program exists at the Exxon Donor Solventmore » Plant. Excellent manuals regarding general safety requirements and protection against carcinogens have been prepared and distributed. A Safe Operations Committee is in effect as is a Risk Management Committee. Adequate safety and industrial hygiene staff has been assigned and an excellent medical surveillance program has been established. Adequate compliance with environmental codes, standards, and regulations is being achieved. Although this plant is not subject to SARS because of the nature of the contract, adequate documentation exists in any case to exempt it from the SARS backfit requirement.« less

50 CFR 530.2 - Ensuring that environmental documents are actually considered in agency decision-making.

Code of Federal Regulations, 2010 CFR

2010-10-01

... actually considered in agency decision-making. 530.2 Section 530.2 Wildlife and Fisheries MARINE MAMMAL... documents are actually considered in agency decision-making. Section 1505.1 of the NEPA regulations contains requirements to ensure adequate consideration of environmental documents in agency decision-making. To...

Open-source framework for documentation of scientific software written on MATLAB-compatible programming languages

NASA Astrophysics Data System (ADS)

Konnik, Mikhail V.; Welsh, James

2012-09-01

Numerical simulators for adaptive optics systems have become an essential tool for the research and development of the future advanced astronomical instruments. However, growing software code of the numerical simulator makes it difficult to continue to support the code itself. The problem of adequate documentation of the astronomical software for adaptive optics simulators may complicate the development since the documentation must contain up-to-date schemes and mathematical descriptions implemented in the software code. Although most modern programming environments like MATLAB or Octave have in-built documentation abilities, they are often insufficient for the description of a typical adaptive optics simulator code. This paper describes a general cross-platform framework for the documentation of scientific software using open-source tools such as LATEX, mercurial, Doxygen, and Perl. Using the Perl script that translates M-files MATLAB comments into C-like, one can use Doxygen to generate and update the documentation for the scientific source code. The documentation generated by this framework contains the current code description with mathematical formulas, images, and bibliographical references. A detailed description of the framework components is presented as well as the guidelines for the framework deployment. Examples of the code documentation for the scripts and functions of a MATLAB-based adaptive optics simulator are provided.

7 CFR 1430.605 - Proof of production.

Code of Federal Regulations, 2010 CFR

2010-01-01

... commercial production, including any dumped production and dairy cow purchases, for each month of the... by the dairy operation. (d) Adequate proof of dairy cow additions to the milking herd during the... any other documents available to confirm the cow purchases. (e) If adequate proof of normally marketed...

Federal Employees Health Benefits Program: Removal of Eligible and Ineligible Individuals From Existing Enrollments. Final rule.

PubMed

2018-01-23

The United States Office of Personnel Management (OPM) is issuing a final rule amending Federal Employees Health Benefits (FEHB) Program regulations to provide a process for removal of certain identified individuals who are found not to be eligible as family members from FEHB enrollments. This process would apply to individuals for whom there is a failure to provide adequate documentation of eligibility when requested. This action also amends Federal Employees Health Benefits (FEHB) Program regulations to allow certain eligible family members to be removed from existing self and family or self plus one enrollments.

Recognition of clinical characteristics for population-based surveillance of fetal alcohol syndrome.

PubMed

Andrews, Jennifer G; Galindo, Maureen K; Meaney, F John; Benavides, Argelia; Mayate, Linnette; Fox, Deborah; Pettygrove, Sydney; O'Leary, Leslie; Cunniff, Christopher

2018-06-01

The diagnosis of fetal alcohol syndrome (FAS) rests on identification of characteristic facial, growth, and central nervous system (CNS) features. Public health surveillance of FAS depends on documentation of these characteristics. We evaluated if reporting of FAS characteristics is associated with the type of provider examining the child. We analyzed cases aged 7-9 years from the Fetal Alcohol Syndrome Surveillance Network II (FASSNetII). We included cases whose surveillance records included the type of provider (qualifying provider: developmental pediatrician, geneticist, neonatologist; other physician; or other provider) who evaluated the child as well as the FAS diagnostic characteristics (facial dysmorphology, CNS impairment, and/or growth deficiency) reported by the provider. A total of 345 cases were eligible for this analysis. Of these, 188 (54.5%) had adequate information on type of provider. Qualifying physicians averaged more than six reported FAS characteristics while other providers averaged less than five. Qualifying physicians reported on facial characteristics and developmental delay more frequently than other providers. Also, qualifying physicians reported on all three domains of characteristics (facial, CNS, and growth) in 97% of cases while others reported all three characteristics on two thirds of cases. Documentation in medical records during clinical evaluations for FAS is lower than optimal for cross-provider communication and surveillance purposes. Lack of documentation limits the quality and quantity of information in records that serve as a major source of data for public health surveillance systems. © 2018 Wiley Periodicals, Inc.

General physicians do not take adequate travel histories.

PubMed

Price, Victoria A; Smith, Rachel A S; Douthwaite, Sam; Thomas, Sherine; Almond, D Solomon; Miller, Alastair R O; Beeching, Nicholas J; Thompson, Gail; Ustianowski, Andrew; Beadsworth, Mike B J

2011-01-01

Our aim was to document how often travel histories were taken and the quality of their content. Patients admitted over 2 months to acute medical units of two hospitals in the Northwest of England with a history of fever, rash, diarrhea, vomiting, jaundice, or presenting as "unwell post-travel" were identified. The initial medical clerking was assessed. A total of 132 relevant admissions were identified. A travel history was documented in only 26 patients (19.7%). Of the 16 patients who had traveled, there was no documentation of pretravel advice or of sexual/other activities abroad in 15 (93.8%) and 12 (75.0%) patients, respectively. There needs to be better awareness and education about travel-related illness and the importance of taking an adequate travel history. © 2011 International Society of Travel Medicine.

38 CFR 16.115 - IRB records.

Code of Federal Regulations, 2011 CFR

2011-07-01

... adequate documentation of IRB activities, including the following: (1) Copies of all research proposals reviewed, scientific evaluations, if any, that accompany the proposals, approved sample consent documents... basis for requiring changes in or disapproving research; and a written summary of the discussion of...

38 CFR 16.115 - IRB records.

Code of Federal Regulations, 2010 CFR

2010-07-01

... adequate documentation of IRB activities, including the following: (1) Copies of all research proposals reviewed, scientific evaluations, if any, that accompany the proposals, approved sample consent documents... basis for requiring changes in or disapproving research; and a written summary of the discussion of...

45 CFR 690.115 - IRB records.

Code of Federal Regulations, 2011 CFR

2011-10-01

... adequate documentation of IRB activities, including the following: (1) Copies of all research proposals reviewed, scientific evaluations, if any, that accompany the proposals, approved sample consent documents... basis for requiring changes in or disapproving research; and a written summary of the discussion of...

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

Code of Federal Regulations, 2011 CFR

2011-01-01

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

Software for Statistical Analysis of Weibull Distributions with Application to Gear Fatigue Data: User Manual with Verification

NASA Technical Reports Server (NTRS)

Krantz, Timothy L.

2002-01-01

The Weibull distribution has been widely adopted for the statistical description and inference of fatigue data. This document provides user instructions, examples, and verification for software to analyze gear fatigue test data. The software was developed presuming the data are adequately modeled using a two-parameter Weibull distribution. The calculations are based on likelihood methods, and the approach taken is valid for data that include type 1 censoring. The software was verified by reproducing results published by others.

Joeropsididae Nordenstam, 1933 (Crustacea, Isopoda, Asellota) from the Lizard Island region of the Great Barrier Reef, Queensland, Australia

PubMed Central

Bruce, Niel L.

2015-01-01

Abstract The marine isopod family Joeropsididae (Asellota) is documented for the Lizard Island region of the Great Barrier Reef, Australia. Fifteen species of Joeropsis are recorded, including ten new species; descriptive notes are provided for five species that lacked adequate material for description. A revised family and genus diagnosis is presented together with comments on the most useful characters for species identification and a key to Joeropsis of the Lizard Island region. PMID:25878536

Safety analysis report for the Waste Storage Facility. Revision 2

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

Bengston, S.J.

1994-05-01

This safety analysis report outlines the safety concerns associated with the Waste Storage Facility located in the Radioactive Waste Management Complex at the Idaho National Engineering Laboratory. The three main objectives of the report are: define and document a safety basis for the Waste Storage Facility activities; demonstrate how the activities will be carried out to adequately protect the workers, public, and environment; and provide a basis for review and acceptance of the identified risk that the managers, operators, and owners will assume.

Software for Statistical Analysis of Weibull Distributions with Application to Gear Fatigue Data: User Manual with Verification

NASA Technical Reports Server (NTRS)

Kranz, Timothy L.

2002-01-01

The Weibull distribution has been widely adopted for the statistical description and inference of fatigue data. This document provides user instructions, examples, and verification for software to analyze gear fatigue test data. The software was developed presuming the data are adequately modeled using a two-parameter Weibull distribution. The calculations are based on likelihood methods, and the approach taken is valid for data that include type I censoring. The software was verified by reproducing results published by others.

Final Record of Decision for the Defense Reutilization and Marketing Office Yard (AOC 32) and Petroleum, Oil, and Lubricants Storage Area (AOC 43A) Devens, Massachusetts.

DTIC Science & Technology

1998-02-01

decision document presents the U.S. Army’s (Army’s) selected remedial actions for AOCs 32 DRMO Yard, including Underground Storage Tank (UST) #13...of commencing the remedial action to ensure that the remedy at each AOC continues to provide adequate protection of human health and the environment... Devens , Massachusetts RAO remedial action objective RBC risk-based concentration RCRA Resource Conservation and Recovery Act RI remedial

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

Finley, V.L.; Stencel, J.R.

This report gives the results of the environmental activities and monitoring programs at the Princeton Plasma Physics Laboratory (PPPL) for CY91. The report is prepared to provide the US Department of Energy (DOE) and the public with information on the level of radioactive and nonradioactive pollutants, if any, added to the environment as a result of PPPL operations, as well as environmental initiatives, assessments, and programs. The objective of the Annual Site Environmental Report is to document evidence that DOE facility environmental protection programs adequately protect the environment and the public health.

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

Finley, V.L.; Wieczorek, M.A.

This report gives the results of the environmental activities and monitoring programs at the Princeton Plasma Physics Laboratory (PPPL) for CY92. The report is prepared to provide the US Department of Energy (DOE) and the public with information on the level of radioactive and nonradioactive pollutants, if any, added to the environment as a result of PPPL operations, as well as environmental initiatives, assessments, and programs. The objective of the Annual Site Environmental Report is to document evidence that DOE facility environmental protection programs adequately protect the environment and the public health.

36 CFR § 1222.28 - What are the series level recordkeeping requirements?

Code of Federal Regulations, 2013 CFR

2013-07-01

... AND RECORDS ADMINISTRATION RECORDS MANAGEMENT CREATION AND MAINTENANCE OF FEDERAL RECORDS Agency... series and systems adequately document agency policies, transactions, and activities, each program must... documentation of phone calls, meetings, instant messages, and electronic mail exchanges that include substantive...

EPA Concurrence/Approval of Federal Facility Proposed Plans and Records of Decision and other Documents

EPA Pesticide Factsheets

The purpose of this memorandum is to ensure that EPA Regions scrutinize all proposed plans, draft and final RODs, and post-ROD documents that address institutional controls (ICs) in order to verify that they adequately document the objectives of the ICs and clearly identify who has responsibility for implementation, monitoring, reporting, and enforcement of the IC.

An Audit of Nursing Documentation at Three Public Hospitals in Jamaica.

PubMed

Lindo, Jascinth; Stennett, Rosain; Stephenson-Wilson, Kayon; Barrett, Kerry Ann; Bunnaman, Donna; Anderson-Johnson, Pauline; Waugh-Brown, Veronica; Wint, Yvonne

2016-09-01

Nursing documentation provides an important indicator of the quality of care provided for hospitalized patients. This study assessed the quality of nursing documentation on medical wards at three hospitals in Jamaica. This cross-sectional study audited a multilevel stratified sample of 245 patient records from three type B hospitals. An audit instrument which assessed nursing documentation of client history, biological data, client assessment, nursing standards, discharge planning, and teaching facilitated data collection. Descriptive statistics were conducted using IBM SPSS, Version 19 (IBM Inc., Armonk, NY, USA). Records from three hospitals (Hospital 1, n = 119, 48.6%; Hospital 2, n = 56, 22.9%; Hospital 3, n = 70, 28.6%) were audited. Documented evidence of the patient's chief complaint (81.6%), history of present illness (78.8%), past health (79.2%), and family health (11.0%) were noted; however, less than a third of the dockets audited recorded adequate assessment data (e.g., occupation or living accommodations of patients). The audit noted 90% of records had a physical assessment completed within 24 hr of admission and entries timed, dated, and signed by a nurse. Less than 5% of dockets had evidence of patient teaching, and 13.5% had documented evidence of discharge planning conducted within 72 hr of admission. This study highlights the weakness in nursing documentation and the need for increased training and continued monitoring of nursing documentation at the hospitals studied. Additional research regarding the factors that affect nursing documentation practice could prove useful. The study provides valuable information for the development of strategic risk management programs geared at improving the quality of care delivered to clients and presents an opportunity for nurse leaders to implement structured interventions geared at improving nursing documentation in Jamaica. In light of Jamaica's epidemiologic transition of chronic diseases, gaps in nurses' documentation of client assessment, patient teaching, and discharge planning should be addressed with urgency. Patient teaching and discharge planning enable the clients to participate more effectively in their health maintenance process. © 2016 Sigma Theta Tau International.

Good documentation practice in clinical research

PubMed Central

Bargaje, Chitra

2011-01-01

One of the most common inspection findings in investigator site inspections is lack of reliable, accurate and adequate source documentation. This also happens to be the most common pitfall identified during sponsor audits. The importance of good documentation practice needs to be emphasized to investigator sites to ensure that the study results are built on the foundation of credible and valid data. This article focuses on the key principles of good documentation practice and offers suggestions for improvement. PMID:21731856

Good documentation practice in clinical research.

PubMed

Bargaje, Chitra

2011-04-01

One of the most common inspection findings in investigator site inspections is lack of reliable, accurate and adequate source documentation. This also happens to be the most common pitfall identified during sponsor audits. The importance of good documentation practice needs to be emphasized to investigator sites to ensure that the study results are built on the foundation of credible and valid data. This article focuses on the key principles of good documentation practice and offers suggestions for improvement.

Biology Needs Evolutionary Software Tools: Let’s Build Them Right

PubMed Central

Team, Galaxy; Goecks, Jeremy; Taylor, James

2018-01-01

Abstract Research in population genetics and evolutionary biology has always provided a computational backbone for life sciences as a whole. Today evolutionary and population biology reasoning are essential for interpretation of large complex datasets that are characteristic of all domains of today’s life sciences ranging from cancer biology to microbial ecology. This situation makes algorithms and software tools developed by our community more important than ever before. This means that we, developers of software tool for molecular evolutionary analyses, now have a shared responsibility to make these tools accessible using modern technological developments as well as provide adequate documentation and training. PMID:29688462

Human Trafficking in Areas of Conflict: Health Care Professionals' Duty to Act.

PubMed

Bloem, Christina; Morris, Rikki E; Chisolm-Straker, Makini

2017-01-01

Given the significant global burden of human trafficking, the ability of clinicians to identify and provide treatment for trafficked persons is critical. Particularly in conflict settings, health care facilities often serve as the first and sometimes only point of contact for trafficked persons. As such, medical practitioners have a unique opportunity and an ethical imperative to intervene, even in nonclinical roles. With proper training, medical practitioners can assist trafficked persons by documenting human trafficking cases, thereby placing pressure on key stakeholders to enforce legal protections, and by providing adequate services to those trafficked. © 2017 American Medical Association. All Rights Reserved.

TECHNICAL APPROACHES TO CHARACTERIZING AND ...

EPA Pesticide Factsheets

The document provides brownfields planners with an overview of the technical methods that can be used to achieve successful site assessment and cleanup which are two key components of the brownfields redevelopment process. No two brownfields sites are identical and planners will need to base assessment and cleanup activities on the conditions of the particular sites with which they are dealing. A site assessment strategy should address: the type and extent of contamination, if any, that is present, the types of data needed to adequately assess the site; appropriate sampling and analytical methods to characterize the contamination; acceptable level of uncertainty and cleanup technologies that contain or treat the types of wastes present.This document includes references to state agency roles including the Voluntary Cleanup Program, public involvement and other guidances that may be used. Information

Implementing AORN recommended practices for environmental cleaning.

PubMed

Allen, George

2014-05-01

In recent years, researchers have developed an increasing awareness of the role of the environment in the development of health care-associated infections. AORN's "Recommended practices for environmental cleaning" is an evidence-based document that provides specific guidance for cleaning processes, for the selection of appropriate cleaning equipment and supplies, and for ongoing education and quality improvement. This updated recommended practices document has an expanded focus on the need for health care personnel to work collaboratively to accomplish adequately thorough cleanliness in a culture of safety and mutual support. Perioperative nurses, as the primary advocates for patients while they are being cared for in the perioperative setting, should help ensure that a safe, clean environment is reestablished after each surgical procedure. Copyright © 2014 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Model documentation: Renewable Fuels Module of the National Energy Modeling System

NASA Astrophysics Data System (ADS)

1994-04-01

This report documents the objectives, analytical approach, and design of the National Energy Modeling System (NEMS) Renewable Fuels Module (RFM) as it related to the production of the 1994 Annual Energy Outlook (AEO94) forecasts. The report catalogues and describes modeling assumptions, computational methodologies, data inputs, and parameter estimation techniques. A number of offline analyses used in lieu of RFM modeling components are also described. This documentation report serves two purposes. First, it is a reference document for model analysts, model users, and the public interested in the construction and application of the RFM. Second, it meets the legal requirement of the Energy Information Administration (EIA) to provide adequate documentation in support of its models. The RFM consists of six analytical submodules that represent each of the major renewable energy resources -- wood, municipal solid waste (MSW), solar energy, wind energy, geothermal energy, and alcohol fuels. Of these six, four are documented in the following chapters: municipal solid waste, wind, solar and biofuels. Geothermal and wood are not currently working components of NEMS. The purpose of the RFM is to define the technological and cost characteristics of renewable energy technologies, and to pass these characteristics to other NEMS modules for the determination of mid-term forecasted renewable energy demand.

ADM guidance-Ceramics: guidance to the use of fractography in failure analysis of brittle materials.

PubMed

Scherrer, Susanne S; Lohbauer, Ulrich; Della Bona, Alvaro; Vichi, Alessandro; Tholey, Michael J; Kelly, J Robert; van Noort, Richard; Cesar, Paulo Francisco

2017-06-01

To provide background information and guidance as to how to use fractography accurately, a powerful tool for failure analysis of dental ceramic structures. An extended palette of qualitative and quantitative fractography is provided, both for in vivo and in vitro fracture surface analyses. As visual support, this guidance document will provide micrographs of typical critical ceramic processing flaws, differentiating between pre- versus post sintering cracks, grinding damage related failures and occlusal contact wear origins and of failures due to surface degradation. The documentation emphasizes good labeling of crack features, precise indication of the direction of crack propagation (dcp), identification of the fracture origin, the use of fractographic photomontage of critical flaws or flaw labeling on strength data graphics. A compilation of recommendations for specific applications of fractography in Dentistry is also provided. This guidance document will contribute to a more accurate use of fractography and help researchers to better identify, describe and understand the causes of failure, for both clinical and laboratory-scale situations. If adequately performed at a large scale, fractography will assist in optimizing the methods of processing and designing of restorative materials and components. Clinical failures may be better understood and consequently reduced by sending out the correct message regarding the fracture origin in clinical trials. Copyright © 2017 The Academy of Dental Materials. All rights reserved.

49 CFR 236.1037 - Records retention.

Code of Federal Regulations, 2010 CFR

2010-10-01

... railroad shall: (1) Report the inconsistency in writing by mail, facsimile, e-mail, or hand delivery to the... approved Type Approval, if any, PTCDP, and PTCSP that it holds; (2) Adequate documentation to demonstrate..., DC 20590, within 15 days of discovery. Documents that are hand delivered must not be enclosed in an...

7 CFR 1709.108 - Supporting data for determining community eligibility.

Code of Federal Regulations, 2013 CFR

2013-01-01

... UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ASSISTANCE TO HIGH ENERGY COST COMMUNITIES RUS High Energy Cost... include the following: (a) Documentation of energy costs. Documents or references to published or other... eligibility, or where such information is unavailable or does not adequately reflect the actual cost of...

7 CFR 1709.108 - Supporting data for determining community eligibility.

Code of Federal Regulations, 2011 CFR

2011-01-01

... UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ASSISTANCE TO HIGH ENERGY COST COMMUNITIES RUS High Energy Cost... include the following: (a) Documentation of energy costs. Documents or references to published or other... eligibility, or where such information is unavailable or does not adequately reflect the actual cost of...

7 CFR 1709.108 - Supporting data for determining community eligibility.

Code of Federal Regulations, 2012 CFR

2012-01-01

... UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ASSISTANCE TO HIGH ENERGY COST COMMUNITIES RUS High Energy Cost... include the following: (a) Documentation of energy costs. Documents or references to published or other... eligibility, or where such information is unavailable or does not adequately reflect the actual cost of...

7 CFR 1709.108 - Supporting data for determining community eligibility.

Code of Federal Regulations, 2014 CFR

2014-01-01

... UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ASSISTANCE TO HIGH ENERGY COST COMMUNITIES RUS High Energy Cost... include the following: (a) Documentation of energy costs. Documents or references to published or other... eligibility, or where such information is unavailable or does not adequately reflect the actual cost of...

MagIC: Geomagnetic Applications from Earth History to Archeology

NASA Astrophysics Data System (ADS)

Constable, C.; Tauxe, L.; Koppers, A.; Minnett, R.; Jarboe, N.

2016-12-01

Major scientific challenges increasingly require an interdisciplinary approach, and highlight the need for open archives, incorporating visualization and analysis tools that are flexible enough to address novel research problems. Increasingly modern standards for publication are (or should be) demanding direct links to data, data citations, and adequate documentation that allow other researchers direct access to the fundamental measurements and analyses producing the results. Carefully documented metadata are essential and data models may need considerable complexity to accommodate re-use of observations originally collected with a different purpose in mind. The Magnetics Information Consortium (MagIC) provides an online home for all kinds of paleo-, archeo-magnetic, rock, and environmental magnetic data, from documentation of fieldwork, through lab protocols, to interpretations in terms of geomagnetic history. Examples of their application to understanding geomagnetic field behavior, archeological dating, and voyages of exploration to discover America will be used to highlight best practices and illustrate unexpected benefits of data archived using best practices with the goal of maintaining high standards for reproducibility.

ADM guidance-Ceramics: all-ceramic multilayer interfaces in dentistry.

PubMed

Lohbauer, Ulrich; Scherrer, Susanne S; Della Bona, Alvaro; Tholey, Michael; van Noort, Richard; Vichi, Alessandro; Kelly, J Robert; Cesar, Paulo F

2017-06-01

This guidance document describes the specific issues involved in dental multilayer ceramic systems. The material interactions with regard to specific thermal and mechanical properties are reviewed and the characteristics of dental tooth-shaped processing parameters (sintering, geometry, thickness ratio, etc.) are discussed. Several techniques for the measurement of bond quality and residual stresses are presented with a detailed discussion of advantages and disadvantages. In essence no single technique is able to describe adequately the all-ceramic interface. Invasive or semi-invasive methods have been shown to distort the information regarding the residual stress state while non-invasive methods are limited due to resolution, field of focus or working depth. This guidance document has endeavored to provide a scientific basis for future research aimed at characterizing the ceramic interface of dental restorations. Along with the methodological discussion it is seeking to provide an introduction and guidance to relatively inexperienced researchers. Copyright © 2017 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Transonic flow about a thick circular-arc airfoil

NASA Technical Reports Server (NTRS)

Mcdevitt, J. B.; Levy, L. L., Jr.; Deiwert, G. S.

1975-01-01

An experimental and theoretical study of transonic flow over a thick airfoil, prompted by a need for adequately documented experiments that could provide rigorous verification of viscous flow simulation computer codes, is reported. Special attention is given to the shock-induced separation phenomenon in the turbulent regime. Measurements presented include surface pressures, streamline and flow separation patterns, and shadowgraphs. For a limited range of free-stream Mach numbers the airfoil flow field is found to be unsteady. Dynamic pressure measurements and high-speed shadowgraph movies were taken to investigate this phenomenon. Comparisons of experimentally determined and numerically simulated steady flows using a new viscous-turbulent code are also included. The comparisons show the importance of including an accurate turbulence model. When the shock-boundary layer interaction is weak the turbulence model employed appears adequate, but when the interaction is strong, and extensive regions of separation are present, the model is inadequate and needs further development.

An Ada implementation of the network manager for the advanced information processing system

NASA Technical Reports Server (NTRS)

Nagle, Gail A.

1986-01-01

From an implementation standpoint, the Ada language provided many features which facilitated the data and procedure abstraction process. The language supported a design which was dynamically flexible (despite strong typing), modular, and self-documenting. Adequate training of programmers requires access to an efficient compiler which supports full Ada. When the performance issues for real time processing are finally addressed by more stringent requirements for tasking features and the development of efficient run-time environments for embedded systems, the full power of the language will be realized.

Use of Ni63 Overvoltage Gap Switches in the Flight Termination Systems on Boosters Launched from U.S. Army Kwajalein Atoll (USAKA)

DTIC Science & Technology

1990-05-01

J3 w c’f oz us~ w - 0n fn 00:1 0 Ic 0 L o 0j 0 0I LL 0 Iof the less than adequate reliability of the earlier Exploding Foil Initiator ( EFI ) design...Action and Alternatives EFI Exploding Foil Initiator Environmental Assessment (EA) A concise public document in which a Federal agency provides...Interceptor (GBI) firing unit (the Explosive Foil Initiator ) was built and tested, it operated unreliably. Many hardware development problems were

Guidelines for Good Epidemiology Practices for Occupational and Environmental Epidemiologic Research. The Chemical Manufacturers Association's Epidemiology Task Group.

PubMed

1991-12-01

The Guidelines for Good Epidemiology Practices (GEPs) for Occupational and Environmental Epidemiologic Research address the conduct of studies generally undertaken to answer questions about human health in relationship to the work place or the environment. The GEPs propose minimum practices and procedures that should be considered to help ensure the quality and integrity of data used in epidemiologic research and to provide adequate documentation of the research methods. The GEPs address the process of conducting individual epidemiologic studies and do not prescribe specific research methods. The Guidelines for Good Epidemiology Practices propose minimum practices and procedures in the following areas: I. Organization and Personnel II. Facilities, Resource Commitment, and Contractors III. Protocol IV. Review and Approval V. Study Conduct VI. Communication VII. Archiving VIII. Quality Assurance Although the Guidelines for Good Epidemiology Practices will not guarantee good epidemiology, they do provide a useful framework for ensuring that all research issues are adequately addressed. This framework is proposed as a first step in improving epidemiologic research practices through adherence to sound scientific research principles. Appendices provide an overview of standard operating procedures, a glossary of terms used in the Guidelines, and suggested references on occupational epidemiology methods.

Librarianship and Documentation Studies: A Handbook of Teaching and Learning Materials. Volume 2.

ERIC Educational Resources Information Center

Huttemann, Lutz, Ed.

The improvement of information infrastructures in the eastern and southern sub-region of Africa through the adequate training of personnel for libraries and information establishments is one of the major objectives of the Education, Science and Documentation Centre of the German Foundation for International Development (DSE). This reader, designed…

SeaWiFS Technical Report Series. Volume 7: Cloud screening for polar orbiting visible and infrared (IR) satellite sensors

NASA Technical Reports Server (NTRS)

Darzi, Michael; Hooker, Stanford B. (Editor); Firestone, Elaine R. (Editor)

1992-01-01

Methods for detecting and screening cloud contamination from satellite derived visible and infrared data are reviewed in this document. The methods are applicable to past, present, and future polar orbiting satellite radiometers. Such instruments include the Coastal Zone Color Scanner (CZCS), operational from 1978 through 1986; the Advanced Very High Resolution Radiometer (AVHRR); the Sea-viewing Wide Field-of-view Sensor (SeaWiFS), scheduled for launch in August 1993; and the Moderate Resolution Imaging Spectrometer (IMODIS). Constant threshold methods are the least demanding computationally, and often provide adequate results. An improvement to these methods are the least demanding computationally, and often provide adequate results. An improvement to these methods is to determine the thresholds dynamically by adjusting them according to the areal and temporal distributions of the surrounding pixels. Spatial coherence methods set thresholds based on the expected spatial variability of the data. Other statistically derived methods and various combinations of basic methods are also reviewed. The complexity of the methods is ultimately limited by the computing resources. Finally, some criteria for evaluating cloud screening methods are discussed.

Space Communication Artificial Intelligence for Link Evaluation Terminal (SCAILET)

NASA Technical Reports Server (NTRS)

Shahidi, Anoosh K.; Schlegelmilch, Richard F.; Petrik, Edward J.; Walters, Jerry L.

1992-01-01

A software application to assist end-users of the high burst rate (HBR) link evaluation terminal (LET) for satellite communications is being developed. The HBR LET system developed at NASA Lewis Research Center is an element of the Advanced Communications Technology Satellite (ACTS) Project. The HBR LET is divided into seven major subsystems, each with its own expert. Programming scripts, test procedures defined by design engineers, set up the HBR LET system. These programming scripts are cryptic, hard to maintain and require a steep learning curve. These scripts were developed by the system engineers who will not be available for the end-users of the system. To increase end-user productivity a friendly interface needs to be added to the system. One possible solution is to provide the user with adequate documentation to perform the needed tasks. With the complexity of this system the vast amount of documentation needed would be overwhelming and the information would be hard to retrieve. With limited resources, maintenance is another reason for not using this form of documentation. An advanced form of interaction is being explored using current computer techniques. This application, which incorporates a combination of multimedia and artificial intelligence (AI) techniques to provided end-users with an intelligent interface to the HBR LET system, is comprised of an intelligent assistant, intelligent tutoring, and hypermedia documentation. The intelligent assistant and tutoring systems address the critical programming needs of the end-user.

Analysis of British American Tobacco's questionable use of privilege and protected document claims at the Guildford Depository

PubMed Central

LeGresley, Eric; Lee, Kelley

2017-01-01

Background Tobacco companies have a documented history of attempting to hide information from public scrutiny, including inappropriate privilege claims. The 1998 Minnesota Consent Judgement created two depositories to provide public access to discovered documents. Users raised concerns about the access conditions and ongoing integrity of the Guildford Depository collection operated until 2015 by British American Tobacco (BAT). Methods A metadata search of the Legacy Tobacco Documents Library identified inconsistent privilege claims, and duplicates of documents withheld by BAT from public visitors. A review of the validity of claims, for documents obtained through these searches, was conducted against recognised legal definitions of privilege. Findings BAT has asserted inappropriate privilege claims over 49% of the documents reviewed (n=63). The quantity of such claims and consistency of the stated rationale for the privilege claims suggest a concerted effort rather than human error. Conclusions There was insufficient attention given to the operation of the Guildford Depository by the original plaintiffs, including to the subsequent use of privilege claims. Appropriate access to these documents, commensurate with the terms of legal settlements creating the collection, was critical given their public interest value for enhancing understanding of industry strategies and activities, informing of policy interventions, and for holding the industry to account. Future legal settlements should prevent defendants from subsequently withholding disclosed documents, aside from those legitimately privileged, from public view. Control of publicly disclosed documents should not be placed back into the hands of defendant tobacco companies. Plaintiffs also need to invest adequate resources into policing claims of legal privilege. PMID:27354678

An introductory pharmacy practice experience based on a medication therapy management service model.

PubMed

Agness, Chanel F; Huynh, Donna; Brandt, Nicole

2011-06-10

To implement and evaluate an introductory pharmacy practice experience (IPPE) based on the medication therapy management (MTM) service model. Patient Care 2 is an IPPE that introduces third-year pharmacy students to the MTM service model. Students interacted with older adults to identify medication-related problems and develop recommendations using core MTM elements. Course outcome evaluations were based on number of documented medication-related problems, recommendations, and student reviews. Fifty-seven older adults participated in the course. Students identified 52 medication-related problems and 66 medical problems, and documented 233 recommendations relating to health maintenance and wellness, pharmacotherapy, referrals, and education. Students reported having adequate experience performing core MTM elements. Patient Care 2 may serve as an experiential learning model for pharmacy schools to teach the core elements of MTM and provide patient care services to the community.

Standard classification of software documentation

NASA Technical Reports Server (NTRS)

Tausworthe, R. C.

1976-01-01

General conceptual requirements for standard levels of documentation and for application of these requirements to intended usages. These standards encourage the policy to produce only those forms of documentation that are needed and adequate for the purpose. Documentation standards are defined with respect to detail and format quality. Classes A through D range, in order, from the most definitive down to the least definitive, and categories 1 through 4 range, in order, from high-quality typeset down to handwritten material. Criteria for each of the classes and categories, as well as suggested selection guidelines for each are given.

Improving the Product Documentation Process of a Small Software Company

NASA Astrophysics Data System (ADS)

Valtanen, Anu; Ahonen, Jarmo J.; Savolainen, Paula

Documentation is an important part of the software process, even though it is often neglected in software companies. The eternal question is how much documentation is enough. In this article, we present a practical implementation of lightweight product documentation process resulting from SPI efforts in a small company. Small companies’ financial and human resources are often limited. The documentation process described here, offers a template for creating adequate documentation consuming minimal amount of resources. The key element of the documentation process is an open source web-based bugtracking system that was customized to be used as a documentation tool. The use of the tool enables iterative and well structured documentation. The solution best serves the needs of a small company with off-the-shelf software products and striving for SPI.

African American men's understanding and perceptions about prostate cancer: why multiple dimensions of health literacy are important in cancer communication.

PubMed

Friedman, Daniela B; Corwin, Sara J; Dominick, Gregory M; Rose, India D

2009-10-01

Prostate cancer (PrCA) is the most diagnosed cancer among men in the United States, especially among African American (AA) men. The purpose of this formative study was to explore the implications of applying Nutbeam's multidimensional health literacy framework to AA men's understanding of PrCA information. Participants were 25 AA men aged 45 and older in South Carolina. Their functional health literacy was assessed using two modified Cloze tests and the Shortened Test of Functional Health Literacy in Adults (S-TOFHLA). Men also participated in interviews or focus groups during which they were asked questions about PrCA risk, prevention, and screening. Transcripts were reviewed for recurrent themes and analyzed qualitatively using NVivo7. Mean S-TOFHLA was 28.28 (+/-1.98), implying "adequate" comprehension. Mean Cloze was .71 (+/-.05) for a Grade 8 document and .66 (+/-.04) for a Grade 13 document, also showing "adequate" comprehension. Cloze scores for the Grade 8 resource were lower for participants with less education (P = .047). Despite having satisfactory literacy test scores, results from interviews and focus groups revealed participants' limited understanding and misconceptions about PrCA risk. Many wanted information about screening and family history delivered word-of-mouth by AA women and church pastors as few of them had ever received or actively sought out PrCA resources. Using Nutbeam's framework, gaps in health literacy which were not adequately captured by the validated tools emerged during the interviews and focus groups. Study findings provide important implications for PrCA communication with AA men to correct misperceptions about cancer risk and motivate preventive behaviors.

Endoscopic ultrasound guided fine needle aspiration and useful ancillary methods

PubMed Central

Tadic, Mario; Stoos-Veic, Tajana; Kusec, Rajko

2014-01-01

The role of endoscopic ultrasound (EUS) in evaluating pancreatic pathology has been well documented from the beginning of its clinical use. High spatial resolution and the close proximity to the evaluated organs within the mediastinum and abdominal cavity allow detection of small focal lesions and precise tissue acquisition from suspected lesions within the reach of this method. Fine needle aspiration (FNA) is considered of additional value to EUS and is performed to obtain tissue diagnosis. Tissue acquisition from suspected lesions for cytological or histological analysis allows, not only the differentiation between malignant and non-malignant lesions, but, in most cases, also the accurate distinction between the various types of malignant lesions. It is well documented that the best results are achieved only if an adequate sample is obtained for further analysis, if the material is processed in an appropriate way, and if adequate ancillary methods are performed. This is a multi-step process and could be quite a challenge in some cases. In this article, we discuss the technical aspects of tissue acquisition by EUS-guided-FNA (EUS-FNA), as well as the role of an on-site cytopathologist, various means of specimen processing, and the selection of the appropriate ancillary method for providing an accurate tissue diagnosis and maximizing the yield of this method. The main goal of this review is to alert endosonographers, not only to the different possibilities of tissue acquisition, namely EUS-FNA, but also to bring to their attention the importance of proper sample processing in the evaluation of various lesions in the gastrointestinal tract and other accessible organs. All aspects of tissue acquisition (needles, suction, use of stylet, complications, etc.) have been well discussed lately. Adequate tissue samples enable comprehensive diagnoses, which answer the main clinical questions, thus enabling targeted therapy. PMID:25339816

Perceptions of housing conditions among migrant farmworkers and their families: implications for health, safety and social policy.

PubMed

Keim-Malpass, Jessica; Spears Johnson, Chaya R; Quandt, Sara A; Arcury, Thomas A

2015-01-01

In the USA, migrant farmworkers are a vulnerable group due to their low socioeconomic status, risk of occupational exposures and injury, lack of social mobility, lack of adequate access to health services and dependency on employer for provided housing. Previous reports have documented migrant farmworker housing conditions to be variable, but poor overall. This paper explores the perceptions of housing conditions among migrant farmworkers in rural North Carolina, and develops an understanding of potential impacts of their housing on health and safety. This study used qualitative descriptive data and directed content analysis to analyse semi-structured interviews and photographs that were data elements of a larger community-based participatory research study designed to document housing quality and health among North Carolina farmworkers. Many of the study participants described poor housing conditions that were reflected in the photographic analysis of the houses and camps. Specific problems described by the participants include exposure to pesticides, safety issues, pests, water supply and air quality, temperature and moisture. This study describes migrant farmworkers' perceptions of housing quality and numerous potential impacts on health and safety. Research, social policy and practice-based implications derived from this research could serve to improve the health status of these individuals and their families. This study suggests there is much room for sustained advocacy and action, given that many of the farmworkers' descriptions and photographs depicted housing conditions below accepted standards of living. Access to adequate and safe employer-provided housing for migrant farmworkers should be considered a basic human right.

Perceptions of housing conditions among migrant farmworkers and their families: Implications for health, safety and social policy

PubMed Central

Keim-Malpass, Jessica; Spears, Chaya R.; Quandt, Sara A.; Arcury, Thomas A.

2016-01-01

Introduction In the United States, migrant farmworkers are a vulnerable group due to their low socioeconomic status, risk of occupational exposures and injury, lack of social mobility, lack of adequate access to health services and dependency on employer for provided housing. Previous reports have documented migrant farmworker housing conditions to be variable, but poor overall. This paper explores the perceptions of housing conditions among migrant farmworkers in rural North Carolina, as well as understanding potential impacts of their housing on health and safety. Methods This study used qualitative descriptive data and directed content analysis to analyze semi-structured interviews and photographs that were data elements of a larger community-based participatory research study designed to document housing quality and health among North Carolina farmworkers. Results Many of the study participants described poor housing conditions that were reflected in the photographic analysis of the houses and camps. Specific problems described by the participants include: exposure to pesticides, safety issues, pests, water supply and air quality, temperature and moisture. Conclusions This study describes migrant farmworkers’ perceptions of housing quality and numerous potential impacts on health and safety. Research, social policy and practice-based implications derived from this research could serve to improve the health status of these individuals and their families. This study suggests there is much room for sustained advocacy and action, given that many of the farmworkers’ descriptions and photographs depicted housing conditions below accepted standards of living. Access to adequate and safe employer-provided housing for migrant farmworkers should be considered a basic human right. PMID:25682066

Quality expectations and tolerance limits of trial master files (TMF) – Developing a risk-based approach for quality assessments of TMFs

PubMed Central

Hecht, Arthur; Busch-Heidger, Barbara; Gertzen, Heiner; Pfister, Heike; Ruhfus, Birgit; Sanden, Per-Holger; Schmidt, Gabriele B.

2015-01-01

This article addresses the question of when a trial master file (TMF) can be considered sufficiently accurate and complete: What attributes does the TMF need to have so that a clinical trial can be adequately reconstructed from documented data and procedures? Clinical trial sponsors face significant challenges in assembling the TMF, especially when dealing with large, international, multicenter studies; despite all newly introduced archiving techniques it is becoming more and more difficult to ensure that the TMF is complete. This is directly reflected in the number of inspection findings reported and published by the EMA in 2014. Based on quality risk management principles in clinical trials the authors defined the quality expectations for the different document types in a TMF and furthermore defined tolerance limits for missing documents. This publication provides guidance on what type of documents and processes are most important, and in consequence, indicates on which documents and processes trial team staff should focus in order to achieve a high-quality TMF. The members of this working group belong to the CQAG Group (Clinical Quality Assurance Germany) and are QA (quality assurance) experts (auditors or compliance functions) with long-term experience in the practical handling of TMFs. PMID:26693218

Quality expectations and tolerance limits of trial master files (TMF) - Developing a risk-based approach for quality assessments of TMFs.

PubMed

Hecht, Arthur; Busch-Heidger, Barbara; Gertzen, Heiner; Pfister, Heike; Ruhfus, Birgit; Sanden, Per-Holger; Schmidt, Gabriele B

2015-01-01

This article addresses the question of when a trial master file (TMF) can be considered sufficiently accurate and complete: What attributes does the TMF need to have so that a clinical trial can be adequately reconstructed from documented data and procedures? Clinical trial sponsors face significant challenges in assembling the TMF, especially when dealing with large, international, multicenter studies; despite all newly introduced archiving techniques it is becoming more and more difficult to ensure that the TMF is complete. This is directly reflected in the number of inspection findings reported and published by the EMA in 2014. Based on quality risk management principles in clinical trials the authors defined the quality expectations for the different document types in a TMF and furthermore defined tolerance limits for missing documents. This publication provides guidance on what type of documents and processes are most important, and in consequence, indicates on which documents and processes trial team staff should focus in order to achieve a high-quality TMF. The members of this working group belong to the CQAG Group (Clinical Quality Assurance Germany) and are QA (quality assurance) experts (auditors or compliance functions) with long-term experience in the practical handling of TMFs.

Westinghouse Hanford Company (WHC) standards/requirements identification document (S/RID)

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

Bennett, G.L.

1996-03-15

This Standards/Requirements Identification Document (S/RID) set forth the Environmental Safety and Health (ES&H) standards/requirements for Westinghouse Hanford Company Level Programs, where implementation and compliance is the responsibility of these organizations. These standards/requirements are adequate to ensure the protection of the health and safety of workers, the public, and the environment.

Preoperative selection of patients with colorectal cancer liver metastasis for hepatic resection

PubMed Central

Mattar, Rafif E; Al-alem, Faisal; Simoneau, Eve; Hassanain, Mazen

2016-01-01

Surgical resection of colorectal liver metastases (CRLM) has a well-documented improvement in survival. To benefit from this intervention, proper selection of patients who would be adequate surgical candidates becomes vital. A combination of imaging techniques may be utilized in the detection of the lesions. The criteria for resection are continuously evolving; currently, the requirements that need be met to undergo resection of CRLM are: the anticipation of attaining a negative margin (R0 resection), whilst maintaining an adequate functioning future liver remnant. The timing of hepatectomy in regards to resection of the primary remains controversial; before, after, or simultaneously. This depends mainly on the tumor burden and symptoms from the primary tumor. The role of chemotherapy differs according to the resectability of the liver lesion(s); no evidence of improved survival was shown in patients with resectable disease who received preoperative chemotherapy. Presence of extrahepatic disease in itself is no longer considered a reason to preclude patients from resection of their CRLM, providing limited extra-hepatic disease, although this currently is an area of active investigations. In conclusion, we review the indications, the adequate selection of patients and perioperative factors to be considered for resection of colorectal liver metastasis. PMID:26811608

Adequacy of physician documentation and correlation with assessment of transfusion appropriateness: a follow-up study in the setting of prospective audits and patient blood management.

PubMed

Madrigal, Emilio; Prajapati, Shyam; Avadhani, Vaidehi; Annen, Kyle; Friedman, Mark T

2017-02-01

A previous study in our hospitals correlated suboptimal documentation and failure to justify transfusions. In light of implemented blood-conservation strategies, including patient blood management (PBM) and prospective audits (PAs), we performed a follow-up study. We reviewed prospectively audited red blood cell (RBC) transfusions received by adult patients from January to July 2014. Survey forms were used to assess the level of documentation and to classify documentation as adequate, intermediate, or inadequate. Transfusions were deemed justified or not by comparisons with hospital transfusion guidelines. We also analyzed the effect of implemented blood-conservation strategies on our hospital transfusion rates and costs from 2009 to 2015. During the study period, there were 259 prospectively audited transfusion events (TEs) (one or more RBC units transfused to a patient), of which we reviewed 94 TEs (36.3%) in 87 patients. TEs with suboptimal (intermediate and inadequate) documentation accounted for 46.8% of the reviewed TEs, of which 81.8% could not be justified compared with 18.0% of nonjustified, adequately documented TEs. The correlation between suboptimal documentation and failure to justify transfusion was significant (p < 0.001). This correlation remained even in a comparison between the site with a PBM program and the sites without such a program. Overall transfusion rates declined after the introduction of PA, although the decline was only statistically significant at the sites with a PBM program. Suboptimal transfusion documentation remains problematic and is highly correlated with nonjustifiable transfusions. Newly adopted approaches to minimize blood transfusions have not improved transfusion documentation and corresponding out-of-guideline transfusions, although overall transfusions have been reduced by PA, particularly in the setting of a PBM program. © 2016 AABB.

Army General Fund Adjustments Not Adequately Documented or Supported

DTIC Science & Technology

2016-07-26

compilation process. Finding The Office of the Assistant Secretary of the Army (Financial Management & Comptroller) (OASA[FM&C]) and the Defense Finance and...statements were unreliable and lacked an adequate audit trail. Furthermore, DoD and Army managers could not rely on the data in their accounting...systems when making management and resource decisions. Until the Army and DFAS Indianapolis correct these control deficiencies, there is considerable

Factors influencing work productivity and intent to stay in nursing.

PubMed

Letvak, Susan; Buck, Raymond

2008-01-01

The researchers document the individual and workplace characteristics associated with decreased work productivity and intent to stay in nursing for nurses employed in direct patient care in the hospital setting. Factors associated with decreased work productivity were age, total years worked as a RN, quality of care provided, job stress score, having had a job injury, and having a health problem. Nurse leaders must place additional efforts on changes needed to improve the hospital workplace environment to decrease job stress, improve RNs' ability to provide quality care, and to assure the health and safety of nurses. Reducing job stress and providing adequate staffing so quality of care can be provided will enhance job satisfaction which will also encourage RNs to stay at the bedside. Improved work environments may delay older RNs' retirement from the workforce.

Respiratory support in patients with acute respiratory distress syndrome: an expert opinion.

PubMed

Chiumello, Davide; Brochard, Laurent; Marini, John J; Slutsky, Arthur S; Mancebo, Jordi; Ranieri, V Marco; Thompson, B Taylor; Papazian, Laurent; Schultz, Marcus J; Amato, Marcelo; Gattinoni, Luciano; Mercat, Alain; Pesenti, Antonio; Talmor, Daniel; Vincent, Jean-Louis

2017-09-12

Acute respiratory distress syndrome (ARDS) is a common condition in intensive care unit patients and remains a major concern, with mortality rates of around 30-45% and considerable long-term morbidity. Respiratory support in these patients must be optimized to ensure adequate gas exchange while minimizing the risks of ventilator-induced lung injury. The aim of this expert opinion document is to review the available clinical evidence related to ventilator support and adjuvant therapies in order to provide evidence-based and experience-based clinical recommendations for the management of patients with ARDS.

Report of NPSAT1 Battery Thermal Contact Resistance Testing, Modeling and Simulation

DTIC Science & Technology

2012-10-01

lithium ion battery is the spacecraft component with the smallest temperature range of 0?C to 45?C during operation. Thermal analysis results, however, can only provide adequate results if there is sufficient fidelity in thermal modeling. Arguably, the values used in defining thermal coupling for components are the most difficult to estimate because of the many variables that define them. This document describes the work performed by the authors starting in the 2012 winter quarter as part of the SS3900 directed study course. The objectives of the study were to

Joint FAM/Line Management Assessment Report on LLNL Machine Guarding Safety Program

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

Armstrong, J. J.

2016-07-19

The LLNL Safety Program for Machine Guarding is implemented to comply with requirements in the ES&H Manual Document 11.2, "Hazards-General and Miscellaneous," Section 13 Machine Guarding (Rev 18, issued Dec. 15, 2015). The primary goal of this LLNL Safety Program is to ensure that LLNL operations involving machine guarding are managed so that workers, equipment and government property are adequately protected. This means that all such operations are planned and approved using the Integrated Safety Management System to provide the most cost effective and safest means available to support the LLNL mission.

Review of Urinalysis Drug Testing Program. Report by a Panel of Army and Civilian Experts in Toxicology and Drug Testing Legal Issues for the Surgeon General of the U.S. Army

DTIC Science & Technology

1983-12-12

the National Institute on Drug Abuse (NIDA). Dr. Simon is a consultant on forensic toxicology and currently is the Director of Industrial...THC ratio algorithm, and no laboratory has the personnel trained to provide forensic testimony on the THC or other drug GC/MS data. d. The GC/MS...adequate expertise to support GC/MS internally and forensically document (for courts-martial) GC/MS. The USAF Homestead AFB case is a glaring example of

Analysis of British American Tobacco's questionable use of privilege and protected document claims at the Guildford Depository.

PubMed

LeGresley, Eric; Lee, Kelley

2017-05-01

Tobacco companies have a documented history of attempting to hide information from public scrutiny, including inappropriate privilege claims. The 1998 Minnesota Consent Judgement created two depositories to provide public access to discovered documents. Users raised concerns about the access conditions and ongoing integrity of the Guildford Depository collection operated until 2015 by British American Tobacco (BAT). A metadata search of the Legacy Tobacco Documents Library identified inconsistent privilege claims, and duplicates of documents withheld by BAT from public visitors. A review of the validity of claims, for documents obtained through these searches, was conducted against recognised legal definitions of privilege. BAT has asserted inappropriate privilege claims over 49% of the documents reviewed (n=63). The quantity of such claims and consistency of the stated rationale for the privilege claims suggest a concerted effort rather than human error. There was insufficient attention given to the operation of the Guildford Depository by the original plaintiffs, including to the subsequent use of privilege claims. Appropriate access to these documents, commensurate with the terms of legal settlements creating the collection, was critical given their public interest value for enhancing understanding of industry strategies and activities, informing of policy interventions, and for holding the industry to account. Future legal settlements should prevent defendants from subsequently withholding disclosed documents, aside from those legitimately privileged, from public view. Control of publicly disclosed documents should not be placed back into the hands of defendant tobacco companies. Plaintiffs also need to invest adequate resources into policing claims of legal privilege. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Age Discrimination: Quality of Enforcement. Hearing before the Select Committee on Aging. House of Representatives, One Hundredth Congress, Second Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Select Committee on Aging.

The text of a Congressional hearing exploring whether there is validity to complaints that the Equal Employment Opportunity Commission (EEOC) is not adequately and effectively enforcing the protections of the Age Discrimination in Employment Act is presented in this document. The document begins with the opening statement of committee chairman…

Response of School Districts to the New York State Concussion Awareness and Management Act: Review of Policies and Procedures.

PubMed

Kajankova, Maria; Oswald, Jennifer M; Terranova, Lauren M; Kaplen, Michael V; Ambrose, Anne F; Spielman, Lisa A; Gordon, Wayne A

2017-06-01

By 2014, all states implemented concussion laws that schools must translate into daily practice; yet, limited knowledge exists regarding implementation of these laws. We examined the extent to which concussion management policies and procedure (P&P) documents of New York State school districts comply with the State's Concussion Awareness and Management Act (the Act). We also aimed to identify barriers to compliance. Forty-seven school districts provided P&P documents. We examined compliance with the Act and the relationship between compliance and each district's demographics. Compliance varied across school districts, with higher overall compliance in large city school districts compared to county districts. However, there was low compliance for several critical items. We found no statistically significant relationship between compliance and demographics. School districts need to increase compliance with concussion legislation to ensure the adequate implementation necessary for the law to impact health and educational outcomes. The results provide important information to individuals charged with the responsibility of implementation and ultimately reducing the negative outcomes associated with brain injuries in schools. © 2017, American School Health Association.

Republic Act No. 6734, 1 August 1989.

PubMed

1989-01-01

This document contains provisions of the Republic Act No. 6734 of August 1989 which sets forth the Organic Act for the Autonomous Region of Mindanao. Article 9 creates a Shari'ah Appellate Court for the Region which will have jurisdiction over cases involving persons, family, and property relations. Article 11 calls on the Regional Government to protect the ancestral domain and lands of the indigenous population. The Regional Assembly is directed to enact legislation covering child health and development, the condition of women and status of the indigenous population, and the registration of vital statistics. The Regional Government is also to create a housing program that will provide adequate, low-cost housing and other basic services. The family is recognized as the foundation of the nation, and the role of women in nation-building and regional development is acknowledged. Women will be adequately represented in appropriate decision- and policy-making bodies, and the government will take appropriate action against all forms of exploitation of and discrimination against women.

Report on SARS backfit evaluation, Catalytic, Inc. Solvent Refined Coal Pilot Plant, Wilsonville, Alabama

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

Meyer, A.F. Jr.

1980-07-02

A site visit was made in company with the DOE-OPTA-EA Safety and Health Official for the purpose of providing that official with technical assistance in evaluating the validity of an earlier DOE-OPTA recommendation exempting this facility from the Safety and Analysis and Review backfit requirements of DOE Order 5481.1. A further purpose of the visit was to assess and evaluate the occupational safety and health program at this facility, as compared with the criteria and guidelines contained in ASFE Order 5481.1. Adequate documentation regarding compliance with codes, standards, and regulations were observed at this facility. There is in existence anmore » ongoing continuous safety analysis effort for both modifications or additions to this facility. Adequate environmental safeguards and plans and procedures were observed. The SARS backfit exemption is appropriate. The occupational safety and health program is in many ways a model for the scope of work and nature of hazards involved, and is consistent with ASFE guidelines and statutory requirements.« less

28 CFR 68.41 - Official notice.

Code of Federal Regulations, 2010 CFR

2010-07-01

... ALIENS, UNFAIR IMMIGRATION-RELATED EMPLOYMENT PRACTICES, AND DOCUMENT FRAUD § 68.41 Official notice... so noticed, and shall be given adequate opportunity to show the contrary. [54 FR 48596, Nov. 24, 1989...

Medical Record Keeping in the Summer Camp Setting.

PubMed

Kaufman, Laura; Holland, Jaycelyn; Weinberg, Stuart; Rosenbloom, S Trent

2016-12-14

Approximately one fifth of school-aged children spend a significant portion of their year at residential summer camp, and a growing number have chronic medical conditions. Camp health records are essential for safe, efficient care and for transitions between camp and home providers, yet little research exists regarding these systems. To survey residential summer camps for children to determine how camps create, store, and use camper health records. To raise awareness in the informatics community of the issues experienced by health providers working in a special pediatric care setting. We designed a web-based electronic survey concerning medical recordkeeping and healthcare practices at summer camps. 953 camps accredited by the American Camp Association received the survey. Responses were consolidated and evaluated for trends and conclusions. Of 953 camps contacted, 298 (31%) responded to the survey. Among respondents, 49.3% stated that there was no computer available at the health center, and 14.8% of camps stated that there was not any computer available to health staff at all. 41.1% of camps stated that internet access was not available. The most common complaints concerning recordkeeping practices were time burden, adequate completion, and consistency. Summer camps in the United States make efforts to appropriately document healthcare given to campers, but inconsistency and inefficiency may be barriers to staff productivity, staff satisfaction, and quality of care. Survey responses suggest that the current methods used by camps to document healthcare cause limitations in consistency, efficiency, and communications between providers, camp staff, and parents. As of 2012, survey respondents articulated need for a standard software to document summer camp healthcare practices that accounts for camp-specific needs. Improvement may be achieved if documentation software offers the networking capability, simplicity, pediatrics-specific features, and avoidance of technical jargon.

Medical records for animals used in research, teaching, and testing: public statement from the American College of Laboratory Animal Medicine.

PubMed

Field, Karl; Bailey, Michele; Foresman, Larry L; Harris, Robert L; Motzel, Sherri L; Rockar, Richard A; Ruble, Gaye; Suckow, Mark A

2007-01-01

Medical records are considered to be a key element of a program of adequate veterinary care for animals used in research, teaching, and testing. However, prior to the release of the public statement on medical records by the American College of Laboratory Animal Medicine (ACLAM), the guidance that was available on the form and content of medical records used for the research setting was not consistent and, in some cases, was considered to be too rigid. To address this concern, ACLAM convened an ad hoc Medical Records Committee and charged the Committee with the task of developing a medical record guideline that was based on both professional judgment and performance standards. The Committee provided ACLAM with a guidance document titled Public Statements: Medical Records for Animals Used in Research, Teaching, and Testing, which was approved by ACLAM in late 2004. The ACLAM public statement on medical records provides guidance on the definition and content of medical records, and clearly identifies the Attending Veterinarian as the individual who is charged with authority and responsibility for oversight of the institution's medical records program. The document offers latitude to institutions in the precise form and process used for medical records but identifies typical information to be included in such records. As a result, the ACLAM public statement on medical records provides practical yet flexible guidelines to assure that documentation of animal health is performed in research, teaching, and testing situations.

A model for a PC-based, universal-format, multimedia digitization system: moving beyond the scanner.

PubMed

McEachen, James C; Cusack, Thomas J; McEachen, John C

2003-08-01

Digitizing images for use in case presentations based on hardcopy films, slides, photographs, negatives, books, and videos can present a challenging task. Scanners and digital cameras have become standard tools of the trade. Unfortunately, use of these devices to digitize multiple images in many different media formats can be a time-consuming and in some cases unachievable process. The authors' goal was to create a PC-based solution for digitizing multiple media formats in a timely fashion while maintaining adequate image presentation quality. The authors' PC-based solution makes use of off-the-shelf hardware applications to include a digital document camera (DDC), VHS video player, and video-editing kit. With the assistance of five staff radiologists, the authors examined the quality of multiple image types digitized with this equipment. The authors also quantified the speed of digitization of various types of media using the DDC and video-editing kit. With regard to image quality, the five staff radiologists rated the digitized angiography, CT, and MR images as adequate to excellent for use in teaching files and case presentations. With regard to digitized plain films, the average rating was adequate. As for performance, the authors recognized a 68% improvement in the time required to digitize hardcopy films using the DDC instead of a professional quality scanner. The PC-based solution provides a means for digitizing multiple images from many different types of media in a timely fashion while maintaining adequate image presentation quality.

7 CFR 1942.126 - Planning, bidding, contracting, constructing, procuring.

Code of Federal Regulations, 2013 CFR

2013-01-01

... evaluate the proposals received or can obtain adequate assistance from other sources, such as State or.... Contract documents must be sufficiently descriptive and legally binding to accomplish the work as...

7 CFR 1942.126 - Planning, bidding, contracting, constructing, procuring.

Code of Federal Regulations, 2012 CFR

2012-01-01

... evaluate the proposals received or can obtain adequate assistance from other sources, such as State or.... Contract documents must be sufficiently descriptive and legally binding to accomplish the work as...

7 CFR 1942.126 - Planning, bidding, contracting, constructing, procuring.

Code of Federal Regulations, 2010 CFR

2010-01-01

... evaluate the proposals received or can obtain adequate assistance from other sources, such as State or.... Contract documents must be sufficiently descriptive and legally binding to accomplish the work as...

7 CFR 1942.126 - Planning, bidding, contracting, constructing, procuring.

Code of Federal Regulations, 2011 CFR

2011-01-01

... evaluate the proposals received or can obtain adequate assistance from other sources, such as State or.... Contract documents must be sufficiently descriptive and legally binding to accomplish the work as...

7 CFR 1942.126 - Planning, bidding, contracting, constructing, procuring.

Code of Federal Regulations, 2014 CFR

2014-01-01

... evaluate the proposals received or can obtain adequate assistance from other sources, such as State or.... Contract documents must be sufficiently descriptive and legally binding to accomplish the work as...

49 CFR 236.917 - Retention of records.

Code of Federal Regulations, 2014 CFR

2014-10-01

...-Based Signal and Train Control Systems § 236.917 Retention of records. (a) What life-cycle and...: (i) For the life-cycle of the product, adequate documentation to demonstrate that the PSP meets the...

49 CFR 236.917 - Retention of records.

Code of Federal Regulations, 2012 CFR

2012-10-01

...-Based Signal and Train Control Systems § 236.917 Retention of records. (a) What life-cycle and...: (i) For the life-cycle of the product, adequate documentation to demonstrate that the PSP meets the...

Independent Review of Simulation of Net Infiltration for Present-Day and Potential Future Climates

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

Review Panel: Soroosh Sorooshian, Ph.D., Panel Chairperson, University of California, Irvine; Jan M. H. Hendrickx, Ph.D., New Mexico Institute of Mining and Technology; Binayak P. Mohanty, Ph.D., Texas A&M University

The DOE Office of Civilian Radioactive Waste Management (OCRWM) tasked Oak Ridge Institute for Science and Education (ORISE) with providing an independent expert review of the documented model and prediction results for net infiltration of water into the unsaturated zone at Yucca Mountain. The specific purpose of the model, as documented in the report MDL-NBS-HS-000023, Rev. 01, is “to provide a spatial representation, including epistemic and aleatory uncertainty, of the predicted mean annual net infiltration at the Yucca Mountain site ...” (p. 1-1) The expert review panel assembled by ORISE concluded that the model report does not provide a technicallymore » credible spatial representation of net infiltration at Yucca Mountain. Specifically, the ORISE Review Panel found that: • A critical lack of site-specific meteorological, surface, and subsurface information prevents verification of (i) the net infiltration estimates, (ii) the uncertainty estimates of parameters caused by their spatial variability, and (iii) the assumptions used by the modelers (ranges and distributions) for the characterization of parameters. The paucity of site-specific data used by the modeling team for model implementation and validation is a major deficiency in this effort. • The model does not incorporate at least one potentially important hydrologic process. Subsurface lateral flow is not accounted for by the model, and the assumption that the effect of subsurface lateral flow is negligible is not adequately justified. This issue is especially critical for the wetter climate periods. This omission may be one reason the model results appear to underestimate net infiltration beneath wash environments and therefore imprecisely represent the spatial variability of net infiltration. • While the model uses assumptions consistently, such as uniform soil depths and a constant vegetation rooting depth, such assumptions may not be appropriate for this net infiltration simulation because they oversimplify a complex landscape and associated hydrologic processes, especially since the model assumptions have not been adequately corroborated by field and laboratory observations at Yucca Mountain.« less

Assessing Living Conditions in Iraq’s Anbar Province in 2009

DTIC Science & Technology

2010-01-01

Defense Research Institute View document details For More Information Purchase this document Browse Books & Publications Make a charitable contribution...new (rather than secondhand ) clothes Replace worn-out furniture and appliances Pay for a funeral Keep your home adequately warm during winter Pay for...and university levels of education. This suggests that most of the money is spent on tuition rather than on uniforms, books , meals, or private

A diagnostic expert system for structured reports, quality assessment, and training of residents in sonography.

PubMed

Huettig, Matthias; Buscher, Georg; Menzel, Thomas; Scheppach, Wolfgang; Puppe, Frank; Buscher, Hans-Peter

2004-03-15

The quality of medical reports on diagnostic procedures has a considerable impact on the quality of medical care. Handwritten or otherwise unstructured reports tend to be incomplete, whereas structured questionnaires are of limited flexibility and not considered case-adequate. Thus, medical reports of this kind may promote an incomplete and misleading documentation and, therefore, be problematic with respect to their reliability. SonoConsult (SC), an expert system for structured and case-adequate documentation of sonographic findings with an additional diagnostic component, was evaluated with respect to user acceptance and suitability for enhancing the quality of reports and supporting sonographic beginners. The expectations and the attitudes of the users toward the program were evaluated by anonymous questionnaires. The documentation of findings and the diagnostic conclusions in 103 free text reports made by experienced examiners were evaluated by subjecting their information to a subsequent input into SC. Free text reports were checked for information that was asked by SC but not mentioned in the reports. In a series of 150 cases, the system diagnoses were blinded during input of findings into SC-questionnaires and the examiners' diagnostic conclusions were compared with the uncovered SC-diagnoses with respect to forgotten diagnoses. The structured and data-driven acquisition of information by the program was well accepted by the users. However, only a medium interest in the system-delivered diagnoses was noted. The program-generated reports were characterized by a more detailed description of the findings and a higher number of diagnoses in comparison to the unstructured reports before introduction of SC as the only documentation system. When unaware of the system diagnoses, information was entered into the questionnaires, and SC generated some diagnoses which were not mentioned by the examiners in their conclusions. The possibility to inspect the system diagnoses led to an enhancement of the number of diagnoses the examiners mentioned in their conclusions. By contrast, the examiners meant that the influence of the program on their conclusions was minimal or dispensable. Beginners in sonography acknowledged that the program led them to perform a complete examination in an adequate sequence. An expert system for the data-driven, case-adequate information acquisition of abdominal ultrasound examinations may enhance the quality of the reports and, potentially, of the examinations at the same time. In addition, it may help beginners to learn a structured problem- and finding-adequate examination sequence.

13 CFR 307.13 - Records and retention.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) Maintain adequate accounting records and source documentation to substantiate the amount and percent of RLF..., unless fraud is at issue. [71 FR 56675, Sept. 27, 2006, as amended at 73 FR 62867, Oct. 22, 2008] ...

Abbott Opinions #1-5.

ERIC Educational Resources Information Center

Education Law Center, Inc., Newark, NJ.

This document contains the following "Abbott Opinions": (1) "Early Childhood Education"; (2) "Adequate School Facilities"; (3) "Supplemental Programs and Whole School Reform in Elementary Schools"; (4) "Supplemental Programs in Middle and High Schools"; and (5) "Planning Programs and Budgets…

Subsonic stability and control derivatives for an unpowered, remotely piloted 3/8-scale F-15 airplane model obtained from flight test

NASA Technical Reports Server (NTRS)

Iliff, K. W.; Maine, R. E.; Shafer, M. F.

1976-01-01

In response to the interest in airplane configuration characteristics at high angles of attack, an unpowered remotely piloted 3/8-scale F-15 airplane model was flight tested. The subsonic stability and control characteristics of this airplane model over an angle of attack range of -20 to 53 deg are documented. The remotely piloted technique for obtaining flight test data was found to provide adequate stability and control derivatives. The remotely piloted technique provided an opportunity to test the aircraft mathematical model in an angle of attack regime not previously examined in flight test. The variation of most of the derivative estimates with angle of attack was found to be consistent, particularly when the data were supplemented by uncertainty levels.

Deep Energy Retrofit Guidance for the Building America Solutions Center

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

Less, Brennan; Walker, Iain

2015-01-01

The U.S. DOE Building America program has established a research agenda targeting market-relevant strategies to achieve 40% reductions in existing home energy use by 2030. Deep Energy Retrofits (DERs) are part of the strategy to meet and exceed this goal. DERs are projects that create new, valuable assets from existing residences, by bringing homes into alignment with the expectations of the 21st century. Ideally, high energy using, dated homes that are failing to provide adequate modern services to their owners and occupants (e.g., comfortable temperatures, acceptable humidity, clean, healthy), are transformed through comprehensive upgrades to the building envelope, services andmore » miscellaneous loads into next generation high performance homes. These guidance documents provide information to aid in the broader market adoption of DERs.« less

Perspectives on mealtime management in residential aged care: insights from a cross-disciplinary investigation.

PubMed

Bennett, Michelle K; Ward, Elizabeth; Scarinci, Nerina; Waite, Monique

2014-01-01

Meeting the medical, nutritional, and psychosocial mealtime needs of aged care residents requires a holistic, multidisciplinary approach. To date the perspectives of this multidisciplinary team have not been adequately explored. The aim of this study was to explore the perspectives of a range of service providers involved in mealtime management in residential aged care. In-depth semistructured interviews were conducted with 61 participants from five service disciplines. Four themes emerged: ( 1 ) mealtimes are highly valued; ( 2 ) service providers face common barriers to mealtime management; ( 3 ) communication among service providers is challenging; and ( 4 ) education in mealtime management is limited. Data indicated service providers acknowledge the importance of mealtimes but recognize numerous shortfalls in current care. The need for interdisciplinary training and increased communication and collaboration among providers was emphasized, including the need for clarification of provider roles. Limited consideration of mealtimes in policy and funding documents was identified as a primary barrier in further prioritizing mealtime management and advancing mealtime care.

76 FR 21810 - Defense Federal Acquisition Regulation Supplement; Acquisition of Commercial Items (DFARS Case...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-19

... required to fully and adequately document the contract file regarding the market research performed by the... commercial determination is made before contract award. This determination is based on market research, an...

Factors that influence the clinical utilization of the nursing process at a hospital in Accra, Ghana.

PubMed

Agyeman-Yeboah, Joana; Korsah, Kwadwo Ameyaw; Okrah, Jane

2017-01-01

The nursing process is a tool that is recommended for use by all professional nurses working in Ghana, in order to provide nursing care. However, there is currently a limited use of this tool by nurses in Ghana. The purpose of this research study was to explore the various factors that influence the utilization of this nursing process. An exploratory descriptive qualitative-research design was employed. Ten participants were involved by using the purposive sampling method. A semi-structured interview guide was used to collect the data from the research participants; and the data were analysed by using content analysis. One main theme, with five subthemes, emerged from the analysis. It was found that there are factors, such as nurses not having a better understanding of the nursing process, whilst in school; the absence of the care plan in the ward, as well as the lack of adequate staff, with limited time being available for coping with contributed to the non-usage of the nursing process. We conclude that the clinical utilization of the Nursing process at the clinical setting is influenced by lack of understanding of Nurses on the Nursing process and care plan as well as lack of adequate nurses and time. We recommend that the care-plan form be made officially a part of the admission documents. Furthermore, the nursing administration should put measures in place to provide nurses with the needed resources to implement the nursing process. Additionally, they should ensure that the care-plan forms and other resources needed by the nurses are regularly and adequately provided. Nurses should further see the nursing process as a means of providing comprehensive care to their patients and addressing their specific problems. They should therefore make time despite their busy schedules to use it in order to improve quality of care and the image of nursing in Ghana.

The National Commitment Towards Conserving the Heritage (documentation of Historical and Cultural Sites in Gcc Countries)

NASA Astrophysics Data System (ADS)

AlSulaiti, F.

2013-07-01

The five Arab Gulf countries of Kuwait, Bahrain, Qatar, the United Arab Emirates and Oman possess many shared characteristics and historical ties across their common peninsula. The prime factor uniting them is the historical nature of their entwined involvement with peoples and nations beyond the region. That the Gulf has been an important water passageway since ancient times suggests that the inhabitants of its shores met early on with other civilizations. The knowledge of one's roots, history, and traditional arts supports awareness of inherited culture and can help contextualize and illuminate community reflection and identification. The intricacy of the recording and understanding processes of documentation requires skilled professionals, with knowledge and awareness for the associated tasks. Responsible of cultural heritage should provide the adequate documentations, recording and updating of the records. Collaboration of different individuals such as specialist heritage, archaeologists, surveyors, conservators, researchers, architectural historians, and many other expert personnel is the golden key of successful documentation. The purpose of this document is to show the authorities of Gulf Arab countries and their planning measures, management and sharing effect of recording the cultural heritage. This essay identifies key points in the approach to contextualizing and developing cultural identity in a way that respects organic qualities. Through highlighting a number of archeological ruins and outlining management plans, the essay explores frameworks that can be applied to promote and preserve integral identity of important sites and their greater surrounding communities.

Fundus spectroscopy and studies in retinal oximetry using intravitreal illumination

NASA Astrophysics Data System (ADS)

Salyer, David Alan

This dissertation documents the development of a new illumination technique for use in the studies of retinal oximetry and fundus spectroscopy. Intravitreal illumination is a technique where the back of the eye is illuminated trans-sclerally using a scanning monochromator coupled into a fiber optic illuminator. Retinal oximetry is the process of measuring the oxygen saturation of blood contained in retinal vessels by quantitative measurement of the characteristic color shift seen as blood oxygen saturation changes from oxygenated blood (reddish) to deoxygenated blood (bluish). Retinal oximetry was first attempted in 1963 but due to a variety of problems with accuracy and difficulty of measurement, has not matured to the point of clinical acceptability or commercial viability. Accurate retinal oximetry relies in part on an adequate understanding of the spectral reflectance characteristics of the fundus. The use of intravitreal illumination allows new investigations into the spectral reflectance properties of the fundus. The results of much research in fundus reflectance and retinal oximetry is detailed in this document, providing new insight into both of these related fields of study. Intravitreal illumination has been used to study retinal vessel oximetry and fundus reflectometry resulting in several important findings that are presented in this document. Studies on enucleated swine eyes have provided new insight into the bidirectional reflectance distribution function of the fundus. Research on live swine has shown accurate measurement of retinal vessel oxygen saturation and provided the first in vivo spectral transmittance measurement of the sensory retina. A secondary discovery during this research suggests that vitrectomy alters the retinal vasculature, an finding that should spawn new research in its own right.

Examination of the Occupational Health and Safety Initiatives Available within the Chemistry Departments of Australian Universities

NASA Astrophysics Data System (ADS)

Goodwin, Veronica; Cobbin, Deirdre; Logan, Peter

1999-09-01

This paper reports the findings of a survey that was conducted in 1996 of all Australian university chemistry departments. Thirty-one of the 33 chemistry departments provided input to the project. The aims were twofold: first, to ascertain how different departments approach the task of occupational health and safety (OHS) education and training for students and staff; and second, to produce a resource document that describes the techniques used by the various departments. A key issue identified in the study is the importance of ensuring that academic staff are kept up to date on all relevant aspects of OHS and laboratory safety. This is crucial because teaching staff are responsible for instructing their undergraduate and postgraduate students in OHS knowledge and practice. In addition, the study found that adequate funding and departmental commitment are necessary for the success of OHS and laboratory safety programs. The resource document should assist in promoting quality OHS knowledge and awareness in the academic chemistry laboratory, since it will provide chemistry departments with a wide range of OHS educational initiatives from which they can select the most appropriate for their own needs.

Digital-flight-control-system software written in automated-engineering-design language: A user's guide of verification and validation tools

NASA Technical Reports Server (NTRS)

Saito, Jim

1987-01-01

The user guide of verification and validation (V&V) tools for the Automated Engineering Design (AED) language is specifically written to update the information found in several documents pertaining to the automated verification of flight software tools. The intent is to provide, in one document, all the information necessary to adequately prepare a run to use the AED V&V tools. No attempt is made to discuss the FORTRAN V&V tools since they were not updated and are not currently active. Additionally, the current descriptions of the AED V&V tools are contained and provides information to augment the NASA TM 84276. The AED V&V tools are accessed from the digital flight control systems verification laboratory (DFCSVL) via a PDP-11/60 digital computer. The AED V&V tool interface handlers on the PDP-11/60 generate a Univac run stream which is transmitted to the Univac via a Remote Job Entry (RJE) link. Job execution takes place on the Univac 1100 and the job output is transmitted back to the DFCSVL and stored as a PDP-11/60 printfile.

Developing a Low-Cost System for 3d Data Acquisition

NASA Astrophysics Data System (ADS)

Kossieris, S.; Kourounioti, O.; Agrafiotis, P.; Georgopoulos, A.

2017-11-01

In this paper, a developed low-cost system is described, which aims to facilitate 3D documentation fast and reliably by acquiring the necessary data in outdoor environment for the 3D documentation of façades especially in the case of very narrow streets. In particular, it provides a viable solution for buildings up to 8-10m high and streets as narrow as 2m or even less. In cases like that, it is practically impossible or highly time-consuming to acquire images in a conventional way. This practice would lead to a huge number of images and long processing times. The developed system was tested in the narrow streets of a medieval village on the Greek island of Chios. There, in order to by-pass the problem of short taking distances, it was thought to use high definition action cameras together with a 360˚ camera, which are usually provided with very wide-angle lenses and are capable of acquiring images, of high definition, are rather cheap and, most importantly, extremely light. Results suggest that the system can perform fast 3D data acquisition adequate for deliverables of high quality.

Report: Fiscal 2005 and 2004 (restated) Financial Statements for the Pesticide Registration Fund

EPA Pesticide Factsheets

Report #2007-1-00002, January 9, 2007. EPA’s Washington Finance Center recorded adjusting and correcting entries for PRIA collections in the Integrated Financial Management System without adequately documenting the errors, corrections, or modifications.

36 CFR 1222.28 - What are the series level recordkeeping requirements?

Code of Federal Regulations, 2012 CFR

2012-07-01

... RECORDS ADMINISTRATION RECORDS MANAGEMENT CREATION AND MAINTENANCE OF FEDERAL RECORDS Agency Recordkeeping... systems adequately document agency policies, transactions, and activities, each program must develop... phone calls, meetings, instant messages, and electronic mail exchanges that include substantive...

36 CFR 1222.28 - What are the series level recordkeeping requirements?

Code of Federal Regulations, 2011 CFR

2011-07-01

... RECORDS ADMINISTRATION RECORDS MANAGEMENT CREATION AND MAINTENANCE OF FEDERAL RECORDS Agency Recordkeeping... systems adequately document agency policies, transactions, and activities, each program must develop... phone calls, meetings, instant messages, and electronic mail exchanges that include substantive...

36 CFR 1222.28 - What are the series level recordkeeping requirements?

Code of Federal Regulations, 2014 CFR

2014-07-01

... RECORDS ADMINISTRATION RECORDS MANAGEMENT CREATION AND MAINTENANCE OF FEDERAL RECORDS Agency Recordkeeping... systems adequately document agency policies, transactions, and activities, each program must develop... phone calls, meetings, instant messages, and electronic mail exchanges that include substantive...

Chromium Chemistry in the Subsurface

EPA Science Inventory

Chromium (VI) (Cr) is carcinogenic and a threat to human and ecological health. There are adequate and acceptable methods to characterize and assess Cr contaminated sites. Cr chemistry in the environment is well understood. There are documented methods to address Cr contaminat...

American Recovery and Reinvestment Act Wind Turbine Projects at Long-Range Radar Sites in Alaska Were Not Adequately Planned

DTIC Science & Technology

2011-09-30

Ratio TAFS Treasury Appropriation Fund Symbol INSPECTOR GENERAL DEPARTMENT OF DEFENSE 400 ARMY NAVY DRIVE ARLINGTON, VIRGINIA 22202-4704...Symbol ( TAFS ) to the www.recovery.gov Web site. As a result of our review, officials at AFCESA took action to correct the errors in the...projects in a timely manner, and the funding authorization documents properly identified a Recovery Act designation. Funding documents cited a TAFS of

POOL WATER TREATMENT AND COOLING SYSTEM DESCRIPTION DOCUMENT

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

V. King

2000-06-19

The Pool Water Treatment and Cooling System is located in the Waste Handling Building (WHB), and is comprised of various process subsystems designed to support waste handling operations. This system maintains the pool water temperature within an acceptable range, maintains water quality standards that support remote underwater operations and prevent corrosion, detects leakage from the pool liner, provides the capability to remove debris from the pool, controls the pool water level, and helps limit radiological exposure to personnel. The pool structure and liner, pool lighting, and the fuel staging racks in the pool are not within the scope of themore » Pool Water Treatment and Cooling System. Pool water temperature control is accomplished by circulating the pool water through heat exchangers. Adequate circulation and mixing of the pool water is provided to prevent localized thermal hotspots in the pool. Treatment of the pool water is accomplished by a water treatment system that circulates the pool water through filters, and ion exchange units. These water treatment units remove radioactive and non-radioactive particulate and dissolved solids from the water, thereby providing the water clarity needed to conduct waste handling operations. The system also controls pool water chemistry to prevent advanced corrosion of the pool liner, pool components, and fuel assemblies. Removal of radioactivity from the pool water contributes to the project ALARA (as low as is reasonably achievable) goals. A leak detection system is provided to detect and alarm leaks through the pool liner. The pool level control system monitors the water level to ensure that the minimum water level required for adequate radiological shielding is maintained. Through interface with a demineralized water system, adequate makeup is provided to compensate for loss of water inventory through evaporation and waste handling operations. Interface with the Site Radiological Monitoring System provides continuous radiological monitoring of the pool water. The Pool Water Treatment and Cooling System interfaces with the Waste Handling Building System, Site-Generated Radiological Waste Handling System, Site Radiological Monitoring System, Waste Handling Building Electrical System, Site Water System, and the Monitored Geologic Repository Operations Monitoring and Control System.« less

Radiographic evaluation of the ankle syndesmosis.

PubMed

Croft, Stephen; Furey, Andrew; Stone, Craig; Moores, Carl; Wilson, Robert

2015-02-01

Radiographic measurements to document ankle anatomy have been suggested in recent literature to be inadequate. Focus has been put on stress views and computed tomography; however, there are also issues with these modalities. An orthogonal view that could be used both statically and dynamically could help determine syndesmotic stability. The purpose of this study was to determine a parameter on a normal lateral ankle radiograph that will increase the reliability of standard radiography in diagnosing syndesmotic integrity. Three orthopedic surgeons reviewed 80 lateral ankle radiographs. Thirty of those radiographs were reviewed on a second occasion. Rotation of the radiographs was determined by evaluating the overlap of the talar dome. Four radiographic parameters were measured 1 cm above the tibial plafond: fibular width, tibial width, and anterior and posterior tibiofibular intervals. Seventy-two radiographs were determined by consensus to be adequate. Means and ratios were documented to determine the relationship of the fibula to the tibia. Interrater reliability ranged from moderate to near-perfect, and the intrarater reliability was documented for each ratio. The anterior tibiofibular ratio was shown to be strong to near-perfect. It demonstrates that 40% of the tibia should be seen anterior to the fibula at 1cm above the tibial plafond. The anterior tibiofibular ratio provides an orthogonal measure for the syndesmosis that, in conjunction with those parameters previously documented, could clinically and economically improve the diagnosis of syndesmotic disruptions.

Modeling of detachment experiments at DIII-D

DOE PAGES

Canik, John M.; Briesemeister, Alexis R.; Lasnier, C. J.; ...

2014-11-26

Edge fluid–plasma/kinetic–neutral modeling of well-diagnosed DIII-D experiments is performed in order to document in detail how well certain aspects of experimental measurements are reproduced within the model as the transition to detachment is approached. Results indicate, that at high densities near detachment onset, the poloidal temperature profile produced in the simulations agrees well with that measured in experiment. However, matching the heat flux in the model requires a significant increase in the radiated power compared to what is predicted using standard chemical sputtering rates. Lastly, these results suggest that the model is adequate to predict the divertor temperature, provided thatmore » the discrepancy in radiated power level can be resolved.« less

The prevalence of the Wernicke-Korsakoff syndrome in Sydney, Australia: a prospective necropsy study.

PubMed Central

Harper, C; Gold, J; Rodriguez, M; Perdices, M

1989-01-01

In a prospective necropsy study, the prevalence of the Wernicke-Korsakoff syndrome (WKS) in Sydney, Australia was 2.1% of adults over the age of 15 years. The population studied encompassed a wide spectrum of socio-economic and cultural backgrounds. Abuse of alcohol appeared to be the major predisposing factor to the development of the WKS in cases which were adequately documented. This high prevalence rate is in line with other clinical and pathological Australian studies and provides additional support for the idea of prevention of the WKS by the use of thiamin supplements in the Australian diet in flour, bread and perhaps alcoholic beverages. PMID:2784828

Letter Report to Address Comments on the Closure Report for Corrective Action Unit 224: Decon Pad and Septic Systems, Nevada Test Site, Nevada, Revision 0, March 2008

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

NSTec Environmental Restoration

2008-03-17

The Closure Report (CR) for Corrective Action Unit (CAU) 224, Decon Pad and Septic Systems, was approved by the Nevada Department of Environmental Protection (NDEP) on November 01, 2007. The approval letter contained the following two comments: Comment 1--For 06-05-01, 06-17-04, 06-23-01 provide evidence that the 6 inch VCP pipe originating from building CP-2 is no longer active and sealed to prevent possible future contamination. Comment 2--For the area that includes 06-03-01, provide evidence that active lines are no longer feeding the North and South lagoons and have been sealed to prevent possible future contamination. To address these comments, closuremore » documentation was reviewed, and site visits were conducted to locate and document the areas of concern. Additional fieldwork was conducted in March 2008 to seal the lines and openings described in the two comments. Photographs were taken of the closed drains and lines to document that the NDEP comments were adequately addressed and potential inadvertent discharge to the environment has been eliminated. Investigation and closure documentation was reviewed to identify the locations of potential drains, lines, and other features that could receive and/or transmit liquid. Based on the investigation findings and subsequent closure activities, no openings, distribution boxes, or other features (excluding known floor drains at CP-2) that could receive liquid were found at the CP-2 location (Figure 1), and potential manholes for the north and south sewage lagoons were identified for Corrective Action Site (CAS) 06-03-01 (Figure 2). The distribution box identified in Figure 1 was not located during the investigation and was assumed to have been previously removed.« less

[Harmonisation of the Marketing Authorisation Application dossier: perspectives due to harmonised requirements. Assessing Rules and the Common Technical Document].

PubMed

Menges, Klaus

2008-07-01

Assessing Rules for Marketing Authorisation Applications and the Common Technical Document provide the framework regarding data-related requirements and regarding the structural requirements of marketing authorisation application dossiers, similar to the structural levels and rooms of buildings on the one hand and their interior equipment on the other hand. Since the 1970s requirements about how to submit application dossiers and how to assess them have become increasingly harmonised, aiming for the use of a single format and identical rules for assessment. In regard of the format, harmonisation has been achieved beyond Europe by implementing the mandatory use of CTD in the three main regions of interests of the pharmaceutical industry, Japan, the United States of America and Europe. The assessment rules have been extensively harmonised throughout Europe in a way that the same rules apply to the marketing authorisation applications submitted in Germany as well as in other Member States. Different interpretations of the guidance documents, different understanding of the provided data or divergent conclusions drawn up may still occur. All stakeholders within the European network of Drug Regulatory Affairs will act on the level floor of the European and--apart from some exceptions--also nationally implemented legislation. This will not only serve the internationally acting pharmaceutical companies' interests but also consumer interests in obtaining consistent information on drug products based on transparent rules safeguarding the necessary pharmaceutical quality, efficacy and safety with respect to an adequate risk-benefit relationship.

[Pseudohypoparathyroidism associated with hyperaldosteronism and polyglobulia].

PubMed

Battaia, L; Pedrazzoli, M; Pachor, M L; Bambara, L M; Corrocher, R

1984-04-07

A new case of familial PHP, associated with polyglobulia and biochemical parameters of hyperaldosteronism has been described. This association represents a very rare entity. PHP has been documented by the common tests and the unresponsiveness of AMPc to PTH. The poliglobulia , which appears after a period of severe anaemia, needs now periodical blood subtraction; nevertheless a cerebral thrombosis with conseguent hemiparesis has recently occurred. The hyperaldosteronism has been documented by hypopotassiemia , a raised level of plasma aldosterone as well as suppressed plasma renin activity even after adequate stimulus.

Neonatal records and the computer.

PubMed Central

Walker, C H

1977-01-01

To use a combined single document clinical case sheet/computer record which can form the basic document for a life medical record is a practical proposition. With adequate briefing doctors and nurses soon become familiar with the record and appreciate its value. Secretarial and clerical requirements are reduced to a minimum as transcription of medical data is eliminated, so greatly speeding up processing and feed back to the medical services. A few illustrations of trends in neonatal statistics and of computer linked maternal/neonatal data are presented. PMID:879830

General Practitioner Supervisor assessment and teaching of Registrars consulting with Aboriginal patients – is cultural competence adequately considered?

PubMed Central

2014-01-01

Background General Practitioner (GP) Supervisors have a key yet poorly defined role in promoting the cultural competence of GP Registrars who provide healthcare to Aboriginal and Torres Strait Islander people during their training placements. Given the markedly poorer health of Indigenous Australians, it is important that GP training and supervision of Registrars includes assessment and teaching which address the well documented barriers to accessing health care. Methods A simulated consultation between a GP Registrar and an Aboriginal patient, which illustrated inadequacies in communication and cultural awareness, was viewed by GP Supervisors and Medical Educators during two workshops in 2012. Participants documented teaching points arising from the consultation which they would prioritise in supervision provided to the Registrar. Content analysis was performed to determine the type and detail of the planned feedback. Field notes from workshop discussions and participant evaluations were used to gain insight into participant confidence in cross cultural supervision. Results Sixty four of 75 GPs who attended the workshops participated in the research. Although all documented plans for detailed teaching on the Registrar’s generic communication and consultation skills, only 72% referred to culture or to the patient’s Aboriginality. Few GPs (8%) documented a plan to advise on national health initiatives supporting access for Aboriginal and Torres Strait Islander people. A lack of Supervisor confidence in providing guidance on cross cultural consulting with Aboriginal patients was identified. Conclusions The role of GP Supervisors in promoting the cultural competence of GP Registrars consulting with Aboriginal and Torres Strait Islander patients could be strengthened. A sole focus on generic communication and consultation skills may lead to inadequate consideration of the health disparities faced by Indigenous peoples and of the need to ensure Registrars utilise health supports designed to decrease the disadvantage faced by vulnerable populations. PMID:25115609

RETHINKING HUMAN HEALTH IMPACT ASSESSMENT. (R825758)

EPA Science Inventory

Most EIA programs around the world require the consideration of human health impacts. Yet relatively few EIA documents adequately address those impacts. This article examines how, why, and to what extent health impacts are analyzed in environmental impact assessments in the U.S. ...

49 CFR 1104.3 - Copies.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Microsoft Open Database Connectivity (ODBC) standard. ODBC is a Windows technology that allows a database software package to import data from a database created using a different software package. We currently...-compatible format. All databases must be supported with adequate documentation on data attributes, SQL...

12 CFR 1410.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... particular loan constitutes an independent credit risk and such determination is adequately documented in the... Banking FARM CREDIT SYSTEM INSURANCE CORPORATION PREMIUMS § 1410.2 Definitions. (a) Act means the Farm Credit Act of 1971, as amended. (b) Average principal outstanding means the average annual principal...

Peer exchange : journey from adequate to vital : the pathway to excellence.

DOT National Transportation Integrated Search

2013-06-01

This report documents the NMDOT Research Peer Exchange held April 10-11, 2013 in : Albuquerque, New Mexico in accordance with the requirements of 23 CFR 420. It : involved NMDOT staff and representatives from the state DOTs of Arizona, Ohio, : Texas,...

24 CFR 954.104 - Performance thresholds.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Performance thresholds. 954.104... DEVELOPMENT INDIAN HOME PROGRAM Applying for Assistance § 954.104 Performance thresholds. Applicants must have... HOME program must have performed adequately. In cases of previously documented deficient performance...

24 CFR 954.104 - Performance thresholds.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Performance thresholds. 954.104... DEVELOPMENT INDIAN HOME PROGRAM Applying for Assistance § 954.104 Performance thresholds. Applicants must have... HOME program must have performed adequately. In cases of previously documented deficient performance...

Comparison of Registered and Reported Outcomes in Randomized Clinical Trials Published in Anesthesiology Journals.

PubMed

Jones, Philip M; Chow, Jeffrey T Y; Arango, Miguel F; Fridfinnson, Jason A; Gai, Nan; Lam, Kevin; Turkstra, Timothy P

2017-10-01

Randomized clinical trials (RCTs) provide high-quality evidence for clinical decision-making. Trial registration is one of the many tools used to improve the reporting of RCTs by reducing publication bias and selective outcome reporting bias. The purpose of our study is to examine whether RCTs published in the top 6 general anesthesiology journals were adequately registered and whether the reported primary and secondary outcomes corresponded to the originally registered outcomes. Following a prespecified protocol, an electronic database was used to systematically screen and extract data from RCTs published in the top 6 general anesthesiology journals by impact factor (Anaesthesia, Anesthesia & Analgesia, Anesthesiology, British Journal of Anaesthesia, Canadian Journal of Anesthesia, and European Journal of Anaesthesiology) during the years 2007, 2010, 2013, and 2015. A manual search of each journal's Table of Contents was performed (in duplicate) to identify eligible RCTs. An adequately registered trial was defined as being registered in a publicly available trials registry before the first patient being enrolled with an unambiguously defined primary outcome. For adequately registered trials, the outcomes registered in the trial registry were compared with the outcomes reported in the article, with outcome discrepancies documented and analyzed by the type of discrepancy. During the 4 years studied, there were 860 RCTs identified, with 102 RCTs determined to be adequately registered (12%). The proportion of adequately registered trials increased over time, with 38% of RCTs being adequately registered in 2015. The most common reason in 2015 for inadequate registration was registering the RCT after the first patient had already been enrolled. Among adequately registered trials, 92% had at least 1 primary or secondary outcome discrepancy. In 2015, 42% of RCTs had at least 1 primary outcome discrepancy, while 90% of RCTs had at least 1 secondary outcome discrepancy. Despite trial registration being an accepted best practice, RCTs published in anesthesiology journals have a high rate of inadequate registration. While mandating trial registration has increased the proportion of adequately registered trials over time, there is still an unacceptably high proportion of inadequately registered RCTs. Among adequately registered trials, there are high rates of discrepancies between registered and reported outcomes, suggesting a need to compare a published RCT with its trial registry entry to be able to fully assess the quality of the study. If clinicians base their decisions on evidence distorted by primary outcome switching, patient care could be negatively affected.

Risk factors for inadequate antibody response to primary rabies vaccination in dogs under one year of age

PubMed Central

Wallace, Ryan M.; Pees, Anna; Blanton, Jesse B.

2017-01-01

Ensuring the adequacy of response to rabies vaccination in dogs is important, particularly in the context of pet travel. Few studies have examined the factors associated with dogs’ failure to achieve an adequate antibody titer after vaccination (0.5 IU/ml). This study evaluated rabies antibody titers in dogs after primary vaccination. Dogs under one year of age whose serum was submitted to a reference laboratory for routine diagnostics, and which had no prior documented history of vaccination were enrolled (n = 8,011). Geometric mean titers (GMT) were calculated and univariate analysis was performed to assess factors associated with failure to achieve 0.5 IU/mL. Dogs vaccinated at >16 weeks of age had a significantly higher GMT compared to dogs vaccinated at a younger age (1.64 IU/ml, 1.57–1.72, ANOVA p < 0.01). There was no statistical difference in GMT between dogs vaccinated <12 weeks and dogs vaccinated 12–16 weeks (1.22 IU/ml and 1.21 IU/ml). The majority of dogs failed to reach an adequate titer within the first 3 days of primary vaccination; failure rates were also high if the interval from vaccination to titer check was greater than 90 days. Over 90% of dogs that failed primary vaccination were able to achieve adequate titers after booster vaccination. The ideal timing for blood draw is 8–30 days after primary vaccination. In the event of a failure, most dogs will achieve an adequate serologic response upon a repeat titer (in the absence of booster vaccination). Booster vaccination after failure provided the highest probability of an acceptable titer. PMID:28759602

Risk factors for inadequate antibody response to primary rabies vaccination in dogs under one year of age.

PubMed

Wallace, Ryan M; Pees, Anna; Blanton, Jesse B; Moore, Susan M

2017-07-01

Ensuring the adequacy of response to rabies vaccination in dogs is important, particularly in the context of pet travel. Few studies have examined the factors associated with dogs' failure to achieve an adequate antibody titer after vaccination (0.5 IU/ml). This study evaluated rabies antibody titers in dogs after primary vaccination. Dogs under one year of age whose serum was submitted to a reference laboratory for routine diagnostics, and which had no prior documented history of vaccination were enrolled (n = 8,011). Geometric mean titers (GMT) were calculated and univariate analysis was performed to assess factors associated with failure to achieve 0.5 IU/mL. Dogs vaccinated at >16 weeks of age had a significantly higher GMT compared to dogs vaccinated at a younger age (1.64 IU/ml, 1.57-1.72, ANOVA p < 0.01). There was no statistical difference in GMT between dogs vaccinated <12 weeks and dogs vaccinated 12-16 weeks (1.22 IU/ml and 1.21 IU/ml). The majority of dogs failed to reach an adequate titer within the first 3 days of primary vaccination; failure rates were also high if the interval from vaccination to titer check was greater than 90 days. Over 90% of dogs that failed primary vaccination were able to achieve adequate titers after booster vaccination. The ideal timing for blood draw is 8-30 days after primary vaccination. In the event of a failure, most dogs will achieve an adequate serologic response upon a repeat titer (in the absence of booster vaccination). Booster vaccination after failure provided the highest probability of an acceptable titer.

Electrical, Electronic, and Electromechanical (EEE) parts management and control requirements for NASA space flight programs

NASA Technical Reports Server (NTRS)

1989-01-01

This document establishes electrical, electronic, and electromechanical (EEE) parts management and control requirements for contractors providing and maintaining space flight and mission-essential or critical ground support equipment for NASA space flight programs. Although the text is worded 'the contractor shall,' the requirements are also to be used by NASA Headquarters and field installations for developing program/project parts management and control requirements for in-house and contracted efforts. This document places increased emphasis on parts programs to ensure that reliability and quality are considered through adequate consideration of the selection, control, and application of parts. It is the intent of this document to identify disciplines that can be implemented to obtain reliable parts which meet mission needs. The parts management and control requirements described in this document are to be selectively applied, based on equipment class and mission needs. Individual equipment needs should be evaluated to determine the extent to which each requirement should be implemented on a procurement. Utilization of this document does not preclude the usage of other documents. The entire process of developing and implementing requirements is referred to as 'tailoring' the program for a specific project. Some factors that should be considered in this tailoring process include program phase, equipment category and criticality, equipment complexity, and mission requirements. Parts management and control requirements advocated by this document directly support the concept of 'reliability by design' and are an integral part of system reliability and maintainability. Achieving the required availability and mission success objectives during operation depends on the attention given reliability and maintainability in the design phase. Consequently, it is intended that the requirements described in this document are consistent with those of NASA publications, 'Reliability Program Requirements for Aeronautical and Space System Contractors,' NHB 5300.4(1A-l); 'Maintainability Program Requirements for Space Systems,' NHB 5300.4(1E); and 'Quality Program Provisions for Aeronautical and Space System Contractors,' NHB 5300.4(1B).

Psychometric Evaluation of the D-Catch, an Instrument to Measure the Accuracy of Nursing Documentation.

PubMed

D'Agostino, Fabio; Barbaranelli, Claudio; Paans, Wolter; Belsito, Romina; Juarez Vela, Raul; Alvaro, Rosaria; Vellone, Ercole

2017-07-01

To evaluate the psychometric properties of the D-Catch instrument. A cross-sectional methodological study. Validity and reliability were estimated with confirmatory factor analysis (CFA) and internal consistency and inter-rater reliability, respectively. A sample of 250 nursing documentations was selected. CFA showed the adequacy of a 1-factor model (chronologically descriptive accuracy) with an outlier item (nursing diagnosis accuracy). Internal consistency and inter-rater reliability were adequate. The D-Catch is a valid and reliable instrument for measuring the accuracy of nursing documentation. Caution is needed when measuring diagnostic accuracy since only one item measures this dimension. The D-Catch can be used as an indicator of the accuracy of nursing documentation and the quality of nursing care. © 2015 NANDA International, Inc.

16 CFR 1028.115 - IRB records.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 16 Commercial Practices 2 2012-01-01 2012-01-01 false IRB records. 1028.115 Section 1028.115... records. (a) An institution, or when appropriate an IRB, shall prepare and maintain adequate documentation of IRB activities, including the following: (1) Copies of all research proposals reviewed, scientific...

16 CFR 1028.115 - IRB records.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 16 Commercial Practices 2 2014-01-01 2014-01-01 false IRB records. 1028.115 Section 1028.115... records. (a) An institution, or when appropriate an IRB, shall prepare and maintain adequate documentation of IRB activities, including the following: (1) Copies of all research proposals reviewed, scientific...

Region 9: California San Bernardino County Inadequate Letter (1/4/2000)

EPA Pesticide Factsheets

This November 23, 1999, letter from EPA notifies CARB that the documentation of the Moderate PM10 SIP submittal for the Mojave Desert planning area of San Bernadino county does not allow EPA to find it adequate for use in conformity analyses.

iPhone 4s and iPhone 5s Imaging of the Eye.

PubMed

Jalil, Maaz; Ferenczy, Sandor R; Shields, Carol L

2017-01-01

To evaluate the technical feasibility of a consumer-grade cellular iPhone camera as an ocular imaging device compared to existing ophthalmic imaging equipment for documentation purposes. A comparison of iPhone 4s and 5s images was made with external facial images (macrophotography) using Nikon cameras, slit-lamp images (microphotography) using Zeiss photo slit-lamp camera, and fundus images (fundus photography) using RetCam II. In an analysis of six consecutive patients with ophthalmic conditions, both iPhones achieved documentation of external findings (macrophotography) using standard camera modality, tap to focus, and built-in flash. Both iPhones achieved documentation of anterior segment findings (microphotography) during slit-lamp examination through oculars. Both iPhones achieved fundus imaging using standard video modality with continuous iPhone illumination through an ophthalmic lens. Comparison to standard ophthalmic cameras, macrophotography and microphotography were excellent. In comparison to RetCam fundus photography, iPhone fundus photography revealed smaller field and was technically more difficult to obtain, but the quality was nearly similar to RetCam. iPhone versions 4s and 5s can provide excellent ophthalmic macrophotography and microphotography and adequate fundus photography. We believe that iPhone imaging could be most useful in settings where expensive, complicated, and cumbersome imaging equipment is unavailable.

Systematic Review of Plant-Based Homeopathic Basic Research: An Update.

PubMed

Ücker, Annekathrin; Baumgartner, Stephan; Sokol, Anezka; Huber, Roman; Doesburg, Paul; Jäger, Tim

2018-05-01

 Plant-based test systems have been described as a useful tool for investigating possible effects of homeopathic preparations. The last reviews of this research field were published in 2009/2011. Due to recent developments in the field, an update is warranted. Publications on plant-based test systems were analysed with regard to publication quality, reproducibility and potential for further research.  A literature search was conducted in online databases and specific journals, including publications from 2008 to 2017 dealing with plant-based test systems in homeopathic basic research. To be included, they had to contain statistical analysis and fulfil quality criteria according to a pre-defined manuscript information score (MIS). Publications scoring at least 5 points (maximum 10 points) were assumed to be adequate. They were analysed for the use of adequate controls, outcome and reproducibility.  Seventy-four publications on plant-based test systems were found. Thirty-nine publications were either abstracts or proceedings of conferences and were excluded. From the remaining 35 publications, 26 reached a score of 5 or higher in the MIS. Adequate controls were used in 13 of these publications. All of them described specific effects of homeopathic preparations. The publication quality still varied: a substantial number of publications (23%) did not adequately document the methods used. Four reported on replication trials. One replication trial found effects of homeopathic preparations comparable to the original study. Three replication trials failed to confirm the original study but identified possible external influencing factors. Five publications described novel plant-based test systems. Eight trials used systematic negative control experiments to document test system stability.  Regarding research design, future trials should implement adequate controls to identify specific effects of homeopathic preparations and include systematic negative control experiments. Further external and internal replication trials, and control of influencing factors, are needed to verify results. Standardised test systems should be developed. The Faculty of Homeopathy.

A Method of Retrospective Computerized System Validation for Drug Manufacturing Software Considering Modifications

NASA Astrophysics Data System (ADS)

Takahashi, Masakazu; Fukue, Yoshinori

This paper proposes a Retrospective Computerized System Validation (RCSV) method for Drug Manufacturing Software (DMSW) that relates to drug production considering software modification. Because DMSW that is used for quality management and facility control affects big impact to quality of drugs, regulatory agency required proofs of adequacy for DMSW's functions and performance based on developed documents and test results. Especially, the work that explains adequacy for previously developed DMSW based on existing documents and operational records is called RCSV. When modifying RCSV conducted DMSW, it was difficult to secure consistency between developed documents and test results for modified DMSW parts and existing documents and operational records for non-modified DMSW parts. This made conducting RCSV difficult. In this paper, we proposed (a) definition of documents architecture, (b) definition of descriptive items and levels in the documents, (c) management of design information using database, (d) exhaustive testing, and (e) integrated RCSV procedure. As a result, we could conduct adequate RCSV securing consistency.

Monitoring-well installation, slug testing, and groundwater quality for selected sites in South Park, Park County, Colorado, 2013

USGS Publications Warehouse

Arnold, Larry R. Rick

2015-01-01

During May–June, 2013, the U.S. Geological Survey, in cooperation with Park County, Colorado, drilled and installed four groundwater monitoring wells in areas identified as needing new wells to provide adequate spatial coverage for monitoring water quality in the South Park basin. Lithologic logs and well-construction reports were prepared for each well, and wells were developed after drilling to remove mud and foreign material to provide for good hydraulic connection between the well and aquifer. Slug tests were performed to estimate hydraulic-conductivity values for aquifer materials in the screened interval of each well, and groundwater samples were collected from each well for analysis of major inorganic constituents, trace metals, nutrients, dissolved organic carbon, volatile organic compounds, ethane, methane, and radon. Documentation of lithologic logs, well construction, well development, slug testing, and groundwater sampling are presented in this report.

Report of the Northern California Conference for Guidelines on Aid-in-Dying: definitions, differences, convergences, conclusions.

PubMed Central

Young, E W; Marcus, F S; Drought, T; Mendiola, M; Ciesielski-Carlucci, C; Alpers, A; Eaton, M; Koenig, B A; Loewy, E; Raffin, T A; Ross, C

1997-01-01

In September 1996, the Stanford University Center for Biomedical Ethics convened a conference entitled "Comprehensive Care of the Terminally Ill: The Northern California Consensus Development Conference for Guidelines on Aid-in-Dying." The regionally based, multidisciplinary conference gathered people from a variety of disciplines and diverse perspectives on physician aid-in-dying. This report documents important points of convergence, disagreement, and uncertainty that emerged from the conference and provides commentary on crucial issues: the definition of terminal illness, ensuring adequate palliative care, psychiatric challenges, coping with family pressures, the doctor-patient relationship, the managed care context, the role of ethics committees, and institutional challenges. Should physician aid-in-dying become a legal practice in California, the report will provide guidance to health care organizations, health professionals, and public policy officials engaged in local or state guideline or policy development. PMID:9217449

Passenger aircraft cabin air quality: trends, effects, societal costs, proposals.

PubMed

Hocking, M B

2000-08-01

As aircraft operators have sought to substantially reduce propulsion fuel cost by flying at higher altitudes, the energy cost of providing adequate outside air for ventilation has increased. This has lead to a significant decrease in the amount of outside air provided to the passenger cabin, partly compensated for by recirculation of filtered cabin air. The purpose of this review paper is to assemble the available measured air quality data and some calculated estimates of the air quality for aircraft passenger cabins to highlight the trend of the last 25 years. The influence of filter efficiencies on air quality, and a few medically documented and anecdotal cases of illness transmission aboard aircraft are discussed. Cost information has been collected from the perspective of both the airlines and passengers. Suggestions for air quality improvement are given which should help to result in a net, multistakeholder savings and improved passenger comfort.

Space shuttle configuration accounting functional design specification

NASA Technical Reports Server (NTRS)

1974-01-01

An analysis is presented of the requirements for an on-line automated system which must be capable of tracking the status of requirements and engineering changes and of providing accurate and timely records. The functional design specification provides the definition, description, and character length of the required data elements and the interrelationship of data elements to adequately track, display, and report the status of active configuration changes. As changes to the space shuttle program levels II and III configuration are proposed, evaluated, and dispositioned, it is the function of the configuration management office to maintain records regarding changes to the baseline and to track and report the status of those changes. The configuration accounting system will consist of a combination of computers, computer terminals, software, and procedures, all of which are designed to store, retrieve, display, and process information required to track proposed and proved engineering changes to maintain baseline documentation of the space shuttle program levels II and III.

Vegetarian food guide pyramid: a conceptual framework.

PubMed

Haddad, E H; Sabaté, J; Whitten, C G

1999-09-01

The purpose of this article and the accompanying vegetarian food guide pyramid graphic is to provide the conceptual framework for the development of a new and unique food guide. Food guides for vegetarians have tended to be adaptations of guides developed for the general nonvegetarian population instead of being designed to emphasize the healthy components of vegetarian dietary patterns. A subcommittee of the organizers of the Third International Congress on Vegetarian Nutrition began a process that led to the development of a pyramid-shaped graphic illustration and a supporting document, both of which were introduced at the congress. The 5 major plant-based food groups (whole grains, legumes, vegetables, fruit, nuts, and seeds) form the trapezoid-shaped lower portion of the pyramid. Optional food groups, which may be avoided by some vegetarians (vegetable oils, dairy, eggs, and sweets), form the smaller, separate, triangle-shaped top portion of the pyramid. The supporting document discusses the concepts that affect vegetarian food guidance and the rationale for selecting the food groups. It is hoped that this framework will provide the impetus for further research and discussion and will lead to the development of a guide that is nutritionally adequate, is conducive to good health, and can be adopted by vegetarians of diverse eating practices.

The Opportunities of Crises and Emergency Risk Communication in Activities of Serbian Public Health Workforce in Emergencies

PubMed Central

Radović, V; Ćurčić, L

2012-01-01

Background: The aim of the study was a recommendation and establishment the concept of the appropriate communication between public health, other competent services and population in emergency as the corner stone which guarantee that all goals which are important for community life will be achieved. Methods: We used methodology appropriate for social science: analyses of documents, historical approach and comparative analysis. Results: The finding shows the urgent need for accepting of crises and emergency risk communication principles, or some similar concepts, in Serbia, and implementing effective two way communication especially in multiethnic region. The pragmatic value of the paper lays in information about the recent improvement of health workforce and emergency services in emergencies using new concept of communication and as source of numerous useful documents published in USA and few recent Serbian examples. Conclusion: Health workforce has significant role in the process of protection of population in emergencies. Policy makers should work on finding a way to improve their coordination and communication, creating new academic programs, providing of adequate training, and financial means in order to give them different role in society and provide visibility. From other side health workforce should build back to the citizen trust in what they are doing for society welfare using all their skills and abilities. PMID:23308348

User-friendly solutions for microarray quality control and pre-processing on ArrayAnalysis.org

PubMed Central

Eijssen, Lars M. T.; Jaillard, Magali; Adriaens, Michiel E.; Gaj, Stan; de Groot, Philip J.; Müller, Michael; Evelo, Chris T.

2013-01-01

Quality control (QC) is crucial for any scientific method producing data. Applying adequate QC introduces new challenges in the genomics field where large amounts of data are produced with complex technologies. For DNA microarrays, specific algorithms for QC and pre-processing including normalization have been developed by the scientific community, especially for expression chips of the Affymetrix platform. Many of these have been implemented in the statistical scripting language R and are available from the Bioconductor repository. However, application is hampered by lack of integrative tools that can be used by users of any experience level. To fill this gap, we developed a freely available tool for QC and pre-processing of Affymetrix gene expression results, extending, integrating and harmonizing functionality of Bioconductor packages. The tool can be easily accessed through a wizard-like web portal at http://www.arrayanalysis.org or downloaded for local use in R. The portal provides extensive documentation, including user guides, interpretation help with real output illustrations and detailed technical documentation. It assists newcomers to the field in performing state-of-the-art QC and pre-processing while offering data analysts an integral open-source package. Providing the scientific community with this easily accessible tool will allow improving data quality and reuse and adoption of standards. PMID:23620278

75 FR 8256 - Nicosulfuron; Pesticide Tolerances for Emergency Exemptions

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-24

....gov in the July 14, 2009 document ``Nicosulfuron: Human Health Risk Assessment for Proposed Section 18... considered adequate for purposes of assessing human health risk from this emergency exemption use. Available... the extrapolation from laboratory animal data to humans and in the variations in sensitivity among...

Linking Cognition and Literacy in Students with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Carnahan, Christina R.; Williamson, Pamela S.; Christman, Jennifer

2011-01-01

Literacy skills, especially silent reading comprehension, serve as the foundation for learning, independence, and quality of life for all individuals. It is well documented that students on the autism spectrum have difficulties with reading comprehension even though they demonstrate adequate decoding skills. Unfortunately, communication…

12 CFR 1808.619 - Reporting requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... requirements of this part and the Bond Documents; (3) Evaluate the impact of the CDFI Bond Guarantee Program... (5) Accomplish such other purposes that the CDFI Fund may deem appropriate. (b) Customer profiles...) are adequately served and to evaluate the impact of the CDFI Bond Guarantee Program. (c) Audits...

41 CFR 109-45.304-51 - Documentation.

Code of Federal Regulations, 2012 CFR

2012-01-01

... return for property sold. (g) When appropriate, full and adequate justification for not advertising the... of auction or spot bid sales, the following additional information should be included: (1) A summary listing of the advertising used (e.g., newspapers, radio, television, and public postings). (2) The names...

41 CFR 109-45.304-51 - Documentation.

Code of Federal Regulations, 2014 CFR

2014-01-01

... return for property sold. (g) When appropriate, full and adequate justification for not advertising the... of auction or spot bid sales, the following additional information should be included: (1) A summary listing of the advertising used (e.g., newspapers, radio, television, and public postings). (2) The names...

41 CFR 109-45.304-51 - Documentation.

Code of Federal Regulations, 2013 CFR

2013-07-01

... return for property sold. (g) When appropriate, full and adequate justification for not advertising the... of auction or spot bid sales, the following additional information should be included: (1) A summary listing of the advertising used (e.g., newspapers, radio, television, and public postings). (2) The names...

41 CFR 109-45.304-51 - Documentation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... return for property sold. (g) When appropriate, full and adequate justification for not advertising the... of auction or spot bid sales, the following additional information should be included: (1) A summary listing of the advertising used (e.g., newspapers, radio, television, and public postings). (2) The names...

41 CFR 109-45.304-51 - Documentation.

Code of Federal Regulations, 2011 CFR

2011-01-01

... return for property sold. (g) When appropriate, full and adequate justification for not advertising the... of auction or spot bid sales, the following additional information should be included: (1) A summary listing of the advertising used (e.g., newspapers, radio, television, and public postings). (2) The names...

40 CFR 52.232 - Part D conditional approval.

Code of Federal Regulations, 2010 CFR

2010-07-01

... IX office). (ii) By January 1, 1981, a cutback asphalt rule which reflects reasonably available... SIP revision: (a) Adequate justification that the cutback asphalt rule represents RACT, (b) amendment of the cutback asphalt rule to conform with the controls recommended in the CTG document for cutback...

Aerospace Medicine: Immunizations and Chemoprophylaxis

DTIC Science & Technology

1995-11-01

disease transmission. 15.2. Navy and Marine Corps Only. Officer and enlisted acces- sions receive mumps vaccine and influenza vaccine year–round. 16...documented history of prior receipt of live virus mumps vaccine or MMR vaccine is adequate evidence of immunity. 34.3. Health Care Workers. All military and

15 CFR 27.115 - IRB records.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 15 Commerce and Foreign Trade 1 2013-01-01 2013-01-01 false IRB records. 27.115 Section 27.115... records. (a) An institution, or when appropriate an IRB, shall prepare and maintain adequate documentation of IRB activities, including the following: (1) Copies of all research proposals reviewed, scientific...

NCLB: Let's Get It Right

ERIC Educational Resources Information Center

American Federation of Teachers, 2005

2005-01-01

This document suggests changes to the No Child Left Behind Act (NCLB) in four targeted areas. Regarding Adequate Yearly Progress (AYP), The American Federation of Teachers (AFT) supports: (1) Setting challenging but demonstrably attainable student progress goals; (2) Judging school effectiveness by measuring progress of the same students over…

Effects of Multiple Crimps and Cable Length on Reflection Signatures from Long Cables

DOT National Transportation Integrated Search

2002-03-19

The accuracy of time domain reflectometry (TDR) measurements of rock shearing with cable lengths greater than 60 m has not been adequately documented. This paper presents the results of controlled crimping and shearing of a 530 m long, 22.2mm diamete...

Technical Basis for PNNL Beryllium Inventory

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

Johnson, Michelle Lynn

2014-07-09

The Department of Energy (DOE) issued Title 10 of the Code of Federal Regulations Part 850, “Chronic Beryllium Disease Prevention Program” (the Beryllium Rule) in 1999 and required full compliance by no later than January 7, 2002. The Beryllium Rule requires the development of a baseline beryllium inventory of the locations of beryllium operations and other locations of potential beryllium contamination at DOE facilities. The baseline beryllium inventory is also required to identify workers exposed or potentially exposed to beryllium at those locations. Prior to DOE issuing 10 CFR 850, Pacific Northwest Nuclear Laboratory (PNNL) had documented the beryllium characterizationmore » and worker exposure potential for multiple facilities in compliance with DOE’s 1997 Notice 440.1, “Interim Chronic Beryllium Disease.” After DOE’s issuance of 10 CFR 850, PNNL developed an implementation plan to be compliant by 2002. In 2014, an internal self-assessment (ITS #E-00748) of PNNL’s Chronic Beryllium Disease Prevention Program (CBDPP) identified several deficiencies. One deficiency is that the technical basis for establishing the baseline beryllium inventory when the Beryllium Rule was implemented was either not documented or not retrievable. In addition, the beryllium inventory itself had not been adequately documented and maintained since PNNL established its own CBDPP, separate from Hanford Site’s program. This document reconstructs PNNL’s baseline beryllium inventory as it would have existed when it achieved compliance with the Beryllium Rule in 2001 and provides the technical basis for the baseline beryllium inventory.« less

The influence of land-use change and landscape dynamics on the climate system: relevance to climate-change policy beyond the radiative effect of greenhouse gases.

PubMed

Pielke, Roger A; Marland, Gregg; Betts, Richard A; Chase, Thomas N; Eastman, Joseph L; Niles, John O; Niyogi, Dev Dutta S; Running, Steven W

2002-08-15

Our paper documents that land-use change impacts regional and global climate through the surface-energy budget, as well as through the carbon cycle. The surface-energy budget effects may be more important than the carbon-cycle effects. However, land-use impacts on climate cannot be adequately quantified with the usual metric of 'global warming potential'. A new metric is needed to quantify the human disturbance of the Earth's surface-energy budget. This 'regional climate change potential' could offer a new metric for developing a more inclusive climate protocol. This concept would also implicitly provide a mechanism to monitor potential local-scale environmental changes that could influence biodiversity.

A Review of Evidence-Based Traffic Engineering Measures Designed to Reduce Pedestrian–Motor Vehicle Crashes

PubMed Central

Retting, Richard A.; Ferguson, Susan A.; McCartt, Anne T.

2003-01-01

We provide a brief critical review and assessment of engineering modifications to the built environment that can reduce the risk of pedestrian injuries. In our review, we used the Transportation Research Information Services database to conduct a search for studies on engineering countermeasures documented in the scientific literature. We classified countermeasures into 3 categories—speed control, separation of pedestrians from vehicles, and measures that increase the visibility and conspicuity of pedestrians. We determined the measures and settings with the greatest potential for crash prevention. Our review, which emphasized inclusion of studies with adequate methodological designs, showed that modification of the built environment can substantially reduce the risk of pedestrian–vehicle crashes. PMID:12948963

A large-scale cryoelectronic system for biological sample banking

NASA Astrophysics Data System (ADS)

Shirley, Stephen G.; Durst, Christopher H. P.; Fuchs, Christian C.; Zimmermann, Heiko; Ihmig, Frank R.

2009-11-01

We describe a polymorphic electronic infrastructure for managing biological samples stored over liquid nitrogen. As part of this system we have developed new cryocontainers and carrier plates attached to Flash memory chips to have a redundant and portable set of data at each sample. Our experimental investigations show that basic Flash operation and endurance is adequate for the application down to liquid nitrogen temperatures. This identification technology can provide the best sample identification, documentation and tracking that brings added value to each sample. The first application of the system is in a worldwide collaborative research towards the production of an AIDS vaccine. The functionality and versatility of the system can lead to an essential optimization of sample and data exchange for global clinical studies.

A medical social work perspective on rehabilitation.

PubMed

Fugl-Meyer, Kerstin Sjögren

2016-10-12

This paper introduces a biopsychosocial model for use as a tool by medical social workers and other rehabilitation professionals for the descriptive analysis of the case history and follow-up of patients needing rehabilitative support. The model is based on action theory and emphasizes the demands on evidence-based clarification of the interplay between a subject's contextual life situation, their ability to act in order to realize their goals, and their emotional adaptation. Using clinical experience and literature searches, a standard operations procedure to adequately document the case history in clinical practice is suggested, thus providing strategies through which the work of medical social workers can be based on evidence. Some specific areas of concern for the medical social worker within the rehabilitation of disabled people are highlighted.

36 CFR 79.9 - Standards to determine when a repository possesses the capability to provide adequate long-term...

Code of Federal Regulations, 2010 CFR

2010-07-01

... repository possesses the capability to provide adequate long-term curatorial services. 79.9 Section 79.9... FEDERALLY-OWNED AND ADMINISTERED ARCHAEOLOGICAL COLLECTIONS § 79.9 Standards to determine when a repository... shall determine that a repository has the capability to provide adequate long-term curatorial services...

Nature's Notebook Provides Phenology Observations for NASA Juniper Phenology and Pollen Transport Project

NASA Technical Reports Server (NTRS)

Luval, J. C.; Crimmins, T. M.; Sprigg, W. A.; Levetin, E.; Huete, A.; Nickovic, S.; Prasad, A.; Vukovic, A.; VandeWater, P. K.; Budge, A. M.;

Physical, Social, and Political Inequities Constraining Girls' Menstrual Management at Schools in Informal Settlements of Nairobi, Kenya.

PubMed

Girod, Candace; Ellis, Anna; Andes, Karen L; Freeman, Matthew C; Caruso, Bethany A

2017-12-01

Access to adequate water and sanitation is limited in informal settlements, contributing to girls' challenges managing menstruation at school, especially when they cannot access materials to absorb menstrual blood and appropriate facilities for hygiene. This study documents differences between girls' experience of menstruation at public schools (where the Kenyan government provides menstrual pads) and private schools (where pads are not provided) in two informal settlements of Nairobi, Kenya. Results showed that supply chains to public schools were not reliable, and equitable pad provision was not assured. Girls in private schools struggled to access pads because they were not provided. Sanitation facilities were physically available, but Muslim girls were unable to practice ablution due to the design of toilets in our study schools. Girls experienced fear and anxiety due to harassment from male peers and had incomplete information about menstruation from teachers. Findings suggest that practitioners and policy-makers should acknowledge the diversity of school populations and monitor programs to ensure efforts do not contribute to inequity.

Deployment-related Respiratory Issues.

PubMed

Morris, Michael J; Rawlins, Frederic A; Forbes, Damon A; Skabelund, Andrew J; Lucero, Pedro F

2016-01-01

Military deployment to Southwest Asia since 2003 in support of Operations Enduring Freedom/Iraqi Freedom/New Dawn has presented unique challenges from a pulmonary perspective. Various airborne hazards in the deployed environment include suspended geologic dusts, burn pit smoke, vehicle exhaust emissions, industrial air pollution, and isolated exposure incidents. These exposures may give rise to both acute respiratory symptoms and in some instances development of chronic lung disease. While increased respiratory symptoms during deployment are well documented, there is limited data on whether inhalation of airborne particulate matter is causally related to an increase in either common or unique pulmonary diseases. While disease processes such as acute eosinophilic pneumonia and exacerbation of preexisting asthma have been adequately documented, there is significant controversy surrounding the potential effects of deployment exposures and development of rare pulmonary disorders such as constrictive bronchiolitis. The role of smoking and related disorders has yet to be defined. This article presents the current evidence for deployment-related respiratory symptoms and ongoing Department of Defense studies. Further, it also provides general recommendations for evaluating pulmonary health in the deployed military population.

Standard Review Plan for Environmental Restoration Program Quality Management Plans. Revision 2

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

Not Available

1993-12-01

The Department of Energy, Richland Operations Office (RL) Manual Environmental Restoration Program Quality System Requirements (QSR) for the Hanford Site, defines all quality requirements governing Hanford Environmental Restoration (ER) Program activities. The QSR requires that ER Program participants develop Quality Management Plans (QMPs) that describe how the QSR requirements will be implemented for their assigned scopes of work. This standard review plan (SRP) describes the ER program participant responsibilities for submittal of QMPs to the RL Environmental Restoration Division for review and the RL methodology for performing the reviews of participant QMPS. The SRP serves the following functions: acts asmore » a guide in the development or revision of QMPs to assure that the content is complete and adequate; acts as a checklist to be used by the RL staff in their review of participant QMPs; acts as an index or matrix between the requirements of the QSR and implementing methodologies described in the QMPs; decreases the time and subjectivity of document reviews; and provides a formal, documented method for describing exceptions, modifications, or waivers to established ER Program quality requirements.« less

Environmental/Biomedical Terminology Index

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

Huffstetler, J.K.; Dailey, N.S.; Rickert, L.W.

1976-12-01

The Information Center Complex (ICC), a centrally administered group of information centers, provides information support to environmental and biomedical research groups and others within and outside Oak Ridge National Laboratory. In-house data base building and development of specialized document collections are important elements of the ongoing activities of these centers. ICC groups must be concerned with language which will adequately classify and insure retrievability of document records. Language control problems are compounded when the complexity of modern scientific problem solving demands an interdisciplinary approach. Although there are several word lists, indexes, and thesauri specific to various scientific disciplines usually groupedmore » as Environmental Sciences, no single generally recognized authority can be used as a guide to the terminology of all environmental science. If biomedical terminology for the description of research on environmental effects is also needed, the problem becomes even more complex. The building of a word list which can be used as a general guide to the environmental/biomedical sciences has been a continuing activity of the Information Center Complex. This activity resulted in the publication of the Environmental Biomedical Terminology Index (EBTI).« less

A five-year review of burn injuries in Irrua

PubMed Central

Dongo, Andrew E; Irekpita, Eshobo E; Oseghale, Lilian O; Ogbebor, Charles E; Iyamu, Christopher E; Onuminya, John E

2007-01-01

Background The management of burns remains a challenge in developing countries. Few data exist to document the extent of the problem. This study provides data from a suburban setting by documenting the epidemiology of burn injury and ascertaining outcome of management. This will help in planning strategies for prevention of burns and reducing severity of complications. Methods A total of 72 patients admitted for burns between January 1st, 2002 and December 31st, 2006 at the Irrua specialist teaching hospital were studied retrospectively. Sources of information were the case notes and operation registers. Data extracted included demographics as well as treatment methods and outcome Results The results revealed male to female ratio of 2.1:1. Over 50% of the injuries occurred at home. There was a seasonal variation with over 40% of injuries occurring between November and January. The commonest etiologic agent was flame burn from kerosene explosion. There were 7 deaths in the series. Conclusion Burns are preventable. We recommend adequate supply of unadulterated petroleum products and establishment of burn centers. PMID:17956614

Hanford Site Composite Analysis Technical Approach Description: Groundwater Pathway Dose Calculation.

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

Morgans, D. L.; Lindberg, S. L.

The purpose of this technical approach document (TAD) is to document the assumptions, equations, and methods used to perform the groundwater pathway radiological dose calculations for the revised Hanford Site Composite Analysis (CA). DOE M 435.1-1, states, “The composite analysis results shall be used for planning, radiation protection activities, and future use commitments to minimize the likelihood that current low-level waste disposal activities will result in the need for future corrective or remedial actions to adequately protect the public and the environment.”

Position of the Academy of Nutrition and Dietetics: The Role of Medical Nutrition Therapy and Registered Dietitian Nutritionists in the Prevention and Treatment of Prediabetes and Type 2 Diabetes.

PubMed

Briggs Early, Kathaleen; Stanley, Kathleen

2018-02-01

It is the position of the Academy of Nutrition and Dietetics that for adults with prediabetes or type 2 diabetes, medical nutrition therapy (MNT) provided by registered dietitian nutritionists (RDNs) is effective in improving medical outcomes and quality of life, and is cost-effective. MNT provided by RDNs is also successful and essential to preventing progression of prediabetes and obesity to type 2 diabetes. It is essential that MNT provided by RDNs be integrated into health care systems and public health programs and be adequately reimbursed. The Academy's evidence-based nutrition practice guidelines for the prevention of diabetes and the management of diabetes document strong evidence supporting the clinical effectiveness of MNT provided by RDNs. Cost-effectiveness has also been documented. The nutrition practice guidelines recommend that as part of evidence-based health care, providers caring for individuals with prediabetes or type 2 diabetes should be referred to an RDN for individualized MNT upon diagnosis and at regular intervals throughout the lifespan as part of their treatment regimen. Standards of care for three levels of diabetes practice have been published by the Diabetes Care and Education Practice Group. RDNs are also qualified to provide additional services beyond MNT in diabetes care and management. Unfortunately, barriers to accessing RDN services exist. Reimbursement for services is essential. Major medical and health organizations have provided support for the essential role of MNT and RDNs for the prevention and treatment of type 2 diabetes. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

European Policies to Promote Children's Rights and Combat Child Poverty.

PubMed

Sandbæk, Mona

2017-07-26

The upbringing of children relies heavily on shared responsibilities between parents and society. The Council of Europe Recommendation (2006) 19 on Policy to Support Positive Parenting and the European Commission Recommendation (2013) Investing in Children: Breaking the Cycle of Disadvantage, both aim at supporting parents to care and provide for their children in accordance with the UN Convention on the Rights of the Child. By means of a document analysis this article examines what kind of parental practices and provision to parents the recommendations suggest to safeguard children's rights in the family. Three findings are highlighted: first, both recommendations reflect a commitment to respecting children's rights while at the same time acknowledging parents as children's primary caregivers. Second, both recognize parents' rights to work, while also recognizing the necessity of adequate income support if work is not available or income too low. Third, adequate resources are defined as a combination of universal policies and services, which guarantee a minimum level for all, and targeted measures reaching out to the most disadvantaged. The recommendations' emphasis on children and parents as partners and on the families' economic situations are valuable for future development of family and child policy and support programs.

European Policies to Promote Children’s Rights and Combat Child Poverty

PubMed Central

Sandbæk, Mona

2017-01-01

The upbringing of children relies heavily on shared responsibilities between parents and society. The Council of Europe Recommendation (2006) 19 on Policy to Support Positive Parenting and the European Commission Recommendation (2013) Investing in Children: Breaking the Cycle of Disadvantage, both aim at supporting parents to care and provide for their children in accordance with the UN Convention on the Rights of the Child. By means of a document analysis this article examines what kind of parental practices and provision to parents the recommendations suggest to safeguard children’s rights in the family. Three findings are highlighted: first, both recommendations reflect a commitment to respecting children’s rights while at the same time acknowledging parents as children’s primary caregivers. Second, both recognize parents’ rights to work, while also recognizing the necessity of adequate income support if work is not available or income too low. Third, adequate resources are defined as a combination of universal policies and services, which guarantee a minimum level for all, and targeted measures reaching out to the most disadvantaged. The recommendations’ emphasis on children and parents as partners and on the families’ economic situations are valuable for future development of family and child policy and support programs. PMID:28933743

Proceedings of the IAEA specialists` meeting on cracking in LWR RPV head penetrations

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

Pugh, C.E.; Raney, S.J.

1996-07-01

This report contains 17 papers that were presented in four sessions at the IAEA Specialists` meeting on Cracking in LWR RPV Head Penetrations held at ASTM Headquarters in Philadelphia on May 2-3, 1995. The papers are compiled here in the order that presentations were made in the sessions, and they relate to operational observations, inspection techniques, analytical modeling, and regulatory control. The goal of the meeting was to allow international experts to review experience in the field of ensuring adequate performance of reactor pressure vessel (RPV) heads and penetrations. The emphasis was to allow a better understanding of RPV materialmore » behavior, to provide guidance supporting reliability and adequate performance, and to assist in defining directions for further investigations. The international nature of the meeting is illustrated by the fact that papers were presented by researchers from 10 countries. There were technical experts present form other countries who participated in discussions of the results presented. This present document incorporates the final version of the papers as received from the authors. The final chapter includes conclusions and recommendations. Individual papers have been cataloged separately.« less

Equity in Assistance? Usability of a U.S. Government Food Assistance Application

ERIC Educational Resources Information Center

Saal, Leah Katherine

2016-01-01

This article focuses on the quantitative phase of a multiphase mixed methods study investigating adults' and families' access to government food assistance. The research evaluates participants' comprehension of, and ability to, adequately complete authentic complex texts--national food assistance application documents. Summative usability testing…

7 CFR 1940.318 - Completing environmental assessments for Class II actions.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., depending upon the seriousness of the potential impacts and the need for formal documentation. Appropriate... Public Law 103-354 to adequately assess the degree of a potential impact or the need for avoidance or... this subpart or the potential environmental impact is either controversial, complex, major, or...

7 CFR 1940.318 - Completing environmental assessments for Class II actions.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., depending upon the seriousness of the potential impacts and the need for formal documentation. Appropriate... Public Law 103-354 to adequately assess the degree of a potential impact or the need for avoidance or... this subpart or the potential environmental impact is either controversial, complex, major, or...

Report: PricewaterhouseCoopers, LLP Single Audit of Natural Resources Defense Council, Inc., for Year Ended June 30, 2003

EPA Pesticide Factsheets

Report #2006-S-00002, May 25, 2006. We did not adequately test and document the auditee’s compliance with Federal procurement regulations, and did not properly report the auditee’s lack of compliance with indirect cost proposal requirements.

Linking School Facility Conditions to Teacher Satisfaction and Success.

ERIC Educational Resources Information Center

Schneider, Mark.

School facilities directly affect teaching and learning. Poor conditions make it more difficult for teachers to deliver an adequate education to their students, adversely affect teachers' health, and increase the likelihood that teachers will leave their school. This study documented how teachers in Chicago and Washington, DC rated their working…

Design of Chemistry Teacher Education Course on Nature of Science

ERIC Educational Resources Information Center

Vesterinen, Veli-Matti; Aksela, Maija

2013-01-01

To enhance students' understanding of nature of science (NOS), teachers need adequate pedagogical content knowledge related to NOS. The educational design research study presented here describes the design and development of a pre-service chemistry teacher education course on NOS instruction. The study documents two iterative cycles of…

42 CFR 488.18 - Documentation of findings.

Code of Federal Regulations, 2014 CFR

2014-10-01

... conditions of participation, requirements (for SNFs and NFs), or conditions for coverage must be adequately... with the conditions or requirements (for SNFs and NFs), and therefore not eligible to participate in... requirements (for SNFs and NFs) or as meeting the requirements for special certification (see § 488.54), with...

42 CFR 488.18 - Documentation of findings.

Code of Federal Regulations, 2012 CFR

2012-10-01

... conditions of participation, requirements (for SNFs and NFs), or conditions for coverage must be adequately... with the conditions or requirements (for SNFs and NFs), and therefore not eligible to participate in... requirements (for SNFs and NFs) or as meeting the requirements for special certification (see § 488.54), with...

42 CFR 488.18 - Documentation of findings.

Code of Federal Regulations, 2011 CFR

2011-10-01

... conditions of participation, requirements (for SNFs and NFs), or conditions for coverage must be adequately... with the conditions or requirements (for SNFs and NFs), and therefore not eligible to participate in... requirements (for SNFs and NFs) or as meeting the requirements for special certification (see § 488.54), with...

42 CFR 488.18 - Documentation of findings.

Code of Federal Regulations, 2010 CFR

2010-10-01

... conditions of participation, requirements (for SNFs and NFs), or conditions for coverage must be adequately... with the conditions or requirements (for SNFs and NFs), and therefore not eligible to participate in... requirements (for SNFs and NFs) or as meeting the requirements for special certification (see § 488.54), with...

42 CFR 488.18 - Documentation of findings.

Code of Federal Regulations, 2013 CFR

2013-10-01

... conditions of participation, requirements (for SNFs and NFs), or conditions for coverage must be adequately... with the conditions or requirements (for SNFs and NFs), and therefore not eligible to participate in... requirements (for SNFs and NFs) or as meeting the requirements for special certification (see § 488.54), with...

32 CFR 651.33 - Actions normally requiring an EA.

Code of Federal Regulations, 2010 CFR

2010-07-01

... for the use of a CX: (a) Special field training exercises or test activities in excess of five acres... off-post construction. (c) Changes to established installation land use that generate impacts on the..., and the action is not adequately addressed by existing NEPA documentation. Examples of actions...

Building on Strength: Positive Youth Development in Juvenile Justice Programs

ERIC Educational Resources Information Center

Barton William H.; Butts, Jeffrey A.

2008-01-01

This report describes the results of an exploratory study of juvenile justice programs where managers and practitioners are attempting to build youth interventions with strength-based, positive youth development principles. Previous researchers have not adequately documented how such reforms take place, let alone whether they produce effective…

9 CFR 3.81 - Environment enhancement to promote psychological well-being.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Environment enhancement to promote..., Treatment, and Transportation of Nonhuman Primates 2 Facilities and Operating Standards § 3.81 Environment..., document, and follow an appropriate plan for environment enhancement adequate to promote the psychological...

9 CFR 3.81 - Environment enhancement to promote psychological well-being.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Environment enhancement to promote..., Treatment, and Transportation of Nonhuman Primates 2 Facilities and Operating Standards § 3.81 Environment..., document, and follow an appropriate plan for environment enhancement adequate to promote the psychological...

9 CFR 3.81 - Environment enhancement to promote psychological well-being.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Environment enhancement to promote..., Treatment, and Transportation of Nonhuman Primates 2 Facilities and Operating Standards § 3.81 Environment..., document, and follow an appropriate plan for environment enhancement adequate to promote the psychological...

Space and Place: Urban Parents' Geographical Preferences for Schools

ERIC Educational Resources Information Center

Bell, Courtney A.

2007-01-01

Prior research documents the almost universal preference for schools that are "convenient." Drawing on longitudinal interview data gathered from 36 urban parents, I argue parents' preference for "convenient" schools is more complex than previously understood. Conceptions of geography used by policy makers do not adequately capture the ways in…

33 CFR 157.12g - Plan approval requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... OIL IN BULK Design, Equipment, and Installation § 157.12g Plan approval requirements. Adequate documentation must be prepared well in advance of the intended installation of a monitoring system and must be... ballast handling manuals. Special considerations will be given to installations in oil tankers, which have...

Education and Job Satisfaction: A Questionable Payoff.

ERIC Educational Resources Information Center

Baldi de Mandilovitch, Martha S.; Quinn, Robert P.

The relationship between education and job satisfaction has not been sufficiently well documented to qualify as unquestionable. Published research on the subject either fails to adequately assess the influence of education on job satisfaction or is too occupationally and/or geographically limited to form the basis for generalization. To examine on…

16 CFR § 1028.115 - IRB records.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 16 Commercial Practices 2 2013-01-01 2013-01-01 false IRB records. § 1028.115 Section § 1028.115... records. (a) An institution, or when appropriate an IRB, shall prepare and maintain adequate documentation of IRB activities, including the following: (1) Copies of all research proposals reviewed, scientific...

Matching Linguistic Training with Individual Indigenous Community's Needs

ERIC Educational Resources Information Center

Caffery, Jo

2016-01-01

Australia is rapidly losing its Indigenous multicultural and multilingual identity. This vast continent has lost 90 per cent of its Indigenous languages and cultures, without adequate documentation, and risks losing the rest by 2050 if action is not taken. There are formal, accredited linguistics courses designed specifically for Indigenous…

Administration of Public School Transportation. School Business Administration Publication No. 6.

ERIC Educational Resources Information Center

California State Dept. of Education, Sacramento. Bureau of Administrative Services.

This document is intended to help California school boards in the selection of an appropriate and adequate student transportation system; and in the establishment, operation, and maintenance of a school bus fleet. Guidelines and pertinent State legislation are given for school bus purchase, maintenance, insurance and replacement; health…

NATO CBRN Medical Working Group Table Top Exercise on International Health Regulations: Documentation and Output

DTIC Science & Technology

2014-05-01

DHSC) in Munich, Germany for the purpose of consolidating and analyzing biosurveillance information collected from NATO forces. Discussions during...to ensure the application of adequate measures for the protection of public health. • Article 15 Temporary recommendations – If it has been

40 CFR 160.81 - Standard operating procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... methods that management is satisfied are adequate to insure the quality and integrity of the data... authorized by the study director and shall be documented in the raw data. Significant changes in established... procedures shall be established for, but not limited to, the following: (1) Test system area preparation. (2...

40 CFR 160.81 - Standard operating procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... methods that management is satisfied are adequate to insure the quality and integrity of the data... authorized by the study director and shall be documented in the raw data. Significant changes in established... procedures shall be established for, but not limited to, the following: (1) Test system area preparation. (2...

41 CFR 101-30.505 - Assistance by Government suppliers.

Code of Federal Regulations, 2010 CFR

2010-07-01

... need for the new item shall determine whether or not adequate identification data for cataloging the item are available. If the data are not available, the agency may specify in procurement documents the use of Federal Standard No. 5, Standard Guides for Preparation of Proposed Item Logistics Data Records...

41 CFR 101-30.505 - Assistance by Government suppliers.

Code of Federal Regulations, 2011 CFR

2011-07-01

... need for the new item shall determine whether or not adequate identification data for cataloging the item are available. If the data are not available, the agency may specify in procurement documents the use of Federal Standard No. 5, Standard Guides for Preparation of Proposed Item Logistics Data Records...

7 CFR 1430.305 - Proof of production.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., including any dumped production and dairy cow purchases, for each month of the period July 2004 through... confirm the production history and losses incurred by the dairy operation. (d) Adequate proof of dairy cow..., invoices, State health certificates, or any other documents available to confirm the cow purchases. (e) All...

Childhood in Crisis: Our Future at Risk. Issues in Education.

ERIC Educational Resources Information Center

Haller, Marilyn L.

2003-01-01

Documents the need for and importance of high-quality child care; the influence of caregivers on children's cognitive, social, and emotional development; qualifications of and remuneration for child caregivers; and the relation of quality care to lower juvenile crime. Proposes that child caregivers be given adequate training (including alternate…

Current practice and perspectives in CRO oversight based on a survey performed among members of the German Association of Research-Based Pharmaceutical Companies (vfa)

PubMed Central

Hennig, Michael; Hundt, Ferdinand; Busta, Susanne; Mikus, Stefan; Sanden, Per-Holger; Sörgel, Andrea; Ruppert, Thorsten

2017-01-01

In recent years, the number and scope of outsourced activities in the pharmaceutical industry have increased heavily. In addition, also the type of outsourcing has changed significantly in that time. This raises the question of whether and how sponsors retain the capability to select and to control the contract research organizations (CROs) involved and what expertise still has to be present in the development department as well as other relevant departments to ensure adequate oversight, also in line with the expectations of regulators and health authorities. In order to answer these questions, a survey was conducted among the German vfa member companies. The survey describes the latest developments and experiences in outsourcing by 18 German vfa member companies. It concentrates on measures how to implement Quality Assurance (QA) when performing outsourced clinical studies. This study shows that the majority of companies apply a full-outsourcing, preferred-provider model of clinical trial services, with the clinical research department playing the major role in this process. A large amount of guiding documents, processes and tools are used to ensure an adequate oversight of the services performed by the CRO(s). Finally the guiding principles for all oversight processes should be transparent communication, a clearly established expectation for quality, a precise definition of accountability and responsibility while avoiding silo mentality, and a comprehensive documentation of the oversight’s evidence. For globally acting and outsourcing sponsors, oversight processes need to be aligned with regards to local and global perspectives. This survey shows that the current implementation of oversight processes in the participating companies covers all relevant areas to ensure highest quality and integrity of the data produced by the outsourced clinical trial. PMID:28163667

Current practice and perspectives in CRO oversight based on a survey performed among members of the German Association of Research-Based Pharmaceutical Companies (vfa).

PubMed

Hennig, Michael; Hundt, Ferdinand; Busta, Susanne; Mikus, Stefan; Sanden, Per-Holger; Sörgel, Andrea; Ruppert, Thorsten

2017-01-01

In recent years, the number and scope of outsourced activities in the pharmaceutical industry have increased heavily. In addition, also the type of outsourcing has changed significantly in that time. This raises the question of whether and how sponsors retain the capability to select and to control the contract research organizations (CROs) involved and what expertise still has to be present in the development department as well as other relevant departments to ensure adequate oversight, also in line with the expectations of regulators and health authorities. In order to answer these questions, a survey was conducted among the German vfa member companies. The survey describes the latest developments and experiences in outsourcing by 18 German vfa member companies. It concentrates on measures how to implement Quality Assurance (QA) when performing outsourced clinical studies. This study shows that the majority of companies apply a full-outsourcing, preferred-provider model of clinical trial services, with the clinical research department playing the major role in this process. A large amount of guiding documents, processes and tools are used to ensure an adequate oversight of the services performed by the CRO(s). Finally the guiding principles for all oversight processes should be transparent communication, a clearly established expectation for quality, a precise definition of accountability and responsibility while avoiding silo mentality, and a comprehensive documentation of the oversight's evidence. For globally acting and outsourcing sponsors, oversight processes need to be aligned with regards to local and global perspectives. This survey shows that the current implementation of oversight processes in the participating companies covers all relevant areas to ensure highest quality and integrity of the data produced by the outsourced clinical trial.

A novel, web-based application for assessing and enhancing practice-based learning in surgery residency.

PubMed

Wu, Bob J; Dietz, Patrick A; Bordley, James; Borgstrom, David C

2009-01-01

Practice-Based Learning and Improvement (PBLI) is 1 of 6 integral competencies required by the Accreditation Council for Graduate Medical Education (ACGME) for proof of adequate resident training and accreditation of residency programs. Moreover, the Outcome Project of the ACGME is beginning to enforce the provision of documented, objective evidence of resident PBLI. Current assessment tools, such as resident portfolios and performance evaluations, by faculty tend to be qualitative in nature. However, few objective, outcome-based, and quantitative evaluation tools have been developed. A web-based application was designed to assess every consultation performed by senior residents at a university-affiliated general surgery residency. In real time, residents documented patient presentations along with their initial impression and plan. As patient outcomes became available, they were also documented into this application, which allowed residents to self-assess whether their impressions and plans were correct. A running "batting average" (BA) is then calculated based on percentage correct. Seven senior residents participated in this study, which included a total of 459 consults: 222 documented by PGY4 residents and 237 documented by PGY5 residents. The average BA of PGY4 residents in their first 3 months was 82.9%, which was followed by 85.9%, 88.7%, and 94.3% for each of the next 3 quarters. For PGY5 residents, the corresponding results were 96.4%, 94.4%, 93.8%, and 96.4% respectively. A web-based outcome-tracking program is useful for conducting rapid and ongoing evaluation of residents' practice-based learning, generating data for analysis of individual resident knowledge gaps, stimulating self-assessment and targeted learning, as well as providing objective data of PBLI for accreditation purposes.

76 FR 68373 - Proposed Revision to Vintage Date Requirements

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-04

... foreign, while still ensuring that consumers are provided with adequate information as to the identity and... labels provide the consumer with adequate information as to the identity and quality of the product. The... mandate to ensure that consumers have adequate information about the quality and identity of the product...

36 CFR 79.7 - Methods to fund curatorial services.

Code of Federal Regulations, 2014 CFR

2014-07-01

... available for adequate, long-term care and maintenance of collections. Those methods include, but are not..., expanding, operating, and maintaining a repository that has the capability to provide adequate long-term... with a repository that has the capability to provide adequate long-term curatorial services as set...

36 CFR 79.7 - Methods to fund curatorial services.

Code of Federal Regulations, 2012 CFR

2012-07-01

... available for adequate, long-term care and maintenance of collections. Those methods include, but are not..., expanding, operating, and maintaining a repository that has the capability to provide adequate long-term... with a repository that has the capability to provide adequate long-term curatorial services as set...

36 CFR 79.7 - Methods to fund curatorial services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... available for adequate, long-term care and maintenance of collections. Those methods include, but are not..., expanding, operating, and maintaining a repository that has the capability to provide adequate long-term... with a repository that has the capability to provide adequate long-term curatorial services as set...

36 CFR 79.7 - Methods to fund curatorial services.

Code of Federal Regulations, 2011 CFR

2011-07-01

... available for adequate, long-term care and maintenance of collections. Those methods include, but are not..., expanding, operating, and maintaining a repository that has the capability to provide adequate long-term... with a repository that has the capability to provide adequate long-term curatorial services as set...

36 CFR 79.7 - Methods to fund curatorial services.

Code of Federal Regulations, 2013 CFR

2013-07-01

... available for adequate, long-term care and maintenance of collections. Those methods include, but are not..., expanding, operating, and maintaining a repository that has the capability to provide adequate long-term... with a repository that has the capability to provide adequate long-term curatorial services as set...

Neural networks for data mining electronic text collections

NASA Astrophysics Data System (ADS)

Walker, Nicholas; Truman, Gregory

1997-04-01

The use of neural networks in information retrieval and text analysis has primarily suffered from the issues of adequate document representation, the ability to scale to very large collections, dynamism in the face of new information and the practical difficulties of basing the design on the use of supervised training sets. Perhaps the most important approach to begin solving these problems is the use of `intermediate entities' which reduce the dimensionality of document representations and the size of documents collections to manageable levels coupled with the use of unsupervised neural network paradigms. This paper describes the issues, a fully configured neural network-based text analysis system--dataHARVEST--aimed at data mining text collections which begins this process, along with the remaining difficulties and potential ways forward.

Vaccines provided by family physicians.

PubMed

Campos-Outcalt, Doug; Jeffcott-Pera, Michelle; Carter-Smith, Pamela; Schoof, Bellinda K; Young, Herbert F

2010-01-01

This study was conducted to document current immunization practices by family physicians. In 2008 the American Academy of Family Physicians (AAFP) conducted a survey among a random sample of 2,000 of its members who reported spending 80% or more of their time in direct patient care. The survey consisted of questions regarding the demographics of the practice, vaccines that are provided at the physicians' clinical site, whether the practice refers patients elsewhere for vaccines, and participation in the Vaccines for Children (VFC) program. The response rate was 38.5%, 31.8% after non-office-based respondents were deleted. A high proportion of respondents (80% or more) reported providing most routinely recommended child, adolescent, and adult vaccines at their practice sites. The exceptions were rotavirus vaccine for children and herpes zoster vaccine for adults., A significant proportion, however, reported referring elsewhere for some vaccines (44.1% for children and adolescent vaccines and 53.5% for adult vaccines), with the most frequent referral location being a public health department. A higher proportion of solo and 2-physician practices than larger practices reported referring patients. A lack of adequate payment was listed as the reason for referring patients elsewhere for vaccines by one-half of those who refer patients. One-half of responders do not participate in the VFC program. Provision of recommended vaccines by most family physicians remains an important service. Smaller practices have more difficulty offering a full array of vaccine products, and lack of adequate payment contributes to referring patients outside the medical home. The reasons behind the lack of participation in the VFC program deserve further study.

Migration patterns and wintering range of common loons breeding in the Northeastern United States

USGS Publications Warehouse

Kenow, K.P.; Adams, D.; Schoch, N.; Evers, D.C.; Hanson, W.; Yates, D.; Savoy, L.; Fox, T.J.; Major, A.; Kratt, R.; Ozard, J.

2009-01-01

A study, using satellite telemetry, was conducted to determine the precise migration patterns and wintering locations of Common Loons (Gavia immer) breeding in the northeastern United States. Transmitters were implanted in 17 loons (16 adults and one juvenile) that were captured on breeding lakes in New York, New Hampshire, and Maine during the summers of 2003, 2004, and 2005. Transmitters from ten of the birds provided adequate location data to document movement to wintering areas. Most adult loons appeared to travel non-stop from breeding lakes, or neighboring lakes (within 15 km), to the Atlantic coast. Adult loons marked in New Hampshire and Maine wintered 152 to 239 km from breeding lakes, along the Maine coast. Adult loons marked in the Adirondack Park of New York wintered along the coasts of Massachusetts (414 km from breeding lake), Rhode Island (362 km), and southern New Jersey (527 km). Most of the loons remained relatively stationary throughout the winter, but the size of individual wintering areas of adult loons ranged from 43 to 1,159 km 2, based on a 95% fixed kernel utilization distribution probability. A juvenile bird from New York made a number of stops at lakes and reservoirs en route to Long Island Sound (325 km from breeding lake). Maximum functional life of transmitters was about 12 months, providing an opportunity to document spring migration movements as well. This work provides essential information for development and implementation of regional Common Loon conservation strategies in the Northeastern U.S.

34 CFR 300.311 - Specific documentation for the eligibility determination.

Code of Federal Regulations, 2012 CFR

2012-07-01

... does not achieve adequately for the child's age or to meet State-approved grade-level standards...-approved grade-level standards consistent with § 300.309(a)(2)(i); or (B) The child exhibits a pattern of strengths and weaknesses in performance, achievement, or both, relative to age, State-approved grade level...

34 CFR 300.311 - Specific documentation for the eligibility determination.

Code of Federal Regulations, 2014 CFR

2014-07-01

... adequately for the child's age or to meet State-approved grade-level standards consistent with § 300.309(a)(1); and (ii)(A) The child does not make sufficient progress to meet age or State-approved grade-level... weaknesses in performance, achievement, or both, relative to age, State-approved grade level standards or...

34 CFR 300.311 - Specific documentation for the eligibility determination.

Code of Federal Regulations, 2013 CFR

2013-07-01

... does not achieve adequately for the child's age or to meet State-approved grade-level standards...-approved grade-level standards consistent with § 300.309(a)(2)(i); or (B) The child exhibits a pattern of strengths and weaknesses in performance, achievement, or both, relative to age, State-approved grade level...

43 CFR 418.9 - Reporting changes in eligible land.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Conditions of Water Delivery § 418.9 Reporting changes in eligible land. (a) Eligible land anticipated to be... each water user that year. (i) Any adjustments based on changes in lands anticipated to be irrigated... adequate documentation, the District may notify the Bureau of any changes in domestic water requirements at...

43 CFR 418.9 - Reporting changes in eligible land.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Conditions of Water Delivery § 418.9 Reporting changes in eligible land. (a) Eligible land anticipated to be... each water user that year. (i) Any adjustments based on changes in lands anticipated to be irrigated... adequate documentation, the District may notify the Bureau of any changes in domestic water requirements at...

43 CFR 418.9 - Reporting changes in eligible land.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Conditions of Water Delivery § 418.9 Reporting changes in eligible land. (a) Eligible land anticipated to be... each water user that year. (i) Any adjustments based on changes in lands anticipated to be irrigated... adequate documentation, the District may notify the Bureau of any changes in domestic water requirements at...

43 CFR 418.9 - Reporting changes in eligible land.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Conditions of Water Delivery § 418.9 Reporting changes in eligible land. (a) Eligible land anticipated to be... each water user that year. (i) Any adjustments based on changes in lands anticipated to be irrigated... adequate documentation, the District may notify the Bureau of any changes in domestic water requirements at...

Late reversal reaction after 10 years of adequately treated leprosy.

PubMed Central

Thacker, A. K.; Kumar, P.; Mukhija, R. D.; Sharma, S. P.

1997-01-01

Differentiation between a relapse or late reversal reaction following completion of regular drug therapy in patients with leprosy is often difficult, though it has definite therapeutic implications. The present case documents a late reversal reaction occurring an unusually long time after the completion of multi-drug therapy. Images Figure PMID:9519194

Development and Validation of a Behavioral Screener for Preschool-Age Children

ERIC Educational Resources Information Center

DiStefano, Christine A.; Kamphaus, Randy W.

2007-01-01

The purpose of this study was to document the development of a short behavioral scale that could be used to assess preschoolers' behavior while still retaining adequate scale coverage, reliability, and validity. Factor analysis and item analysis techniques were applied to data from a nationally representative, normative database to create a…

Modeling Rare and Unique Documents: Using FRBR[subscript OO]/CIDOC CRM

ERIC Educational Resources Information Center

Le Boeuf, Patrick

2012-01-01

Both the library and the museum communities have developed conceptual models for the information they produce about the collections they hold: FRBR (Functional Requirements for Bibliographic Records) and CIDOC CRM (Conceptual Reference Model). But neither proves perfectly adequate when it comes to some specific types of rare and unique materials:…

What Does the Research Tell Us about Teacher Leadership? Research Brief

ERIC Educational Resources Information Center

Center for Comprehensive School Reform and Improvement, 2005

2005-01-01

In this age of high accountability, teacher quality is receiving more attention than ever before. Research that investigates ways to increase teacher quality is much needed, making this study a timely addition to the literature. Although increases in student achievement related to teacher quality have yet to be adequately documented, the research…

Interservice Procedures for Instructional Systems Development: Executive Summary and Model.

ERIC Educational Resources Information Center

Branson, Robert K.

The document is the last of a five-part series focusing in minute detail on the processes involved in the formulation of an instructional systems development (ISD) program for military interservice training that will adequately train individuals to do a particular job and which can also be applied to any interservice curriculum development…

Curriculum-Making in South Africa: Promoting Gender Equality and Empowering Women (?)

ERIC Educational Resources Information Center

Simmonds, Shan

2014-01-01

The United Nations Millennium Development Goals (2000-2015) are clearly embedded in South Africa's education policy documents. However, they are not adequately infused into the curriculum. This article focuses specifically on the third Millennium Development Goal (MDG) - promoting gender equality and empowering women - and the need to place this…

12 CFR 621.7 - Rule of aggregation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... constitutes an independent credit risk and such determination is adequately documented in the loan file. (1) A loan shall be considered an independent credit risk if a substantial portion of the loan is guaranteed... credit risks if and so long as: (i) The primary sources of repayment are independent for each loan; (ii...

7 CFR 1794.72 - Adoption of an EIS.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AGRICULTURE (CONTINUED) ENVIRONMENTAL POLICIES AND PROCEDURES Adoption of Environmental Documents § 1794.72... portion of the EIS as a part of its draft EIS. The circulation and notice provisions for a draft and final... agency's EIS is adequate, RUS shall adopt that agency's EIS as its final EIS. RUS and the applicant shall...

40 CFR 725.235 - Conditions of exemption for activities conducted inside a structure.

Code of Federal Regulations, 2010 CFR

2010-07-01

... exposed, or any other method of notification which adequately informs persons of health risks which the... nature and method of notification of risk, including copies of any labels or written notices used. (C... determine the need to make any notification of risk. (iii) Documentation of the nature and method of...

Dullgren extraction of soil mites (Acarina): Effect of refrigeration time on extraction efficiency

Treesearch

Michelle B. Lakly; D.A. Crossley

2000-01-01

Soil microarthropods constitute one of the most species rich communities in . forest ecosystems (Crossley & Blair, 1991). The effects of soil fauna in these systems on decomposition rates, nutrient regeneration and soil structure have been well documented; however, dependable estimates of population size and community structure largely depend upon adequate sampling...

10 CFR 1021.330 - Programmatic (including site-wide) NEPA documents.

Code of Federal Regulations, 2010 CFR

2010-01-01

... prepare a programmatic EIS or EA (40 CFR 1502.4). DOE may also prepare a programmatic EIS or EA at any... Analysis, DOE shall determine whether the existing EIS remains adequate or whether to prepare a new site-wide EIS or supplement the existing EIS, as appropriate. The determination and supporting analysis...

25 CFR 542.10 - What are the minimum internal control standards for keno?

Code of Federal Regulations, 2014 CFR

2014-04-01

...) The random number generator shall be linked to the computer system and shall directly relay the... information shall be generated by the computer system. (2) This documentation shall be restricted to... to the computer system shall be adequately restricted (i.e., passwords are changed at least quarterly...

50 CFR 253.12 - Guaranteed note, U.S. note, and security documents.

Code of Federal Regulations, 2010 CFR

2010-10-01

... substantial pledged assets other than the project property, and all major limited partners. The Division may... credit judgment, be less. (2) Maturity. This may not exceed 25 years, but shall not exceed the project... pledge of all project property (or adequate substitute collateral). The Division will require such other...

External Stakeholders' Roles and Factors Influencing Their Participation in Developing Generic Skills for Students in Vietnamese Universities

ERIC Educational Resources Information Center

Nghia, Tran Le Huu

2018-01-01

External stakeholders have increasingly participated in instructional and training activities in higher education; however, their contribution has not yet been adequately documented, especially in non-Western university contexts. This article reports a study that examined external stakeholders' roles and factors influencing their participation in…

Work Experience Employability Skills, Junior High.

ERIC Educational Resources Information Center

Mims, Murry; And Others

Educators have long recognized the need for schools to train students adequately for the world of work. This training includes both the necessary technical skills and employability skills. This document, the Employability Skills Guide, is Duval County Schools' part of such a plan to meet this need. The performance objectives utilized in this guide…

Effectiveness of a Middle School Summer Mathematics Remediation Program

ERIC Educational Resources Information Center

Chapman, Scott

2013-01-01

The No Child Left Behind Act of 2001 requires schools to show measureable improvement in student achievement in order to demonstrate Adequate Yearly Progress. Although the Georgia Department of Education has documented the short-comings of Georgia's students in mathematics on standardized tests, little research has been done on short-term…

26 CFR 1.1012-1 - Basis of property.

Code of Federal Regulations, 2014 CFR

2014-04-01

... document. (i) Where the stock is left in the custody of a broker or other agent, an adequate identification... trustee or executor or administrator of an estate holding stock (not left in the custody of a broker... periodic acquisition of shares of L Company, a regulated investment company. W acquires for D's account...

iPhone 4s and iPhone 5s Imaging of the Eye

PubMed Central

Jalil, Maaz; Ferenczy, Sandor R.; Shields, Carol L.

2017-01-01

Background/Aims To evaluate the technical feasibility of a consumer-grade cellular iPhone camera as an ocular imaging device compared to existing ophthalmic imaging equipment for documentation purposes. Methods A comparison of iPhone 4s and 5s images was made with external facial images (macrophotography) using Nikon cameras, slit-lamp images (microphotography) using Zeiss photo slit-lamp camera, and fundus images (fundus photography) using RetCam II. Results In an analysis of six consecutive patients with ophthalmic conditions, both iPhones achieved documentation of external findings (macrophotography) using standard camera modality, tap to focus, and built-in flash. Both iPhones achieved documentation of anterior segment findings (microphotography) during slit-lamp examination through oculars. Both iPhones achieved fundus imaging using standard video modality with continuous iPhone illumination through an ophthalmic lens. Comparison to standard ophthalmic cameras, macrophotography and microphotography were excellent. In comparison to RetCam fundus photography, iPhone fundus photography revealed smaller field and was technically more difficult to obtain, but the quality was nearly similar to RetCam. Conclusions iPhone versions 4s and 5s can provide excellent ophthalmic macrophotography and microphotography and adequate fundus photography. We believe that iPhone imaging could be most useful in settings where expensive, complicated, and cumbersome imaging equipment is unavailable. PMID:28275604

78 FR 66366 - Draft Guidance for Industry: Use of Donor Screening Tests To Test Donors of Human Cells, Tissues...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-05

...The Food and Drug Administration (FDA) is announcing the availability of a draft document entitled ``Guidance for Industry: Use of Donor Screening Tests to Test Donors of Human Cells, Tissues, and Cellular and Tissue-Based Products (HCT/Ps) for Infection with Treponema pallidum (Syphilis),'' dated October 2013. The draft guidance document provides establishments that make donor eligibility determinations for donors of HCT/Ps (HCT/P Establishments), with updated recommendations concerning donor testing for evidence of Treponema pallidum (T. pallidum) infection, the etiologic agent of syphilis. HCT/P Establishments must, as required under Federal regulations, test a donor specimen for evidence of T. pallidum infection using appropriate FDA-licensed, approved, or cleared donor screening tests, in accordance with the manufacturer's instructions, unless an exception to this requirement applies. The draft guidance clarifies that FDA does not consider diagnostic tests or pre-amendment devices (which have not been licensed, approved, or cleared) to be adequate for use in donor testing for T. pallidum infection under the criteria specified in Federal regulations. The recommendations in this guidance, when finalized, will supersede those recommendations for testing HCT/P donors for evidence of T. pallidum infection contained in the document entitled ``Guidance for Industry: Eligibility Determination for Donors of Human Cells, Tissues, and Cellular and Tissue-Based Products (HCT/Ps),'' dated August 2007.

Environmental Baseline Survey for Installation of Five New Hydrogeologic Groundwater Monitoring Wells

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

Catechis, Christopher S.

This Phase I Environmental Baseline Survey (EBS) provides the findings of a survey and assessment for termination of an existing easement granted to the Department of Energy (DOE) for the installation of 5 new hydrogeologic groundwater monitoring wells located on KAFB, New Mexico. The purpose of this EBS is to: Document the nature, magnitude, and extent of any environmental contamination of the property. Identify potential environmental contamination liabilities associated with the property. Develop sufficient information to assess the health and safety risks. Ensure adequate protection for human health and the environment related to a specific property. Determine possible effects ofmore » contamination on property valuation, and serve as the basis for notice of environmental condition for applicable federal or local real property disclosure requirements.« less

Chemical Weapons Exposures in Iraq: Challenges of a Public Health Response a Decade Later.

PubMed

Baird, Coleen; Mirza, Raul; Sharkey, Jessica M; Teichman, Ron; Longmire, Romarius; Harkins, Deanna; Llanos, Joseph; Abraham, Joseph; McCannon, Charles; Heller, Jack; Tinklepaugh, Carole; Rice, William

2016-01-01

An October 14, 2014 article in The New York Times reported that the US Department of Defense (DoD) concealed, for nearly a decade, circumstances surrounding service members' exposure to chemical warfare agents (CWA) while deployed to Iraq in support of Operations Iraqi Freedom and New Dawn from March 13, 2003, to December 31, 2011, and alleged failure of the DoD to provide expedient and adequate medical care. This report prompted the DoD to devise a public health investigation, with the Army Public Health Center (Provisional) as the lead agency to identify, evaluate, document, and track CWA casualties of the Iraq war. Further, the DoD revisited and revised clinical guidelines and health policies concerning CWA exposure based on current evidence-based guidelines and best practices.

Analog to digital converter system for temperature monitoring -- B, C, D, DR, F, and H reactors

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

Ballowe, J.W.

1961-03-23

This document discusses a proposal that certain presently installed reactor process water outlet temperature data logging equipment in subject reactors to be replaced with new functionally simplified equipment of a more adequate design. The primary purpose of the proposed installation is to replace existing equipment which is obsolete and in three reactors is worn out to the point where the equipment is out of service frequently for periods of time up to 8 hours or more. The new equipment will provide reliable process tube temperature information for use in the functions of reactor control and product accountability. Based upon anticipatedmore » incremental production gains resulting from use of the new equipment, the amortization period for the project is calculated at 2.7 years.« less

The Multimission Image Processing Laboratory's virtual frame buffer interface

NASA Technical Reports Server (NTRS)

Wolfe, T.

1984-01-01

Large image processing systems use multiple frame buffers with differing architectures and vendor supplied interfaces. This variety of architectures and interfaces creates software development, maintenance and portability problems for application programs. Several machine-dependent graphics standards such as ANSI Core and GKS are available, but none of them are adequate for image processing. Therefore, the Multimission Image Processing laboratory project has implemented a programmer level virtual frame buffer interface. This interface makes all frame buffers appear as a generic frame buffer with a specified set of characteristics. This document defines the virtual frame uffer interface and provides information such as FORTRAN subroutine definitions, frame buffer characteristics, sample programs, etc. It is intended to be used by application programmers and system programmers who are adding new frame buffers to a system.

I-131 rose bengal excretion test is not dead

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

Antico, V.F.; Denhartog, P.; Ash, J.M.

1985-03-01

One hundred and thirty I-131 Rose Bengal Excretion Studies (RBI) were performed on 84 patients over nine years. In 90% (56/60) of cases with biliary atresia, the 72-hour RBI was less than or equal to 7%. In only 12.5% (3/24) of cases with neonatal hepatitis was the 72-hour RBI less than or equal to 7%. The accuracy of the test was 91% with a specificity of 88%. Thirty patients later were studied following a Kasai procedure. The RBI test reliably predicted the patency of the anastomosis. The authors conclude that the 72-hour RBI is a reliable test in the diagnosismore » of biliary atresia and in the documentation of biliary patency following surgery, provided adequate care is taken in stool collection and measurement.« less

RadVel: The Radial Velocity Modeling Toolkit

NASA Astrophysics Data System (ADS)

Fulton, Benjamin J.; Petigura, Erik A.; Blunt, Sarah; Sinukoff, Evan

2018-04-01

RadVel is an open-source Python package for modeling Keplerian orbits in radial velocity (RV) timeseries. RadVel provides a convenient framework to fit RVs using maximum a posteriori optimization and to compute robust confidence intervals by sampling the posterior probability density via Markov Chain Monte Carlo (MCMC). RadVel allows users to float or fix parameters, impose priors, and perform Bayesian model comparison. We have implemented real-time MCMC convergence tests to ensure adequate sampling of the posterior. RadVel can output a number of publication-quality plots and tables. Users may interface with RadVel through a convenient command-line interface or directly from Python. The code is object-oriented and thus naturally extensible. We encourage contributions from the community. Documentation is available at http://radvel.readthedocs.io.

Astronomical Activities with Disabled People

NASA Astrophysics Data System (ADS)

Gil, Amelia Ortiz

With this contribution we would like to share our experiences in organizing astronomical activities addressed to people with disabilities. The goal is twofold: we would like to invite all those with similar experiences to contribute to the compilation of a document to guide other astronomers who might be interested in carrying out these kind of activities aimed at groups of people with special needs. We also want to persuade public outreach officers that working with disabled people is not as difficult as it may seem at first, as long as they are provided with adequate educational material and guidelines about how to do it. The final goal is to build a repository that can be used by educators and public outreach officers as a guide when working with disabled people, specially during the International Year of Astronomy.

Ontology-Driven Search and Triage: Design of a Web-Based Visual Interface for MEDLINE.

PubMed

Demelo, Jonathan; Parsons, Paul; Sedig, Kamran

2017-02-02

Diverse users need to search health and medical literature to satisfy open-ended goals such as making evidence-based decisions and updating their knowledge. However, doing so is challenging due to at least two major difficulties: (1) articulating information needs using accurate vocabulary and (2) dealing with large document sets returned from searches. Common search interfaces such as PubMed do not provide adequate support for exploratory search tasks. Our objective was to improve support for exploratory search tasks by combining two strategies in the design of an interactive visual interface by (1) using a formal ontology to help users build domain-specific knowledge and vocabulary and (2) providing multi-stage triaging support to help mitigate the information overload problem. We developed a Web-based tool, Ontology-Driven Visual Search and Triage Interface for MEDLINE (OVERT-MED), to test our design ideas. We implemented a custom searchable index of MEDLINE, which comprises approximately 25 million document citations. We chose a popular biomedical ontology, the Human Phenotype Ontology (HPO), to test our solution to the vocabulary problem. We implemented multistage triaging support in OVERT-MED, with the aid of interactive visualization techniques, to help users deal with large document sets returned from searches. Formative evaluation suggests that the design features in OVERT-MED are helpful in addressing the two major difficulties described above. Using a formal ontology seems to help users articulate their information needs with more accurate vocabulary. In addition, multistage triaging combined with interactive visualizations shows promise in mitigating the information overload problem. Our strategies appear to be valuable in addressing the two major problems in exploratory search. Although we tested OVERT-MED with a particular ontology and document collection, we anticipate that our strategies can be transferred successfully to other contexts. ©Jonathan Demelo, Paul Parsons, Kamran Sedig. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 02.02.2017.

Sharing and reuse of individual participant data from clinical trials: principles and recommendations

PubMed Central

Ohmann, Christian; Banzi, Rita; Canham, Steve; Battaglia, Serena; Matei, Mihaela; Ariyo, Christopher; Becnel, Lauren; Bierer, Barbara; Bowers, Sarion; Clivio, Luca; Dias, Monica; Druml, Christiane; Faure, Hélène; Fenner, Martin; Galvez, Jose; Ghersi, Davina; Gluud, Christian; Houston, Paul; Karam, Ghassan; Kalra, Dipak; Krleža-Jerić, Karmela; Kubiak, Christine; Kuchinke, Wolfgang; Kush, Rebecca; Lukkarinen, Ari; Marques, Pedro Silverio; Newbigging, Andrew; O’Callaghan, Jennifer; Ravaud, Philippe; Schlünder, Irene; Shanahan, Daniel; Sitter, Helmut; Spalding, Dylan; Tudur-Smith, Catrin; van Reusel, Peter; van Veen, Evert-Ben; Visser, Gerben Rienk; Wilson, Julia; Demotes-Mainard, Jacques

2017-01-01

Objectives We examined major issues associated with sharing of individual clinical trial data and developed a consensus document on providing access to individual participant data from clinical trials, using a broad interdisciplinary approach. Design and methods This was a consensus-building process among the members of a multistakeholder task force, involving a wide range of experts (researchers, patient representatives, methodologists, information technology experts, and representatives from funders, infrastructures and standards development organisations). An independent facilitator supported the process using the nominal group technique. The consensus was reached in a series of three workshops held over 1 year, supported by exchange of documents and teleconferences within focused subgroups when needed. This work was set within the Horizon 2020-funded project CORBEL (Coordinated Research Infrastructures Building Enduring Life-science Services) and coordinated by the European Clinical Research Infrastructure Network. Thus, the focus was on non-commercial trials and the perspective mainly European. Outcome We developed principles and practical recommendations on how to share data from clinical trials. Results The task force reached consensus on 10 principles and 50 recommendations, representing the fundamental requirements of any framework used for the sharing of clinical trials data. The document covers the following main areas: making data sharing a reality (eg, cultural change, academic incentives, funding), consent for data sharing, protection of trial participants (eg, de-identification), data standards, rights, types and management of access (eg, data request and access models), data management and repositories, discoverability, and metadata. Conclusions The adoption of the recommendations in this document would help to promote and support data sharing and reuse among researchers, adequately inform trial participants and protect their rights, and provide effective and efficient systems for preparing, storing and accessing data. The recommendations now need to be implemented and tested in practice. Further work needs to be done to integrate these proposals with those from other geographical areas and other academic domains. PMID:29247106

Ontology-Driven Search and Triage: Design of a Web-Based Visual Interface for MEDLINE

PubMed Central

2017-01-01

Background Diverse users need to search health and medical literature to satisfy open-ended goals such as making evidence-based decisions and updating their knowledge. However, doing so is challenging due to at least two major difficulties: (1) articulating information needs using accurate vocabulary and (2) dealing with large document sets returned from searches. Common search interfaces such as PubMed do not provide adequate support for exploratory search tasks. Objective Our objective was to improve support for exploratory search tasks by combining two strategies in the design of an interactive visual interface by (1) using a formal ontology to help users build domain-specific knowledge and vocabulary and (2) providing multi-stage triaging support to help mitigate the information overload problem. Methods We developed a Web-based tool, Ontology-Driven Visual Search and Triage Interface for MEDLINE (OVERT-MED), to test our design ideas. We implemented a custom searchable index of MEDLINE, which comprises approximately 25 million document citations. We chose a popular biomedical ontology, the Human Phenotype Ontology (HPO), to test our solution to the vocabulary problem. We implemented multistage triaging support in OVERT-MED, with the aid of interactive visualization techniques, to help users deal with large document sets returned from searches. Results Formative evaluation suggests that the design features in OVERT-MED are helpful in addressing the two major difficulties described above. Using a formal ontology seems to help users articulate their information needs with more accurate vocabulary. In addition, multistage triaging combined with interactive visualizations shows promise in mitigating the information overload problem. Conclusions Our strategies appear to be valuable in addressing the two major problems in exploratory search. Although we tested OVERT-MED with a particular ontology and document collection, we anticipate that our strategies can be transferred successfully to other contexts. PMID:28153818

Realization of the right to adequate food and the nutritional status of land evictees: a case for mothers/caregivers and their children in rural Central Uganda.

PubMed

Nahalomo, Aziiza; Iversen, Per Ole; Rukundo, Peter Milton; Kaaya, Archileo; Kikafunda, Joyce; Eide, Wenche Barth; Marais, Maritha; Wamala, Edward; Kabahenda, Margaret

2018-05-24

In developing countries like Uganda, the human right to adequate food (RtAF) is inextricably linked to access to land for households to feed themselves directly through production or means for its procurement. Whether RtAF is enjoyed among Ugandan land evictees, is unknown. We therefore explored this among land evictees (rights-holders) in Wakiso and Mpigi districts in rural Central Uganda. We assessed food accessibility and related coping strategies, diet quality and nutritional status of children 6-59 months old, and their caregivers. Effectiveness of the complaint and redress mechanisms in addressing RtAF violations was also explored. In this cross-sectional study, quantitative data was collected using a structured questionnaire, with food security and nutritional assessment methods from a total of 215 land evictees including 187 children aged 6-59 months. Qualitative data was collected by reviewing selected national and international documents on the RtAF and key informant interviews with 15 purposively sampled duty-bearers. These included individuals or representatives of the Uganda Human Rights Commission, Resident District Commissioner, Sub-county Chiefs, and local Council leaders. We found that 78% of land evictees had insufficient access to food while 69.4% had consumed a less diversified diet. A majority of evictees (85.2%) relied on borrowing food or help from others to cope with food shortages. Of the 187 children assessed, 9.6% were wasted, 18.2% were underweight and 34.2% were stunted. Small, but significant associations, were found between food accessibility, diet quality, food insecurity coping strategies; and the nutritional status of evictees. We observed that administrative, quasi-judicial and judicial mechanisms to provide adequate legal remedies regarding violations of the RtAF among evictees in Uganda are in place, but not effective in doing so. Land eviction without adequate legal remedies is a contributor to food insecurity and undernutrition in rural Central Uganda. It is essential that the Government strengthens and enforces the policy and legal environment to ensure adequate and timely compensation of evictees in order to reduce their vulnerability to food insecurity.

Improving the Quality of Oral and Maxillofacial Surgical Notes in an Indian Public Sector Hospital in Accordance with the Royal College of Surgeons Guidelines: A Completed Audit Loop Study.

PubMed

Krishnan, B; Prasad, G Arun; Madhan, B

2016-09-01

Proper and adequate documentation in operation notes is a basic tool of clinical practice with medical and legal implications. An audit was done to ascertain if oral and maxillofacial surgery operative notes in an Indian public sector hospital adhered to the guidelines published by the Royal College of Surgeons England. Fifty randomly selected operative notes were evaluated against the guidelines by RCS England with regards to the essential generic components of an operation note. Additional criteria relevant to oral and Maxillofacial Surgery were also evaluated. Changes were introduced in the form of Oral and Maxillofacial Surgery specific consent forms, diagram sheets and a computerized operation note proforma containing all essential and additional criteria along with prefilled template of operative findings. Re-audit of 50 randomly selected operation notes was performed after a 6 month period. In the 1st audit cycle, excellent documentation ranging from 94 to 100 % was seen in 9 essential criteria. Unsatisfactory documentation was observed in criteria like assistant name, date of surgery. Most consent forms contained abbreviations and some did not provide all details. Additional criteria specific to Oral and Maxillofacial Surgery scored poorly. In the 2nd Audit for loop completion, excellent documentation was seen in almost all essential and additional criteria. Mean percentage of data point inclusion improved from 84.6 to 98.4 % (0.001< P value <0.005). The use of abbreviations was seen in only 6 notes. Regular audits are now considered a mandatory quality improvement process that seeks to improve patient care and outcomes. To the best of our knowledge, this is the first completed audit on operation notes documentation in Oral and Maxillofacial Surgery from India. The introduction of a computerized operation note proforma showed excellent improvement in operation note documentation. Surgeons can follow the RCS guidelines to ensure standardization of operation notes.

21 CFR 226.20 - Buildings.

Code of Federal Regulations, 2014 CFR

2014-04-01

... operation for their intended purpose. The building shall: (a) Provide adequate space for the orderly.... (c) Provide for adequate washing, cleaning, toilet, and locker facilities. Work areas and equipment...

21 CFR 226.20 - Buildings.

Code of Federal Regulations, 2011 CFR

2011-04-01

... operation for their intended purpose. The building shall: (a) Provide adequate space for the orderly.... (c) Provide for adequate washing, cleaning, toilet, and locker facilities. Work areas and equipment...

21 CFR 226.20 - Buildings.

Code of Federal Regulations, 2013 CFR

2013-04-01

... operation for their intended purpose. The building shall: (a) Provide adequate space for the orderly.... (c) Provide for adequate washing, cleaning, toilet, and locker facilities. Work areas and equipment...

Assessing Global Water Storage Variability from GRACE: Trends, Seasonal Cycle, Subseasonal Anomalies and Extremes.

PubMed

Humphrey, Vincent; Gudmundsson, Lukas; Seneviratne, Sonia I

Throughout the past decade, the Gravity Recovery and Climate Experiment (GRACE) has given an unprecedented view on global variations in terrestrial water storage. While an increasing number of case studies have provided a rich overview on regional analyses, a global assessment on the dominant features of GRACE variability is still lacking. To address this, we survey key features of temporal variability in the GRACE record by decomposing gridded time series of monthly equivalent water height into linear trends, inter-annual, seasonal, and subseasonal (intra-annual) components. We provide an overview of the relative importance and spatial distribution of these components globally. A correlation analysis with precipitation and temperature reveals that both the inter-annual and subseasonal anomalies are tightly related to fluctuations in the atmospheric forcing. As a novelty, we show that for large regions of the world high-frequency anomalies in the monthly GRACE signal, which have been partly interpreted as noise, can be statistically reconstructed from daily precipitation once an adequate averaging filter is applied. This filter integrates the temporally decaying contribution of precipitation to the storage changes in any given month, including earlier precipitation. Finally, we also survey extreme dry anomalies in the GRACE record and relate them to documented drought events. This global assessment sets regional studies in a broader context and reveals phenomena that had not been documented so far.

Clinical photography in dermatology: ethical and medico-legal considerations in the age of digital and smartphone technology.

PubMed

Kunde, Lauren; McMeniman, Erin; Parker, Malcolm

2013-08-01

Clinical photography has long been an important aspect in the management of dermatological pathology and has many applications in contemporary dermatology practice. With the continuous evolution of digital and smartphone technology, clinicians must maintain ethical and medico-legal standards. This article reviews how dermatology trainees are utilising this technology in their clinical practice and what procedures they follow when taking photos of patients. We review the ethical and legal considerations of clinical photography in dermatology and present a hypothetical medico-legal scenario. Dermatology registrars were surveyed on their use of personal smartphones and digital equipment for photographing patients in their clinical practice. Numerous medico-legal providers were approached to provide medico-legal advice about a hypothetical scenario. We found that the use of these technologies is prevalent among dermatology registrars and all respondents reported regular use. Clinicians should routinely obtain and document adequate patient consent in relation to clinical photography, utilise strict privacy settings on smartphones and other digital devices and ensure that the images are stored on these devices for minimal periods. Express consent documentation in the clinical file puts the clinician in a more defensible position if a complaint is made to the medical board or privacy commissioner. © 2013 The Authors. Australasian Journal of Dermatology © 2013 The Australasian College of Dermatologists.

Deep Energy Retrofit Guidance for the Building America Solutions Center

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

Less, Brennan; Walker, Iain

2015-01-01

The U.S. DOE Building America program has established a research agenda targeting market-relevant strategies to achieve 40% reductions in existing home energy use by 2030. Deep Energy Retrofits (DERs) are part of the strategy to meet and exceed this goal. DERs are projects that create new, valuable assets from existing residences, by bringing homes into alignment with the expectations of the 21st century. Ideally, high energy using, dated homes that are failing to provide adequate modern services to their owners and occupants (e.g., comfortable temperatures, acceptable humidity, clean, healthy), are transformed through comprehensive upgrades to the building envelope, services andmore » miscellaneous loads into next generation high performance homes. These guidance documents provide information to aid in the broader market adoption of DERs. They are intended for inclusion in the online resource the Building America Solutions Center (BASC). This document is an assemblage of multiple entries in the BASC, each of which addresses a specific aspect of Deep Energy Retrofit best practices for projects targeting at least 50% energy reductions. The contents are based upon a review of actual DERs in the U.S., as well as a mixture of engineering judgment, published guidance from DOE research in technologies and DERs, simulations of cost-optimal DERs, Energy Star and Consortium for Energy Efficiency (CEE) product criteria, and energy codes.« less

[Documented effects of SSRI preparations in anxiety].

PubMed

Allgulander, C

1998-05-20

The article consists in a review of the clinical evidence for treating anxiety disorders with selective serotonin re-uptake inhibitors (SSRIs). Sufficient documentation now exists to support the use of SSRIs in treating panic and obsessive-compulsive disorders, and in Sweden moclobemide is now approved for use in treating social phobia, and buspirone for use in treating generalised anxiety disorder. Further documentation of the treatment of post-traumatic stress disorder with SSRIs is probably to be expected. Benzodiazepines remain the most commonly used anxiolytics. Although persistent adverse sexual reactions, and withdrawal symptoms upon abrupt termination of medication, are notable side effects of SSRIs, patients become measurably more self-confident and focused, and manage risks more adequately. This underscores the need of further research into the interrelationship of personality traits and anxiety symptoms.

External audit of clinical practice and medical decision making in a new Asian oncology center: Results and implications for both developing and developed nations

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

Shakespeare, Thomas P.; Back, Michael F.; Lu, Jiade J.

2006-03-01

Purpose: The external audit of oncologist clinical practice is increasingly important because of the incorporation of audits into national maintenance of certification (MOC) programs. However, there are few reports of external audits of oncology practice or decision making. Our institution (The Cancer Institute, Singapore) was asked to externally audit an oncology department in a developing Asian nation, providing a unique opportunity to explore the feasibility of such a process. Methods and Materials: We audited 100 randomly selected patients simulated for radiotherapy in 2003, using a previously reported audit instrument assessing clinical documentation/quality assurance and medical decision making. Results: Clinical documentation/qualitymore » assurance, decision making, and overall performance criteria were adequate 74.4%, 88.3%, and 80.2% of the time, respectively. Overall 52.0% of cases received suboptimal management. Multivariate analysis revealed palliative intent was associated with improved documentation/clinical quality assurance (p = 0.07), decision making (p 0.007), overall performance (p = 0.003), and optimal treatment rates (p 0.07); non-small-cell lung cancer or central nervous system primary sites were associated with better decision making (p = 0.001), overall performance (p = 0.03), and optimal treatment rates (p = 0.002). Conclusions: Despite the poor results, the external audit had several benefits. It identified learning needs for future targeting, and the auditor provided facilitating feedback to address systematic errors identified. Our experience was also helpful in refining our national revalidation audit instrument. The feasibility of the external audit supports the consideration of including audit in national MOC programs.« less

Employee Assistance Program Issues

NASA Technical Reports Server (NTRS)

Gettleman, Alan G.; McGuire, William

1999-01-01

Employee Assistance Program (EAP) officers, as well as personnel in other disciplines from eight NASA Centers, attended this breakout session. Ms. Brenda Blair, MA, CEAP, a guest speaker at the conference, also attended as a consultant. Representatives from the NASA Centers introduced themselves and spoke briefly about their programs. In a discussion related to the conference theme on benchmarking, quality control issues within the EAP community and adequate documentation of cases were addressed. Disposition and provision for quality assurance checks for EAP providers in single person offices were also discussed. Ms. Blair presented methods for consulting with other NASA personnel in single person EAP offices as a quality control measure. EAP intervention in critical incidents was discussed. The question of whether EAP assistance is an asset or a potential liability in those situations was addressed. Suggestions were made of topics for future EAP video-teleconference topics. A program on EAP ethics was planned for a September video teleconference. Each person was asked to provide intake forms they use to Mr. Gettleman or Ms. Blair. Ms. Blair said she would review the forms to ensure that adequate notification is provided to the client for confidentiality. She would also review them to ensure they have adequate limits of confidentiality--a topic for future video teleconferencing. Mr. Gettleman described the NASA initiative to reduce stresses in the workplace, and the activities of an ad-hoc EAP group that will make recommendations to NASA senior management. Alternative training methods were discussed for reaching target audiences such as employees at risk, supervisors, and others. Pfc. David A. Pendleton, Victim Assistance Coordinator, U.S. Capitol Police. U.S. House of Representatives made a special presentation. Pfc. Pendleton was on duty during the tragic shooting of two Federal guards at the U.S. Capitol. He related the events immediately after the incident. He described the nature and structure of the EAP's and the separate nature of the House and Senate programs. This episode was a particularly difficult situation as large numbers of tourists were involved. William S. Barry, MD, the new Manager of the NASA Occupational Health Program Office was introduced to those attending the breakout session.

20 CFR 416.2209 - Responsibility for making payment decisions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... recipient, for a month after March 1988, based on his or her continued participation in a VR program; (c) If and when medical recovery has occurred; (d) Whether documentation of VR services and expenditures is adequate; (e) If payment is to be based on completion of a continuous 9-month period of SGA, whether the VR...

20 CFR 416.2209 - Responsibility for making payment decisions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... recipient, for a month after March 1988, based on his or her continued participation in a VR program; (c) If and when medical recovery has occurred; (d) Whether documentation of VR services and expenditures is adequate; (e) If payment is to be based on completion of a continuous 9-month period of SGA, whether the VR...

The deuterium oxide-to-the-mother method documents adequate breast-milk intake among Sri Lankan infants

USDA-ARS?s Scientific Manuscript database

The WHO recommends that exclusive breastfeeding should last up to 6 months. However, human milk intake of Sri Lankan infants has not been quantified scientifically. The objectives of this study were to measure the human milk intake of Sri Lankan infants during the first 6 months of age and to docume...

77 FR 56874 - Extension of Comment Period: Remedies for Small Copyright Claims: Additional Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-14

... (not a scanned document). The form and face of the comments must include both the name of the submitter..., it appears that some stakeholders may need additional time to respond. In order to facilitate full and adequate public comment, the Office hereby extends the time for filing additional comments to...

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

NASA Technical Reports Server (NTRS)

Zellitti, Ron; Royse, Jeff; Jackson, Steve

2000-01-01

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

40 CFR 798.5500 - Differential growth inhibition of repair proficient and repair deficient bacteria: “Bacterial DNA...

Code of Federal Regulations, 2010 CFR

2010-07-01

... should be documented and should be adequate for the experimental design. (5) Metabolic activation... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Differential growth inhibition of... titers (cells per ml). Transformed data alone in the absence of experimental data are not acceptable (i.e...

20 CFR 416.2209 - Responsibility for making payment decisions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... recipient, for a month after March 1988, based on his or her continued participation in a VR program; (c) If and when medical recovery has occurred; (d) Whether documentation of VR services and expenditures is adequate; (e) If payment is to be based on completion of a continuous 9-month period of SGA, whether the VR...

20 CFR 416.2209 - Responsibility for making payment decisions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... recipient, for a month after March 1988, based on his or her continued participation in a VR program; (c) If and when medical recovery has occurred; (d) Whether documentation of VR services and expenditures is adequate; (e) If payment is to be based on completion of a continuous 9-month period of SGA, whether the VR...

20 CFR 416.2209 - Responsibility for making payment decisions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... recipient, for a month after March 1988, based on his or her continued participation in a VR program; (c) If and when medical recovery has occurred; (d) Whether documentation of VR services and expenditures is adequate; (e) If payment is to be based on completion of a continuous 9-month period of SGA, whether the VR...

The Relative Costs of American Men, Skills, and Machines: A Long View.

ERIC Educational Resources Information Center

Williamson, Jeffrey G.

The document is based on a premise that mid-twentieth century experience with income distribution cannot be adequately understood without a better knowledge of the long-term macroeconomic forces that have endogenously determined the wage structure. The secular performance of the price of skills and the occupational wage structure are important to…

To Fee or Not to Fee--That Is the Question! NECTAC Notes. Issue No. 22

ERIC Educational Resources Information Center

Andrews, Susan D. Mackey; Taylor, Anne

2007-01-01

Across the country, state planners and stakeholders continue to be challenged with ensuring a stable and adequate financing foundation for their Part C early intervention system. Increased enrollment (excluding children at risk) from 2001 to 2004 has been documented for all but nine states and one Territory. Further, the challenges that states…

Water Purification, Distribution and Sewage Disposal. Appropriate Technologies for Development. Reprint R-29.

ERIC Educational Resources Information Center

1979

This document, designed to serve as a training manual for technical instructors and as a field resource reference for Peace Corps volunteers, consists of nine units. Unit topics focus on: (1) water supply sources; (2) water treatment; (3) planning water distribution systems; (4) characteristics of an adequate system; (5) construction techniques;…

Science-Based Recommendations to Prevent or Reduce Potential Exposure to Biological, Chemical, and Physical Agents in Schools.

ERIC Educational Resources Information Center

Shendell, Derek G.; Barnett, Claire; Boese, Stephen

2004-01-01

The US General Accounting Office (GAO) documented generally poor conditions of school facilities in the early 1990s. Previous papers examined, for time intervals ending before 2002, relationships between education facility indoor air and environmental quality (IEQ), including adequate ventilation, and occupant health and productivity. Research on…

Transitions to Adulthood for Homeless Adolescents: Education and Public Policy

ERIC Educational Resources Information Center

Tierney, William G.; Gupton, Jarrett T.; Hallett, Ronald E.

2008-01-01

Education plays a critical role in how adolescents mature into adults. A vulnerable, and often forgotten, sub-population of the poor is homeless youth, for whom lack of a stable or adequate residence creates a unique set of educational barriers. The Center for Higher Education Policy Analysis (CHEPA) spent 18 months documenting the experiences of…

Regulation of flow computers for the measurement of biofuels

NASA Astrophysics Data System (ADS)

Almeida, R. O.; Aguiar Júnior, E. A.; Costa-Felix, R. P. B.

2018-03-01

This article aims to discuss the need to develop a standard or regulation applicable to flow computers in the measurement of biofuels. International standards and recommendations are presented which are possibly adequate to fill this gap and at the end of the article a way is proposed to obtain a single document on the subject.

75 FR 32275 - Regulated Navigation Area; Gulf Intracoastal Waterway, Inner Harbor Navigation Canal, Harvey...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-08

... period and may change the rule based on your comments. Viewing Comments and Documents To view comments... contingency plan be developed for vessels that are prevented from departing the Inner Harbor Navigation Canal... companies with adequate notice about the rule. The commenter also requested that the RNA be implemented as a...

Placement of Religion in the Social Studies Curriculum. Committee Report.

ERIC Educational Resources Information Center

North Carolina State Dept. of Public Instruction, Raleigh.

This document is the report of a committee charged with two tasks: (1) to examine the state recommended sequence of study and the recommended textbooks for purposes of determining whether or not North Carolina's students were afforded adequate opportunities to study the roles of religion in shaping the human heritage in the United States and the…

Meteoroid/Orbital Debris Shield Engineering Development Practice and Procedure

NASA Technical Reports Server (NTRS)

Zwitter, James G.; Adams, Marc A.

2011-01-01

A document describes a series of models created for the determination of the probability of survival of critical spacecraft components from particle strike damage caused by hypervelocity impact of meteoroids and/or orbital debris. These models were integrated with both shield design and hypervelocity impact testing to develop adequate protection of said components to meet mission survivability requirements.

Securing the Human: The Journey Toward World Law and Justice. The Whole Earth Papers, No. 14.

ERIC Educational Resources Information Center

Mische, Patricia; And Others

The document contains a variety of papers that examine the linkages between local concerns and global concerns and explore alternative world futures. An introductory article, "Securing the Human," discusses how the world community needs to develop adequate means to deal with crimes against humans. These means include sound analysis, spiritual…

The Planetary Data System— Archiving Planetary Data for the use of the Planetary Science Community

NASA Astrophysics Data System (ADS)

Morgan, Thomas H.; McLaughlin, Stephanie A.; Grayzeck, Edwin J.; Vilas, Faith; Knopf, William P.; Crichton, Daniel J.

2014-11-01

NASA’s Planetary Data System (PDS) archives, curates, and distributes digital data from NASA’s planetary missions. PDS provides the planetary science community convenient online access to data from NASA’s missions so that they can continue to mine these rich data sets for new discoveries. The PDS is a federated system consisting of nodes for specific discipline areas ranging from planetary geology to space physics. Our federation includes an engineering node that provides systems engineering support to the entire PDS.In order to adequately capture complete mission data sets containing not only raw and reduced instrument data, but also calibration and documentation and geometry data required to interpret and use these data sets both singly and together (data from multiple instruments, or from multiple missions), PDS personnel work with NASA missions from the initial AO through the end of mission to define, organize, and document the data. This process includes peer-review of data sets by members of the science community to ensure that the data sets are scientifically useful, effectively organized, and well documented. PDS makes the data in PDS easily searchable so that members of the planetary community can both query the archive to find data relevant to specific scientific investigations and easily retrieve the data for analysis. To ensure long-term preservation of data and to make data sets more easily searchable with the new capabilities in Information Technology now available (and as existing technologies become obsolete), the PDS (together with the COSPAR sponsored IPDA) developed and deployed a new data archiving system known as PDS4, released in 2013. The LADEE, MAVEN, OSIRIS REx, InSight, and Mars2020 missions are using PDS4. ESA has adopted PDS4 for the upcoming BepiColumbo mission. The PDS is actively migrating existing data records into PDS4 and developing tools to aid data providers and users. The PDS is also incorporating challenge-based competitions to rapidly and economically develop new tools for both users and data providers.Please visit our User Support Area at the meeting (Booth #114) if you have questions accessing our data sets or providing data to the PDS.

Optical Property Requirements for Glasses, Ceramics and Plastics in Spacecraft Window Systems

NASA Technical Reports Server (NTRS)

Estes, Lynda

2011-01-01

This is a preliminary draft of a standard published by the National Aeronautics and Space Administration (NASA) Johnson Space Center (JSC) that is intended to provide uniform window optical design requirements in support of the development of human-rated spaceflight hardware. The material covered in this standard is based on data from extensive testing by the Advanced Sensing and Optical Measurement Branch at NASA Langley Research Center, and compiled into requirements format by the NASA JSC Structural Engineering Division. At the time of this initial document release, a broader technical community has not reviewed this standard. The technical content of this standard is primarily based on the Constellation Program Orion Crew Exploration Vehicle Window Optical Properties Requirements, CxP 72407, Baseline. Unlike other optical requirements documents available for human rated spacecraft, this document includes requirements that ensure functionality for windows that contain glass/ceramic and/or plastic window substrate materials. These requirements were derived by measuring the optical properties of fused silica and aluminosilicate glass window assemblies and ensuring that the performance of any window assembly that includes a plastic pane or panes will meet the performance level of the all-glass assemblies. The resulting requirements are based upon the performance and parameter metrology testing of a variety of materials, including glass, transparent ceramics, acrylics, and polycarbonates. In general, these requirements are minimum specifications for each optical parameter in order to achieve the function specified for each functional category, A through D. Because acrylic materials perform at a higher level than polycarbonates in the optics regime, and CxP/Orion is planning to use acrylic in the Orion spacecraft, these requirements are based heavily on metrology from that material. As a result, two of the current Category D requirements for plastics are cited in such a way that will result in the screening out of polycarbonates. It is acknowledged that many polycarbonates can perform the functions of Category D, such as piloting and imagery with lens with apertures up to 25mm, without performance issues. Therefore, this forward warns users that certain requirements, such as birefringence and wavefront, for Category D plastics need to be revised to allow those polycarbonates that perform adequately in Category D to be accepted, while at the same time, screen out those materials that do not perform up to par. At the time of document release, the requirements in question have been identified by a TBD beside the proposed requirement criteria (which is based upon acrylic performance). Vehicles that are designed with acrylic materials for windowpanes are encouraged to use the values presented in this document for all requirements, in order to ensure adequate optical performance.

Under-treatment of cancer pain.

PubMed

Fairchild, Alysa

2010-03-01

Cancer pain remains inadequately treated, despite internationally accepted management guidelines and a myriad of treatment options. Risk factors for undertreatment are reviewed, along with possible explanations. Recent studies documenting the scope of the problem as well as investigating solutions are discussed with clinical-practice recommendations outlined. Women over 65 years of age representative of a cultural minority, with earlier stage disease, cared for at home, and with high-school education or less are at highest risk of having uncontrolled cancer pain. Optimal treatment is impeded by patients' maladaptive beliefs, nonadherence, underreporting or miscommunication with caregivers; from a healthcare provider perspective, it may be due to inadequate assessment, documentation, knowledge, and communication. Emerging data support the vital influence of lay caregivers on appropriate pain management. Although home-education programs may decrease pain and improve quality of life, there are also less intensive approaches deliverable by individuals to holistically address pain. Prospective study of barriers to both delivery and receipt of adequate pain management is needed, as the majority of published literature is based on survey studies. Treatment must be individualized based on clinical circumstances and patient wishes, with the goal of maximizing function and quality of life.

Key Decision Record Creation and Approval Module

NASA Technical Reports Server (NTRS)

Hebert, Barrt; Messer, Elizabeth A.; Albasini, Colby; Le, Thang; ORourke, William, Sr.; Stiglets, Tim; Strain, Ted

2012-01-01

Retaining good key decision records is critical to ensuring the success of a project or operation. Having adequately documented decisions with supporting documents and rationale can greatly reduce the amount of rework or reinvention over a project's, vehicle's, or facility's lifecycle. Stennis Space Center developed and uses a software tool that automates the Key Decision Record (KDR) process for its engineering and test projects. It provides the ability for a user to log key decisions that are made during the course of a project. By customizing Parametric Technology Corporation's (PTC) Windchill product, the team was able to log all information about a decision, and electronically route that information for approval. Customizing the Windchill product allowed the team to directly connect these decisions to the engineering data that it might affect and notify data owners of the decision. The user interface was created in JSP and Javascript, within the OOTB (Out of the Box) Windchill product, allowing users to create KDRs. Not only does this interface allow users to create and track KDRs, but it also plugs directly into the OOTB ability to associate these decision records with other relevant engineering data such as drawings, designs, models, requirements, or specifications

Unique clinical and imaging findings in a first ever documented PCR positive rabies survival patient: A case report.

PubMed

M, Netravathi; V, Udani; Rs, Mani; V, Gadad; M A, Ashwini; M, Bhat; S, Mehta; A, Chowdhary; P K, Pal; S N, Madhusudana; P, Satishchandra

2015-09-01

Rabies is fatal encephalitis which is a major public health problem in Asian and African countries. Till date, only 12 cases have been reported who have survived after rabies. In this communication we report a patient who is unique as the first documented long term rabies survivor with PCR positivity even after 4½ years of illness. Child sustained dog bite following which he received adequate prophylaxis. Within two weeks, child developed encephalopathy requiring evaluation. Child continues to have persistent myoclonic jerks, seizures, is dependent on all activities with severe neurological deficits. Nested reverse transcriptase PCR (RT-PCR) specific for rabies nucleoprotein gene in CSF and nuchal skin biopsy were positive for rabies viral RNA. The nuchal skin biopsy was also positive for rabies nucleoprotein antigen by fluorescent antibody test (FAT). We describe the clinical evolution and sequential MRI brain changes in this child. Despite the uniformly dismal prognosis of human rabies, these unusual reports of survival of rabies patients may provide an impetus to explore newer therapeutic strategies for this otherwise fatal disease. Copyright © 2015 Elsevier B.V. All rights reserved.

[Computerized system validation of clinical researches].

PubMed

Yan, Charles; Chen, Feng; Xia, Jia-lai; Zheng, Qing-shan; Liu, Daniel

2015-11-01

Validation is a documented process that provides a high degree of assurance. The computer system does exactly and consistently what it is designed to do in a controlled manner throughout the life. The validation process begins with the system proposal/requirements definition, and continues application and maintenance until system retirement and retention of the e-records based on regulatory rules. The objective to do so is to clearly specify that each application of information technology fulfills its purpose. The computer system validation (CSV) is essential in clinical studies according to the GCP standard, meeting product's pre-determined attributes of the specifications, quality, safety and traceability. This paper describes how to perform the validation process and determine relevant stakeholders within an organization in the light of validation SOPs. Although a specific accountability in the implementation of the validation process might be outsourced, the ultimate responsibility of the CSV remains on the shoulder of the business process owner-sponsor. In order to show that the compliance of the system validation has been properly attained, it is essential to set up comprehensive validation procedures and maintain adequate documentations as well as training records. Quality of the system validation should be controlled using both QC and QA means.

The Healthnet project: extending online information resources to end users in rural hospitals.

PubMed

Holtum, E; Zollo, S A

1998-10-01

The importance of easily available, high quality, and current biomedical literature within the clinical enterprise is now widely documented and accepted. Access to this information has been shown to have a direct bearing on diagnosis, choices of tests, choices of drugs, and length of hospital stay. However, many health professionals do not have adequate access to current health information, particularly those practicing in rural, isolated, or underserved hospitals. Thanks to a three-year telemedicine award from the National Library of Medicine, The University of Iowa (UI) has developed a high-speed, point-to-point telecommunications network to deliver clinical and educational applications to ten community-based Iowa hospitals. One of the services offered over the network allows health professionals from the site hospitals to access online health databases and order articles via an online document delivery service. Installation, training, and troubleshooting support are provided to the remote sites by UI project staff. To date, 1,339 health professionals from the ten networked hospitals have registered to use the Healthnet program. Despite the friendly interface on the computer workstations installed at the sites, training emerged as the key issue in maximizing health professional utilization of these programs.

The Healthnet project: extending online information resources to end users in rural hospitals.

PubMed Central

Holtum, E; Zollo, S A

1998-01-01

The importance of easily available, high quality, and current biomedical literature within the clinical enterprise is now widely documented and accepted. Access to this information has been shown to have a direct bearing on diagnosis, choices of tests, choices of drugs, and length of hospital stay. However, many health professionals do not have adequate access to current health information, particularly those practicing in rural, isolated, or underserved hospitals. Thanks to a three-year telemedicine award from the National Library of Medicine, The University of Iowa (UI) has developed a high-speed, point-to-point telecommunications network to deliver clinical and educational applications to ten community-based Iowa hospitals. One of the services offered over the network allows health professionals from the site hospitals to access online health databases and order articles via an online document delivery service. Installation, training, and troubleshooting support are provided to the remote sites by UI project staff. To date, 1,339 health professionals from the ten networked hospitals have registered to use the Healthnet program. Despite the friendly interface on the computer workstations installed at the sites, training emerged as the key issue in maximizing health professional utilization of these programs. PMID:9803302

Ultraviolet Free Electron Laser Facility preliminary design report

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

Ben-Zvi, I.

1993-02-01

This document, the Preliminary Design Report (PDR) for the Brookhaven Ultraviolet Free Electron Laser (UV FEL) facility, describes all the elements of a facility proposed to meet the needs of a research community which requires ultraviolet sources not currently available as laboratory based lasers. Further, for these experiments, the requisite properties are not extant in either the existing second or upcoming third generation synchrotron light sources. This document is the result of our effort at BNL to identify potential users, determine the requirements of their experiments, and to design a facility which can not only satisfy the existing need, butmore » have adequate flexibility for possible future extensions as need dictates and as evolving technology allows. The PDR is comprised of three volumes. In this, the first volume, background for the development of the proposal is given, including descriptions of the UV FEL facility, and representative examples of the science it was designed to perform. Discussion of the limitations and potential directions for growth are also included. A detailed description of the facility design is then provided, which addresses the accelerator, optical, and experimental systems. Information regarding the conventional construction for the facility is contained in an addendum to volume one (IA).« less

Image-Based 3d Reconstruction and Analysis for Orthodontia

NASA Astrophysics Data System (ADS)

Knyaz, V. A.

2012-08-01

Among the main tasks of orthodontia are analysis of teeth arches and treatment planning for providing correct position for every tooth. The treatment plan is based on measurement of teeth parameters and designing perfect teeth arch curve which teeth are to create after treatment. The most common technique for teeth moving uses standard brackets which put on teeth and a wire of given shape which is clamped by these brackets for producing necessary forces to every tooth for moving it in given direction. The disadvantages of standard bracket technique are low accuracy of tooth dimensions measurements and problems with applying standard approach for wide variety of complex orthodontic cases. The image-based technique for orthodontic planning, treatment and documenting aimed at overcoming these disadvantages is proposed. The proposed approach provides performing accurate measurements of teeth parameters needed for adequate planning, designing correct teeth position and monitoring treatment process. The developed technique applies photogrammetric means for teeth arch 3D model generation, brackets position determination and teeth shifting analysis.

ORNL Remedial Action Program strategy (FY 1987-FY 1992)

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

Trabalka, J.R.; Myrick, T.E.

1987-12-01

Over 40 years of Oak Ridge National Laboratory (ORNL) operations have produced a diverse legacy of contaminated inactive facilities, research areas, and waste disposal areas that are potential candidates for remedial action. The ORNL Remedial Action Program (RAP) represents a comprehensive effort to meet new regulatory requirements and ensure adequate protection of on-site workers, the public, and the environment by providing appropriate corrective measures at over 130 sites contaminated historically with radioactive, hazardous chemical, or mixed wastes. A structured path of program planning, site characterization, alternatives assessment, technology development, engineering design, continued site maintenance and surveillance, interim corrective action, andmore » eventual site closure or decommissioning is required to meet these objectives. This report documents the development of the Remedial Action Program, through its preliminary characterization, regulatory interface, and strategy development activities. It provides recommendations for a comprehensive, long-term strategy consistent with existing technical, institutional, and regulatory information, along with a six-year plan for achieving its initial objectives. 53 refs., 8 figs., 12 tabs.« less

Current Status of NASDA Terminology Database

NASA Astrophysics Data System (ADS)

Kato, Akira

2002-01-01

NASDA Terminology Database System provides the English and Japanese terms, abbreviations, definition and reference documents. Recent progress includes a service to provide abbreviation data from the NASDA Home Page, and publishing a revised NASDA bilingual dictionary. Our next efforts to improve the system are (1) to combine our data with the data of NASA THESAURUS, (2) to add terms from new academic and engineering fields that have begun to have relations with space activities, and (3) to revise the NASDA Definition List. To combine our data with the NASA THESAURUS database we must consider the difference between the database concepts. Further effort to select adequate terms is thus required. Terms must be added from other fields to deal with microgravity experiments, human factors and so on. Some examples of new terms to be added have been collected. To revise the NASDA terms definition list, NASA and ESA definition lists were surveyed and a general concept to revise the NASDA definition list was proposed. I expect these activities will contribute to the IAA dictionary.

Orthopedic resident work-shift analysis: are we making the best use of resident work hours?

PubMed

Hamid, Kamran S; Nwachukwu, Benedict U; Hsu, Eugene; Edgerton, Colston A; Hobson, David R; Lang, Jason E

2014-01-01

Surgery programs have been tasked to meet rising demands in patient surgical care while simultaneously providing adequate resident training in the midst of increasing resident work-hour restrictions. The purpose of this study was to quantify orthopedic surgery resident workflow and identify areas needing improved resident efficiency. We hypothesize that residents spend a disproportionate amount of time involved in activities that do not relate directly to patient care or maximize resident education. We observed 4 orthopedic surgery residents on the orthopedic consult service at a major tertiary care center for 72 consecutive hours (6 consecutive shifts). We collected minute-by-minute data using predefined work-task criteria: direct new patient contact, direct existing patient contact, communications with other providers, documentation/administrative time, transit time, and basic human needs. A seventh category comprised remaining less-productive work was termed as standby. In a 720-minute shift, residents spent on an average: 191 minutes (26.5%) performing documentation/administrative duties, 167.0 minutes (23.2%) in direct contact with new patient consults, 129.6 minutes (17.1%) in communication with other providers regarding patients, 116.2 (16.1%) minutes in standby, 63.7 minutes (8.8%) in transit, 32.6 minutes (4.5%) with existing patients, and 20 minutes (2.7%) attending to basic human needs. Residents performed an additional 130 minutes of administrative work off duty. Secondary analysis revealed residents were more likely to perform administrative work rather than directly interact with existing patients (p = 0.006) or attend to basic human needs (p = 0.003). Orthopedic surgery residents spend a large proportion of their time performing documentation/administrative-type work and their workday can be operationally optimized to minimize nonvalue-adding tasks. Formal workflow analysis may aid program directors in systematic process improvements to better align resident skills with tasks. III. Published by Elsevier Inc.

Use of donor milk in the neonatal intensive care unit.

PubMed

de Halleux, Virginie; Pieltain, Catherine; Senterre, Thibault; Rigo, Jacques

2017-02-01

Own mother's milk is the first choice in feeding preterm infants and provides multiple short- and long-term benefits. When it is unavailable, donor human milk is recommended as the first alternative. Donor milk undergoes processing (i.e. pasteurization) to reduce bacteriological and viral contaminants but influences its bioactive properties with potentially fewer benefits than raw milk. However, there is no clinical evidence of health benefit of raw compared to pasteurized human milk, and donor milk maintains documented advantages compared to formula. Nutrient content of donor and own mother's milk fails to meet the requirements of preterm infants. Adequate fortification is necessary to provide optimal growth. There are significant challenges in providing donor milk for premature infants; therefore, specific clinical guidelines for human milk banks and donor milk use in the neonatal intensive care unit should be applied and research should focus on innovative solutions to process human milk while preserving its immunological and nutritional components. In addition, milk banks are not the only instrument to collect, process and store donor milk but represent an excellent tool for breastfeeding promotion. Copyright © 2016 Elsevier Ltd. All rights reserved.

Did Universal Access to ARVT in Mexico Impact Suboptimal Antiretroviral Prescriptions?

PubMed Central

Caro-Vega, Yanink; Sierra-Madero, Juan; Colchero, M. Arantxa; Crabtree-Ramírez, Brenda; Bautista-Arredondo, Sergio

2013-01-01

Background. Universal access to antiretroviral therapy (ARVT) started in Mexico in 2001; no evaluation of the features of ARVT prescriptions over time has been conducted. The aim of the study is to document trends in the quality of ARVT-prescription before and after universal access. Methods. We describe ARVT prescriptions before and after 2001 in three health facilities from the following subsystems: the Mexican Social Security (IMSS), the Ministry of Health (SSA), and National Institutes of Health (INS). Combinations of drugs and reasons for change were classified according to current Mexican guidelines and state-of-the-art therapy. Comparisons were made using χ 2 tests. Results. Before 2001, 29% of patients starting ARVT received HAART; after 2001 it increased to 90%. The proportion of adequate prescriptions decreased within the two periods of study in all facilities (P value < 0.01). The INS and SSA were more likely to be prescribed adequately (P value < 0.01) compared to IMSS. The distribution of reasons for change was not significantly different during this time for all facilities (P value > 0.05). Conclusions. Universal ARVT access in Mexico was associated with changes in ARVT-prescription patterns over time. Health providers' performance improved, but not homogeneously. Training of personnel and guidelines updating is essential to improve prescription. PMID:24396592

30 CFR 71.402 - Minimum requirements for bathing facilities, change rooms, and sanitary flush toilet facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Showers shall be provided with both hot and cold water. (ii) At least one shower head shall be provided... urinal. (iv) An adequate supply of toilet paper shall be provided with each toilet. (v) Adequate...

30 CFR 71.402 - Minimum requirements for bathing facilities, change rooms, and sanitary flush toilet facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) Showers shall be provided with both hot and cold water. (ii) At least one shower head shall be provided... urinal. (iv) An adequate supply of toilet paper shall be provided with each toilet. (v) Adequate...

30 CFR 71.402 - Minimum requirements for bathing facilities, change rooms, and sanitary flush toilet facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) Showers shall be provided with both hot and cold water. (ii) At least one shower head shall be provided... urinal. (iv) An adequate supply of toilet paper shall be provided with each toilet. (v) Adequate...

30 CFR 71.402 - Minimum requirements for bathing facilities, change rooms, and sanitary flush toilet facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) Showers shall be provided with both hot and cold water. (ii) At least one shower head shall be provided... urinal. (iv) An adequate supply of toilet paper shall be provided with each toilet. (v) Adequate...

30 CFR 71.402 - Minimum requirements for bathing facilities, change rooms, and sanitary flush toilet facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) Showers shall be provided with both hot and cold water. (ii) At least one shower head shall be provided... urinal. (iv) An adequate supply of toilet paper shall be provided with each toilet. (v) Adequate...

Temporal trends in receipt of adequate lymphadenectomy in bladder cancer 1988 to 2010.

PubMed

Cole, Alexander P; Dalela, Deepansh; Hanske, Julian; Mullane, Stephanie A; Choueiri, Toni K; Meyer, Christian P; Nguyen, Paul L; Menon, Mani; Kibel, Adam S; Preston, Mark A; Bellmunt, Joaquim; Trinh, Quoc-Dien

2015-12-01

The importance of pelvic lymphadenectomy (LND) for diagnostic and therapeutic purposes at the time of radical cystectomy (RC) for bladder cancer is well documented. Although some debate remains on the optimal number of lymph nodes removed, 10 nodes has been proposed as constituting an adequate LND. We used data from the Surveillance, Epidemiology, and End Results database to examine predictors and temporal trends in the receipt of an adequate LND at the time of RC for bladder cancer. Within the Surveillance, Epidemiology, and End Results database, we extracted data on all patients with nonmetastatic bladder cancer receiving RC in the years 1988 to 2010. First, we assess the proportion of individuals undergoing RC who received an adequate LND (≥10 nodes removed) over time. Second, we calculate odds ratios (ORs) of receiving an adequate LND using logistic regression modeling to compare study periods. Covariates included sex, race, age, region, tumor stage, urban vs. rural location, and insurance status. Among the 5,696 individuals receiving RC during the years 1988 to 2010, 2,576 (45.2%) received an adequate LND. Over the study period, the proportion of individuals receiving an adequate LND increased from 26.4% to 61.3%. The odds of receiving an adequate LND increased over the study period; a patient undergoing RC in 2008 to 2010 was over 4-fold more likely to receive an adequate LND relative to a patient treated in 1988 to 1991 (OR = 4.63, 95% CI: 3.32-6.45). In addition to time of surgery, tumor stage had a positive association with receipt of adequate LND (OR = 1.49 for stage IV [T4 N1 or N0] vs. stage I [T1 or Tis], 95% CI: 1.22-1.82). Age, sex, marital status, and race were not significant predictors of adequate LND. Adequacy of pelvic LND remains an important measure of surgical quality in bladder cancer. Our data show that over the years 1988 to 2010, the likelihood of receiving an adequate LND has increased substantially; however, a substantial minority of patients still does not receive LND. Further study into factors leading to adequate LND is needed to increase the use of this important technique. Copyright © 2015 Elsevier Inc. All rights reserved.

Operator-related aspects in endodontic malpractice claims in Finland.

PubMed

Vehkalahti, Miira M; Swanljung, Outi

2017-04-01

We analyzed operator-related differences in endodontic malpractice claims in Finland. Data comprised the endodontic malpractice claims handled at the Patient Insurance Centre (PIC) in 2002-2006 and 2011-2013. Two dental advisors at the PIC scrutinized the original documents of the cases (n = 1271). The case-related information included patient's age and gender, type of tooth, presence of radiographs, and methods of instrumentation and apex location. As injuries, we recorded broken instrument, perforation, injuries due to root canal irrigants/medicaments, and miscellaneous injuries. We categorized the injuries according to the PIC decisions as avoidable, unavoidable, or no injury. Operator-related information included dentist's age, gender, specialization, and service sector. We assessed level of patient documentation as adequate, moderate, or poor. Chi-squared tests, t-tests, and logistic regression modelling served in statistical analyses. Patients' mean age was 44.7 (range 8-85) years, and 71% were women. The private sector constituted 54% of claim cases. Younger patients, female dentists, and general practitioners predominated in the public sector. We found no sector differences in patients' gender, dentists' age, or type of injured tooth. PIC advisors confirmed no injury in 24% of claim cases; the advisors considered 65% of injury cases (n = 970) as avoidable and 35% as unavoidable. We found no operator-related differences in these figures. Working methods differed by operator's age and gender. Adequate patient documentation predominated in the public sector and among female, younger, or specialized dentists. Operator-related factors had no impact on endodontic malpractice claims.

A qualitative analysis of health professionals' job descriptions for surgical service delivery in Uganda.

PubMed

Buwembo, William; Munabi, Ian G; Galukande, Moses; Kituuka, Olivia; Luboga, Samuel A

2014-01-01

The ever increasing demand for surgical services in sub-Saharan Africa is creating a need to increase the number of health workers able to provide surgical care. This calls for the optimisation of all available human resources to provide universal access to essential and emergency surgical services. One way of optimising already scarce human resources for health is by clarifying job descriptions to guide the scope of practice, measuring rewards/benefits for the health workers providing surgical care, and informing education and training for health professionals. This study set out to determine the scope of the mandate to perform surgical procedures in current job descriptions of surgical care health professionals in Uganda. A document review was conducted of job descriptions for the health professionals responsible for surgical service delivery in the Ugandan Health care system. The job descriptions were extracted and subjected to a qualitative content data analysis approach using a text based RQDA package of the open source R statistical computing software. It was observed that there was no explicit mention of assignment of delivery of surgical services to a particular cadre. Instead the bulk of direct patient related care, including surgical attention, was assigned to the lower cadres, in particular the medical officer. Senior cadres were assigned to perform predominantly advisory and managerial roles in the health care system. In addition, a no cost opportunity to task shift surgical service delivery to the senior clinical officers was identified. There is a need to specifically assign the mandate to provide surgical care tasks, according to degree of complexity, to adequately trained cadres of health workers. Health professionals' current job descriptions are not explicit, and therefore do not adequately support proper training, deployment, defined scope of practice, and remuneration for equitable surgical service delivery in Uganda. Such deliberate assignment of mandates will provide a means of increasing surgical service delivery through further optimisation of the available human resources for health.

ANMCO/SIC Consensus Document: cardiology networks for outpatient heart failure care

PubMed Central

Gulizia, Michele Massimo; Di Lenarda, Andrea; Mortara, Andrea; Battistoni, Ilaria; De Maria, Renata; Gabriele, Michele; Iacoviello, Massimo; Navazio, Alessandro; Pini, Daniela; Di Tano, Giuseppe; Marini, Marco; Ricci, Renato Pietro; Alunni, Gianfranco; Radini, Donatella; Metra, Marco; Romeo, Francesco

2017-01-01

Abstract Changing demographics and an increasing burden of multiple chronic comorbidities in Western countries dictate refocusing of heart failure (HF) services from acute in-hospital care to better support the long inter-critical out-of- hospital phases of HF. In Italy, as well as in other countries, needs of the HF population are not adequately addressed by current HF outpatient services, as documented by differences in age, gender, comorbidities and recommended therapies between patients discharged for acute hospitalized HF and those followed-up at HF clinics. The Italian Working Group on Heart Failure has drafted a guidance document for the organisation of a national HF care network. Aims of the document are to describe tasks and requirements of the different health system points of contact for HF patients, and to define how diagnosis, management and care processes should be documented and shared among health-care professionals. The document classifies HF outpatient clinics in three groups: (i) community HF clinics, devoted to management of stable patients in strict liaison with primary care, periodic re-evaluation of emerging clinical needs and prompt treatment of impending destabilizations, (ii) hospital HF clinics, that target both new onset and chronic HF patients for diagnostic assessment, treatment planning and early post-discharge follow-up. They act as main referral for general internal medicine units and community clinics, and (iii) advanced HF clinics, directed at patients with severe disease or persistent clinical instability, candidates to advanced treatment options such as heart transplant or mechanical circulatory support. Those different types of HF clinics are integrated in a dedicated network for management of HF patients on a regional basis, according to geographic features. By sharing predefined protocols and communication systems, these HF networks integrate multi-professional providers to ensure continuity of care and patient empowerment. In conclusion, This guidance document details roles and interactions of cardiology specialists, so as to best exploit the added value of their input in the care of HF patients and is intended to promote a more efficient and effective organization of HF services. PMID:28751837

A network collaboration implementing technology to improve medication dispensing and administration in critical access hospitals.

PubMed

Wakefield, Douglas S; Ward, Marcia M; Loes, Jean L; O'Brien, John

2010-01-01

We report how seven independent critical access hospitals collaborated with a rural referral hospital to standardize workflow policies and procedures while jointly implementing the same health information technologies (HITs) to enhance medication care processes. The study hospitals implemented the same electronic health record, computerized provider order entry, pharmacy information systems, automated dispensing cabinets (ADC), and barcode medication administration systems. We conducted interviews and examined project documents to explore factors underlying the successful implementation of ADC and barcode medication administration across the network hospitals. These included a shared culture of collaboration; strategic sequencing of HIT component implementation; interface among HIT components; strategic placement of ADCs; disciplined use and sharing of workflow analyses linked with HIT applications; planning for workflow efficiencies; acquisition of adequate supply of HIT-related devices; and establishing metrics to monitor HIT use and outcomes.

Teleoperator Human Factors Study

NASA Technical Reports Server (NTRS)

1986-01-01

An investigation of the spectrum of space teleoperation activities likely in the 1985 to 1995 decade focused on the resolution of critical human engineering issues and characterization of the technology effect on performance of remote human operators. The study began with the identification and documentation of a set of representative reference teleoperator tasks. For each task, technology, development, and design options, issues, and alternatives that bear on human operator performance were defined and categorized. A literature survey identified existing studies of man/machine issues. For each teleoperations category, an assessment was made of the state of knowledge on a scale from adequate to void. The tests, experiments, and analyses necessary to provide the missing elements of knowledge were then defined. A limited set of tests were actually performed, including operator selection, baseline task definition, control mode study, lighting study, camera study, and preliminary time delay study.

Recommended vitamin D levels in the general population.

PubMed

Varsavsky, Mariela; Rozas Moreno, Pedro; Becerra Fernández, Antonio; Luque Fernández, Inés; Quesada Gómez, José Manuel; Ávila Rubio, Verónica; García Martín, Antonia; Cortés Berdonces, María; Naf Cortés, Silvia; Romero Muñoz, Manuel; Reyes García, Rebeca; Jódar Gimeno, Esteban; Muñoz Torres, Manuel

2017-03-01

To provide recommendations based on evidence on the management of vitaminD deficiency in the general population. Members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology. Recommendations were formulated using the GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) to describe both the strength of recommendations and the quality of evidence. A systematic search was made in MEDLINE (Pubmed) using the term VitaminD and the name of each issue. Papers in English and Spanish with publication date before 17 March 2016 were included. Recommendations were jointly discussed by the Working Group. This document summarizes the data about vitaminD deficiency in terms of prevalence, etiology, screening indications, adequate levels and effects of supplementation on bone and non-skeletal health outcomes. Copyright © 2017 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

Scenario analysis of the future of medicines.

PubMed Central

Leufkens, H.; Haaijer-Ruskamp, F.; Bakker, A.; Dukes, G.

1994-01-01

Planning future policy for medicines poses difficult problems. The main players in the drug business have their own views as to how the world around them functions and how the future of medicines should be shaped. In this paper we show how a scenario analysis can provide a powerful teaching device to readjust peoples' preconceptions. Scenarios are plausible, not probable or preferable, portraits of alternative futures. A series of four of alternative scenarios were constructed: "sobriety in sufficiency," "risk avoidance," "technology on demand," and "free market unfettered." Each scenario was drawn as a narrative, documented quantitatively wherever possible, that described the world as it might be if particular trends were to dominate development. The medical community and health policy markers may use scenarios to take a long term view in order to be prepared adequately for the future. PMID:7987110

Site transition framework for long-term surveillance and maintenance

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

None

2014-04-01

This document provides a framework for all U.S. Department of Energy (DOE) facilities and sites where DOE may have anticipated long-term surveillance and maintenance (LTSM) responsibilities. It is a tool to help facilitate a smooth transition from remediation to LTSM, providing a systematic process for affected parties to utilize in analyzing the baseline to understand and manage the actions from EM mission completion through a site’s transition into LTSM. The framework is not meant to provide an exhaustive list of the specific requirement and information that are needed. Sites will have unique considerations that may not be adequately addressed bymore » this tool, and it is anticipated that a team comprised of the transferring and receiving organization will use judgment in utilizing this augmenting with other DOE guidance. However the framework should be followed to the extent possible at each site; and adapted to accommodate unique site-specific requirements, needs, and documents. Since the objective of the tool is facilitate better understanding of the conditions of the site and the actions required for transfer, the transition team utilizing the checklist is expected to consult with management of both the receiving and transferring organization to verify that major concerns are addressed. Ideally, this framework should be used as early in the remediation process as possible. Subsequent applications of the Site Transition Framework (STF) to the site should be conducted periodically and used to verify that all appropriate steps have been or will be taken to close-out the site and that actions by both organization are identified to transfer the site to LTSM. The requirements are provided herein.« less

Information Security Program Regulation

DTIC Science & Technology

1986-06-01

above. When an alarmed area is used for the storage of Top Secret material, the physical barrier must be adequate to prevent (a) surreptitious removal ...IV-9 4-304 Removable ADP and Word Processing Storage Media ---------- IV-10 4-305 Documents Produced by ADP Equipment...with a removal or cancellation of the classification designation. 1-315 Declassification Event An event that eliminates the need for continued

Effects of Pine and Hardwood Basal Areas After Uneven-Aged Silvicultural Treatments on Wildlife Habitat

Treesearch

Darren A. Miller; Bruce D. Leopold; L. Mike Conner; Michael G. Shelton

1999-01-01

Uneven-aged management (UEAM) is becoming increasingly popular in the southeastern United States. However, effects of UEAM on wildlife habitat have not been adequately documented. We examined response of habitat within stands of varying levels of pine and hardwood basal area under an uneven-aged managegement regime in southern Mississippi. Summer and winter trends in...

The Child Suicide Risk Assessment: A Screening Measure of Suicide Risk in Pre-Adolescents

ERIC Educational Resources Information Center

Larzelere, Robert E.; Andersen, Jamie J.; Ringle, Jay L.; Jorgensen, Dan D.

2004-01-01

This study documents the initial reliability and validity of the Child Suicide Risk Assessment (CSRA) for children under the age of 13. The revised CSRA retained 18 of 20 original items based on item-specific psychometric data from 140 pre-adolescents in out-of-home treatment programs. The CSRA demonstrated adequate internal consistency (alpha =…

American Indian Women: Sorting through Myth and History. A Study of American Indian Women, Stereotypes, and Education in the Classroom

ERIC Educational Resources Information Center

Attardo, Jessica L.

2005-01-01

The following study was conducted to examine existing research in education regarding the development of stereotypes in children, analyze historical documents and research to acquire an accurate portrayal of American Indian women, and determine if secondary social studies students lack adequate knowledge about the history of American Indian women,…

Part-Time Community Development Workers and Training: A Study of Needs and Provision.

ERIC Educational Resources Information Center

Munn, Pamela; And Others

The study reported in this document canvassed the views of part-time Scottish community education workers, their employers, and their trainers about training needs and how adequately those needs were being met. Of primary concern to the study were the characteristics and roles of part-time staff, the level of satisfaction with existing training,…

Using LibQUAL+[R] Survey Results to Document the Adequacy of Services to Distance Learning Students for an Accreditation Review

ERIC Educational Resources Information Center

Lewis, Janice S.

2011-01-01

Accreditation is critical to the viability of institutions of higher education. Each of the six regional groups that accredit two- and four-year institutions has standards specifically addressing online or distance learning. In general, these standards require institutions to show that distance learners have adequate access to appropriate library…

Economic impact of stimulated technological activity. Part 3: Case study, knowledge additions and earth links from space crew systems

NASA Technical Reports Server (NTRS)

1971-01-01

A case study of knowledge contributions from the crew life support aspect of the manned space program is reported. The new information needed to be learned, the solutions developed, and the relation of new knowledge gained to earthly problems were investigated. Illustrations are given in the following categories: supplying atmosphere for spacecraft; providing carbon dioxide removal and recycling; providing contaminant control and removal; maintaining the body's thermal balance; protecting against the space hazards of decompression, radiation, and meteorites; minimizing fire and blast hazards; providing adequate light and conditions for adequate visual performance; providing mobility and work physiology; and providing adequate habitability.

[Errors in Peruvian medical journals references].

PubMed

Huamaní, Charles; Pacheco-Romero, José

2009-01-01

References are fundamental in our studies; an adequate selection is asimportant as an adequate description. To determine the number of errors in a sample of references found in Peruvian medical journals. We reviewed 515 scientific papers references selected by systematic randomized sampling and corroborated reference information with the original document or its citation in Pubmed, LILACS or SciELO-Peru. We found errors in 47,6% (245) of the references, identifying 372 types of errors; the most frequent were errors in presentation style (120), authorship (100) and title (100), mainly due to spelling mistakes (91). References error percentage was high, varied and multiple. We suggest systematic revision of references in the editorial process as well as to extend the discussion on this theme. references, periodicals, research, bibliometrics.

25 CFR 30.109 - Will the Secretary provide assistance in developing an alternative AYP definition?

Code of Federal Regulations, 2011 CFR

2011-04-01

... EDUCATION ADEQUATE YEARLY PROGRESS Defining Adequate Yearly Progress Technical Assistance § 30.109 Will the... Bureau, shall provide technical assistance either directly or through contract to the tribal governing...

25 CFR 30.109 - Will the Secretary provide assistance in developing an alternative AYP definition?

Code of Federal Regulations, 2010 CFR

2010-04-01

... EDUCATION ADEQUATE YEARLY PROGRESS Defining Adequate Yearly Progress Technical Assistance § 30.109 Will the... Bureau, shall provide technical assistance either directly or through contract to the tribal governing...

Using Transom Jack in the Human Engineering Analysis of the Materials Science Research Rack-1 and Quench Module Insert

NASA Technical Reports Server (NTRS)

Dunn, Mariea C.; Alves, Jeffrey R.; Hutchinson, Sonya L.

1999-01-01

This paper describes the human engineering analysis performed on the Materials Science Research Rack-1 and Quench Module Insert (MSRR-1/QMI) using Transom Jack (Jack) software. The Jack software was used to model a virtual environment consisting of the MSRR-1/QMI hardware configuration and human figures representing the 95th percentile male and 5th percentile female. The purpose of the simulation was to assess the human interfaces in the design for their ability to meet the requirements of the Pressurized Payloads Interface Requirements Document - International Space Program, Revision C (SSP 57000). Jack was used in the evaluation because of its ability to correctly model anthropometric body measurements and the physical behavior of astronauts working in microgravity, which is referred to as the neutral body posture. The Jack model allows evaluation of crewmember interaction with hardware through task simulation including but not limited to collision avoidance behaviors, hand/eye coordination, reach path planning, and automatic grasping to part contours. Specifically, this virtual simulation depicts the human figures performing the QMI installation and check-out, sample cartridge insertion and removal, and gas bottle drawer removal. These tasks were evaluated in terms of adequate clearance in reach envelopes, adequate accessibility in work envelopes, appropriate line of sight in visual envelopes, and accommodation of full size range for male and female stature maneuverability. The results of the human engineering analysis virtual simulation indicate that most of the associated requirements of SSP 57000 were met. However, some hardware design considerations and crew procedures modifications are recommended to improve accessibility, provide an adequate work envelope, reduce awkward body posture, and eliminate permanent protrusions.

Cultural diversity: blind spot in medical curriculum documents, a document analysis.

PubMed

Paternotte, Emma; Fokkema, Joanne P I; van Loon, Karsten A; van Dulmen, Sandra; Scheele, Fedde

2014-08-22

Cultural diversity among patients presents specific challenges to physicians. Therefore, cultural diversity training is needed in medical education. In cases where strategic curriculum documents form the basis of medical training it is expected that the topic of cultural diversity is included in these documents, especially if these have been recently updated. The aim of this study was to assess the current formal status of cultural diversity training in the Netherlands, which is a multi-ethnic country with recently updated medical curriculum documents. In February and March 2013, a document analysis was performed of strategic curriculum documents for undergraduate and postgraduate medical education in the Netherlands. All text phrases that referred to cultural diversity were extracted from these documents. Subsequently, these phrases were sorted into objectives, training methods or evaluation tools to assess how they contributed to adequate curriculum design. Of a total of 52 documents, 33 documents contained phrases with information about cultural diversity training. Cultural diversity aspects were more prominently described in the curriculum documents for undergraduate education than in those for postgraduate education. The most specific information about cultural diversity was found in the blueprint for undergraduate medical education. In the postgraduate curriculum documents, attention to cultural diversity differed among specialties and was mainly superficial. Cultural diversity is an underrepresented topic in the Dutch documents that form the basis for actual medical training, although the documents have been updated recently. Attention to the topic is thus unwarranted. This situation does not fit the demand of a multi-ethnic society for doctors with cultural diversity competences. Multi-ethnic countries should be critical on the content of the bases for their medical educational curricula.

Cultural diversity: blind spot in medical curriculum documents, a document analysis

PubMed Central

2014-01-01

Background Cultural diversity among patients presents specific challenges to physicians. Therefore, cultural diversity training is needed in medical education. In cases where strategic curriculum documents form the basis of medical training it is expected that the topic of cultural diversity is included in these documents, especially if these have been recently updated. The aim of this study was to assess the current formal status of cultural diversity training in the Netherlands, which is a multi-ethnic country with recently updated medical curriculum documents. Methods In February and March 2013, a document analysis was performed of strategic curriculum documents for undergraduate and postgraduate medical education in the Netherlands. All text phrases that referred to cultural diversity were extracted from these documents. Subsequently, these phrases were sorted into objectives, training methods or evaluation tools to assess how they contributed to adequate curriculum design. Results Of a total of 52 documents, 33 documents contained phrases with information about cultural diversity training. Cultural diversity aspects were more prominently described in the curriculum documents for undergraduate education than in those for postgraduate education. The most specific information about cultural diversity was found in the blueprint for undergraduate medical education. In the postgraduate curriculum documents, attention to cultural diversity differed among specialties and was mainly superficial. Conclusions Cultural diversity is an underrepresented topic in the Dutch documents that form the basis for actual medical training, although the documents have been updated recently. Attention to the topic is thus unwarranted. This situation does not fit the demand of a multi-ethnic society for doctors with cultural diversity competences. Multi-ethnic countries should be critical on the content of the bases for their medical educational curricula. PMID:25150546

Customizing Process to Align with Purpose and Program: The 2003 MS PHD'S in Ocean Sciences Program Evaluative Case Study

NASA Astrophysics Data System (ADS)

Williamson, V. A.; Pyrtle, A. J.

2004-12-01

How did the 2003 Minorities Striving and Pursuing Higher Degrees of Success (MS PHD'S) in Ocean Sciences Program customize evaluative methodology and instruments to align with program goals and processes? How is data captured to document cognitive and affective impact? How are words and numbers utilized to accurately illustrate programmatic outcomes? How is compliance with implicit and explicit funding regulations demonstrated? The 2003 MS PHD'S in Ocean Sciences Program case study provides insightful responses to each of these questions. MS PHD'S was developed by and for underrepresented minorities to facilitate increased and sustained participation in Earth system science. Key components of this initiative include development of a community of scholars sustained by face-to-face and virtual mentoring partnerships; establishment of networking activities between and among undergraduate, graduate, postgraduate students, scientists, faculty, professional organization representatives, and federal program officers; and provision of forums to address real world issues as identified by each constituent group. The evaluative case study of the 2003 MS PHD'S in Ocean Sciences Program consists of an analysis of four data sets. Each data set was aligned to document progress in the achievement of the following program goals: Goal 1: The MS PHD'S Ocean Sciences Program will successfully market, recruit, select, and engage underrepresented student and non-student participants with interest/ involvement in Ocean Sciences; Goal 2: The MS PHD'S Ocean Sciences Program will provide meaningful engagement for participants as determined by quantitative analysis of user-feedback; Goal 3: The MS PHD'S Ocean Sciences Program will provide meaningful engagement for participants as determined by qualitative analysis of user-feedback, and; Goal 4: The MS PHD'S Ocean Sciences Program will develop a constituent base adequate to demonstrate evidence of interest, value, need and sustainability in its vision, mission, goals and activities. In addition to the documentation of evaluative process, the case study also provides insight on the establishment of mutually supportive principal investigator and evaluator partnerships as necessary foundations for building effective teams. The study addresses frequently asked questions (FAQ's) on the formation and sustenance of partnerships among visionaries and evaluators and the impact of this partnership on the achievement of program outcomes.

Decline of clinical research in academic medical centers.

PubMed

Meador, Kimford J

2015-09-29

Marked changes in US medical school funding began in the 1960s with progressively increasing revenues from clinical services. The growth of clinical revenues slowed in the mid-1990s, creating a funding crisis for US academic health care centers, who responded by having their faculty increase their clinical duties at the expense of research activities. Surveys document the resultant stresses on the academic clinician researcher. The NIH provides greater funding for basic and translational research than for clinical research, and the new Patient-Centered Outcomes Research Institute is inadequately funded to address the scope of needed clinical research. An increasing portion of clinical research is funded by industry, which leaves many important clinical issues unaddressed. There is an inadequate supply of skilled clinical researchers and a lack of external support for clinical research. The impact on the academic environment in university medical centers is especially severe on young faculty, who have a shrinking potential to achieve successful academic careers. National health care research funding policies should encourage the right balance of life-science investigations. Medical universities need to improve and highlight education on clinical research for students, residents, fellows, and young faculty. Medical universities also need to provide appropriate incentives for clinical research. Without training to ensure an adequate supply of skilled clinical researchers and a method to adequately fund clinical research, discoveries from basic and translational research cannot be clinically tested and affect patient care. Thus, many clinical problems will continue to be evaluated and treated with inadequate or even absent evidence-based knowledge. © 2015 American Academy of Neurology.

Decline of clinical research in academic medical centers

PubMed Central

2015-01-01

Marked changes in US medical school funding began in the 1960s with progressively increasing revenues from clinical services. The growth of clinical revenues slowed in the mid-1990s, creating a funding crisis for US academic health care centers, who responded by having their faculty increase their clinical duties at the expense of research activities. Surveys document the resultant stresses on the academic clinician researcher. The NIH provides greater funding for basic and translational research than for clinical research, and the new Patient-Centered Outcomes Research Institute is inadequately funded to address the scope of needed clinical research. An increasing portion of clinical research is funded by industry, which leaves many important clinical issues unaddressed. There is an inadequate supply of skilled clinical researchers and a lack of external support for clinical research. The impact on the academic environment in university medical centers is especially severe on young faculty, who have a shrinking potential to achieve successful academic careers. National health care research funding policies should encourage the right balance of life-science investigations. Medical universities need to improve and highlight education on clinical research for students, residents, fellows, and young faculty. Medical universities also need to provide appropriate incentives for clinical research. Without training to ensure an adequate supply of skilled clinical researchers and a method to adequately fund clinical research, discoveries from basic and translational research cannot be clinically tested and affect patient care. Thus, many clinical problems will continue to be evaluated and treated with inadequate or even absent evidence-based knowledge. PMID:26156509

Data expansion: the potential of grey literature for understanding floods

NASA Astrophysics Data System (ADS)

Uhlemann, S.; Bertelmann, R.; Merz, B.

2012-09-01

Sophisticated methods have been developed and become standard in analysing floods as well as for assessing the flood risk. However, increasingly critique of the current standards and scientific practice can be found both in the flood hydrology community as well as in the risk community who argue that the considerable amount of information already available on natural disasters has not been adequately deployed and brought to effective use. We describe this phenomenon as a failure to synthesize knowledge that results from barriers and ignorance in awareness, use and management of the entire spectrum of relevant content, that is, data, information and knowledge. In this paper we argue that the scientific community in flood risk research ignores event specific analysis and documentations as another source of data. We present results from a systematic search that includes an intensive study on sources and ways of information dissemination of flood relevant publications. We obtain 183 documents that contain information on the sources, pathways, receptors and/or consequences for any of the 40 strongest trans-basin floods in Germany in the period 1952-2002. This study therefore provides the most comprehensive meta-data collection of flood documentations for the considered geographical space and period. 87.5% of all events have been documented and especially the most severe floods have received extensive coverage. Only 30% of the material has been produced in the scientific/academic environment and the majority of all documents (about 80%) can be considered grey literature. Therefore, ignoring grey sources in flood research also means ignoring the largest part of knowledge available on single flood events (in Germany). Further, the results of this study underpin the rapid changes in information dissemination of flood event literature over the last decade. We discuss the options and obstacles of incorporating this data in the knowledge building process in the light of the current technological developments and international, interdisciplinary debates for data curation.

Nutrition for brain recovery after ischemic stroke: an added value to rehabilitation.

PubMed

Aquilani, Roberto; Sessarego, Paolo; Iadarola, Paolo; Barbieri, Annalisa; Boschi, Federica

2011-06-01

In patients who undergo rehabilitation after ischemic stroke, nutrition strategies are adopted to provide tube-fed individuals with adequate nutrition and/or to avoid the body wasting responsible for poor functional outcome and prolonged stay in the hospital. Investigations have documented that nutrition interventions can enhance the recovery of neurocognitive function in individuals with ischemic stroke. Experimental studies have shown that protein synthesis is suppressed in the ischemic penumbra. In clinical studies on rehabilitation patients designed to study the effects of counteracting or limiting this reduction of protein synthesis by providing protein supplementation, patients receiving such supplementation had enhanced recovery of neurocognitive function. Cellular damage in cerebral ischemia is also partly caused by oxidative damage secondary to free radical formation and lipid peroxidation. Increased oxidative stress negatively affects a patient's life and functional prognosis. Some studies have documented that nutrition supplementation with B-group vitamins may mitigate oxidative damage after acute ischemic stroke. Experimental investigations have also shown that cerebral ischemia changes synaptic zinc release and that acute ischemia increases zinc release, aggravating neuronal injury. In clinical practice, patients with ischemic stroke were found to have a lower than recommended dietary intake of zinc. Patients in whom daily zinc intake was normalized had better recovery of neurological deficits than subjects given a placebo. The aim of this review is to highlight those brain metabolic alterations susceptible to nutrition correction in clinical practice. The mechanisms underlying the relationship between cerebral ischemia and nutrition metabolic conditions are discussed.

Alleviating Bandwidth Constraints by Implementing Quality of Service on Teleport Site Connections

DTIC Science & Technology

2008-02-19

adequate 1 SkillSoft, "Implementing Quality of Service," DISA eLearning Portal, <https://hr.disa.mil...training/ elearning /index.html> (19 February 2008), QoS overview. Cited hereafter as Skillsoft. 4 bandwidth, the router’s QoS mechanism is passive...nation’s warfighter. Hence, he tasked DISA to create Net- Centric Implementation Documents (NCID) that relate Global

The Temporal Focus Scale: Factor Structure and Association with Alcohol Use in a Sample of Northern Irish School Children

ERIC Educational Resources Information Center

McKay, Michael T.; Percy, Andrew; Goudie, Andrew J.; Sumnall, Harry R.; Cole, Jon C.

2012-01-01

The Temporal Focus Scale (TFS) is a 12-item self-report measure of cognitive engagement with the temporal domains of past, present and future. Developed in college student samples, a three-factor structure with adequate reliability and validity was documented in a series of independent studies. We tested the factor structure of the scale in a…

77 FR 56525 - Special Conditions: Bombardier, Model CL-600-2B16 Airplane (CL-601-3A, CL-601-3R, and CL-604...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-13

... and CL- 604. This airplane, as modified by Atlantic Aero, Inc., will have a novel or unusual design... airworthiness regulations do not contain adequate or appropriate safety standards for this design feature. These... documents or comments received may be read at http://www.regulations.gov/ at any time. Follow the online...

Correspondence Concerning Women and the Army Air Forces in World War II. Teaching with Documents.

ERIC Educational Resources Information Center

Schamel, Wynell B.; Blondo, Richard A.

1994-01-01

Contends that, although the role of women in the U.S. military and on the homefront during World War II has received increased attention, the service of the civilian women pilots has not been adequately recognized. Presents a classroom lesson on the origins and work of the Women Airforce Service Pilots (WASP's) during World War II. (CFR)

Effects of Finite Element Resolution in the Simulation of Magnetospheric Particle Motion

NASA Technical Reports Server (NTRS)

Hansen, Richard

2006-01-01

This document describes research done in conjunction with a degree program. The purpose of the research was to compare particle trajectories in a specified set of global electric and magnetic fields; to study the effect of mesh spacing, resulting in an evaluation of adequate spacing resolution; and to study time-dependent fields in the context of substorm dipolarizations of the magnetospheric tail.

Advanced Q-switched DPSS lasers for ID-card marking

NASA Astrophysics Data System (ADS)

Hertwig, Michael; Paster, Martin; Terbrueggen, Ralf

2008-02-01

Increased homeland security concerns across the world have generated a strong demand for forgery-proof ID documents. Manufacturers currently employ a variety of high technology techniques to produce documents that are difficult to copy. However, production costs and lead times are still a concern when considering any possible manufacturing technology. Laser marking has already emerged as an important tool in the manufacturer's arsenal, and is currently being utilized to produce a variety of documents, such as plastic ID cards, drivers' licenses, health insurance cards and passports. The marks utilized can range from simple barcodes and text to high resolution, true grayscale images. The technical challenges posed by these marking tasks include delivering adequate mark legibility, minimizing substrate burning or charring, accurately reproducing grayscale data, and supporting the required process throughput. This article covers the advantages and basic requirements on laser marking of cards and reviews how laser output parameters affect marking quality, speed and overall process economics.

Narrow pH Range of Surface Water Bodies Receiving Pesticide Input in Europe.

PubMed

Bundschuh, Mirco; Weyers, Arnd; Ebeling, Markus; Elsaesser, David; Schulz, Ralf

2016-01-01

Fate and toxicity of the active ingredients (AI's) of plant protection products in surface waters is often influenced by pH. Although a general range of pH values is reported in literature, an evaluation targeting aquatic ecosystems with documented AI inputs is lacking at the larger scale. Results show 95% of European surface waters (n = 3075) with a documented history of AI exposure fall within a rather narrow pH range, between 7.0 and 8.5. Spatial and temporal variability in the data may at least be partly explained by the calcareous characteristics of parental rock material, the affiliation of the sampling site to a freshwater ecoregion, and the photosynthetic activity of macrophytes (i.e., higher pH values with photosynthesis). Nonetheless, the documented pH range fits well with the standard pH of most ecotoxicological test guidelines, confirming the fate and ecotoxicity of AIs are usually adequately addressed.

Transportation Shock and Vibration Literature Review

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

Maheras, Steven J.; Lahti, Erik A.; Ross, Steven B.

2013-06-06

This report fulfills the M4 milestone M4FT-13OR08220112, "Report Documenting Experimental Activities." The purpose of this report is to document the results of a literature review conducted of studies related to the vibration and shock associated with the normal conditions of transport for rail shipments of used nuclear fuel from commercial light-water reactors. As discussed in Adkins (2013), the objective of this report is to determine if adequate data exist that would enable the impacts of the shock and vibration associated with the normal conditions of transport on commercial light-water reactor used nuclear fuel shipped in current generation rail transportation casksmore » to be realistically modeled.« less

How accessible was information about H1N1 flu? Literacy assessments of CDC guidance documents for different audiences.

PubMed

Lagassé, Lisa P; Rimal, Rajiv N; Smith, Katherine C; Storey, J Douglas; Rhoades, Elizabeth; Barnett, Daniel J; Omer, Saad B; Links, Jonathan

2011-01-01

We assessed the literacy level and readability of online communications about H1N1/09 influenza issued by the Centers for Disease Control and Prevention (CDC) during the first month of outbreak. Documents were classified as targeting one of six audiences ranging in technical expertise. Flesch-Kincaid (FK) measure assessed literacy level for each group of documents. ANOVA models tested for differences in FK scores across target audiences and over time. Readability was assessed for documents targeting non-technical audiences using the Suitability Assessment of Materials (SAM). Overall, there was a main-effect by audience, F(5, 82) = 29.72, P<.001, but FK scores did not vary over time, F(2, 82) = .34, P>.05. A time-by-audience interaction was significant, F(10, 82) = 2.11, P<.05. Documents targeting non-technical audiences were found to be text-heavy and densely-formatted. The vocabulary and writing style were found to adequately reflect audience needs. The reading level of CDC guidance documents about H1N1/09 influenza varied appropriately according to the intended audience; sub-optimal formatting and layout may have rendered some text difficult to comprehend.

Automation of servicibility of radio-relay station equipment

NASA Astrophysics Data System (ADS)

Uryev, A. G.; Mishkin, Y. I.; Itkis, G. Y.

1985-03-01

Automation of the serviceability of radio relay station equipment must ensure central gathering and primary processing of reliable instrument reading with subsequent display on the control panel, detection and recording of failures soon enough, advance enough warning based on analysis of detertioration symptoms, and correct remote measurement of equipment performance parameters. Such an inspection will minimize transmission losses while reducing nonproductive time and labor spent on documentation and measurement. A multichannel automated inspection system for this purpose should operate by a parallel rather than sequential procedure. Digital data processing is more expedient in this case than analog method and, therefore, analog to digital converters are required. Spepcial normal, above limit and below limit test signals provide means of self-inspection, to which must be added adequate interference immunization, stabilization, and standby power supply. Use of a microcomputer permits overall refinement and expansion of the inspection system while it minimizes though not completely eliminates dependence on subjective judgment.

Reflexive Research Ethics in Fetal Tissue Xenotransplantation Research

PubMed Central

Panikkar, Bindu; Smith, Natasha; Brown, Phil

2013-01-01

For biomedical research in which the only involvement of the human subject is the provision of tissue or organ samples, a blanket consent, i.e. consent to use the tissue for anything researchers wish to do, is considered by many to be adequate for legal and IRB requirements. Alternatively, a detailed informed consent provides patients or study participants with more thorough information about the research topic. We document here the beliefs and opinions of the research staff on informed consent and the discussion-based reflexive research ethics process that we employed in our fetal tissue xenotransplantion research on the impact of environmental exposures on fetal development. Reflexive research ethics entails the continued adjustment of research practice according to relational and reflexive understandings of what might be beneficent or harmful. Such reflexivity is not solely an individual endeavor, but rather a collective relationship between all actors in the research process. PMID:23074992

Development Programme, 1983-1989.

PubMed

1987-01-01

This document reprints provisions of Chile's Development Program for 1983-89. The population and family objectives of the Program include: strengthening the right of every couple to decide freely the number of their children by providing everyone with access to information and adequate health care services, as well as seeking a balanced population growth and appropriate geographic distribution for this increased population. Specific policies include protecting human life from the moment of conception; offering family planning methods that may include sterilization but not abortion; recognizing the equality of women and their right to participate in economic and social development without arbitrary discrimination while validating their role as mothers; social protection of minors; provision of special services to underprivileged children; inclusion of a "family education" course in schools; promotion of programs of family development for the general public; and encouragement of women's participation as volunteers in accomplishing tasks of social action.

Increasing the Number of Outpatients Receiving Spiritual Assessment: A Pain and Palliative Care Service Quality Improvement Project.

PubMed

Gomez-Castillo, Blanca J; Hirsch, Rosemarie; Groninger, Hunter; Baker, Karen; Cheng, M Jennifer; Phillips, Jayne; Pollack, John; Berger, Ann M

2015-11-01

Spirituality is a patient need that requires special attention from the Pain and Palliative Care Service team. This quality improvement project aimed to provide spiritual assessment for all new outpatients with serious life-altering illnesses. Percentage of new outpatients receiving spiritual assessment (Faith, Importance/Influence, Community, Address/Action in care, psychosocial evaluation, chaplain consults) at baseline and postinterventions. Interventions included encouraging clinicians to incorporate adequate spiritual assessment into patient care and implementing chaplain covisits for all initial outpatient visits. The quality improvement interventions increased spiritual assessment (baseline vs. postinterventions): chaplain covisits (25.5% vs. 50%), Faith, Importance/Influence, Community, Address/Action in care completion (49% vs. 72%), and psychosocial evaluation (89% vs. 94%). Improved spiritual assessment in an outpatient palliative care clinic setting can occur with a multidisciplinary approach. This project also identifies data collection and documentation processes that can be targeted for improvement. Published by Elsevier Inc.

A Selected Library of Transport Coefficients for Combustion and Plasma Physics Applications

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

Cloutman, L.D.

2000-08-01

COYOTE and similar combustion programs based on the multicomponent Navier-Stokes equations require the mixture viscosity, thermal conductivity, and species transport coefficients as input. This report documents a model of these molecular transport coefficients that is simpler than the general theory, but which provides adequate accuracy for many purposes. This model leads to a computationally convenient, self-contained, and easy-to-use source of such data in a format suitable for use by such programs. We present the data for various neutral species in two forms. The first form is a simple functional fit to the transport coefficients. The second form is the usemore » of tabulated Lennard-Jones parameters in simple theoretical expressions for the gas-phase transport coefficients. The model then is extended to the case of a two-temperature plasma. Lennard-Jones parameters are given for a number of chemical species of interest in combustion research.« less

Survey of the Physical and Environmental Parameters of the Moon

NASA Technical Reports Server (NTRS)

Niedz, F. J.; Kopal, Zdenek

1963-01-01

This document presents, in summary, a compilation of the physical and environmental parameters of the moon. A determined attempt has been made to be objective at all times. Many of the physical sciences are presented in sufficient depth to adequately identify the basic information available. It is expected that the appropriate references will be consulted when additional detail is required. It is obvious both from the text and the reference material that divergent opinions prevail and uncertainties exist in almost every phase of lunar science; e.g., the existence of the lunar bulge, the thickness of the dust layer, etc. No pretense is made to resolve these differences, but by bringing together many references, it is hoped that some contribution will be made in lunar science. The subject index will be of particular value since it relates the reference section by subject. A glossary of terms used throughout the text is also provided.

Promising Practices in E-Supervision: Exploring Graduate Speech-Language Pathology Interns’ Perceptions

PubMed Central

Carlin, Charles H.; Milam, Jennifer L.; Carlin, Emily L.; Owen, Ashley

2012-01-01

E-supervision has a potential role in addressing speech-language personnel shortages in rural and difficult to staff school districts. The purposes of this article are twofold: to determine how e-supervision might support graduate speech-language pathologist (SLP) interns placed in rural, remote, and difficult to staff public school districts; and, to investigate interns’ perceptions of in-person supervision compared to e-supervision. The study used a mixed methodology approach and collected data from surveys, supervision documents and records, and interviews. The results showed the use of e-supervision allowed graduate SLP interns to be adequately supervised across a variety of clients and professional activities in a manner that was similar to in-person supervision. Further, e-supervision was perceived as a more convenient and less stressful supervision format when compared to in-person supervision. Other findings are discussed and implications and limitations provided. PMID:25945201

Addendum report to atmospheric science facility pallet-only mode space transportation system payload feasibility study, volume 3, revision A

NASA Technical Reports Server (NTRS)

1976-01-01

The feasibility of accomplishing selected atmospheric science mission using a pallet-only mode was studied. Certain unresolved issues were identified. The first issue was that of assuring that the on-board computer facility was adequate to process scientific data, control subsystems such as instrument pointing, provide mission operational program capability, and accomplish display and control. The second issue evolved from an investigation of the availability of existing substitute instruments that could be used instead of the prime instrumentation where the development tests and schedules are incompatible with the realistic budgets and shuttle vehicle schedules. Some effort was expended on identifying candidate substitute instruments, and the performance, cost, and development schedule trade-offs found during that effort were significant enough to warrant a follow-on investigation. This addendum documents the results of that follow-on effort, as it applies to the Atmospheric Sciences Facility.

Ethical considerations in the conduct of electronic surveillance research.

PubMed

Bharucha, Ashok J; London, Alex John; Barnard, David; Wactlar, Howard; Dew, Mary Amanda; Reynolds, Charles F

2006-01-01

The extant clinical literature indicates profound problems in the assessment, monitoring, and documentation of care in long-term care facilities. The lack of adequate resources to accommodate higher staff-to-resident ratios adds additional urgency to the goal of identifying more cost-effective mechanisms to provide care oversight. The ever expanding array of electronic monitoring technologies in the clinical research arena demands a conceptual and pragmatic framework for the resolution of ethical tensions inherent in the use of such innovative tools. CareMedia is a project that explores the utility of video, audio and sensor technologies as a continuous real-time assessment and outcomes measurement tool. In this paper, the authors describe the seminal ethical challenges encountered during the implementation phase of this project, namely privacy and confidentiality protection, and the strategies employed to resolve the ethical tensions by applying principles of the interest theory of rights.

Recommendations on the effect of antidiabetic drugs in bone.

PubMed

Rozas-Moreno, Pedro; Reyes-García, Rebeca; Jódar-Gimeno, Esteban; Varsavsky, Mariela; Luque-Fernández, Inés; Cortés-Berdonces, María; Muñoz-Torres, Manuel

2017-03-01

To provide recommendations on the effect of antidiabetic drugs on bone fragility to help select the most adequate antidiabetic treatment, especially in diabetic patients with high risk of fracture. Members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology. The GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) was used to establish both the strength of recommendations and the quality of evidence. A systematic search was made in MEDLINE (Pubmed) using the following terms associated to the name of each antidiabetic drug: AND "osteoporosis", "fractures", "bone mineral density", "bone markers", "calciotropic hormones". Papers in English with publication date before 30 April 2016 were reviewed. Recommendations were jointly discussed by the Working Group. The document summaries the data on the potential effects of antidiabetic drugs on bone metabolism and fracture risk. Copyright © 2017 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

Statement on gender-affirmative approach to care from the pediatric endocrine society special interest group on transgender health.

PubMed

Lopez, Ximena; Marinkovic, Maja; Eimicke, Toni; Rosenthal, Stephen M; Olshan, Jerrold S

2017-08-01

The purpose of this Position Statement is to emphasize the importance of an affirmative approach to the health care of transgender individuals, as well as to improve the understanding of the rights of transgender youth. Transgender youth have optimal outcomes when affirmed in their gender identity, through support by their families and their environment, as well as appropriate mental health and medical care. The Pediatric Endocrine Society Special Interest Group on Transgender Health joins other academic societies involved in the care of children and adolescents in supporting policies that promote a safe and accepting environment for gender nonconforming/transgender youth, as well as adequate mental health and medical care. This document provides a summary of relevant definitions, information and current literature on which the medical management and affirmative approach to care of transgender youth are based.

Sharing and reuse of individual participant data from clinical trials: principles and recommendations.

PubMed

Ohmann, Christian; Banzi, Rita; Canham, Steve; Battaglia, Serena; Matei, Mihaela; Ariyo, Christopher; Becnel, Lauren; Bierer, Barbara; Bowers, Sarion; Clivio, Luca; Dias, Monica; Druml, Christiane; Faure, Hélène; Fenner, Martin; Galvez, Jose; Ghersi, Davina; Gluud, Christian; Groves, Trish; Houston, Paul; Karam, Ghassan; Kalra, Dipak; Knowles, Rachel L; Krleža-Jerić, Karmela; Kubiak, Christine; Kuchinke, Wolfgang; Kush, Rebecca; Lukkarinen, Ari; Marques, Pedro Silverio; Newbigging, Andrew; O'Callaghan, Jennifer; Ravaud, Philippe; Schlünder, Irene; Shanahan, Daniel; Sitter, Helmut; Spalding, Dylan; Tudur-Smith, Catrin; van Reusel, Peter; van Veen, Evert-Ben; Visser, Gerben Rienk; Wilson, Julia; Demotes-Mainard, Jacques

2017-12-14

We examined major issues associated with sharing of individual clinical trial data and developed a consensus document on providing access to individual participant data from clinical trials, using a broad interdisciplinary approach. This was a consensus-building process among the members of a multistakeholder task force, involving a wide range of experts (researchers, patient representatives, methodologists, information technology experts, and representatives from funders, infrastructures and standards development organisations). An independent facilitator supported the process using the nominal group technique. The consensus was reached in a series of three workshops held over 1 year, supported by exchange of documents and teleconferences within focused subgroups when needed. This work was set within the Horizon 2020-funded project CORBEL (Coordinated Research Infrastructures Building Enduring Life-science Services) and coordinated by the European Clinical Research Infrastructure Network. Thus, the focus was on non-commercial trials and the perspective mainly European. We developed principles and practical recommendations on how to share data from clinical trials. The task force reached consensus on 10 principles and 50 recommendations, representing the fundamental requirements of any framework used for the sharing of clinical trials data. The document covers the following main areas: making data sharing a reality (eg, cultural change, academic incentives, funding), consent for data sharing, protection of trial participants (eg, de-identification), data standards, rights, types and management of access (eg, data request and access models), data management and repositories, discoverability, and metadata. The adoption of the recommendations in this document would help to promote and support data sharing and reuse among researchers, adequately inform trial participants and protect their rights, and provide effective and efficient systems for preparing, storing and accessing data. The recommendations now need to be implemented and tested in practice. Further work needs to be done to integrate these proposals with those from other geographical areas and other academic domains. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Dietary guidelines for the Spanish population (SENC, December 2016); the new graphic icon of healthy nutrition

PubMed

Aranceta Bartrina, Javier; Arija Val, Victoria; Maíz Aldalur, Edurne; Martínez de la Victoria Muñoz, Emilio; Ortega Anta, Rosa María; Pérez-Rodrigo, Carmen; Quiles Izquierdo, Joan; Rodríguez Martín, Amelia; Román Viñas, Blanca; Salvador Castell, Gemma; Tur Marí, Josep Antoni; Varela Moreiras, Gregorio; Serra Majem, Lluis

2016-12-07

Objective: The Spanish Society of Community Nutrition (SENC) designed in 1994 a food guide for the Spanish population, updated in 2001. This report presents a new updated edition based on the best scientifi c evidence available. Methods: From a health in all policies approach, a group of experts in nutrition and public health associated with SENC was convened to review the evidence on diet-health, nutrition intake and food consumption in the Spanish population, as well as food preparation and consumption habits, determinants and impact of diet on environmental sustainability. Existing systematic reviews, updates, reports, meta-analysis and the latest quality studies have been considered. The collaborative group contributed to draft the document and design the graphic icon, then subject of a consultation process, discussion and qualitative evaluation, particularly relevant through the Advisory Group for the SENC-December 2016 Dietary Guidelines. Results: The new recommendations and its graphical representation highlights as basic considerations the practice of physical activity, emotional balance, energy balance to maintain body weight at adequate levels, healthy cooking procedures and adequate water intake. The recommendations promote a balanced, varied and moderate diet that includes whole grains, fruits, vegetables, legumes, varying amounts of dairy and alternating consumption of fi sh, eggs and lean meats, along with the preferential use of extra virgin olive oil for cooking and seasoning. Reinforce the interest in a healthy, sympathetic, supportive, sustainable diet, based on seasonal and local products, axis for conviviality, devoting adequate time and encourage the use of nutrition labelling information. Conclusions: The analysis of the evidence available and updated information on food consumption in Spain highlights the need to strengthen and implement the recommendations contained in this document to progressively achieve a greater adherence.

Dietary Guidelines for the Spanish population (SENC, diciembre 2016); the new graphic icon of healthy food

PubMed

Aranceta Bartrina, Javier; Arija Val, Victoria; Maíz Aldalur, Edurne; Martínez de Victoria Muñoz, Emilio; Ortega Anta, Rosa María; Pérez-Rodrigo, Carmen; Quiles Izquierdo, Joan; Rodríguez Martín, Amelia; Román Viñas, Blanca; Salvador Castell, Gemma; Tur Marí, Josep Antoni; Varela Moreira, Gregorio; Serra Majem, Lluis

2016-12-07

Objective: The Spanish Society of Community Nutrition (SENC) designed in 1994 a food guide for the Spanish population, updated in 2001. This report presents a new updated edition based on the best scientific evidence available. Methods: From a health in all policies approach, a group of experts in nutrition and public health associated with SENC was convened to review the evidence on diet-health, nutrition intake and food consumption in the Spanish population, as well as food preparation and consumption habits, determinants and impact of diet on environmental sustainability. Existing systematic reviews, updates, reports, meta-analysis and the latest quality studies have been considered. The collaborative group contributed to draft the document and design the graphic icon, then subject of a consultation process, discussion and qualitative evaluation, particularly relevant through the Advisory Group for the SENC-December 2016 Dietary Guidelines. Results: The new recommendations and its graphical representation highlights as basic considerations the practice of physical activity, emotional balance, energy balance to maintain body weight at adequate levels, healthy cooking procedures and adequate water intake. The recommendations promote a balanced, varied and moderate diet that includes whole grains, fruits, vegetables, legumes, varying amounts of dairy and alternating consumption of fi sh, eggs and lean meats, along with the preferential use of extra virgin olive oil for cooking and seasoning. Reinforce the interest in a healthy, sympathetic, supportive, sustainable diet, based on seasonal and local products, axis for conviviality, devoting adequate time and encourage the use of nutrition labelling information. Conclusions: The analysis of the evidence available and updated information on food consumption in Spain highlights the need to strengthen and implement the recommendations contained in this document to progressively achieve a greater adherence.

Normal probabilities for Cape Kennedy wind components: Monthly reference periods for all flight azimuths. Altitudes 0 to 70 kilometers

NASA Technical Reports Server (NTRS)

Falls, L. W.

1973-01-01

This document replaces Cape Kennedy empirical wind component statistics which are presently being used for aerospace engineering applications that require component wind probabilities for various flight azimuths and selected altitudes. The normal (Gaussian) distribution is presented as an adequate statistical model to represent component winds at Cape Kennedy. Head-, tail-, and crosswind components are tabulated for all flight azimuths for altitudes from 0 to 70 km by monthly reference periods. Wind components are given for 11 selected percentiles ranging from 0.135 percent to 99,865 percent for each month. Results of statistical goodness-of-fit tests are presented to verify the use of the Gaussian distribution as an adequate model to represent component winds at Cape Kennedy, Florida.

Day two post retrieval 1500 IUI hCG bolus, progesterone-free luteal support post GnRH agonist trigger - a proof of concept study.

PubMed

Vanetik, Sharon; Segal, Linoy; Breizman, Tatiana; Kol, Shahar

2018-02-01

Small dose of hCG (1500 IU) on the day of oocyte retrieval, followed by daily progesterone administration, is currently the preferred way to secure adequate luteal support following GnRH agonist trigger. In the current proof-of-concept study, we explored the possibility that a bolus of 1500 IU hCG, given two days after oocyte retrieval, may be sufficient to sustain adequate luteal support without additional progesterone treatment. From February 2015 to August 2016, we obtained 44 pregnancies following GnRHa trigger followed by day 2 hCG (1500 IU) support only (study group). Data from these 44 cycles were compared with the latest 44 pregnancies obtained following hCG (6500 IU) trigger followed by conventional progesterone luteal documented (control group). Mean progesterone levels (14 days postoocyte retrieval) in the study and control groups were 197 nmol/l and 173 nmol/l, respectively (NS). Mean E 2 levels (14 days post oocyte retrieval) in the study group was 6937 pmol/l, significantly higher (p < .001) than in the control group (3.276 pmol/l). We conclude that bolus of 1500 IU hCG, administered 2 days after retrieval, can provide excellent support, without the need to further supplement with progesterone.

Water and Sanitation in Schools: A Systematic Review of the Health and Educational Outcomes

PubMed Central

Jasper, Christian; Le, Thanh-Tam; Bartram, Jamie

2012-01-01

A systematic review of the literature on the effects of water and sanitation in schools was performed. The goal was to characterize the impacts of water and sanitation inadequacies in the academic environment. Published peer reviewed literature was screened and articles that documented the provision of water and sanitation at schools were considered. Forty-one peer-reviewed papers met the criteria of exploring the effects of the availability of water and/or sanitation facilities in educational establishments. Chosen studies were divided into six fields based on their specific foci: water for drinking, water for handwashing, water for drinking and handwashing, water for sanitation, sanitation for menstruation and combined water and sanitation. The studies provide evidence for an increase in water intake with increased provision of water and increased access to water facilities. Articles also report an increase in absenteeism from schools in developing countries during menses due to inadequate sanitation facilities. Lastly, there is a reported decrease in diarrheal and gastrointestinal diseases with increased access to adequate sanitation facilities in schools. Ensuring ready access to safe drinking water, and hygienic toilets that offer privacy to users has great potential to beneficially impact children’s health. Additional studies that examine the relationship between sanitation provisions in schools are needed to more adequately characterize the impact of water and sanitation on educational achievements. PMID:23066396

34 CFR 668.60 - Deadlines for submitting documentation and the consequences of failing to provide documentation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... consequences of failing to provide documentation. 668.60 Section 668.60 Education Regulations of the Offices of... Deadlines for submitting documentation and the consequences of failing to provide documentation. (a) An... Stafford/Ford Loan programs— (1) If an applicant fails to provide the requested documentation within a...

34 CFR 668.60 - Deadlines for submitting documentation and the consequences of failing to provide documentation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... consequences of failing to provide documentation. 668.60 Section 668.60 Education Regulations of the Offices of... Deadlines for submitting documentation and the consequences of failing to provide documentation. (a) An... Stafford/Ford Loan programs— (1) If an applicant fails to provide the requested documentation within a...

[Consensus statement on the clinical management of human immunodeficiency virus-associated neurocognitive disorders].

PubMed

Podzamczer Palter, Daniel; Muñoz-Moreno, José A; Alcolea Rodríguez, Daniel; Alonso Villaverde, Carlos; Antela López, Antonio; Blanch Andreu, Jordi; Casado Osorio, José Luis; Galindo Puerto, M José; Garolera i Freixa, Maite; Locutura Rupérez, Jaime; Lleó Bisa, Albert; Prats París, Anna; Pérez-Valero, Ignacio; Portilla Sogorb, Joaquín; Rovira Cañellas, Alex; Téllez Molina, M Jesús; Tiraboschi, Juan Manuel; Vergara Moragues, Esperanza; Arribas López, José Ramón; Goenaga Sánchez, Miguel Ángel; de León-Naranjo, Fernando Lozano; Martínez Chamorro, Esteban; Polo Rodríguez, Rosa; Muñoz-Moreno, José A; Podzamczer, Daniel

2014-01-01

To develop a consensus document containing clinical recommendations for the management of human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND). We assembled a panel of experts appointed by GeSIDA and the Secretariat of the National AIDS Plan (PNS), including internal medicine physicians with expertise in the field of HIV, neuropsychologists, neurologists and neuroradiologists. Scientific information was reviewed to October 2012 in publications and conference papers. In support of the recommendations using two levels of evidence: the strength of the recommendation in the opinion of the experts (A, B, C) and the level of empirical evidence (I, II, III), two levels based on the criteria of the Infectious Disease Society of America, already used in previous documents GeSIDA/SPNS. Multiple recommendations for the clinical management of these disorders are provided, including two graphics algorithms, considering both the diagnostic and possible therapeutic strategies. Neurocognitive disorders associated with HIV infection is currently highly prevalent, are associated with a decreased quality of life and daily activities, and given the possibility of occurrence of an increase in the coming years, there is a need to adequately manage these disorders, from a diagnostic as well as therapeutic point of view, and always from a multidisciplinary perspective. Copyright © 2013 Elsevier España, S.L. All rights reserved.

SPILC: An expert student advisor

NASA Technical Reports Server (NTRS)

Read, D. R.

1990-01-01

The Lamar University Computer Science Department serves about 350 undergraduate C.S. majors, and 70 graduate majors. B.S. degrees are offered in Computer Science and Computer and Information Science, and an M.S. degree is offered in Computer Science. In addition, the Computer Science Department plays a strong service role, offering approximately sixteen service course sections per long semester. The department has eight regular full-time faculty members, including the Department Chairman and the Undergraduate Advisor, and from three to seven part-time faculty members. Due to the small number of regular faculty members and the resulting very heavy teaching loads, undergraduate advising has become a difficult problem for the department. There is a one week early registration period and a three-day regular registration period once each semester. The Undergraduate Advisor's regular teaching load of two classes, 6 - 8 semester hours, per semester, together with the large number of majors and small number of regular faculty, cause long queues and short tempers during these advising periods. The situation is aggravated by the fact that entering freshmen are rarely accompanied by adequate documentation containing the facts necessary for proper counselling. There has been no good method of obtaining necessary facts and documenting both the information provided by the student and the resulting advice offered by the counsellors.

Italian intersociety consensus on DOAC use in internal medicine.

PubMed

Prisco, Domenico; Ageno, Walter; Becattini, Cecilia; D'Angelo, Armando; Davì, Giovanni; De Cristofaro, Raimondo; Dentali, Francesco; Di Minno, Giovanni; Falanga, Anna; Gussoni, Gualberto; Masotti, Luca; Palareti, Gualtiero; Pignatelli, Pasquale; Santi, Roberto M; Santilli, Francesca; Silingardi, Mauro; Tufano, Antonella; Violi, Francesco

2017-04-01

The direct oral anticoagulants (DOACs) are drugs used in clinical practice since 2009 for the prevention of stroke or systemic embolism in non-valvular atrial fibrillation, and for the treatment and secondary prevention of venous thromboembolism. The four DOACs, including the three factor Xa inhibitors (rivaroxaban, apixaban and edoxaban) and one direct thrombin inhibitor (dabigatran) provide oral anticoagulation therapy alternatives to Vitamin K antagonists (VKAs). Despite their clear advantages, the DOACs require on the part of the internist a thorough knowledge of their pharmacokinetic and pharmacodynamic characteristics to ensure their correct use, laboratory monitoring and the appropriate management of adverse events. This document represents a consensus paper on the use of DOACs by representatives of three Italian scientific societies: the Italian Society of Internal Medicine (SIMI), the Federation of the Associations of Hospital Managers (FADOI), and the Society for the Study of Haemostasis and Thrombosis (SISET). This document formulates expert opinion guidance for pragmatic managing, monitoring and reversing the anticoagulant effect of DOACs in both chronic and emergency settings. This practical guidance may help the internist to create adequate protocols for patients hospitalized ion internal medicine wards, where patients are often elderly subjects affected by poly-morbidities and renal insufficiency, and, thus, require particular attention to drug-drug interactions and peri-procedural protocols.

Training Manual for Elements of Interface Definition and Control

NASA Technical Reports Server (NTRS)

Lalli, Vincent R. (Editor); Kastner, Robert E. (Editor); Hartt, Henry N. (Editor)

1997-01-01

The primary thrust of this manual is to ensure that the format and information needed to control interfaces between equipment are clear and understandable. The emphasis is on controlling the engineering design of the interface and not on the functional performance requirements of the system or the internal workings of the interfacing equipment. Interface control should take place, with rare exception, at the interfacing elements and no further. There are two essential sections of the manual. Chapter 2, Principles of Interface Control, discusses how interfaces are defined. It describes different types of interfaces to be considered and recommends a format for the documentation necessary for adequate interface control. Chapter 3, The Process: Through the Design Phases, provides tailored guidance for interface definition and control. This manual can be used to improve planned or existing interface control processes during system design and development. It can also be used to refresh and update the corporate knowledge base. The information presented herein will reduce the amount of paper and data required in interface definition and control processes by as much as 50 percent and will shorten the time required to prepare an interface control document. It also highlights the essential technical parameters that ensure that flight subsystems will indeed fit together and function as intended after assembly and checkout.

Employee organizational commitment and hospital performance.

PubMed

Baird, Kevin M; Tung, Amy; Yu, Yanjie

2017-09-15

There is widespread evidence of the purported benefits of employee organizational commitment (EOC) and its impact on both individual and organizational performance. This study contributes to this literature by providing a unique insight into this relationship, focusing on the interrelationship between EOC with hospital performance and the role of the provision of adequate facilities in eliciting EOC. The aim of this study was to introduce and empirically examine a new theoretical model in which it is argued that the performance of hospitals with regard to the provision of adequate facilities (medical facilities, support facilities, and staff resources) influences the level of EOC, which in turn influences hospital performance with regard to patient care and operational effectiveness. To examine the interrelationships between the provision of adequate facilities, EOC, and hospital performance, the study utilizes a survey of hospital managers. The findings support the theoretical model, with the provision of support facilities and staff resources positively indirectly associated with both patient care and operational effectiveness through their impact on EOC. The findings highlight the importance of providing adequate facilities and EOC within hospitals and suggest that CEOs and general managers should try to enhance the provision of such resources in an attempt to elicit EOC within their hospitals. The findings suggest that managers should try to enhance their provision of adequate facilities in order to elicit EOC and enhance hospital performance. With regard to medical facilities, they should consider and incorporate the latest technology and up-to-date equipment. They should also provide adequate staff resources, including appropriate numbers of beds, nurses, and doctors, to prevent "fatigue" (West, 2001, p. 41) and provide adequate support facilities.

9 CFR 2.33 - Attending veterinarian and adequate veterinary care.

Code of Federal Regulations, 2010 CFR

2010-01-01

... veterinary care. 2.33 Section 2.33 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE... adequate veterinary care. (a) Each research facility shall have an attending veterinarian who shall provide adequate veterinary care to its animals in compliance with this section: (1) Each research facility shall...

9 CFR 2.33 - Attending veterinarian and adequate veterinary care.

Code of Federal Regulations, 2011 CFR

2011-01-01

... veterinary care. 2.33 Section 2.33 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE... adequate veterinary care. (a) Each research facility shall have an attending veterinarian who shall provide adequate veterinary care to its animals in compliance with this section: (1) Each research facility shall...

ICH E14 Q & A (R1) document: perspectives on the updated recommendations on thorough QT studies.

PubMed

Shah, Rashmi R; Morganroth, Joel

2013-04-01

The International Conference on Harmonization (ICH) guidance ICH E14 provides recommendations, focusing on a clinical 'thorough QT/QTc (TQT) study', to evaluate the QT liability of a drug during its development. An Implementation Working Group (IWG) was also established to assist the sponsors with any uncertainties and clarify any ambiguities. In April 2012, the IWG updated its June 2008 version of the Questions and Answers document to address additional issues. These include the gender of the study population, a reasonable approach to evaluating QTc changes in late stage clinical development and the recommended approach to correcting the measured QT interval. This commentary provides our observations and, when appropriate, recommendations, on these issues. We review briefly evidence that suggests that (i) the greater QT effect observed in females is not entirely related to differences in drug exposure and (ii) the Fridericia correction of measured QT interval is adequate for a majority of TQT studies. Until further evidence suggests otherwise, we recommend balanced gender representation in TQT studies, unless warranted otherwise, and for positive studies, subgroup analysis of key data by common demographic variables including the gender and ethnicity. We provide a general scheme for ECG monitoring in late phase clinical trials and consider that while intensive monitoring and centralized reading of ECGs in late phase clinical trials is the norm when a TQT study is positive, there are other circumstances that also call for high quality ECG reading. Therefore, locally read ECGs should only be acceptable as long as accurate high quality ECG data can be guaranteed. © 2012 The Authors. British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society.

34 CFR 668.60 - Deadlines for submitting documentation and the consequences of failing to provide documentation.

Code of Federal Regulations, 2014 CFR

2014-07-01

... consequences of failing to provide documentation. 668.60 Section 668.60 Education Regulations of the Offices of... § 668.60 Deadlines for submitting documentation and the consequences of failing to provide documentation..., excluding the Federal Pell Grant Program— (1) If an applicant fails to provide the requested documentation...

Providers perspective and geographic and institutional factors associated with family planning counseling.

PubMed

de la Vara-Salazar, Elvia; Suárez-López, Leticia; Rivera, Leonor; Lazcano-Ponce, Eduardo

2018-06-01

Family planning (FP) counseling is an essential activity to prevent unplanned pregnancies and allow a fulfilling sex life. We defined adequate counseling in FP as the counseling given to women and men of reproductive age that provided complete information about use, application, effectiveness, side effects, and contraindications. Two objectives are proposed in this study. First, we seek to analyze geographic and institutional factors associated with FP counseling in primary and secondary healthcare facilities in Mexico. Second, we seek to identify the cultural barriers that providers perceive as a limitation of the clients so that they can come to request information related to FP and that are associated with FP counseling. This cross-sectional study uses a complex, probabilistic, stratified sampling design representative at national level by institution, region and rural-urban areas. We collected 16,829 provider questionnaires at healthcare facilities. Bivariate and logistic regression analyses were performed. Providers in rural areas had a greater possibility of offering adequate counseling (OR = 2.98; 95%CI 1.18-7.53). Providers in the northern region of the country were more likely to provide adequate counseling (OR = 5.37; 95% CI 1.91-15.12). Providers whom perceive religion as a limitation for clients to come to request information about FP are less likely to provide adequate counseling (OR = 0.37; 95% CI 0.15-0.88). Physical space exclusively for the provision of FP counseling and the availability of manuals were not associated with adequate counseling. There is a need to address the social and cultural influences on the quality of counseling in these healthcare facilities. Copyright © 2018 Elsevier B.V. All rights reserved.

Cognitive Performance and Physiological Changes under Heavy Load Carriage

DTIC Science & Technology

2010-07-01

tensions needed to maintain adequate levels of biomechanical functioning have been associated with an increased likelihood of injury, muscle strain...34Fog of War": Documenting cognitive decrements associated with the stress of combat. Paper presented at the Proceedings of the 23rd Army Science...and the mobility of a nation . Quantico, VA. Mastroianni, G. R., Chuba, D. M., & Zupan, M. O. (2003). Self-pacing and cognitive performance while

Expanding the Navy’s Managers Internal Control Program’s (MICP) Capability to Prepare for External Financial Audits

DTIC Science & Technology

2015-06-01

adequate documentation to substantiate transactions , and effective internal controls surrounding business processes along with the verification that...organization, such as its personnel, processes, and objectives. The internal auditing profession brings a composite of in-depth knowledge and best business ...with internal auditors. Organizations should keep internal auditors abreast of changes in expectations as the business evolves. Doing so helps

Analysis of documentary support for environmental restoration programs in Russia

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

Nechaev, A.F.; Projaev, V.V.

1995-12-31

Taking into account an importance of an adequate regulations for ensuring of radiological safety of the biosphere and for successful implementation of environmental restoration projects, contents of legislative and methodical documents as well as their comprehensitivity and substantiation are subjected to critical analysis. It is shown that there is much scope for further optimization of and improvements in regulatory basis both on Federal and regional levels.

Defense Nuclear Facilities Safety Board: Improvements Needed to Strengthen Internal Control and Promote Transparency

DTIC Science & Technology

2015-01-01

results of those steps. GAO reviewed relevant federal laws, regulations , and guidance; analyzed DNFSB documents, including records of internal...agencies’ regulations on Sunshine Act meetings.11 We also interviewed a representative of the Sunlight Foundation, an organization focused on...Secretary’s role as operator and regulator of DOE’s defense nuclear facilities—to ensure adequate protection of public health and safety at these

Highlights of GAO’s Corporate Governance, Transparency and Accountability Forum

DTIC Science & Technology

2002-03-01

the current accounting and reporting model does not adequately address (e.g., special purpose entities, uncovered arbitrage positions)? • Is there...TRANSPARENCY AND ACCOUNTABILITY FORUM a GAO-02-494SP Report Documentation Page Report Date 00MAR2002 Report Type N/A Dates Covered (from...its oversight in connection with these matters. In particular, the Congress and GAO are interested in changes that could serve to reduce the

XML syntax for clinical laboratory procedure manuals.

PubMed

Saadawi, Gilan; Harrison, James H

2003-01-01

We have developed a document type description (DTD) in Extensable Markup Language (XML) for clinical laboratory procedures. Our XML syntax can adequately structure a variety of procedure types across different laboratories and is compatible with current procedure standards. The combination of this format with an XML content management system and appropriate style sheets will allow efficient procedure maintenance, distributed access, customized display and effective searching across a large body of test information.

Curation of Federally Owned Archeological Collections at NASA Langley Research Center

NASA Technical Reports Server (NTRS)

Eastman, John Arnold (Compiler)

1995-01-01

As a Federal agency, NASA has a moral and legal obligation to the public to manage the archeological heritage resources under its control. Archeological sites are unique, nonrenewable resources that must be preserved so that future generations may experience and interpret the material remains of the past. These sites are protected by a wide array of federal regulations. These regulations are intended to ensure that our nation's cultural heritage is preserved for the study and enjoyment of future generations. Once a site has been excavated, all that remains of it are the artifacts and associated records which, taken together, allow researchers to reconstruct the past. With the contextual information provided by associated records such as field notes, maps and photographs, archeological collections can provide important information about life in the past. An integral component of the federal archeology program is the curation of these databases so that qualified scholars will have access to them in years to come. Standards for the maintenance of archeological collections have been codified by various professional organizations and by the federal government. These guidelines focus on providing secure, climate-controlled archival storage conditions for the collections and an adequate study area in which researchers can examine the artifacts and documents. In the 1970's and early 1980's, a group of NASA employees formed the LRC Historical and Archeological Society (LRCHAS) in order to pursue studies of the colonial plantations that ha been displaced by Langley Research Center (LaRC). They collected data on family histories and land ownership as well as conducting archeological surveys and excavations at two important 17th-20th century plantation sites in LaRC, Cloverdale and Chesterville. The excavations produced a wealth of information in the form of artifacts, photographs, maps and other documents. Unfortunately, interest on the part of the LRCHAS membership waned before a report was written, and since 1982 the artifacts have moldered in a flimsy trailer with no climate controls, which had once served as a field laboratory but which threatened to become a tomb for the collection. A recent analysis of Langley's cultural resources by Gray & Pape, Inc. recommended that the collection be organized, cataloged, and placed in a proper curation facility in accordance with Federal regulations. The project for the LARSS program was to research curation standards, organize the collection, catalog it, and prepare it for transfer to a facility which could provide adequate long-term curation conditions for the artifacts and documents. The first phase was to organize the artifacts, which were lying about the lab in various stages of cleaning, analysis, and conservation. Once all of the artifacts from the various excavation units and levels had been regrouped, they were cleaned and/or repackaged in archivally-stable materials. A basic catalog was prepared which will provide interested parties with a rough idea of what we have and where it can be found. Another aspect of the project was to organize the records left by the LRCHAS. Bundles of papers, photographs, and field data found in every corner and drawer of the laboratory trailer were put into order and, where appropriate, copies were made on acid-free Permabond paper for long term storage. Finally, the entire collection and most of the lab equipment was transferred into a secure, climate controlled room which will serve as an archive and study space for qualified scholars interested in exploring LaRC's rich historical heritage.

Performance of the 0.3-meter transonic cryogenic tunnel with air, nitrogen, and sulfur hexafluoride media under closed loop automatic control

NASA Technical Reports Server (NTRS)

Balakrishna, S.; Kilgore, W. Allen

1995-01-01

The NASA Langley 0.3-m Transonic Cryogenic Tunnel was modified in 1994, to operate with any one of the three test gas media viz., air, cryogenic nitrogen gas, or sulfur hexafluoride gas. This document provides the initial test results with respect to the tunnel performance and tunnel control, as a part of the commissioning activities on the microcomputer based controller. The tunnel can provide precise and stable control of temperature to less than or equal to +/- 0.3 K in the range 80-320 K in cyro mode or 300-320 K in air/SF6 mode, pressure to +/- 0.01 psia in the range 15-88 psia and Mach number to +/- O.0015 in the range 0.150 to transonic Mach numbers up to 1.000. A new heat exchanger has been included in the tunnel circuit and is performing adequately. The tunnel airfoil testing benefits considerably by precise control of tunnel states and helps in generating high quality aerodynamic test data from the 0.3-m TCT.

Using computer graphics to design Space Station Freedom viewing

NASA Technical Reports Server (NTRS)

Goldsberry, Betty S.; Lippert, Buddy O.; Mckee, Sandra D.; Lewis, James L., Jr.; Mount, Francis E.

1993-01-01

Viewing requirements were identified early in the Space Station Freedom program for both direct viewing via windows and indirect viewing via cameras and closed-circuit television (CCTV). These requirements reside in NASA Program Definition and Requirements Document (PDRD), Section 3: Space Station Systems Requirements. Currently, analyses are addressing the feasibility of direct and indirect viewing. The goal of these analyses is to determine the optimum locations for the windows, cameras, and CCTV's in order to meet established requirements, to adequately support space station assembly, and to operate on-board equipment. PLAID, a three-dimensional computer graphics program developed at NASA JSC, was selected for use as the major tool in these analyses. PLAID provides the capability to simulate the assembly of the station as well as to examine operations as the station evolves. This program has been used successfully as a tool to analyze general viewing conditions for many Space Shuttle elements and can be used for virtually all Space Station components. Additionally, PLAID provides the ability to integrate an anthropometric scale-modeled human (representing a crew member) with interior and exterior architecture.

Chromatographic and spectroscopic identification and recognition of ammoniacal cochineal dyes and pigments

NASA Astrophysics Data System (ADS)

Chieli, A.; Sanyova, J.; Doherty, B.; Brunetti, B. G.; Miliani, C.

2016-06-01

In this work a combined chromatographic and spectroscopic approach is used to provide a diagnostic assessment of semi-synthetic ammoniacal cochineal through the syntheses of its dyes and lakes according to art historical recipes. Commercially introduced in the late XIX century as a dye and pigment, it was used to obtain a brilliant purplish/violet nuance which provided a more stable option over carminic acid although its evidenced use in manufacts and artworks of heritage importance have been scarcely documented. Through HPLC-DAD, it has been possible to identify 4-aminocarminic acid as the main component of ammoniacal cochineal highlighting a chemical formula analogous to acid stable carmine, a recent patented food dye. FTIR clearly distinguishes the amine group in the ammoniacal cochineal dye preparation and TLC-SERS allows for an adequate separation and spectral differentiation in its main components to be evidenced. Colloidal SERS has permitted spectral markers useful in discerning ammoniacal cochineal over carminic acid to be highlighted and discussed. Finally, the methods experimented in this study for the identification of ammoniacal cochineal have been validated on analyzing a sample of dyed wool.

A decision-support system for the analysis of clinical practice patterns.

PubMed

Balas, E A; Li, Z R; Mitchell, J A; Spencer, D C; Brent, E; Ewigman, B G

1994-01-01

Several studies documented substantial variation in medical practice patterns, but physicians often do not have adequate information on the cumulative clinical and financial effects of their decisions. The purpose of developing an expert system for the analysis of clinical practice patterns was to assist providers in analyzing and improving the process and outcome of patient care. The developed QFES (Quality Feedback Expert System) helps users in the definition and evaluation of measurable quality improvement objectives. Based on objectives and actual clinical data, several measures can be calculated (utilization of procedures, annualized cost effect of using a particular procedure, and expected utilization based on peer-comparison and case-mix adjustment). The quality management rules help to detect important discrepancies among members of the selected provider group and compare performance with objectives. The system incorporates a variety of data and knowledge bases: (i) clinical data on actual practice patterns, (ii) frames of quality parameters derived from clinical practice guidelines, and (iii) rules of quality management for data analysis. An analysis of practice patterns of 12 family physicians in the management of urinary tract infections illustrates the use of the system.

Interprofessional education in a student-led emergency department: A realist evaluation.

PubMed

Ericson, Anne; Löfgren, Susanne; Bolinder, Gunilla; Reeves, Scott; Kitto, Simon; Masiello, Italo

2017-03-01

This article reports a realist evaluation undertaken to identify factors that facilitated or hindered the successful implementation of interprofessional clinical training for undergraduate students in an emergency department. A realist evaluation provides a framework for understanding how the context and underlying mechanisms affect the outcome patterns of an intervention. The researchers gathered both qualitative and quantitative data from internal documents, semi-structured interviews, observations, and questionnaires to study what worked, for whom, and under what circumstances in this specific interprofessional setting. The study participants were medical, nursing, and physiotherapy students, their supervisors, and two members of the emergency department's management staff. The data analysis indicated that the emergency ward provided an excellent environment for interprofessional education (IPE), as attested by the students, supervisors, and the clinical managers. An essential prerequisite is that the students have obtained adequate skills to work independently. Exemplary conditions for IPE to work well in an emergency department demand the continuity of effective and encouraging supervision throughout the training period and supervisors who are knowledgeable about developing a team.

Cost analysis of a novel HIV testing strategy in community pharmacies and retail clinics.

PubMed

Lecher, Shirley Lee; Shrestha, Ram K; Botts, Linda W; Alvarez, Jorge; Moore, James H; Thomas, Vasavi; Weidle, Paul J

2015-01-01

To document the cost of implementing point-of-care (POC) human immunodeficiency virus (HIV) rapid testing in busy community pharmacies and retail clinics. Providing HIV testing services in community pharmacies and retail clinics is an innovative way to expand HIV testing. The cost of implementing POC HIV rapid testing in a busy retail environment needs to be documented to provide program and policy leaders with adequate information for planning and budgeting. Cost analysis from a pilot project that provided confidential POC HIV rapid testing services in community pharmacies and retail clinics. The pharmacy sites were operated under several different ownership structures (for-profit, nonprofit, sole proprietorship, corporation, public, and private) in urban and rural areas. We included data from the initial six sites that participated in the project. We collected the time spent by pharmacy and retail clinic staff for pretest and posttest counseling in an activity log for time-in-motion for each interaction. Pharmacists and retail clinic staff. HIV rapid testing. The total cost was calculated to include costs of test kits, control kits, shipping, test supplies, training, reporting, program administration, and advertising. The six sites trained 22 staff to implement HIV testing. A total of 939 HIV rapid tests were conducted over a median time of 12 months, of which 17 were reactive. Median pretest counseling time was 2 minutes. Median posttest counseling time was 2 minutes for clients with a nonreactive test and 10 minutes for clients with a reactive test. The average cost per person tested was an estimated $47.21. When we considered only recurrent costs, the average cost per person tested was $32.17. Providing POC HIV rapid testing services required a modest amount of staff time and costs that are comparable to other services offered in these settings. HIV testing in pharmacies and retail clinics can provide an additional alternative venue for increasing the availability and accessibility of HIV testing services in the United States.

Society for maternal-fetal medicine (SMFM) special report: the maternal-fetal medicine subspecialists' role within a health care system.

PubMed

Sciscione, Anthony; Berghella, Vincenzo; Blackwell, Sean; Boggess, Kim; Helfgott, Andrew; Iriye, Brian; Keller, James; Menard, M Kathryn; O'Keeffe, Daniel; Riley, Laura; Stone, Joanne

2014-12-01

A maternal-fetal medicine (MFM) subspecialist has advanced knowledge of the medical, surgical, obstetrical, fetal, and genetic complications of pregnancy and their effects on both the mother and fetus. MFM subspecialists are complementary to obstetric care providers in providing consultations, co-management, or transfer of care for complicated patients before, during, and after pregnancy. The MFM subspecialist provides peer and patient education and performs research concerning the most recent approaches and treatments for obstetrical problems, thus promoting risk-appropriate care for these complicated pregnancies. The relationship between the obstetric care provider and the MFM subspecialist depends on the acuity of the maternal and/or fetal condition and the local resources. To achieve the goal of promoting early access and sustained adequate prenatal care for all pregnant women, we encourage collaboration with obstetricians, family physicians, certified midwives, and others, and we also encourage providing preconception, prenatal, and postpartum care counseling and coordination. Effective communication between all obstetric care team members is imperative. This special report was written with the intent that it would be broad in scope and appeal to a diverse readership, including administrators, allowing it to be applied to various systems of care both horizontally and vertically. We understand that these relationships are often complex and there are more models of care than could be addressed in this document. However, we aimed to promote the development of a highly effective team approach to the care of the high-risk pregnancy that will be useful in the most common models for obstetric care in the United States. The MFM subspecialist functions most effectively within a fully integrated and collaborative health care environment. This document defines the various roles that the MFM subspecialist can fulfill within different heath care systems through consultation, co-management, and transfer of care, as well as education, research, and leadership. Copyright © 2014 Elsevier Inc. All rights reserved.

76 FR 9982 - Airworthiness Directives; Bombardier, Inc. Model DHC-8-400 Series Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-23

... manufactured with an outlet fitting containing red anodized threads. These MFCV do not provide adequate... that some motive flow check valves (MFCV) were manufactured with an outlet fitting containing red... containing red anodized threads. These MFCV do not provide adequate electrical bonding between the valve and...

29 CFR 417.4 - Pre-hearing conference.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Constitution and Bylaws for Removal of Officers of Local Labor Organizations § 417.4 Pre-hearing conference. (a... constitution and bylaws of the labor organization do not provide an adequate procedure for the removal of an...) on the question of whether its constitution and bylaws provide an adequate procedure for the removal...

29 CFR 417.4 - Pre-hearing conference.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Constitution and Bylaws for Removal of Officers of Local Labor Organizations § 417.4 Pre-hearing conference. (a... constitution and bylaws of the labor organization do not provide an adequate procedure for the removal of an...) on the question of whether its constitution and bylaws provide an adequate procedure for the removal...

29 CFR 417.4 - Pre-hearing conference.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Constitution and Bylaws for Removal of Officers of Local Labor Organizations § 417.4 Pre-hearing conference. (a... constitution and bylaws of the labor organization do not provide an adequate procedure for the removal of an...) on the question of whether its constitution and bylaws provide an adequate procedure for the removal...

Document clustering methods, document cluster label disambiguation methods, document clustering apparatuses, and articles of manufacture

DOEpatents

Sanfilippo, Antonio [Richland, WA; Calapristi, Augustin J [West Richland, WA; Crow, Vernon L [Richland, WA; Hetzler, Elizabeth G [Kennewick, WA; Turner, Alan E [Kennewick, WA

2009-12-22

Document clustering methods, document cluster label disambiguation methods, document clustering apparatuses, and articles of manufacture are described. In one aspect, a document clustering method includes providing a document set comprising a plurality of documents, providing a cluster comprising a subset of the documents of the document set, using a plurality of terms of the documents, providing a cluster label indicative of subject matter content of the documents of the cluster, wherein the cluster label comprises a plurality of word senses, and selecting one of the word senses of the cluster label.

The Principles for Successful Scientific Data Management Revisited

NASA Astrophysics Data System (ADS)

Walker, R. J.; King, T. A.; Joy, S. P.

2005-12-01

It has been 23 years since the National Research Council's Committee on Data Management and Computation (CODMAC) published its famous list of principles for successful scientific data management that have provided the framework for modern space science data management. CODMAC outlined seven principles: 1. Scientific Involvement in all aspects of space science missions. 2. Scientific Oversight of all scientific data-management activities. 3. Data Availability - Validated data should be made available to the scientific community in a timely manner. They should include appropriate ancillary data, and complete documentation. 4. Facilities - A proper balance between cost and scientific productivity should be maintained. 5. Software - Transportable well documented software should be available to process and analyze the data. 6. Scientific Data Storage - The data should be preserved in retrievable form. 7. Data System Funding - Adequate data funding should be made available at the outset of missions and protected from overruns. In this paper we will review the lessons learned in trying to apply these principles to space derived data. The Planetary Data System created the concept of data curation to carry out the CODMAC principles. Data curators are scientists and technologists who work directly with the mission scientists to create data products. The efficient application of the CODMAC principles requires that data curators and the mission team start early in a mission to plan for data access and archiving. To build the data products the planetary discipline adopted data access and documentation standards and has adhered to them. The data curators and mission team work together to produce data products and make them available. However even with early planning and agreement on standards the needs of the science community frequently far exceed the available resources. This is especially true for smaller principal investigator run missions. We will argue that one way to make data systems for small missions more effective is for the data curators to provide software tools to help develop the mission data system.

42 CFR 417.568 - Adequate financial records, statistical data, and cost finding.

Code of Federal Regulations, 2012 CFR

2012-10-01

... ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS Medicare Payment: Cost Basis § 417... health care industry. (b) Provision of data. (1) The HMO or CMP must provide adequate cost and... 42 Public Health 3 2012-10-01 2012-10-01 false Adequate financial records, statistical data, and...

General guidelines for safe and expeditious international transport of samples subjected to biological dosimetry assessment.

PubMed

Di Giorgio, Marina; Radl, Analía; Taja, María R; Bubniak, Ruth; Deminge, Mayra; Sapienza, Carla; Vázquez, Marina; Baciu, Florian; Kenny, Pat

2014-06-01

It has been observed that victims of accidental overexposures show better chance of survival if they receive medical treatment early. The increased risk of scenarios involving mass casualties has stimulated the scientific community to develop tools that would help the medical doctors to treat victims. The biological dosimetry has become a routine test to estimate the dose, supplementing physical and clinical dosimetry. In case of radiation emergencies, in order to provide timely and effectively biological dosimetry assistance it is essential to guarantee an adequate transport of blood samples in principal, for providing support to countries that do not have biodosimetry laboratories. The objective of the present paper is to provide general guidelines, summarised in 10 points, for timely and proper receiving and sending of blood samples under National and International regulations, for safe and expeditious international transport. These guidelines cover the classification, packaging, marking, labelling, refrigeration and documentation requirements for the international shipping of blood samples and pellets, to provide assistance missions with a tool that would contribute with the preparedness for an effective biodosimetric response in cases of radiological or nuclear emergencies. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Weather data dissemination to aircraft

NASA Technical Reports Server (NTRS)

Mcfarland, Richard H.; Parker, Craig B.

1990-01-01

Documentation exists that shows weather to be responsible for approximately 40 percent of all general aviation accidents with fatalities. Weather data products available on the ground are becoming more sophisticated and greater in number. Although many of these data are critical to aircraft safety, they currently must be transmitted verbally to the aircraft. This process is labor intensive and provides a low rate of information transfer. Consequently, the pilot is often forced to make life-critical decisions based on incomplete and outdated information. Automated transmission of weather data from the ground to the aircraft can provide the aircrew with accurate data in near-real time. The current National Airspace System Plan calls for such an uplink capability to be provided by the Mode S Beacon System data link. Although this system has a very advanced data link capability, it will not be capable of providing adequate weather data to all airspace users in its planned configuration. This paper delineates some of the important weather data uplink system requirements, and describes a system which is capable of meeting these requirements. The proposed system utilizes a run-length coding technique for image data compression and a hybrid phase and amplitude modulation technique for the transmission of both voice and weather data on existing aeronautical Very High Frequency (VHF) voice communication channels.

The theoretical background to BS7167: 1990 - specification for Bordeaux connections

NASA Astrophysics Data System (ADS)

Gorley, T. A. E.

1992-03-01

The theoretical background to the specification of Bordeaux connections (components of lifting gear used to join together wire rope and a chain, or two lengths of wire rope, where the joined lengths have to run over a sheave as in the case of grabbing cranes) is documented. Decisions taken in the drafting of earlier specifications are not documented. The design criteria for BS7167:1990 are addressed. The various parts of the Bordeaux connection specified in the standard are discussed in turn: the link portion, the rope portion, and the grab shackle. Some tests on the new design undertaken by the Health and Safety Executive confirm the new design criteria to be adequate for the strengths of rope to be used with this component.

Societal views and animal welfare science: understanding why the modified cage may fail and other stories.

PubMed

Weary, D M; Ventura, B A; von Keyserlingk, M A G

2016-02-01

The innovations developed by scientists working on animal welfare are often not adopted in practice. In this paper, we argue that one important reason for this failure is that the solutions proposed do not adequately address the societal concerns that motivated the original research. Some solutions also fail because they do not adequately address perceived constraints within the industry. Using examples from our own recent work, we show how research methods from the social sciences can address both of these limitations. For example, those who persist in tail-docking cattle (despite an abundance of evidence showing that the practice has no benefits) often justify their position by citing concern for cow cleanliness. This result informs the nature of new extension efforts directed at farmers that continue to tail dock, suggesting that these efforts will be more effective if they focus on providing producers with methods (of proven efficacy) for keeping cows clean. Work on pain mitigation for dehorning shows that some participants reluctant to provide pain relief believe that the pain from this procedure is short lasting and has little impact on the calf. This result informs the direction of new biological research efforts to understand both the magnitude and duration of any suffering that result from this type of procedure. These, and other examples, illustrate how social science methodologies can document the shared and divergent values of different stakeholders (to ensure that proposed solutions align with mainstream values), beliefs regarding the available evidence (to help target new scientific research that meets the perceived gaps), and barriers in implementing changes (to ease adoption of ideas by addressing these barriers).

Understanding Peripheral Bat Populations Using Maximum-Entropy Suitability Modeling

PubMed Central

Barnhart, Paul R.; Gillam, Erin H.

2016-01-01

Individuals along the periphery of a species distribution regularly encounter more challenging environmental and climatic conditions than conspecifics near the center of the distribution. Due to these potential constraints, individuals in peripheral margins are expected to change their habitat and behavioral characteristics. Managers typically rely on species distribution maps when developing adequate management practices. However, these range maps are often too simplistic and do not provide adequate information as to what fine-scale biotic and abiotic factors are driving a species occurrence. In the last decade, habitat suitability modelling has become widely used as a substitute for simplistic distribution mapping which allows regional managers the ability to fine-tune management resources. The objectives of this study were to use maximum-entropy modeling to produce habitat suitability models for seven species that have a peripheral margin intersecting the state of North Dakota, according to current IUCN distributions, and determine the vegetative and climatic characteristics driving these models. Mistnetting resulted in the documentation of five species outside the IUCN distribution in North Dakota, indicating that current range maps for North Dakota, and potentially the northern Great Plains, are in need of update. Maximum-entropy modeling showed that temperature and not precipitation were the variables most important for model production. This fine-scale result highlights the importance of habitat suitability modelling as this information cannot be extracted from distribution maps. Our results provide baseline information needed for future research about how and why individuals residing in the peripheral margins of a species’ distribution may show marked differences in habitat use as a result of urban expansion, habitat loss, and climate change compared to more centralized populations. PMID:27935936

Lungscape: resected non-small-cell lung cancer outcome by clinical and pathological parameters.

PubMed

Peters, Solange; Weder, Walter; Dafni, Urania; Kerr, Keith M; Bubendorf, Lukas; Meldgaard, Peter; O'Byrne, Kenneth J; Wrona, Anna; Vansteenkiste, Johan; Felip, Enriqueta; Marchetti, Antonio; Savic, Spasenija; Lu, Shun; Smit, Egbert; Dingemans, Anne-Marie; Blackhall, Fiona H; Baas, Paul; Camps, Carlos; Rosell, Rafael; Stahel, Rolf A

2014-11-01

The Lungscape project was designed to address the impact of clinical, pathological, and molecular characteristics on outcome in resected non-small- cell lung cancer (NSCLC). A decentralized biobank with fully annotated tissue samples was established. Selection criteria for participating centers included sufficient number of cases, tissue microarray building capability, and documented ethical approval. Patient selection was based on availability of comprehensive clinical data, radical resection between 2003 and 2009 with adequate follow-up, and adequate quantity and quality of formalin-fixed tissue. Fifteen centers contributed 2449 cases. The 5-year overall survival (OS) was 69.6% and 63.6% for stages IA and IB, 51.6% and 47.7% for stages IIA and IIB, and 29.0% and 13.0% for stages IIIA and IIIB, respectively (p < 0.001). Median and 5-year relapse-free survival (RFS) were 52.8 months and 47.3%, respectively. Distant relapse was recorded for 44.4%, local for 26.0%, and both for 16.9% of patients. Based on multivariate analysis for the OS, RFS, and time to relapse, the factors significantly associated with all of them are performance status and pathological stage. The aim of this report is to present the results from Lungscape, the first large series reporting on NSCLC surgical outcome measured not only by OS but also by RFS and time to relapse and including multivariate analysis by significant clinical and pathological prognostic parameters. As tissue from all patients is preserved locally and is available for detailed molecular investigations, Lungscape provides an excellent basis to evaluate the influence of molecular parameters on the disease outcome after radical resection, besides providing an overview of the molecular landscape of stage I to III NSCLC.

'That would have been beneficial': LGBTQ education for home-care service providers.

PubMed

Daley, Andrea; MacDonnell, Judith A

2015-05-01

This paper reports qualitative findings from a pilot study that explored the lesbian, gay, bisexual, transgender and queer (LGBTQ) education needs of home-care service providers working in one large, urban Canadian city. The pilot study builds upon research that has documented barriers to health services for diversely situated LGBTQ people, which function to limit access to good-quality healthcare. LGBTQ activists, organisations and allies have underscored the need for health provider education related to the unique health and service experiences of sexual and gender minority communities. However, the home-care sector is generally overlooked in this important body of research literature. We used purposeful convenience sampling to conduct four focus groups and two individual interviews with a total of 15 professionally diverse home-care service providers. Data collection was carried out from January 2011 to July 2012 and data were analysed using grounded theory methods towards the identification of the overarching theme, 'provider education' and it had two sub-themes: (i) experiences of LGBTQ education; and (ii) recommendations for LGBTQ education. The study findings raise important questions about limited and uneven access to adequate LGBTQ education for home-care service providers, suggest important policy implications for the education and health sectors, and point to the need for anti-oppression principles in the development of education initiatives. © 2014 John Wiley & Sons Ltd.

77 FR 32930 - Certain Steel Wire Garment Hangers From the Socialist Republic of Vietnam: Preliminary...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-04

... allegations concerning electricity that the GOV allegedly provided for less than adequate remuneration (LTAR... investigation into petitioners' allegation.\\9\\ \\9\\ See Memorandum to Melissa G. Skinner, Director, Office 3, AD... for determining whether a government good or service is provided for less than adequate remuneration...

76 FR 43175 - Approval of Air Quality Implementation Plans; Indiana and Ohio; Disapproval of Interstate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-20

... impact. EPA stated that the state's conclusion should be supported by an adequate technical analysis. EPA... by an adequate technical analysis. IDEM did not provide a technical analysis in its submittal, but... technical analysis and justification necessary to make that demonstration. Indiana did not provide any...

14 CFR 91.1029 - Flight scheduling and locating requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... program manager must establish and use an adequate system to schedule and release program aircraft. (b) Except as provided in paragraph (d) of this section, each program manager must have adequate procedures... manager with at least the information required to be included in a VFR flight plan; (2) Provide for timely...

29 CFR 417.4 - Pre-hearing conference.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Constitution and Bylaws for Removal of Officers of Local Labor Organizations § 417.4 Pre-hearing conference. (a... constitution and bylaws of the labor organization do not provide an adequate procedure for the removal of an... question of whether its constitution and bylaws provide an adequate procedure for the removal of an elected...

29 CFR 417.4 - Pre-hearing conference.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Constitution and Bylaws for Removal of Officers of Local Labor Organizations § 417.4 Pre-hearing conference. (a... constitution and bylaws of the labor organization do not provide an adequate procedure for the removal of an... question of whether its constitution and bylaws provide an adequate procedure for the removal of an elected...

Use of a new novel humidification system with high frequency percussive ventilation in a patient with inhalation injury.

PubMed

Jones, Samuel W; Short, Kathy A; Joseph, Mark; Sommer, Courtney; Cairns, Bruce A

2010-01-01

Historically, it has been difficult to provide adequate humidification delivery with the high frequency percussive ventilator (HFPV) used in many burn centers. It is possible burn centers have avoided using HFPV because of the risk of mucus plugging, dried secretions, and cast formation. Experiences with HFPV provided doubt that the HFPV ventilator circuit could supply adequate humidification to patients receiving this mode of ventilation. Independent gas-flow delivery through the ventilator circuit inherent in HFPV provided a challenge in maintaining adequate humidification delivery to the patient. This report describes a dramatic reduction in dried, inspissated secretions by using a novel new humidification device with HFPV. The new device called the Hydrate Omni (Hydrate, Inc., Midlothian, VA) uses a small ceramic disk to provide fine water particles delivered by a pump to the HFPV circuit. This new device may alleviate previous concerns related to the delivery of adequate humidification with the HFPV. This case report was approved by the University of North Carolina School of Medicine Institutional Review Board.

21 CFR 606.40 - Facilities.

Code of Federal Regulations, 2014 CFR

2014-04-01

...) Provide adequate space for the following when applicable: (1) Private and accurate examinations of... convenient toilet facilities for donors and personnel. Drains shall be of adequate size and, where connected...

21 CFR 606.40 - Facilities.

Code of Federal Regulations, 2013 CFR

2013-04-01

...) Provide adequate space for the following when applicable: (1) Private and accurate examinations of... convenient toilet facilities for donors and personnel. Drains shall be of adequate size and, where connected...

21 CFR 606.40 - Facilities.

Code of Federal Regulations, 2012 CFR

2012-04-01

...) Provide adequate space for the following when applicable: (1) Private and accurate examinations of... convenient toilet facilities for donors and personnel. Drains shall be of adequate size and, where connected...

Conflict of Interest Reporting by Authors Involved in Promotion of Off-Label Drug Use: An Analysis of Journal Disclosures

PubMed Central

Kesselheim, Aaron S.; Wang, Bo; Studdert, David M.; Avorn, Jerry

2012-01-01

Background Litigation documents reveal that pharmaceutical companies have paid physicians to promote off-label uses of their products through a number of different avenues. It is unknown whether physicians and scientists who have such conflicts of interest adequately disclose such relationships in the scientific publications they author. Methods and Findings We collected whistleblower complaints alleging illegal off-label marketing from the US Department of Justice and other publicly available sources (date range: 1996–2010). We identified physicians and scientists described in the complaints as having financial relationships with defendant manufacturers, then searched Medline for articles they authored in the subsequent three years. We assessed disclosures made in articles related to the off-label use in question, determined the frequency of adequate disclosure statements, and analyzed characteristics of the authors (specialty, author position) and articles (type, connection to off-label use, journal impact factor, citation count/year). We identified 39 conflicted individuals in whistleblower complaints. They published 404 articles related to the drugs at issue in the whistleblower complaints, only 62 (15%) of which contained an adequate disclosure statement. Most articles had no disclosure (43%) or did not mention the pharmaceutical company (40%). Adequate disclosure rates varied significantly by article type, with commentaries less likely to have adequate disclosure compared to articles reporting original studies or trials (adjusted odds ratio [OR] = 0.10, 95%CI = 0.02–0.67, p = 0.02). Over half of the authors (22/39, 56%) made no adequate disclosures in their articles. However, four of six authors with ≥25 articles disclosed in about one-third of articles (range: 10/36–8/25 [28%–32%]). Conclusions One in seven authors identified in whistleblower complaints as involved in off-label marketing activities adequately disclosed their conflict of interest in subsequent journal publications. This is a much lower rate of adequate disclosure than has been identified in previous studies. The non-disclosure patterns suggest shortcomings with authors and the rigor of journal practices. Please see later in the article for the Editors' Summary PMID:22899894

Conflict of interest reporting by authors involved in promotion of off-label drug use: an analysis of journal disclosures.

PubMed

Kesselheim, Aaron S; Wang, Bo; Studdert, David M; Avorn, Jerry

2012-01-01

Litigation documents reveal that pharmaceutical companies have paid physicians to promote off-label uses of their products through a number of different avenues. It is unknown whether physicians and scientists who have such conflicts of interest adequately disclose such relationships in the scientific publications they author. We collected whistleblower complaints alleging illegal off-label marketing from the US Department of Justice and other publicly available sources (date range: 1996-2010). We identified physicians and scientists described in the complaints as having financial relationships with defendant manufacturers, then searched Medline for articles they authored in the subsequent three years. We assessed disclosures made in articles related to the off-label use in question, determined the frequency of adequate disclosure statements, and analyzed characteristics of the authors (specialty, author position) and articles (type, connection to off-label use, journal impact factor, citation count/year). We identified 39 conflicted individuals in whistleblower complaints. They published 404 articles related to the drugs at issue in the whistleblower complaints, only 62 (15%) of which contained an adequate disclosure statement. Most articles had no disclosure (43%) or did not mention the pharmaceutical company (40%). Adequate disclosure rates varied significantly by article type, with commentaries less likely to have adequate disclosure compared to articles reporting original studies or trials (adjusted odds ratio [OR] = 0.10, 95%CI = 0.02-0.67, p = 0.02). Over half of the authors (22/39, 56%) made no adequate disclosures in their articles. However, four of six authors with ≥ 25 articles disclosed in about one-third of articles (range: 10/36-8/25 [28%-32%]). One in seven authors identified in whistleblower complaints as involved in off-label marketing activities adequately disclosed their conflict of interest in subsequent journal publications. This is a much lower rate of adequate disclosure than has been identified in previous studies. The non-disclosure patterns suggest shortcomings with authors and the rigor of journal practices. Please see later in the article for the Editors' Summary.

Health literacy of an urban business community.

PubMed

Johnson, Barbara H; Hayes, Sandra C; Ekundayo, Olugbemiga T; Wheeler, Primus; Ford, D'Arcy M

2012-02-01

The impact of community-based organizations on the delivery of health care knowledge is well documented. Little research has focused on the importance of health literacy in the dissemination of health care information by minority small business owners. This study sampled 38 business owners within a local business district to assess their level of health literacy. Although adequate health literacy is not required to serve as a community resource, it may be necessary to understand the health literacy level of local business owners as gatekeepers in order to develop appropriate training/educational programs. The results of this descriptive cross-sectional study indicate that for sample of business owners, health literacy levels are adequate. The findings suggest the feasibility of using local business owners as disseminators of health-related materials to the communities in which they operate their businesses.

Availability and Quality of Size Estimations of Female Sex Workers, Men Who Have Sex with Men, People Who Inject Drugs and Transgender Women in Low- and Middle-Income Countries

PubMed Central

Sabin, Keith; Zhao, Jinkou; Garcia Calleja, Jesus Maria; Sheng, Yaou; Arias Garcia, Sonia; Reinisch, Annette; Komatsu, Ryuichi

2016-01-01

Objective To assess the availability and quality of population size estimations of female sex workers (FSW), men who have sex with men (MSM), people who inject drug (PWID) and transgender women. Methods Size estimation data since 2010 were retrieved from global reporting databases, Global Fund grant application documents, and the peer-reviewed and grey literature. Overall quality and availability were assessed against a defined set of criteria, including estimation methods, geographic coverage, and extrapolation approaches. Estimates were compositely categorized into ‘nationally adequate’, ‘nationally inadequate but locally adequate’, ‘documented but inadequate methods’, ‘undocumented or untimely’ and ‘no data.’ Findings Of 140 countries assessed, 41 did not report any estimates since 2010. Among 99 countries with at least one estimate, 38 were categorized as having nationally adequate estimates and 30 as having nationally inadequate but locally adequate estimates. Multiplier, capture-recapture, census and enumeration, and programmatic mapping were the most commonly used methods. Most countries relied on only one estimate for a given population while about half of all reports included national estimates. A variety of approaches were applied to extrapolate from sites-level numbers to national estimates in two-thirds of countries. Conclusions Size estimates for FSW, MSM, PWID and transgender women are increasingly available but quality varies widely. The different approaches present challenges for data use in design, implementation and evaluation of programs for these populations in half of the countries assessed. Guidance should be further developed to recommend: a) applying multiple estimation methods; b) estimating size for a minimum number of sites; and, c) documenting extrapolation approaches. PMID:27163256

Content analysis of consumer information about knee arthroscopy in Australia.

PubMed

Buchbinder, Rachelle; Bourne, Allison

2018-04-01

Despite the availability of consistent guidelines recommending against arthroscopic treatment for people with symptomatic knee osteoarthritis, Australian data indicate continued use of this treatment modality. A paucity of easy to understand and reliable consumer information about knee arthroscopy may be one explanatory factor. The aim of this study was to determine whether consumer information about knee arthroscopy available in Australia is adequate to inform evidence-based decision-making for people with symptomatic osteoarthritis. We performed a content analysis of consumer information about knee arthroscopy for symptomatic osteoarthritis. Information sources were identified from the Australian Commission on Quality and Safety in Health Care and Internet searches conducted 20-28 May 2015. Search terms were 'knee arthroscopy', 'knee pain', 'osteoarthritis knee' and 'meniscal tear', and 'orthopaedic surgeon' linked to each Australian capital city. Two independent reviewers selected documents for inclusion and extracted data. Main outcomes were specific advice regarding use of arthroscopic treatment for people with knee osteoarthritis, mention of guidelines, and/or supporting evidence. Ninety-three documents were analyzed (44 were a paragraph or less). Only eight made a clear recommendation against use of arthroscopy for all/most people with knee osteoarthritis. None included an explicit statement attributed to a guideline, while only six provided any research evidence to support their advice. Wikipedia provided the most valid information but it may be incomprehensible to the average reader. Currently available consumer information about knee arthroscopy in Australia may be inadequate to help people with symptomatic knee osteoarthritis make informed decisions about this treatment. © 2018 Royal Australasian College of Surgeons.

Evaluation of a palliative and hospice care telephone hotline for patients severely affected by multiple sclerosis and their caregivers.

PubMed

Strupp, J; Groebe, B; Knies, A; Mai, M; Voltz, R; Golla, H

2017-12-01

Palliative and hospice care (PHC) still mainly focuses on patients with cancer. In order to connect patients severely affected by multiple sclerosis (MS) and caregivers to PHC, a nationwide hotline was implemented to facilitate access to PHC. The hotline was designed in cooperation with the German Multiple Sclerosis Society. Self-disclosed information given by callers was documented using case-report forms supplemented by personal notes. Data were analysed descriptively. A total of 222 calls were documented in 27 months. The patients' mean age was 51.12 years (range 27-84 years) and mean illness duration was 18 years (range 1 month to 50 years). Inquiries included information on PHC (28.8%) and access to PHC (due to previous refusal of PHC, 5.4%), general care for MS (36.1%), adequate housing (9.0%) and emotional support in crisis (4.5%). A total of 31.1% of callers reported 'typical' palliative symptoms (e.g. pain, 88.4%), 50.5% reported symptoms evolving from MS and 35.6% reported psychosocial problems. For 67 callers (30.2%), PHC services were recommended as indicated. The hotline provided insight into the needs and problems of patients severely affected by MS and their caregivers, some of which may be met by PHC. Future follow-up calls will demonstrate if the hotline helped to improve access to PHC beyond providing information. Overall, the hotline seemed to be easily accessible for patients severely affected by MS whose mobility is limited. © 2017 EAN.

Iraqi Police Development Program: Opportunities for Improved Program Accountability and Budget Transparency

DTIC Science & Technology

2011-10-24

makes three recommendations to the Secretary of State, highlighting the need for (1) an adequate current assessment of the Iraqi police forces, (2...with documents obtained from other sources, allowed us to determine that: • DoS does not have a current assessment of Iraqi police forces...capabilities upon which to base its program. Such an assessment is essential for effective program targeting. Further, DoS does not have a sufficiently

Information transfer satellite concept study. Volume 3: Appendices

NASA Technical Reports Server (NTRS)

Bergin, P.; Kincade, C.; Kurpiewski, D.; Leinhaupel, F.; Millican, F.; Onstad, R.

1971-01-01

Briefly reviewed are the various documents which supply background information for the information transfer satellite study. The sixteen papers reviewed are evaluated in terms of: (1) the category of service or demand being treated; (2) the extent to which information transfer predictions are quantified; (3) the degree to which the data supplied is adequate for the purposes of system synthesis; (4) some assessment as to the overall utility of the data presented in the paper.

The SRI NIST 2010 Speaker Recognition Evaluation System (PREPRINT)

DTIC Science & Technology

2011-01-01

of several subsystems with the use of adequate side information gives a 35% improvement on the standard telephone condition. We also show that a...ratio and amount of detected speech as side information . The SRI submissions were among the best-performing systems in SRE10. 2. COMMONALITIES This...Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting burden for the collection of information is estimated to average 1 hour per response

Impact of New DoD Directives on Marine Corps Acquisition Policy at Milestone IV

DTIC Science & Technology

1991-03-01

Logistics Services Center (DLSC) files are compatible on the Effective Transfer Data Base. The Hardware Systems Command ( HSC ) develops a uniform stock...financial evaluation. Based on established review dates, the HSC publishes the location and time of the stock transfer review meeting. Forty-five days...letter to NAVSUP. The HSC also maintains adequate documentation to justify material that they retain and ensures that items designated for retention at the

21 CFR 530.5 - Veterinary records.

Code of Federal Regulations, 2014 CFR

2014-04-01

... retrieval of information. Such records shall be adequate to substantiate the identification of the animals..., flock, or per-client basis. Records shall be adequate to provide the following information: (1) The...

21 CFR 530.5 - Veterinary records.

Code of Federal Regulations, 2012 CFR

2012-04-01

... retrieval of information. Such records shall be adequate to substantiate the identification of the animals..., flock, or per-client basis. Records shall be adequate to provide the following information: (1) The...

Guidelines for noise and vibration levels for the space station

NASA Technical Reports Server (NTRS)

1987-01-01

Human habitability noise and vibration guidelines for the Space Station are presented. These were developed by a working group of experts established by the Committee on Hearing, Bioacoustics, and Biomechanics (CHABA) of the National Research Council's Commission on Behavioral and Social Science and Education. Noise exposure limits are suggested that will permit adequate speech communication, sleep, and hearing safety. Vibration exposure limits are suggested which will provide adequate comfort and permit adequate task performance. These are provided for guidance only for setting criteria. The exact criteria will depend on Space Station design and duty cycles.

Guidelines for noise and vibration levels for the space station

NASA Astrophysics Data System (ADS)

1987-06-01

Human habitability noise and vibration guidelines for the Space Station are presented. These were developed by a working group of experts established by the Committee on Hearing, Bioacoustics, and Biomechanics (CHABA) of the National Research Council's Commission on Behavioral and Social Science and Education. Noise exposure limits are suggested that will permit adequate speech communication, sleep, and hearing safety. Vibration exposure limits are suggested which will provide adequate comfort and permit adequate task performance. These are provided for guidance only for setting criteria. The exact criteria will depend on Space Station design and duty cycles.

How Readable are Spanish-Language Medicaid Applications?

PubMed Central

Hansen, Julie S.; DeVoe, Jennifer E.

2015-01-01

Nationally, Hispanics comprise nearly one-quarter of all non-elderly Medicaid recipients. We evaluated readability, layout characteristics, and document complexity of state-issued Spanish-language Medicaid enrollment applications. We located and analyzed Internet-based Spanish enrollment applications from 37 states and the District of Columbia. We calculated the readability of each Medicaid enrollment application “Signature” page using the Spanish Lexile Analyzer. We assessed application layout characteristics utilizing the User-Friendliness Tool, and we evaluated document complexity using the PMOSE/IKIRSCH scale. The average Lexile score estimated an 11th–12th grade reading level (M = 1184, SD = 192) for “Signature” pages of enrollment applications. Most applications used small font size and lacked adequate white space. Document complexity ranged from level 3 (moderate) to level 5 (very high); the majority of applications ranked at level 4 (high). Spanish-language Medicaid enrollment applications should be revised to adhere to low-literacy guidelines, which may improve the accessibility of Medicaid coverage for eligible Spanish-speaking families. PMID:21213122

40 CFR 280.66 - Corrective action plan.

Code of Federal Regulations, 2011 CFR

2011-07-01

... submitting a plan that provides for adequate protection of human health and the environment as determined by... will adequately protect human health, safety, and the environment. In making this determination, the...

75 FR 15765 - Request for Comments on Carriers' Temporary Exemption Requests From DOT's Tarmac Delay Rules for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-30

... closing, and will ensure that each of its aircraft is stocked with sufficient food and beverages to... informing passengers of the likelihood of delays, and ensuring that it provides adequate food, beverage, and... flights, carriers must provide adequate food and water no later than two hours after the aircraft leaves...

Testing and validating environmental models

USGS Publications Warehouse

Kirchner, J.W.; Hooper, R.P.; Kendall, C.; Neal, C.; Leavesley, G.

1996-01-01

Generally accepted standards for testing and validating ecosystem models would benefit both modellers and model users. Universally applicable test procedures are difficult to prescribe, given the diversity of modelling approaches and the many uses for models. However, the generally accepted scientific principles of documentation and disclosure provide a useful framework for devising general standards for model evaluation. Adequately documenting model tests requires explicit performance criteria, and explicit benchmarks against which model performance is compared. A model's validity, reliability, and accuracy can be most meaningfully judged by explicit comparison against the available alternatives. In contrast, current practice is often characterized by vague, subjective claims that model predictions show 'acceptable' agreement with data; such claims provide little basis for choosing among alternative models. Strict model tests (those that invalid models are unlikely to pass) are the only ones capable of convincing rational skeptics that a model is probably valid. However, 'false positive' rates as low as 10% can substantially erode the power of validation tests, making them insufficiently strict to convince rational skeptics. Validation tests are often undermined by excessive parameter calibration and overuse of ad hoc model features. Tests are often also divorced from the conditions under which a model will be used, particularly when it is designed to forecast beyond the range of historical experience. In such situations, data from laboratory and field manipulation experiments can provide particularly effective tests, because one can create experimental conditions quite different from historical data, and because experimental data can provide a more precisely defined 'target' for the model to hit. We present a simple demonstration showing that the two most common methods for comparing model predictions to environmental time series (plotting model time series against data time series, and plotting predicted versus observed values) have little diagnostic power. We propose that it may be more useful to statistically extract the relationships of primary interest from the time series, and test the model directly against them.

Quality of care provided to patients with diabetes mellitus in Puerto Rico; managed care versus fee-for-service experience.

PubMed

Rodríguez-Vigil, Efraín; Kianes-Pérez, Zaira

2005-01-01

To evaluate and compare the quality of diabetes care in a large managed care system and fee-for-service payment system in Puerto Rico. This retrospective cross-sectional study assessed the adherence to standards of diabetes care in 1,687,202 subjects--226,210 from a fee-for-service population and 1,460,992 from a managed care group. Patients with diabetes mellitus were identified from insurance claims reports. Type of health-care provider, service location, number of visits, and laboratory utilization were also assessed. From the analysis, we identified 90,616 patients with diabetes (5.4% of the overall study group). Of these, 66,587 (73.5%) were found to have at least one encounter with a physician in a medical visit. Of the 66,586 patients with diabetes who visited a physician, only 4% were treated by an endocrinologist. General laboratory utilization was 34% for the entire population of patients with diabetes studied. In the group of patients with documented laboratory tests, 93% had a documented fasting blood glucose test; in contrast, hemoglobin A lc testing was performed in only 9% of the patients. The fee-for-service group had a higher rate of visits to medical specialists and general laboratory utilization, whereas the managed care group had a higher rate of hospital admissions and emergency department visits. The quality of diabetes management and the subsequent outcomes are related to patient and health-care provider adherence to standards of care. In this analysis, we found that patients and physicians are responsible for low compliance with recognized standards of diabetes care in Puerto Rico. The lack of adequate management will lead to increased mortality, development and severity of chronic complications, and increased emergency department utilization. Therefore, health-care providers and payers should find ways to achieve more effective promotion of adherence to accepted standards of care for patients with diabetes.

Towards a Standard for Provenance and Context for Preservation of Data for Earth System Science

NASA Technical Reports Server (NTRS)

Ramaprian, Hampapuram K.; Moses, John F.

2011-01-01

Long-term data sets with data from many missions are needed to study trends and validate model results that are typical in Earth System Science research. Data and derived products originate from multiple missions (spaceborne, airborne and/or in situ) and from multiple organizations. During the missions as well as well past their termination, it is essential to preserve the data and products to support future studies. Key aspects of preservation are: preserving bits and ensuring data are uncorrupted, preserving understandability with appropriate documentation, and preserving reproducibility of science with appropriate documentation and other artifacts. Computer technology provides adequate standards to ensure that, with proper engineering, bits are preserved as hardware evolves. However, to ensure understandability and reproducibility, it is essential to plan ahead to preserve all the relevant data and information. There are currently no standards to identify the content that needs to be preserved, leading to non-uniformity in content and users not being sure of whether preserved content is comprehensive. Each project, program or agency can specify the items to be preserved as a part of its data management requirements. However, broader community consensus that cuts across organizational or national boundaries would be needed to ensure comprehensiveness, uniformity and long-term utility of archived data. The Federation of Earth Science Information Partners (ESIP), a diverse network of scientists, data stewards and technology developers, has a forum for ESIP members to collaborate on data preservation issues. During early 2011, members discussed the importance of developing a Provenance and Context Content Standard (PCCS) and developed an initial list of content items. This list is based on the outcome of a NASA and NOAA meeting held in 1998 under the auspices of the USGCRP, documentation requirements from NOAA and our experience with some of the NASA Earth science missions. The items are categorized into the following 8 high level categories: Preflight/Pre-Operations, Products (Data), Product Documentation, Mission Calibration, Product Software, Algorithm Input, Validation, Software Tools.

Criteria Considered in Selecting Feed Items for Americium-241 Oxide Production Operations

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

Schulte, Louis D.

The analysis in this document serves the purpose of defining a number of attributes in selection of feed items to be utilized in recovery/recycle of Pu and also production operations of 241AmO 2 material intended to meet specification requirements. This document was written in response to a specific request on the part of the 2014 annual program review which took place over the dates of October 28-29, 2014. A number of feed attributes are noted including: (1) Non-interference with existing Pu recovery operations; (2) Content of sufficient 241Am to allow process efficiency in recovery operations; (3) Absence of indications thatmore » 243Am might be mixed in with the Pu/ 241Am material; (4) Absence of indications that Cm might be mixed in with the Pu/ 241Am material; (5) Absence of indications of other chemical elements that would present difficulty in chemical separation from 241Am; (6) Feed material not expected to present difficulty in dissolution; (7) Dose issues; (8) Process efficiency; (9) Size; (10) Hazard associated with items and package configuration in the vault; (11) Within existing NEPA documentation. The analysis in this document provides a baseline of attributes considered for feed materials, but does not presume to replace the need for technical expertise and judgment on the part of individuals responsible for selecting the material feed to be processed. This document is not comprehensive as regards all attributes that could prove to be important. The value of placing a formal QA hold point on accepting feed items versus more informal management of feed items is discussed in the summation of this analysis. The existing planned QA hold points on 241AmO 2 products produced and packaged may be adequate as the entire project is based on QA of the product rather than QA of the process. The probability of introduction of items that would inherently cause the 241AmO 2 products produced to be outside of specification requirements appears to be rather small.« less

Insights into the Affordable Medicines Facility-malaria in Ghana: the role of caregivers and licensed chemical sellers in four regions.

PubMed

Adjei, Andrew A; Winch, Peter; Laar, Amos; Sullivan, David J; Sakyi, Kwame S; Stephens, Judith K; Adjei, George O; Boateng, Isaac A; Aubyn, Vivian N Ama; Kubio, Chrysantus; Tuakli, Julliette; Vanotoo, Linda; Bortei, Bernard B; Amo-Addae, Maame; Sorvor, Felix; Coleman, Nathaniel; Dalglish, Sarah; Owusu, Richmond; Gebreyesus, Tsega; Essuman, Edward; Greene, Rebecca; Ankomah, Ezekiel; Houston, Kiely; Bart-Plange, Constance; Salamat, Samuel; Addison, Ebenezer A; Quakyi, Isabella A

2016-05-10

The Affordable Medicine Facility-malaria (AMFm) was an innovative global financing mechanism for the provision of quality-assured artemisinin-based combination therapy (ACT) across both the private and public health sectors in eight countries in sub-Saharan Africa. This study evaluated the effectiveness of AMFm subsidies in increasing access to ACT in Ghana and documented malaria management practices at the household and community levels during the implementation of the AMFm. This study, conducted in four regions in Ghana between January, 2011 to December, 2012, employed cross-sectional mixed-methods design that included qualitative and quantitative elements, specifically household surveys, focus group discussions (FGD) and in-depth interviews. The study indicated high ACT availability, adequate provider knowledge and reasonably low quality-assured ACT use in the study areas, all of which are a reflection of a high market share of ACT in these hard-to-reach areas of the country. Adequate recognition of childhood malaria symptoms by licensed chemical seller (LCS) attendants was observed. A preference by caregivers for LCS over health facilities for seeking treatment solutions to childhood malaria was found. Artemisinin-based combination therapy with the AMFm logo was accessible and affordable for most people seeking treatment from health facilities and LCS shops in rural areas. Caregivers and LCS were seen to play key roles in the health of the community especially with children under 5 years of age.

Guidelines for seizure management in palliative care: Proposal for an updated clinical practice model based on a systematic literature review.

PubMed

León Ruiz, M; Rodríguez Sarasa, M L; Sanjuán Rodríguez, L; Pérez Nieves, M T; Ibáñez Estéllez, F; Arce Arce, S; García-Albea Ristol, E; Benito-León, J

2017-02-27

Very little has been written on seizure management in palliative care (PC). Given this situation, and considering the forthcoming setting up of the Palliative Care Unit at our neurorehabilitation centre, the Clínica San Vicente, we decided to establish a series of guidelines on the use of antiepileptic drugs (AEDs) for handling seizures in PC. We conducted a literature search in PubMed to identify articles, recent manuals, and clinical practice guidelines on seizure management in PC published by the most relevant scientific societies. Clinical practice guidelines are essential to identify patients eligible for PC, manage seizures adequately, and avoid unnecessary distress to these patients and their families. Given the profile of these patients, we recommend choosing AEDs with a low interaction potential and which can be administered by the parenteral route, preferably intravenously. Diazepam and midazolam appear to be the most suitable AEDs during the acute phase whereas levetiracetam, valproic acid, and lacosamide are recommended for refractory cases and long-term treatment. These guidelines provide general recommendations that must be adapted to each particular clinical case. Nevertheless, we will require further well-designed randomised controlled clinical trials including large samples of patients eligible for PC to draft a consensus document recommending adequate, rational, and effective use of AEDs, based on a high level of evidence, in this highly complex area of medical care. Copyright © 2017 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

Availability of Life Support Equipment and its Utilization by Ambulance Drivers.

PubMed

Acharya, Rija; Badhu, Angur; Shah, Tara; Shrestha, Sharmila

2017-09-08

An effective ambulance is a vital requirement for providing an emergency medical service. Well-equipped ambulances with trained paramedics can save many lives during the golden hours of trauma care. The objective was to document the availability and utilization of basic life support equipment in the ambulances and to assess knowledge on first aid among the drivers. Descriptive design was used. Total of 109 ambulances linked to B.P. Koirala Institute of Health Sciences were enrolled using purposive sampling method. Self- constructed observation checklist and semi structured interview schedule was used for data collection. More than half of the respondents had less than five years of experience and were not trained in first aid. About two-third of the respondents had adequate knowledge on first aid. About 90% of the ambulance had oxygen cylinder and adult oxygen mask which was 'usually' used equipment. More than half of ambulance had equipment less than 23% as compared to that of national guidelines. There was significant association of knowledge with the experience (p = 0.004) and training (p = 0.001). Availability of equipment was associated with training received (p = 0.007),organization (p= 0.032)and district (p = 0.023) in which the ambulance is registered. The study concludes that maximum ambulance linked to BPKIHS, Nepal did not have even one fourth of the equipment for basic life support. Equipment usually used was oxygen cylinder and oxygen mask. Majority of driver had adequate knowledge on first aid and it was associated with training and experience.

Detection with Enhanced Energy Windowing Phase I Report

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

Bass, David A.; Enders, Alexander L.

2016-12-01

This document reviews the progress of Phase I of the Detection with Enhanced Energy Windowing (DEEW) project. The DEEW project is the implementation of software incorporating an algorithm which reviews data generated by radiation portal monitors and utilizes advanced and novel techniques for detecting radiological and fissile material while not alarming on Naturally Occurring Radioactive Material. Independent testing indicated that the Enhanced Energy Windowing algorithm showed promise at reducing the probability of alarm in the stream of commerce compared to existing algorithms and other developmental algorithms, while still maintaining adequate sensitivity to threats. This document contains a brief description ofmore » the project, instructions for setting up and running the applications, and guidance to help make reviewing the output files and source code easier.« less

Proceedings of Shuttle Environmental Effects Program Review. [conferences

NASA Technical Reports Server (NTRS)

Potter, A. E. (Editor)

1980-01-01

Measurements of Titan exhaust cloud effluents are documented and compared, mesoscale and microphysical acid rain models are described, and a submesoscale model is proposed. Various instruments and facilities for measuring ice nuclei and other constituents of solid rocket motor exhaust effluents are discussed. Regional air quality monitoring and rain collection systems are described, and the ecological impact of solid rocket motor exhaust effluents is examined. The potential effect of space shuttle launches is estimated where data are adequate.

Wave-Ice and Air-Ice-Ocean Interaction During the Chukchi Sea Ice Edge Advance

DTIC Science & Technology

2015-09-30

1 DISTRIBUTION STATEMENT A. Approved for public release; distribution is unlimited. Wave -Ice and Air-Ice-Ocean Interaction During the...Chukchi Sea in the late summer have potentially changed the impact of fall storms by creating wave fields in the vicinity of the advancing ice edge. A...first) wave -ice interaction field experiment that adequately documents the relationship of a growing pancake ice cover with a time and space varying

DoD Needs to Improve Oversight of the Afghan National Police Training/Mentoring and Logistics Support Contract

DTIC Science & Technology

2013-06-25

test Waste Water Treatment Plant” because no testing kit was onsite. The COR additionally stated he identified failed equipment and the contractor...Officer ( PCO ) confirmed with the previous ACC-Rl PCO and neither recall ever making this statement. The previous PCO recalls discussing that a QASP...performance surveillance and have access to all contract documents. Adequate contract oversight is always a concern of the PCO , in part due to the

Assessment of Cabin Dimensions to Accommodate Infantry Soldiers for the Future Vertical Lift/Joint Multi-Role Medium-Class Aircraft

DTIC Science & Technology

2014-07-01

an official Department of the Army position unless so designated by other authorized documents. Citation of manufacturer’s or trade names does...The dimensions assessed included seat space widths, cabin ceiling heights, aisle widths, seating configurations, and cabin door widths. Emergency... seat spacing, 66-in. cabin ceiling height, 72-in. floor width, and 32-in. door width. These dimensions will help ensure that Soldiers have adequate

Performance of thermal sprayed aluminium coatings in the splash zone and for riser service

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

Fischer, K.P.; Rosbrook, T.; Thomason, W.H.

1994-12-31

Historically, the coatings used in the splash zone have been either heavy duty coal tar epoxy or a glassflake epoxy. In 1982 Conoco justified a minimum 20 year service life for a sealed thermal sprayed aluminium (TSA) coating for the Hutton TLP risers and tethers. In 1984 the Hutton TLP was installed with 200 microns thickness TSA as the corrosion protection coating and without adding a corrosion allowance. After eight years service the TSA coating on the production risers and tethers is still in good condition. It was noted that the splash zone area was indistinguishable from the remainder ofmore » the inspected components. However, there was a noticeable difference between the production risers and the tethers. The tethers having a vinyl sealer showed a blistered surface while the risers with a silicone sealer did not show any blistering. No corrosion has been observed underneath any of the blisters. The importance of adequate sealers in connection with blistering has been documented by testing. The excellent long term performance of TSA coating in the splash zone has been further documented by the results of field studies published in the last few years. These experiences indicate that TSA coatings properly applied and with the use of specific sealer systems may provide a service life in excess of 30 years with no required maintenance.« less

ISHNE/EHRA expert consensus on remote monitoring of cardiovascular implantable electronic devices (CIEDs).

PubMed

Dubner, Sergio; Auricchio, Angelo; Steinberg, Jonathan S; Vardas, Panos; Stone, Peter; Brugada, Josep; Piotrowicz, Ryszard; Hayes, David L; Kirchhof, Paulus; Breithardt, Günter; Zareba, Wojciech; Schuger, Claudio; Aktas, Mehmet K; Chudzik, Michal; Mittal, Suneet; Varma, Niraj

2012-02-01

We are in the midst of a rapidly evolving era of technology-assisted medicine. The field of telemedicine provides the opportunity for highly individualized medical management in a way that has never been possible before. Evolving medical technologies using cardiac implantable devices (CIEDs) with capabilities for remote monitoring permit evaluation of multiple parameters of cardiovascular physiology and risk, including cardiac rhythm, device function, blood pressure values, the presence of myocardial ischaemia, and the degree of compensation of congestive heart failure. Cardiac risk, device status, and response to therapies can now be assessed with these electronic systems of detection and reporting. This document reflects the extensive experience from investigators and innovators around the world who are shaping the evolution of this rapidly expanding field, focusing in particular on implantable pacemakers (IPGs), implantable cardioverter-defibrillators (ICDs), devices for cardiac resynchronization therapy (CRT) (both, with and without defibrillation properties), loop recorders, and haemodynamic monitoring devices. This document covers the basic methodologies, guidelines for their use, experience with existing applications, and the legal and reimbursement aspects associated with their use. To adequately cover this important emerging topic, the International Society for Holter and Noninvasive Electrocardiology (ISHNE) and the European Heart Rhythm Association (EHRA) combined their expertise in this field. We hope that the development of this field can contribute to improve care of our cardiovascular patients.

Modern Processing Capabilities of Analog Data from Documentation of the Great Omayyad Mosque in Aleppo, Syria, Damaged in Civil War

NASA Astrophysics Data System (ADS)

Pavelka, K.; Šedina, J.; Raeva, P.; Hůlková, M.

2017-08-01

In 1999, a big project for the documentation of the Great Omayyad mosque in Aleppo / Syria under UNESCO was conducted. By end of the last century, still analogue cameras were still being used, like the UMK Zeiss, RolleiMetric System. Digital cameras and digital automatic data processing were just starting to be on the rise and laser scanning was not relevant. In this situation, photogrammetrical measurement used stereo technology for complicated situations, and object and single-image technology for creating photoplans. Hundreds of photogrammetric images were taken. However, data processing was carried out on digital stereo plotters or workstations; it was necessary that all analogue photos were converted to digital form using a photogrammetric scanner. The outputs were adequate to the end of the last century. Nowadays, after 19 years, the photogrammetric materials still exist, but the technology and processing is completely different. Our original measurement is historical and nowadays quite obsolete. So we was it decided to explore the possibilities of the new processing of historical materials. Why? The reason is that in the last few years there has been civil war in Syria and the above mentioned monument was severely damaged. The existing historical materials therefore provide a unique opportunity for possible future reconstruction. This paper refers to the completion of existing materials, their evaluation and possibilities of new processing with today's technologies.

DYNA3D/ParaDyn Regression Test Suite Inventory

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

Lin, Jerry I.

2016-09-01

The following table constitutes an initial assessment of feature coverage across the regression test suite used for DYNA3D and ParaDyn. It documents the regression test suite at the time of preliminary release 16.1 in September 2016. The columns of the table represent groupings of functionalities, e.g., material models. Each problem in the test suite is represented by a row in the table. All features exercised by the problem are denoted by a check mark (√) in the corresponding column. The definition of “feature” has not been subdivided to its smallest unit of user input, e.g., algorithmic parameters specific to amore » particular type of contact surface. This represents a judgment to provide code developers and users a reasonable impression of feature coverage without expanding the width of the table by several multiples. All regression testing is run in parallel, typically with eight processors, except problems involving features only available in serial mode. Many are strictly regression tests acting as a check that the codes continue to produce adequately repeatable results as development unfolds; compilers change and platforms are replaced. A subset of the tests represents true verification problems that have been checked against analytical or other benchmark solutions. Users are welcomed to submit documented problems for inclusion in the test suite, especially if they are heavily exercising, and dependent upon, features that are currently underrepresented.« less

Latin American guidelines on hypertension. Latin American Expert Group.

PubMed

Sanchez, Ramiro A; Ayala, Miryam; Baglivo, Hugo; Velazquez, Carlos; Burlando, Guillermo; Kohlmann, Oswaldo; Jimenez, Jorge; Jaramillo, Patricio López; Brandao, Ayrton; Valdes, Gloria; Alcocer, Luis; Bendersky, Mario; Ramirez, Agustín José; Zanchetti, Alberto

2009-05-01

Hypertension is a highly prevalent cardiovascular risk factor in the world and particularly overwhelming in low and middle-income countries. Recent reports from the WHO and the World Bank highlight the importance of chronic diseases such as hypertension as an obstacle to the achievement of good health status. It must be added that for most low and middle-income countries, deficient strategies of primary healthcare are the major obstacles for blood pressure control. Furthermore, the epidemiology of hypertension and related diseases, healthcare resources and priorities, the socioeconomic status of the population vary considerably in different countries and in different regions of individual countries. Considering the low rates of blood pressure control achieved in Latin America and the benefits that can be expected from an improved control, it was decided to invite specialists from different Latin American countries to analyze the regional situation and to provide a consensus document on detection, evaluation and treatment of hypertension that may prove to be cost-utility adequate. The recommendations here included are the result of preparatory documents by invited experts and a subsequent very active debate by different discussion panels, held during a 2-day sessions in Asuncion, Paraguay, in May 2008. Finally, in order to improve clinical practice, the publication of the guidelines should be followed by implementation of effective interventions capable of overcoming barriers (cognitive, behavioral and affective) preventing attitude changes in both physicians and patients.