[Laparoscopic sacrocolpopexy for pelvic organ prolapse: guidelines for clinical practice].

PubMed

Wagner, L; Meurette, G; Vidart, A; Warembourg, S; Terassa, J-B; Berrogain, N; Ragni, E; Le Normand, L

2016-07-01

Open sacrocolpopexy have demonstrated its efficiency in surgical treatment of pelvic organ prolapse with an important backward on a large number of patients. Laparoscopic sacrocolpopexy reproduced the same surgical technique with reduced morbidity and may benefits from the recent development of robotic. Numerous technical variants have been developped around the original procedure but results seems not ever equivalent. Our objectives are to establish practical recommendations issues from the data of the litterature on the various technical aspects of this technique. This work leans on an exhaustive lecture of the literature concerning meta analyses, randomized tries, registers, controlled studies and the largest non controlled studies published on the subject. Recommendations were developed by a multidisciplinary workgroup then reread and amended by an also multidisciplinary group of proofreaders (urologists, gynecologists, gastroenterologists and surgeons). The methodology follows at best the recommendations of the HAS with a scientific argument for every question (accompanied with the level of proof, NP) and the recommendations, the officers (In, B, C and agreement of experts) and validated at the end of the phase of review. Surgical treatment of uro-genital prolapse by abdominal route classically associated hystero and anterior vaginopexy on the sacral ligament with a synthethic mesh. There are no argument to systematically associated a posterior vaginopexy to prevent secondary rectocele (level C). The consensual indication of laparoscopic rectopexy is represented by symptomatic rectal prolapse, the anatomical and functional results of which are the best estimated (level C). The surgical treatment of rectocele, elytrocele and enterocele with a posterior vaginopexy is not well estimated (level 3). Thus, it is not possible to conclude on the results of a posterior vaginal fixation with a mesh in these indications (AP). In the absence of colpocèle, the interest brought by the posterior vaginal mesh is not established (level 3). There is no comparative studies which allows to conclude on the type and mode of fixation of the prostheses of sacrocolpopexy. We would only report the most common practices without other conclusion. The anterior mesh is usually fixed upper on the anterior part of uterus cervix and lower on the anterior vaginal wall. These fixations are most of the time made by suture and on the promontory with non absorbable suture. The great majority of the authors recommend to make a peritonisation of prostheses to limit the risk of post-operative occlusion. It is now recommended to use only 2 kind of not absorbable prostheses: type I (macroporous polypropylene) or type III (polyester) and not to use any more prostheses type II (PTFE, Silicone) (level C) because of a high rate of mesh erosion: PTFE (9 %) or Silicone (19%) (level 3). Biological prostheses are no more recommended, because of short and medium-term lower anatomical results (level B). Anatomical and functional results are not stastistically differents between laparotomy and coelioscopy (NP1) but the comparison of tong-term results between both ways is not yet established. Coelioscopy allows significant reduction of blood losses, hospital stay and return to normal activity (level 1). Furthemore, there is a higher level of post-operative complications in laparotomy (level 1). When sacrocolpopexy is indicated, coelioscopy is thus recommended (level B). During coelioscopic sacrocolpopexy, anatomical and functional result have not shown any significance difference when using or no a robotics assistance but real randomised studies does not exist (level 2). In comparison to coelioscopy, robotic seems not to improve post-operative consequences and not to decrease the rate of complications of sacrocolpopexy (level 3). Robotic assistance cannot be yet recommended when a coelioscopic sacrocolpopexy is indicated (rank B). Sacrocolpopexy using not absorbable meshes allows to cure pelvic organ prolapses with very good results with few complications in terms of prothetic exposure and infection and thus is now considered as the referent prothetic surgical technique in this indication. Thus, it seems very important to establish clear recommendations on the numerous operating technical variants which developed around the original technique. © 2016 Published by Elsevier Masson SAS. © 2016 Elsevier Masson SAS. Tous droits réservés.

Review of the Human Resources, Finance, and Information Technology Operations of the Seattle Public Schools

ERIC Educational Resources Information Center

Council of the Great City Schools, 2008

2008-01-01

In late 2007, the Council of the Great City Schools conducted a high-level management review of the school district's human resources, financial, and technology operations to: (1) Review and evaluate the leadership, management, organization, and operations of the respective departments; and (2) Develop recommendations and proposals that would…

Evaluation of nurse staffing levels and outcomes under the government--recommended staffing levels in Korea.

PubMed

Yu, Soyoung; Kim, Tae Gon

2015-05-01

This study aimed to evaluate registered nurse staffing levels and outcomes enforced by the current Korean nursing regulations. Registered nurse staffing levels are closely related to patient and nurse outcomes. Thus, the government's policy regarding nursing staffing has a practical impact, and better policies could lead to more appropriate nurse staffing. The actual evaluation of the government-recommended staffing levels in Korea is paramount for the establishment of a realistic and effective system that promotes quality care and patient safety. The participating hospital operated under the government-recommended staffing levels (Grade 2 of the Graded Fee of Nursing Management Inpatient System). For unit-level evaluations, one surgical unit was chosen and its staffing level was changed by assigning one additional registered nurse for 6 months. Length of hospitalisation, incidents of death, overtime hours and nursing job performance were measured prior to and after the addition of the extra staff. After 6 months, the length of patient hospitalisation and registered nurse overtime hours reduced and nurse job performance scores in the unit analysed improved. The results demonstrated that increasing the number of registered nurses beyond the current government-recommended staffing level improves patient and nurse outcomes. This indicates the importance and value of empirically assessing the need for changes in the recommended nurse staffing levels to develop appropriate, realistic and effective policies. © 2013 John Wiley & Sons Ltd.

Surveillance of Environmental and Procedural Measures of Infection Control in the Operating Theatre Setting

PubMed Central

Raggi, Alessandra; Sanna, Tiziana; Mazzetti, Magda; Orsi, Alessandra; Zanni, Angela; Farruggia, Patrizia

2017-01-01

The microbiological contamination of operating theatres and the lack of adherence to best practices by surgical staff represent some of the factors affecting Surgical Site Infections (SSIs). The aim of the present study was to assess the microbiological quality of operating settings and the staff compliance to the SSI evidence-based control measures. Ten operating rooms were examined for microbiological contamination of air and surfaces, after cleaning procedures, in “at rest” conditions. Furthermore, 10 surgical operations were monitored to assess staff compliance to the recommended practices. None of the air samples exceeded microbiological reference standards and only six of the 200 surface samples (3.0%) were slightly above recommended levels. Potentially pathogenic bacteria and moulds were never detected. Staff compliance to best practices varied depending on the type of behaviour investigated and the role of the operator. The major not compliant behaviours were: pre-operative skin antisepsis, crowding of the operating room and hand hygiene of the anaesthetist. The good environmental microbiological quality observed is indicative of the efficacy of the cleaning-sanitization procedures adopted. The major critical point was staff compliance to recommended practices. Awareness campaigns are therefore necessary, aimed at improving the organisation of work so as to facilitate compliance to operative protocols. PMID:29283367

What have we learned about intelligent transportation systems? Chapter 6, What have we learned about ITS for commercial vehicle operations? Status, challenges, and benefits of CVISN level 1 deployment

DOT National Transportation Integrated Search

2006-01-01

This handbook provides guidance and recommended practices on managing and controlling traffic on ramps with freeway facilities. The use or application of the guidance and recommendations provided will in time serve to enhance the use and effectivenes...

Evaluation and Management of Traumatic Diaphragmatic Injuries: A Practice Management Guideline from the Eastern Association for the Surgery of Trauma.

PubMed

McDonald, Amy A; Robinson, Bryce R H; Alarcon, Louis; Bosarge, Patrick L; Dorion, Heath; Haut, Elliott R; Juern, Jeremy; Madbak, Firas; Reddy, Srinivas; Weiss, Patricia; Como, John J

2018-04-02

Traumatic diaphragm injuries (TDI) pose both diagnostic and therapeutic challenges in both the acute and chronic phases. There are no published practice management guidelines to date for TDI. We aim to formulate a practice management guideline for TDI using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. The working group formulated five Patient, Intervention, Comparator, Outcome (PICO) questions regarding the following topics: 1) diagnostic approach (laparoscopy vs. computed tomography); 2) non-operative management of penetrating right-sided injuries; 3) surgical approach (abdominal or thoracic) for acute TDI, including 4) the use of laparoscopy; and 5) surgical approach (abdominal or thoracic) for delayed TDI. A systematic review was undertaken and last updated December 2016. RevMan 5 (Cochran Collaboration) and GRADEpro (Grade Working Group) software were utilized. Recommendations were voted on by working group members. Consensus was obtained for each recommendation. A total of 56 articles were utilized to formulate the recommendations. Most studies were retrospective case series with variable reporting of outcomes measures and outcomes frequently not stratified to intervention or comparator. The overall quality of the evidence was very low for all PICOs. Therefore, only conditional recommendations could be made. Recommendations were made in favor of laparoscopy over CT for diagnosis, non-operative vs. operative approach for right-sided penetrating injuries, abdominal vs. thoracic approach for acute TDI, and laparoscopy (with the appropriate skill set and resources) vs. open approach for isolated TDI. No recommendation could be made for the preferred operative approach for delayed TDI. Very low-quality evidence precluded any strong recommendations. Further study of the diagnostic and therapeutic approaches to TDI is warranted. Guideline LEVEL OF EVIDENCE: 4.

Traffic flow and microbial air contamination in operating rooms at a major teaching hospital in Ghana.

PubMed

Stauning, M T; Bediako-Bowan, A; Andersen, L P; Opintan, J A; Labi, A-K; Kurtzhals, J A L; Bjerrum, S

2018-07-01

Current literature examining the relationship between door-opening rate, number of people present, and microbial air contamination in the operating room is limited. Studies are especially needed from low- and middle-income countries, where the risk of surgical site infections is high. To assess microbial air contamination in operating rooms at a Ghanaian teaching hospital and the association with door-openings and number of people present. Moreover, we aimed to document reasons for door-opening. We conducted active air-sampling using an MAS 100 ® portable impactor during 124 clean or clean-contaminated elective surgical procedures. The number of people present, door-opening rate and the reasons for each door-opening were recorded by direct observation using pretested structured observation forms. During surgery, the mean number of colony-forming units (cfu) was 328 cfu/m 3 air, and 429 (84%) of 510 samples exceeded a recommended level of 180 cfu/m 3 . Of 6717 door-openings recorded, 77% were considered unnecessary. Levels of cfu/m 3 were strongly correlated with the number of people present (P = 0.001) and with the number of door-openings/h (P = 0.02). In empty operating rooms, the mean cfu count was 39 cfu/m 3 after 1 h of uninterrupted ventilation and 52 (51%) of 102 samples exceeded a recommended level of 35 cfu/m 3 . The study revealed high values of intraoperative airborne cfu exceeding recommended levels. Minimizing the number of door-openings and people present during surgery could be an effective strategy to reduce microbial air contamination in low- and middle-income settings. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

[Optimizing post-operative pain management in Latin America].

PubMed

Garcia, João Batista Santos; Bonilla, Patricia; Kraychete, Durval Campos; Flores, Fernando Cantú; Valtolina, Elizabeth Diaz Perez de; Guerrero, Carlos

Post-operative pain management is a significant problem in clinical practice in Latin America. Insufficient or inappropriate pain management is in large part due to insufficient knowledge, attitudes and education, and poor communications at various levels. In addition, the lack of awareness of the availability and importance of clear policies and guidelines for recording pain intensity, the use of specific analgesics and the proper approach to patient education have led to the consistent under-treatment of pain management in the region. However, these problems are not insurmountable and can be addressed at both the provider and patient level. Robust policies and guidelines can help insure continuity of care and reduce unnecessary variations in practice. The objective of this paper is to call attention to the problems associated with Acute Post-Operative Pain (APOP) and to suggest recommendations for their solutions in Latin America. A group of experts on anesthesiology, surgery and pain developed recommendations that will lead to more efficient and effective pain management. It will be necessary to change the knowledge and behavior of health professionals and patients, and to obtain a commitment of policy makers. Success will depend on a positive attitude and the commitment of each party through the development of policies, programs and the promotion of a more efficient and effective system for the delivery of APOP services as recommended by the authors of this paper. The writing group believes that implementation of these recommendations should significantly enhance efficient and effective post-operative pain management in Latin America. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

Maintaining radiation exposures as low as reasonably achievable (ALARA) for dental personnel operating portable hand-held x-ray equipment.

PubMed

McGiff, Thomas J; Danforth, Robert A; Herschaft, Edward E

2012-08-01

Clinical experience indicates that newly available portable hand-held x-ray units provide advantages compared to traditional fixed properly installed and operated x-ray units in dental radiography. However, concern that hand-held x-ray units produce higher operator doses than fixed x-ray units has caused regulatory agencies to mandate requirements for use of hand-held units that go beyond those recommended by the manufacturer and can discourage the use of this technology. To assess the need for additional requirements, a hand-held x-ray unit and a pair of manikins were used to measure the dose to a simulated operator under two conditions: exposures made according to the manufacturer's recommendations and exposures made according to manufacturer's recommendation except for the removal of the x-ray unit's protective backscatter shield. Dose to the simulated operator was determined using an array of personal dosimeters and a pair of pressurized ion chambers. The results indicate that the dose to an operator of this equipment will be less than 0.6 mSv y⁻¹ if the device is used according to the manufacturer's recommendations. This suggests that doses to properly trained operators of well-designed, hand-held dental x-ray units will be below 1.0 mSv y⁻¹ (2% of the annual occupational dose limit) even if additional no additional operational requirements are established by regulatory agencies. This level of annual dose is similar to those reported as typical dental personnel using fixed x-ray units and appears to satisfy the ALARA principal for this class of occupational exposures.

Industry-wide studies report of an industrial-hygiene survey of Riverside Manor Nursing and Rehabilitation Center, Newcomerstown, Ohio. [Ethylene oxide exposures

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

Ringenburg, V.L.; Molina, D.; Elliott, L.J.

Occupational exposure of workers to ethylene oxide (EtO) was examined. Two of six side-by-side short-term personal breathing-zone (BZ) exposure levels, determined while the sterilizer operator unloaded the EtO sterilizer unit, exceeded NIOSH recommended short term levels of 5 parts per million (ppm) for any 10-minute period per workday. Three of 12 personal BZ exposure levels exceeded the NIOSH recommended standard of less than 0.1ppm for an 8-hour time-weighted average. Measurable levels of EtO, ranging from 0.18 to 14.5ppm were detected in the storage room where the EtO sterilized items were aerated. The authors conclude that EtO exposure potential at themore » nursing and rehabilitation center could be reduced by improving administrative controls, work practices, and engineering controls. Recommended improvements were given.« less

Whole-body vibration exposure: a comprehensive field study.

PubMed

Ozkaya, N; Willems, B; Goldsheyder, D

1994-12-01

A comprehensive field study investigated whole-body vibration exposure levels experienced by the train operators of a large metropolitan subway system. The purposes of the study were to measure mechanical vibrations transmitted to the seated train operators, to calculate daily whole-body vibration exposure levels, and to compare these levels with maximum acceptable exposure levels recommended by the international standard on whole-body vibration (ISO 2631). The study also sought to identify factors that may influence mechanical vibrations transmitted to the operators and quantify their effects on the measured vibration levels. The study was carried out by dividing the subway system into subway lines, each line into southbound and northbound directions, and each direction into station-to-station observations. Triaxial measurements were made on all subway lines and for all car types used in the system. For each line, at least two round trips of data were collected. Time-weighted averages of the two sets of data were used for final presentation. A total of 48 round trips were made and more than 100 hours of vibration data was collected and analyzed. All phases of the study were carried out in accordance with the procedures outlined in ISO 2631. It was determined that 6 out of 20 subway lines had vibration levels higher than daily exposure limits recommended by ISO 2631. It was also determined that train speed was the most significant factor influencing vibration exposure levels.

The reduction methods of operator's radiation dose for portable dental X-ray machines.

PubMed

Cho, Jeong-Yeon; Han, Won-Jeong

2012-08-01

This study was aimed to investigate the methods to reduce operator's radiation dose when taking intraoral radiographs with portable dental X-ray machines. Two kinds of portable dental X-ray machines (DX3000, Dexcowin and Rextar, Posdion) were used. Operator's radiation dose was measured with an 1,800 cc ionization chamber (RadCal Corp.) at the hand level of X-ray tubehead and at the operator's chest and waist levels with and without the backscatter shield. The operator's radiation dose at the hand level was measured with and without lead gloves and with long and short cones. The backscatter shield reduced operator's radiation dose at the hand level of X-ray tubehead to 23 - 32%, the lead gloves to 26 - 31%, and long cone to 48 - 52%. And the backscatter shield reduced operator's radiation dose at the operator's chest and waist levels to 0.1 - 37%. When portable dental X-ray systems are used, it is recommended to select X-ray machine attached with a backscatter shield and a long cone and to wear the lead gloves.

NSPWG-recommended safety requirements and guidelines for SEI nuclear propulsion

NASA Technical Reports Server (NTRS)

Marshall, Albert C.; Sawyer, J. C., Jr.; Bari, Robert A.; Brown, Neil W.; Cullingford, Hatice S.; Hardy, Alva C.; Lee, James H.; Mcculloch, William H.; Niederauer, George F.; Remp, Kerry

1992-01-01

An interagency Nuclear Safety Policy Working Group (NSPWG) was chartered to recommend nuclear safety policy, requirements, and guidelines for the Space Exploration Initiative (SEI) nuclear propulsion program to facilitate the implementation of mission planning and conceptual design studies. The NSPWG developed a top-level policy to provide the guiding principles for the development and implementation of the nuclear propulsion safety program and the development of safety functional requirements. In addition, the NSPWG reviewed safety issues for nuclear propulsion and recommended top-level safety requirements and guidelines to address these issues. Safety requirements were developed for reactor start-up, inadvertent criticality, radiological release and exposure, disposal, entry, and safeguards. Guidelines were recommended for risk/reliability, operational safety, flight trajectory and mission abort, space debris and meteoroids, and ground test safety. In this paper the specific requirements and guidelines will be discussed.

The benefit of therapeutic medial branch blocks after cervical operations.

PubMed

Klessinger, Stephan

2010-01-01

Persistent neck pain is a common problem after surgery of the cervical spine. No therapy recommendation exists for these patients. The objective of this study was to determine if a therapeutic medial branch block is a rational treatment for patients with postoperative neck pain after cervical spine operations. Retrospective practice audit. Review of charts of all patients who underwent cervical spine operations for degenerative reasons during a time period of 3 years. Patients with persistent postsurgical pain were treated with therapeutic medial branch blocks (local anesthetic and steroid). A positive treatment response was defined if at least 80% reduction of pain could be achieved or if the patient was sufficiently satisfied with the relief. All patients with a minimum follow up time of 6 months were included. Of the 312 operations performed, 128 were artificial disc operations, 125 were stand alone cages, and 59 were fusions with cage and plate. Persistent neck pain occurred in 33.3% of the patients. There was no difference between the patients with neck pain and the whole group of patients. More than half of the patients with neck pain--52.9%--were treated successfully with therapeutic medial branch blocks. Since no further treatment was necessary, the initial treatment was considered successful. Nearly a third--32.2%--of the patients were initially treated successfully, but their pain recurred and further diagnostics and treatments were necessary. In this group of patients, significantly more with double level operations were found (P = 0.003). Patients not responding to the medial branch block were 14.9%. This audit is retrospective and observational, and therefore does not represent a high level of evidence. However, to our knowledge, since this information has not been previously reported and no recommendation for the treatment of post-operative zygapophysial joint pain exists, it appears to be the best available research upon which to recommend treatment and to plan higher quality studies. For persistent postsurgical neck pain only limited therapy recommendations exist. This study suggests treating these patients in a first instance with therapeutic medial branch blocks. The success rate is 52.9 %.

Communicating Homeland Security Threats: Government and Public Efforts

DTIC Science & Technology

2010-12-01

States has never operated at a threat level lower than blue - guarded risk. The Homeland Security Advisory Council’s primary recommendations included...changing the alert level baseline to blue (guarded risk). Their rationale for resetting the threat level baseline includes acknowledging that a...accustomed to the guarded blue level indicative of a general threat of terrorist attack. To assume that public officials and citizens would ever

[The evaluation of the consequences of electromagnetic irradiation of hands in operators of high-frequency welding devices].

PubMed

Rudakov, M L

2000-01-01

Method of secondary sources (method of integral equations) was applied to calculate specific absorbed intensity in hands of operators working at non-shielded high-frequency (27.12 Mhz) welding devices. The authors present calculations for "female" and "male" hand sizes, give recommendations on lower level of specific absorption.

Compliance with federal and state legislation by indoor tanning facilities in San Diego.

PubMed

Culley, C A; Mayer, J A; Eckhardt, L; Busic, A J; Eichenfield, L F; Sallis, J F; Quintana, P J; Woodruff, S I

2001-01-01

The prevalence rates of both skin cancers and indoor tanning among the US population are high and have increased substantially in recent years. Low compliance by indoor tanning facilities with safety regulations may place consumers at greater risk of skin and ocular damage. This study quantified the level of compliance by indoor tanning facilities with selected federal and state regulations and recommendations. Tanning facilities (N = 54) in San Diego County, California, were visited by a confederate posing as a prospective customer. Compliance with 13 regulations/recommendations were assessed by either direct query or observation of the presence/absence of signs and warning labels. Operators' responses to 5 risk-based questions also were noted. No facility complied with all 13 regulations/recommendations. Compliance with 3 protective eyewear regulations was high (89%-100%). In contrast, compliance with maximum tanning frequency recommendations (approximately 6%) and parental consent regulations (approximately 43%) was disturbingly low. The investigators recommend instituting mandatory, comprehensive training for operators, as well as systematic compliance monitoring with enforcement of penalties for noncompliance.

Soft Regulation with Crowd Recommendation: Coordinating Self-Interested Agents in Sociotechnical Systems under Imperfect Information.

PubMed

Luo, Yu; Iyengar, Garud; Venkatasubramanian, Venkat

2016-01-01

Regulating emerging industries is challenging, even controversial at times. Under-regulation can result in safety threats to plant personnel, surrounding communities, and the environment. Over-regulation may hinder innovation, progress, and economic growth. Since one typically has limited understanding of, and experience with, the novel technology in practice, it is difficult to accomplish a properly balanced regulation. In this work, we propose a control and coordination policy called soft regulation that attempts to strike the right balance and create a collective learning environment. In soft regulation mechanism, individual agents can accept, reject, or partially accept the regulator's recommendation. This non-intrusive coordination does not interrupt normal operations. The extent to which an agent accepts the recommendation is mediated by a confidence level (from 0 to 100%). Among all possible recommendation methods, we investigate two in particular: the best recommendation wherein the regulator is completely informed and the crowd recommendation wherein the regulator collects the crowd's average and recommends that value. We show by analysis and simulations that soft regulation with crowd recommendation performs well. It converges to optimum, and is as good as the best recommendation for a wide range of confidence levels. This work sheds a new theoretical perspective on the concept of the wisdom of crowds.

Soft Regulation with Crowd Recommendation: Coordinating Self-Interested Agents in Sociotechnical Systems under Imperfect Information

PubMed Central

2016-01-01

Regulating emerging industries is challenging, even controversial at times. Under-regulation can result in safety threats to plant personnel, surrounding communities, and the environment. Over-regulation may hinder innovation, progress, and economic growth. Since one typically has limited understanding of, and experience with, the novel technology in practice, it is difficult to accomplish a properly balanced regulation. In this work, we propose a control and coordination policy called soft regulation that attempts to strike the right balance and create a collective learning environment. In soft regulation mechanism, individual agents can accept, reject, or partially accept the regulator’s recommendation. This non-intrusive coordination does not interrupt normal operations. The extent to which an agent accepts the recommendation is mediated by a confidence level (from 0 to 100%). Among all possible recommendation methods, we investigate two in particular: the best recommendation wherein the regulator is completely informed and the crowd recommendation wherein the regulator collects the crowd’s average and recommends that value. We show by analysis and simulations that soft regulation with crowd recommendation performs well. It converges to optimum, and is as good as the best recommendation for a wide range of confidence levels. This work sheds a new theoretical perspective on the concept of the wisdom of crowds. PMID:26977699

A quantitative Kirkpatrick Level 1 and 2 study of equipment specialist apprentice operations training

NASA Astrophysics Data System (ADS)

Hughes, Dirk D.

The primary purpose of the quantitative experimental study is to compare employee-learning outcomes for a course of study that is offered in two formats: explicit and tacit instructor led and explicit e-learning operations training. A Kirkpatrick Level 2 course examination is used to establish a pretest knowledge baseline and to measure posttest learning outcomes for each instructional format. A secondary purpose is to compare responses of the two groups using a Kirkpatrick Level 1 customer satisfaction index survey. Several authors reported the United States electric utility industry would have an employee attrition issue during the 2010 through 2015 period. This is at the same time the industry will be experiencing an increased demand for electricity. There now is a demand for highly training powerplant operators. A review of literature yielded few studies comparing instructor led training and e-based training. Though the Electric Power Research Institute stated the two training modes would be acceptable instruction, the organization did not develop a quantifiable justified recommendation as to the training. Subjects participated in a basic operations course and decided to take either the instructor led or e-based training course. Results of the study concluded that both instructor led and e-based training provided significant learning to the participants. The Kirkpatrick Level 1 results indicated significantly better results for instructor led training. There was not a significant difference in the Kirkpatrick Level 2 results between the two training modalities. Recommendation for future research include conducting a quantitative studies including a Phillips Level 5 study and qualitative studies including a more detailed examination of the customer satisfaction survey (Kirkpatrick Level 1).

Application of a pilot control banding tool for risk level assessment and control of nanoparticle exposures.

PubMed

Paik, Samuel Y; Zalk, David M; Swuste, Paul

2008-08-01

Control banding (CB) strategies offer simplified solutions for controlling worker exposures to constituents that are found in the workplace in the absence of firm toxicological and exposure data. These strategies may be particularly useful in nanotechnology applications, considering the overwhelming level of uncertainty over what nanomaterials and nanotechnologies present as potential work-related health risks, what about these materials might lead to adverse toxicological activity, how risk related to these might be assessed and how to manage these issues in the absence of this information. This study introduces a pilot CB tool or 'CB Nanotool' that was developed specifically for characterizing the health aspects of working with engineered nanoparticles and determining the level of risk and associated controls for five ongoing nanotechnology-related operations being conducted at two Department of Energy research laboratories. Based on the application of the CB Nanotool, four of the five operations evaluated in this study were found to have implemented controls consistent with what was recommended by the CB Nanotool, with one operation even exceeding the required controls for that activity. The one remaining operation was determined to require an upgrade in controls. By developing this dynamic CB Nanotool within the realm of the scientific information available, this application of CB appears to be a useful approach for assessing the risk of nanomaterial operations, providing recommendations for appropriate engineering controls and facilitating the allocation of resources to the activities that most need them.

Recommended procedures for measuring aircraft noise and associated parameters

NASA Technical Reports Server (NTRS)

Marsh, A. H.

1977-01-01

Procedures are recommended for obtaining experimental values of aircraft flyover noise levels (and associated parameters). Specific recommendations are made for test criteria, instrumentation performance requirements, data-acquisition procedures, and test operations. The recommendations are based on state-of-the-art measurement capabilities available in 1976 and are consistent with the measurement objectives of the NASA Aircraft Noise Prediction Program. The recommendations are applicable to measurements of the noise produced by an airplane flying subsonically over (or past) microphones located near the surface of the ground. Aircraft types covered by the recommendations are fixed-wing airplanes powered by turbojet or turbofan engines and using conventional aerodynamic means for takeoff and landing. Various assumptions with respect to subsequent data processing and analysis were made (and are described) and the recommended measurement procedures are compatible with the assumptions. Some areas where additional research is needed relative to aircraft flyover noise measurement techniques are also discussed.

Projections for Achieving the Lancet Commission Recommended Surgical Rate of 5000 Operations per 100,000 Population by Region-Specific Surgical Rate Estimates.

PubMed

Uribe-Leitz, Tarsicio; Esquivel, Micaela M; Molina, George; Lipsitz, Stuart R; Verguet, Stéphane; Rose, John; Bickler, Stephen W; Gawande, Atul A; Haynes, Alex B; Weiser, Thomas G

2015-09-01

We previously identified a range of 4344-5028 annual operations per 100,000 people to be related to desirable health outcomes. From this and other evidence, the Lancet Commission on Global Surgery recommends a minimum rate of 5000 operations per 100,000 people. We evaluate rates of growth and estimate the time it will take to reach this minimum surgical rate threshold. We aggregated country-level surgical rate estimates from 2004 to 2012 into the twenty-one Global Burden of Disease (GBD) regions. We calculated mean rates of surgery proportional to population size for each year and assessed the rate of growth over time. We then extrapolated the time it will take each region to reach a surgical rate of 5000 operations per 100,000 population based on linear rates of change. All but two regions experienced growth in their surgical rates during the past 8 years. Fourteen regions did not meet the recommended threshold in 2012. If surgical capacity continues to grow at current rates, seven regions will not meet the threshold by 2035. Eastern Sub-Saharan Africa will not reach the recommended threshold until 2124. The rates of growth in surgical service delivery are exceedingly variable. At current rates of surgical and population growth, 6.2 billion people (73% of the world's population) will be living in countries below the minimum recommended rate of surgical care in 2035. A strategy for strengthening surgical capacity is essential if these targets are to be met in a timely fashion as part of the integrated health system development.

Personal exposure to pesticide among workers engaged in pesticide container recycling operations.

PubMed

Guidotti, T L; Yoshida, K; Clough, V

1994-12-01

Pesticide container handling operations in western Canada were examined to determine the exposure of workers to residual pesticide in sorting, metal-container crushing, metal-container shredding, plastic-container shredding, metal washing, and metal melting. Environmental exposure monitoring and biological monitoring were applied, including measurement of pesticide deposition density on outer clothing (test coveralls and other protective wear), deposition on fabric and gauze patches under the outer clothing, inhalation of airborne pesticide residues, dislodgement of pesticide residues by hand washing, and pre- and postexposure urinary excretion of pesticide (2,4-D). Exposure levels were highly variable; some variability was accounted for by work practices or lapses in protection. The highest levels of exposure were observed for metal washing, metal crushing, and metal shredding; sorting and plastic shredding were intermediate, and metal melting was associated with very little exposure. Urinary 2,4-D excretion, as an indicator of internal dose, correlated most closely with exposure by the inhalation route, and both were highest for metal washing and shredding. Deposition of pesticide on garments was highest for metal crushing. Melting of washed metal does not appear to present a significant hazard of exposure. Recommendations are proposed for the protection of workers emphasizing health and safety guidelines, worker education, personal hygiene, exposure and health monitoring, and record-keeping, and specific recommendations for each process. These recommendations apply to all pesticide container recycling operations except melting of washed metal containers.

Post-tonsillectomy analgesia: the use of benzocaine lozenges.

PubMed

Dempster, J H

1988-09-01

Tonsillectomy frequently results in a significant degree of post-operative pain. Conventional management consists of the administration of intra-muscular opiates prior to the commencement of oral analgesia and is often inadequate, producing variable levels of pain relief. One of the recommended uses of benzocaine lozenges is the relief of throat discomfort following tonsillectomy, but there are no clinical trials to support this claim. Therefore, a prospective placebo controlled trial was undertaken to compare the efficacy of benzocaine lozenges (10 mg.) with standard oral analgesia in the management of post-operative pain following tonsillectomy in an adult population. Consecutive patients undergoing elective tonsillectomy were randomised to receive either benzocaine lozenges (10 mg.) or placebo. Intake of supplementary oral analgesia was recorded, and the level of post-operative pain was assessed by use of a visual linear analogue scale. There was no significant difference in analgesic intake or pain severity as measured by linear analogue between the two groups. These results suggest that there is no benefit in administering benzocaine lozenges for the relief of post-tonsillectomy pain, and its use in this situation cannot be recommended.

An interagency space nuclear propulsion safety policy for SEI - Issues and discussion

NASA Technical Reports Server (NTRS)

Marshall, A. C.; Sawyer, J. C., Jr.

1991-01-01

An interagency Nuclear Safety Policy Working Group (NSPWG) was chartered to recommend nuclear safety policy, requirements, and guidelines for the Space Exploration Initiative nuclear propulsion program to facilitate the implementation of mission planning and conceptual design studies. The NSPWG developed a top level policy to provide the guiding principles for the development and implementation of the nuclear propulsion safety program and the development of Safety Functional Requirements. In addition, the NSPWG reviewed safety issues for nuclear propulsion and recommended top level safety requirements and guidelines to address these issues. Safety topics include reactor start-up, inadvertent criticality, radiological release and exposure, disposal, entry, safeguards, risk/reliability, operational safety, ground testing, and other considerations. In this paper the emphasis is placed on the safety policy and the issues and considerations that are addressed by the NSPWG recommendations.

Lessons Learned in the First Year Operating Software Defined Radios in Space

NASA Technical Reports Server (NTRS)

Chelmins, David; Mortensen, Dale; Shalkhauser, Mary Jo; Johnson, Sandra K.; Reinhart, Richard

2014-01-01

Operating three unique software defined radios (SDRs) in a space environment aboard the Space Communications and Navigation (SCaN) Testbed for over one year has provided an opportunity to gather knowledge useful for future missions considering using software defined radios. This paper provides recommendations for the development and use of SDRs, and it considers the details of each SDRs approach to software upgrades and operation. After one year, the SCaN Testbed SDRs have operated for over 1000 hours. During this time, the waveforms launched with the SDR were tested on-orbit to assure that they operated in space at the same performance level as on the ground prior to launch to obtain an initial on-orbit performance baseline. A new waveform for each SDR has been developed, implemented, uploaded to the flight system, and tested in the flight environment. Recommendations for SDR-based missions have been gathered from early development through operations. These recommendations will aid future missions to reduce the cost, schedule, and risk of operating SDRs in a space environment. This paper considers the lessons learned as they apply to SDR pre-launch checkout, purchasing space-rated hardware, flexibility in command and telemetry methods, on-orbit diagnostics, use of engineering models to aid future development, and third-party software. Each SDR implements the SCaN Testbed flight computer command and telemetry interface uniquely, allowing comparisons to be drawn. The paper discusses the lessons learned from these three unique implementations, with suggestions on the preferred approach. Also, results are presented showing that it is important to have full system performance knowledge prior to launch to establish better performance baselines in space, requiring additional test applications to be developed pre-launch. Finally, the paper presents the issues encountered with the operation and implementation of new waveforms on each SDR and proposes recommendations to avoid these issues.

Lessons Learned in the First Year Operating Software Defined Radios in Space

NASA Technical Reports Server (NTRS)

Chelmins, David; Mortensen, Dale; Shalkhauser, Mary Jo; Johnson, Sandra K.; Reinhart, Richard

2014-01-01

Operating three unique software defined radios (SDRs) in a space environment aboard the Space Communications and Navigation (SCaN) Testbed for over one year has provided an opportunity to gather knowledge useful for future missions considering using software defined radios. This paper provides recommendations for the development and use of SDRs, and it considers the details of each SDR's approach to software upgrades and operation. After one year, the SCaN Testbed SDRs have operated for over 1000 hours. During this time, the waveforms launched with the SDR were tested on-orbit to assure that they operated in space at the same performance level as on the ground prior to launch to obtain an initial on-orbit performance baseline. A new waveform for each SDR has been developed, implemented, uploaded to the flight system, and tested in the flight environment. Recommendations for SDR-based missions have been gathered from early development through operations. These recommendations will aid future missions to reduce the cost, schedule, and risk of operating SDRs in a space environment. This paper considers the lessons learned as they apply to SDR pre-launch checkout, purchasing space-rated hardware, flexibility in command and telemetry methods, on-orbit diagnostics, use of engineering models to aid future development, and third-party software. Each SDR implements the SCaN Testbed flight computer command and telemetry interface uniquely, allowing comparisons to be drawn. The paper discusses the lessons learned from these three unique implementations, with suggestions on the preferred approach. Also, results are presented showing that it is important to have full system performance knowledge prior to launch to establish better performance baselines in space, requiring additional test applications to be developed pre-launch. Finally, the paper presents the issues encountered with the operation and implementation of new waveforms on each SDR and proposes recommendations to avoid these issues.

Preparedness of households and catering establishments for incidents involving radioactive contamination.

PubMed

Enqvist, H

2005-01-01

This short paper describes a number of investigations carried out to ensure preparedness for crises involving radioactivity to catering operations and private households in Finland. The specific recommendations for catering kitchens during crises were published in 1994. A study to determine the level of adherence to these recommendations is summarised here, together with its findings and subsequent recommendations. Another study on the pre-planning of crisis menus is described. New challenges for the catering kitchens are touched upon. A crisis food preparation booklet for households is described and based on consumers' attitudes suggestions are made for how this can be improved in the future.

Mainstreaming climate change adaptation strategies into New York State Department of Transportation's operations.

DOT National Transportation Integrated Search

2011-10-31

This study identifies climate change adaptation strategies and recommends ways of mainstreaming them into planned actions, including legislation, policies, programs and projects in all areas and at all levels within the New York State Department of T...

Determination of the Minimum Use Level of Fuel System Icing Inhibitor (FSII) in JP-8 That Will Provide Adquate Icing Inhibition and Biostatic Protection for Air Force Aircraft

DTIC Science & Technology

2013-12-01

experimental studies and analyses performed and the resulting recommendations. Results from the present effort indicated that a minimum use limit of... experimental studies performed and the resulting recommendations regarding the minimum on-board use limit of FSII while maintaining safe operability...sumping. A detailed summary of the experimental efforts and results are provided in a separate report (Balster et al., 2010). For the ATCC

Uprated OMS Engine Status-Sea Level Testing Results

NASA Technical Reports Server (NTRS)

Bertolino, J. D.; Boyd, W. C.

1990-01-01

The current Space Shuttle Orbital Maneuvering Engine (OME) is pressure fed, utilizing storable propellants. Performance uprating of this engine, through the use of a gas generator driven turbopump to increase operating pressure, is being pursued by the NASA Johnson Space Center (JSC). Component level design, fabrication, and test activities for this engine system have been on-going since 1984. More recently, a complete engine designated the Integrated Component Test Bed (ICTB), was tested at sea level conditions by Aerojet. A description of the test hardware and results of the sea level test program are presented. These results, which include the test condition operating envelope and projected performance at altitude conditions, confirm the capability of the selected Uprated OME (UOME) configuration to meet or exceed performance and operational requirements. Engine flexibility, demonstrated through testing at two different operational mixture ratios, along with a summary of projected Space Shuttle performance enhancements using the UOME, are discussed. Planned future activities, including ICTB tests at simulated altitude conditions, and recommendations for further engine development, are also discussed.

Suspected dietary supplement injuries in special operations soldiers.

PubMed

Hughes, John; Shelton, Byron; Hughes, Teresa

2010-01-01

Evidence suggests that a number of Special Operations Soldiers are using dietary supplements to augment their physical training programs and that some of these supplements are not entirely benign. This article presents a series of case reports of Soldiers who suffered adverse effects that may be at least partially attributable to the use of dietary supplements. Given that many Special Operations Soldiers train at the same level as world class athletes and the use of supplements is common among world class athletes, the use of supplements is not likely to stop. To this end, the purpose of this article is to provide awareness of the problem, discuss some of the harmful effects of dietary supplements, make a recommendation for education to help reduce the number of injuries resulting from the use of dietary supplements, and recommend that scientific studies be done to prove the benefits and risks of taking dietary supplements. © 2010.

Dietary Supplements for Musculoskeletal Pain: Science Versus Claims.

PubMed

Crawford, Cindy; Saldanha, Leila; Costello, Rebecca; Deuster, Patricia A

2018-01-01

Special Operations Forces (SOF) face unique challenges that manifest themselves both mentally and physically. The extremes of training and combat can affect the readiness to perform at peak levels, especially when confronted with musculoskeletal pain. Many SOF Operators turn to dietary supplements in hopes of gaining an edge. Although some supplements are now being marketed for pain, decisions to use these products need to be driven by information that is evidence based. We describe SOF-specific evidence-based recommendations for the use of dietary ingredients for pain that emerged from a rigorous scientific evaluation. These recommendations are compared with the label claims made in the commercial market by companies selling products to combat musculoskeletal pain. This information can be used by the SOF medical community to assist Operators in making informed decisions when considering or selecting dietary supplements for maintaining and optimizing performance. 2018.

Drug, devices, technologies, and techniques for blood management in minimally invasive and conventional cardiothoracic surgery: a consensus statement from the International Society for Minimally Invasive Cardiothoracic Surgery (ISMICS) 2011.

PubMed

Menkis, Alan H; Martin, Janet; Cheng, Davy C H; Fitzgerald, David C; Freedman, John J; Gao, Changqing; Koster, Andreas; Mackenzie, G Scott; Murphy, Gavin J; Spiess, Bruce; Ad, Niv

2012-01-01

The objectives of this consensus conference were to evaluate the evidence for the efficacy and safety of perioperative drugs, technologies, and techniques in reducing allogeneic blood transfusion for adults undergoing cardiac surgery and to develop evidence-based recommendations for comprehensive perioperative blood management in cardiac surgery, with emphasis on minimally invasive cardiac surgery. The consensus panel short-listed the potential topics for review from a comprehensive list of potential drugs, devices, technologies, and techniques. The process of short-listing was based on the need to prioritize and focus on the areas of highest importance to surgeons, anesthesiologists, perfusionists, hematologists, and allied health care involved in the management of patients who undergo cardiac surgery whether through the conventional or minimally invasive approach. MEDLINE, Cochrane Library, and Embase databases were searched from their date of inception to May 2011, and supplemental hand searches were also performed. Detailed methodology and search strategies are outlined in each of the subsequently published systematic reviews. In general, all relevant synonyms for drugs (antifibrinolytic, aprotinin, [Latin Small Letter Open E]-aminocaproic acid, tranexamic acid [TA], desmopressin, anticoagulants, heparin, antiplatelets, anti-Xa agents, adenosine diphosphate inhibitors, acetylsalicylic acid [ASA], factor VIIa [FVIIa]), technologies (cell salvage, miniaturized cardiopulmonary bypass (CPB) circuits, biocompatible circuits, ultrafiltration), and techniques (transfusion thresholds, minimally invasive cardiac or aortic surgery) were searched and combined with terms for blood, red blood cells, fresh-frozen plasma, platelets, transfusion, and allogeneic exposure. The American Heart Association/American College of Cardiology system was used to label the level of evidence and class of each recommendation. Database search identified more than 6900 articles, with 4423 full-text randomized controlled trials assessed for eligibility, and the final 125 systematic reviews and meta-analyses were used in the consensus conference. The results of the consensus conference, including the evidence-based statements and the recommendations, are outlined in the text, with references given for the relevant evidence that formed the basis for the statements and recommendations. RECOMMENDATIONS FOR ANTIFIBRINOLYTICS: The lysine analogs ?-aminocaproic acid (Amicar) and tranexamic acid (TA) reduce exposure to allogeneic blood inpatients undergoing on-pump cardiac surgery. These agents are recommended to be used routinely as part of a blood conservation strategy especially in patients at risk of undergoing onpump cardiac surgery (Class I, Level A). It is important not to exceed maximum TA total dosages (50Y100mg/kg) because of potential neurotoxicity in the elderly and open-heart procedures (Class IIb, Level C). Aprotinin is not recommended in adult cardiac surgery until further studies on its safety profile have been performed (Class III, Level A). RECOMMENDATIONS FOR TA IN OFF-PUMP CORONARY ARTERY BYPASS: Tranexamic acid may be recommended as part of a blood conservation strategy in high risk patients undergoing off-pump coronary artery bypass (OPCAB) surgery (Class I, Level A).Tranexamic acid dosing in OPCAB surgery needs further study particularly with regard to possible neurotoxicity such as seizures.In addition, the benefit-risk ratio in OPCAB needs further eludication because of the lower inherent risk for bleeding in this group (Class IIb, Level C). RECOMMENDATIONS FOR DDAVP: DDAVP can be considered for prophylaxis in coronary artery bypass grafting (CABG) surgery, in particular, for patients onASA within 7 days or prolonged CPB more than 140 minutes (Class IIa, Level A). Caution should be used with the DDAVP infusion rate to avoid significant systemic hypotension (Class I, Level A). RECOMMENDATIONS FOR TOPICAL HEMOSTATICS: The routine use of topical antifibrinolytics in cardiac surgery isnot recommended (Class IIa, Level A). Topical fibrin sealants may be considered in clinical situations where conventional approaches of surgical and medical improvement of hemostasis are not effective, that is, with bleeding problems more local than generalized, bearing in mind the blackbox warning of bovine thrombin by the US Food and Drug Administration (Class IIb, Level C).Recommendations for FVIIa:Prophylactic use of FVIIa cannot be recommended because of a significant increase in the risk of thromboembolic events and stroke (Class IIa, Level A).Factor VIIa may be considered in clinical situations where conventional approaches of surgical and pharmacologic hemostasis have failed and uncontrollable hemorrhage poses a high risk of severe and life-threatening outcomes (Class IIb, Level B). RECOMMENDATIONS FOR ERYTHROPOIETIN PLUS IRON: It is reasonable to administer erythropoietin preoperatively to increase red blood cell mass in patients who are anemic or refuse blood products (such as for Jehovah’s Witness faith) or who are likely to have postoperative anemia (Class IIa, Level A). RECOMMENDATIONS FOR ANTIPLATELETS BEFORE CARDIAC SURGERY: Acetylsalicylic acid may be continued until surgery (Class IIa,Level B) For stable elective CABG procedures with no drug-elutingstent, stop clopidogrel 5 days before surgery (Class I, Level A).h For stable elective CABG procedures with drug-eluting stents less than 1 year old, consider continuing clopidogrel or heparin as abridge to surgery (Class IIb, Level C).h Direct-acting P2Y12 receptor antagonists may be a better alternative than clopidogrel in acute coronary syndrome patients undergoing CABG surgery (Class IIa, Level B). RECOMMENDATIONS FOR ANTIPLATELETS AFTER CARDIAC SURGERY: In stable CABG surgery (nonYacute coronary syndrome patients), the routine use of postoperative clopidogrel with ASAis not warranted (Class IIb, Level B). RECOMMENDATIONS FOR ACUTE NORMOVOLEMIC HEMODILUTION: Acute normovolemic hemodilution can be considered in selected patients with adequate preoperative hemoglobin to reduce post-CPB bleeding (Class IIa, Level A).The routine use of acute normovolemic hemodilution is not recommended (Class IIb, Level B). RECOMMENDATIONS FOR RETROGRADE AUTOLOGOUS PRIMING: Retrograde autologous priming is recommended as a blood conservation modality to reduce allogeneic blood transfusion for onpump cardiac surgery (Class I, Level A). RECOMMENDATIONS FOR CELL SALVAGE: Routine use of cell salvage is recommended in operations where an increased blood loss is expected (Class 1, Level A). Cell salvage should be used throughout the entire operation and not merely as a replacement for CPB cardiotomy suction (Class IIa, Level A). BIOCOMPATIBLE CPB CIRCUITS: The routine use of biocompatible coated CPB circuitry may be considered as part of a multimodal blood conservation program. However, the heterogeneity of surface-modified products, anticoagulation management, and CPB technique does not significantly impact surgical blood loss and transfusion needs (Class IIb,Level A). RECOMMENDATIONS FOR MINIATURIZED EXTRACORPOREAL CARDIOPULMONARY CIRCUIT VERSUS CONVENTIONAL EXTRACORPOREAL CARDIOPULMONARY CIRCUIT: Miniaturized extracorporeal cardiopulmonary circuit can be considered as a blood conservation technique to reduce allogeneic blood exposure (Class IIa, Level A); however, issues related to heparinization management and biocompatible coatings remain to be clarified. RECOMMENDATIONS FOR ULTRAFILTRATION (CONTINUOUS OR MODIFIED):h Ultrafiltration may be considered for blood conservation (Class IIb, Level A); however, the impact on clinically relevant outcomes remains unknown. RECOMMENDATIONS FOR PLATELET PLASMAPHERESIS:It is reasonable to recommend platelet plasmapheresis for blood management in cardiac surgery (Class IIa, Level A), although the impact on clinically relevant outcomes remains unknown. RECOMMENDATIONS FOR POINT-OF-CARE MONITORING:The evidence is too premature to recommend point-of-caretechnology for routine use because its use has not been shown to impact clinical outcome (Class IIb, Level A). RECOMMENDATIONS FOR SURGICAL TECHNIQUES FOR OPCAB, MINIMALLY INVASIVE STERNOTOMY FOR AORTIC VALVE SURGERY, MINIMALLY INVASIVE STERNOTOMY FOR MITRAL VALVE SURGERY, AND TRANSCATHETHER AORTIC VALVE IMPLANTATION: Although these minimally invasive procedures are not primarily selected for the purpose of blood management, the reduced allogeneic blood exposure should be considered in the balance of benefits and risks when selecting the appropriate surgery for patients.

Mainstreaming climate change adaptation strategies into New York State Department of Transportation's operations : final report.

DOT National Transportation Integrated Search

2011-10-31

This study identifies climate change adaptation strategies and recommends ways of mainstreaming them into planned actions, including legislation, policies, programs and projects in all areas and at all levels within the New York State Department of T...

Comments on settling chamber design for quiet, blowdown wind tunnels

NASA Technical Reports Server (NTRS)

Beckwith, I. E.

1981-01-01

Transfer of an existing continous circuit supersonic wind tunnel to Langley and its operation there as a blowdown tunnel is planned. Flow disturbance requirements in the supply section and methods for reducing the high level broad band acoustic disturbances present in typical blowdown tunnels are reviewed. Based on recent data and the analysis of two blowdown facilities at Langley, methods for reducing the total turbulence levels in the settling chamber, including both acoustic and vorticity modes, to less than one percent are recommended. The pertinent design details of the damping screens and honeycomb and the recommended minimum pressure drop across the porous components providing the required two orders of magnitude attenuation of acoustic noise levels are given. A suggestion for the support structure of these high pressure drop porous components is offered.

Instrumental delivery: clinical practice guidelines from the French College of Gynaecologists and Obstetricians.

PubMed

Vayssière, Christophe; Beucher, Gael; Dupuis, Olivier; Feraud, Olivia; Simon-Toulza, Caroline; Sentilhes, Loïc; Meunier, Emmanuelle; Parant, Olivier; Schmitz, Thomas; Riethmuller, Didier; Baud, Olivier; Galley-Raulin, Fabienne; Diemunsch, Pierre; Pierre, Fabrice; Schaal, Jean-Patrick; Fournié, Alain; Oury, Jean François

2011-11-01

Routine use of a partograph is associated with a reduction in the use of forceps, but is not associated with a reduction in the use of vacuum extraction (Level A). Early artificial rupture of the membranes, associated with oxytocin perfusion, does not reduce the number of operative vaginal deliveries (Level A), but does increase the rate of fetal heart rate abnormalities (Level B). Early correction of lack of progress in dilatation by oxytocin perfusion can reduce the number of operative vaginal deliveries (Level B). The use of low-concentration epidural infusions of bupivacaine potentiated by morphinomimetics reduces the number of operative interventions compared with larger doses (Level A). Placement of an epidural before 3-cm dilatation does not increase the number of operative vaginal deliveries (Level A). Posterior positions of the fetus result in more operative vaginal deliveries (Level B). Manual rotation of the fetus from a posterior position to an anterior position may reduce the number of operative deliveries (Level C). Walking during labour is not associated with a reduction in the number of operative vaginal deliveries (Level A). Continuous support of the parturient by a midwife or partner/family member during labour reduces the number of operative vaginal deliveries (Level A). Under epidural analgesia, delayed pushing (2h after full dilatation) reduces the number of difficult operative vaginal deliveries (Level A). Ultrasound is recommended if there is any clinical doubt about the presentation of the fetus (Level B). The available scientific data are insufficient to contra-indicate attempted midoperative delivery (professional consensus). The duration of the operative intervention is slightly shorter with forceps than with a vacuum extractor (Level C). Nonetheless, the urgency of operative delivery is not a reason to choose one instrument over another (professional consensus). The cup-shaped vacuum extractor seems to be the instrument of choice for operative deliveries of fetuses in a cephalic transverse position, and may also be preferred for fetuses in a posterior position (professional consensus). Vacuum extraction deliveries fail more often than forceps deliveries (Level B). Overall, immediate maternal complications are more common for forceps deliveries than vacuum extraction deliveries (Level B). Compared with forceps, operative vaginal delivery using a vacuum extractor appears to reduce the number of episiotomies (Level B), first- and second-degree perineal lesions, and damage to the anal sphincter (Level B). Among the long-term complications, the rate of urinary incontinence is similar following forceps, vacuum extraction and spontaneous vaginal deliveries (Level B). Anal incontinence is more common following forceps delivery (Level B). Persistent anal incontinence has a similar prevalence regardless of the mode of delivery (caesarean or vaginal, instrumental or non-instrumental), suggesting the involvement of other factors (Level B). Rates of immediate neonatal mortality and morbidity are similar for forceps and vacuum extraction deliveries (Level B). It appears that difficult instrumental delivery may lead to psychological sequelae that may result in a decision not to have more children (Level C). The rates of neonatal convulsions, intracranial haemorrhage and jaundice do not differ between forceps and vacuum extraction deliveries (Levels B and C). Rapid sequence induction with a Sellick manoeuvre (pressure to the cricoid cartilage) and tracheal intubation with a balloon catheter is recommended for any general anaesthesia (Level B). Training must ensure that obstetricians can identify indications and contra-indications, choose the appropriate instrument, use the instruments correctly, and know the principles of quality control applied to operative vaginal delivery. Nowadays, traditional training can be accompanied by simulations. Training should be individualized and extended for some students. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Pollutant levels in discarded fish species by Spanish trawlers operating in the Great Sole Bank and the Atlantic coast of the Iberian Peninsula.

PubMed

Antelo, Luis T; Ordóñez-Del Pazo, Tatiana; Lopes, Carla; Franco-Uría, Amaya; Pérez-Martín, Ricardo I; Alonso, Antonio A

2016-07-15

Organic and inorganic pollutant levels were determined for the most discarded species from trawlers operating in Great Sole and Spanish coastal fishing grounds. Results for heavy metals indicated that Cd can reach values higher than legal limits for some species and tissues, while Hg and Pb concentrations are below established values. No significant variation was noticed with fishing grounds, but both season influences in the case of Pb and interspecies variation for Hg and Cd have been detected. Valorization recommendations could be therefore established according to the levels found in the different species. Copyright © 2016 Elsevier Ltd. All rights reserved.

US Military Dietary Protein Recommendations: A Simple But Often Confused Topic.

PubMed

Pasiakos, Stefan M; Sepowitz, John J; Deuster, Patricia A

2015-01-01

Military recommendations for dietary protein are based on the recommended dietary allowance (RDA) of 0.8 g of protein per kilogram of body mass (BM) established by the Food and Nutrition Board, Institute of Medicine (IOM) of the National Academies. The RDA is likely adequate for most military personnel, particularly when activity levels are low and energy intake is sufficient to maintain a healthy body weight. However, military recommendations account for periods of increased metabolic demand during training and real-world operations, especially those that produce an energy deficit. Under those conditions, protein requirements are higher (1.5-2.0 g/kg BM) in an attempt to attenuate the unavoidable loss of muscle mass that occurs during prolonged or repeated exposure to energy deficits. Whole foods are recommended as the primary method to consume more protein, although there are likely operational scenarios where whole foods are not available and consuming supplemental protein at effective, not excessive, doses (20-25 g or 0.25-0.3 g/kg BM per meal) is recommended. Despite these evidence-based, condition-specific recommendations, the necessity of protein supplements and the requirements and rationale for consuming higher-protein diets are often misunderstood, resulting in an overconsumption of dietary protein and unsubstantiated health-related concerns. This review will provide the basis of the US military dietary protein requirements and highlight common misconceptions associated with the amount and safety of protein in military diets. 2015.

Noise characteristics of grass-trimming machine engines and their effect on operators.

PubMed

Mallick, Zulquernain; Badruddin, Irfan Anjum; Khaleed Hussain, M T; Salman Ahmed, N J; Kanesan, Jeevan

2009-01-01

Over the last few years, interaction of humans with noisy power-driven agricultural tools and its possible adverse after effects have been realized. Grass-trimmer engine is the primary source of noise and the use of motorized cutter, spinning at high speed, is the secondary source of noise to which operators are exposed. In the present study, investigation was carried out to determine the effect of two types of grass-trimming machine engines (SUM 328 SE and BG 328) noise on the operators in real working environment. It was found that BG-328 and SUM-328 SE produced high levels of noise, of the order of 100 and 105 dB(A), respectively, to which operators are exposed while working. It was also observed that situation aggravates when a number of operators simultaneously operate resulting in still higher levels of noise. Operators should be separated 15 meters from each other in order to avoid the combined level of noise exposure while working with these machines. It was found that SPL, of the grass-trimmer machine engines (BG-328 and SUM-328 SE), were higher than the limit of noise recommended by ISO, NIOSH, and OSHA for an 8-hour workday. Such a high level of noise exposure may cause physiological and psychological problems to the operators in long run.

Standard formatted data units-control authority procedures

NASA Technical Reports Server (NTRS)

1991-01-01

The purpose of this document is to establish a set of minimum and optional requirements for the implementation of Control Authority (CA) organizations within and among the Agencies participating in the Consultative Committee for Space Data Systems (CCSDS). By satisfying these requirements, the resultant cooperating set of CA organizations will produce a global CA service supporting information transfer with digital data under the Standard Formatted Data Unit (SFDU) concept. This service is primarily accomplished through the registration, permanent archiving, and dissemination of metadata in the form of Metadata Objects (MDO) that assist in the interpretation of data objects received in SFDU form. This Recommendation addresses the responsibilities, services, and interface protocols for a hierarchy of CA organizations. The top level, consisting of the CCSDS Secretariat and its operational agent, is unique and primarily provides a global coordination function. The lower levels are Agency CA organizations that have primary responsibility for the registration, archiving, and dissemination of MDOs. As experience is gained and technology evolves, the CA Procedures will be extended to include enhanced services and their supporting protocols. In particular, it is anticipated that eventually CA organizations will be linked via networks on a global basis, and will provide requestors with online automated access to CA services. While this Recommendation does not preclude such operations, it also does not recommend the specific protocols to be used to ensure global compatibility of these services. These recommendations will be generated as experience is gained.

Fiscal Year 1999 Higher Education Budget Recommendations. Operations and Grants.

ERIC Educational Resources Information Center

Illinois State Board of Higher Education, Springfield.

This report presents staff recommendations of the Illinois Board of Higher Education concerning budget recommendations for higher education operations and grants for fiscal year 1999. General funds recommendations total $2,207.1 million, an increase of 6.1 percent over 1998 appropriations. Recommendations are also included for locally-held…

The micronutrient intake profile of a multicentre cohort of Australian LAGB patients.

PubMed

McGrice, Melanie A; Porter, Judi A

2014-03-01

Patients who have undergone bariatric surgery have increased risks of developing micronutrient deficiencies. Translational research investigating the actual micronutrient intake of bariatric patients is limited. We examined the micronutrient intake of a multicentre cohort of laparoscopic adjustable gastric banding patients 1 year post-surgery. These data were compared to micronutrient recommendations for the general population. Consecutive patients from three bariatric surgery facilities in Melbourne, Australia, were invited to participate 12 months post-operatively. A validated food frequency questionnaire was posted to 215 prospective participants. Of the 52 participants, micronutrient intakes from food and fluids alone were below population recommendations for calcium, folate, magnesium, potassium, retinol equivalents, thiamin and vitamin E. Males did not meet the recommended intakes for zinc, and iron intakes in pre-menopausal women were insufficient. Intakes lower than recommended levels for these micronutrients suggest inadequate intake of foods from vegetable, dairy, lean meat (or alternatives) and wholegrains. Micronutrient intakes below recommended levels in this patient group can be further explained by their macronutrient intakes that suggested diets of poor nutrient density. Recommendations for supplementation in this group have wide variations, usually having been developed through the presence of clinical and biochemical deficiencies. Nutritional supplementation should be more extensive in scope and dosage than is currently recommended by some professional guidelines. Further long-term studies are needed to explore both macro- and micronutrient intakes on the morbidity and mortality of this patient population.

Effect of commercial and military performance requirements for transport category aircraft on space shuttle booster design and operation

NASA Technical Reports Server (NTRS)

Bithell, R. A.; Pence, W. A., Jr.

1972-01-01

The effect of two sets of performance requirements, commercial and military, on the design and operation of the space shuttle booster is evaluated. Critical thrust levels are established according to both sets of operating rules for the takeoff, cruise, and go-around flight modes, and the effect on engine requirements determined. Both flyback and ferry operations are considered. The impact of landing rules on potential shuttle flyback and ferry bases is evaluated. Factors affecting reserves are discussed, including winds, temperature, and nonstandard flight operations. Finally, a recommended set of operating rules is proposed for both flyback and ferry operations that allows adequate performance capability and safety margins without compromising design requirements for either flight phase.

Functional requirements for the man-vehicle systems research facility. [identifying and correcting human errors during flight simulation

NASA Technical Reports Server (NTRS)

Clement, W. F.; Allen, R. W.; Heffley, R. K.; Jewell, W. F.; Jex, H. R.; Mcruer, D. T.; Schulman, T. M.; Stapleford, R. L.

1980-01-01

The NASA Ames Research Center proposed a man-vehicle systems research facility to support flight simulation studies which are needed for identifying and correcting the sources of human error associated with current and future air carrier operations. The organization of research facility is reviewed and functional requirements and related priorities for the facility are recommended based on a review of potentially critical operational scenarios. Requirements are included for the experimenter's simulation control and data acquisition functions, as well as for the visual field, motion, sound, computation, crew station, and intercommunications subsystems. The related issues of functional fidelity and level of simulation are addressed, and specific criteria for quantitative assessment of various aspects of fidelity are offered. Recommendations for facility integration, checkout, and staffing are included.

Review of Human Resource Operations in the Charlotte-Mecklenburg Schools

ERIC Educational Resources Information Center

Council of the Great City Schools, 2006

2006-01-01

In October 2006, the Superintendent of the Charlotte-Mecklenburg Schools, asked the Council of the Great City Schools to examine the district's human resources division and to provide: (1) High level review of the division's organizational and administrative structure with recommendations for improvements; (2) Assessment of the effectiveness of…

Evaluation and recommendations for work group integration within the Materials and Processes Lab

NASA Technical Reports Server (NTRS)

Farrington, Phillip A.

1992-01-01

The goal of this study was to evaluate and make recommendations for improving the level of integration of several work groups within the Materials and Processes Lab at the Marshall Space Flight Center. This evaluation has uncovered a variety of projects that could improve the efficiency and operation of the work groups as well as the overall integration of the system. In addition, this study provides the foundation for specification of a computer integrated manufacturing test bed environment in the Materials and Processes Lab.

Power supply of autonomous systems using solar modules

NASA Astrophysics Data System (ADS)

Yurchenko, A. V.; Zotov, L. G.; Mekhtiev, A. D.; Yugai, V. V.; Tatkeeva, G. G.

2015-04-01

The article shows the methods of constructing autonomous decentralized energy systems from solar modules. It shows the operation of up DC inverter. It demonstrates the effectiveness of DC inverters with varying structure. The system has high efficiency and low level of conductive impulse noise and at the same time the system is practically feasible. Electrical processes have been analyzed to determine the characteristics of operating modes of the main circuit elements. Recommendations on using the converters have been given.

The factors influencing the decision making of operative treatment for proximal humeral fractures.

PubMed

Hageman, Michiel G J S; Jayakumar, Prakash; King, John D; Guitton, Thierry G; Doornberg, Job N; Ring, David

2015-01-01

The factors influencing the decision making of operative treatment for fractures of the proximal humerus are debated. We hypothesized that there is no difference in treatment recommendations between surgeons shown radiographs alone and those shown radiographs and patient information. Secondarily, we addressed (1) factors associated with a recommendation for operative treatment, (2) factors associated with recommendation for arthroplasty, (3) concordance with the recommendations of the treating surgeons, and (4) factors affecting the inter-rater reliability of treatment recommendations. A total of 238 surgeons of the Science of Variation Group rated 40 radiographs of patients with proximal humerus fractures. Participants were randomized to receive information about the patient and mechanism of injury. The response variables included the choice of treatment (operative vs nonoperative) and the percentage of matches with the actual treatment. Participants who received patient information recommended operative treatment less than those who received no information. The patient information that had the greatest influence on treatment recommendations included age (55%) and fracture mechanism (32%). The only other factor associated with a recommendation for operative treatment was region of practice. There was no significant difference between participants who were and were not provided with information regarding agreement with the actual treatment (operative vs nonoperative) provided by the treating surgeon. Patient information-older age in particular-is associated with a higher likelihood of recommending nonoperative treatment than radiographs alone. Clinical information did not improve agreement of the Science of Variation Group with the actual treatment or the generally poor interobserver agreement on treatment recommendations. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Fiscal Year 1998 Higher Education Budget Recommendations. Operations and Grants.

ERIC Educational Resources Information Center

Illinois State Board of Higher Education, Springfield.

This report summarizes staff recommendations of the Illinois Board of Higher Education concerning budget recommendations for higher education operations and grants for fiscal year 1998. The report also includes recommendations for state appropriated revolving funds, locally held university income funds, and other appropriated funds. Specific…

40 CFR 240.200-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) SOLID WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended Procedures § 240.200-3 Recommended procedures: Operations. (a) Storage areas for special wastes should be... acceptance of Special Wastes. ...

40 CFR 240.200-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) SOLID WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended Procedures § 240.200-3 Recommended procedures: Operations. (a) Storage areas for special wastes should be... acceptance of Special Wastes. ...

Carbon monoxide and nitrogen dioxide levels in an indoor ice skating rink with mitigation methods

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

Lee, K.; Yanagisawa, Y.; Spengler, J.D.

1993-05-01

An indoor ice skating rink is an enclosed space with intermittent air pollutant emissions from fuel-powered ice-resurfacing equipment, such as a resurfacer and an edger. Exhaust gases discharged from the resurfacing equipment actually include significant quantities of carbon monoxide (CO) and nitrogen dioxide (NO[sub 2]) which may induced adverse health effects. Carbon monoxide exposures in ice skating rinks resulting from malfunctioning ice resurfacing equipment were first reported more than twenty years ago. Attempts to reduce emissions of CO and NO[sub 2] form resurfacing equipment, such as the extended exhaust pipe, operation of the air recirculation system or reduced resurfacer operation,more » appeared not to be effective for maintaining the air pollutant concentrations below guidelines. Even though improved indoor air quality was obtained by the combination of the full operation of the air exhaust system and the reduced number of resurfacer operations in this investigation, these methods may be impractical for most skating rinks. Replacement of the fuel-powered resurfacer with a battery operated resurfacer is recommended. If replacement is not feasible, then increasing the air ventilation rate is recommended as a second choice. 10 refs., 1 fig., 1 tab.« less

Health behavior change models for HIV prevention and AIDS care: practical recommendations for a multi-level approach.

PubMed

Kaufman, Michelle R; Cornish, Flora; Zimmerman, Rick S; Johnson, Blair T

2014-08-15

Despite increasing recent emphasis on the social and structural determinants of HIV-related behavior, empirical research and interventions lag behind, partly because of the complexity of social-structural approaches. This article provides a comprehensive and practical review of the diverse literature on multi-level approaches to HIV-related behavior change in the interest of contributing to the ongoing shift to more holistic theory, research, and practice. It has the following specific aims: (1) to provide a comprehensive list of relevant variables/factors related to behavior change at all points on the individual-structural spectrum, (2) to map out and compare the characteristics of important recent multi-level models, (3) to reflect on the challenges of operating with such complex theoretical tools, and (4) to identify next steps and make actionable recommendations. Using a multi-level approach implies incorporating increasing numbers of variables and increasingly context-specific mechanisms, overall producing greater intricacies. We conclude with recommendations on how best to respond to this complexity, which include: using formative research and interdisciplinary collaboration to select the most appropriate levels and variables in a given context; measuring social and institutional variables at the appropriate level to ensure meaningful assessments of multiple levels are made; and conceptualizing intervention and research with reference to theoretical models and mechanisms to facilitate transferability, sustainability, and scalability.

Appropriateness of Prescriptions of Recommended Treatments in Organisation for Economic Co-operation and Development Health Systems: Findings Based on the Long-Term Registry of the European Society of Cardiology on Heart Failure.

PubMed

Maggioni, Aldo P; Van Gool, Kees; Biondi, Nelly; Urso, Renato; Klazinga, Niek; Ferrari, Roberto; Maniadakis, Nikolaos; Tavazzi, Luigi

2015-12-01

This observational study aimed to identify clinical variables and health system characteristics associated with incomplete guideline application in drug treatment of patients with chronic heart failure (HF) across 15 countries. Three data sets were used: European Society of Cardiology Heart Failure Registry, Organisation for Economic Co-operation and Development's Health System Characteristics Survey, and Organisation for Economic Co-operation and Development Health Statistics 2013. Patient and country variables were examined by multilevel, multiple logistic regression. The study population consisted of ambulatory patients with chronic HF and reduced ejection fraction. Inappropriateness of prescription of pharmacological treatments was defined as patients not prescribed at least one of the two recommended treatments (angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers and beta-blockers) or treated with both medications but at suboptimal dosage and in absence of documented contraindication/intolerance. Of 4605 patients, 1097 (23.8%) received inappropriate drug prescriptions with a large variation within and across countries, with 18.5% of the total variability accounted for by between-country health structure characteristics. Patient-level characteristics such as having mitral regurgitation (odds ratio 1.4; 95% confidence interval 1.1-1.7) was significantly associated with inappropriate prescription of recommended drugs, whereas chronic obstructive pulmonary disease (odds ratio 0.7; 95% confidence interval 0.5-0.9) was associated with more appropriate prescriptions. Among the country-level variables, incentives or obligation to comply with guidelines increased the probability of prescription appropriateness. Combining clinical variables with health system characteristics is a promising exercise to explain the appropriateness of recommended drug prescriptions. Such an understanding can help decision makers to design more effective policies to improve adherence to guidelines, improve health care outcomes, and potentially reduce costs. Copyright © 2015. Published by Elsevier Inc.

Comparison of International Guidelines of Dermal Absorption Tests Used in Pesticides Exposure Assessment for Operators

PubMed Central

So, Jaehwan; Ahn, Junyoung; Lee, Tae-Hee; Park, Kyung-Hun; Paik, Min-Kyoung; Jeong, Mihye; Cho, Myung-Haing

2014-01-01

The number of farmers who have suffered from non-fatal acute pesticide poisoning has been reported to vary from 5.7% to 86.7% in South Korea since 1975. Absorption through the skin is the main route of exposure to pesticides for farmers who operate with them. Several in vitro tests using the skins of humans or animal and in vivo tests using laboratory animals are introduced for the assessment of human dermal absorption level of pesticides. The objective of this study is to evaluate and compare international guidelines and strategies of dermal absorption assessments and to propose unique approaches for applications into pesticide registration process in our situation. Until present in our situation, pesticide exposure level to operator is determined just using default value of 10 as for skin absorption ratio because of data shortage. Dermal absorption tests are requested to get exposure level of pesticides and to ultimately know the safety of pesticides for operators through the comparison with the value of AOEL. When the exposure level is higher than AOEL, the pesticide cannot be approved. We reviewed the skin absorption test guidelines recommended by OECD, EFSA and EPA. The EPA recommends assessment of skin absorption of pesticides for humans through the TPA which includes all the results of in vitro human and animal and animal in vivo skin absorption studies. OECD and EFSA, employ a tiered approach, which the requirement of further study depends on the results of the former stage study. OECD guidelines accept the analysis of pesticide level absorbed through skin without radioisotope when the recovery using the non-labeled method is within 80~120%. Various factors are reviewed in this study, including the origin of skin (gender, animal species and sites of skin), thickness, temperature and, etc., which can influence the integrity of results. PMID:25584144

Serum Glutamine Levels as a Potential Diagnostic Biomarker in Sepsis following Surgery for Peritonitis.

PubMed

Yang, Chun-Ju; Huang, Ting-Shuo; Lee, Tung-Liang; Yang, Kang-Chung; Yuan, Shin-Sheng; Lu, Ruey-Hwa; Hsieh, Chung-Ho; Shyu, Yu-Chiau

2017-12-31

Few diagnostic biomarkers for sepsis after emergency peritonitis surgery are available to clinicians, and, thus, it is important to develop new biomarkers for patients undergoing this procedure. We investigated whether serum glutamine and selenium levels could be diagnostic biomarkers of sepsis in individuals recovering from emergency peritonitis surgery. From February 2012 to March 2013, patients who had peritonitis diagnosed at the emergency department and underwent emergency surgery were screened for eligibility. Serum glutamine and selenium levels were obtained at pre-operative, post-operative and recovery time points. The average level of pre-operation serum glutamine was significantly different from that on the recovery day (0.317 ± 0.168 vs. 0.532 ± 0.155 mM, P < 0.001); moreover, serum glutamine levels were unaffected by surgery. Selenium levels were significantly lower on the day of surgery than they were at recovery (106.6 ± 36.39 vs. 130.68 ± 56.98 ng/mL, P = 0.013); no significant difference was found between pre-operation and recovery selenium levels. Unlike selenium, glutamine could be a sepsis biomarker for individuals with peritonitis. We recommend including glutamine as a biomarker for sepsis severity assessment in addition to the commonly used clinical indicators.

A Comparative Study of Student Math Skills: Perceptions, Validation, and Recommendations

ERIC Educational Resources Information Center

Jones, Thomas W.; Price, Barbara A.; Randall, Cindy H.

2011-01-01

A study was conducted at a southern university in sophomore level production classes to assess skills such as the order of arithmetic operations, decimal and percent conversion, solving of algebraic expressions, and evaluation of formulas. The study was replicated using business statistics and quantitative analysis classes at a southeastern…

Radiological incident preparedness: planning at the local level.

PubMed

Tan, Clive M; Barnett, Daniel J; Stolz, Adam J; Links, Jonathan M

2011-03-01

Radiological terrorism has been recognized as a probable scenario with high impact. Radiological preparedness planning at the federal and state levels has been encouraging, but translating complex doctrines into operational readiness at the local level has proved challenging. Based on the authors' experience with radiological response planning for the City of Baltimore, this article describes an integrated approach to municipal-level radiological emergency preparedness planning, provides information on resources that are useful for radiological preparedness planning, and recommends a step-by-step process toward developing the plan with relevant examples from the experience in Baltimore. Local governmental agencies constitute the first line of response and are critical to the success of the operation. This article is intended as a starting framework for local governmental efforts toward developing a response plan for radiological incidents in their communities.

A status review of photovoltaic power conversion equipment reliability, safety, and quality assurance protocols

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

Hacke, Peter; Lokanath, Sumanth; Williams, Paul

Data indicate that the inverter is the element of the photovoltaic plant that has the highest number of service calls and the greatest operation and maintenance cost burden. This paper describes the projects and relevant background needed in developing design qualification standards that would serve to establish a minimum level of reliability, along with a review of photovoltaic inverter quality and safety standards, most of which are in their infancy. We compare stresses and levels for accelerated testing of inverters proposed in the standard drafts, and those proposed by manufacturers and purchasers of inverters. We also review bases for themore » methods, stress types, and stress levels for durability testing of key inverter components. Many of the test protocols appear to need more comprehensive inclusion of stress factors existing in the natural environment such as wind driven rain, dust, and grid disturbances. Further understanding of how temperature, humidity ingress, and voltage bias affect the inverters and their components is also required. We provide data indicating inconsistent quality of the inverters and the durability of components leading to greater cost for the photovoltaic plant operator. Accordingly, the recommendation for data collection within quality standards for obtaining cost of ownership metrics is made. Design validation testing using realistic operation, environmental, and connection conditions, including under end-use field conditions with feedback for continuous improvement is recommended for inclusion within a quality standard.« less

A status review of photovoltaic power conversion equipment reliability, safety, and quality assurance protocols

DOE PAGES

Hacke, Peter; Lokanath, Sumanth; Williams, Paul; ...

2017-10-10

Data indicate that the inverter is the element of the photovoltaic plant that has the highest number of service calls and the greatest operation and maintenance cost burden. This paper describes the projects and relevant background needed in developing design qualification standards that would serve to establish a minimum level of reliability, along with a review of photovoltaic inverter quality and safety standards, most of which are in their infancy. We compare stresses and levels for accelerated testing of inverters proposed in the standard drafts, and those proposed by manufacturers and purchasers of inverters. We also review bases for themore » methods, stress types, and stress levels for durability testing of key inverter components. Many of the test protocols appear to need more comprehensive inclusion of stress factors existing in the natural environment such as wind driven rain, dust, and grid disturbances. Further understanding of how temperature, humidity ingress, and voltage bias affect the inverters and their components is also required. We provide data indicating inconsistent quality of the inverters and the durability of components leading to greater cost for the photovoltaic plant operator. Accordingly, the recommendation for data collection within quality standards for obtaining cost of ownership metrics is made. Design validation testing using realistic operation, environmental, and connection conditions, including under end-use field conditions with feedback for continuous improvement is recommended for inclusion within a quality standard.« less

Noise levels and their effects on Shuttle crewmembers' performance: Operational concerns

NASA Technical Reports Server (NTRS)

Koros, Anton S.; Adam, Susan C.; Wheelwright, Charles D.

1993-01-01

When excessive, noise can result in sleep interference, fatigue, interference with verbal communication, and hearing damage. Shuttle crewmembers are exposed to noise throughout their mission. The contribution of noise to decrements in crew performance over these extended exposure durations was the focus of this study. On the STS-40/SLS-1, mission noise levels were evaluated through the use of a sound level meter and a crew questionnaire. Crewmembers noted that sleep, concentration, and relaxation were negatively impacted by high noise levels. Speech Interference Levels (SIL's), calculated from the sound level measurements, suggested that crewmembers were required to raise their voice in order to be heard. No difficulty detecting caution and warning alarms was noted. The higher than desirable noise levels in Spacelab were attributed to flight specific payloads for which acoustic waivers were granted. It is recommended that current noise levels be reduced in Spacelab and the Orbiter Middeck especially as longer missions are planned for the buildup of Space Station Freedom. Levels of NC 50 are recommended in areas where speech communication is required and NC 40 in sleep areas. These levels are in accordance with the NASA Man-Systems Integration Standards. Measurements proposed for subsequent orbiter missions are discussed.

A development of logistics management models for the Space Transportation System

NASA Technical Reports Server (NTRS)

Carrillo, M. J.; Jacobsen, S. E.; Abell, J. B.; Lippiatt, T. F.

1983-01-01

A new analytic queueing approach was described which relates stockage levels, repair level decisions, and the project network schedule of prelaunch operations directly to the probability distribution of the space transportation system launch delay. Finite source population and limited repair capability were additional factors included in this logistics management model developed specifically for STS maintenance requirements. Data presently available to support logistics decisions were based on a comparability study of heavy aircraft components. A two-phase program is recommended by which NASA would implement an integrated data collection system, assemble logistics data from previous STS flights, revise extant logistics planning and resource requirement parameters using Bayes-Lin techniques, and adjust for uncertainty surrounding logistics systems performance parameters. The implementation of these recommendations can be expected to deliver more cost-effective logistics support.

Relation between selected water-quality variables and lake level in Upper Klamath and Agency Lakes, Oregon

USGS Publications Warehouse

Wood, Tamara M.; Fuhrer, Gregory J.; Morace, Jennifer L.

1996-01-01

Based on the analysis of data that they have been collecting for several years, the Klamath Tribes recently recommended that the Bureau of Reclamation (Reclamation) modify the operating plan for the dam to make the minimum lake levels for the June-August period more closely resemble pre-dam conditions (Jacob Kann, written commun., 1995). The U.S. Geological Survey (USGS) was asked to analyze the available data for the lake and to assess whether the evidence exists to conclude that year-to-year differences in certain lake water-quality variables are related to year-to-year differences in lake level. The results of the analysis will be used as scientific input in the process of developing an operating plan for the Link River Dam.

2009 Continued Testing of the Orion Atmosphere Revitalization Technology

NASA Technical Reports Server (NTRS)

Button, Amy B.; Swerterlitsch, Jeffrey J.

2010-01-01

An amine-based carbon dioxide (CO2) and water vapor sorbent in pressure-swing regenerable beds has been developed by Hamilton Sundstrand and baselined for the Orion Atmosphere Revitalization System (ARS). In three previous years at this conference, reports were presented on extensive Johnson Space Center (JSC) testing of this technology in a sea-level pressure environment, with simulated and real human metabolic loads, in both open and closed-loop configurations. The test article design was iterated a third time before the latest series of such tests, which was performed in the first half of 2009. The new design incorporates a canister configuration modification for overall unit compactness and reduced pressure drop, as well as a new process flow control valve that incorporates both compressed gas purge and dual-end vacuum desorption capabilities. This newest test article is very similar to the flight article designs. Baseline tests of the new unit were performed to compare its performance to that of the previous test articles. Testing of compressed gas purge operations helped refine launchpad operating condition recommendations developed in earlier testing. Operating conditions used in flight program computer models were tested to validate the model projections. Specific operating conditions that were recommended by the JSC test team based on past test results were also tested for validation. The effects of vacuum regeneration line pressure on resulting cabin conditions was studied for high metabolic load periods, and a maximum pressure is recommended

2009 Continued Testing of the Orion Atmosphere Revitalization Technology

NASA Technical Reports Server (NTRS)

Button, Amy Lin; Sweterlitsch, Jeffrey

2009-01-01

An amine-based carbon dioxide (CO2) and water vapor sorbent in pressure-swing regenerable beds has been developed by Hamilton Sundstrand and baselined for the Orion Atmosphere Revitalization System (ARS). In three previous years at this conference, reports were presented on extensive Johnson Space Center (JSC) testing of this technology in a sea-level pressure environment with simulated and real human metabolic loads in both open and closed-loop configurations. The test article design was iterated a third time before the latest series of such tests, which was performed in the first half of 2009. The new design incorporates a canister configuration modification for overall unit compactness and reduced pressure drop, as well as a new process flow control valve that incorporates both compressed gas purge and dual-end vacuum desorption capabilities. This newest test article is very similar to the flight article designs. Baseline tests of the new unit were performed to compare its performance to that of the previous test articles. Testing of compressed gas purge operations helped refine launchpad operating condition recommendations developed in earlier testing. Operating conditions used in flight program computer models were tested to validate the model projections. Specific operating conditions that were recommended by the JSC test team based on past test results were also tested for validation. The effects of vacuum regeneration line pressure on resulting cabin conditions was studied for high metabolic load periods, and a maximum pressure is recommended.

Optimal Demand Execution Strategy for the Defense Logistics Agency

DTIC Science & Technology

2014-12-01

PLT Production Lead-Time PTO Paid Time Off FSC Federal Stock /Supply Class NIIN National Item Identification Number S&OP Sales and Operations...new software sets a recommended inventory level that balances the risk of stock out with holding cost expenses and buys to the optimal level instead...when a PR should be generated. A Time Phased Inventory Plan (TPIP) is computed daily that accounts for the lead-time and current stock on the shelf

Community Noise Exposure Resulting from Aircraft Operations: Acquisition and Analysis of Aircraft Noise and Performance Data

DTIC Science & Technology

1975-08-01

defined for a noise event as: SELT - 10 log ALT i^dt L For purposes of aircraft noise evaluation, SELT is computed from tone-corrected A - levels sampled...In calculating values of PNLr PNLT, A - levels , EPNL, etc. T’ased on the Investigation summarized in Appendix C, we recommend that noise spectra be...handled In the following manner: a. Do not calculate or report PNL, PNLT, A - levels or other measures for spectra where less than 10 one- third

Impact of a Risk Calculator on Risk Perception and Surgical Decision Making: A Randomized Trial.

PubMed

Sacks, Greg D; Dawes, Aaron J; Ettner, Susan L; Brook, Robert H; Fox, Craig R; Russell, Marcia M; Ko, Clifford Y; Maggard-Gibbons, Melinda

2016-12-01

The aim of this study was to determine whether exposure to data from a risk calculator influences surgeons' assessments of risk and in turn, their decisions to operate. Little is known about how risk calculators inform clinical judgment and decision-making. We asked a national sample of surgeons to assess the risks (probability of serious complications or death) and benefits (recovery) of operative and nonoperative management and to rate their likelihood of recommending an operation (5-point scale) for 4 detailed clinical vignettes wherein the best treatment strategy was uncertain. Surgeons were randomized to the clinical vignettes alone (control group; n = 384) or supplemented by data from a risk calculator (risk calculator group; n = 395). We compared surgeons' judgments and decisions between the groups. Surgeons exposed to the risk calculator judged levels of operative risk that more closely approximated the risk calculator value (RCV) compared with surgeons in the control group [mesenteric ischemia: 43.7% vs 64.6%, P < 0.001 (RCV = 25%); gastrointestinal bleed: 47.7% vs 53.4%, P < 0.001 (RCV = 38%); small bowel obstruction: 13.6% vs 17.5%, P < 0.001 (RCV = 14%); appendicitis: 13.4% vs 24.4%, P < 0.001 (RCV = 5%)]. Surgeons exposed to the risk calculator also varied less in their assessment of operative risk (standard deviations: mesenteric ischemia 20.2% vs 23.2%, P = 0.01; gastrointestinal bleed 17.4% vs 24.1%, P < 0.001; small bowel obstruction 10.6% vs 14.9%, P < 0.001; appendicitis 15.2% vs 21.8%, P < 0.001). However, averaged across the 4 vignettes, the 2 groups did not differ in their reported likelihood of recommending an operation (mean 3.7 vs 3.7, P = 0.76). Exposure to risk calculator data leads to less varied and more accurate judgments of operative risk among surgeons, and thus may help inform discussions of treatment options between surgeons and patients. Interestingly, it did not alter their reported likelihood of recommending an operation.

40 CFR 240.208-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Recommended procedures: Operations. 240.208-3 Section 240.208-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended...

40 CFR 240.210-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Recommended procedures: Operations. 240.210-3 Section 240.210-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended...

40 CFR 240.202-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Recommended procedures: Operations. 240.202-3 Section 240.202-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended...

40 CFR 240.203-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Recommended procedures: Operations. 240.203-3 Section 240.203-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended...

2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth.

PubMed

Negrini, Stefano; Donzelli, Sabrina; Aulisa, Angelo Gabriele; Czaprowski, Dariusz; Schreiber, Sanja; de Mauroy, Jean Claude; Diers, Helmut; Grivas, Theodoros B; Knott, Patrick; Kotwicki, Tomasz; Lebel, Andrea; Marti, Cindy; Maruyama, Toru; O'Brien, Joe; Price, Nigel; Parent, Eric; Rigo, Manuel; Romano, Michele; Stikeleather, Luke; Wynne, James; Zaina, Fabio

2018-01-01

The International Scientific Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) produced its first guidelines in 2005 and renewed them in 2011. Recently published high-quality clinical trials on the effect of conservative treatment approaches (braces and exercises) for idiopathic scoliosis prompted us to update the last guidelines' version. The objective was to align the guidelines with the new scientific evidence to assure faster knowledge transfer into clinical practice of conservative treatment for idiopathic scoliosis (CTIS). Physicians, researchers and allied health practitioners working in the area of CTIS were involved in the development of the 2016 guidelines. Multiple literature reviews reviewing the evidence on CTIS (assessment, bracing, physiotherapy, physiotherapeutic scoliosis-specific exercises (PSSE) and other CTIS) were conducted. Documents, recommendations and practical approach flow charts were developed using a Delphi procedure. The process was completed with the Consensus Session held during the first combined SOSORT/IRSSD Meeting held in Banff, Canada, in May 2016. The contents of the new 2016 guidelines include the following: background on idiopathic scoliosis, description of CTIS approaches for various populations with flow-charts for clinical practice, as well as literature reviews and recommendations on assessment, bracing, PSSE and other CTIS. The present guidelines include a total of 68 recommendations divided into following topics: bracing ( n  = 25), PSSE to prevent scoliosis progression during growth ( n  = 12), PSSE during brace treatment and surgical therapy ( n  = 6), other conservative treatments ( n  = 2), respiratory function and exercises ( n  = 3), general sport activities ( n  = 6); and assessment ( n  = 14). According to the agreed strength and level of evidence rating scale, there were 2 recommendations on bracing and 1 recommendation on PSSE that reached level of recommendation "I" and level of evidence "II". Three recommendations reached strength of recommendation A based on the level of evidence I (2 for bracing and one for assessment); 39 recommendations reached strength of recommendation B (20 for bracing, 13 for PSSE, and 6 for assessment).The number of paper for each level of evidence for each treatment is shown in Table 8. The 2016 SOSORT guidelines were developed based on the current evidence on CTIS. Over the last 5 years, high-quality evidence has started to emerge, particularly in the areas of efficacy of bracing (one large multicentre trial) and PSSE (three single-centre randomized controlled trials). Several grade A recommendations were presented. Despite the growing high-quality evidence, the heterogeneity of the study protocols limits generalizability of the recommendations. There is a need for standardization of research methods of conservative treatment effectiveness, as recognized by SOSORT and the Scoliosis Research Society (SRS) non-operative management Committee.

[Occupational exposure of physical therapists to electric and magnetic fields and the efficacy of Faraday cages].

PubMed

Messias, Iracimara de Anchieta; Okuno, Emico; Colacioppo, Sérgio

2011-10-01

Measure physical therapists' exposure to the electric and magnetic fields produced by 17 shortwave diathermy devices in physical therapy clinics in the city of Presidente Prudente, São Paulo State, Brazil. Compare the observed values with the exposure levels recommended by the International Commission on Non-ionizing Radiation Protection (ICNIRP). Observe the efficacy of Faraday cages as a means of protecting physical therapists from exposure to oscillating electric and magnetic fields. Electric and magnetic field measurements were taken at four points during actual physical therapy sessions: in proximity to the operator's pelvis and head, the devices' electrical cables, and the electrodes. The measuring equipment was a Wandel & Goltermann EMR-200. The values obtained in proximity to the electrodes and cables were 10 to 30 times higher than ICNIRP's recommended occupational reference levels. In the shortwave diathermy treatment rooms with Faraday cages, the fields were even higher than in treatment rooms not so equipped-principally the magnetic field, where the values were more than 100 times higher than the ICNIRP exposure limit. The electric and magnetic field intensities obtained in this study are generally above the exposure levels recommend in ICNIRP standards. It was also observed that the Faraday cage offers physical therapists no protection, and instead, increases their level of exposure.

MASTER'S DEGREE PROGRAMS AND THE LIBERAL ARTS COLLEGE. REPORT AND RECOMMENDATIONS FOR FINCH COLLEGE.

ERIC Educational Resources Information Center

HAWKES, CAROL

A STUDY OF MASTER'S DEGREE PROGRAMS WAS CONDUCTED IN ORDER TO DETERMINE THE FEASIBILITY OF ESTABLISHING SUCH A PROGRAM AT FINCH COLLEGE. THE NEED FOR PROGRAMS ON THE GRADUATE LEVEL, TYPES OF MASTER'S DEGREES OFFERED, AND ADMINISTRATIVE POLICIES AND STANDARDS ARE DISCUSSED IN PART ONE. PART TWO, "PROGRAMS IN OPERATION," DESCRIBES IN…

Public High School Principals' Perceptions of Academic Reform. Center for Education Statistics Bulletin.

ERIC Educational Resources Information Center

Center for Education Statistics (ED/OERI), Washington, DC.

A survey of public high school principals asked which policies, programs, and practices designed to improve learning were currently in operation at their schools, and whether these policies were instituted or substantially strengthened in the past 5 years. These policies reflect the school-level recommendations for education reform made in "A…

Operating room sound level hazards for patients and physicians.

PubMed

Fritsch, Michael H; Chacko, Chris E; Patterson, Emily B

2010-07-01

Exposure to certain new surgical instruments and operating room devices during procedures could cause hearing damage to patients and personnel. Surgical instruments and related equipment generate significant sound levels during routine usage. Both patients and physicians are exposed to these levels during the operative cases, many of which can last for hours. The noise loads during cases are cumulative. Occupational Safety and Health Administration (OSHA) and National Institute for Occupational Safety and Health (NIOSH) standards are inconsistent in their appraisals of potential damage. Implications of the newer power instruments are not widely recognized. Bruel and Kjaer sound meter spectral recordings for 20 major instruments from 5 surgical specialties were obtained at the ear levels for the patient and the surgeon between 32 and 20 kHz. Routinely used instruments generated sound levels as high as 131 dB. Patient and operator exposures differed. There were unilateral dominant exposures. Many instruments had levels that became hazardous well within the length of an average surgical procedure. The OSHA and NIOSH systems gave contradicting results when applied to individual instruments and types of cases. Background noise, especially in its intermittent form, was also of significant nature. Some patients and personnel have additional predisposing physiologic factors. Instrument noise levels for average length surgical cases may exceed OSHA and NIOSH recommendations for hearing safety. Specialties such as Otolaryngology, Orthopedics, and Neurosurgery use instruments that regularly exceed limits. General operating room noise also contributes to overall personnel exposures. Innovative countermeasures are suggested.

The WLCG Messaging Service and its Future

NASA Astrophysics Data System (ADS)

Cons, Lionel; Paladin, Massimo

2012-12-01

Enterprise messaging is seen as an attractive mechanism to simplify and extend several portions of the Grid middleware, from low level monitoring to experiments dashboards. The production messaging service currently used by WLCG includes four tightly coupled brokers operated by EGI (running Apache ActiveMQ and designed to host the Grid operational tools such as SAM) as well as two dedicated services for ATLAS-DDM and experiments dashboards (currently also running Apache ActiveMQ). In the future, this service is expected to grow in numbers of applications supported, brokers and technologies. The WLCG Messaging Roadmap identified three areas with room for improvement (security, scalability and availability/reliability) as well as ten practical recommendations to address them. This paper describes a messaging service architecture that is in line with these recommendations as well as a software architecture based on reusable components that ease interactions with the messaging service. These two architectures will support the growth of the WLCG messaging service.

Trace anesthetic vapors in hospital operating-room environments

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

Choi-Lao, A.T.

1981-05-01

This study investigated concentrations of halothane anesthetic vapors in the operating rooms of two hospitals in the Ottawa, Ontario, Canada, area. Air samples, taken by active charcoal tubes and dosimeter badges, were analyzed by a gas chromatographic technique. Readings of 71 samples taken from hospital A and 65 samples from hospital B ranged from 1.0 to 29.4 parts per billion (ppb) for the active period and 0.1 to 3.8 ppb for the inactive period. All samples showed trace concentrations of halothane, but were well below the recommended maximal level.

Small hydroelectric power plant for Aztec, New Mexico

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

Frey, E.W.

1982-05-01

Preliminary engineering results and the outcome of other specific studies associated with the establishment of a hydroelectric power plant at Aztec, New Mexico, are presented, with particular emphasis on estimated costs of construction and long-term operation. Four alternative levels of effort were evaluated. Recommendations, based primarily on cost effectiveness, are presented along with material useful as a basis for a possible follow-on Phase II study. At least three levels of effort appear economically attractive alternatives for the city to pursue.

Data on the noise vibrations of modern traction locomotives. [auditory effects on diesel engine operators

NASA Technical Reports Server (NTRS)

Paslaru, V.; Popescu, A.; Vrasti, R.

1974-01-01

A survey is presented of data on noise and vibration sources in modern locomotives and their influence on engine drivers. An attempt is made hierarchize noise and vibration sources in terms of importance and to correlate the noise level with the influence of noise on the engine drivers' organ of hearing. Some possible recommendations are outlined for reducing the level of these noxae in order to improve the acoustic comfort of engine drivers.

Arthroscopic hip preservation surgery practice patterns: an international survey

PubMed Central

Smith, Kevin M.; Gerrie, Brayden J.; McCulloch, Patrick C.; Lewis, Brian D.; Mather, R. Chad; Van Thiel, Geoffrey; Nho, Shane J.

2017-01-01

Abstract To design and conduct a survey analyzing pre-, intra- and post- hip arthroscopy practice patterns among hip arthroscopists worldwide. A 21-question, IRB-exempt, HIPAA-compliant, cross-sectional survey was conducted via email using SurveyMonkey to examine pre-operative evaluation, intra-operative techniques and post-operative management. The survey was administered internationally to 151 hip arthroscopists identified from publicly available sources. Seventy-five respondents completed the survey (151 ± 116 hip arthroscopy procedures per year; 8.6 ± 7.1 years hip arthroscopy experience). Standing AP pelvis, false profile and Dunn 45 were the most common radiographs utilized. CT scans were utilized by 54% of surgeons at least some of the time. Only 56% of participants recommended an arthrogram with MRI. Nearly all surgeons either never (40%) or infrequently (58%) performed arthroscopy in Tönnis grade-2 or grade-3 osteoarthritis. Surgeons rarely performed hip arthroscopy on patients with dysplasia (51% never; 44% infrequently). Only 25% of participants perform a routine ‘T’ capsulotomy and 41% close the capsule if the patient is at risk for post-operative instability. Post-operatively, 52% never use a brace, 39% never use a continuous passive motion, 11% never recommended heterotopic ossification prophylaxis and 30% never recommended formal thromboembolic disease prophylaxis. Among a large number of high-volume experienced hip arthroscopists worldwide, pre-, intra- and post- hip arthroscopy practice patterns have been established and reported. Within this cohort of respondents, several areas of patient evaluation and management remain discordant and controversial without universal agreement. Future research should move beyond expert opinion level V evidence towards high-quality appropriately designed and conducted investigations. PMID:28630717

Ocular hazards of industrial spot welding.

PubMed

Chou, B R; Cullen, A P

1996-06-01

Any welding process is perceived to be a radiation hazard to the eye. Site visits were made to an automotive assembly plant to assess the levels of optical radiation and other hazards on the production line. Measurements were taken with a scanning spectro-radiometer and optical power and energy meters at operating working distances at spot welding stations where nonrobotic procedures were performed. Ultraviolet (UV) irradiance levels produced while spot welding with electrodes operating at 10 to 15 kA and 10 to 20 V were several orders of magnitude below recommended safety limits for industrial exposure. Flashes were rich in visible light and infrared (IR) radiation, but not at hazardous levels. The principal hazards in manual spot welding with high-current electrodes are high-speed droplets of molten metal produced by the process. These are easily defended against by wraparound polycarbonate eye shields.

Operational integration in primary health care: patient encounters and workflows.

PubMed

Sifaki-Pistolla, Dimitra; Chatzea, Vasiliki-Eirini; Markaki, Adelais; Kritikos, Kyriakos; Petelos, Elena; Lionis, Christos

2017-11-29

Despite several countrywide attempts to strengthen and standardise the primary healthcare (PHC) system, Greece is still lacking a sustainable, policy-based model of integrated services. The aim of our study was to identify operational integration levels through existing patient care pathways and to recommend an alternative PHC model for optimum integration. The study was part of a large state-funded project, which included 22 randomly selected PHC units located across two health regions of Greece. Dimensions of operational integration in PHC were selected based on the work of Kringos and colleagues. A five-point Likert-type scale, coupled with an algorithm, was used to capture and transform theoretical framework features into measurable attributes. PHC services were grouped under the main categories of chronic care, urgent/acute care, preventive care, and home care. A web-based platform was used to assess patient pathways, evaluate integration levels and propose improvement actions. Analysis relied on a comparison of actual pathways versus optimal, the latter ones having been identified through literature review. Overall integration varied among units. The majority (57%) of units corresponded to a basic level. Integration by type of PHC service ranged as follows: basic (86%) or poor (14%) for chronic care units, poor (78%) or basic (22%) for urgent/acute care units, basic (50%) for preventive care units, and partial or basic (50%) for home care units. The actual pathways across all four categories of PHC services differed from those captured in the optimum integration model. Certain similarities were observed in the operational flows between chronic care management and urgent/acute care management. Such similarities were present at the highest level of abstraction, but also in common steps along the operational flows. Existing patient care pathways were mapped and analysed, and recommendations for an optimum integration PHC model were made. The developed web platform, based on a strong theoretical framework, can serve as a robust integration evaluation tool. This could be a first step towards restructuring and improving PHC services within a financially restrained environment.

Comparison of Anterior Cervical Discectomy and Fusion versus Posterior Cervical Foraminotomy in the Treatment of Cervical Radiculopathy: A Systematic Review.

PubMed

Liu, Wei-Jun; Hu, Ling; Chou, Po-Hsin; Wang, Jun-Wen; Kan, Wu-Sheng

2016-11-01

Controversy remains over whether anterior cervical discectomy and fusion (ACDF) or posterior cervical foraminotomy (PCF) is superior for the treatment of cervical radiculopathy. We therefore performed a systematic review including three prospective randomized controlled trails (RCT) and seven retrospective comparative studies (RCoS) by searching PubMed and EMBASE. These studies were assessed on risk of bias according to the Cochrane Handbook for Systematic Reviews of Interventions, and the quality of evidence and level of recommendation were evaluated according to the GRADE approach. Clinical outcomes, complications, reoperation rates, radiological parameters, and cost/cost-utility were evaluated. The mean complication rate was 7% in the ACDF group and 4% in the PCF group, and the mean reoperation rate was 4% in the ACDF group and 6% in the PCF group within 2 years of the initial surgery. There was a strong level of recommendation that no difference existed in clinical outcome, complication rate and reoperation rate between the ACDF and the PCF group. There was conflicting evidence that the ACDF group had better clinical outcomes than the PCF group (one study with weak level of recommendation). PCF could preserve the range of motion (ROM) of the operated segment but did not increase the ROM of the adjacent segment (weak level of recommendation). Meanwhile, the average cost or cost-utility of the PCF group was significantly lower than that of the ACDF group (weak level of recommendation). In conclusion, the PCF was just as safe and effective as the ACDF in the treatment of cervical radiculopathy. Meanwhile, PCF might have lower medical cost than ACDF and decrease the incidence of adjacent segment disease. Based on the available evidence, PCF appears to be another good surgical approach in the treatment of cervical radiculopathy. © 2016 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

Toward a Safety Risk-Based Classification of Unmanned Aircraft

NASA Technical Reports Server (NTRS)

Torres-Pomales, Wilfredo

2016-01-01

There is a trend of growing interest and demand for greater access of unmanned aircraft (UA) to the National Airspace System (NAS) as the ongoing development of UA technology has created the potential for significant economic benefits. However, the lack of a comprehensive and efficient UA regulatory framework has constrained the number and kinds of UA operations that can be performed. This report presents initial results of a study aimed at defining a safety-risk-based UA classification as a plausible basis for a regulatory framework for UA operating in the NAS. Much of the study up to this point has been at a conceptual high level. The report includes a survey of contextual topics, analysis of safety risk considerations, and initial recommendations for a risk-based approach to safe UA operations in the NAS. The next phase of the study will develop and leverage deeper clarity and insight into practical engineering and regulatory considerations for ensuring that UA operations have an acceptable level of safety.

Recommendations; Operational History. Demonstration Center for Language-Hanciapped Children.

ERIC Educational Resources Information Center

Hale, James R.

Recommendations based on the two-and-a-half-year history of The Demonstration Center for Language Handicapped (LH) Children are reported. Noted are such recommendations as the following: that each school district develop its own operational definition of LH based on the state definition, adding the concept of significant discrepancy between…

Ambient noise levels in mobile audiometric testing facilities: compliance with industry standards.

PubMed

Lankford, J E; Perrone, D C; Thunder, T D

1999-04-01

Excessive ambient noise levels in audiometric test booths may elevate and therefore invalidate hearing thresholds of employees included in a hearing conservation program. This study was conducted to determine if a sample of mobile test vans and trailers operating in the Midwest met the 1983 Occupational Safety and Health Administration (OSHA) maximum permissible ambient noise levels (MPANLs), the MPANLs in the American National Standards Institute (ANSI) S3.1-1991, and the suggested National Hearing Conservation Association (NHCA) values. Ambient noise levels were measured in 13 audiometric test booths contained in 12 different industrial mobile test vans and trailers operating in the Midwest. Results indicated that all 13 (100%) of the industrial mobile test vans and trailers evaluated complied with 1983 OSHA permissible levels and the NHCA 1996 recommended levels. With regard to the 1991 ANSI MPANLs, 5 (38%) of the 13 booths were in compliance at all frequencies. Those that failed did so at 125, 250, and 500 Hz. It appears that the NHCA levels need to be used for all hearing conservation programs with respect to compliance for noise levels in mobile audiometric test booths.

Environmental issues in operations management

NASA Astrophysics Data System (ADS)

Muthulingam, Suresh

Adoption of sustainable operating practices is becoming an increasingly important issue for many organizations in the world today. In this dissertation, I use empirical methods to investigate factors that influence the adoption of sustainable practices and also identify issues that may hinder the adoption of such practices. I explore these issues in two diverse settings. In Chapter 1, I investigate the adoption and non-adoption of energy efficiency initiatives using a database of over 100,000 recommendations provided to more than 13,000 small and medium sized manufacturing firms. Even though the average payback across all recommendations is just over one year, many of these profitable opportunities are not implemented. Using a probit instrumental variable model, I identify four biases in the adoption of these recommendations. First, managers are myopic as they miss out on many profitable opportunities. Second, managers are more influenced by upfront costs than by net benefits when evaluating such initiatives. Third, adoption of a recommendation depends not only on its characteristics but also on the sequence in which the recommendations are presented. Adoption rates are higher for initiatives appearing early in a list of recommendations. Finally, adoption is not influenced by the number of options provided to decision makers. This contributes to the debate about whether or not choice overload occurs. We highlight decision biases previously unobserved in the Operations Management literature using field data rather than experimental data. We draw implications for enhancing adoption of energy efficiency initiatives and for other decision contexts where a collection of process improvement recommendations are made to firms. In Chapter 2, I examine the depth of adoption of the voluntary LEED (Leadership in Energy and Environmental Design) standards for green buildings. Depth of adoption refers to the extent to which the buildings adopt practices related to the standard. The LEED standard is based on a point system where buildings are awarded different certification levels based on the number of points they achieve. We use a database of 721 buildings certified to the LEED standard to investigate four issues related to the depth of adoption. First, I find that depth of adoption is influenced by the various certification levels (certified, silver, gold, platinum) incorporated into the LEED standards. In the distribution of points achieved by buildings, this results in large "spikes" at the cutoffs for the various certification levels. Second, we find that the depth of adoption of the LEED standard increases over time as the standard becomes more widely accepted. Third, we find that among organizations that adopt the LEED standard, nonprofit organizations adopt it more deeply than other types of organizations. Finally, we find that deeper adoption is associated with longer project completion times, consistent with the greater complexity involved. Our study contributes to the literature by highlighting that the structure of a standard can influence depth of adoption, that depth of adoption can evolve over time, and that depth of adoption is influenced by organization type. We draw implications for the design and future development of similar voluntary standards.

Automation and robotics human performance

NASA Technical Reports Server (NTRS)

Mah, Robert W.

1990-01-01

The scope of this report is limited to the following: (1) assessing the feasibility of the assumptions for crew productivity during the intra-vehicular activities and extra-vehicular activities; (2) estimating the appropriate level of automation and robotics to accomplish balanced man-machine, cost-effective operations in space; (3) identifying areas where conceptually different approaches to the use of people and machines can leverage the benefits of the scenarios; and (4) recommending modifications to scenarios or developing new scenarios that will improve the expected benefits. The FY89 special assessments are grouped into the five categories shown in the report. The high level system analyses for Automation & Robotics (A&R) and Human Performance (HP) were performed under the Case Studies Technology Assessment category, whereas the detailed analyses for the critical systems and high leverage development areas were performed under the appropriate operations categories (In-Space Vehicle Operations or Planetary Surface Operations). The analysis activities planned for the Science Operations technology areas were deferred to FY90 studies. The remaining activities such as analytic tool development, graphics/video demonstrations and intelligent communicating systems software architecture were performed under the Simulation & Validations category.

Demonstration of a Real Time Capability to Produce Tidal Heights and Currents for Naval Operational Use: A Cast Study for the West Coast of Africa (Liberia)

NASA Technical Reports Server (NTRS)

Mehra, Avichal; Anantharaj, Valentine; Payne, Steve; Kantha, Lakshmi

1996-01-01

This report documents an existing capability to produce operationally relevant products on sea level and currents from a tides/storm surge model for any coastal region around the world within 48 hours from the time of the request. The model is ready for transition to the Naval Oceanographic Office (NAVOCEANO) for potential contingency use anywhere around the world. A recent application to naval operations offshore Liberia illustrates this. Mississippi State University, in collaboration with the University of Colorado and NAVOCEANO, successfully deployed the Colorado University Rapidly Relocatable Nestable Tides and Storm Surge (CURReNTSS) model that predicts sea surface height, tidal currents and storm surge, and provided operational products on tidal sea level and currents in the littoral region off south-western coast of Africa. This report summarizes the results of this collaborative effort in an actual contingency use of the relocatable model, summarizes the lessons learned, and provides recommendations for further evaluation and transition of this modeling capability to operational use.

Recommendations for Exploration Space Medicine from the Apollo Medical Operations Project

NASA Technical Reports Server (NTRS)

Scheuring, R. a.; Davis, J. R.; Duncan, J. M.; Polk, J. D.; Jones, J. A.; Gillis, D. B.

2007-01-01

Introduction: A study was requested in December, 2005 by the Space Medicine Division at the NASA-Johnson Space Center (JSC) to identify Apollo mission issues relevant to medical operations that had impact to crew health and/or performance. The objective was to use this new information to develop medical requirements for the future Crew Exploration Vehicle (CEV), Lunar Surface Access Module (LSAM), Lunar Habitat, and Advanced Extravehicular Activity (EVA) suits that are currently being developed within the exploration architecture. Methods: Available resources pertaining to medical operations on the Apollo 7 through 17 missions were reviewed. Ten categories of hardware, systems, or crew factors were identified in the background research, generating 655 data records in a database. A review of the records resulted in 280 questions that were then posed to surviving Apollo crewmembers by mail, face-to-face meetings, or online interaction. Response analysis to these questions formed the basis of recommendations to items in each of the categories. Results: Thirteen of 22 surviving Apollo astronauts (59%) participated in the project. Approximately 236 pages of responses to the questions were captured, resulting in 107 recommendations offered for medical consideration in the design of future vehicles and EVA suits based on the Apollo experience. Discussion: The goals of this project included: 1) Develop or modify medical requirements for new vehicles; 2) create a centralized database for future access; and 3) take this new knowledge and educate the various directorates at NASA-JSC who are participating in the exploration effort. To date, the Apollo Medical Operations recommendations are being incorporated into the exploration mission architecture at various levels and a centralized database has been developed. The Apollo crewmembers input has proved to be an invaluable resource, prompting ongoing collaboration as the requirements for the future exploration missions continue to evolve and be refined.

Solvent hold tank sample results for MCU-16-1488-1493 (December 2016), MCU-17-86-88 (January 2017), and MCU-17-119-121 (February 2017): Quarterly Report

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

Fondeur, F. F.; Jones, D. H.

A trend summary of three Solvent Hold Tank (SHT) monthly samples; MCU-16-1488-1493 (December 2016), MCU-17-86-88 (January 2017), and MCU-17-119-121 (February 2017) are reported. Analyses indicate that the modifier (CS-7SB) and the extractant (MaxCalix) concentrations are at their nominal recommended levels (169,000 mg/L and 46,300 mg/L respectively). The suppressor (TiDG) level has decreased to a steady state level of 673 mg/L well above the minimum recommended level (479 mg/L). This analysis confirms the Isopar™ addition to the solvent in January 18, 2017. This analysis also indicates the solvent did not require further additions. Based on the current monthly sample, the levelsmore » of TiDG, Isopar™L, MaxCalix, and modifier are sufficient for continuing operation but are expected to decrease with time. Periodic characterization and trimming additions to the solvent are recommended. No impurities above the 1000 ppm level were found in this solvent by the Semi-Volatile Organic Analysis (SVOA). No impurities were observed in the Hydrogen Nuclear Magnetic Resonance (HNMR). Another impurity observed in the samples was mercury. Up to 38 ± 8 micrograms of mercury per mL of solvent was detected in these samples (the average of the CV-AA and XRF methods). The higher mercury concentration in the solvent (as determined in the last three monthly samples) is possibly due to the higher mercury concentration in Salt Batches 8 and 9 (Tank 49H) or mixing of previously undisturbed areas of high mercury concentration in Tank 49H. The gamma level (0.21E5 dpm/mL) measured in the February SHT sample was one order of magnitude lower than the gamma levels observed in the December and January SHT samples. The February gamma level is consistent with the solvent being idle (since January 10, 2017). The gamma levels observed in the December and January SHT samples were consistent with previous monthly measurements where the process operated normally. The laboratory will continue to monitor the quality of the solvent in particular for any new impurities or degradation of the solvent components.« less

Safety recommendation : operator fatigue

DOT National Transportation Integrated Search

1999-06-01

During the 1980s, the National Transportation Safety Board investigated several accindets that involved operator fatigue. Following completion of these accident investigations, the Safety Board in 1989 issues three recommendation to the U.S. Departme...

Music and communication in the operating theatre.

PubMed

Weldon, Sharon-Marie; Korkiakangas, Terhi; Bezemer, Jeff; Kneebone, Roger

2015-12-01

To observe the extent and the detail with which playing music can impact on communication in the operating theatre. According to the cited sources, music is played in 53-72% of surgical operations performed. Noise levels in the operating theatre already exceed World Health Organisation recommendations. There is currently a divide in opinions on the playing of music in operating theatres, with few studies conducted and no policies or guidance provided. An ethnographic observational study of teamwork in operating theatres through video recordings. Quantitative and qualitative data analysis approaches were used. This study was conducted between 2012-2013 in the UK. Video recordings of 20 operations over six months in two operating theatres were captured. The recordings were divided into music and non-music playing cases. Each case was logged using a request/response sequence identified through interactional analysis. Statistical analysis, using a χ(2) , explored the difference between the proportion of request repetitions and whether music was playing or not. Further interactional analysis was conducted for each request repetition. Request/response observations (N = 5203) were documented. A chi-square test revealed that repeated requests were five times more likely to occur in cases that played music than those that did not. A repeated request can add 4-68 seconds each to operation time and increased tensions due to frustration at ineffective communication. Music played in the operating theatre can interfere with team communication, yet is seldom recognized as a potential safety hazard. Decisions around whether music is played and around the choice of music and its volume, are determined largely by surgeons. Frank discussions between clinicians, managers, patients and governing bodies should be encouraged for recommendations and guidance to be developed. © 2015 John Wiley & Sons Ltd.

Axial forces in centrifugal compressor couplings

NASA Astrophysics Data System (ADS)

Ivanov, A. N.; Ivanov, N. M.; Yun, V. K.

2017-08-01

The article presents the results of the theoretical and experimental investigation of axial forces arising in the toothed and plate couplings of centrifugal compressor shaft lines. Additional loads on the thrust bearing are considered that can develop in the toothed couplings as a result of coupled rotors misalignment. Design relationships to evaluate the level of axial forces and recommendations for their reduction in the operating conditions are given.

Remote sensing training for Corps of Engineering personnel: The university training module concept

NASA Technical Reports Server (NTRS)

1982-01-01

A concept to permit Corps of Engineers personnel to obtain and maintain an appropriate level of individual proficiency in the application of remote sensing to water resource management is described. Recommendations are made for specific training courses and include structure and staffing requirements, syllabi and methods of operation, supporting materials, and procedures for integrating information systems management into the University Training Modules.

Power conditioning for space nuclear reactor systems

NASA Technical Reports Server (NTRS)

Berman, Baruch

1987-01-01

This paper addresses the power conditioning subsystem for both Stirling and Brayton conversion of space nuclear reactor systems. Included are the requirements summary, trade results related to subsystem implementation, subsystem description, voltage level versus weight, efficiency and operational integrity, components selection, and shielding considerations. The discussion is supported by pertinent circuit and block diagrams. Summary conclusions and recommendations derived from the above studies are included.

Assessment of the NASA Space Shuttle Program's Problem Reporting and Corrective Action System

NASA Technical Reports Server (NTRS)

Korsmeryer, D. J.; Schreiner, J. A.; Norvig, Peter (Technical Monitor)

2001-01-01

This paper documents the general findings and recommendations of the Design for Safety Programs Study of the Space Shuttle Programs (SSP) Problem Reporting and Corrective Action (PRACA) System. The goals of this Study were: to evaluate and quantify the technical aspects of the SSP's PRACA systems, and to recommend enhancements addressing specific deficiencies in preparation for future system upgrades. The Study determined that the extant SSP PRACA systems accomplished a project level support capability through the use of a large pool of domain experts and a variety of distributed formal and informal database systems. This operational model is vulnerable to staff turnover and loss of the vast corporate knowledge that is not currently being captured by the PRACA system. A need for a Program-level PRACA system providing improved insight, unification, knowledge capture, and collaborative tools was defined in this study.

Civil helicopter noise assessment study Boeing-Vertol model 347. [recommendations for reduction of helicopter noise levels

NASA Technical Reports Server (NTRS)

Hinterkeuser, E. G.; Sternfeld, H., Jr.

1974-01-01

A study was conducted to forecast the noise restrictions which may be imposed on civil transport helicopters in the 1975-1985 time period. Certification and community acceptance criteria were predicted. A 50 passenger tandem rotor helicopter based on the Boeing-Vertol Model 347 was studied to determine the noise reductions required, and the means of achieving them. Some of the important study recommendations are: (1) certification limits should be equivalent to 95 EPNdb at data points located at 500 feet to each side of the touchdown/takeoff point, and 1000 feet from this point directly under the approach and departure flight path. (2) community acceptance should be measured as Equivalent Noise Level (Leq), based on dBA, with separate limits for day and night operations, and (3) in order to comply with the above guidelines, the Model 347 helicopter will require studies and tests leading to several modifications.

Fatigue Management in Spaceflight Operations

NASA Technical Reports Server (NTRS)

Whitmire, Alexandra

2011-01-01

Sleep loss and fatigue remain an issue for crewmembers working on the International Space Station, and the ground crews who support them. Schedule shifts on the ISS are required for conducting mission operations. These shifts lead to tasks being performed during the biological night, and sleep scheduled during the biological day, for flight crews and the ground teams who support them. Other stressors have been recognized as hindering sleep in space; these include workload, thinking about upcoming tasks, environmental factors, and inadequate day/night cues. It is unknown if and how other factors such as microgravity, carbon dioxide levels, or increased radiation, may also play a part. Efforts are underway to standardize and provide care for crewmembers, ground controllers and other support personnel. Through collaborations between research and operations, evidenced-based clinical practice guidelines are being developed to equip flight surgeons with the tools and processes needed for treating circadian desynchrony (and subsequent sleep loss) caused by jet lag and shift work. The proper implementation of countermeasures such as schedules, lighting protocols, and cognitive behavioral education can hasten phase shifting, enhance sleep and optimize performance. This panel will focus on Fatigue Management in Spaceflight Operations. Speakers will present on research-based recommendations and technologies aimed at mitigating sleep loss, circadian desynchronization and fatigue on-orbit. Gaps in current mitigations and future recommendations will also be discussed.

Parallel dispatch: a new paradigm of electrical power system dispatch

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

Zhang, Jun Jason; Wang, Fei-Yue; Wang, Qiang

Modern power systems are evolving into sociotechnical systems with massive complexity, whose real-time operation and dispatch go beyond human capability. Thus, the need for developing and applying new intelligent power system dispatch tools are of great practical significance. In this paper, we introduce the overall business model of power system dispatch, the top level design approach of an intelligent dispatch system, and the parallel intelligent technology with its dispatch applications. We expect that a new dispatch paradigm, namely the parallel dispatch, can be established by incorporating various intelligent technologies, especially the parallel intelligent technology, to enable secure operation of complexmore » power grids, extend system operators U+02BC capabilities, suggest optimal dispatch strategies, and to provide decision-making recommendations according to power system operational goals.« less

Operator Performance Evaluation of Fault Management Interfaces for Next-Generation Spacecraft

NASA Technical Reports Server (NTRS)

Hayashi, Miwa; Ravinder, Ujwala; Beutter, Brent; McCann, Robert S.; Spirkovska, Lilly; Renema, Fritz

2008-01-01

In the cockpit of the NASA's next generation of spacecraft, most of vehicle commanding will be carried out via electronic interfaces instead of hard cockpit switches. Checklists will be also displayed and completed on electronic procedure viewers rather than from paper. Transitioning to electronic cockpit interfaces opens up opportunities for more automated assistance, including automated root-cause diagnosis capability. The paper reports an empirical study evaluating two potential concepts for fault management interfaces incorporating two different levels of automation. The operator performance benefits produced by automation were assessed. Also, some design recommendations for spacecraft fault management interfaces are discussed.

Aerospace Safety Advisory Panel report to the NASA acting administrator

NASA Technical Reports Server (NTRS)

1986-01-01

The level of activity of the Aerospace Safety Advisory Panel was increased smewhat during 1985 in concert with the increased mission rate of the National Space Transportation System, the evolutionary changes in management and operation of that program, and the preparation of the Vandenberg Launch Site; the implementation of the Program Definition Phase of the Space Station Program; and the actual flight testing of the X-29 research aircraft. Impending payload STS missions and NASA's overall aircraft operations are reviewed. The safety aspects of the LEASAT salvage mission were assessed. The findings and recommendation of the committee are summerized.

Verification approach for the Shuttle/Payload Contamination Evaluation computer program - Spacelab induced environment

NASA Technical Reports Server (NTRS)

Bareiss, L. E.

1978-01-01

The paper presents a compilation of the results of a systems level Shuttle/payload contamination analysis and related computer modeling activities. The current technical assessment of the contamination problems anticipated during the Spacelab program are discussed and recommendations are presented on contamination abatement designs and operational procedures based on experience gained in the field of contamination analysis and assessment, dating back to the pre-Skylab era. The ultimate test of the Shuttle/Payload Contamination Evaluation program will be through comparison of predictions with measured levels of contamination during actual flight.

Evidence-based medicine in obstetrics: can levels B and C recommendations be elevated to level A recommendations?

PubMed Central

Chauhan, Suneet P; Chang, Eugene; Brost, Brian; Assel, Barbara; Baxter, Jason; Smith, James A; Grobman, Robert; Berghella, Vincenzo; Scardo, James A; Magann, Everett F; Morrison, John C

2009-01-01

In this study, 65% (132/195) of level B/C obstetric recommendations are amenable to randomized clinical trials (RCTs) and seven were identified as most needed. The purpose of the survey was to evaluate levels B and C recommendations in obstetric practice bulletins (PBs) regarding the feasibility of performing RCT to elevate each subject to level A evidence. Eleven geographically dispersed physicians with experience in research reviewed levels B and C recommendations for the ethical and logistical feasibility of performing an RCT. In the 35 obstetric PBs, 195 level B/C recommendations were reviewed. The majority considered 47 (24%) topics unethical for an RCT and thought 16 (11%) did not need an RCT, thus leaving 132 (67%) levels B and C recommendations available for an RCT. Two-thirds of levels B and C recommendations in obstetric PB are amenable to RCTs and potentially becoming level A evidence. PMID:27582813

49 CFR 195.573 - What must I do to monitor external corrosion control?

Code of Federal Regulations, 2013 CFR

2013-10-01

... operation and maintenance of the system are in accordance with API Recommended Practice 651. However, this...) why compliance with all or certain operation and maintenance provisions of API Recommended Practice...

49 CFR 195.573 - What must I do to monitor external corrosion control?

Code of Federal Regulations, 2014 CFR

2014-10-01

... operation and maintenance of the system are in accordance with API Recommended Practice 651. However, this...) why compliance with all or certain operation and maintenance provisions of API Recommended Practice...

Annual report to the Chairman and Ranking Minority Members, House and Senate Committees on Appropriations. Status of open recommendations: Improving operations of federal departments and agencies

NASA Technical Reports Server (NTRS)

1995-01-01

Each year, GAO's work contributes to many legislative and executive branch actions that result in significant financial savings and other improvements in government operations. Some, but not all, are identified through GAO's system for periodically following up to determine the status of actions taken on the recommendations made in its audit and evaluation reports. In fiscal year 1994, GAO made 1,450 recommendations, but, more importantly, about 4,400 GAO recommendations made over the past 5 years have been implemented. This report includes summary information on the status of all GAO recommendations that have not been fully implemented and highlights some of the key ones. This information should help congressional and agency leaders prepare for upcoming appropriations and oversight activities and stimulate further actions to achieve the desired improvements in government operations. In addition to including printed issue area summaries highlighting the ipact of GAO's work and the key open recommendations, this volume includes a set of computer diskettes with details on all open recommendations.

Municipal water-based heat pump heating and/or cooling systems: Findings and recommendations. Final report

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

Bloomquist, R.G.; Wegman, S.

1998-04-01

The purpose of the present work was to determine if existing heat pump systems based on municipal water systems meet existing water quality standards, to analyze water that has passed through a heat pump or heat exchanger to determine if corrosion products can be detected, to determine residual chlorine levels in municipal waters on the inlet as well as the outlet side of such installations, to analyses for bacterial contaminants and/or regrowth due to the presence of a heat pump or heat exchanger, to develop and suggest criteria for system design and construction, to provide recommendations and specifications for materialmore » and fluid selection, and to develop model rules and regulations for the installation, operation, and monitoring of new and existing systems. In addition, the Washington State University (WSU) has evaluated availability of computer models that would allow for water system mapping, water quality modeling and system operation.« less

Role of theory in space science

NASA Technical Reports Server (NTRS)

1983-01-01

The goal of theory is to understand how the fundamental laws of physics laws of physics and chemistry give rise to the features of the universe. It is recommended that NASA establish independent theoretical research programs in planetary sciences and in astrophysics similar to the solar-system plasma-physics theory program, which is characterized by stable, long-term support for theorists in university departments, NASA centers, and other organizations engaged in research in topics relevant to present and future space-derived data. It is recommended that NASA keep these programs under review to full benefit from the resulting research and to assure opportunities for inflow of new ideas and investigators. Also, provisions should be made by NASA for the computing needs of the theorists in the programs. Finally, it is recommended that NASA involve knowledgeable theorists in mission planning activities at all levels, from the formulation of long-term scientific strategies through the planning and operation of specific missions.

Space Station Mission Planning Study (MPS) development study. Volume 3: Software development plan

NASA Technical Reports Server (NTRS)

Klus, W. L.

1987-01-01

A software development plan is presented for the definition, design, and implementation of the Space Station (SS) Payload Mission Planning System (MPS). This plan is an evolving document and must be updated periodically as the SS design and operations concepts as well as the SS MPS concept evolve. The major segments of this plan are as follows: an overview of the SS MPS and a description of its required capabilities including the computer programs identified as configurable items with an explanation of the place and function of each within the system; an overview of the project plan and a detailed description of each development project activity breaking each into lower level tasks where applicable; identification of the resources required and recommendations for the manner in which they should be utilized including recommended schedules and estimated manpower requirements; and a description of the practices, standards, and techniques recommended for the SS MPS Software (SW) development.

Consultative Committee for Space Data Systems recommendation for space data system standards: Telecommand. Part 2.1: Command operation procedures

NASA Technical Reports Server (NTRS)

1991-01-01

This recommendation contains the detailed specification of the logic required to carry out the Command Operations Procedures of the Transfer Layer. The Recommendation for Telecommand--Part 2, Data Routing Service contains the standard data structures and data communication procedures used by the intermediate telecommand system layers (the Transfer and Segmentation Layers). In particular, it contains a brief description of the Command Operations Procedures (COP) within the Transfer Layer. This recommendation contains the detailed definition of the COP's in the form of state tables, along with definitions of the terms used. It is assumed that the reader of this document is familiar with the data structures and terminology of part 2. In case of conflict between the description of the COP's in part 2 and in this recommendation, the definition in this recommendation will take precedence. In particular, this document supersedes section 4.3.3.1 through 4.3.3.4 of part 2.

Evaluation of exposures of hospital employees to anesthetic gases

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

Lambeth, J.D.

1988-01-01

Hospital employees who work in hospital operating and recovery rooms are often exposed to a number of anesthetic gases. There is evidence to support the belief that such exposures have led to higher rates of miscarriages and spontaneous abortions of pregnancies among women directly exposed to these gases than among women not exposed. Most of the studies assessing exposure levels were conducted prior to the widespread use of scavenging systems. Air sampling was conducted in hospital operatories and recovery rooms of three large hospitals to assess the current exposure levels in these areas and determine the effectiveness of these systemsmore » in reducing exposures to fluoride-containing anesthetic gases. It was determined that recovery-room personnel are exposed to levels of anesthesia gases that often approach and exceed the recommended Threshold Limit Value-Time Weighted Average (TLV-TWA) of 2.0 ppm. Recovery-room personnel do not have the protection from exposure provided by scavenging systems in operating rooms. Operating-room personnel were exposed to anesthesia gas levels above the TLV-TWA only when patients were masked, or connected and disconnected from the scavenging systems. Recovery-room personnel also need to be protected from exposure to anesthesia gases by a scavenging system.« less

NASA Weather Support 2017

NASA Technical Reports Server (NTRS)

Carroll, Matt

2017-01-01

In the mid to late 1980's, as NASA was studying ways to improve weather forecasting capabilities to reduce excessive weather launch delays and to reduce excessive weather Launch Commit Criteria (LCC) waivers, the Challenger Accident occurred and the AC-67 Mishap occurred.[1] NASA and USAF weather personnel had advance knowledge of extremely high levels of weather hazards that ultimately caused or contributed to both of these accidents. In both cases, key knowledge of the risks posed by violations of weather LCC was not in the possession of final decision makers on the launch teams. In addition to convening the mishap boards for these two lost missions, NASA convened expert meteorological boards focusing on weather support. These meteorological boards recommended the development of a dedicated organization with the highest levels of weather expertise and influence to support all of American spaceflight. NASA immediately established the Weather Support Office (WSO) in the Office of Space Flight (OSF), and in coordination with the United Stated Air Force (USAF), initiated an overhaul of the organization and an improvement in technology used for weather support as recommended. Soon after, the USAF established a senior civilian Launch Weather Officer (LWO) position to provide meteorological support and continuity of weather expertise and knowledge over time. The Applied Meteorology Unit (AMU) was established by NASA, USAF, and the National Weather Service to support initiatives to place new tools and methods into an operational status. At the end of the Shuttle Program, after several weather office reorganizations, the WSO function had been assigned to a weather branch at Kennedy Space Center (KSC). This branch was dismantled in steps due to further reorganization, loss of key personnel, and loss of budget line authority. NASA is facing the loss of sufficient expertise and leadership required to provide current levels of weather support. The recommendation proposed herein is to re-establish the WSO under a high level office, with funding set at about the same levels as today, with a revitalized charter and focus to allow for the WSO to operate as originally intended.

Radiological Operations Support Specialist (ROSS) Pilot Course Summary and Recommendations

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

Alai, M.; Askin, A.; Buddemeier, B.

In support of the Department of Homeland Security / Science and Technology Directorate’s (DHS/S&T) creation of a new position called the Radiological Operations Support Specialist (ROSS), Lawrence Livermore National Laboratory (LLNL) in Sub-task 1.1 and 1.2 has assisted in the development of the ROSS skills, knowledge, and abilities (SKAs); identified potentially relevant training; cross-mapped the training to the SKAs; and identified gaps in the training related to the SKAs, as well as their respective level of training knowledge - current versus desired. In the follow on task, Sub-task 1.3, a 5 day ROSS Pilot Training course was developed to fillmore » the priority gaps identified in Sub-Task 1.2. Additionally, in Sub-Task 1.5, LLNL has performed a gap analysis of electronic tools, handbooks, and job-aides currently available to the ROSS and developed recommendations for additional and next generation tools to ensure the operational effectiveness of the ROSS position. This document summarizes the feedback received from the instructors and pilot course observers on what worked in the course and what could be improved as well as an assessment of the Pre- and Post-Test administered to the students.« less

Defense Commissaries: DOD Needs to Improve Business Processes to Ensure Patron Benefits and Achieve Operational Efficiencies

DTIC Science & Technology

2017-03-01

sales, leverage efficiencies, and achieve savings in commissary operations. Second, DeCA has not conducted cost - benefit analyses for costs ...conduct comprehensive cost - benefit analyses for service contracts and distribution options. DOD concurred with GAO’s first two recommendations and...partially concurred with the third recommendation. GAO continues to believe the cost - benefit analysis recommendation is valid

Effect on patient anxiety of lidocaine infiltration into nasal packing after septoplasty: prospective, controlled study.

PubMed

Sahin, C; Aras, H I

2015-08-01

This prospective, controlled study investigated the effect on patient anxiety of lidocaine infiltration into nasal packing following septoplasty. The study included 50 patients who underwent septoplasty operation. Patient anxiety levels were measured 24 hours pre-operatively; 48 hours post-operatively, before saline or lidocaine infiltration; and 15 minutes after lidocaine or saline infiltration into the packing. The patients were asked to mark their level of pain during pack removal on a visual analogue scale. Hamilton Anxiety Scale scores for lidocaine infiltration patients were: 15.1 ± 7.4 pre-operatively; 16 ±7.6 post-operatively, before infiltration; and 13.7 ± 6.6 at 15 minutes after infiltration. The scores for saline infiltration patients were: 16.3 ± 6.8 pre-operatively, 16.4 ± 5.5 before infiltration and 16.1 ± 6.1 after infiltration. The visual analogue scale pain score was 5.3 ± 2.0 in the lidocaine study group and 7.5 ± 1.8 in the control saline group. Infiltration of lidocaine into nasal packing significantly reduced patient pain. Patients developed mild to moderate anxiety before nasal packing removal. Use of techniques without nasal packing can be recommended after septoplasty to ease patient post-operative discomfort.

Aerospace Safety Advisory Panel

NASA Technical Reports Server (NTRS)

1998-01-01

During 1997, the Aerospace Safety Advisory Panel (ASAP) continued its safety reviews of NASA's human space flight and aeronautics programs. Efforts were focused on those areas that the Panel believed held the greatest potential to impact safety. Continuing safe Space Shuttle operations and progress in the manufacture and testing of primary components for the International Space Station (ISS) were noteworthy. The Panel has continued to monitor the safety implications of the transition of Space Shuttle operations to the United Space Alliance (USA). One area being watched closely relates to the staffing levels and skill mix in both NASA and USA. Therefore, a section of this report is devoted to personnel and other related issues that are a result of this change in NASA's way of doing business for the Space Shuttle. Attention will continue to be paid to this important topic in subsequent reports. Even though the Panel's activities for 1997 were extensive, fewer specific recommendations were formulated than has been the case in recent years. This is indicative of the current generally good state of safety of NASA programs. The Panel does, however, have several longer term concerns that have yet to develop to the level of a specific recommendation. These are covered in the introductory material for each topic area in Section 11. In another departure from past submissions, this report does not contain individual findings and recommendations for the aeronautics programs. While the Panel devoted its usual efforts to examining NASA's aeronautic centers and programs, no specific recommendations were identified for inclusion in this report. In lieu of recommendations, a summary of the Panel's observations of NASA's safety efforts in aeronautics and future Panel areas of emphasis is provided. With profound sadness the Panel notes the passing of our Chairman, Paul M. Johnstone, on December 17, 1997, and our Staff Assistant, Ms. Patricia M. Harman, on October 5, 1997. Other changes to the Panel composition during the past year were: the resignation of Mr. Dennis E. Fitch as a Consultant; the appointment of Mr. Roger D. Schaufele as a Consultant; and the assignment of Ms. Susan M. Smith as Staff Assistant.

NASA's UAS [Unmanned Aircraft Systems] Related Activities

NASA Technical Reports Server (NTRS)

Bauer, Jeffrey

2012-01-01

NASA continues to operate all sizes of UAS in all classes of airspace both domestically and internationally. Missions range from highly complex operations in coordination with piloted aircraft, ground, and space systems in support of science objectives to single aircraft operations in support of aeronautics research. One such example is a scaled commercial transport aircraft being used to study recovery techniques due to large upsets. NASA's efforts to support routine UAS operations continued on several fronts last year. At the national level in the United States (U.S.), NASA continued its support of the UAS Executive Committee (ExCom) comprised of the Federal Aviation Administration (FAA), Department of Defense (DoD), Department of Homeland Security (DHS), and NASA. The committee was formed in recognition of the need of UAS operated by these agencies to access to the National Airspace System (NAS) to support operational, training, development and research requirements. Recommendations were received on how to operate both manned and unmanned aircraft in class D airspace and plans are being developed to validate and implement those recommendations. In addition the UAS ExCom has begun developing recommendations for how to achieve routine operations in remote areas as well as for small UAS operations in class G airspace. As well as supporting the UAS ExCom, NASA is a participant in the recently formed Aviation Rule Making Committee for UAS. This committee, established by the FAA, is intended to propose regulatory guidance which would enable routine civil UAS operations. As that effort matures NASA stands ready to supply the necessary technical expertise to help that committee achieve its objectives. By supporting both the UAS ExCom and UAS ARC, NASA is positioned to provide its technical expertise across the full spectrum of UAS airspace access related topic areas. The UAS NAS Access Project got underway this past year under the leadership of NASA s Aeronautics Research Mission Directorate. This project is focused on advancing the state of the art and providing research and analysis results in the areas of Separation Assurance, Communications (non-governmental spectrum allocation for UAS), Certification, and Human System Integration (ground control station design/pilot interfaces). The project is working in close coordination with the FAA and industry standards organizations (e.g. RTCA SC 203). More details on this project are provided in a separate article in this year's yearbook

FY 2009-11 Operating Budget for Higher Education: Appropriations Committee Recommendations. Highlights

ERIC Educational Resources Information Center

Connecticut Department of Higher Education (NJ1), 2009

2009-01-01

This report explains that the General Fund budget: (1) calls for $1,565.4 million for the FY 2009-11 biennium, including $781.2 million in FY 2010 and $784.2 million in FY 2011; and (2) maintains the State's primary student financial aid programs at FY 2009 funding levels, with Connecticut Aid to Charter Oak funded at 80.0 percent of full funding…

Recommendations of the panels: Panel on flight planning to avoid high ozone

NASA Technical Reports Server (NTRS)

Mohnen, V. A.

1979-01-01

Flights planned or accomplished during certain months of the year at the higher latitudes and altitudes at or above the tropopause are discussed. Cabin ozone level limitations are established, and additional information is required for more accurate and qualtitative forecasting and design data base for operational utilization. Better tropopause heights, ozone concentration and corresponding meteorological data along selected flight routes, and meteorological data were investigated.

Understanding the roles of NHS trust board members.

PubMed

Deffenbaugh, J

1996-01-01

The establishment of NHS trust boards on a business format was a recent innovation resulting from the NHS reforms. In order to realize benefits for patients, it is essential that boards operate effectively. Explores within the framework of corporate governance, the practical implications of board member roles. Drawing on experience of strategy formulation at board level, analyses and clarifies the roles, and presents recommendations to increase board effectiveness.

Narratives of change and reform processes: global and local transactions in French psychiatric hospital reform after the Second World War.

PubMed

Henckes, Nicolas

2009-02-01

As with the rest of biomedicine, psychiatry has, since the Second World War, developed under the strong influence of the transnational accumulation of a whole series of practices and knowledge. Anthropology has taught us to pay attention to the transactions between local-level actors and those operating at the global level in the construction of this new world of medicine. This article examines the role played by the recommendations of the WHO Expert Committee of Mental Health in the reform of the French mental health system during the 1950s. Rooted in the experience of practitioners and administrators participating in the process of reforming local psychiatric systems, the recommendations of the WHO Expert Committee developed a new vision of regulating psychiatry, based on professionalism and an idea of a normativity of the doctor-patient relation. This article shows how, by mobilizing the WHO reports' recommendations, French administrators and doctors succeeded in creating a typically French object: "the psychiatric sector", founded on elaborating a new mandate for the psychiatric profession. The article thus questions the deinstitutionalization model as an explanation of transformations of the structure of the French psychiatry system in the post-war period.

Health-hazard evaluation report HETA 88-030-2109, Neiman Sawmills, Inc. , Hulett, Wyoming

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

Tubbs, R.L.

1991-04-01

In response to a request from management, an evaluation was undertaken of possible hazardous working conditions as a result of excessive noise at the Neiman Sawmill facilities (SIC-2421), Hulett, Wyoming. The company produced several varieties of untreated boards and lumber products from pine logs. During this survey 108 workers were employed. Noise dosimetry readings revealed that 73% of the surveyed job descriptions (16 of 22) had time weighted average (TWA) noise levels in excess of 90 decibles-A (dBA). Only one job had TWA levels less than the NIOSH recommended limits of 85dBA. Engineering noise controls produced differing amounts of noisemore » reduction to the workers. An enclosure around the planer in the planer mill was found to be effective. However, the separation of the edger and trimmer operations to their own buildings was not an effective noise reduction technique. Hearing tests revealed that 72.5% of the employees exhibited some degree of hearing impairment at one or more audiometric test frequencies. The author concludes that a health hazard existed for workers. The author recommends that a comprehensive hearing conservation program should be implemented. Recommendations for engineering controls for the mills are included.« less

A Clinical Audit of Escorts' Awareness And Patients' Safety Following Intravenous Sedation In Adult Oral Surgery.

PubMed

Licheri, Luca; Erriu, Matteo; Bryant, Vincenzo; Piras, Vincenzo

2016-01-01

To evaluate current level of safety under the care of an escort following intravenous sedation, post-sedation arrangements and to identify potential risk levels. Information and post-sedation arrangements are important to patients'safety following surgery but although there is a general consensus over what is recommended for patients and their escorts, there is little, if any, literature on the escorts' awareness of sedation and accordance to post-sedation arrangement and recommendations. Escorts of 113 consecutive patients treated in oral surgery under sedation (midazolam) completed a questionnaire composed of 27 questions divided into seven sections including demographics, awareness of sedation, source of information and post-operative arrangement. From the data collected, two scores were calculated representative of the escorts' Safety and Reliability. Data were then analysed by ANOVA. Safety scores were statistically correlated with instruction source while Reliability correlated to a wider variety of parameters including gender, age as well as information source. Provision of clear written information to escorts is recommended as likely to improve patients' safety. Assessment of escorts' Safety and Reliability could provide a means for improving quality and safety of sedation service.

Reliability and validity of the instrument used in BRFSS to assess physical activity.

PubMed

Yore, Michelle M; Ham, Sandra A; Ainsworth, Barbara E; Kruger, Judy; Reis, Jared P; Kohl, Harold W; Macera, Caroline A

2007-08-01

State-level statistics of adherence to the physical activity objectives in Healthy People 2010 are derived from the Behavioral Risk Factor Surveillance System (BRFSS) data. BRFSS physical activity questions were updated in 2001 to include domains of leisure time, household, and transportation-related activity of moderate- and vigorous intensity, and walking questions. This article reports the reliability and validity of these questions. The BRFSS Physical Activity Study (BPAS) was conducted from September 2000 to May 2001 in Columbia, SC. Sixty participants were followed for 22 d; they answered the physical activity questions three times via telephone, wore a pedometer and accelerometer, and completed a daily physical activity log for 1 wk. Measures for moderate, vigorous, recommended (i.e., met the criteria for moderate or vigorous), and strengthening activities were created according to Healthy People 2010 operational definitions. Reliability and validity were assessed using Cohen's kappa (kappa) and Pearson correlation coefficients. Seventy-three percent of participants met the recommended activity criteria compared with 45% in the total U.S. population. Test-retest reliability (kappa) was 0.35-0.53 for moderate activity, 0.80-0.86 for vigorous activity, 0.67-0.84 for recommended activity, and 0.85-0.92 for strengthening. Validity (kappa) of the survey (using the accelerometer as the standard) was 0.17-0.22 for recommended activity. Validity (kappa) of the survey (using the physical activity log as the standard) was 0.40-0.52 for recommended activity. The validity and reliability of the BRFSS physical activity questions suggests that this instrument can classify groups of adults into the levels of recommended and vigorous activity as defined by Healthy People 2010. Repeated administration of these questions over time will help to identify trends in physical activity.

Switching operations fatality analysis : findings and recommendations of the SOFA working group

DOT National Transportation Integrated Search

1999-10-01

On February 1998, a Switching Operations Fatality Analysis (SOFA) Working Group (WG) was formed at the request of the Federal Railroad Administration (FRA) to review recent fatal incidents and develop recommendations for reducing fatalities in switch...

40 CFR 246.200-4 - Recommended procedures: Levels of separation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Recommended procedures: Levels of... § 246.200-4 Recommended procedures: Levels of separation. A two-level separation is recommended for most... separate category cost effective may choose to implement three levels of separation: (1) Computer papers...

Management of adult pancreatic injuries: A practice management guideline from the Eastern Association for the Surgery of Trauma.

PubMed

Ho, Vanessa Phillis; Patel, Nimitt J; Bokhari, Faran; Madbak, Firas G; Hambley, Jana E; Yon, James R; Robinson, Bryce R H; Nagy, Kimberly; Armen, Scott B; Kingsley, Samuel; Gupta, Sameer; Starr, Frederic L; Moore, Henry R; Oliphant, Uretz J; Haut, Elliott R; Como, John J

2017-01-01

Traumatic injury to the pancreas is rare but is associated with significant morbidity and mortality, including fistula, sepsis, and death. There are currently no practice management guidelines for the medical and surgical management of traumatic pancreatic injuries. The overall objective of this article is to provide evidence-based recommendations for the physician who is presented with traumatic injury to the pancreas. The MEDLINE database using PubMed was searched to identify English language articles published from January 1965 to December 2014 regarding adult patients with pancreatic injuries. A systematic review of the literature was performed, and the Grading of Recommendations Assessment, Development and Evaluation framework was used to formulate evidence-based recommendations. Three hundred nineteen articles were identified. Of these, 52 articles underwent full text review, and 37 were selected for guideline construction. Patients with grade I/II injuries tend to have fewer complications; for these, we conditionally recommend nonoperative or nonresectional management. For grade III/IV injuries identified on computed tomography or at operation, we conditionally recommend pancreatic resection. We conditionally recommend against the routine use of octreotide for postoperative pancreatic fistula prophylaxis. No recommendations could be made regarding the following two topics: optimal surgical management of grade V injuries, and the need for routine splenectomy with distal pancreatectomy. Systematic review, level III.

Is Operative Treatment of Achilles Tendon Ruptures Superior to Nonoperative Treatment?

PubMed Central

Erickson, Brandon J.; Mascarenhas, Randy; Saltzman, Bryan M.; Walton, David; Lee, Simon; Cole, Brian J.; Bach, Bernard R.

2015-01-01

Background: Multiple meta-analyses have been published in efforts to determine whether operative or nonoperative treatment of Achilles tendon ruptures affords superior outcomes. Purpose: To perform a systematic review of overlapping meta-analyses comparing operative and nonoperative treatment of Achilles tendon ruptures to determine which meta-analyses provide the highest level of evidence for treatment recommendations. Study Design: Systematic review; Level of evidence, 3. Methods: A systematic review of the literature was performed to identify meta-analyses that fit the study inclusion criteria. Data were extracted from these meta-analyses regarding patient outcomes and reruptures. Meta-analysis quality was assessed using the Oxman-Guyatt and QUOROM (Quality of Reporting of Meta-analyses) systems. The Jadad algorithm was applied to determine the meta-analyses with the highest level of evidence. Results: Nine meta-analyses met the eligibility criteria, with all but 1 study including level 1 evidence. A total of 5842 patients were included. Seven studies found a higher rate of rerupture in the nonoperative group but a higher rate of complications in the operative group. One study found no differences in rerupture or complication rates, and 1 study found surgery decreased rerupture rates only when compared with nonoperative treatment without a functional brace. Three studies also identified an earlier return to work in the operative group. Almost all (8 of 9) of the meta-analyses had Oxman-Guyatt scores >3, indicating no major flaws. Conclusion: Operative treatment of Achilles tendon ruptures decreases rerupture rates but increases the risk for minor complications when compared with nonoperative treatment. Additionally, surgical treatment may allow earlier return to work. PMID:26665055

A Study of the Economic Benefit Potential of Intermodal Transports

NASA Technical Reports Server (NTRS)

Nelson, J. M.; Kawai, R. T.; Gregg, R. D.; McKinley, Robert E., Jr. (Technical Monitor)

2001-01-01

A conceptual study was conducted to determine the benefit potential of an Intermodal Transport in which quick change payload modules are used to reduce the cost of air travel by increasing daily utilization. Three basic concepts varying the degree of modularity were investigated for a 122,000 pounds payload 3,000 NM range regional wide body transport. The profit potential for operating as a passenger transport during the day and as a freighter at night was assessed. Assuming current levels of profitability, Intermodal operations could offer an operating cost reduction potential up to 20%. Enabling technology needs are identified as very quiet aircraft for expanded night operations, distributed load carrying quick disconnect latching, and configuration dependent safety issues. Recommendations are made to explore if additional benefits are possible from alternative mission and usage modules.

Acoustic measurements of F-16 aircraft operating in hush house, NSN 4920-02-070-2721

NASA Astrophysics Data System (ADS)

Miller, V. R.; Plzak, G. A.; Chinn, J. M.

1981-09-01

The purpose of this test program was to measure the acoustic environment in the hush house facility located at Kelly Air Force Base, Texas, during operation of the F-16 aircraft to ensure that aircraft structural acoustic design limits were not exceeded. The acoustic measurements showed that no sonic fatigue problems are anticipated with the F-16 aircraft aft fuselage structure during operation in the hush house. The measured acoustic levels were less than those measured in an F-16 aircraft water cooled hush house at Hill AFB, but were increased over that measured during ground run up. It was recommended that the acoustic loads measured in this program should be specified in the structural design criteria for aircraft which will be subjected to hush house operation or defining requirements for associated equipment.

[Prevention of medical device-related adverse events in hospitals: Specifying the recommendations of the German Coalition for Patient Safety (APS) for users and operators of anaesthesia equipment].

PubMed

Bohnet-Joschko, Sabine; Zippel, Claus; Siebert, Hartmut

2015-01-01

The use and organisation of medical technology has an important role to play for patient and user safety in anaesthesia. Specification of the recommendations of the German Coalition for Patient Safety (APS) for users and operators of anaesthesia equipment, explore opportunities and challenges for the safe use and organisation of anaesthesia devices. We conducted a literature search in Medline/PubMed for studies dealing with the APS recommendations for the prevention of medical device-related risks in the context of anaesthesia. In addition, we performed an internet search for reports and recommendations focusing on the use and organisation of medical devices in anaesthesia. Identified studies were grouped and assigned to the recommendations. The division into users and operators was maintained. Instruction and training in anaesthesia machines is sometimes of minor importance. Failure to perform functional testing seems to be a common cause of critical incidents in anaesthesia. There is a potential for reporting to the federal authority. Starting points for the safe operation of anaesthetic devices can be identified, in particular, at the interface of staff, organisation, and (anaesthesia) technology. The APS recommendations provide valuable information on promoting the safe use of medical devices and organisation in anaesthesia. The focus will be on risks relating to the application as well as on principles and materials for the safe operation of anaesthesia equipment. Copyright © 2015. Published by Elsevier GmbH.

Working session 5: Operational aspects and risk analysis

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

Cizelj, L.; Donoghue, J.

1997-02-01

A general observation is that both operational aspects and risk analysis cannot be adequately discussed without information presented in other sessions. Some overlap of conclusions and recommendations is therefore to be expected. Further, it was assumed that recommendations concerning improvements in some related topics were generated by other sessions and are not repeated here. These include: (1) Knowledge on degradation mechanisms (initiation, progression, and failure). (2) Modeling of degradation (initiation, progression, and failure). (3) Capabilities of NDE methods. (4) Preventive maintenance and repair. One should note here, however, that all of these directly affect both operational and risk aspects ofmore » affected plants. A list of conclusions and recommendations is based on available presentations and discussions addressing risk and operational experience. The authors aimed at reaching as broad a consensus as possible. It should be noted here that there is no strict delineation between operational and safety aspects of degradation of steam generator tubes. This is caused by different risk perceptions in different countries/societies. The conclusions and recommendations were divided into four broad groups: human reliability; leakage monitoring; risk impact; and consequence assessment.« less

Physical and chemical characterization of airborne particles from welding operations in automotive plants.

PubMed

Dasch, Jean; D'Arcy, James

2008-07-01

Airborne particles were characterized from six welding operations in three automotive plants, including resistance spot welding, metal inert gas (MIG) welding and tungsten inert gas (TIG) welding of aluminum and resistance spot welding, MIG welding and weld-through sealer of galvanized steel. Particle levels were measured throughout the process area to select a sampling location, followed by intensive particle sampling over one working shift. Temporal trends were measured, and particles were collected on filters to characterize their size and chemistry. In all cases, the particles fell into a bimodal size distribution with very large particles >20 mum in diameter, possibly emitted as spatter or metal expulsions, and very small particles about 1 mum in diameter, possibly formed from condensation of vaporized metal. The mass median aerodynamic diameter was about 1 mum, with only about 7% of the particle mass present as ultrafine particles <100 nm. About half the mass of aluminum welding particles could be accounted for by chemical analysis, with the remainder possibly present as oxygen. Predominant species were organic carbon, elemental carbon, iron, and aluminum. More than 80% of the particle mass could be accounted for from steel welding, primarily present as iron, organic carbon, zinc, and copper. Particle concentrations and elemental concentrations were compared with allowable concentrations as recommended by the Occupational Safety and Health Administration and the American Conference of Governmental Industrial Hygienists. In all cases, workplace levels were at least 11 times lower than recommended levels.

40 CFR 243.201-2 - Recommended procedures: Operations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... equipment should meet the applicable provisions of the Occupational Safety and Health Administration... 40 Protection of Environment 25 2014-07-01 2014-07-01 false Recommended procedures: Operations. 243.201-2 Section 243.201-2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...

40 CFR 243.202-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 25 2014-07-01 2014-07-01 false Recommended procedures: Operations. 243.202-3 Section 243.202-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... receive periodic vehicle safety checks, including, but not limited to, inspection of brakes, windshield...

40 CFR 240.209-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Occupational Respiratory Disease, National Institute for Occupational Safety and Health, Morgantown, W. Va. (c... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Recommended procedures: Operations. 240.209-3 Section 240.209-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...

40 CFR 243.202-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Recommended procedures: Operations. 243.202-3 Section 243.202-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... receive periodic vehicle safety checks, including, but not limited to, inspection of brakes, windshield...

40 CFR 240.209-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Occupational Respiratory Disease, National Institute for Occupational Safety and Health, Morgantown, W. Va. (c... 40 Protection of Environment 26 2013-07-01 2013-07-01 false Recommended procedures: Operations. 240.209-3 Section 240.209-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...

40 CFR 243.202-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 26 2013-07-01 2013-07-01 false Recommended procedures: Operations. 243.202-3 Section 243.202-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... receive periodic vehicle safety checks, including, but not limited to, inspection of brakes, windshield...

40 CFR 240.209-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Occupational Respiratory Disease, National Institute for Occupational Safety and Health, Morgantown, W. Va. (c... 40 Protection of Environment 25 2014-07-01 2014-07-01 false Recommended procedures: Operations. 240.209-3 Section 240.209-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...

40 CFR 243.203-2 - Recommended procedures: Operations.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) The minimum collection frequency consistent with public health and safety should be adopted to... 40 Protection of Environment 26 2013-07-01 2013-07-01 false Recommended procedures: Operations. 243.203-2 Section 243.203-2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...

40 CFR 243.203-2 - Recommended procedures: Operations.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) The minimum collection frequency consistent with public health and safety should be adopted to... 40 Protection of Environment 25 2014-07-01 2014-07-01 false Recommended procedures: Operations. 243.203-2 Section 243.203-2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...

40 CFR 243.203-2 - Recommended procedures: Operations.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) The minimum collection frequency consistent with public health and safety should be adopted to... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Recommended procedures: Operations. 243.203-2 Section 243.203-2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...

40 CFR 243.202-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Recommended procedures: Operations. 243.202-3 Section 243.202-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... receive periodic vehicle safety checks, including, but not limited to, inspection of brakes, windshield...

Bicycle Lanes Versus Wide Curb Lanes: Operational and Safety Findings and Countermeasure Recommendations

DOT National Transportation Integrated Search

1999-10-01

This report presents operational and safety findings and countermeasure recommendations from a comparative analysis of bicycle lanes (BLs) versus wide curb lanes (WCLs). The primary analysis was based on videotapes of almost 4,600 bicyclists in Santa...

The role of surgical resection in the management of newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline.

PubMed

Kalkanis, Steven N; Kondziolka, Douglas; Gaspar, Laurie E; Burri, Stuart H; Asher, Anthony L; Cobbs, Charles S; Ammirati, Mario; Robinson, Paula D; Andrews, David W; Loeffler, Jay S; McDermott, Michael; Mehta, Minesh P; Mikkelsen, Tom; Olson, Jeffrey J; Paleologos, Nina A; Patchell, Roy A; Ryken, Timothy C; Linskey, Mark E

2010-01-01

Should patients with newly-diagnosed metastatic brain tumors undergo open surgical resection versus whole brain radiation therapy (WBRT) and/or other treatment modalities such as radiosurgery, and in what clinical settings? Target population These recommendations apply to adults with a newly diagnosed single brain metastasis amenable to surgical resection. Recommendations Surgical resection plus WBRT versus surgical resection alone Level 1 Surgical resection followed by WBRT represents a superior treatment modality, in terms of improving tumor control at the original site of the metastasis and in the brain overall, when compared to surgical resection alone. Surgical resection plus WBRT versus SRS +/- WBRT Level 2 Surgical resection plus WBRT, versus stereotactic radiosurgery (SRS) plus WBRT, both represent effective treatment strategies, resulting in relatively equal survival rates. SRS has not been assessed from an evidence-based standpoint for larger lesions (>3 cm) or for those causing significant mass effect (>1 cm midline shift). Level 3 Underpowered class I evidence along with the preponderance of conflicting class II evidence suggests that SRS alone may provide equivalent functional and survival outcomes compared with resection + WBRT for patients with single brain metastases, so long as ready detection of distant site failure and salvage SRS are possible. Note The following question is fully addressed in the WBRT guideline paper within this series by Gaspar et al. Given that the recommendation resulting from the systematic review of the literature on this topic is also highly relevant to the discussion of the role of surgical resection in the management of brain metastases, this recommendation has been included below. Question Does surgical resection in addition to WBRT improve outcomes when compared with WBRT alone? Target population This recommendation applies to adults with a newly diagnosed single brain metastasis amenable to surgical resection; however, the recommendation does not apply to relatively radiosensitive tumors histologies (i.e., small cell lung cancer, leukemia, lymphoma, germ cell tumors and multiple myeloma). Recommendation Surgical resection plus WBRT versus WBRT alone Level 1 Class I evidence supports the use of surgical resection plus post-operative WBRT, as compared to WBRT alone, in patients with good performance status (functionally independent and spending less than 50% of time in bed) and limited extra-cranial disease. There is insufficient evidence to make a recommendation for patients with poor performance scores, advanced systemic disease, or multiple brain metastases.

Remotely Piloted Aircraft Systems Panel (RPASP) Working Paper: Autonomy and Automation

NASA Technical Reports Server (NTRS)

Shively, Jay

2017-01-01

A significant level of debate and confusion has surrounded the meaning of the terms "autonomy" and "automation". Automation is a multi-dimensional concept, and we propose that RPAS automation should be described with reference to the specific system and task that has been automated, the context in which the automation functions, and other relevant dimensions. In this paper, we present a definition of "automation". We recommend that autonomy and autonomous operations are out of the scope of the RPAS panel. WG7 proposes to develop, in consultation with other workgroups, a taxonomy of "Levels of Automation" for RPAS.

40 CFR 243.202-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 26 2012-07-01 2011-07-01 true Recommended procedures: Operations. 243.202-3 Section 243.202-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID... receive periodic vehicle safety checks, including, but not limited to, inspection of brakes, windshield...

40 CFR 243.201-2 - Recommended procedures: Operations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... should meet the applicable provisions of the Occupational Safety and Health Administration Standards for... 40 Protection of Environment 26 2012-07-01 2011-07-01 true Recommended procedures: Operations. 243.201-2 Section 243.201-2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID...

40 CFR 240.209-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Occupational Respiratory Disease, National Institute for Occupational Safety and Health, Morgantown, W. Va. (c... 40 Protection of Environment 26 2012-07-01 2011-07-01 true Recommended procedures: Operations. 240.209-3 Section 240.209-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID...

40 CFR 243.203-2 - Recommended procedures: Operations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... minimum collection frequency consistent with public health and safety should be adopted to minimize... 40 Protection of Environment 26 2012-07-01 2011-07-01 true Recommended procedures: Operations. 243.203-2 Section 243.203-2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID...

49 CFR 192.616 - Public awareness.

Code of Federal Regulations, 2012 CFR

2012-10-01

... follows the guidance provided in the American Petroleum Institute's (API) Recommended Practice (RP) 1162... recommendations of API RP 1162 and assess the unique attributes and characteristics of the operator's pipeline and... supplemental requirements of API RP 1162, unless the operator provides justification in its program or...

49 CFR 192.616 - Public awareness.

Code of Federal Regulations, 2014 CFR

2014-10-01

... follows the guidance provided in the American Petroleum Institute's (API) Recommended Practice (RP) 1162... recommendations of API RP 1162 and assess the unique attributes and characteristics of the operator's pipeline and... supplemental requirements of API RP 1162, unless the operator provides justification in its program or...

49 CFR 192.616 - Public awareness.

Code of Federal Regulations, 2013 CFR

2013-10-01

... follows the guidance provided in the American Petroleum Institute's (API) Recommended Practice (RP) 1162... recommendations of API RP 1162 and assess the unique attributes and characteristics of the operator's pipeline and... supplemental requirements of API RP 1162, unless the operator provides justification in its program or...

Bypass Ratio: The US Air Force and Light-Attack Aviation

DTIC Science & Technology

2013-06-01

for making recommendations which optimize base activity and its impact on the environment. Local and state politics can keep a base open even if it is...for the region, and this conduct can affect global commerce. Such disruption and destabilization in turn can have large impacts on the US diplomatic... IFR ) operations, emergency procedures, low-level flight and two-ship formation flight by this stage. Once track selection occurs, the light-attack

An Air Operations Division Live, Virtual, and Constructive (LVC) Corporate Interoperability Standards Development Strategy

DTIC Science & Technology

2011-07-01

Orlando, Florida, September 2009, 09F- SIW -090. [HLA (2000) - 1] - Modeling and Simulation Standard - High Level Architecture (HLA) – Framework and...Simulation Interoperability Workshop, Orlando, FL, USA, September 2009, 09F- SIW -023. [MaK] - www.mak.com [MIL-STD-3011] - MIL-STD-3011...Spring Simulation Interoperability Workshop, Norfolk, VA, USA, March 2007, 07S- SIW -072. [Ross] - Ross, P. and Clark, P. (2005), “Recommended

Occupational noise exposure during endourologic procedures.

PubMed

Soucy, Frédéric; Ko, Raymond; Denstedt, John D; Razvi, Hassan

2008-08-01

Long-term noise exposure in the workplace is a known cause of hearing loss. There has been limited study on the potential harm related to shock wave lithotripsy (SWL) or intracorporeal devices on patients and operating room personnel. We used a digital sound meter to measure decibel levels in the operating room during several endourologic procedures. The decibel levels were recorded during SWL (Storz SLX-F2), percutaneous nephrolithotomy using single- and dual-probe ultrasonic lithotripters (Olympus LUS-2, CyberWand), and during ureteroscopy using the Versa Pulse Holmium:YAG laser. Findings were compared with the U.S. Department of Labor Occupational Health and Safety Administration and Canadian Centre for Occupational Health recommendations on permissible noise levels in the workplace. The background sound level in the operating room prior to endourologic procedures ranged between 58 and 60 dB. In the SWL control room, 5 m from the source, the mean sound level was 68 dB (range 64-75) during treatment. The mean corresponding decibel level recorded at the patient's head during SWL was 77 dB (range 73-83). Noises produced by intracorporeal lithotripters were recorded at the surgeon's head, 2 m from the source. Measurements of the CyberWand (dual-probe) device revealed a higher mean decibel reading of 93 dB (range 85-102). Noise levels recorded for the Olympus LUS-2 (single-probe) ultrasound and the holmium laser were 65 dB (62 -68) and 60 dB (58-62), respectively. Although we noted that patients and urologists maybe exposed to significant noise levels during endourologic procedures, the duration of exposure is short. This risk appears to be minimal, based on current occupational guidelines, for most operating personnel.

EULAR recommendations for the role of the nurse in the management of chronic inflammatory arthritis.

PubMed

van Eijk-Hustings, Yvonne; van Tubergen, Astrid; Boström, Carina; Braychenko, Elena; Buss, Beate; Felix, José; Firth, Jill; Hammond, Alison; Harston, Benny; Hernandez, Cristina; Huzjak, Masa; Korandová, Jana; Kukkurainen, Marja Leena; Landewé, Robert; Mezieres, Maryse; Milincovic, Marijana; Moretti, Antonella; Oliver, Susan; Primdahl, Jette; Scholte-Voshaar, Marieke; de la Torre-Aboki, Jenny; Waite-Jones, Jennifer; Westhovens, Rene; Zangi, Heidi Andersen; Heiberg, Turid; Hill, Jackie

2012-01-01

The authors aim to develop European League Against Rheumatism recommendations for the role of the nurse in the management of patients with chronic inflammatory arthritis, to identify a research agenda and to determine an educational agenda. A task force made up of a multidisciplinary expert panel including nurses, rheumatologists, occupational therapist, physiotherapist, psychologist, epidemiologist and patient representatives, representing 14 European countries, carried out the development of the recommendations, following the European League Against Rheumatism standardised operating procedures. The task force met twice. In the first meeting, the aims of the task force were defined, and eight research questions were developed. This was followed by a comprehensive, systematic literature search. In the second meeting, the results from the literature review were presented to the task force that subsequently formulated the recommendations, research agenda and educational agenda. In total, 10 recommendations were formulated. Seven recommendations covered the contribution of nurses to care and management: education, satisfaction with care, access to care, disease management, psychosocial support, self-management and efficiency of care. Three recommendations focused on professional support for nurses: availability of guidelines or protocols, access to education and encouragement to undertake extended roles. The strength of the recommendations varied from A to C, dependent on the category of evidence (1A-3), and a high level of agreement was achieved. Additionally, the task force agreed upon 10 topics for future research and an educational agenda. 10 recommendations for the role of the nurse in the management of chronic inflammatory arthritis were developed using a combination of evidence-based and expert consensus approach.

Making Multi-Level Tsunami Evacuation Playbooks Operational in California and Hawaii

NASA Astrophysics Data System (ADS)

Wilson, R. I.; Peterson, D.; Fryer, G. J.; Miller, K.; Nicolini, T.; Popham, C.; Richards, K.; Whitmore, P.; Wood, N. J.

2016-12-01

In the aftermath of the 2010 Chile, 2011 Japan, and 2012 Haida Gwaii tsunamis in California and Hawaii, coastal emergency managers requested that state and federal tsunami programs investigate providing more detailed information about the flood potential and recommended evacuation for distant-source tsunamis well ahead of their arrival time. Evacuation "Playbooks" for tsunamis of variable sizes and source locations have been developed for some communities in the two states, providing secondary options to an all or nothing approach for evacuation. Playbooks have been finalized for nearly 70% of the coastal communities in California, and have been drafted for evaluation by the communities of Honolulu and Hilo in Hawaii. A key component to determining a recommended level of evacuation during a distant-source tsunami and making the Playbooks operational has been the development of the "FASTER" approach, an acronym for factors that influence the tsunami flood hazard for a community: Forecast Amplitude, Storm, Tides, Error in forecast, and the Run-up potential. Within the first couple hours after a tsunami is generated, the FASTER flood elevation value will be computed and used to select the appropriate minimum tsunami phase evacuation "Playbook" for use by the coastal communities. The states of California and Hawaii, the tsunami warning centers, and local weather service offices are working together to deliver recommendations on the appropriate evacuation Playbook plans for communities to use prior to the arrival of a distant-source tsunami. These partners are working closely with individual communities on developing conservative and consistent protocols on the use of the Playbooks. Playbooks help provide a scientifically-based, minimum response for small- to moderate-size tsunamis which could reduce the potential for over-evacuation of hundreds of thousands of people and save hundreds of millions of dollars in evacuation costs for communities and businesses.

Stretching and Joint Mobilization Exercises Reduce Call-Center Operators’ Musculoskeletal Discomfort and Fatigue

PubMed Central

de Castro Lacaze, Denise Helena; Sacco, Isabel de C. N.; Rocha, Lys Esther; de Bragança Pereira, Carlos Alberto; Casarotto, Raquel Aparecida

2010-01-01

AIM: We sought to evaluate musculoskeletal discomfort and mental and physical fatigue in the call-center workers of an airline company before and after a supervised exercise program compared with rest breaks during the work shift. INTRODUCTION: This was a longitudinal pilot study conducted in a flight-booking call-center for an airline in São Paulo, Brazil. Occupational health activities are recommended to decrease the negative effects of the call-center working conditions. In practice, exercise programs are commonly recommended for computer workers, but their effects have not been studied in call-center operators. METHODS: Sixty-four call-center operators participated in this study. Thirty-two subjects were placed into the experimental group and attended a 10-min daily exercise session for 2 months. Conversely, 32 participants were placed into the control group and took a 10-min daily rest break during the same period. Each subject was evaluated once a week by means of the Corlett-Bishop body map with a visual analog discomfort scale and the Chalder fatigue questionnaire. RESULTS: Musculoskeletal discomfort decreased in both groups, but the reduction was only statistically significant for the spine and buttocks (p=0.04) and the sum of the segments (p=0.01) in the experimental group. In addition, the experimental group showed significant differences in the level of mental fatigue, especially in questions related to memory Rienzo, #181ff and tiredness (p=0.001). CONCLUSIONS: Our preliminary results demonstrate that appropriately designed and supervised exercise programs may be more efficient than rest breaks in decreasing discomfort and fatigue levels in call-center operators. PMID:20668622

Shuttle Ground Operations Efficiencies/Technologies (SGOE/T) study. Volume 2: Ground Operations evaluation

NASA Technical Reports Server (NTRS)

Scholz, A. L.; Hart, M. T.; Lowry, D. J.

1987-01-01

The Ground Operations Evaluation describes the breath and depth of the various study elements selected as a result of an operational analysis conducted during the early part of the study. Analysis techniques used for the evaluation are described in detail. Elements selected for further evaluation are identified; the results of the analysis documented; and a follow-on course of action recommended. The background and rationale for developing recommendations for the current Shuttle or for future programs is presented.

Superfund record of decision (EPA Region 7): Cornhusker Army Ammunition Plant, Operable Unit 1, Hall County, Grand Island, NE, September 29, 1994

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

NONE

1995-04-01

The decision document presents the selected interim remedial action for the groundwater operable unit at the Cornhusker Army Ammunition Plant (CAAP). Operable Unit One encompasses the explosives groundwater plume(s), both on-post and off-post. Explosives of concern in the contaminant plume include RDX, TNT, HMX, and their decomposition products. The objective of the interim action is to contain the plume and prevent further migration of contaminants, and does not encompass full restoration of the plume of contaminated groundwater. The recommended alternatives provide an approach to containing and removing contaminant mass from the groundwater plume. This approach will control further migration ofmore » the plume and reduce the levels of the contamination in groundwater.« less

Evaluation of training programs and entry-level qualifications for nuclear-power-plant control-room personnel based on the systems approach to training

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

Haas, P M; Selby, D L; Hanley, M J

1983-09-01

This report summarizes results of research sponsored by the US Nuclear Regulatory Commission (NRC) Office of Nuclear Regulatory Research to initiate the use of the Systems Approach to Training in the evaluation of training programs and entry level qualifications for nuclear power plant (NPP) personnel. Variables (performance shaping factors) of potential importance to personnel selection and training are identified, and research to more rigorously define an operationally useful taxonomy of those variables is recommended. A high-level model of the Systems Approach to Training for use in the nuclear industry, which could serve as a model for NRC evaluation of industrymore » programs, is presented. The model is consistent with current publically stated NRC policy, with the approach being followed by the Institute for Nuclear Power Operations, and with current training technology. Checklists to be used by NRC evaluators to assess training programs for NPP control-room personnel are proposed which are based on this model.« less

[Music therapy and regional anesthesia in orthopedic surgery].

PubMed

Rupérez Ruiz, Ma Pilar; De San José, Isabel; Hermoso Montoya, Anna; Ferreira Valencia, Teresa; Gómez Sanz, Amelia; López Gutiérrez, Anna

2014-06-01

To evaluate the sedative effects, intra-operation, of music therapy in orthopedic surgery patients with locoregional anesthesia in the Hospital Clínic i Provincial of Barcelona. Prospective comparative study on a random sample of 110 patients undergoing or not music therapy. The degree of anxiety was assessed with the Questionnaire STAIC. The application of the music was done with a MP3 player and headphones. The collected data were analyzed with Excel. For the statistical analysis we used the SPSS-18 software and Chi-square test to test the hypothesis of whether there was relationship between the level of peace and music therapy. After the analysis, the results of Chi-square were in the group of no sedation with/without music Chi2 = 2.01, P = 0.35. The statistical significance level was p < 0.05. No relationship was found between hearing music or not and the patient's comfort level. Most patients recommend listening to music in the operating room despite the sounds around do not bother them.

Exposure to hazardous substances in Cathode Ray Tube (CRT) recycling sites in France

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

Lecler, Marie-Thérèse, E-mail: marie-therese.lecler@inrs.fr; Zimmermann, François; Silvente, Eric

Highlights: • Chemical risks were assessed in the nine cathode ray tube screens recycling facilities. • The main hazardous agents are dust containing lead, cadmium, barium and yttrium. • Exposure and pollutant levels are described for different operations and processes. • All the operations and processes are concerned by significant levels of pollutants. • We suggest recommendations to reduce chemical risk. - Abstract: The Waste Electrical and Electronic Equipment (WEEE) or e-waste recycling sector has grown considerably in the last fifteen years due to the ever shorter life cycles of consumables and an increasingly restrictive policy context. Cathode Ray Tubesmore » (CRTs) from used television and computer screens represent one of the main sources of e-waste. CRTs contain toxic materials such as lead, cadmium, barium, and fluorescent powders which can be released if recycling of CRTs is not appropriate. Exposure to these harmful substances was assessed in nine workshops where CRT screens are treated. Particulate exposure levels were measured using a gravimetric method and metals were analysed by plasma emission spectrometry. The maximum levels of worker exposure were 8.8 mg/m{sup 3}, 1504.3 μg/m{sup 3}, 434.9 μg/m{sup 3}, 576.3 μg/m{sup 3} and 2894.3 μg/m{sup 3} respectively for inhalable dust, barium, cadmium, lead and yttrium. The maximum levels of airborne pollutants in static samples were 39.0 mg/m{sup 3}, 848.2 μg/m{sup 3}, 698.4 μg/m{sup 3}, 549.3 μg/m{sup 3} and 3437.9 μg/m{sup 3} for inhalable dust, barium, cadmium, lead and yttrium. The most harmful operations were identified, and preventive measures for reducing the chemical risk associated with screen recycling were proposed. Workplace measurements were used to define recommendations for reducing the chemical risks in CRT screens recycling facilities and for promoting the design and development of “clean and safe” processes in emerging recycling channels.« less

(abstract) Mission Operations and Control Assurance: Flight Operations Quality Improvements

NASA Technical Reports Server (NTRS)

Welz, Linda L.; Bruno, Kristin J.; Kazz, Sheri L.; Witkowski, Mona M.

1993-01-01

Mission Operations and Command Assurance (MO&CA), a recent addition to flight operations teams at JPL. provides a system level function to instill quality in mission operations. MO&CA's primary goal at JPL is to help improve the operational reliability for projects during flight. MO&CA tasks include early detection and correction of process design and procedural deficiencies within projects. Early detection and correction are essential during development of operational procedures and training of operational teams. MO&CA's effort focuses directly on reducing the probability of radiating incorrect commands to a spacecraft. Over the last seven years at JPL, MO&CA has become a valuable asset to JPL flight projects. JPL flight projects have benefited significantly from MO&CA's efforts to contain risk and prevent rather than rework errors. MO&CA's ability to provide direct transfer of knowledge allows new projects to benefit directly from previous and ongoing experience. Since MO&CA, like Total Quality Management (TQM), focuses on continuous improvement of processes and elimination of rework, we recommend that this effort be continued on NASA flight projects.

Lack of Consensus in Physician Recommendations Regarding Return to Driving After Cervical Spine Surgery.

PubMed

Moses, Michael J; Tishelman, Jared C; Hasan, Saqib; Zhou, Peter L; Zevgaras, Ioanna; Smith, Justin S; Buckland, Aaron J; Kim, Yong; Razi, Afshin; Protopsaltis, Themistocles S

2018-03-09

Cross-Sectional Study. The goal of this study is to investigate how surgeons differ in collar and narcotic use, as well as return to driving recommendations following cervical spine surgeries and the associated medico-legal ramifications of these conditions. Restoration of quality of life is one of the main goals of cervical spine surgery. Patients frequently inquire when they may safely resume driving after cervical spine surgery. There is no consensus regarding post-operative driving restrictions. This study addresses how surgeons differ in their recommendations concerning cervical immobilization, narcotic analgesia, and suggested timeline of return to driving following cervical spine surgery. Surgeons at the Cervical Spine Research Society annual meeting completed anonymous surveys assessing postoperative patient management following fusion and non-fusion cervical spine surgeries. 70% of surgeons returned completed surveys (n = 71). 80.3% were orthopaedic surgeons and 94.2% completed a spine fellowship. Experienced surgeons (>15y in practice) were more likely to let patients return to driving within 2 weeks than less experienced surgeons (47.1% vs 24.3%, p = .013) for multi-level ACDF and laminectomy with fusion procedures. There were no differences between surgeons practicing inside and outside the USA for prescribing collars or return to driving time. Cervical collars were used more for fusions than non-fusions (57.7% vs 31.0%, p = .001). Surgeons reported 75.3% of patients ask when they may resume driving. For cervical fusions, 31.4% of surgeons allowed their patients to resume driving while restricting them with collars for longer durations. Furthermore, 27.5% of surgeons allowed their patients to resume driving while taking narcotics post-operatively. This survey-based study highlights the lack of consensus regarding patient 'fitness to drive' following cervical spine surgery. The importance of establishing evidence-based guidelines is critical as recommendations for driving in the post-operative period may have significant medical, legal, and financial implications. 5.

Performance and operational considerations in the design of vehicle antennas for mobile satellite communications

NASA Technical Reports Server (NTRS)

Milne, R.

1995-01-01

This paper examines the vehicle antenna requirements for mobile satellite systems. The antenna parameters are discussed in the light of the requirements and the limitations in performance imposed by the physical constraints of antenna and by vehicle geometries. Measurements of diffraction and antenna noise temperature in an operational environment are examined, as well as their effects on system margins. Mechanical versus electronic designs are compared with regards to performance, cost, reliability, and design complexity. Comparisons between open-loop and close-loop tracking systems are made and the effects of bandwidth, sidelobe levels, operational constraints, vehicle angular velocity, and acceleration are discussed. Some consideration is given to the use of hybrid systems employing both open and closed-loop tracking. Changes to antenna/terminal specifications are recommended which will provide greater design flexibility and increase the likelihood of meeting the performance and operational requirements.

The sound of operation and the acoustic attenuation of the Ohmeda Medical Giraffe OmniBed™.

PubMed

Wubben, Stephanie M; Brueggeman, Paul M; Stevens, Dennis C; Helseth, Carol C; Blaschke, Kristen

2011-01-01

The neonatal intensive care unit (NICU) is an environment that provides premature and fragile infants with health provisions needed to make a complete recovery. Premature infants are often born before their auditory systems have had an opportunity to fully mature. Research has shown that the ambient acoustic environment in the NICU exceeds the maximum noise level recommended by the American Academy of Pediatrics, even after measures have been taken to decrease noise levels. The purpose of this study is to evaluate noise levels inside an Ohmeda Medical Giraffe™ OmniBed™, the natural attenuation of the incubator, and the effects of modifications on attenuation and reverberation within the Giraffe TM OmniBed™. The normal operation of the Giraffe™ OmniBed™ is 41.7 dBA which indicates a lower noise of operation than previous studies. The Giraffe™ OmniBed™ naturally attenuates 12 dBA. Leaving an access latch or portal door open causes a statistically significant (P=.001) increase in sound within the bassinet. All modifications in the no-noise and the noise conditions showed a statistically significant (P=.001) drop in L(eq) when compared to baseline.

COST–RISK–BENEFIT ANALYSIS IN DIAGNOSTIC RADIOLOGY: A THEORETICAL AND ECONOMIC BASIS FOR RADIATION PROTECTION OF THE PATIENT

PubMed Central

Moores, B. Michael

2016-01-01

In 1973, International Commission on Radiological Protection Publication 22 recommended that the acceptability of radiation exposure levels for a given activity should be determined by a process of cost–benefit analysis. It was felt that this approach could be used to underpin both the principle of ALARA as well for justification purposes. The net benefit, B, of an operation involving irradiation was regarded as equal to the difference between its gross benefit, V, and the sum of three components; the basic production cost associated with the operation, P; the cost of achieving the selected level of protection, X; and the cost Y of the detriment involved in the operation: B=V−(P+X+Y). This article presents a theoretical cost–risk–benefit analysis that is applicable to the diagnostic accuracy (Levels 1 and 2) of the hierarchical efficacy model presented by National Council on Radiation Protection and Measurements in 1992. This enables the costs of an examination to be related to the sensitivity and specificity of an X-ray examination within a defined clinical problem setting and introduces both false-positive/false-negative diagnostic outcomes into the patient radiation protection framework. PMID:26705358

77 FR 5415 - National Organic Program: Notice of Draft Guidance for Accredited Certifying Agents, Certified...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-03

... in order to be excluded from the organic certification requirements of Part 205. The NOSB recommended... handling operations that are or are not excluded from organic certification. The draft guidance proposes... excluded from certification and, therefore, must be certified organic operations. \\1\\ NOSB Recommendation...

RECOMMENDED OPERATING PROCEDURE NO. 56: COLLECTION OF GASEOUS GRAB SAMPLES FROM COMBUSTION SOURCES FOR NITROUS OXIDE MEASUREMENT

EPA Science Inventory

The document is a recommended operating procedure, prepare or use in research activities conducted by EPA's Air and Energy Engineering Research Laboratory (AEERL). The procedure applies to the collection of gaseous grab samples from fossil fuel combustion sources for subsequent a...

RECOMMENDED OPERATING PROCEDURE NO. 45: ANALYSIS OF NITROUS OXIDE FROM COMBUSTION SOURCES

EPA Science Inventory

The recommended operating procedure (ROP) has been prepared for use in research activities conducted by EPA's Air and Energy Engineering Research Laboratory (AEERL). he procedure applies to the measurement of nitrous oxide (N2O) in dry gas samples extracted from gas streams where...

RECOMMENDED OPERATING PROCEDURE NO. 2.3: SAMPLING AND ANALYSIS OF TOTAL HYDROCARBONS FROM SOURCES BY CONTINUOUS EMISSION MONITOR

EPA Science Inventory

The report is a recommended operating procedure (ROP) prepared for use in research activities conducted by EPA's Air and Energy Engineering Research Laboratory (AEERL). he described method is applicable to the continuous measurement of total hydrocarbons (THCs), also known as tot...

RECOMMENDED OPERATING PROCEDURE NO. 51: GLASS SOURCE ASSESSMENT SAMPLING SYSTEM (GLASS SASS)

EPA Science Inventory

The report is a recommended operating procedure (ROP), prepared for use in research activities conducted by EPA's Air and Energy Engineering Research Laboratory (AEERL). he method described is applicable to the stack sampling of flue gas from a rotary kiln and to associated equip...

78 FR 58123 - Migratory Bird Hunting; Final Frameworks for Late-Season Migratory Bird Hunting Regulations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-20

... recommended changing Indiana's experimental late Canada goose season status to operational. Service Response: We concur with the Mississippi Flyway Council's recommendation to make Indiana's experimental late Canada goose season in the Terre Haute region operational. In 2007, Indiana initiated an experimental...

Best practices in peri-operative management of patients with skeletal dysplasias.

PubMed

White, Klane K; Bompadre, Viviana; Goldberg, Michael J; Bober, Michael B; Cho, Tae-Joon; Hoover-Fong, Julie E; Irving, Melita; Mackenzie, William G; Kamps, Shawn E; Raggio, Cathleen; Redding, Gregory J; Spencer, Samantha S; Savarirayan, Ravi; Theroux, Mary C

2017-10-01

Patients with skeletal dysplasia frequently require surgery. This patient population has an increased risk for peri-operative complications related to the anatomy of their upper airway, abnormalities of tracheal-bronchial morphology and function; deformity of their chest wall; abnormal mobility of their upper cervical spine; and associated issues with general health and body habitus. Utilizing evidence analysis and expert opinion, this study aims to describe best practices regarding the peri-operative management of patients with skeletal dysplasia. A panel of 13 multidisciplinary international experts participated in a Delphi process that included a thorough literature review; a list of 22 possible care recommendations; two rounds of anonymous voting; and a face to face meeting. Those recommendations with more than 80% agreement were considered as consensual. Consensus was reached to support 19 recommendations for best pre-operative management of patients with skeletal dysplasia. These recommendations include pre-operative pulmonary, polysomnography; cardiac, and neurological evaluations; imaging of the cervical spine; and anesthetic management of patients with a difficult airway for intubation and extubation. The goals of this consensus based best practice guideline are to provide a minimum of standardized care, reduce perioperative complications, and improve clinical outcomes for patients with skeletal dysplasia. © 2017 Wiley Periodicals, Inc.

Improved Quick Disconnect (QD) Interface Through Fail Safe Parts Identification

NASA Technical Reports Server (NTRS)

Blanch-Payne, Evelyn

2001-01-01

An extensive review of existing Quick Disconnects (QDs) mating and demating operations was performed to determine which shuttle part interface identifications and procedures contribute to human factor errors. The research methods used consisted of interviews with engineers and technicians, examination of incident reports, critiques of video and audio tapes of QD operations, and attendance of a Hyper QD operational course. The data strongly suggests that there are inherit human factor errors involved in QD operations. To promote fail-safe operations, QD interface problem areas and recommendations were outlined and reviewed. It is suggested that dialogue, investigations and recommendations continue.

Model Recommended Values of Corporate Culture for Industrial Companies in Slovak Republic

NASA Astrophysics Data System (ADS)

Urbanovičová, Petra; Mikulášková, Justína; Čambál, Miloš

2017-09-01

The main objective of the paper is to describe the recommended values model of corporate culture and supporting business performance for industrial companies operating in the Slovak Republic. This model was developed on the basis of research results within the STU Project to support young researchers entitled "Changing the potential of the companýs success using the principles of spiral management and its impact on corporate culture". The current paper is a part of submitted VEGA project No.1/0348/17 "The impact of the coexistence of different generations of employees on the sustainable performance of organisations". This model will be the basis for defining corporate values and developing or changing corporate culture for the companies operating on or coming (from abroad) to the Slovak market. The characteristic features of the value model are simplicity, complexity and applicability. This model takes into account the current situation on the Slovak market. The values of this model have a different level of significance given and each value is defined by the specified principles.

Level I academic trauma center integration as a model for sustaining combat surgical skills: The right surgeon in the right place for the right time.

PubMed

Hight, Rachel A; Salcedo, Edgardo S; Martin, Sean P; Cocanour, Christine S; Utter, Garth; Galante, Joseph M

2015-06-01

As North Atlantic Treaty Organization (NATO) countries begin troop withdrawal from Afghanistan, military medicine needs programs for combat surgeons to retain the required knowledge and surgical skills. Each military branch runs programs at various Level I academic trauma centers to deliver predeployment training and provide a robust trauma experience for deploying surgeons. Outside of these successful programs, there is no system-wide mechanism for nondeploying military surgeons to care for a high volume of critically ill trauma patients on a regular basis in an educational environment that promotes continued professional development. We hypothesize that fully integrated military-civilian relationship regional Level I trauma centers provide a surgical experience more closely mirroring that seen in a Role III hospital than local Level II and Level III trauma center or medical treatment facilities. We characterized the Level I trauma center practice using the number of trauma resuscitations, operative trauma/acute care surgery procedures, number of work shifts, operative density (defined as the ratio of operative procedures/days worked), and frequency of educational conferences. The same parameters were collected from two NATO Role III hospitals in Afghanistan during the peak of Operation Enduring Freedom. Data for two civilian Level II trauma centers, two civilian Level III trauma centers, and a Continental United States Military Treatment Facility without trauma designation were collected. The number of trauma resuscitations, number of 24-hour shifts, operative density, and educational conferences are shown in the table for the Level I trauma center compared with the different institutions. Civilian center trauma resuscitations and operative density were highest at the Level I trauma center and were only slightly lower than what was seen in Afghanistan. Level II and III trauma centers had lower numbers for both. The Level I trauma center provided the most frequent educational opportunities. In a Level I academic trauma center integrated program, military and civilian surgeons have the same clinical and educational responsibilities: rounding and operating, managing critical care patients, covering trauma/acute care surgery call, and mentoring surgery residents in an integrated residency program. The Level I trauma center experience most closely mimics the combat surgeon experience seen at NATO Role III hospitals in Afghanistan compared with other civilian trauma centers. At high-volume Level I trauma centers, military surgeons will have a comprehensive trauma practice, including dedicated educational opportunities. We recommend integrated programs with Level I academic trauma centers as the primary mechanism for sustaining military combat surgical skills in the future.

Research Priorities in Spasmodic Dysphonia

PubMed Central

Ludlow, Christy L.; Adler, Charles H.; Berke, Gerald S.; Bielamowicz, Steven A.; Blitzer, Andrew; Bressman, Susan B.; Hallett, Mark; Jinnah, H. A.; Juergens, Uwe; Martin, Sandra B.; Perlmutter, Joel S.; Sapienza, Christine; Singleton, Andrew; Tanner, Caroline M.; Woodson, Gayle E.

2009-01-01

OBJECTIVE To identify research priorities for increasing understanding of the pathogenesis, diagnosis and improved treatment of spasmodic dysphonia. STUDY DESIGN AND SETTING A multidisciplinary working group was formed including both scientists and clinicians from multiple disciplines, otolaryngology, neurology, speech pathology, genetics and neuroscience, to review currently available information on spasmodic dysphonia and to identify research priorities. RESULTS Operational definitions for spasmodic dysphonia at different levels of certainty were recommended for diagnosis and recommendations made for a multi-center multidisciplinary validation study. CONCLUSIONS The highest priority is to characterize the disorder and identify risk factors that may contribute to its onset. Future research should compare and contrast spasmodic dysphonia with other forms of focal dystonia. Development of animal models is recommended to explore hypotheses related to pathogenesis. Improved understanding of the pathophysiology of SD should provide the basis for developing new treatment options and exploratory clinical trials. SIGNIFICANCE This document should foster future research to improve the care of patients with this chronic debilitating voice and speech disorder by otolaryngology, neurology, and speech pathology. PMID:18922334

Accounting for charity care on a systemwide basis.

PubMed

Peck, T

1988-06-01

The Daughters of Charity National Health System (DCNHS), St. Louis, has developed a systemwide model which formally sets a policy statement, goals, and procedures that enable the 42 DCNHS health-care ministries to effectively serve the poor in their communities on a daily basis, while addressing the long-term challenges of providing charity care for the sick poor. One of the first steps was forming a task force known as the Working Group on Care of the Poor. Its goal was to set the stage for the expansion and accountability of charity care at every level within the new national system. The group outlined these objectives: To identify and recommend several advocacy models. To recommend test models of healthcare delivery for the poor. To recommend strategies for involving the private sector. To develop a method of documenting charity care. To recommend linkage models to jointly provide charity care with related organizations. To gain a firm knowledge of charity care actually provided by the Daughters of Charity After hours of discussions and research, the task force developed a cohesive, workable set of goals and policies that today is helping individual health-care ministries nationwide meet local needs for care of the sick poor. By identifying specific programs and determining how to report charity care in terms of money and services, individual health-care institutions gain insights into their annual operational planning and reporting for the present and the future. This approach ensures that charity care remains in the forefront at every level of planning.

Gaining the Edge: Connecting with the Millennials

DTIC Science & Technology

2008-12-01

AIR WAR COLLEGE AIR UNIVERSITY GAINING THE EDGE: CONNECTING WITH THE MILLENNIALS by Kay A. Smith, Lt Col, USAF A Research Report Submitted to...Operational & Tactical Leaders in AFRS—Generation X………………………...14 Target Market for AFRS— Millennial Generation………………….…..…………17 Recommendations...conceptually broader level and examines the benefits of using generational cultural training to target the values and interests of the Millennial

Level I Energy and Water Survey, ERDC-CERL, Champaign, IL

DTIC Science & Technology

2015-05-12

heating will allow for better capacity distribution, optimized boiler fire rates, and the flexibility of moving to possibly more efficient methods in the...by 108 hrs/week. The heat transfer coefficient of the areas served by the FCUs was calculat- ed to estimate the energy savings by operating the HVAC...configuration is not op- timal and should be retrofitted. F&S recommended removing one of the 1968 Cleaver Brooks fire -tube boilers and replacing it with two

An investigation of pre-launch and in-flight STS range safety radio signal degradation and dropout

NASA Technical Reports Server (NTRS)

Mcdonald, Malcolm W.

1991-01-01

The range safety system (RSS) transmitters operate at a frequency of 416.500 MHz. The transmitting antennas transmit left circularly polarized waves, and the shuttle range safety system (SRSS) receiving antennas onboard the shuttle vehicle receive left circular polarization. Preliminary explanations are proposed for many of the observed fluctuations in signal levels. It is recommended that experiments and further investigation be performed to test the validity of certain of these explanations.

History of the Joint Chiefs of Staff. The Joint Chiefs of Staff and National Policy 1955-1956. Volume VI.

DTIC Science & Technology

1992-01-01

allocation of responsibility among the military services for de- veloping and operating the new weapons systems. This turned out to be a con- tentious...the choices made regarding the allocation of resources and the deployments and strategies to be pursued. The Joint Chiefs of Staff developed their...decisions or preparing recommendations on such specific matters as force levels and budget allocations , clearly took his principal guidance from the

Superphenix: Restarting, with emphasis on research

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

NONE

1994-04-01

French Prime Minister Edouard Baladour announced on February 22 that the Superphenix fast reactor at Creys-Malville will be allowed to restart. Along with his industry minister, Gerard Longuet, and the environment minister, Michel Bamier, Baladour has accepted the recommendation for reissuance of an operating license submitted to the ministers in January by the nuclear installations safety directorate (DSIN). In announcing their approval for restart, the ministers emphasized that the reactor was to be used as a research and demonstration facility rather than a power station. In particular, they said it should be used to investigate the possibility of using fastmore » reactors as plutonium burners rather than breeders and for the incineration of other long-lived actinide wastes. This point was made also by DSIN Director Andre-Claude Lacoste in his recommendations, but appears to have been given more weight by the government ministers. The ministers also accepted the DSIN recommendation that restart be conditional on completion of improvements to fire protection systems for the secondary sodium coolant ducts. Baladour said that it would take several months to complete this work, but other sources have suggested that the reactor could be ready to operate this month. DSIN has also stipulated that the power level be limited for several months to around 50 percent of the plant`s 1200-MWe potential in order to check out all the systems carefully.« less

Reassessment of psychological distress and post-traumatic stress disorder in United States Air Force Distributed Common Ground System operators.

PubMed

Prince, Lillian; Chappelle, Wayne L; McDonald, Kent D; Goodman, Tanya; Cowper, Sara; Thompson, William

2015-03-01

The goal of this study was to assess for the main sources of occupational stress, as well as self-reported symptoms of distress and post-traumatic stress disorder among U.S. Air Force (USAF) Distributed Common Ground System (DCGS) intelligence exploitation and support personnel. DCGS intelligence operators (n=1091) and nonintelligence personnel (n = 447) assigned to a USAF Intelligence, Surveillance, and Reconnaissance Wing responded to the web-based survey. The overall survey response rate was 31%. Study results revealed the most problematic stressors among DCGS intelligence personnel included high workload, low manning, as well as organizational leadership and shift work issues. Results also revealed 14.35% of DCGS intelligence operators' self-reported high levels of psychological distress (twice the rate of DCGS nonintelligence support personnel). Furthermore, 2.0% to 2.5% self-reported high levels of post-traumatic stress disorder symptoms, with no significant difference between groups. The implications of these findings are discussed along with recommendations for USAF medical and mental health providers, as well as operational leadership. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Pre-operative skin preparation practices: results of the 2007 French national assessment.

PubMed

Borgey, F; Thibon, P; Ertzscheid, M-A; Bernet, C; Gautier, C; Mourens, C; Bettinger, A; Aggoune, M; Galy, E; Lejeune, B; Kadi, Z

2012-05-01

Pre-operative skin preparation, aimed at reducing the endogenous microbial flora, is one of the main preventive measures employed to decrease the likelihood of surgical site infection. National recommendations on pre-operative management of infection risks were issued in France in 2004. To assess compliance with the French national guidelines for pre-operative skin preparation in 2007. A prospective audit was undertaken in French hospitals through interviews with patients and staff, and observation of professional practice. Compliance with five major criteria selected from the guidelines was studied: patient information, pre-operative showering, pre-operative hair removal, surgical site disinfection and documentation of these procedures. Data for 41,188 patients from all specialties at 609 facilities were analysed. Patients were issued with information about pre-operative showering in 88.2% of cases [95% confidence interval (CI) 87.9-88.5]. The recommended procedure for pre-operative showering, including hairwashing, with an antiseptic skin wash solution was followed by 70.3% of patients (95% CI 69.9-70.8); this percentage was higher when patients had received appropriate information (P < 0.001). Compliance with hair removal procedures was observed in 91.5% of cases (95% CI 91.2-91.8), and compliance with surgical site disinfection recommendations was observed in 25,529 cases (62.0%, 95% CI 61.5-62.5). The following documentary evidence was found: information given to patient, 35.6% of cases; pre-operative surgical hygiene, 82.3% of cases; and pre-operative site disinfection, 71.7% of cases. The essential content of the French guidelines seems to be understood, but reminders need to be issued. Some recommendations may need to be adapted for certain specialties. Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

An Evidenced-Based Approach for Estimating Decompression Sickness Risk in Aircraft Operations

NASA Technical Reports Server (NTRS)

Robinson, Ronald R.; Dervay, Joseph P.; Conkin, Johnny

1999-01-01

Estimating the risk of decompression Sickness (DCS) in aircraft operations remains a challenge, making the reduction of this risk through the development of operationally acceptable denitrogenation schedules difficult. In addition, the medical recommendations which are promulgated are often not supported by rigorous evaluation of the available data, but are instead arrived at by negotiation with the aircraft operations community, are adapted from other similar aircraft operations, or are based upon the opinion of the local medical community. We present a systematic approach for defining DCS risk in aircraft operations by analyzing the data available for a specific aircraft, flight profile, and aviator population. Once the risk of DCS in a particular aircraft operation is known, appropriate steps can be taken to reduce this risk to a level acceptable to the applicable aviation community. Using this technique will allow any aviation medical community to arrive at the best estimate of DCS risk for its specific mission and aviator population and will allow systematic reevaluation of the decisions regarding DCS risk reduction when additional data are available.

Air Force Air Refueling for Naval Operations: History, Practice, and Recommendations

DTIC Science & Technology

1990-08-01

Air Force Air Refueling 0 ELECTE C4 N 910U for BU Naval Operations History, Practice, and Recommendations UtMON STA~IMENT X [ Apov.e ,opu,. Lt Col...as three hose reels provide redundancy over just one. 13. Be used in coordination with carriler -launched buddy tankers, there- by providing the

Recommended Practices for the Safe Design and Operation of Flywheels

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

Bender, Donald Arthur

2015-12-01

Flywheel energy storage systems are in use globally in increasing numbers . No codes pertaining specifically to flywheel energy storage exist. A number of industrial incidents have occurred. This protocol recommends a technical basis for safe flywheel de sign and operation for consideration by flywheel developers, users of flywheel systems and standards setting organizations.

Recommendations For The Safe Design, Operation And Use Of Commercial Sun Tanning Equipment

NASA Astrophysics Data System (ADS)

Cox, E. A.

1982-02-01

HSE Guidance Notes are being prepared to give recommendations to the designers, manufacturers, operators and users of commercial sun tanning equipment on the various health and safety aspects associated with the safe construction, siting and use of such equipment. Medically prescribed ultraviolet treatments are excluded from the guidance.

Radiation Safety Issues in High Altitude Commercial Aircraft

NASA Technical Reports Server (NTRS)

Wilson, John W.; Cucinotta, Francis A.; Shinn, Judy L.

1995-01-01

The development of a global economy makes the outlook for high speed commercial intercontinental flight feasible, and the development of various configurations operating from 20 to 30 km have been proposed. In addition to the still unresolved issues relating to current commercial operations (12-16 km), the higher dose rates associated with the higher operating altitudes makes il imperative that the uncertainties in the atmospheric radiation environment and the associated health risks be re-examined. Atmospheric radiation associated with the galactic cosmic rays forms a background level which may, under some circumstances, exceed newly recommended allowable exposure limits proposed on the basis of recent evaluations of the A -bomb survivor data (due to increased risk coefficients). These larger risk coefficients, within the context of the methodology for estimating exposure limits, are resulting in exceedingly low estimated allowable exposure limits which may impact even present day flight operations and was the reason for the CEC workshop in Luxembourg (1990). At higher operating altitudes, solar particles events can produce exposures many orders of magnitude above background levels and pose significant health risks to the most sensitive individuals (such as during pregnancy). In this case the appropriate quality factors are undefined, and some evidence exists which indicates that the quality factor for stochastic effects is a substantial underestimate.

Using full-mission simulation for human factors research in air transport operations

NASA Technical Reports Server (NTRS)

Orlady, Harry W.; Hennessy, Robert W.; Obermayer, Richard; Vreuls, Donald; Murphy, Miles R.

1988-01-01

This study examined state-of-the-art mission oriented simulation and its use in human factors research. Guidelines were developed for doing full-mission human factors research on crew member behavior during simulated air transport operations. The existing literature was reviewed. However, interviews with experienced investigators provided the most useful information. The fundamental scientific and practical issues of behavioral research in a simulation environment are discussed. Guidelines are presented for planning, scenario development, and the execution of behavioral research using full-mission simulation in the context of air transport flight operations . Research is recommended to enhance the validity and productivity of full-mission research by: (1) validating the need for high-fidelity simulation of all major elements in the operational environment, (2) improving methods for conducting full-mission research, and (3) examining part-task research on specific problems through the use of vehicles which contain higher levels of abstraction (and lower fidelity) of the operational environment.

Criticality Safety Evaluation for Small Sample Preparation and Non-Destructive Assay (NDA) Operations in Wing 7 Basement of the CMR Facility

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

Kunkle, Paige Elizabeth; Zhang, Ning

Nuclear Criticality Safety (NCS) has reviewed the fissionable material small sample preparation and NDA operations in Wing 7 Basement of the CMR Facility. This is a Level-1 evaluation conducted in accordance with NCS-AP-004 [Reference 1], formerly NCS-GUIDE-01, and the guidance set forth on use of the Standard Criticality Safety Requirements (SCSRs) [Reference 2]. As stated in Reference 2, the criticality safety evaluation consists of both the SCSR CSED and the SCSR Application CSED. The SCSR CSED is a Level-3 CSED [Reference 3]. This Level-1 CSED is the SCSR Application CSED. This SCSR Application (Level-1) evaluation does not derive controls, itmore » simply applies controls derived from the SCSR CSED (Level-3) for the application of operations conducted here. The controls derived in the SCSR CSED (Level-3) were evaluated via the process described in Section 6.6.5 of SD-130 (also reproduced in Section 4.3.5 of NCS-AP-004 [Reference 1]) and were determined to not meet the requirements for consideration of elevation into the safety basis documentation for CMR. According to the guidance set forth on use of the SCSRs [Reference 2], the SCSR CSED (Level-3) is also applicable to the CMR Facility because the process and the normal and credible abnormal conditions in question are bounded by those that are described in the SCSR CSED. The controls derived in the SCSR CSED include allowances for solid materials and solution operations. Based on the operations conducted at this location, there are less-than-accountable (LTA) amounts of 233U. Based on the evaluation documented herein, the normal and credible abnormal conditions that might arise during the execution of this process will remain subcritical with the following recommended controls.« less

2016 update of the EULAR recommendations for the management of early arthritis.

PubMed

Combe, Bernard; Landewe, Robert; Daien, Claire I; Hua, Charlotte; Aletaha, Daniel; Álvaro-Gracia, Jose María; Bakkers, Margôt; Brodin, Nina; Burmester, Gerd R; Codreanu, Catalin; Conway, Richard; Dougados, Maxime; Emery, Paul; Ferraccioli, Gianfranco; Fonseca, Joao; Raza, Karim; Silva-Fernández, Lucía; Smolen, Josef S; Skingle, Diana; Szekanecz, Zoltan; Kvien, Tore K; van der Helm-van Mil, Annette; van Vollenhoven, Ronald

2017-06-01

Since the 2007 recommendations for the management of early arthritis have been presented, considerable research has been published in the field of early arthritis, mandating an update of the 2007 European League Against Rheumatism (EULAR) recommendations for management of early arthritis. In accordance with the 2014 EULAR Standardised Operating Procedures, the expert committee pursued an approach that was based on evidence in the literature and on expert opinion. The committee involved 20 rheumatologists, 2 patients and 1 healthcare professional representing 12 European countries. The group defined the focus of the expert committee and target population, formulated a definition of 'management' and selected the research questions. A systematic literature research (SLR) was performed by two fellows with the help of a skilled librarian. A set of draft recommendations was proposed on the basis of the research questions and the results of the SLR. For each recommendation, the categories of evidence were identified, the strength of recommendations was derived and the level of agreement was determined through a voting process. The updated recommendations comprise 3 overarching principles and 12 recommendations for managing early arthritis. The selected statements involve the recognition of arthritis, referral, diagnosis, prognostication, treatment (information, education, pharmacological and non-pharmacological interventions), monitoring and strategy. Eighteen items were identified as relevant for future research. These recommendations provide rheumatologists, general practitioners, healthcare professionals, patients and other stakeholders with an updated EULAR consensus on the entire management of early arthritis. 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/.

Applications of massively parallel computers in telemetry processing

NASA Technical Reports Server (NTRS)

El-Ghazawi, Tarek A.; Pritchard, Jim; Knoble, Gordon

1994-01-01

Telemetry processing refers to the reconstruction of full resolution raw instrumentation data with artifacts, of space and ground recording and transmission, removed. Being the first processing phase of satellite data, this process is also referred to as level-zero processing. This study is aimed at investigating the use of massively parallel computing technology in providing level-zero processing to spaceflights that adhere to the recommendations of the Consultative Committee on Space Data Systems (CCSDS). The workload characteristics, of level-zero processing, are used to identify processing requirements in high-performance computing systems. An example of level-zero functions on a SIMD MPP, such as the MasPar, is discussed. The requirements in this paper are based in part on the Earth Observing System (EOS) Data and Operation System (EDOS).

Standard operating procedures for vascular surgery in erectile dysfunction: revascularization and venous procedures.

PubMed

Sohn, Michael; Hatzinger, Martin; Goldstein, Irwin; Krishnamurti, Sudhakar

2013-01-01

The impact of penile blood supply on erectile function was recognized some 500 years ago. At the turn of the 20th century first results of penile venous ligation were published and in 1973 the first surgical attempts to restore penile arterial inflow were undertaken. Numerous techniques were published in the meantime, but inclusion criteria, patient selection, and success evaluation differed extremely between study groups. To develop evidence-based standard operating procedures (SOPs) for vascular surgery in erectile dysfunction, based on recent state of the art consensus reports and recently published articles in peer-reviewed journals. Based on the recent publication of the consensus process during the 2009 International Consultation on Sexual Medicine in Paris, recommendations are derived for diagnosis and surgical treatment of vascular erectile dysfunction. In addition several recent publications in this field not mentioned in the consensus statements are included in the discussion. The Oxford system of evidence-based review was systematically applied. Due to the generally low level of evidence in this field expert opinions were accepted, if published after a well-defined consensus process in peer-reviewed journals. Referring to penile revascularization it may be concluded, that in the face of missing randomized trials, only recommendations grade D may be given: this kind of surgery may be offered to men less than 55 years, who are nonsmokers, nondiabetic, and demonstrate isolated arterial stenoses in the absence of generalized vascular disease. The evidence level for recommendations concerning penile venous ligations may be even lower. Too many unsolved controversies exist and universal diagnostic criteria for patient selection as well as operative technique selection have not been unequivocally established. This kind of surgery is still considered investigational but may be offered in special situations on an individualized basis in an investigational or research setting after obtaining written consent, using both pre- and postoperatively validated measuring instruments of success evaluation. SOPs for penile revascularization procedures can be developed, concerning a highly selected patient group with isolated arterial stenoses. Based on the available data it is not yet possible to define SOPs for surgical treatment of corporal veno-occlusive dysfunction. © 2012 International Society for Sexual Medicine.

Summary of recommendations for the management of infantile seizures: Task Force Report for the ILAE Commission of Pediatrics.

PubMed

Wilmshurst, Jo M; Gaillard, William D; Vinayan, Kollencheri Puthenveettil; Tsuchida, Tammy N; Plouin, Perrine; Van Bogaert, Patrick; Carrizosa, Jaime; Elia, Maurizio; Craiu, Dana; Jovic, Nebojsa J; Nordli, Doug; Hirtz, Deborah; Wong, Virginia; Glauser, Tracy; Mizrahi, Eli M; Cross, J Helen

2015-08-01

Evidence-based guidelines, or recommendations, for the management of infants with seizures are lacking. A Task Force of the Commission of Pediatrics developed a consensus document addressing diagnostic markers, management interventions, and outcome measures for infants with seizures. Levels of evidence to support recommendations and statements were assessed using the American Academy of Neurology Guidelines and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The report contains recommendations for different levels of care, noting which would be regarded as standard care, compared to optimal care, or "state of the art" interventions. The incidence of epilepsy in the infantile period is the highest of all age groups (strong evidence), with epileptic spasms the largest single subgroup and, in the first 2 years of life, febrile seizures are the most commonly occurring seizures. Acute intervention at the time of a febrile seizure does not alter the risk for subsequent epilepsy (class 1 evidence). The use of antipyretic agents does not alter the recurrence rate (class 1 evidence), and there is no evidence to support initiation of regular antiepileptic drugs for simple febrile seizures (class 1 evidence). Infants with abnormal movements whose routine electroencephalography (EEG) study is not diagnostic, would benefit from video-EEG analysis, or home video to capture events (expert opinion, level U recommendation). Neuroimaging is recommended at all levels of care for infants presenting with epilepsy, with magnetic resonance imaging (MRI) recommended as the standard investigation at tertiary level (level A recommendation). Genetic screening should not be undertaken at primary or secondary level care (expert opinion). Standard care should permit genetic counseling by trained personal at all levels of care (expert opinion). Genetic evaluation for Dravet syndrome, and other infantile-onset epileptic encephalopathies, should be available in tertiary care (weak evidence, level C recommendation). Patients should be referred from primary or secondary to tertiary level care after failure of one antiepileptic drug (standard care) and optimal care equates to referral of all infants after presentation with a seizure (expert opinion, level U evidence). Infants with recurrent seizures warrant urgent assessment for initiation of antiepileptic drugs (expert opinion, level U recommendation). Infantile encephalopathies should have rapid introduction and increment of antiepileptic drug dosage (expert opinion, level U recommendation). There is no high level evidence to support any particular current agents for use in infants with seizures. For focal seizures, levetiracetam is effective (strong evidence); for generalized seizures, weak evidence supports levetiracetam, valproate, lamotrigine, topiramate, and clobazam; for Dravet syndrome, strong evidence supports that stiripentol is effective (in combination with valproate and clobazam), whereas weak evidence supports that topiramate, zonisamide, valproate, bromide, and the ketogenic diet are possibly effective; and for Ohtahara syndrome, there is weak evidence that most antiepileptic drugs are poorly effective. For epileptic spasms, clinical suspicion remains central to the diagnosis and is supported by EEG, which ideally is prolonged (level C recommendation). Adrenocorticotropic hormone (ACTH) is preferred for short-term control of epileptic spasms (level B recommendation), oral steroids are probably effective in short-term control of spasms (level C recommendation), and a shorter interval from the onset of spasms to treatment initiation may improve long-term neurodevelopmental outcome (level C recommendation). The ketogenic diet is the treatment of choice for epilepsy related to glucose transporter 1 deficiency syndrome and pyruvate dehydrogenase deficiency (expert opinion, level U recommendation). The identification of patients as potential candidates for epilepsy surgery should be part of standard practice at primary and secondary level care. Tertiary care facilities with experience in epilepsy surgery should undertake the screening for epilepsy surgical candidates (level U recommendation). There is insufficient evidence to conclude if there is benefit from vagus nerve stimulation (level U recommendation). The key recommendations are summarized into an executive summary. The full report is available as Supporting Information. This report provides a comprehensive foundation of an approach to infants with seizures, while identifying where there are inadequate data to support recommended practice, and where further data collection is needed to address these deficits. Wiley Periodicals, Inc. © 2015 International League Against Epilepsy.

[Hybrid operating rooms: only for advanced endovascular procedures?].

PubMed

Verhoeven, E; Katsargyris, A; Töpel, I; Steinbauer, M

2013-10-01

The evolution of endovascular techniques has led to the concept of the "hybrid operating room" (hybrid OR). A hybrid OR combines the sterility of an OR in an operating theatre environment with a high-quality fixed imaging system. On the basis of these advantages it would be desirable that an angio-hybrid OR becomes a standard requirement for endovascular surgery. In Great Britain guidelines have already been published that require a hybrid OR even for normal endovascular management of the infrarenal aorta. However, in Germany there are no guidelines from professional societies or formal rules from the federal joint committee, thus in this article a classification of endovascular procedures according to their complexity and the necessary infrastructures are proposed in order to define particular procedures that should only be performed in an angio-hybrid OR. According to our experience, endovascular procedures can be classified into four categories based on their complexity and the requirements regarding fluoroscopy: level 1: standard EVAR, TEVAR, iliac and popliteal artery procedures; level 2: iliac branched (IBD) and standard (2 fenestrations for the renal arteries and a scallop for the superior mesenteric artery) fenestrated stent-grafting; level 3: more complex fenestrated procedures (three or four fenestrations); and level 4: branched stent-grafting for TAAA. At this moment it is still acceptable to perform level 1 and level 2 procedures outside of a hybrid OR. In our opinion, it is not recommended to perform level 3 and level 4 endovascular procedures without a hybrid OR. Georg Thieme Verlag KG Stuttgart · New York.

Symptoms of psychological distress and post-traumatic stress disorder in United States Air Force "drone" operators.

PubMed

Chappelle, Wayne L; McDonald, Kent D; Prince, Lillian; Goodman, Tanya; Ray-Sannerud, Bobbie N; Thompson, William

2014-08-01

The goal of this study is to repeat a survey administered in 2010 to assess for changes in mental health among United States Air Force aircrew operating Predator/Reaper remotely piloted aircraft, also commonly referred to as "drones." Participants were assessed for self-reported sources of occupational stress, levels of clinical distress using the Outcome Questionnaire-45.2, and symptoms of post-traumatic stress disorder (PTSD) using the PTSD Checklist-Military Version. A total of 1,094 aircrew responded to the web-based survey composed of the commercially available standardized instruments mentioned above. The survey also contained nonstandardized items asking participants to report the main sources of their occupational stress, as well as questions addressing demographics and work-related characteristics. The estimated response rate to the survey was 49%. Study results reveal the most problematic self-reported stressors are operational: low manning, extra duties/administrative tasks, rotating shift work, and long hours. The results also reveal 10.72% of operators self-reported experiencing high levels of distress and 1.57% reported high levels of PTSD symptomology. The results are lower than findings from the 2010 survey and from soldiers returning from Iraq and Afghanistan. Implications of the study and recommendations for United States Air Force line leadership and mental health providers are discussed. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Discomfort analysis in computerized numeric control machine operations.

PubMed

Muthukumar, Krishnamoorthy; Sankaranarayanasamy, Krishnasamy; Ganguli, Anindya Kumar

2012-06-01

The introduction of computerized numeric control (CNC) technology in manufacturing industries has revolutionized the production process, but there are some health and safety problems associated with these machines. The present study aimed to investigate the extent of postural discomfort in CNC machine operators, and the relationship of this discomfort to the display and control panel height, with a view to validate the anthropometric recommendation for the location of the display and control panel in CNC machines. The postural discomforts associated with CNC machines were studied in 122 male operators using Corlett and Bishop's body part discomfort mapping, subject information, and discomfort level at various time intervals from starting to end of a shift. This information was collected using a questionnaire. Statistical analysis was carried out using ANOVA. Neck discomfort due to the positioning of the machine displays, and shoulder and arm discomfort due to the positioning of controls were identified as common health issues in the operators of these machines. The study revealed that 45.9% of machine operators reported discomfort in the lower back, 41.8% in the neck, 22.1% in the upper-back, 53.3% in the shoulder and arm, and 21.3% of the operators reported discomfort in the leg. Discomfort increased with the progress of the day and was highest at the end of a shift; subject age had no effect on patient tendency to experience discomfort levels.

Discomfort Analysis in Computerized Numeric Control Machine Operations

PubMed Central

Sankaranarayanasamy, Krishnasamy; Ganguli, Anindya Kumar

2012-01-01

Objectives The introduction of computerized numeric control (CNC) technology in manufacturing industries has revolutionized the production process, but there are some health and safety problems associated with these machines. The present study aimed to investigate the extent of postural discomfort in CNC machine operators, and the relationship of this discomfort to the display and control panel height, with a view to validate the anthropometric recommendation for the location of the display and control panel in CNC machines. Methods The postural discomforts associated with CNC machines were studied in 122 male operators using Corlett and Bishop's body part discomfort mapping, subject information, and discomfort level at various time intervals from starting to end of a shift. This information was collected using a questionnaire. Statistical analysis was carried out using ANOVA. Results Neck discomfort due to the positioning of the machine displays, and shoulder and arm discomfort due to the positioning of controls were identified as common health issues in the operators of these machines. The study revealed that 45.9% of machine operators reported discomfort in the lower back, 41.8% in the neck, 22.1% in the upper-back, 53.3% in the shoulder and arm, and 21.3% of the operators reported discomfort in the leg. Conclusion Discomfort increased with the progress of the day and was highest at the end of a shift; subject age had no effect on patient tendency to experience discomfort levels. PMID:22993720

[Quantitative analysis of blood loss in liposuction].

PubMed

Schor, N; Zatz, R M; Mendonça, A R; Takatu, P M; Patto, G S

1989-01-01

This study was performed in 15 female patients submitted to suction lipectomy as an isolated procedure, to establish blood loss in the procedure. A wide variation of blood-to-fat ratios was observed (17 to 59%) with a mean blood loss in lipoaspirates of 34 +/- 3%. Internal blood losses occurring in the first 72 post-operative hours were as important as or more important than external losses, and responsible for a mean 7% fall in the level of hemoglobin. Internal blood losses occurred between 72 hours and the 7th to the 10th post-operative days and were responsible for a mean 3% fall in the level of hemoglobin. Blood losses occurring in this study were demonstrated to be greater than usually assumed. Some prophylactic measures are recommended to provide for a safer treatment of these patients: an iron supplementation during the pre-operative period; careful clinical and laboratorial screening for bleeding disorders and for the intake of drugs that can interfere with coagulation; use of smaller-diameter cannulas for aspiration, auto-transfusion when aspirating in excess of 1,000 ml, and limiting the aspiration to 1,500 ml.

Overview of Intelligent Systems and Operations Development

NASA Technical Reports Server (NTRS)

Pallix, Joan; Dorais, Greg; Penix, John

2004-01-01

To achieve NASA's ambitious mission objectives for the future, aircraft and spacecraft will need intelligence to take the correct action in a variety of circumstances. Vehicle intelligence can be defined as the ability to "do the right thing" when faced with a complex decision-making situation. It will be necessary to implement integrated autonomous operations and low-level adaptive flight control technologies to direct actions that enhance the safety and success of complex missions despite component failures, degraded performance, operator errors, and environment uncertainty. This paper will describe the array of technologies required to meet these complex objectives. This includes the integration of high-level reasoning and autonomous capabilities with multiple subsystem controllers for robust performance. Future intelligent systems will use models of the system, its environment, and other intelligent agents with which it interacts. They will also require planners, reasoning engines, and adaptive controllers that can recommend or execute commands enabling the system to respond intelligently. The presentation will also address the development of highly dependable software, which is a key component to ensure the reliability of intelligent systems.

Non-operative management of a complete anterior cruciate ligament injury in an English Premier League football player with return to play in less than 8 weeks: applying common sense in the absence of evidence

PubMed Central

Weiler, Richard; Monte-Colombo, Mathew; Mitchell, Adam; Haddad, Fares

2015-01-01

This case report illustrates and discusses the non-operative management of a complete anterior cruciate ligament (ACL) injury in an English Premier League football player, his return to play within 8 weeks and problem-free follow-up at 18 months post injury. When non-operative verses surgical ACL reconstruction is considered there are many fundamental gaps in our knowledge and currently, at elite level, there are no cases in cutting sports within the literature to guide these decisions. When the norm is for all professional footballers to be recommended surgery, it will be very challenging when circumstances and patient autonomy dictate a conservative approach, where prognosis, end points and risk are unclear and assumed to be high. This case challenges current dogma and provides a starting point for much needed debate about best practice, treatment options, research direction and not just at the elite level of sport. PMID:25917066

Water contamination in fallout areas. Project No. 7806

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

Robeck, G.G.; Woodward, R.L.; Muschler, W.K.

1958-05-01

An evaluation of the potential radiological hazard to Air Force personnel from drinking water contaminated with fission products is presented. Ground water supplies should be safe from fallout contamination and only surface supplies may need special treatment. Even in untreated water, the radioactivity in surface supplies is not likely to reduce significantly the military effectiveness of personnel using it except where the general level of contamination is greater than 1000 r/hr at H + 1. Dust samples were collected at the Priscilla shot of Operation Plumbbob 24 June 1957. In each of the samples, material containing approximately 10% of themore » activity was soluble; however, strontium was preferentially dissolved by a factor of 5. For the first 10 days after fallout, a supply of one gallon of water per person per day will suffice for drinking and culinary purposes. Ion-exchange, which is over 99% efficient, is the most practical and economical method of supplying decontaminated water. For immediate demand, small mixed-bed demineralizers, which are easily installed and maintained, are recommended; for long term demand, pressure cation-exchange beds operated on the sodium cycle are recommended. A shelter accommodating 100 people would require a small mixed-bed demineralizer with an initial cost of $81 and an operating cost of $9 per day. A pressure cation-exchange bed could be installed for $7,500 which would have an operating cost of 15 cents per 1,000 gallons. This could supply an average daily water requirement of 50,000 gallons.« less

WATER CONTAMINATION IN FALLOUT AREAS

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

Robeck, G.G.; Woodward, R.L.; Muschler, W.K.

1958-05-01

An evaluation of the potential radiological hazard to Air Force personnel from drinking water contaminated with fission products is presented. Ground water supplies should be safe from fall-out contamination and only surface supplies may need special treatment. Even in untreated water, the radioactivity in surface supplies is not likely to reduce significantly the military effectiveness of personnel using it except where the general level of contamination is greater than 1000 r/hr at H + 1. Dust samples were collected at the Priscilla shot of Operation Plumbbob 24 June 1957. In each of the samples, material containing approximately 10% of themore » activity was soluble; however, strontium was preferentially dissolved by a factor of 5. For the first 10 days after fall-out, a supply of one gallon of water per person per day will suffice for drinking and culinary purposes, Ion-exchange, which is over 99% efficient, is the most practical and economical method of supplying decontaminated water, For immediate demand, small mixed-bed demineralizers, which are easily installed and maintained, are recommended; for long term demand, pressure cation-exchange beds operated on the sodium cycle are recommended. A shelter accommodating 100 people would require a small mixed-bed demineralizer with an initial cost of and an operating cost of per day. A pressure cation-exchange bed could be installed for 500 which would have an operating cost of 15 cents per 1,000 gallons. This could supply an average daily water requirement of 50,000 gallons. (auth)« less

Work Package 5: Contingency Management. Mission Planning Requirements Document: Preliminary Version. Revision A

NASA Technical Reports Server (NTRS)

2005-01-01

The purpose of this document is to identify the general flight/mission planning requirements for same-day file-and-fly access to the NAS for both civil and military High-Altitude Long Endurance (HALE) Unmanned Aircraft System (UAS). Currently the scope of this document is limited to Step 1, operations above flight level 43,000 feet (FL430). This document describes the current applicable mission planning requirements and procedures for both manned and unmanned aircraft and addresses HALE UAS flight planning considerations in the future National Airspace System (NAS). It also discusses the unique performance and operational capabilities of HALE UAS associated with the Access 5 Project, presents some of the projected performance characteristics and conceptual missions for future systems, and provides detailed analysis of the recommended mission planning elements for operating HALE UAS in the NAS.

Summary of the Italian inter-society recommendations for radiation protection optimization in interventional radiology.

PubMed

Compagnone, Gaetano; Padovani, Renato; D'Avanzo, Maria Antonietta; Grande, Sveva; Campanella, Francesco; Rosi, Antonella

2018-05-01

A Working Group coordinated by the Italian National Institute of Health (Istituto Superiore di Sanità) and the National Workers Compensation Authority (Istituto Nazionale per l'Assicurazione contro gli Infortuni sul Lavoro, INAIL) and consisting of 11 Italian scientific/professional societies involved in the fluoroscopically guided interventional practices has been established to define recommendations for the optimization of patients and staff radiation protection in interventional radiology. A summary of these recommendations is here reported. A multidisciplinary approach was used to establish the Working Group by involving radiologists, interventional radiologists, neuroradiologists, interventional cardiologists, occupational health specialists, medical physicists, radiation protection experts, radiographers and nurses. The Group operated as a "Consensus Conference". Three main topics have been addressed: patient radiation protection (summarized in ten "golden rules"); staff radiation protection (summarized in ten "golden rules"); and education/training of interventional radiology professionals. In the "golden rules", practical and operational recommendations were provided to help the professionals in optimizing dose delivered to patients and reducing their own exposure. Operative indications dealt also with continuing education and training, and recommendations on professional accreditation and certification. The "Consensus Conference" was the methodology adopted for the development of these recommendations. Involvement of all professionals is a winning approach to improve practical implementation of the recommendations, thus getting a real impact on the optimization of the interventional radiology practices.

Management of prolonged post-operative ileus: evidence-based recommendations.

PubMed

Vather, Ryash; Bissett, Ian

2013-05-01

Prolonged post-operative ileus (PPOI) occurs in up to 25% of patients following major elective abdominal surgery. It is associated with a higher risk of developing post-operative complications, prolongs hospital stay and confers a significant financial load on health-care institutions. Literature outlining best-practice management strategies for PPOI is nebulous. The aim of this text was to review the literature and provide concise evidence-based recommendations for its management. A literature search through the Ovid MEDLINE, EMBASE, Google Scholar and Cochrane databases was performed from inception to July 2012 using a combination of keywords and MeSH terms. Review of the literature was followed by synthesis of concise recommendations for management accompanied by Strength of Recommendation Taxonomy (either A, B or C). Recommendations for management include regular evaluation and correction of electrolytes (B); review of analgesic prescription with weaning of narcotics and substitution with regular paracetamol, regular non-steroidal anti-inflammatory drugs if not contraindicated, and regular or as-required Tramadol (A); nasogastric decompression for those with nausea or vomiting as prominent features (C); isotonic dextrose-saline crystalloid maintenance fluids administered within a restrictive regimen (B); balanced isotonic crystalloid replacement fluids containing supplemental potassium, in equivalent volume to losses (C); regular ambulation (C); parenteral nutrition if unable to tolerate an adequate oral intake for more than 7 days post-operatively (A) and exclusion of precipitating pathology or alternate diagnoses if clinically suspected (C). Recommendations have a variable and frequently inconsistent evidence base. Further research is required to validate many of the outlined recommendations and to investigate novel interventions that may be used to shorten duration of PPOI. © 2013 The Authors. ANZ Journal of Surgery © 2013 Royal Australasian College of Surgeons.

State Board for Higher Education Consolidated Capital and Operating Budget Recommendations and Appendices, FY 1985.

ERIC Educational Resources Information Center

Maryland State Board for Higher Education, Annapolis.

The Maryland Board for Higher Education's consolidated capital and operating budget for fiscal year 1985 for higher education institutions and agencies is presented. Recommendations of the Board are summarized, and the status of higher education funding is briefly discussed. Methods of funding institutional budget requests for the capital and…

Development of DSRC device and communication system performance measures recommendations for DSRC OBE performance and security requirements.

DOT National Transportation Integrated Search

2016-05-22

This report presents recommendations for minimum DSRC device communication performance and security requirements to ensure effective operation of the DSRC system. The team identified recommended DSRC communications requirements aligned to use cases, ...

Space station definition and preliminary design, WP-01. Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

Lenda, J. A.

1987-01-01

System activities are summarized and an overview of the system level engineering tasks performed are provided. Areas discussed include requirements, system test and verification, the advanced development plan, customer accommodations, software, growth, productivity, operations, product assurance and metrication. The hardware element study results are summarized. Overviews of recommended configurations are provided for the core module, the USL, the logistics elements, the propulsion subsystems, reboost, vehicle accommodations, and the smart front end. A brief overview is provided for costing activities.

Crisis Management for Biobanks.

PubMed

Parry-Jones, Alison; Hansen, Jarle; Simeon-Dubach, Daniel; Bjugn, Roger

2017-06-01

All organizations are subject to risk and uncertainty. Adverse events may disrupt normal organizational activity and may even cause complete failure of business operations. Biorepositories are also at risk and there have been instances where multiple samples or entire collections have been destroyed. Biobank guidelines accordingly recommend the establishment of contingency plans to reduce risk to an acceptable level. In this review article, we will use general theory on risk management and illustrate how such principles can be used to establish a practical crisis management plan for any biobank organization.

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

The technology necessary to build net zero energy buildings (NZEBs) is ready and available today, however, building to net zero energy performance levels can be challenging. Energy efficiency measures, onsite energy generation resources, load matching and grid interaction, climatic factors, and local policies vary from location to location and require unique methods of constructing NZEBs. It is recommended that Components start looking into how to construct and operate NZEBs now as there is a learning curve to net zero construction and FY 2020 is just around the corner.

Protocol Standards and Implementation within the Digital Engineering Laboratory Computer Network (DELNET) Using the Universal Network Interface Device (UNID). Part 1.

DTIC Science & Technology

1983-12-01

Initializes the data tables shared by both the Local and Netowrk Operating Systems. 3. Invint: Written in Assembly Language. Initializes the Input/Output...connection with an appropriate type and grade of transport service and appropriate security authentication (Ref 6:38). Data Transfer within a session...V.; Kent, S. Security in oihr Level Protocolst Anorgaches. Alternatives and Recommendations, Draft Report ICST/HLNP-81-19, Wash ingt on,,D.C.: Dept

Preliminary study of the Suomi NPP VIIRS detector-level spectral response function effects for the long-wave infrared bands M15 and M16

NASA Astrophysics Data System (ADS)

Padula, Francis; Cao, Changyong

2014-09-01

The Suomi NPP Visible Infrared Imaging Radiometer Suite (VIIRS) Sea Surface Temperature (SST) Environmental Data Record (EDR) team observed an anomalous striping pattern in the SST data. To assess possible causes due to the detector-level Spectral Response Functions (SRFs), a study was conducted to compare the radiometric response of the detector-level and operation band averaged SRFs of VIIRS bands M15 & M16 using simulated blackbody radiance data and clear-sky ocean radiances under different atmospheric conditions. It was concluded that the SST product is likely impacted by small differences in detector-level SRFs, and that if users require optimal system performance detector-level processing is recommended. Future work will investigate potential SDR product improvements through detector-level processing in support of the generation of Suomi NPP VIIRS climate quality SDRs.

Laser arytenoidectomy in children with bilateral vocal fold immobility.

PubMed

Worley, G; Bajaj, Y; Cavalli, L; Hartley, B

2007-01-01

Bilateral vocal fold immobility in children is a challenging problem because a balance between good airway and voice quality has to be achieved. Surgery to improve the airway is often postponed or avoided because of fear of losing the voice. In this study our results of laser arytenoidectomy in children are described. This was a retrospective case notes review at a tertiary level paediatric ENT department. The six patients in this case series ranged from nine to 16 years old at the time of laser arytenoidectomy. Post-operative airway and voice quality were assessed. All children in the series had an adequate post-operative airway. Four of these patients had tracheostomies pre-operatively and achieved decannulation. All six patients rated their post-operative voice as better than pre-operatively. This is principally due to increased loudness associated with increased airflow through the larynx, particularly after tracheostomy decannulation. It is recommended that special care should be taken not to disturb the anterior two thirds of the vocal fold during the surgery in order to achieve a good post-operative voice outcome.

[Governance of innovative cardiovascular devices: when evidence is not enough].

PubMed

Addis, Antonio; Davoli, Marina

2016-01-01

Aortic stenosis is the most common valve disease and transcatheter aortic valve implantation (TAVI) is considered as an alternative to surgical valve replacement or to medical treatment in inoperable or high-risk patients. Although physicians have learned how to care for critically ill old patients and enable many to survive, major surgical procedures, operating on patients at very high risk, are often not suitable. Studies showed that selected cohorts of patients undergoing TAVI might have better outcomes in terms of survival and quality of life. However, mortality and safety data associated with the less invasive intervention do not always justify such new technologies for all patients with severe aortic stenosis, taking into account also the high cost associated. A systematic review of the available scientific literature has been performed. In this context, a DECIDE framework has been used providing a systematic and transparent approach for going from evidence to healthcare decisions. Before suggesting final recommendations, historical data of interventions done at regional level and regulatory decisions adopted in other countries following health technology assessment analysis, have been analyzed. All final recommendations based on this document have been discussed and reviewed with a working group done by the health operators directly involved in this technology within the regional health service context. Recommendations for the identification of patients suitable for TAVI are given together with a list of characteristics that should be required to all centers eligible for the performance of TAVI and with a procedure able to allow better quality assurance and prospective monitoring process of all new cases enrolled for such intervention. Impact of these recommendations will be measured using a regional registry collecting data on new patients undergoing TAVI.

Operative fixation of rib fractures after blunt trauma: A practice management guideline from the Eastern Association for the Surgery of Trauma.

PubMed

Kasotakis, George; Hasenboehler, Erik A; Streib, Erik W; Patel, Nimitt; Patel, Mayur B; Alarcon, Louis; Bosarge, Patrick L; Love, Joseph; Haut, Elliott R; Como, John J

2017-03-01

Rib fractures are identified in 10% of all injury victims and are associated with significant morbidity (33%) and mortality (12%). Significant progress has been made in the management of rib fractures over the past few decades, including operative reduction and internal fixation (rib ORIF); however, the subset of patients that would benefit most from this procedure remains ill-defined. The aim of this project was to develop evidence-based recommendations. Population, intervention, comparison, and outcome (PICO) questions were formulated for patients with and without flail chest. Outcomes of interest included mortality, duration of mechanical ventilation (DMV), hospital and intensive care unit (ICU) length of stay (LOS), incidence of pneumonia, need for tracheostomy, and pain control. A systematic review and meta-analysis of currently available evidence was performed per the Grading of Recommendations Assessment, Development, and Evaluation methodology. Twenty-two studies were identified and analyzed. These included 986 patients with flail chest, of whom 334 underwent rib ORIF. Rib ORIF afforded lower mortality; shorter DMV, hospital LOS, and ICU LOS; and lower incidence of pneumonia and need for tracheostomy. The data quality was deemed very low, with only three prospective randomized trials available. Analyses for pain in patients with flail chest and all outcomes in patients with nonflail chest were not feasible due to inadequate data. In adult patients with flail chest, we conditionally recommend rib ORIF to decrease mortality; shorten DMV, hospital LOS, and ICU LOS; and decrease incidence of pneumonia and need for tracheostomy. We cannot offer a recommendation for pain control, or any of the outcomes in patients with nonflail chest with currently available data. Systematic review/meta-analysis, level III.

Surgical management of pancreatic necrosis: A practice management guideline from the Eastern Association for the Surgery of Trauma.

PubMed

Mowery, Nathan T; Bruns, Brandon R; MacNew, Heather G; Agarwal, Suresh; Enniss, Toby M; Khan, Mansoor; Guo, Weidun Alan; Cannon, Jeremy W; Lissauer, Matthew E; Duane, Therese M; Hildreth, Amy N; Pappas, Peter A; Gries, Lynn M; Kaiser, Meghann; Robinson, Bryce R H

2017-08-01

Pancreatic or peripancreatic tissue necrosis confers substantial morbidity and mortality. New modalities have created a wide variation in approaches and timing of interventions for necrotizing pancreatitis. As acute care surgery evolves, its practitioners are increasingly being called upon to manage these complex patients. A systematic review of the MEDLINE database using PubMed was performed. English language articles regarding pancreatic necrosis from 1980 to 2014 were included. Letters to the editor, case reports, book chapters, and review articles were excluded. Topics of investigation included operative timing, the use of adjuvant therapy and the type of operative repair. Grading of Recommendations, Assessment, Development and Evaluations methodology was applied to question development, outcome prioritization, evidence quality assessments, and recommendation creation. Eighty-eight studies were included and underwent full review. Increasing the time to surgical intervention had an improved outcome in each of the periods evaluated (72 hours, 12-14 days, 30 days) with a significant improvement in outcomes if surgery was delayed 30 days. The use of percutaneous and endoscopic procedures was shown to postpone surgery and potentially be definitive. The use of minimally invasive surgery for debridement and drainage has been shown to be safe and associated with reduced morbidity and mortality. Acute Care Surgeons are uniquely trained to care for those with pancreatic necrosis due their training in critical care and complex surgery with ongoing shock. In adult patients with pancreatic necrosis, we recommend that pancreatic necrosectomy be delayed until at least day 12. During the first 30 days of symptoms with infected necrotic collections, we conditionally recommend surgical debridement only if the patients fail to improve after radiologic or endoscopic drainage. Finally, even with documented infected necrosis, we recommend that patients undergo a step-up approach to surgical intervention as the preferred surgical approach. Systematic review/guideline, level III.

INITIATORS AND TRIGGERING CONDITIONS FOR ADAPTIVE AUTOMATION IN ADVANCED SMALL MODULAR REACTORS

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

Katya L Le Blanc; Johanna h Oxstrand

It is anticipated that Advanced Small Modular Reactors (AdvSMRs) will employ high degrees of automation. High levels of automation can enhance system performance, but often at the cost of reduced human performance. Automation can lead to human out-of the loop issues, unbalanced workload, complacency, and other problems if it is not designed properly. Researchers have proposed adaptive automation (defined as dynamic or flexible allocation of functions) as a way to get the benefits of higher levels of automation without the human performance costs. Adaptive automation has the potential to balance operator workload and enhance operator situation awareness by allocating functionsmore » to the operators in a way that is sensitive to overall workload and capabilities at the time of operation. However, there still a number of questions regarding how to effectively design adaptive automation to achieve that potential. One of those questions is related to how to initiate (or trigger) a shift in automation in order to provide maximal sensitivity to operator needs without introducing undesirable consequences (such as unpredictable mode changes). Several triggering mechanisms for shifts in adaptive automation have been proposed including: operator initiated, critical events, performance-based, physiological measurement, model-based, and hybrid methods. As part of a larger project to develop design guidance for human-automation collaboration in AdvSMRs, researchers at Idaho National Laboratory have investigated the effectiveness and applicability of each of these triggering mechanisms in the context of AdvSMR. Researchers reviewed the empirical literature on adaptive automation and assessed each triggering mechanism based on the human-system performance consequences of employing that mechanism. Researchers also assessed the practicality and feasibility of using the mechanism in the context of an AdvSMR control room. Results indicate that there are tradeoffs associated with each mechanism, but that some are more applicable to the AdvSMR domain. The two mechanisms that consistently improve performance in laboratory studies are operator initiated adaptive automation based on hierarchical task delegation and the Electroencephalogram(EEG) –based measure of engagement. Current EEG methods are intrusive and require intensive analysis; therefore it is not recommended for an AdvSMR control rooms at this time. Researchers also discuss limitations in the existing empirical literature and make recommendations for further research.« less

49 CFR 195.440 - Public awareness.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Petroleum Institute's (API) Recommended Practice (RP) 1162 (incorporated by reference, see § 195.3). (b) The operator's program must follow the general program recommendations of API RP 1162 and assess the unique... general program recommendations, including baseline and supplemental requirements of API RP 1162, unless...

49 CFR 195.440 - Public awareness.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Petroleum Institute's (API) Recommended Practice (RP) 1162 (incorporated by reference, see § 195.3). (b) The operator's program must follow the general program recommendations of API RP 1162 and assess the unique... general program recommendations, including baseline and supplemental requirements of API RP 1162, unless...

49 CFR 195.440 - Public awareness.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Petroleum Institute's (API) Recommended Practice (RP) 1162 (incorporated by reference, see § 195.3). (b) The operator's program must follow the general program recommendations of API RP 1162 and assess the unique... general program recommendations, including baseline and supplemental requirements of API RP 1162, unless...

Case factors affecting hearing aid recommendations by hearing care professionals.

PubMed

Gioia, Carmine; Ben-Akiva, Moshe; Kirkegaard, Matilde; Jørgensen, Ole; Jensen, Kasper; Schum, Don

2015-03-01

Professional recommendations to patients concerning hearing instrument (HI) technology levels are not currently evidence-based. Pre-fitting parameters have not been proven to be the primary indicators for optimal patient outcome with different HI technology levels. This results in subjective decision-making as regards the technology level recommendation made by professionals. The objective of this study is to gain insight into the decision-making criteria utilized by professionals when recommending HI technology levels to hearing-impaired patients. A set of patient variables (and their respective levels) was identified by professionals as determinant for their recommendation of HIs. An experimental design was developed and 21 representative patient cases were generated. The design was based on a contrastive vignette technique according to which different types of vignettes (patient cases) were randomly presented to respondents in an online survey. Based on these patient cases, professionals were asked in the survey to make a treatment recommendation. The online survey was sent to approximately 3,500 professionals from the US, Germany, France, and Italy. The professionals were randomly selected from the databases of Oticon sales companies. The manufacturer sponsoring the survey remained anonymous and was only revealed after completing the survey, if requested by the respondent. The response rate was 20.5%. Data comprised of respondent descriptions and patient case recommendations that were collected from the online survey. A binary logit modeling approach was used to identify the variables that discriminate between the respondents' recommendations of HI technology levels. The results show that HI technology levels are recommended by professionals based on their perception of the patient's activity level in life, the level of HI usage for experienced users, their age, and their speech discrimination score. Surprisingly, the patient's lifestyle as perceived by the hearing care professional, followed by speech discrimination, were the strongest factors in explaining treatment recommendation. An active patient with poor speech discrimination had a 17% chance of being recommended the highest technology level HI. For a very active patient with good speech discrimination, the probability increases to 68%. The discrepancies in HI technology level recommendations are not justified by academic research or evidence of optimal patient outcome with a different HI technology level. The paradigm of lifestyle as the significant variable identified in this study is apparently deeply anchored in the mindset of the professional despite the lack of supporting evidence. These results call for a shift in the professional's technology level recommendation practice, from nonevidence-based to a proven practice that can maximize patient outcome. American Academy of Audiology.

Operating room myths: what is the evidence for common practices.

PubMed

Pada, Surinder; Perl, Trish M

2015-08-01

In order to ensure patient safety and prevent surgical site infections (SSIs), operating theaters/rooms have evolved into complex, highly technical environments. Prevention of healthcare-associated infections, and strategies to limit patient harm, have gained momentum over the last decade. This article aims to examine and dispute some commonly held beliefs with specific reference to: laminar airflow, noise and operating theater door openings and how these impact SSI. Laminar airflow may not be necessary for prosthetic implant surgery. Some recent data suggest that there may be patient harm. With the development of better surgical techniques and perioperative care, such costly systems may not be needed. Operating rooms with a high number of door openings have also been shown to experience higher SSI rates, as have operating rooms with high noise levels. These may serve as surrogate markers for operating room discipline. Initiatives which target these areas may be worth considering when devising strategies to reduce SSIs. Improved surveillance systems for SSIs are needed and should include operating theater airflow type. This will allow further analysis of the effect of laminar air flow on SSIs and provide evidence for a decisive recommendation. Cultivating a culture of good operating theater discipline may also reduce SSIs.

Operations & Maintenance Best Practices - A Guide to Achieving Operational Efficiency (Release 3)

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

Sullivan, Greg; Pugh, Ray; Melendez, Aldo P.

This guide highlights operations and maintenance programs targeting energy and water efficiency that are estimated to save 5% to 20% on energy bills without a significant capital investment. The purpose of this guide is to provide you, the Operations and Maintenance (O&M)/Energy manager and practitioner, with useful information about O&M management, technologies, energy and water efficiency, and cost-reduction approaches. To make this guide useful and to reflect your needs and concerns, the authors met with O&M and Energy managers via Federal Energy Management Program (FEMP) workshops. In addition, the authors conducted extensive literature searches and contacted numerous vendors and industrymore » experts. The information and case studies that appear in this guide resulted from these activities. It needs to be stated at the outset that this guide is designed to provide information on effective O&M as it applies to systems and equipment typically found at Federal facilities. This guide is not designed to provide the reader with step-by-step procedures for performing O&M on any specific piece of equipment. Rather, this guide first directs the user to the manufacturer's specifications and recommendations. In no way should the recommendations in this guide be used in place of manufacturer's recommendations. The recommendations in this guide are designed to supplement those of the manufacturer, or, as is all too often the case, provide guidance for systems and equipment for which all technical documentation has been lost. As a rule, this guide will first defer to the manufacturer's recommendations on equipment operation and maintenance.« less

Establishing global policy recommendations: the role of the Strategic Advisory Group of Experts on immunization.

PubMed

Duclos, Philippe; Okwo-Bele, Jean-Marie; Salisbury, David

2011-02-01

The vaccine landscape has changed considerably over the last decade with many new vaccines and technological developments, unprecedented progress in reaching out to children and the development of new financing mechanisms. At the same time, there are more demands and additional expectations of national policy makers, donors and other interested parties for increased protection through immunization. The Global Immunization Vision and Strategy (GIVS), which broadens the previous scope of immunization efforts, sets a number of goals to be met by countries. The WHO has recently reviewed and adjusted both its policy making structure and processes for vaccines and immunization to include an enlarged consultation process to generate evidence-based recommendations, thereby ensuring the transparency of the decision making process and improving communications. This article describes the process of development of immunization policy recommendations at the global level and some of their impacts. It focuses on the roles and modes of operating of the Strategic Advisory Group of Experts on immunization, which is the overarching advisory group involved with the issuance of policy recommendations, monitoring and facilitating the achievement of the GIVS goals. The article also describes the process leading to the publication of WHO vaccine position papers, which provide WHO recommendations on vaccine use. WHO vaccine-related recommendations have become a necessary step in the pathway to the introduction and use of vaccines, especially in developing countries and, consequently, have a clear and significant impact.

Launch COLA Operations: An Examination of Data Products, Procedures, and Thresholds

NASA Technical Reports Server (NTRS)

Hejduk, M. D.; Plakalovic, D.; Hametz, M. E.; Newman, L. K.; Ollivierre, J. C.; Beaver, B. A.; Thompson, R. C.

2015-01-01

NASA GSFC and KSC, acting in response to headquarters NASA direction, performed a year-long study of launch collision avoidance (LCOLA) operations in order to determine and recommend best risk assessment and mitigation practices. The following condenses the findings and recommendations of the study into one short summary, a more expanded version of which appears as Section 10.

Expanded Enlistment Eligibility Metrics (EEEM): Recommendations on a Non-Cognitive Screen for New Soldier Selection

DTIC Science & Technology

2010-07-01

applicants and is pursing further research on the WPA. An operational test and evaluation ( IOT &E) has been initiated to evaluate the new screen...initial operational test and evaluation ( IOT &E) starting in fall 2009. vii EXPANDED ENLISTMENT ELIGIBILITY METRICS (EEEM): RECOMMENDATIONS ON A NON...Evaluation of a Performance Screen for IOT &E ..................................... 49 Approach

[Investigation on the phenomena of bacteria exceeding standards in rural pit water treated by ultrafiltration membrane].

PubMed

Yue, Yinling; Zhang, Lan; Ling, Bo

2011-11-01

To investigate the phenomenon of bacteria exceeding standards in rural pit water, which was intermittently operated by water pump equipped with ultrafiltration membrane, and to explore the solutions. Polyvinyl chloride (PVC) alloy capillary membranes combined with UV, disinfectant, one-way valve, water-seal, high water level-water tank and direct outlet were tested. The operation on water treatment was intermittent, simulating the ways of treating pit water in the rural. The combination modes of ultrafiltration membrane with UV, disinfectant and high water level-water tank are valid in solving the problem of high turbidity and microorganism of pit water stored in cellars, the quality of effluents was consistent with the requirements of the national standards. While the combination modes of ultrafiltration membrane with one-way valve or water-seal were less desirable, more bacteria in treated water than raw water were observed because of bacteria breeding on the membrane component. In order to avoid excessive bacteria in filtered pit water caused by intermittent operation, it is recommended that for the pit water in high water level water tanks, the ultrafiltration membranes should be cleaned with disinfectants on a regular basis. The effluent pit water from underground cellars should be disinfected with UV after ultrafiltration.

Wind Power Forecasting Error Frequency Analyses for Operational Power System Studies: Preprint

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

Florita, A.; Hodge, B. M.; Milligan, M.

2012-08-01

The examination of wind power forecasting errors is crucial for optimal unit commitment and economic dispatch of power systems with significant wind power penetrations. This scheduling process includes both renewable and nonrenewable generators, and the incorporation of wind power forecasts will become increasingly important as wind fleets constitute a larger portion of generation portfolios. This research considers the Western Wind and Solar Integration Study database of wind power forecasts and numerical actualizations. This database comprises more than 30,000 locations spread over the western United States, with a total wind power capacity of 960 GW. Error analyses for individual sites andmore » for specific balancing areas are performed using the database, quantifying the fit to theoretical distributions through goodness-of-fit metrics. Insights into wind-power forecasting error distributions are established for various levels of temporal and spatial resolution, contrasts made among the frequency distribution alternatives, and recommendations put forth for harnessing the results. Empirical data are used to produce more realistic site-level forecasts than previously employed, such that higher resolution operational studies are possible. This research feeds into a larger work of renewable integration through the links wind power forecasting has with various operational issues, such as stochastic unit commitment and flexible reserve level determination.« less

COST-RISK-BENEFIT ANALYSIS IN DIAGNOSTIC RADIOLOGY: A THEORETICAL AND ECONOMIC BASIS FOR RADIATION PROTECTION OF THE PATIENT.

PubMed

Moores, B Michael

2016-06-01

In 1973, International Commission on Radiological Protection Publication 22 recommended that the acceptability of radiation exposure levels for a given activity should be determined by a process of cost-benefit analysis. It was felt that this approach could be used to underpin both the principle of ALARA as well for justification purposes. The net benefit, B, of an operation involving irradiation was regarded as equal to the difference between its gross benefit, V, and the sum of three components; the basic production cost associated with the operation, P; the cost of achieving the selected level of protection, X; and the cost Y of the detriment involved in the operation: [Formula: see text] This article presents a theoretical cost-risk-benefit analysis that is applicable to the diagnostic accuracy (Levels 1 and 2) of the hierarchical efficacy model presented by National Council on Radiation Protection and Measurements in 1992. This enables the costs of an examination to be related to the sensitivity and specificity of an X-ray examination within a defined clinical problem setting and introduces both false-positive/false-negative diagnostic outcomes into the patient radiation protection framework. © The Author 2015. Published by Oxford University Press.

Health-hazard-evaluation report HETA 87-371-2000, Technical Assistance to the Jamaican Ministry of Health, Kingston, Jamaica

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

Matte, T.D.; Burr, G.A.

1989-12-01

In response to a request from the Jamaican Ministry of Health, a study was made of possible health hazards existing due to the operation of a secondary lead smelter in Saint Catherine Parish, Jamaica. Emission controls at the site were upgraded in 1974. A cottage industry of clandestine backyard smelters was also in operation in the area. The survey investigated the health of residents in 58 households in the Red Pond Road community and 21 households in Ebony Vale. Soil lead levels in Red Pond exceeded 500 parts per million at 24% of the households tested. Ten paint samples takenmore » from Red Pond homes exceeded 1% lead by weight. The geometric mean blood lead level of those tested in Red Pond was more than twice the level found in those tested in Ebony Vale. Forty four percent of the children under 6 years of age in Red Pond had blood lead levels above 25 micrograms/deciliter. Soil lead contamination was the strongest predictor of blood lead levels among the Red Pond subjects under 12 years of age. Lead smelter work was an important predictor in the older subjects. The authors conclude that the backyard smelters in combination with the secondary smelter caused a high lead poisoning risk for area residents. The authors recommend that residents stop the backyard smelting operations, and that efforts be made to reduce exposure through hazard abatement, education, and establishment of clean play areas for children.« less

Recommendations for a Cockpit Display that Integrates Weather Information with Traffic Information

NASA Technical Reports Server (NTRS)

Comerford, Doreen A.

2004-01-01

This effort was supported by the System-Wide Accident Prevention element of NASA s Aviation Safety Program. This document may serve as a first step toward the goal of integrating traffic, weather, and terrain information; it provides recommendations for a cockpit display that integrates weather information with traffic information. While some of the recommendations are general enough to be used for any type of operations, these recommendations are targeted for Federal Aviation Regulations Part 121 Operations. The document is organized in the following manner. First, weather information is discussed as an independent subject matter, and recommendations are presented for presenting weather in the cockpit. Second, traffic is discussed independently, but this discussion essentially reviews work on the display of traffic in the cockpit. Third, recommendations for the cockpit integration of weather and traffic information are discussed. Fourth, several research groups are recognized for their efforts in developing systems that are relevant to the current discussion. Finally, closing remarks provide suggestions for future efforts.

The Prevention of Positioning Injuries during Gynecologic Operations. Guideline of DGGG (S1-Level, AWMF Registry No. 015/077, February 2015)

PubMed Central

Fleisch, M. C.; Bremerich, D.; Schulte-Mattler, W.; Tannen, A.; Teichmann, A. T.; Bader, W.; Balzer, K.; Renner, S. P.; Römer, T.; Roth, S.; Schütz, F.; Thill, M.; Tinneberg, H.; Zarras, K.

2015-01-01

Purpose: Official guideline published and coordinated by the German Society of Gynecology and Obstetrics (DGGG). Positioning injuries after lengthy gynecological procedures are rare, but the associated complications can be potentially serious for patients. Moreover, such injuries often lead to claims of malpractice and negligence requiring detailed medical investigation. To date, there are no binding evidence-based recommendations for the prevention of such injuries. Methods: This S1-guideline is the work of an interdisciplinary group of experts from a range of different professions who were commissioned by DGGG to carry out a systematic literature search of positioning injuries. Members of the participating scientific societies develop a consensus in an informal procedure. Afterwards the directorate of the scientific society approves the consensus. The recommendations cover: PMID:26365999

Mid-term changes in blood metal ion levels after Articular Surface Replacement arthroplasty of the hip.

PubMed

Galea, V P; Laaksonen, I; Matuszak, S J; Connelly, J W; Muratoglu, O; Malchau, H

2017-04-01

Our first aim was to determine whether there are significant changes in the level of metal ions in the blood at mid-term follow-up, in patients with an Articular Surface Replacement (ASR) arthroplasty. Secondly, we sought to identify risk factors for any increases. The study involved 435 patients who underwent unilateral, metal-on-metal (MoM) hip resurfacing (HRA) or total hip arthroplasty (THA). These patients all had one measurement of the level of metal ions in the blood before seven years had passed post-operatively (early evaluation) and one after seven years had passed post-operatively (mid-term evaluation). Changes in ion levels were tested using a Wilcoxon signed-rank test. We identified subgroups at the highest risk of increase using a multivariable linear logistic regression model. There were significant increases in the levels of metal ions for patients who underwent both MoM HRA (Chromium (Cr): 0.5 parts per billion (ppb); Cobalt (Co): 1.1 ppb) and MoM THA (Cr: 0.5 ppb; Co: 0.7 ppb). In a multivariable model considering MoM HRAs, the change in the levels of metal ions was influenced by female gender (Co: Odds Ratio (OR) 1.42; p = 0.002 and Cr: OR 1.08; p = 0.006). The change was found to be irrespective of the initial level for the MoM HRAs, whereas there was a negative relationship between the initial level and the change in the level for those with a MoM THA (Co: OR -0.43; p < 0.001 and Cr: OR -0.14; p = 0.033). The levels of metal ions in the blood increase significantly over the period until mid-term follow-up in patients with both a MoM HRA and those with a MoM THA. We recommend that the levels of metal ions be measured most frequently for women with a MoM HRA. While those with a MoM THA appear to stabilise at a certain level, the accuracy of this trend is not yet clear. Vigilant follow-up is still recommended. Cite this article: Bone Joint J 2017;99-B(4 Supple B):33-40. ©2017 Galea et al.

Process management using component thermal-hydraulic function classes

DOEpatents

Morman, James A.; Wei, Thomas Y. C.; Reifman, Jaques

1999-01-01

A process management expert system where following malfunctioning of a component, such as a pump, for determining system realignment procedures such as for by-passing the malfunctioning component with on-line speeds to maintain operation of the process at full or partial capacity or to provide safe shut down of the system while isolating the malfunctioning component. The expert system uses thermal-hydraulic function classes at the component level for analyzing unanticipated as well as anticipated component malfunctions to provide recommended sequences of operator actions. Each component is classified according to its thermal-hydraulic function, and the generic and component-specific characteristics for that function. Using the diagnosis of the malfunctioning component and its thermal hydraulic class, the expert system analysis is carried out using generic thermal-hydraulic first principles. One aspect of the invention employs a qualitative physics-based forward search directed primarily downstream from the malfunctioning component in combination with a subsequent backward search directed primarily upstream from the serviced component. Generic classes of components are defined in the knowledge base according to the three thermal-hydraulic functions of mass, momentum and energy transfer and are used to determine possible realignment of component configurations in response to thermal-hydraulic function imbalance caused by the malfunctioning component. Each realignment to a new configuration produces the accompanying sequence of recommended operator actions. All possible new configurations are examined and a prioritized list of acceptable solutions is produced.

Process management using component thermal-hydraulic function classes

DOEpatents

Morman, J.A.; Wei, T.Y.C.; Reifman, J.

1999-07-27

A process management expert system where following malfunctioning of a component, such as a pump, for determining system realignment procedures such as for by-passing the malfunctioning component with on-line speeds to maintain operation of the process at full or partial capacity or to provide safe shut down of the system while isolating the malfunctioning component. The expert system uses thermal-hydraulic function classes at the component level for analyzing unanticipated as well as anticipated component malfunctions to provide recommended sequences of operator actions. Each component is classified according to its thermal-hydraulic function, and the generic and component-specific characteristics for that function. Using the diagnosis of the malfunctioning component and its thermal hydraulic class, the expert system analysis is carried out using generic thermal-hydraulic first principles. One aspect of the invention employs a qualitative physics-based forward search directed primarily downstream from the malfunctioning component in combination with a subsequent backward search directed primarily upstream from the serviced component. Generic classes of components are defined in the knowledge base according to the three thermal-hydraulic functions of mass, momentum and energy transfer and are used to determine possible realignment of component configurations in response to thermal-hydraulic function imbalance caused by the malfunctioning component. Each realignment to a new configuration produces the accompanying sequence of recommended operator actions. All possible new configurations are examined and a prioritized list of acceptable solutions is produced. 5 figs.

Integrated Decision-Making Tool to Develop Spent Fuel Strategies for Research Reactors

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

Beatty, Randy L; Harrison, Thomas J

IAEA Member States operating or having previously operated a Research Reactor are responsible for the safe and sustainable management and disposal of associated radioactive waste, including research reactor spent nuclear fuel (RRSNF). This includes the safe disposal of RRSNF or the corresponding equivalent waste returned after spent fuel reprocessing. One key challenge to developing general recommendations lies in the diversity of spent fuel types, locations and national/regional circumstances rather than mass or volume alone. This is especially true given that RRSNF inventories are relatively small, and research reactors are rarely operated at a high power level or duration typical ofmore » commercial power plants. Presently, many countries lack an effective long-term policy for managing RRSNF. This paper presents results of the International Atomic Energy Agency (IAEA) Coordinated Research Project (CRP) #T33001 on Options and Technologies for Managing the Back End of the Research Reactor Nuclear Fuel Cycle which includes an Integrated Decision Making Tool called BRIDE (Back-end Research reactor Integrated Decision Evaluation). This is a multi-attribute decision-making tool that combines the Total Estimated Cost of each life-cycle scenario with Non-economic factors such as public acceptance, technical maturity etc and ranks optional back-end scenarios specific to member states situations in order to develop a specific member state strategic plan with a preferred or recommended option for managing spent fuel from Research Reactors.« less

43 CFR 3420.2 - Regional leasing levels.

Code of Federal Regulations, 2011 CFR

2011-10-01

... coal teams shall be the forum through which initial leasing level recommendations are transmitted to the Secretary. Initial leasing level recommendations shall be developed as follows: (1) The... shall be requested by the regional coal team chairperson to provide comments and recommendations...

Space Network Control Conference on Resource Allocation Concepts and Approaches

NASA Technical Reports Server (NTRS)

Moe, Karen L. (Editor)

1991-01-01

The results are presented of the Space Network Control (SNC) Conference. In the late 1990s, when the Advanced Tracking and Data Relay Satellite System is operational, Space Network communication services will be supported and controlled by the SNC. The goals of the conference were to survey existing resource allocation concepts and approaches, to identify solutions applicable to the Space Network, and to identify avenues of study in support of the SNC development. The conference was divided into three sessions: (1) Concepts for Space Network Allocation; (2) SNC and User Payload Operations Control Center (POCC) Human-Computer Interface Concepts; and (3) Resource Allocation Tools, Technology, and Algorithms. Key recommendations addressed approaches to achieving higher levels of automation in the scheduling process.

Study of the application of advanced technologies to long range transport aircraft. Volume 2: Advanced technology program recommendations

NASA Technical Reports Server (NTRS)

1972-01-01

The benefits of the application of advanced technology to future transport aircraft were investigated. The noise reduction goals established by the CARD (Civil Aviation Research and Development) study for the 1981-1985 time period can be satisfied. Reduced terminal area and airway congestion can result from use of advanced on-board systems and operating procedures. The use of advanced structural design concepts can result in greatly reduced gross weight and improved operating economics. The full potential of these benefits can be realized in a 1985 airplane by implementing a research and development program that is funded to an average level of approximately $55 million per year over a ten year period.

Nuclear education and training: marriages that work

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

Hanson, H.D.

1985-11-01

Public Service Electric and Gas Company is meeting the education and training needs of its nuclear department operations, support, and services personnel through a variety of activities in association with institutions of higher education. Activities include credit or credit recommendation programs at the associates, undergraduate, and graduate degree level. The paper emphasizes the process of working with a local college in the development of a new degree program for submission through the State Board of Education. The development, review, evaluation, and approval process is detailed as well as lessons learned. Plans for further development of the program toward ABET accreditationmore » are also described. Samples of the surveys conducted to determine employee interest in terms of academic area, academic level, offering strategies, etc. are presented. The process of soliciting program proposals from universities and colleges, the selection process, and implementation of the programs are also discussed. More briefly described is the preparation for credit recommendation process from regionally accredited groups. External degree programs, off-hours course presentations on-site for undergraduate and graduate credit, faculty extern, student intern, and co-op activities are also discussed.« less

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

PubMed

Sprung, Charles L; Kesecioglu, Jozef

2010-04-01

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

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

PubMed

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

2010-04-01

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

Making the Optimal Decision in Selecting Protective Clothing

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

Price, J. Mark

2008-01-15

Protective Clothing plays a major role in the decommissioning and operation of nuclear facilities. Literally thousands of dress-outs occur over the life of a decommissioning project and during outages at operational plants. In order to make the optimal decision on which type of protective clothing is best suited for the decommissioning or maintenance and repair work on radioactive systems, a number of interrelating factors must be considered. This article discusses these factors as well as surveys of plants regarding their level of usage of single use protective clothing and should help individuals making decisions about protective clothing as it appliesmore » to their application. Individuals considering using SUPC should not jump to conclusions. The survey conducted clearly indicates that plants have different drivers. An evaluation should be performed to understand the facility's true drivers for selecting clothing. It is recommended that an interdisciplinary team be formed including representatives from budgets and cost, safety, radwaste, health physics, and key user groups to perform the analysis. The right questions need to be asked and answered by the company providing the clothing to formulate a proper perspective and conclusion. The conclusions and recommendations need to be shared with senior management so that the drivers, expected results, and associated costs are understood and endorsed. In the end, the individual making the recommendation should ask himself/herself: 'Is my decision emotional, or logical and economical?' 'Have I reached the optimal decision for my plant?'.« less

NATO Special Operations Forces Medical Engagements and Partnering Course: Initial Curriculum Recommendations from the NSHQ SOFMEP Committee.

PubMed

Alderman, Shawn M; Arvidsson, C Jimmy; Boedecker, Ben H; Durck, Craig H; Ferguson, Jason L; Harreld, Chad E; House, John H; Irizarry, Daniel J; Oshiki, Michael S; Sanchack, Kristian E; Torres, John E

2012-01-01

Military partnering operations and military engagements with host nation civil infrastructure are fundamental missions for NATO Special Operations Forces (SOF) conducting military assistance operations. Unit medical advisors are frequently called upon to support partnering operations and execute medical engagements with host nation health systems. As a primary point of NATO SOF medical capability development and coordination, the NATO Special Operations Headquarters (NSHQ) sought to create a practical training opportunity in which medical advisors are taught how to prepare for, plan, and execute these complex military assistance operations. An international committee of SOF medical advisors, planners and teachers was assembled to research and develop the curriculum for the first NSHQ SOF Medical Engagement and Partnering (SOFMEP) course. The committee found no other venues offering the necessary training. Furthermore, a lack of a common operating language and inadequate outcome metrics were identified as sources of knowledge deficits that create confusion and inhibit process improvement. These findings provided the foundation of this committee?s curricular recommendations. The committee constructed operational definitions to improve understanding and promote dialogue between medical advisors and commanders. Active learning principles were used to construct a curriculum that engages learners and enhances retention of new material. This article presents the initial curriculum recommendations for the SOFMEP course, which is currently scheduled for October 2012. 2012.

Recommended Practice for Use of Emissive Probes in Electric Propulsion Testing

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

Sheehan, J. P.; Raitses, Yevgeny; Hershkowitz, Noah

Here, this article provides recommended methods for building, operating, and taking plasma potential measurements from electron-emitting probes in electric propulsion devices, including Hall thrusters, gridded ion engines, and others. The two major techniques, the floating point technique and the inflection point technique, are described in detail as well as calibration and error-reduction methods. The major heating methods are described as well as the various considerations for emissive probe construction. Lastly, special considerations for electric propulsion plasmas are addressed, including high-energy densities, ion flows, magnetic fields, and potential fluctuations. Recommendations for probe design and operation are provided.

Recommended Practice for Use of Emissive Probes in Electric Propulsion Testing

DOE PAGES

Sheehan, J. P.; Raitses, Yevgeny; Hershkowitz, Noah; ...

2016-11-03

Here, this article provides recommended methods for building, operating, and taking plasma potential measurements from electron-emitting probes in electric propulsion devices, including Hall thrusters, gridded ion engines, and others. The two major techniques, the floating point technique and the inflection point technique, are described in detail as well as calibration and error-reduction methods. The major heating methods are described as well as the various considerations for emissive probe construction. Lastly, special considerations for electric propulsion plasmas are addressed, including high-energy densities, ion flows, magnetic fields, and potential fluctuations. Recommendations for probe design and operation are provided.

Employee Perceptions of Their Organization's Level of Emergency Preparedness Following a Brief Workplace Emergency Planning Educational Presentation.

PubMed

Renschler, Lauren A; Terrigino, Elizabeth A; Azim, Sabiya; Snider, Elsa; Rhodes, Darson L; Cox, Carol C

2016-06-01

A brief emergency planning educational presentation was taught during work hours to a convenience sample of employees of various workplaces in Northern Missouri, USA. Participants were familiarized with details about how an emergency plan is prepared by management and implemented by management-employee crisis management teams - focusing on both employee and management roles. They then applied the presentation information to assess their own organization's emergency preparedness level. Participants possessed significantly (p < 0.05) higher perceptions of their organization's level of emergency preparedness than non-participants. It is recommended that an assessment of organizational preparedness level supplement emergency planning educational presentations in order to immediately apply the material covered and encourage employees to become more involved in their organization's emergency planning and response. Educational strategies that involve management-employee collaboration in activities tailored to each workplace's operations and risk level for emergencies should be implemented.

Evaluating optical hazards from plasma arc cutting.

PubMed

Glassford, Eric; Burr, Gregory

2018-01-01

The Health Hazard Evaluation Program of the National Institute for Occupational Safety and Health evaluated a steel building materials manufacturer. The employer requested the evaluation because of concerns about optical radiation hazards from a plasma arc cutting system and the need to clarify eye protection requirements for plasma operators, other employees, and visitors. The strength of the ultraviolet radiation, visible radiation (light), and infrared radiation generated by the plasma arc cutter was measured at various distances from the source and at different operating amperages. Investigators also observed employees performing the plasma arc cutting. Optical radiation above safe levels for the unprotected eyes in the ultraviolet-C, ultraviolet-B, and visible light ranges were found during plasma arc cutting. In contrast, infrared and ultraviolet-A radiation levels during plasma arc cutting were similar to background levels. The highest non-ionizing radiation exposures occurred when no welding curtains were used. A plasma arc welding curtain in place did not eliminate optical radiation hazards to the plasma arc operator or to nearby employees. In most instances, the measured intensities for visible light, UV-C, and UV-B resulted in welding shade lens numbers that were lower than those stipulated in the OSHA Filter Lenses for Protection Against Radiant Energy table in 29 CFR 1910.133(a)(5). [1] Investigators recommended using a welding curtain that enclosed the plasma arc, posting optical radiation warning signs in the plasma arc cutter area, installing audible or visual warning cues when the plasma arc cutter was operating, and using welding shades that covered the plasma arc cutter operator's face to protect skin from ultraviolet radiation hazards.

G6PD testing in support of treatment and elimination of malaria: recommendations for evaluation of G6PD tests.

PubMed

Domingo, Gonzalo J; Satyagraha, Ari Winasti; Anvikar, Anup; Baird, Kevin; Bancone, Germana; Bansil, Pooja; Carter, Nick; Cheng, Qin; Culpepper, Janice; Eziefula, Chi; Fukuda, Mark; Green, Justin; Hwang, Jimee; Lacerda, Marcus; McGray, Sarah; Menard, Didier; Nosten, Francois; Nuchprayoon, Issarang; Oo, Nwe Nwe; Bualombai, Pongwit; Pumpradit, Wadchara; Qian, Kun; Recht, Judith; Roca, Arantxa; Satimai, Wichai; Sovannaroth, Siv; Vestergaard, Lasse S; Von Seidlein, Lorenz

2013-11-04

Malaria elimination will be possible only with serious attempts to address asymptomatic infection and chronic infection by both Plasmodium falciparum and Plasmodium vivax. Currently available drugs that can completely clear a human of P. vivax (known as "radical cure"), and that can reduce transmission of malaria parasites, are those in the 8-aminoquinoline drug family, such as primaquine. Unfortunately, people with glucose-6-phosphate dehydrogenase (G6PD) deficiency risk having severe adverse reactions if exposed to these drugs at certain doses. G6PD deficiency is the most common human enzyme defect, affecting approximately 400 million people worldwide.Scaling up radical cure regimens will require testing for G6PD deficiency, at two levels: 1) the individual level to ensure safe case management, and 2) the population level to understand the risk in the local population to guide Plasmodium vivax treatment policy. Several technical and operational knowledge gaps must be addressed to expand access to G6PD deficiency testing and to ensure that a patient's G6PD status is known before deciding to administer an 8-aminoquinoline-based drug.In this report from a stakeholder meeting held in Thailand on October 4 and 5, 2012, G6PD testing in support of radical cure is discussed in detail. The focus is on challenges to the development and evaluation of G6PD diagnostic tests, and on challenges related to the operational aspects of implementing G6PD testing in support of radical cure. The report also describes recommendations for evaluation of diagnostic tests for G6PD deficiency in support of radical cure.

Prevention of zebra mussel infestation and dispersal during aquaculture operations

USGS Publications Warehouse

Waller, D.L.; Fisher, S.W.; Dabrowska, H.

1996-01-01

The zebra mussel Dreissena polymorpha, an exotic invasive species, poses a major threat to North American fish management programs and the aquaculture industry. Fish hatcheries may become infected with zebra mussels from a variety of sources, including the water supply, fish shipments, boats, and equipment. The hatcheries could then serve as agents for the overland dispersal of zebra mussels into stocked waters and to other fish hatcheries. We evaluated the effectiveness and safety of aquaculture chemicals for use in controlling zebra mussels in fish hatcheries and preventing dispersal of veligers during fish transport. Chemicals were evaluated for use in fish transport and as disinfectants for ponds and equipment. Standardized static toxicity tests were conducted with representative species of warmwater, coolwater, and coldwater fishes and with larval (3-d-old veligers), early juvenile (settling larvae), and adult zebra mussels. Chemical concentrations and exposure durations were based on recommended treatment levels for fish, eggs, and ponds. Recommended treatment levels were also exceeded, if necessary, to establish lethal levels for zebra mussels of different developmental stages. Our results indicate that some chemicals currently in use in hatcheries may be effective for controlling zebra mussels in various operations. Chloride salts were the safest and most effective therapeutants tested for use in fish transport. The toxicity of chloride salts to fish varied among species and with temperature; only one treatment regime (sodium chloride at 10,000 mg/L) was safe to all fish species that we tested, but it was only effective on veliger and settler stages of the zebra mussel. Effective disinfectants were benzalkonium chloride for use on equipment and rotenone for use in ponds after fish are harvested. The regulatory status of the identified chemicals is discussed as well as several nonchemical control alternatives.

Anaerobic co-digestion of dairy manure and potato waste

NASA Astrophysics Data System (ADS)

Yadanaparthi, Sai Krishna Reddy

Dairy and potato are two important agricultural commodities in Idaho. Both the dairy and potato processing industries produce a huge amount of waste which could cause environmental pollution. To minimize the impact of potential pollution associated with dairy manure (DM) and potato waste (PW), anaerobic co-digestion has been considered as one of the best treatment process. The purpose of this research is to evaluate the anaerobic co-digestion of dairy manure and potato waste in terms of process stability, biogas generation, construction and operating costs, and potential revenue. For this purpose, I conducted 1) a literature review, 2) a lab study on anaerobic co-digestion of dairy manure and potato waste at three different temperature ranges (ambient (20-25°C), mesophilic (35-37°C) and thermophilic (55-57°C) with five mixing ratios (DM:PW-100:0, 90:10, 80:20, 60:40, 40:60), and 3) a financial analysis for anaerobic digesters based on assumed different capital costs and the results from the lab co-digestion study. The literature review indicates that several types of organic waste were co-digested with DM. Dairy manure is a suitable base matter for the co-digestion process in terms of digestion process stability and methane (CH4) production (Chapter 2). The lab tests showed that co-digestion of DM with PW was better than digestion of DM alone in terms of biogas and CH4 productions (Chapter 3). The financial analysis reveals DM and PW can be used as substrate for full size anaerobic digesters to generate positive cash flow within a ten year time period. Based on this research, the following conclusions and recommendations were made: ▸ The ratio of DM:PW-80:20 is recommended at thermophilic temperatures and the ratio of DM:PW-90:10 was recommended at mesophilic temperatures for optimum biogas and CH4 productions. ▸ In cases of anaerobic digesters operated with electricity generation equipment (generators), low cost plug flow digesters (capital cost of 600/cow) operating at thermophilic temperatures are recommended. • The ratio of DM:PW-90:10 or 80:20 is recommended while operating low cost plug flow digesters at thermophilic temperatures. ▸ In cases of anaerobic digesters operated without electricity generation equipment (generators), completely mixed or high or low cost plug flow digesters can be used. • The ratio of DM:PW-80:20 is recommended for completely mixed digesters operated at thermophilic temperatures; • The ratio of DM:PW-90:10 or 80:20 is recommended for high cost plug flow digesters (capital cost of 1,000/cow) operated at thermophilic temperatures; • All of the four co-digested mixing ratios (i.e. DM:PW-90:10 or 80:20 or 60:40 or 40:60) are good for low cost plug flow digesters (capital cost of $600/cow) operated at thermophilic temperatures. The ratio of DM:PW-90:10 is recommended for positive cash flow within the ten year period if the low cost plug flow digesters are operated at mesophilic temperatures.

Pre-operative function, motivation and duration of symptoms predict sporting participation after total hip replacement.

PubMed

Ollivier, M; Frey, S; Parratte, S; Flecher, X; Argenson, J N

2014-08-01

There is little in the literature on the level of participation in sports which patients undertake after total hip replacement (THR). Our aims in this study were to determine first, the level of sporting activity, second, the predictive factors for returning to sporting activity, and third, the correlation between participation in sports and satisfaction after THR. We retrospectively identified 815 patients who had undergone THR between 1995 and 2005. All were asked to complete a self-administered questionnaire regarding their sporting activity. A total of 571 patients (71%) met the inclusion criteria and completed the evaluation. At a mean follow-up of 9.8 years (sd 2.9), 366 patients (64%) returned to sporting activity as defined by a University of California at Los Angeles (UCLA) score of > 5. The main reasons that patients had for refraining from sports were fear of dislocation (65; 31.6%), avoiding wear (52; 25.4%), and the recommendation of the surgeon (34; 16.6%). There was a significant relationship between higher post-operative participation in sport in those patients with a higher pre-operative Harris hip score (HHS) (p = 0.0074), motivation to participate in sporting activities (p = 0.00022) and a shorter duration of symptoms (p = 0.0034). Finally, there was a correlation between age (p = 0.00013), UCLA score (p = 0.012) and pre-operative HHS (p = 0.00091) and satisfaction. In conclusion, we found that most patients participate in sporting activity after THR, regardless of the advice of their surgeon, and that there is a correlation between the level of participation and pre-operative function, motivation, duration of symptoms and post-operative satisfaction. ©2014 The British Editorial Society of Bone & Joint Surgery.

Assessment of treatment systems for highway runoff pollution control in Portugal.

PubMed

Barbosa, A E; Fernandes, J N

2009-01-01

Treatment systems for highway runoff pollution control are now common structures for environmental impacts reduction in Portugal. Such systems must be monitored and its performance periodically assessed, in order to understand if they are accomplishing the targets for environmental protection. Wise management decisions must incorporate the soundness of the project, the construction and maintenance costs, and the ability of the system to reduce the pollution to the level required for environmental protection. To gather, organize and analyse all the existing information concerning the constructed treatment systems, their operation, maintenance and efficiency were understood as a priority by the Portuguese Roads' Institute. The authors of this article were responsible for this 3 years study that finished in May 2008. A total of 27 different systems, corresponding to 13 different project types, located in different places in Portugal have been characterized and evaluated. Several conclusions could be drawn from the evaluation and recommendations were produced concerning the project, the construction and operation phases and the monitoring activities. The recommendations concern tasks to be performed and information that should be gathered and presented to the Portuguese Road's Institute. It is expected that these indications will contribute to improve the future practice in Portugal.

Space 2100: A Shared Visioning Exercise for the Future Space Economy

NASA Astrophysics Data System (ADS)

Ferguson, C. K.; Nall, M. E.; Scott, D. W.; Tinker, M. L.; Oneil, D.; Sivak, A. D.; Wright, G. M.; Eberly, E. A.; Ramdall, C.

In 2013, NASA's Marshall Space Flight Center chartered a diverse team for a six-week "sprint" to envision how Earth, space, and public/private entities might be operating in the year 2100. This sprint intended to inspire innovation, creativity and improved teamwork between all levels of employees, in addition to pulling diverse ideas about exploration from organizations that are not traditionally included in technology development at NASA. The team was named Space 2100. In 2014, the team ran a sprint based on the previous outcomes to a) develop detailed estimates of operations and challenges of space activities in the vicinity of the Earth and Moon in the year 2050, b) identify evolutionary steps to make this vision a reality, and c) recommend actions to enable those steps. In 2015, the team continued building on previous years by identifying technologies and approaches to reduce and ultimately eliminate the need for resupply from Earth, enabling self-sufficient exploration throughout the solar system. This exercise identified 30 technologies as potential critical paths to Earth independency. Space 2100's conclusions and recommendations are not part of NASA's strategic planning or policy. This paper explores the three Space 2100 sprints and their implications for the future of space exploration.

Intrapersonal, Behavioral, and Environmental Factors Associated With Meeting Recommended Physical Activity Among Rural Latino Youth

PubMed Central

Perry, Cynthia K.; Saelens, Brian E.; Thompson, Beti

2013-01-01

This study aimed to identify intrapersonal, behavioral, and environmental factors associated with engaging in recommended levels of physical activity among rural Latino middle school youth. Data were from an anonymous survey of 773 Latino youth (51% female) about level of and barriers and motivators to physical activity, risk behaviors, and park use. Logistic regression models identified factors correlated with meeting recommended levels of physical activity (5 days or more 360 min/day). Thirty-four percent of girls and 41% of boys reported meeting this physical activity recommendation. Participation in an organized after school activity (p < .001) and in physical education (PE) classes 5 days a week (p < .001) were strongly associated with meeting recommended physical activity level. Making PE available 5 days a week and creating opportunities for organized after school physical activity programs may increase the number of rural Latino middle school youth who meet recommended physical activity level. PMID:22109778

Intrapersonal, behavioral, and environmental factors associated with meeting recommended physical activity among rural Latino youth.

PubMed

Perry, Cynthia K; Saelens, Brian E; Thompson, Beti

2011-11-01

This study aimed to identify intrapersonal, behavioral, and environmental factors associated with engaging in recommended levels of physical activity among rural Latino middle school youth. Data were from an anonymous survey of 773 Latino youth (51% female) about level of and barriers and motivators to physical activity, risk behaviors, and park use. Logistic regression models identified factors correlated with meeting recommended levels of physical activity (5 days or more 3 60 min/day). Thirty-four percent of girls and 41% of boys reported meeting this physical activity recommendation. Participation in an organized after school activity (p < .001) and in physical education (PE) classes 5 days a week (p < .001) were strongly associated with meeting recommended physical activity level. Making PE available 5 days a week and creating opportunities for organized after school physical activity programs may increase the number of rural Latino middle school youth who meet recommended physical activity level.

Peace-enforcement: Mission, strategy, and doctrine. Monograph report

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

Kohler, J.B.

This monograph examines a new military mission-peace-enforcement. It does so through a five part strategic process that links national interests and national security strategy to tactical operations. it asserts that US national security strategy is evolving as a result of the end of the Cold War and that a new strategy will lead to new military missions. The monograph first describes a limited spectrum of military operations that comprise a peace-enforcement mission. Next, it reviews enduring US national interests then analyzes evolving national security strategy to determine if these elements of strategy support the need for a peace-enforcement mission. Themore » monograph then examines national military strategy, operational level strategy and joint guidance, and finally, US tactical doctrine to determine if peace-enforcement is a mission the US military can execute today. The monograph concludes that national interests and evolving national security strategy will emphasize promotion of democracy and stability in lieu of Cold War deterrence. The national military strategy partially supports this shift; support should increase as the Clinton administration clarifies its policy and solidifies the shift from containment. Lastly, the monograph finds there is sufficient operational and tactical level guidance to conduct the mission and recommends formal acceptance of the peace-enforcement mission into joint doctrine.« less

Heavy construction equipment noise study using dosimetry and time-motion studies

NASA Astrophysics Data System (ADS)

Spencer, Ellsworth R.; Yantek, David S.

2005-09-01

Noise-induced hearing loss continues to afflict workers in many occupational settings despite longstanding recognition of the problems and well-known methods of prevention and regulations. Sound levels associated with heavy construction equipment range from 80 to 120 dB(A) and power tools commonly used in construction produce sound levels up to 115 dB(A). The focus of the research was to determine the noise exposures of heavy construction equipment operators while documenting the workers' tasks, (i.e., hauling, moving, and/or pushing construction material). Time-motion studies were performed at the construction sites and were used to correlate the noise dosage with the work performed by equipment operators. The cumulative dose for the operator was then plotted with references to work tasks, to identify the tasks that caused the greatest noise exposure. Three construction sites were examined and located in the western Pennsylvania and eastern Ohio areas. The types of construction equipment studied included asphalt pavers, backhoes, bulldozers, compaction equipment, excavators, haul trucks, telehandlers, and wheeled loaders. The results showed that bulldozer operators consistently had the highest noise exposures, ranging from a NIOSH REL (Recommended Exposure Limit) dose of 844% to 25836% and an OSHA PEL (Permissible Exposure Limit) dose of 139% to 1397%.

Meteorological support for space operations: Review and recommendations

NASA Technical Reports Server (NTRS)

1988-01-01

The current meteorological support provided to NASA by NOAA, Air Weather Service, and other contractors is reviewed and suggestions are offered for its improvement. These recommendations include improvement in NASA's internal management organizational structure that would accommodate continued improvement in operational weather support, installation of new observing systems, improvement in analysis and forecasting procedures, and the establishment of an Applied Research and Forecasting Facility.

Space station operations task force summary report

NASA Technical Reports Server (NTRS)

1987-01-01

A companion to the Space Stations Operation Task Force Panels' Reports, this document summarizes all space station program goals, operations, and the characteristics of the expected user community. Strategies for operation and recommendations for implementation are included.

Practice guidelines for endoscopic ultrasound-guided celiac plexus neurolysis.

PubMed

Wyse, Jonathan M; Battat, Robert; Sun, Siyu; Saftoiu, Adrian; Siddiqui, Ali A; Leong, Ang Tiing; Arturo Arias, Brenda Lucia; Fabbri, Carlo; Adler, Douglas G; Santo, Erwin; Kalaitzakis, Evangelos; Artifon, Everson; Mishra, Girish; Okasha, Hussein Hassan; Poley, Jan Werner; Guo, Jintao; Vila, Juan J; Lee, Linda S; Sharma, Malay; Bhutani, Manoop S; Giovannini, Marc; Kitano, Masayuki; Eloubeidi, Mohamad Ali; Khashab, Mouen A; Nguyen, Nam Q; Saxena, Payal; Vilmann, Peter; Fusaroli, Pietro; Garg, Pramod Kumar; Ho, Sammy; Mukai, Shuntaro; Carrara, Silvia; Sridhar, Subbaramiah; Lakhtakia, Sundeep; Rana, Surinder S; Dhir, Vinay; Sahai, Anand V

2017-01-01

The objective of guideline was to provide clear and relevant consensus statements to form a practical guideline for clinicians on the indications, optimal technique, safety and efficacy of endoscopic ultrasound guided celiac plexus neurolysis (EUS-CPN). Six important clinical questions were determined regarding EUS-CPN. Following a detailed literature review, 6 statements were proposed attempting to answer those questions. A group of expert endosonographers convened in Chicago, United States (May 2016), where the statements were presented and feedback provided. Subsequently a consensus group of 35 expert endosonographers voted based on their individual level of agreement. A strong recommendation required 80% voter agreement. The modified GRADE (Grading of Recommendations Assessment, Development, and Evaluation) criteria were used to rate the strength of recommendations and the quality of evidence. Eighty percent agreement was reached on 5 of 6 consensus statements, 79.4% agreement was reached on the remaining one. EUS-CPN is efficacious, should be integrated into the management of pancreas cancer pain, and can be considered early at the time of diagnosis of inoperable disease. Techniques may still vary based on operator experience. Serious complications exist, but are rare.

Towards Harmonious Coexistence in the Unlicensed Spectrum: Rational Cooperation of Operators.

PubMed

Bae, Sunghwan; Kim, Hongseok

2017-10-24

5G New Radio (NR) operating in the unlicensed spectrum is accelerating the Fourth Industrial Revolution by supporting Internet of Things (IoT) networks or Industrial IoT deployments. Specifically, LTE-Advanced (LTE-A) is looking to achieve spectrum integration through coexistence with multi-radio access technology (RAT) systems in the same unlicensed bands with both licensed-assisted and stand-alone access. The listen-before-talk (LBT) mechanism is mainly considered to enable an LTE operator to protect other incumbent unlicensed systems. In this article, we investigate the behaviors of multiple LTE operators along with the deployment of WiFi networks in the unlicensed spectrum from both short- and long-term points of view. In countries without mandatory LBT requirements, we show that an LTE operator is susceptible to collusion with another LTE operator, thus exploiting scarce spectrum resources by deceiving other wireless networks into thinking that channels are always busy; hence, mandatory usage of LTE with LBT is highly recommended at national level to achieve harmonious coexistence in the unlicensed spectrum. We discuss several possible coexistence scenarios to resolve the operator's dilemmaas well as to improve unlicensed spectrum efficiency among multi-RAT systems, which is viable in the near future.

Use of a multi-level mixed methods approach to study the effectiveness of a primary care progressive return to activity protocol after acute mild traumatic brain injury/concussion in the military.

PubMed

Gregory, Emma; West, Therese A; Cole, Wesley R; Bailie, Jason M; McCulloch, Karen L; Ettenhofer, Mark L; Cecchini, Amy; Qashu, Felicia M

2017-01-01

The large number of U.S. service members diagnosed with concussion/mild traumatic brain injury each year underscores the necessity for clear and effective clinical guidance for managing concussion. Relevant research continues to emerge supporting a gradual return to pre-injury activity levels without aggravating symptoms; however, available guidance does not provide detailed standards for this return to activity process. To fill this gap, the Defense and Veterans Brain Injury Center released a recommendation for primary care providers detailing a step-wise return to unrestricted activity during the acute phase of concussion. This guidance was developed in collaboration with an interdisciplinary group of clinical, military, and academic subject matter experts using an evidence-based approach. Systematic evaluation of the guidance is critical to ensure positive patient outcomes, to discover barriers to implementation by providers, and to identify ways to improve the recommendation. Here we describe a multi-level, mixed-methods approach to evaluate the recommendation incorporating outcomes from both patients and providers. Procedures were developed to implement the study within complex but ecologically-valid settings at multiple military treatment facilities and operational medical units. Special consideration was given to anticipated challenges such as the frequent movement of military personnel, selection of appropriate design and measures, study implementation at multiple sites, and involvement of multiple service branches (Army, Navy, and Marine Corps). We conclude by emphasizing the need to consider contemporary approaches for evaluating the effectiveness of clinical guidance. Copyright © 2016 Elsevier Inc. All rights reserved.

Quality of Evidence Underlying the American Heart Association/American College of Cardiology/Heart Rhythm Society Guidelines on the Management of Atrial Fibrillation.

PubMed

Barnett, Adam S; Lewis, William R; Field, Michael E; Fonarow, Gregg C; Gersh, Bernard J; Page, Richard L; Calkins, Hugh; Steinberg, Benjamin A; Peterson, Eric D; Piccini, Jonathan P

2017-03-01

The joint American College of Cardiology (ACC), American Heart Association (AHA), and Heart Rhythm Society (HRS) guidelines on the management of atrial fibrillation (AF) are used extensively to guide patient care. To describe the evidence base and changes over time in the AHA/ACC/HRS guidelines on AF with respect to the distribution of recommendations across classes of recommendations and levels of evidence. Data from the AHA/ACC/HRS guidelines on AF from 2001, 2006, 2011, and 2014 were abstracted. A total of 437 recommendations were included. The number of recommendations and distribution of classes of recommendation (I, II, and III) and levels of evidence (A, B, and C) were determined for each guideline edition. Changes in recommendation class and level of evidence were analyzed using the 2001 and 2014 guidelines. From 2001 to 2014, the total number of AF recommendations increased from 95 to 113. Numerically, there was a nonsignificant increase in the use of level of evidence B (30.5% to 39.8%; P = .17) and a nonsignificant decrease in the use of level of evidence C (60.0% to 51.3%; P = .21), with limited changes in the use of level A evidence (8.4% to 8.8%; P = .92). In the 2014 guideline document, 10 of 113 (8.8%) recommendations were supported by level of evidence A, whereas 58 of 113 (51.3%) were supported by level of evidence C. Most recommendations were equally split among class I (49/113; 43.4%) and class IIa/IIb (49/113; 43.4%), with the minority (15/113; 13.3%) assigned as class III. Most class I recommendations were supported by level of evidence C (29/49; 59.2%), whereas only 6 of 49 (12.2%) were supported by level of evidence A. No rate control category recommendations were supported by level of evidence A. Some aspects of the quality of evidence underlying AHA/ACC/HRS AF guidelines have improved over time. However, the use of level of evidence A remains low and has not increased since 2001. These findings highlight the need for focused and pragmatic randomized studies on the clinical management of AF.

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

Young, W.P.; Burkhardt, H.L.; Alsager, M.

Surveys were conducted of 200 machines owned by 194 dentists. The survey consisted of: a visual check of the condition of the machine; determination of whether adequate aluminum filtration and a lead washer were installed; and a check of the condition of the tube housing shielding with a radiation survey meter. The exposures received by the dentist and his assistant while in their normal positions were also measured. Recommended changes in operating technique were: operation at a higher voltage and lower amperage; use of high- speed film; and underexposure and overdevelopment of the film. Before washers and filters were changedmore » it was found that the equivalent filtration in 161 machines was less than 2.5 mm of aluminum, 19 machines had 2.5 mm, and 20 had an unknown amount. Before the program was initiated the beam diameter of 100 machines was 2.75 in.; 71 were larger than 2.75 in., and in 29 cases, unknown. Emulsion rating of film used initially was: 120 dentists used fast, 67 intermediate, 6 slow, and 7 films of unknown speed. The operating kilovoltage varied widely: 11 operated at 50-3 kv, 117 at 65-7, 29 at 70-2, 15 at 80-90, and 18 at an unknown voltage. It was found that 11 machines still in use were manufactured before 1935, 23 were manufactured from 1935 to 1944, 44 from 1955 to 1960, and 20 had an unknown date of manufacture. Although in most instances radiation levels did not approach the maximum allowable limits, it was recommended all unnecessary radiation exposure be eliminated. (H.H.D.)« less

Orbit Transfer Vehicle Engine Study. Phase A, extension 1: Alternate low-thrust capability task report

NASA Technical Reports Server (NTRS)

Mellish, J. A.

1980-01-01

The feasibility and design impact of a requirement for the advanced expander cycle engine to be adaptable to extended low thrust operation of approximately 1K to 2K lb is assessed. It is determined that the orbit transfer vehicle point design engine can be reduced in thrust with minor injector modifications from 15K to 1K without significantly affecting combustion performance efficiency or injector face/chamber wall thermal compatibility. Likewise, high frequency transverse mode combustion instability is not expected to be detrimentally affected. Primarily, the operational limitations consist of feed system chugging instabilities and potential coupling of the injector response with the chamber longitudinal mode resonances under certain operating conditions. The recommended injector modification for low thrust operation is a change in the oxidizer injector element orifice size. Analyses also indicate that chamber coolant flow stability may be a concern below 2K 1bF operation and oxidizer pump stability could be a problem below a 2K thrust level although a recirculation flow could alleviate the problem.

Transit Operations Decision Support System (TODSS) core requirements evaluation and update recommendations.

DOT National Transportation Integrated Search

2009-10-01

Transit Operations Decision Support Systems (TODSS) are systems designed to support dispatchers and others in real-time operations : management in response to incidents, special events, and other changing conditions in order to improve operating spee...

Operation and Maintenance of Water Pollution Control Facilities: A WPCF White Paper.

ERIC Educational Resources Information Center

Hill, William R.; And Others

1979-01-01

Presented are the recommendations of the Water Pollution Control Federation for operation and maintenance consideration during the planning design, construction, and operation of wastewater treatment facilities. (CS)

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

Barr, J.H.; Silha, R.E.; Richards, A.G.

A report of the Radiation Protection Committee of the American Academy of Oral Roentgenology on recommendation for reducing exposure to patient and dentist during oral radiographic procedures is reviewed. The following aspects of the problem of exposure reduction are considered: max permissible exposures to operators and patients, sources of radiation in dental offices, recommended building materials to be used for wall construction (with their lead equivalents), and detailed statements of procedures for protecting operators and patients. (TCO)

Operational Protection from Unmanned Aerial Systems

DTIC Science & Technology

2015-05-15

future threat posed by adversary UAS to U.S. forces, both in the form of system capabilities and methods of employment . It also addresses present...both in the form of system capabilities and methods of employment . It also addresses present counter UAS capabilities and recommends ways and means to...capabilities and methods of employment . It also addresses present counter UAS capabilities and recommends ways and means to provide better operational

AASC Recommendations for the Education of an Applied Climatologist

NASA Astrophysics Data System (ADS)

Nielsen-Gammon, J. W.; Stooksbury, D.; Akyuz, A.; Dupigny-Giroux, L.; Hubbard, K. G.; Timofeyeva, M. M.

2011-12-01

The American Association of State Climatologists (AASC) has developed curricular recommendations for the education of future applied and service climatologists. The AASC was founded in 1976. Membership of the AASC includes state climatologists and others who work in state climate offices; climate researchers in academia and educators; applied climatologists in NOAA and other federal agencies; and the private sector. The AASC is the only professional organization dedicated solely to the growth and development of applied and service climatology. The purpose of the recommendations is to offer a framework for existing and developing academic climatology programs. These recommendations are intended to serve as a road map and to help distinguish the educational needs for future applied climatologists from those of operational meteorologists or other scientists and practitioners. While the home department of climatology students may differ from one program to the next, the most essential factor is that students can demonstrate a breadth and depth of understanding in the knowledge and tools needed to be an applied climatologist. Because the training of an applied climatologist requires significant depth and breadth, the Masters degree is recommended as the minimum level of education needed. This presentation will highlight the AASC recommendations. These include a strong foundation in: - climatology (instrumentation and data collection, climate dynamics, physical climatology, synoptic and regional climatology, applied climatology, climate models, etc.) - basic natural sciences and mathematics including calculus, physics, chemistry, and biology/ecology - fundamental atmospheric sciences (atmospheric dynamics, atmospheric thermodynamics, atmospheric radiation, and weather analysis/synoptic meteorology) and - data analysis and spatial analysis (descriptive statistics, statistical methods, multivariate statistics, geostatistics, GIS, etc.). The recommendations also include a secondary area of concentration (agriculture, economics, geography, hydrology, marine sciences, natural resources, policy, etc.) and a major applied climate research component.

INTERNATIONAL REPORT: Practical realization of the definition of the metre, including recommended radiations of other optical frequency standards (2003)

NASA Astrophysics Data System (ADS)

Felder, R.

2005-08-01

In 2003, the International Committee for Weights and Measures (CIPM) recommended updated values of the frequency for certain optical frequency standards recommended for the practical realization of the definition of the metre. The text of this CIPM Recommendation and details of the updated radiations are given here. The complete updated set of recommended radiations, including frequencies, wavelengths, uncertainties and operating conditions where appropriate, is available on the BIPM website.

Pediatric Drowning: A Standard Operating Procedure to Aid the Prehospital Management of Pediatric Cardiac Arrest Resulting From Submersion.

PubMed

Best, Rebecca R; Harris, Benjamin H L; Walsh, Jason L; Manfield, Timothy

2017-05-08

Drowning is one of the leading causes of death in children. Resuscitating a child following submersion is a high-pressure situation, and standard operating procedures can reduce error. Currently, the Resuscitation Council UK guidance does not include a standard operating procedure on pediatric drowning. The objective of this project was to design a standard operating procedure to improve outcomes of drowned children. A literature review on the management of pediatric drowning was conducted. Relevant publications were used to develop a standard operating procedure for management of pediatric drowning. A concise standard operating procedure was developed for resuscitation following pediatric submersion. Specific recommendations include the following: the Heimlich maneuver should not be used in this context; however, prolonged resuscitation and therapeutic hypothermia are recommended. This standard operating procedure is a potentially useful adjunct to the Resuscitation Council UK guidance and should be considered for incorporation into its next iteration.

40 CFR 240.201-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) SOLID WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended... precautions to be taken if unacceptable wastes are delivered to the facility or are improperly left there...

40 CFR 240.201-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) SOLID WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended... precautions to be taken if unacceptable wastes are delivered to the facility or are improperly left there...

Wealth, health, HIV and the economics of hope

PubMed Central

Barnett, Tony; Weston, Mark

2012-01-01

HIV/AIDS primarily affects people of working age. Population susceptibility is poorly understood. This paper speculates that an operationally defined concept of hope may offer new ways of understanding its social epidemiology. Hope is directly linked to the future in as much as it determines the value people place on that future. Individual and communal levels of hope may vary, with consequent impacts on HIV transmission. HIV/AIDS in turn may reduce hope and thereby reduce societies’ future wellbeing. The paper concludes by offering recommendations for research, programming and policy. PMID:18641467

Aerospace Safety Advisory Panel

NASA Technical Reports Server (NTRS)

1992-01-01

The results of the Panel's activities are presented in a set of findings and recommendations. Highlighted here are both improvements in NASA's safety and reliability activities and specific areas where additional gains might be realized. One area of particular concern involves the curtailment or elimination of Space Shuttle safety and reliability enhancements. Several findings and recommendations address this area of concern, reflecting the opinion that safety and reliability enhancements are essential to the continued successful operation of the Space Shuttle. It is recommended that a comprehensive and continuing program of safety and reliability improvements in all areas of Space Shuttle hardware/software be considered an inherent component of ongoing Space Shuttle operations.

Deployment of Recommender Systems: Operational and Strategic Issues

ERIC Educational Resources Information Center

Ghoshal, Abhijeet

2011-01-01

E-commerce firms are increasingly adopting recommendation systems to effectively target customers with products and services. The first essay examines the impact that improving a recommender system has on firms that deploy such systems. A market with customers heterogeneous in their search costs is considered. We find that in a monopoly, a firm…

30 CFR 250.114 - How must I install and operate electrical equipment?

Code of Federal Regulations, 2012 CFR

2012-07-01

... their facilities. (a) You must classify all areas according to API RP 500, Recommended Practice for... 1 and Division 2, or API RP 505, Recommended Practice for Classification of Locations for Electrical... electrical systems according to API RP 14F, Recommended Practice for Design and Installation of Electrical...

30 CFR 250.114 - How must I install and operate electrical equipment?

Code of Federal Regulations, 2011 CFR

2011-07-01

... structures, and their facilities. (a) You must classify all areas according to API RP 500, Recommended... Class I, Division 1 and Division 2, or API RP 505, Recommended Practice for Classification of Locations... according to API RP 14F, Recommended Practice for Design and Installation of Electrical Systems for Fixed...

30 CFR 250.114 - How must I install and operate electrical equipment?

Code of Federal Regulations, 2014 CFR

2014-07-01

... their facilities. (a) You must classify all areas according to API RP 500, Recommended Practice for... 1 and Division 2, or API RP 505, Recommended Practice for Classification of Locations for Electrical... electrical systems according to API RP 14F, Recommended Practice for Design and Installation of Electrical...

30 CFR 250.114 - How must I install and operate electrical equipment?

Code of Federal Regulations, 2013 CFR

2013-07-01

... their facilities. (a) You must classify all areas according to API RP 500, Recommended Practice for... 1 and Division 2, or API RP 505, Recommended Practice for Classification of Locations for Electrical... electrical systems according to API RP 14F, Recommended Practice for Design and Installation of Electrical...

Disinfection by-products and microbial contamination in the treatment of pool water with granular activated carbon.

PubMed

Uhl, W; Hartmann, C

2005-01-01

For swimming pools, it is generally agreed that free chlorine levels have to be maintained to guarantee adequate disinfection. Recommended free chlorine levels can vary between 0.3 and 0.6 mg/L in Germany and up to 3 mg/L in other countries. Bathers introduce considerable amounts of organic matter, mainly in the form of such as urine and sweat, into the pool water. As a consequence, disinfection byproducts (DBPs) are formed. Regulations in Germany recommend levels of combined chlorine of less than 0.2 mg/L and levels of trihalomethanes (THMs) of less than 20 microg/L. Haloacetic acids (HAAs), haloacetonitriles (HANs), chloropicrin and chloral hydrate are also detected in considerable amounts. However, these compounds are not regulated yet. Swimming pool staff and swimmers, especially athletes, are primarily exposed to these byproducts by inhalation and/or dermal uptake. In Germany, new regulations for swimming pool water treatment generally require the use of activated carbon. In this project, three different types of granular activated carbon (GAC) (one standard GAC, two catalytic GACs) are compared for their long time behaviour in pool water treatment. In a pilot plant operated with real swimming pool water, production and removal of disinfection byproducts (THMs, HAAs, AOXs), of biodegradable substances (AOC), of bacteria (Pseudomonas aeruginosa, Legionella, coliforms, HPC) as well as the removal of chlorine and chloramines are monitored as function of GAC bed depth. Combined chlorine penetrates deeper in the filter bed than free chlorine does. However, both, free and combined chlorine removal efficiencies decrease over the time of filter operation. The decreases of removal efficiencies are also observed for parameters such as dissolved organic carbon, spectral absorption coefficient, adsorbable organic carbon and most of the disinfection byproducts. However, THMs, especially chloroform are produced in the filter bed. The GAC beds were contaminated microbially, especially with P. aeruginosa. The contamination was not removable by backwashing with chlorine concentrations up to 2 mg/l free chlorine.

High Altitude Long Endurance Remotely Operated Aircraft - National Airspace System Integration - Simulation IPT: Detailed Airspace Operations Simulation Plan. Version 1.0

NASA Technical Reports Server (NTRS)

2004-01-01

The primary goal of Access 5 is to allow safe, reliable and routine operations of High Altitude-Long Endurance Remotely Operated Aircraft (HALE ROAs) within the National Airspace System (NAS). Step 1 of Access 5 addresses the policies, procedures, technologies and implementation issues of introducing such operations into the NAS above pressure altitude 40,000 ft (Flight Level 400 or FL400). Routine HALE ROA activity within the NAS represents a potentially significant change to the tasks and concerns of NAS users, service providers and other stakeholders. Due to the complexity of the NAS, and the importance of maintaining current high levels of safety in the NAS, any significant changes must be thoroughly evaluated prior to implementation. The Access 5 community has been tasked with performing this detailed evaluation of routine HALE-ROA activities in the NAS, and providing to key NAS stakeholders a set of recommended policies and procedures to achieve this goal. Extensive simulation, in concert with a directed flight demonstration program are intended to provide the required supporting evidence that these recommendations are based on sound methods and offer a clear roadmap to achieving safe, reliable and routine HALE ROA operations in the NAS. Through coordination with NAS service providers and policy makers, and with significant input from HALE-ROA manufacturers, operators and pilots, this document presents the detailed simulation plan for Step 1 of Access 5. A brief background of the Access 5 project will be presented with focus on Steps 1 and 2, concerning HALE-ROA operations above FL400 and FL180 respectively. An overview of project management structure follows with particular emphasis on the role of the Simulation IPT and its relationships to other project entities. This discussion will include a description of work packages assigned to the Simulation IPT, and present the specific goals to be achieved for each simulation work package, along with the associated deliverables necessary to achieve these goals and the needs of other Access 5 IPTs. The simulation environment chosen for this task is then outlined. This section includes a description of the system architecture, a list of the necessary assumptions made by the Simulation IPT, and the roles, responsibilities and interactions of simulation participants. The method of simulation conduct is presented in the next section with particular emphasis on scenario development and applicability to evaluation of Step 1 HALE-ROA operations. Following, data collection and analysis methods are discussed for air traffic specialists and air vehicle control station operators. Lastly, a schedule of Step 1 simulation activities is presented for reference.

SLUDGE TREATMENT PROJECT PHASE 1 SLUDGE STORAGE OPTIONS ASSESSMENT OF T PLANT VERSUS ALTERNATE STORAGE FACILITY

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

RUTHERFORD WW; GEUTHER WJ; STRANKMAN MR

2009-04-29

The CH2M HILL Plateau Remediation Company (CHPRC) has recommended to the U.S. Department of Energy (DOE) a two phase approach for removal and storage (Phase 1) and treatment and packaging for offsite shipment (Phase 2) of the sludge currently stored within the 105-K West Basin. This two phased strategy enables early removal of sludge from the 105-K West Basin by 2015, allowing remediation of historical unplanned releases of waste and closure of the 100-K Area. In Phase 1, the sludge currently stored in the Engineered Containers and Settler Tanks within the 105-K West Basin will be transferred into sludge transportmore » and storage containers (STSCs). The STSCs will be transported to an interim storage facility. In Phase 2, sludge will be processed (treated) to meet shipping and disposal requirements and the sludge will be packaged for final disposal at a geologic repository. The purpose of this study is to evaluate two alternatives for interim Phase 1 storage of K Basin sludge. The cost, schedule, and risks for sludge storage at a newly-constructed Alternate Storage Facility (ASF) are compared to those at T Plant, which has been used previously for sludge storage. Based on the results of the assessment, T Plant is recommended for Phase 1 interim storage of sludge. Key elements that support this recommendation are the following: (1) T Plant has a proven process for storing sludge; (2) T Plant storage can be implemented at a lower incremental cost than the ASF; and (3) T Plant storage has a more favorable schedule profile, which provides more float, than the ASF. Underpinning the recommendation of T Plant for sludge storage is the assumption that T Plant has a durable, extended mission independent of the K Basin sludge interim storage mission. If this assumption cannot be validated and the operating costs of T Plant are borne by the Sludge Treatment Project, the conclusions and recommendations of this study would change. The following decision-making strategy, which is dependent on the confidence that DOE has in the long term mission for T Plant, is proposed: (1) If the confidence level in a durable, extended T Plant mission independent of sludge storage is high, then the Sludge Treatment Project (STP) would continue to implement the path forward previously described in the Alternatives Report (HNF-39744). Risks to the sludge project can be minimized through the establishment of an Interface Control Document (ICD) defining agreed upon responsibilities for both the STP and T Plant Operations regarding the transfer and storage of sludge and ensuring that the T Plant upgrade and operational schedule is well integrated with the sludge storage activities. (2) If the confidence level in a durable, extended T Plant mission independent of sludge storage is uncertain, then the ASF conceptual design should be pursued on a parallel path with preparation of T Plant for sludge storage until those uncertainties are resolved. (3) Finally, if the confidence level in a durable, extended T Plant mission independent of sludge storage is low, then the ASF design should be selected to provide independence from the T Plant mission risk.« less

Advanced extravehicular protective systems study, volume 2

NASA Technical Reports Server (NTRS)

Sutton, J. G.; Heimlich, P. F.; Tepper, E. H.

1972-01-01

The results of the subsystem studies are presented. Initial identification and evaluation of candidate subsystem concepts in the area of thermal control, humidity control, CO2 control/O2 supply, contaminant control and power supply are discussed. The candidate concepts that were judged to be obviously noncompetitive were deleted from further consideration and the remaining candidate concepts were carried into the go/no go evaluation. A detailed parametric analysis of each of the thermal/humidity control and CO2 control/O2 supply subsystem concepts which passed the go/no go evaluation is described. Based upon the results of the parametric analyses, primary and secondary evaluations of the remaining candidate concepts were conducted. These results and the subsystem recommendations emanating from these results are discussed. In addition, the parametric analyses of the recommended subsystem concepts were updated to reflect the final AEPS specification requirements. A detailed discussion regarding the selection of the AEPS operating pressure level is presented.

40 CFR 240.207-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) SOLID WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended... appearance. (b) Solid wastes that cannot be processed by the facility should be removed from the facility at...

Towards Harmonious Coexistence in the Unlicensed Spectrum: Rational Cooperation of Operators

PubMed Central

2017-01-01

5G New Radio (NR) operating in the unlicensed spectrum is accelerating the Fourth Industrial Revolution by supporting Internet of Things (IoT) networks or Industrial IoT deployments. Specifically, LTE-Advanced (LTE-A) is looking to achieve spectrum integration through coexistence with multi-radio access technology (RAT) systems in the same unlicensed bands with both licensed-assisted and stand-alone access. The listen-before-talk (LBT) mechanism is mainly considered to enable an LTE operator to protect other incumbent unlicensed systems. In this article, we investigate the behaviors of multiple LTE operators along with the deployment of WiFi networks in the unlicensed spectrum from both short- and long-term points of view. In countries without mandatory LBT requirements, we show that an LTE operator is susceptible to collusion with another LTE operator, thus exploiting scarce spectrum resources by deceiving other wireless networks into thinking that channels are always busy; hence, mandatory usage of LTE with LBT is highly recommended at national level to achieve harmonious coexistence in the unlicensed spectrum. We discuss several possible coexistence scenarios to resolve the operator’s dilemmaas well as to improve unlicensed spectrum efficiency among multi-RAT systems, which is viable in the near future. PMID:29064434

Short- and long-term impact of subtotal parathyroidectomy on the achievement of bone and mineral parameters recommended by clinical practice guidelines in dialysis patients: a 12-year single-center experience.

PubMed

Tsai, Wan-Chuan; Peng, Yu-Sen; Yang, Ju-Yeh; Hsu, Shih-Ping; Wu, Hon-Yen; Pai, Mei-Fen; Chang, Jia-Feng; Chen, Hung-Yuan

2013-01-01

The short- and long-term impact of parathyroidectomy (PTX) on the parameters of mineral bone disease in dialysis patients with severe secondary hyperparathyroidism (HPT) remains unclear. A retrospective chart review of 401 consecutive dialysis patients who underwent subtotal PTX by one surgeon was performed. We checked serum levels of calcium (Ca), phosphorus (P), and intact parathyroid hormone (iPTH) for 3 consecutive days, and then monthly for Ca, P, and tri-monthly for iPTH postoperatively. Patients with available laboratory data within the 1st to 6th postoperative months were included in the short-term follow-up group and those with at least 6 months available data were in the long-term follow-up one. Patients (short-term group, n = 401, and long-term group, n = 94) had severely uncontrolled serum iPTH levels, Ca, P and Ca × P before PTX. In the short-term group, percentages of cases achieving K/DOQI targets for serum Ca, Ca × P, and iPTH and KDIGO ones for serum Ca, P, and iPTH after PTX, significantly improved compared with those before operation (all p < 0.05). In the long-term group (mean follow-up of 43 ± 29 months), the percentage of achieved targets for serum iPTH in both guidelines and for serum Ca and Ca × P in the K/DOQI recommendation also improved postoperatively (all p < 0.05). Achievements of K/DOQI recommended values for serum Ca, Ca × P, iPTH and KDIGO recommendations for iPTH can be successfully reached by subtotal PTX in medically refractory, secondary HPT in dialysis patients both during short- and long-term follow-ups. © 2013 S. Karger AG, Basel.

Environmental projects. Volume 3: Environmental compliance audit

NASA Technical Reports Server (NTRS)

1987-01-01

The Goldstone Deep Space Communications Complex is part of NASA's Deep Space Network, one of the world's largest and most sensitive scientific telecommunications and radio navigation networks. Activities at Goldstone are carried out in support of six large parabolic dish antennas. In support of the national goal of the preservation of the environment and the protection of human health and safety, NASA, JPL and Goldstone have adopted a position that their operating installations shall maintain a high level of compliance with Federal, state, and local laws governing the management of hazardous substances, abestos, and underground storage tanks. A JPL version of a document prepared as an environmental audit of Goldstone operations is presented. Both general and specific items of noncompliance at Goldstone are identified and recommendations are provided for corrective actions.

Harnessing Integrated Vector Management for Enhanced Disease Prevention.

PubMed

Chanda, Emmanuel; Ameneshewa, Birkinesh; Bagayoko, Magaran; Govere, John M; Macdonald, Michael B

2017-01-01

The increasing global threat of emerging and re-emerging vector-borne diseases (VBDs) poses a serious health problem. The World Health Organization (WHO) recommends integrated vector management (IVM) strategy for combating VBD transmission. An IVM approach requires entomological knowledge, technical and infrastructure capacity, and systems facilitating stakeholder collaboration. In sub-Saharan Africa, successful operational IVM experience comes from relatively few countries. This article provides an update on the extent to which IVM is official national policy, the degree of IVM implementation, the level of compliance with WHO guidelines, and concordance in the understanding of IVM, and it assesses the operational impact of IVM. The future outlook encompasses rational and sustainable use of effective vector control tools and inherent improved return for investment for disease vector control. Copyright © 2016 Elsevier Ltd. All rights reserved.

Environmental and human exposure assessment monitoring of communities near an abandoned mercury mine in the Philippines: a toxic legacy.

PubMed

Maramba, Nelia P C; Reyes, Jose Paciano; Francisco-Rivera, Ana Trinidad; Panganiban, Lynn Crisanta R; Dioquino, Carissa; Dando, Nerissa; Timbang, Rene; Akagi, Hirokatsu; Castillo, Ma Teresa; Quitoriano, Carmela; Afuang, Maredith; Matsuyama, Akito; Eguchi, Tomomi; Fuchigami, Youko

2006-10-01

Abandoned mines are an important global concern and continue to pose real or potential threats to human safety and health including environmental damage/s. Very few countries had government mine regulation and reclamation policies until the latter part of the century where legal, financial and technical procedures were required for existing mining operations. Major reasons for mine closure may be mainly due to poor economies of the commodity making mining unprofitable, technical difficulties and national security. If the mine is abandoned, more often than not it is the government that shoulders the burden of clean-up, monitoring and remediation. The topic of abandoned mines is complex because of the associated financial and legal liability implications. Abandoned mercury mines have been identified as one of the major concerns because of their significant long-term environmental problems. Primary mercury production is still ongoing in Spain, Kyrgzystan, China, Algeria, Russia and Slovakia while world production declined substantially in the late 1980s. In the Philippines, the mercury mine located southeast of Manila was in operation from 1955 to 1976, before ceasing operation because of the decline in world market price for the commodity. During this time, annual production of mercury was estimated to be about 140,000 kg of mercury yearly. Approximately 2,000,000 t of mine-waste calcines (retorted ore) were produced during mining and roughly 1,000,000 t of these calcines were dumped into nearby Honda Bay to construct a jetty to facilitate mine operations where about 2000 people reside in the nearby three barangays. In October, 1994 the Department of Health received a request from the Provincial Health Office for technical assistance relative to the investigation of increasing complaints of unusual symptoms (e.g. miscarriages, tooth loss, muscle weakness, paralysis, anemia, tremors, etc.) among residents of three barangays. Initial health reports revealed significant elevation of blood mercury levels exceeding the then recommended exposure level of 20ppb in 12 out of the 43 (27.9%) residents examined. The majority of the volunteers were former mine workers. In this study the abnormal findings included gingivitis, mercury lines, gum bleeding and pterydium. The most common neurologic complaints were numbness, weakness, tremors and incoordination. Anemia and elevated liver function tests were also seen in a majority of those examined. The assessment also revealed a probable association between blood mercury level and eosinophilia. The same association was also seen between high mercury levels and the presence of tremors and working in the mercury mine. To date, there are very limited environmental and health studies on the impact of both total and methylmercury that have been undertaken in the Philippines. Thus, this area of study was selected primarily because of its importance as an emerging issue in the country, especially regarding the combined effects of total and methylmercury low-dose and continuous uptake from environmental sources. At present the effects of total mercury exposure combined with MeHg consumption remain an important issue, especially those of low-dose and continuous uptake. Results of the study showed that four (4) species of fish, namely ibis, tabas, lapu-lapu and torsillo, had exceeded the recommended total mercury and methylmercury levels in fish (NV>0.5 microg/gf.w., NV>0.3 microg/gf.w., respectively). Saging and kanuping also exceeded the permissible levels for methylmercury. Total and methylmercury in canned fish, and total mercury in rice, ambient air and drinking water were within the recommended levels, however, additional mercury load from these sources may contribute to the over-all body burden of mercury among residents in the area. Surface water quality at the mining area, Honda Bay and during some monitoring periods at Palawan Bay exceeded total mercury standards (NV>0.002 ng/mL). Soil samples in two sites, namely Tagburos and Honda Bay, exceeded the EPA Region 9 Primary Remediation Goal recommended values for total mercury for residential purposes (NV>23 mg/kg). The hand to mouth activity among infants and children is another significant route for mercury exposure. Statistically significant results were obtained for infants when comparing the results after one year of monitoring for methylmercury levels in hair for both exposed and control sub-groups. Likewise, comparing the initial and final hair methylmercury levels among pregnant women/mothers in the exposed group showed statistically significant (p<0.05) results. Comparing the exposed and control sub-groups' mercury hair levels per sub-group showed statistically significant results among the following: (a) initial and final total mercury hair levels among children, (b) initial and final methylmercury hair levels among children, (c) final total mercury hair levels among pregnant women, (d) initial and final total mercury hair levels among mothers, and (e) initial and final methyl hair levels among mothers.

Recommendations and guidelines on shoreline development and hazards to navigation.

DOT National Transportation Integrated Search

2010-12-01

This guidebook addresses recommendations regarding encroachment into the Gulf Coast : Intracoastal Waterway (GIWW). Encroachment of hazards to navigation creates operational : inefficiencies that impede commerce. The shippers who rely on the waterway...

Aerobic plate counts and ATP levels correlate with Listeria monocytogenes detection in retail delis.

PubMed

Hammons, Susan R; Stasiewicz, Matthew J; Roof, Sherry; Oliver, Haley F

2015-04-01

Listeria monocytogenes is a foodborne pathogen that causes an estimated 1,591 cases of illness and 255 deaths annually in the United States, the majority of which are attributed to ready-to-eat deli meats processed in retail delis. Because retail delis distribute product directly to consumers, rapid methods to validate cleaning and sanitation are needed to improve retail food safety. This study investigated the relationships among ATP levels, standard aerobic plate count (APC), and L. monocytogenes presence in fully operational delis. Fifteen full-service delis were concurrently sampled for ATP, APC, and L. monocytogenes during preoperational hours once monthly for 3 months. Fifteen additional delis were recruited for 6 months of operational sampling (n = 30). A 1-log increase in APC was equivalent to a 3.3-fold increase in the odds of detecting L. monocytogenes (P < 0.001) and a 1.9-log increase in L monocytogenes population (P = 0.03). An ATP level increase of 1 log relative light unit correlated to a 0.22-log increase in APC (P < 0.001). A preoperational ATP level mean increase by 1 log relative light unit increased the odds of detecting L. monocytogenes concurrently fourfold. A 0.5-log increase in mean ATP level during preoperational sampling corresponded to a 2% increase in the predicted L. monocytogenes prevalence during operation (P < 0.01). Additionally, 10 statistically representative sites were identified and recommended for use in sanitation monitoring programs. Our data support the use of ATP as a rapid method to validate effective cleaning and sanitation to reduce L. monocytogenes in retail delis.

Minimum retroreflectivity levels for overhead guide signs and street-name signs

DOT National Transportation Integrated Search

2003-12-01

In 1993, the Federal Highway Administration (FHWA) published research recommendations for minimum retroreflectivity (MR) levels for traffic signs. The recommendations included overhead signs, but not street-name signs. In revisions to the recommended...

Applicability of NASA contract quality management and failure mode effect analysis procedures to the USGS Outer Continental Shelf oil and gas lease management program

NASA Technical Reports Server (NTRS)

Dyer, M. K.; Little, D. G.; Hoard, E. G.; Taylor, A. C.; Campbell, R.

1972-01-01

An approach that might be used for determining the applicability of NASA management techniques to benefit almost any type of down-to-earth enterprise is presented. A study was made to determine the following: (1) the practicality of adopting NASA contractual quality management techniques to the U.S. Geological Survey Outer Continental Shelf lease management function; (2) the applicability of failure mode effects analysis to the drilling, production, and delivery systems in use offshore; (3) the impact on industrial offshore operations and onshore management operations required to apply recommended NASA techniques; and (4) the probable changes required in laws or regulations in order to implement recommendations. Several management activities that have been applied to space programs are identified, and their institution for improved management of offshore and onshore oil and gas operations is recommended.

Practice Guidelines for Operative Performance Assessments.

PubMed

Williams, Reed G; Kim, Michael J; Dunnington, Gary L

2016-12-01

To provide recommended practice guidelines for assessing single operative performances and for combining results of operative performance assessments into estimates of overall operative performance ability. Operative performance is one defining characteristic of surgeons. Assessment of operative performance is needed to provide feedback with learning benefits to surgical residents in training and to assist in making progress decisions for residents. Operative performance assessment has been a focus of investigation over the past 20 years. This review is designed to integrate findings of this research into a set of recommended operative performance practices. Literature from surgery and from other pertinent research areas (psychology, education, business) was reviewed looking for evidence to inform practice guideline development. Guidelines were created along with a conceptual and scientific foundation for each guideline. Ten guidelines are provided for assessing individual operative performances and 10 are provided for combing data from individual operative performances into overall judgments of operative performance ability. The practice guidelines organize available information to be immediately useful to program directors, to support surgical training, and to provide a conceptual framework upon which to build as the base of pertinent knowledge expands through future research and development efforts.

Translation of tobacco policy into practice in disadvantaged and marginalized subpopulations: a study of challenges and opportunities in remote Australian Indigenous communities

PubMed Central

2012-01-01

Background In Australia generally, smoking prevalence more than halved after 1980 and recently commenced to decline among Australia's disadvantaged Indigenous peoples. However, in some remote Indigenous Australian communities in the Northern Territory (NT), extremely high rates of up to 83% have not changed over the past 25 years. The World Health Organisation has called for public health and political leadership to address a global tobacco epidemic. For Indigenous Australians, unprecedented policies aim to overcome disadvantage and close the 'health gap' with reducing tobacco use the top priority. This study identifies challenges and opportunities to implementing these important new tobacco initiatives in remote Indigenous communities. Methods: With little empirical evidence available, we interviewed 82 key stakeholders across the NT representing operational- and management-level service providers, local Indigenous and non-Indigenous participants to identify challenges and opportunities for translating new policies into successful tobacco interventions. Data were analysed using qualitative approaches to identify emergent themes. Results The 20 emergent themes were classified using counts of occasions each theme occurred in the transcribed data as challenge or opportunity. The 'smoke-free policies' theme occurred most frequently as opportunity but infrequently as challenge while 'health workforce capacity' occurred most frequently as challenge but less frequently as opportunity, suggesting that policy implementation is constrained by lack of a skilled workforce. 'Smoking cessation support' occurred frequently as opportunity but also frequently as challenge suggesting that support for individuals requires additional input and attention. Conclusions These results from interviews with local and operational-level participants indicate that current tobacco policies in Australia targeting Indigenous smoking are sound and comprehensive. However, for remote Indigenous Australian communities, local and operational-level participants' views point to an 'implementation gap'. Their views should be heard because they are in a position to provide practical recommendations for effective policy implementation faithful to its design, thereby translating sound policy into meaningful action. Some recommendations may also find a place in culturally diverse low- and middle-income countries. Key words: tobacco policy implementation, challenges, opportunities, remote Indigenous Australian communities. PMID:22839197

A national framework for disaster health education in Australia.

PubMed

FitzGerald, Gerard J; Aitken, Peter; Arbon, Paul; Archer, Frank; Cooper, David; Leggat, Peter; Myers, Colin; Robertson, Andrew; Tarrant, Michael; Davis, Elinor R

2010-01-01

Recent events have heightened awareness of disaster health issues and the need to prepare the health workforce to plan for and respond to major incidents. This has been reinforced at an international level by the World Association for Disaster and Emergency Medicine, which has proposed an international educational framework. The aim of this paper is to outline the development of a national educational framework for disaster health in Australia. The framework was developed on the basis of the literature and the previous experience of members of a National Collaborative for Disaster Health Education and Research. The Collaborative was brought together in a series of workshops and teleconferences, utilizing a modified Delphi technique to finalize the content at each level of the framework and to assign a value to the inclusion of that content at the various levels. The framework identifies seven educational levels along with educational outcomes for each level. The framework also identifies the recommended contents at each level and assigns a rating of depth for each component. The framework is not intended as a detailed curriculum, but rather as a guide for educationalists to develop specific programs at each level. This educational framework will provide an infrastructure around which future educational programs in Disaster Health in Australia may be designed and delivered. It will permit improved articulation for students between the various levels and greater consistency between programs so that operational responders may have a consistent language and operational approach to the management of major events.

Chapter 7. Critical care triage. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster.

PubMed

Christian, Michael D; Joynt, Gavin M; Hick, John L; Colvin, John; Danis, Marion; Sprung, Charles L

2010-04-01

To provide recommendations and standard operating procedures for intensive care unit (ICU) and hospital preparations for an influenza pandemic or mass disaster with a specific focus on critical care triage. Based on a literature review and expert opinion, a Delphi process was used to define the essential topics including critical care triage. Key recommendations include: (1) establish an Incident Management System with Emergency Executive Control Groups at facility, local, regional/state or national levels to exercise authority and direction over resources; (2) developing fair and equitable policies may require restricting ICU services to patients most likely to benefit; (3) usual treatments and standards of practice may be impossible to deliver; (4) ICU care and treatments may have to be withheld from patients likely to die even with ICU care and withdrawn after a trial in patients who do not improve or deteriorate; (5) triage criteria should be objective, ethical, transparent, applied equitably and be publically disclosed; (6) trigger triage protocols for pandemic influenza only when critical care resources across a broad geographic area are or will be overwhelmed despite all reasonable efforts to extend resources or obtain additional resources; (7) triage of patients for ICU should be based on those who are likely to benefit most or a 'first come, first served' basis; (8) a triage officer should apply inclusion and exclusion criteria to determine patient qualification for ICU admission. Judicious planning and adoption of protocols for critical care triage are necessary to optimize outcomes during a pandemic.

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

PubMed

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

2010-04-01

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

Message Variability and Heterogeneity: A Core Challenge for Communication Research

PubMed Central

Slater, Michael D.; Peter, Jochen; Valkenberg, Patti

2015-01-01

Messages are central to human social experience, and pose key conceptual and methodological challenges in the study of communication. In response to these challenges, we outline a systematic approach to conceptualizing, operationalizing, and analyzing messages. At the conceptual level, we distinguish between two core aspects of messages: message variability (the defined and operationalized features of messages) and message heterogeneity (the undefined and unmeasured features of messages), and suggest preferred approaches to defining message variables. At the operational level, we identify message sampling, selection, and research design strategies responsive to issues of message variability and heterogeneity in experimental and survey research. At the analytical level, we highlight effective techniques to deal with message variability and heterogeneity. We conclude with seven recommendations to increase rigor in the study of communication through appropriately addressing the challenges presented by messages. PMID:26681816

Use of insecticide quantification kits to investigate the quality of spraying and decay rate of bendiocarb on different wall surfaces in Kagera region, Tanzania.

PubMed

Thawer, Narjis G; Ngondi, Jeremiah M; Mugalura, Frances E; Emmanuel, Isaac; Mwalimu, Charles D; Morou, Evangelia; Vontas, John; Protopopoff, Natacha; Rowland, Mark; Mutagahywa, Joshua; Lalji, Shabbir; Molteni, Fabrizio; Ramsan, Mahdi M; Willilo, Ritha; Wright, Alexandra; Kafuko, Jessica M; Ndong, Isaiah; Reithinger, Richard; Magesa, Stephen Masingili

2015-04-22

Bendiocarb was introduced for the first time for Indoor Residual Spraying (IRS) in Tanzania in 2012 as part of the interim national insecticide resistance management plan. This move followed reports of increasingly alarming levels of pyrethroid resistance across the country. This study used the insecticide quantification kit (IQK) to investigate the intra-operational IRS coverage and quality of spraying, and decay rate of bendiocarb on different wall surfaces in Kagera region. To assess intra-operational IRS coverage and quality of spraying, 104 houses were randomly selected out of 161,414 sprayed houses. A total of 509 samples (218 in Muleba and 291 in Karagwe) were obtained by scraping the insecticide samples from wall surfaces. To investigate decay rate, 66 houses (36 in Muleba and 30 in Karagwe) were selected and samples were collected monthly for a period of five months. Laboratory testing of insecticide concentration was done using IQK(TM) [Innovative Vector Control Consortium]. Of the 509 samples, 89.5% met the World Health Organization (WHO) recommended concentration (between 100-400 mg/m(2)) for IRS target dosage. The proportion of samples meeting WHO standards varied between Karagwe (84.3%) and Muleba (96.3%) (p < 0.001). Assessment of quality of spraying at house level revealed that Muleba (84.8%) had a significantly higher proportion of households that met the expected target dosage (100-400 mg/m(2)) compared to Karagwe (68.9%) (p < 0.001). The quality of spraying varied across different wall substrates in both districts. Evaluation of bendiocarb decay showed that the proportion of houses with recommended concentration declined from 96.9%, 93.5% and 76.2% at months one, two, and three post IRS, respectively (p-trend = 0.03). The rate of decay increased in the fourth and fifth month post spraying with only 55.9% and 26.3% houses meeting the WHO recommendations, respectively. IQK is an important tool for assessing IRS coverage and quality of spraying. The study found adequate coverage of IRS; however, residual life of bendiocarb was observed to be three months. Results suggest that in order to maintain the recommended concentrations with bendiocarb, a second spray cycle should be carried out after three months.

Recommended messages for truck-mounted changeable message signs during mobile operations.

DOT National Transportation Integrated Search

2009-08-01

"The use of truck-mounted changeable message signs (TMCMSs) for mobile operations is desirable for : providing drivers with information to better prepare them for unexpected conditions. Traditionally, : temporary traffic control for mobile operations...

Recommended messages for truck-mounted changeable message signs during mobile operations.

DOT National Transportation Integrated Search

2009-08-01

The use of truck-mounted changeable message signs (TMCMSs) for mobile operations is desirable for providing drivers with information to better prepare them for unexpected conditions. Traditionally, temporary traffic control for mobile operations has ...

Moving Toward Space Internetworking via DTN: Its Operational Challenges, Benefits, and Management

NASA Technical Reports Server (NTRS)

Barkley, Erik; Burleigh, Scott; Gladden, Roy; Malhotra, Shan; Shames, Peter

2010-01-01

The international space community has begun to recognize that the established model for management of communications with spacecraft - commanded data transmission over individual pair-wise contacts - is operationally unwieldy and will not scale in support of increasingly complex and sophisticated missions such as NASA's Constellation project. Accordingly, the international Inter-Agency Operations Advisory Group (IOAG) ichartered a Space Internetworking Strategy Group (SISG), which released its initial recommendations in a November 2008 report. The report includes a recommendation that the space flight community adopt Delay-Tolerant Networking (DTN) to address the problem of interoperability and communication scaling, especially in mission environments where there are multiple spacecraft operating in concert. This paper explores some of the issues that must be addressed in implementing, deploying, and operating DTN as part of a multi-mission, multi-agency space internetwork as well as benefits and future operational scenarios afforded by DTN-based space internetworking.

SOLVENT HOLD TANK SAMPLE RESULTS FOR MCU-14-259/260/261 AND MCU-14-315/316/317: APRIL AND MAY 2014 MONTHLY SAMPLES

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

Fondeur, F.; Taylor-Pashow, K.

2014-08-05

SRNL received two sets of SHT samples (MCU-14-259/260/261 in April 2014 and MCU-14- 315/316/317 in May 2014) for analysis. The samples were analyzed for composition. Both samples have similar chemical composition. As with the previous solvent sample results, these analyses indicate that the solvent does not require Isopar® L trimming at this time. Since an addition of TiDG and MaxCalix to the SHT was added in early July 2014, the solvent does not require TiDG addition at this time. The current TiDG level (1.5 mM) is above the minimum recommended operating level of 1 mM.

Evidence-based review of interventions for medically at-risk older drivers.

PubMed

Classen, Sherrilene; Monahan, Miriam; Auten, Beth; Yarney, Abraham

2014-01-01

OBJECTIVE. To conduct an evidence-based review of intervention studies of older drivers with medical conditions. METHOD. We used the American Occupational Therapy Association's classification criteria (Levels I-V, I = highest level of evidence) to identify driving interventions. We classified studies using letters to represent the strength of recommendations: A = strongly recommend the intervention; B = recommend intervention is provided routinely; C = weak evidence that the intervention can improve outcomes; D = recommend not to provide the intervention; I = insufficient evidence to recommend for or against the intervention. RESULTS. For clients with stroke, we recommend a graded simulator intervention (A) and multimodal training in traffic theory knowledge and on-road interventions (B); we make no recommendation for or against Dynavision, Useful Field of View, or visual-perceptual interventions (I). For clients with visual deficits, we recommend educational intervention (A) and bioptic training (B); we make no recommendation for or against prism lenses (I). For clients with dementia, we recommend driving restriction interventions (C) and make no recommendation for or against use of compensatory driving strategies (I). CONCLUSION. Level I studies are needed to identify effective interventions for medically at-risk older drivers. Copyright © 2014 by the American Occupational Therapy Association, Inc.

Interstudy heterogeneity of definitions of diastolic dysfunction severely affects reported prevalence

PubMed Central

Selmeryd, Jonas; Henriksen, Egil; Leppert, Jerzy; Hedberg, Pär

2016-01-01

Aims The aim of this article is to examine how the European Association of Cardiovascular Imaging (EACVI) and the American Society of Echocardiography (ASE) recommendations on the classification of diastolic dysfunction (DDF) are interpreted in the scientific community and to explore how variations in the DDF definition affect the reported prevalence. Methods and results A systematic review of studies citing the EACVI/ASE consensus document ‘Recommendations for the evaluation of left ventricular diastolic function by echocardiography’ was performed. The definition of DDF used in each study was recorded. Subsequently, several possible interpretations of the EACVI/ASE classification scheme were used to obtain DDF prevalence in a community-based sample (n = 714). In the systematic review, 60 studies were included. In 13 studies, no specification of DDF definition was presented, a one-level classification tree was used in 13, a two-level classification tree in 18, and in the remaining 16 studies, a DDF definition was presented but no grading of DDF was performed. In 17 studies, the DDF definition relied solely on early diastolic tissue velocity and/or left atrial size. In eight of these studies, a single parameter was used, in two studies the logical operator AND was used to combine two or more parameters, and the remaining seven studies used the logical operator OR. The resulting prevalence of DDF in the community-based sample varied from 12 to 84%, depending on the DDF definition used. Conclusion A substantial heterogeneity of definitions of DDF was evident among the studies reviewed, and the different definitions had a substantial impact on the reported prevalence of DDF. PMID:26374880

RESULTS OF THE ENVIRONMENTAL MANAGEMENT (EM) CORPORATE PROJECT TEAM DISPOSING WASTE & REDUCING RISK

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

SHRADER, T.A.; KNERR, R.

2005-01-31

In 2002, the US Department of Energy's (DOE) Office of Environmental Management (EM) released the Top-To-Bottom Review of cognizant clean-up activities around the DOE Complex. The review contained a number of recommendations for changing the way EM operates in order to reduce environmental risk by significantly accelerating clean-up at the DOE-EM sites. In order to develop and implement these recommendations, a number of corporate project teams were formed to identify, evaluate, and initiate implementation of alternatives for the different aspects of clean-up. In August 2002, a corporate team was formed to review all aspects of the management, treatment, and disposalmore » of low level radioactive waste (LLW), mixed low level radioactive waste (MLLW), transuranic waste (TRU), and hazardous waste (HW). Over the next 21 months, the Corporate Project Team: Disposing Waste, Reducing Risk, developed a number of alternatives for implementing the recommendations of the Top-To-Bottom Review based on information developed during numerous site visits and interviews with complex and industry personnel. With input from over a dozen EM sites at various stages of clean-up, the team identified the barriers to the treatment and disposal of low level waste, mixed low level waste, and transuranic waste. Once identified, preliminary design alternatives were developed and presented to the Acquisition Authority (for this project, the Assistant Secretary for Environmental Management) for review and approval. Once the preliminary design was approved, the team down selected to seven key alternatives which were subsequently fully developed in the Project Execution Plan. The seven most viable alternatives were: (1) creation of an Executive Waste Disposal Board; (2) projectizing the disposal of low level waste and mixed low level waste; (3) creation of a National Consolidation and Acceleration Facility for waste; (4) improvements to the Broad Spectrum contract; (5) improvements to the Toxic Substance Control Act (TSCA) Incinerator contract and operations; (6) development of a policy for load management of waste shipments to the Waste Isolation Pilot Plant (WIPP); and (7) development of a complex-wide fee incentive for transuranic waste disposal. The alternatives were further refined and a plan developed for institutionalizing the alternatives in various site contracts. In order to focus the team's efforts, all team activities were conducted per the principles of DOE Order 413.3, Program and Project Management for the Acquisition of Capital Assets. Although the Order was developed for construction projects, the principles were adapted for use on this ''soft'' project in which the deliverables were alternatives for the way work was performed. The results of the team's investigation and the steps taken during the project are presented along with lessons learned.« less

Cattle and the oil and gas industry in Alberta: A literature review with recommendations for environmental management

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

NONE

1996-12-31

The purpose of this report is to bring together a review of published information on the potential effects of upstream oil and gas industry operations on the cattle industry in Alberta, some indication of the probability of occurrence of these effects, and recommendations on how they might be avoided or mitigated. Based on reviews of scientific papers and industry good-practice manuals, the report describes: The sources and quantities of environmental contaminants generated by Alberta`s oil and gas industry, including normal operations, accidental releases, and the effects of aging infrastructure; the chemical composition of the products, materials, and wastes associated withmore » the industry; the fate and transport of the contaminants through air, water, and soil; cattle operations in Alberta; the toxicology of oil and gas industry contaminants in cattle; and selected Alberta case studies of accidental releases and planned experiments. Conclusions and recommendations deal with critical information gaps and strategies for the sustainable management of cattle and oil/gas operations in the province.« less

TANK48 CFD MODELING ANALYSIS

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

Lee, S.

2011-05-17

The process of recovering the waste in storage tanks at the Savannah River Site (SRS) typically requires mixing the contents of the tank to ensure uniformity of the discharge stream. Mixing is accomplished with one to four dual-nozzle slurry pumps located within the tank liquid. For the work, a Tank 48 simulation model with a maximum of four slurry pumps in operation has been developed to estimate flow patterns for efficient solid mixing. The modeling calculations were performed by using two modeling approaches. One approach is a single-phase Computational Fluid Dynamics (CFD) model to evaluate the flow patterns and qualitativemore » mixing behaviors for a range of different modeling conditions since the model was previously benchmarked against the test results. The other is a two-phase CFD model to estimate solid concentrations in a quantitative way by solving the Eulerian governing equations for the continuous fluid and discrete solid phases over the entire fluid domain of Tank 48. The two-phase results should be considered as the preliminary scoping calculations since the model was not validated against the test results yet. A series of sensitivity calculations for different numbers of pumps and operating conditions has been performed to provide operational guidance for solids suspension and mixing in the tank. In the analysis, the pump was assumed to be stationary. Major solid obstructions including the pump housing, the pump columns, and the 82 inch central support column were included. The steady state and three-dimensional analyses with a two-equation turbulence model were performed with FLUENT{trademark} for the single-phase approach and CFX for the two-phase approach. Recommended operational guidance was developed assuming that local fluid velocity can be used as a measure of sludge suspension and spatial mixing under single-phase tank model. For quantitative analysis, a two-phase fluid-solid model was developed for the same modeling conditions as the single-phase model. The modeling results show that the flow patterns driven by four pump operation satisfy the solid suspension requirement, and the average solid concentration at the plane of the transfer pump inlet is about 12% higher than the tank average concentrations for the 70 inch tank level and about the same as the tank average value for the 29 inch liquid level. When one of the four pumps is not operated, the flow patterns are satisfied with the minimum suspension velocity criterion. However, the solid concentration near the tank bottom is increased by about 30%, although the average solid concentrations near the transfer pump inlet have about the same value as the four-pump baseline results. The flow pattern results show that although the two-pump case satisfies the minimum velocity requirement to suspend the sludge particles, it provides the marginal mixing results for the heavier or larger insoluble materials such as MST and KTPB particles. The results demonstrated that when more than one jet are aiming at the same position of the mixing tank domain, inefficient flow patterns are provided due to the highly localized momentum dissipation, resulting in inactive suspension zone. Thus, after completion of the indexed solids suspension, pump rotations are recommended to avoid producing the nonuniform flow patterns. It is noted that when tank liquid level is reduced from the highest level of 70 inches to the minimum level of 29 inches for a given number of operating pumps, the solid mixing efficiency becomes better since the ratio of the pump power to the mixing volume becomes larger. These results are consistent with the literature results.« less

Performance indicators evaluation of the population-based breast cancer screening programme in Northern Portugal using the European Guidelines.

PubMed

Bento, Maria José; Gonçalves, Guilherme; Aguiar, Ana; Castro, Clara; Veloso, Vitor; Rodrigues, Vítor

2015-10-01

To evaluate the first 10 years of operation of the population-based breast cancer screening programme implemented in the Northern Region of Portugal, using selected recommended standard performance indicators. Data from women aged 50-69 screened with two-view mammography, biennially, in the period 2000-2009, were included. Main performance indicators were compared with the recommended levels of the European Guidelines. A total of 202,039 screening examinations were performed, 71,731 (35.5%) in the initial screening and 130,308 (64.5%) in the subsequent screening. Coverage rate by examination reached 74.3% of the target population, in the last period evaluated. Recall rates were 8.1% and 2.4% and cancer detection rates were 4.4/1000 and 2.9/1000 respectively, for initial and subsequent screenings. The breast cancer detection rate, expressed as a multiple of the background expected incidence was 3.1 in initial screen and 2.2 in subsequent screen. The incidence of invasive interval cancers met the desirable recommended levels both the first and second years since last screening examination, in the initial and subsequent screenings. Invasive tumours <15mm were 50.4% and 53.8% of the invasive cancers detected in initial and subsequent screenings. Less favourable size, grading and biomarkers expression were found in interval cancers compared to screen-detected cancers. Breast cancer screening programme in the Northern Region of Portugal was well accepted by the population. Most of the performance indicators were consistent with the desirable levels of the European Guidelines, which indicate an effective screening programme. Future research should verify the consistency of some of these results by using updated information from a larger population. Copyright © 2015 Elsevier Ltd. All rights reserved.

Operational challenges to continuous LLIN distribution: a qualitative rapid assessment in four countries.

PubMed

Theiss-Nyland, Katherine; Ejersa, Waqo; Karema, Corine; Koné, Diakalia; Koenker, Hannah; Cyaka, Yves; Lynch, Matthew; Webster, Jayne; Lines, Jo

2016-03-01

The World Health Organization recommends that long-lasting insecticidal nets (LLINs) for malaria prevention should be distributed continuously through antenatal care (ANC) and the expanded programme on immunization (EPI) in addition to mass campaigns. Despite these recommendations, the continuous distribution (CD) of LLIN distribution through ANC and EPI is not policy in many countries, and where there is a policy, implementation is incomplete. This study aims to identify the operational strengths and weaknesses of LLINs CD in four country programmes in sub-Saharan Africa. A qualitative rapid assessment process was conducted using semi-structured individual and group interviews at the national, sub-national, and facility level in four countries. Seventy participants were included (23 in Kenya, 13 in Malawi, 18 in Mali and 16 in Rwanda), drawn from malaria programmes, ANC and EPI programmes, government logistics units, and partner organizations. Interviews were structured to identify themes within a health systems approach. Policy and guideline documents and data collection tools were reviewed as a means of triangulation. Data analysis focused on pre-determined and emergent themes. The four countries used a wide variety of management systems for the supply of LLINs to routine services. Issues related to quantification, supply logistics and data collection all contributed to stock-outs at facility level. None of the four countries had guidelines for responding to stock-outs or system enabling local staff to request additional supplies of LLINs. In all four countries, data collection of LLIN distribution was incomplete or absent at facility level, and such data were not used for planning. Training of staff at the facility level was implemented less frequently than national and sub-national staff would have preferred. Logistics systems, independent of other commodities, and in-country partner support strengthened the continuous distribution of LLINs. In these countries, stock-outs were the most important single obstacle to the smooth operations of continuous LLIN distribution. Stock-outs can be avoided if facilities have the capacity to place orders for LLIN resupply as needed. Revised data collection and management systems for LLIN distribution have the potential to increase coverage of the target populations by improving LLIN stock-out response, and strengthening monitoring and evaluation of distribution.

Apollo Medical Operations Project: Recommendations for EVA and Lunar Surface Operations

NASA Technical Reports Server (NTRS)

Scheuring, R. A.; Davis, J. R.; Duncan, J. M.; Polk, J. D.; Jones, J. A.; Gillis, D. B.; Novak, J.

2013-01-01

The potential risk of injury to crewmembers is inherent in aggressive surface activities, whether they be Moon-, Mars-, or asteroid-based. In December 2005, the Space Medicine Division at JSC requested a study to identify Apollo mission issues that had an impact to crew health or performance or both. This talk focused on the Apollo EVA suit and lunar surface operations concerning crew health and performance. There were roughly 20 recommendations from this study of Apollo for improving these two areas for future exploration missions, a few of which were incorporated into the Human Systems Integration Requirements (HSIR). Dr. Richard Scheuring covered these topics along with some of the analog work that has been done regarding surface operations and medical contingencies.

System and method of DPF passive enhancement through powertrain torque-speed management

DOEpatents

Sujan, Vivek A.; Frazier, Timothy R.

2015-11-24

This disclosure provides a method and system for determining recommendations for vehicle operation that reduce soot production in view of a diesel particulate filter (DPF) of an exhaust aftertreatment system. Recommendations generated can reduce excessive particulate matter (PM) production during transient engine events and provide for operating conditions favorable for passive regeneration. In this way, less frequent active regeneration of the DPF is needed and/or more opportunities are provided for passive regeneration. The system and method can utilize location and terrain information to anticipate and project a window of operation in view of reducing soot production and soot loading of the DPF, or provide the operator with instruction when such opportunities are present or will soon be encountered.

System and method of cylinder deactivation for optimal engine torque-speed map operation

DOEpatents

Sujan, Vivek A; Frazier, Timothy R; Follen, Kenneth; Moon, Suk-Min

2014-11-11

This disclosure provides a system and method for determining cylinder deactivation in a vehicle engine to optimize fuel consumption while providing the desired or demanded power. In one aspect, data indicative of terrain variation is utilized in determining a vehicle target operating state. An optimal active cylinder distribution and corresponding fueling is determined from a recommendation from a supervisory agent monitoring the operating state of the vehicle of a subset of the total number of cylinders, and a determination as to which number of cylinders provides the optimal fuel consumption. Once the optimal cylinder number is determined, a transmission gear shift recommendation is provided in view of the determined active cylinder distribution and target operating state.

A systems approach to accident causation in mining: an application of the HFACS method.

PubMed

Lenné, Michael G; Salmon, Paul M; Liu, Charles C; Trotter, Margaret

2012-09-01

This project aimed to provide a greater understanding of the systemic factors involved in mining accidents, and to examine those organisational and supervisory failures that are predictive of sub-standard performance at operator level. A sample of 263 significant mining incidents in Australia across 2007-2008 were analysed using the Human Factors Analysis and Classification System (HFACS). Two human factors specialists independently undertook the analysis. Incidents occurred more frequently in operations concerning the use of surface mobile equipment (38%) and working at heights (21%), however injury was more frequently associated with electrical operations and vehicles and machinery. Several HFACS categories appeared frequently: skill-based errors (64%) and violations (57%), issues with the physical environment (56%), and organisational processes (65%). Focussing on the overall system, several factors were found to predict the presence of failures in other parts of the system, including planned inappropriate operations and team resource management; inadequate supervision and team resource management; and organisational climate and inadequate supervision. It is recommended that these associations deserve greater attention in future attempts to develop accident countermeasures, although other significant associations should not be ignored. In accordance with findings from previous HFACS-based analyses of aviation and medical incidents, efforts to reduce the frequency of unsafe acts or operations should be directed to a few critical HFACS categories at the higher levels: organisational climate, planned inadequate operations, and inadequate supervision. While remedial strategies are proposed it is important that future efforts evaluate the utility of the measures proposed in studies of system safety. Copyright © 2011. Published by Elsevier Ltd.

Review of Issues Associated with Safe Operation and Management of the Space Shuttle Program

NASA Technical Reports Server (NTRS)

Johnstone, Paul M.; Blomberg, Richard D.; Gleghorn, George J.; Krone, Norris J.; Voltz, Richard A.; Dunn, Robert F.; Donlan, Charles J.; Kauderer, Bernard M.; Brill, Yvonne C.; Englar, Kenneth G.;

Recommended level of physical activity and health-related quality of life among Japanese adults

PubMed Central

Shibata, Ai; Oka, Koichiro; Nakamura, Yoshio; Muraoka, Isao

2007-01-01

Background The benefits of a recommended level of physical activity on physiological health indicators such as morbidity and mortality are well-accepted, but less research has addressed whether or not the association between the recommended level of physical activity and a health-related quality of life (HRQOL) exists in the Japanese population. Thus, the present study examined whether the recommended physical activity would be associated with HRQOL in the general Japanese middle-aged population. Methods Data were obtained from 1211 male and female respondents (39.4 ± 10.9 year, mean ± SD) from an Internet-based survey of registrants of an Internet research service. Physical activity level was estimated from the short form of the International Physical Activity Questionnaire. HRQOL was assessed with the Medical Outcomes Survey Short Form-8 questionnaire (SF-8). Based on the current national guidelines for exercise in Japan, respondents were divided into a recommended group, an insufficient group, and an inactive group according to their estimated weekly physical activity level. Multivariate analyses of covariance were utilized. Results Across both genders, the recommended group had significantly higher physical functioning (PF) scores than the inactive group (p < .05). Additionally, across both genders, the recommended group had significantly higher general health perception scores than the insufficient and inactive groups (p < .05). The recommended group had significantly higher vitality scores than the insufficient and inactive groups in males, and higher than only the inactive group in females (p < .05). The insufficient group had significantly higher PF scores than the inactive group across both genders (p < .05). The recommended group had significantly higher physical component scores than the inactive group (p = .001). Conclusion Individuals who attained the recommended level of physical activity had better scores on some dimensions of HRQOL than those who did not, suggesting that the recommended level of physical activity may be applicable not only to the physiological objective outcomes but also to some dimensions in both the physical and mental aspects of HRQOL. PMID:18042301

Training for Today's Office

ERIC Educational Resources Information Center

Wise, Elva Lea

1974-01-01

After observing several large company offices in Denver in operation, the author suggests course content slantings and recommendations to better meet office requirements of today and tomorrow. Recommendations are categorized according to clerical practice, data processing, shorthand, and typewriting. (EA)

Speed limits set lower than engineering recommendations.

DOT National Transportation Integrated Search

2016-08-01

The purpose of this project is to provide the Montana Department of Transportation (MDT) with a better understanding of the : operational and safety impacts of setting posted speed limits below engineering recommended values. This practice has been :...

77 FR 68802 - Advisory Committee on Commercial Operations of Customs and Border Protection (COAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-16

...: Recommendations and resolutions on CBP's Trade Transformation initiatives, recommendations on the role of the... initiative in the area of continuing education should be pursued, requirements for brokers to obtain bona...

Preoperative haemoglobin cut-off values for the prediction of post-operative transfusion in total knee arthroplasty.

PubMed

Yeh, Jared Ze Yang; Chen, Jerry Yongqiang; Bin Abd Razak, Hamid Rahmatullah; Loh, Bryan Huai Gu; Hao, Ying; Yew, Andy Khye Soon; Chia, Shi-Lu; Lo, Ngai Nung; Yeo, Seng Jin

2016-10-01

The purpose of this study is to determine preoperative haemoglobin cut-off values that could accurately predict post-operative transfusion outcome in patients undergoing primary unilateral total knee arthroplasty (TKA). This will allow surgeons to provide selective preoperative type and screen to only patients at high risk of transfusion. A total of 1457 patients diagnosed with osteoarthritis and underwent primary unilateral TKA between January 2012 and December 2014 were retrospectively reviewed. Logistic regression analyses were applied to identify factors that could predict transfusion outcome. A total of 37 patients (2.5 %) were transfused postoperatively. Univariate analysis revealed preoperative haemoglobin (p < 0.001), age (p < 0.001), preoperative haematocrit (p < 0.001), and preoperative creatinine (p < 0.001) to be significant predictors. In the multivariate analysis with patients dichotomised at 70 years of age, preoperative haemoglobin remained significant with adjusted odds ratio of 0.33. Receiver operating characteristic curve identified the preoperative haemoglobin cut-off values to be 12.4 g/dL (AUC = 0.86, sensitivity = 87.5 %, specificity = 77.2 %) and 12.1 g/dL (AUC = 0.85, sensitivity = 69.2 %, specificity = 87.1 %) for age above and below 70, respectively. The authors recommend preoperative haemoglobin cut-off values of 12.4 g/dL for age above 70 and 12.1 g/dL for age below 70 to be used to predict post-operative transfusion requirements in TKA. To maximise the utilisation of blood resources, the authors recommend that only patients with haemoglobin level below the cut-off should receive routine preoperative type and screen before TKA. IV.

Perceptions of pesticides exposure risks by operators, workers, residents and bystanders in Greece, Italy and the UK.

PubMed

Remoundou, K; Brennan, M; Sacchettini, G; Panzone, L; Butler-Ellis, M C; Capri, E; Charistou, A; Chaideftou, E; Gerritsen-Ebben, M G; Machera, K; Spanoghe, P; Glass, R; Marchis, A; Doanngoc, K; Hart, A; Frewer, L J

2015-02-01

The EU Directive on the sustainable use of pesticides (EU128/2009/EC) requires European Member States to develop training activities targeting occupational exposure to pesticides, and communication material aimed at residents and bystanders. Risk perceptions, knowledge and attitudes associated with passive and occupational exposure to pesticide potentially influence the extent to which different stakeholders adopt self-protective behaviour. A methodology for assessing the link between attitudes, adoption of self-protective behaviours and exposure was developed and tested. A survey was implemented in the Greece, Italy and the UK, and targeted stakeholders associated with pesticide exposure linked to orchards, greenhouse crops and arable crops respectively. The results indicated that the adoption of protective measures is low for residents and bystanders, with the exception of residents in Greece, when compared to operators and workers, who tend to follow recommended safety practices. A regression analysis was used to examine the factors affecting the probability of adopting protective measures as well the as the level of exposure in the case of operators and workers where data are available. The results indicate that the likelihood of engaging in self-protective behaviour is not significantly affected by perceptions of own health being affected by pesticides for residents and bystanders. However, operators who perceive that their heath has been negatively affected by the use of pesticides are found to be more likely to adopt self-protective behaviours. Gender and country differences, in perceptions, attitudes and self-protection are also observed. Recommendations for improved communication, in particular for vulnerable groups, are provided. Copyright © 2014 Elsevier B.V. All rights reserved.

Recommendations for UAS Crew Ratings. Pilot Ratings and Authorization Requirements for UAS

NASA Technical Reports Server (NTRS)

2005-01-01

This position paper is intended to recommend the minimum certificate and rating requirements for a pilot to operate an Unmanned Aircraft System (UAS) in the National Airspace System. The paper will recommend the minimum requirements based on the Knowledge, Skills, and Abilities (KSA) required of a UAS pilot and show how those compare to the KSAs required by regulation for manned-aircraft pilots. The paper will provide substantiation based on studies conducted using analyses, simulation and flight experience. The paper is not yet complete; only initial working material is included. The material provided describes the body of work completed thus far and the plan for remaining tasks to complete the recommendation. The HSI Pilot KSA document provides an analysis of the knowledge, skills, and abilities required for UAS operation in the NAS. It is the source document used for the position paper.

Ultraviolet radiation exposure from UV-transilluminators.

PubMed

Akbar-Khanzadeh, Farhang; Jahangir-Blourchian, Mahdi

2005-10-01

UV-transilluminators use ultraviolet radiation (UVR) to visualize proteins, DNA, RNA, and their precursors in a gel electrophoresis procedure. This study was initiated to evaluate workers' exposure to UVR during their use of UV-transilluminators. The levels of irradiance of UV-A, UV-B, and UV-C were determined for 29 UV-transilluminators at arbitrary measuring locations of 6, 25, 62, and 125 cm from the center of the UV-transilluminator's filter surface in the direction of the operator's head. The operators (faculty, research staff, and graduate students) worked within 62 cm of the transilluminators, with most subjects commonly working at < or =25 cm from the UV-transilluminator's filter surface. Daily exposure time ranged from 1 to 60 min. Actinic hazard (effective irradiance level of UVR) was also determined for three representative UV-transilluminators at arbitrary measuring locations of 2.5, 5, 10, 15, 20, 30, 40, and 50 cm from these sets' filter surface in the direction of the operator's head. The allowable exposure time for these instruments was less than 20 sec within 15 cm, less than 35 sec within 25 cm, and less than 2 min within 50 cm from the UV-transilluminators' filter surface. The results of this study suggest that the use of UV-transilluminators exposes operators to levels of UVR in excess of exposure guidelines. It is recommended that special safety training be provided for the affected employees and that exposure should be controlled by one or the combination of automation, substitution, isolation, posted warning signs, shielding, and/or personal protective equipment.

LED luminaire longevity strategy models comparison

NASA Astrophysics Data System (ADS)

Lemieux, Hugo; Thibault, Simon; Martel, Alain A.

2010-08-01

As energy efficiency becomes more and more important, light-emitting diodes (LEDs) are a promising alternative to traditional lighting. Indeed, the energy efficiency of LEDs is still improving as their luminosity is modulated by current. Moreover, for applications such as exterior lamp posts, their small size, directionality, colors and high frequency response allow to combine them and provide design possibilities which are impossible with any other light source. However, as any lamp, LEDs have a lumen depreciation which is a function of both current and temperature. Thus, to take advantage of the full characteristics of LEDs, LED luminaire longevity strategies must be carefully studied and planned, especially since the IES and CIE guidelines state clearly that the luminaire must maintain the rated recommended light level until the end of the system's operating life. The recommended approach for LED luminaire specification is therefore to use the end-of-life light level when evaluating the luminaire. Different power supply strategies have been simulated to determine which one maximizes energy saving and lifetime. With these results, it appears that active control can save at least 25% in energy, but the best strategy cannot be determined because of uncertainties in luminosity degradation models.

Rapid insulin sensitivity test (RIST).

PubMed

Lautt, W W; Wang, X; Sadri, P; Legare, D J; Macedo, M P

1998-12-01

A rapid insulin sensitivity test (RIST) was recently introduced to assess insulin action in vivo (H. Xie, L. Zhu, Y.L. Zhang, D.J. Legare, and W.W. Lautt. J. Pharmacol. Toxicol. Methods, 35: 77-82. 1996). This technical report describes the current recommended standard operating procedure for the use of the RIST in rats based upon additional experience with approximately 100 tests. We describe the manufacture and use of an arterial-venous shunt that allows rapid multiple arterial samples and intravenous administration of drugs. The RIST procedure involves determination of a stable arterial glucose baseline to define the ideal euglycemic level to be maintained following a 5-min infusion of insulin, with the RIST index being the amount of glucose required to be infused to maintain euglycemia over the test period. Insulin administration by a 5-min infusion is preferable to a 30-s bolus administration. No significant difference was determined between the use of Toronto pork-beef or human insulin. Four consecutive RISTs were carried out in the same animal over 4-5 h with no tendency for change with time. The RIST index is sufficiently sensitive and reproducible to permit establishment of insulin dose-response curves and interference of insulin action by elimination of hepatic parasympathetic nerves, using atropine. This technical report provides the current recommended standard operating procedure for the RIST.

Preliminary safety analysis of the Baita Bihor radioactive waste repository, Romania

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

Little, Richard; Bond, Alex; Watson, Sarah

2007-07-01

A project funded under the European Commission's Phare Programme 2002 has undertaken an in-depth analysis of the operational and post-closure safety of the Baita Bihor repository. The repository has accepted low- and some intermediate-level radioactive waste from industry, medical establishments and research activities since 1985 and the current estimate is that disposals might continue for around another 20 to 35 years. The analysis of the operational and post-closure safety of the Baita Bihor repository was carried out in two iterations, with the second iteration resulting in reduced uncertainties, largely as a result taking into account new information on the hydrologymore » and hydrogeology of the area, collected as part of the project. Impacts were evaluated for the maximum potential inventory that might be available for disposal to Baita Bihor for a number of operational and postclosure scenarios and associated conceptual models. The results showed that calculated impacts were below the relevant regulatory criteria. In light of the assessment, a number of recommendations relating to repository operation, optimisation of repository engineering and waste disposals, and environmental monitoring were made. (authors)« less

A 10 year follow-up study after Roux-Elmslie-Trillat treatment for cases of patellar instability.

PubMed

Endres, Stefan; Wilke, Axel

2011-02-18

A retrospective study concerning patients presenting with patella instability, treated using a Roux-Elmslie-Trillat reconstruction operation and followed up for 10 years following surgery, is presented. Pre-operative and follow-up radiographic evaluation included the weight-bearing anteroposterior and merchant views. Evaluation was carried out using the Insall-Salvati index, sulcus and congruence angle. The Roux-Elmslie-Trillat reconstruction operation was performed on 18 patients. The clinical evaluation at follow-up was performed using the Knee-Society-Score (KSS) and Tegner-Score. Subjective results of the operation were classed as excellent or good in 16 of the 18 patients ten years after surgery; persistent instability of the patella was recorded in only one of the 18 patients. The majority of patients returned to the same level of sporting activity after surgery as they had participated in before injury. The Roux-Elmslie-Trillat procedure could be recommended in cases presenting with an increased q-angle, trochlea dysplasia or failed soft tissue surgery. In the present study the majority of patients report a return to previous sporting activity ten years after surgery.

[Death on the operating table and death in the early post-operative period : recommendations of forensic pathologists].

PubMed

Wolff-Maras, R; Klintschar, M

2012-07-01

Death during an operation represents a severe event for physicians and family of the deceased. A further difficulty arises when certifying the cause and manner of death because medical staff are often afraid that they will incriminate themselves when declaring an unnatural death or an unclear manner of death but are also afraid to issue a false statement by declaring a natural death. In such cases of mors in tabula it is recommended to declare an unclear manner of death because this leads to police investigations and in the majority of the cases to exoneration of the medical staff.

77 FR 30560 - Proposed Generic Communication; Generic Letter on Seismic Risk Evaluations for Operating Reactors

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-23

... the Fukushima Near-Term Task Force Recommendations 2.1 and 2.3. The request for information letters... addressing the Fukushima Near-Term Task Force Recommendations 2.1 and 2.3. The memorandum is available... Fukushima Near-Term Task Force Recommendations 2.1 and 2.3 (ADAMS Accession Number ML12056A046), as...

Environmental parameters of the Tennessee River in Alabama. 1: Thermal stratification

NASA Technical Reports Server (NTRS)

Rosing, L. M.

1976-01-01

Thermal stratification data of a transect across Wheeler Reservoir are correlated with the climatological data at the time of sampling. This portion of the Tennessee River is used as a heat sink for the effluent from the three reactor Browns Ferry Nuclear Power Plant. The transect sampling line is 1.3 miles below this point of effluence. Data are presented by weekly samplings for one year prior to plant operations. Post-operational data are presented with one reactor in operation and with two reactors in partial operation. Data gathering was terminated when the plant ceased operations. The results indicate that the effluent for partial plant operation were inconclusive. As a result, recommendations include continuing the sampling when the plant resumes operation at full capacity. Recommendations also include developing math models with the presented thermal and climatological data to be used for predicting the effluent impact in the river with varying climatological conditions and also to predict the effectiveness of the cooling towers.

The role of radiotherapy in the management of patients with diffuse low grade glioma: A systematic review and evidence-based clinical practice guideline.

PubMed

Ryken, Timothy C; Parney, Ian; Buatti, John; Kalkanis, Steven N; Olson, Jeffrey J

2015-12-01

(1) What is the optimal role of external beam radiotherapy in the management of adult patients with newly diagnosed low-grade glioma (LGG) in terms of improving outcome (i.e., survival, complications, seizure control or other reported outcomes of interest)? (2) Which radiation strategies (dose, timing, fractionation, stereotactic radiation, brachytherapy, chemotherapy) improve outcomes compared to standard external beam radiation therapy in the initial management of low grade gliomas in adults? (3) Do specific factors (e.g., age, volume, extent of resection, genetic subtype) identify subgroups with better outcomes following radiation therapy than the general population of adults with newly diagnosed low-grade gliomas? These recommendations apply to adults with newly diagnosed diffuse LGG. OUTCOMES IN ADULT PATIENTS WITH NEWLY DIAGNOSED LOW GRADE GLIOMA TREATED WITH RADIOTHERAPY: Level I Radiotherapy is recommended in the management of newly diagnosed low-grade glioma in adults to prolong progression free survival, irrespective of extent of resection. Level II Radiotherapy is recommended in the management of newly diagnosed low grade glioma in adults as an equivalent alternative to observation in preserving cognitive function, irrespective of extent of resection. Level III Radiotherapy is recommended in the management of newly diagnosed low grade glioma in adults to improve seizure control in patients with epilepsy and subtotal resection. Level III Radiotherapy is recommended in the management of newly diagnosed low-grade glioma in adults to prolong overall survival in patients with subtotal resection. Level III Consideration of the risk of radiation induced morbidity, including cognitive decline, imaging abnormalities, metabolic dysfunction and malignant transformation, is recommended when the delivery of radiotherapy is selected in the management of newly diagnosed low-grade glioma in adults. STRATEGIES OF RADIOTHERAPY IN ADULT PATIENTS WITH NEWLY DIAGNOSED LOW GRADE GLIOMA: Level I Lower dose radiotherapy is recommended as an equivalent alternative to higher dose immediate postoperative radiotherapy (45-50.4 vs. 59.4-64.8 Gy) in the management of newly diagnosed low-grade glioma in adults with reduced toxicity. Level III Delaying radiotherapy until recurrence or progression is recommended as an equivalent alternative to immediate postoperative radiotherapy in the management of newly diagnosed low-grade glioma in adults but may result in shorter time to progression. Level III The addition of chemotherapy to radiotherapy is not recommended over whole brain radiotherapy alone in the management of low-grade glioma, as it provides no additional survival benefit. Level III Limited-field radiotherapy is recommended over whole brain radiotherapy in the management of low-grade glioma. Level III Either stereotactic radiosurgery or brachytherapy are recommended as acceptable alternatives to external radiotherapy in selected patients. PROGNOSTIC FACTORS IN ADULT PATIENTS WITH NEWLY DIAGNOSED LOW GRADE GLIOMA TREATED WITH RADIOTHERAPY: Level II It is recommended that age greater than 40 years, astrocytic pathology, diameter greater than 6 cm, tumor crossing the midline and preoperative neurological deficit be considered as negative prognostic indicators when predicting overall survival in adult low grade glioma patients treated with radiotherapy. Level II It is recommended that smaller tumor size, extent of surgical resection and higher mini-mental status exam be considered as positive prognostic indicators when predicting overall survival and progression free survival in patients in adult low grade glioma patients treated with radiotherapy. Level III It is recommended that seizures at presentation, presence of oligodendroglial histological component and 1p19q deletion (along with additional relevant factors-see Table 1) be considered as positive prognostic indicators when predicting response to radiotherapy in adults with low grade gliomas. Level III It is recommended that increasing age, decreasing performance status, decreasing cognition, presence of astrocytic histological component (along with additional relevant factors (see Tables 1, 2) be considered as negative prognostic indicators when predicting response to radiotherapy.

Impact of Hospital-Employed Physician Assistants on a Level II Community-Based Orthopaedic Trauma System.

PubMed

Althausen, Peter L; Shannon, Steven; Owens, Brianne; Coll, Daniel; Cvitash, Michael; Lu, Minggen; O'Mara, Timothy J; Bray, Timothy J

2016-12-01

The American Academy of Orthopedic Surgeons and the Orthopedic Trauma Association have released guidelines for the provision of orthopedic trauma services such as adequate stipends, designated operating rooms, ancillary staff, and guaranteed reimbursement for indigent care. One recommendation included a provision for hospital-based physician assistants (PAs). Given current reimbursement arrangements, PA collections for billable services may not meet their salary and benefit expenses. However, their actions may indirectly affect emergency room, operating room, and hospital reimbursement and patient care itself. The purpose of our study is to define the true impact of hospitalbased PAs on orthopaedic trauma care at a level II community hospital. Retrospective case series. Level II trauma center. One thousand one hundred four trauma patients with orthopaedic injuries. PA involvement. Emergency room data such as triage time, time until seen by the orthopedic service, and total emergency room time was recorded. Operating room data such as time to surgery, set-up time, total operating time, and out of room time was entered as well. Charts were reviewed to determine if patients were given postoperative antibiotics and Deep Venous Thrombosis (DVT) prophylaxis. Intraoperative and postoperative complications were noted, and lengths of stay were calculated for all patients. At our institution, PA collections from patient care cover only 50% of their costs for salary and benefits. However, with PA involvement, trauma patients with orthopedic injuries were seen 205 minutes faster (P = 0.006), total Emergency Room (ER) time decreased 175 minutes (P = 0.0001), and time to surgery improved 360 minutes (P . 0.03). Operating room parameters were minimally improved, but postoperative DVT prophylaxis increased by a mean of 6.73% (P = 0.0084), postoperative antibiotic administration increased by 2.88% (P = 0.0302), and there was a 4.67% decrease in postoperative complications (P = 0.0034). Average length of stay decreased by 0.61 days (P = 0.27). Although the PA's collections do not cover their costs, the indirect economic and patient care impacts are clear. By increasing emergency room pull through and decreasing times to Operating Room (OR), operative times, lengths of stay, and complications, their existence is clearly beneficial to hospitals, physicians, and patients as well. Economic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Feasibility study for a transportation operations system cask maintenance facility

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

Rennich, M.J.; Medley, L.G.; Attaway, C.R.

The US Department of Energy (DOE), Office of Civilian Radioactive Waste Management (OCRWM) is responsible for the development of a waste management program for the disposition of spent nuclear fuel (SNF) and high-level waste (HLW). The program will include a transportation system for moving the nuclear waste from the sources to a geologic repository for permanent disposal. Specially designed casks will be used to safely transport the waste. The cask systems must be operated within limits imposed by DOE, the Nuclear Regulatory Commission (NRC), and the Department of Transportation (DOT). A dedicated facility for inspecting, testing, and maintaining the caskmore » systems was recommended by the General Accounting Office (in 1979) as the best means of assuring their operational effectiveness and safety, as well as regulatory compliance. In November of 1987, OCRWM requested a feasibility study be made of a Cask Maintenance Facility (CMF) that would perform the required functions. 46 refs., 16 figs., 13 tabs.« less

From Here to Autonomy.

PubMed

Endsley, Mica R

2017-02-01

As autonomous and semiautonomous systems are developed for automotive, aviation, cyber, robotics and other applications, the ability of human operators to effectively oversee and interact with them when needed poses a significant challenge. An automation conundrum exists in which as more autonomy is added to a system, and its reliability and robustness increase, the lower the situation awareness of human operators and the less likely that they will be able to take over manual control when needed. The human-autonomy systems oversight model integrates several decades of relevant autonomy research on operator situation awareness, out-of-the-loop performance problems, monitoring, and trust, which are all major challenges underlying the automation conundrum. Key design interventions for improving human performance in interacting with autonomous systems are integrated in the model, including human-automation interface features and central automation interaction paradigms comprising levels of automation, adaptive automation, and granularity of control approaches. Recommendations for the design of human-autonomy interfaces are presented and directions for future research discussed.

Evaluation of application for approval of alternative methodology for compliance with the NESHAP for shipbuilding and ship repair and recommended requirements for compliance (application submitted by Metro Machine Corporation, Norfolk, Virginia). Final report

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

Serageldin, M.A.

1999-07-01

The US Environmental Protection Agency is providing background information that supports the use of Metro Machine Corporation`s (MMC) compliant all position enclosure (CAPE) plus air management system and regenerative thermal oxidizer (RTO) (CAPE + RTO System) as an alternative means of limiting the emissions of volatile organic hazardous air pollutants per volume of applied solids (nonvolatiles). This document also explains how the authors arrived at the operating, recordkeeping, and reporting conditions that MMC must meet for approval. The add-on control system they used consists of a pollution capture unit operation (CAPE) plus air management system and a destruction unit operationmore » (RTO). When operated according to the specified procedures, it will control emissions to a level no greater than that from using coatings which comply with the limits in Table 2 of 40 CFR Part 63, Subpart II.« less

A BEFORE AND AFTER TRIAL OF THE EFFECTIVENESS OF NETWORK ANALYSIS IN HEALTH OPERATIONS MANAGEMENT.

PubMed

Bhalwar, R; Srivastava, M; Verma, S S; Vaze, M; Tilak, V W

1996-10-01

An intervention trial using "before-and-after" approach was undertaken to address the question whether network analysis as a health managerial tool of control can favourably affect the delays that occur in planning and executing the antimalaria operations of a Station Health Organization in a large military station. Exposure variable of interest was intervention with a network diagram, by which the potential causes of delay along the various activities were assessed and remedial measures were introduced during the second year. Sample size was calculated using conventional alpha and beta error levels. The study indicated that there was a definite beneficial outcome in that the operations could be started as well as completed in time during the intervention year. There was reduction in time requirement in 5 out of the 9 activities, the exact 'p' value being 0.08, by both parametric and non-parametric tests. The use of network analysis in health care management has been recommended.

Antimisting kerosene JT3 engine fuel system integration study

NASA Technical Reports Server (NTRS)

Fiorentino, A.

1987-01-01

An analytical study and laboratory tests were conducted to assist NASA in determining the safety and mission suitability of the modified fuel system and flight tests for the Full-Scale Transport Controlled Impact Demonstration (CID) program. This twelve-month study reviewed and analyzed both the use of antimisting kerosene (AMK) fuel and the incorporation of a fuel degrader on the operational and performance characteristics of the engines tested. Potential deficiencies and/or failures were identified and approaches to accommodate these deficiencies were recommended to NASA Ames -Dryden Flight Research Facility. The result of flow characterization tests on degraded AMK fuel samples indicated levels of degradation satisfactory for the planned missions of the B-720 aircraft. The operability and performance with the AMK in a ground test engine and in the aircraft engines during the test flights were comparable to those with unmodified Jet A. For the final CID test, the JT-3C-7 engines performed satisfactorily while operating on AMK right up to impact.

Work-related health disorders among Saudi computer users.

PubMed

Jomoah, Ibrahim M

2014-01-01

The present study was conducted to investigate the prevalence of musculoskeletal disorders and eye and vision complaints among the computer users of King Abdulaziz University (KAU), Saudi Arabian Airlines (SAUDIA), and Saudi Telecom Company (STC). Stratified random samples of the work stations and operators at each of the studied institutions were selected and the ergonomics of the work stations were assessed and the operators' health complaints were investigated. The average ergonomic score of the studied work station at STC, KAU, and SAUDIA was 81.5%, 73.3%, and 70.3, respectively. Most of the examined operators use computers daily for ≤ 7 hours, yet they had some average incidences of general complaints (e.g., headache, body fatigue, and lack of concentration) and relatively high level of incidences of eye and vision complaints and musculoskeletal complaints. The incidences of the complaints have been found to increase with the (a) decrease in work station ergonomic score, (b) progress of age and duration of employment, (c) smoking, (d) use of computers, (e) lack of work satisfaction, and (f) history of operators' previous ailments. It has been recommended to improve the ergonomics of the work stations, set up training programs, and conduct preplacement and periodical examinations for operators.

Work-Related Health Disorders among Saudi Computer Users

PubMed Central

Jomoah, Ibrahim M.

2014-01-01

The present study was conducted to investigate the prevalence of musculoskeletal disorders and eye and vision complaints among the computer users of King Abdulaziz University (KAU), Saudi Arabian Airlines (SAUDIA), and Saudi Telecom Company (STC). Stratified random samples of the work stations and operators at each of the studied institutions were selected and the ergonomics of the work stations were assessed and the operators' health complaints were investigated. The average ergonomic score of the studied work station at STC, KAU, and SAUDIA was 81.5%, 73.3%, and 70.3, respectively. Most of the examined operators use computers daily for ≤ 7 hours, yet they had some average incidences of general complaints (e.g., headache, body fatigue, and lack of concentration) and relatively high level of incidences of eye and vision complaints and musculoskeletal complaints. The incidences of the complaints have been found to increase with the (a) decrease in work station ergonomic score, (b) progress of age and duration of employment, (c) smoking, (d) use of computers, (e) lack of work satisfaction, and (f) history of operators' previous ailments. It has been recommended to improve the ergonomics of the work stations, set up training programs, and conduct preplacement and periodical examinations for operators. PMID:25383379

Government review of the Mod-2 wind turbine (as-built)

NASA Technical Reports Server (NTRS)

Johnson, W. R.; Birchenough, A. G.; Linscott, B. S.; Reagan, J. R.; Sirocky, P. J.; Sizemore, R. L.; Sullivan, T. L.; Holeman, R. H.

1985-01-01

The findings and recommendations of the Government committee formed to conduct an as-built review of the three Mod-2 wind turbine units at Goldendale, Washington are given. The purpose of the review was to identify any critical deficiencies in machine components that could result in failure, and to recommend any necessary corrective action before resuming safe machine operation. The review concluded that one of the deficiencies identified would preclude planned attended or unattended operation, provided that certain corrective actions were implemented.

Primer Stepper Motor Nomenclature, Definition, Performance and Recommended Test Methods

NASA Technical Reports Server (NTRS)

Starin, Scott; Shea, Cutter

2014-01-01

There has been an unfortunate lack of standardization of the terms and components of stepper motor performance, requirements definition, application of torque margin and implementation of test methods. This paper will address these inconsistencies and discuss in detail the implications of performance parameters, affects of load inertia, control electronics, operational resonances and recommended test methods. Additionally, this paper will recommend parameters for defining and specifying stepper motor actuators. A useful description of terms as well as consolidated equations and recommended requirements is included.

Systematic review of emergency medicine clinical practice guidelines: Implications for research and policy.

PubMed

Venkatesh, Arjun K; Savage, Dan; Sandefur, Benjamin; Bernard, Kenneth R; Rothenberg, Craig; Schuur, Jeremiah D

2017-01-01

Over 25 years, emergency medicine in the United States has amassed a large evidence base that has been systematically assessed and interpreted through ACEP Clinical Policies. While not previously studied in emergency medicine, prior work has shown that nearly half of all recommendations in medical specialty practice guidelines may be based on limited or inconclusive evidence. We sought to describe the proportion of clinical practice guideline recommendations in Emergency Medicine that are based upon expert opinion and low level evidence. Systematic review of clinical practice guidelines (Clinical Policies) published by the American College of Emergency Physicians from January 1990 to January 2016. Standardized data were abstracted from each Clinical Policy including the number and level of recommendations as well as the reported class of evidence. Primary outcomes were the proportion of Level C equivalent recommendations and Class III equivalent evidence. The primary analysis was limited to current Clinical Policies, while secondary analysis included all Clinical Policies. A total of 54 Clinical Policies including 421 recommendations and 2801 cited references, with an average of 7.8 recommendations and 52 references per guideline were included. Of 19 current Clinical Policies, 13 of 141 (9.2%) recommendations were Level A, 57 (40.4%) Level B, and 71 (50.4%) Level C. Of 845 references in current Clinical Policies, 67 (7.9%) were Class I, 272 (32.3%) Class II, and 506 (59.9%) Class III equivalent. Among all Clinical Policies, 200 (47.5%) recommendations were Level C equivalent, and 1371 (48.9%) of references were Class III equivalent. Emergency medicine clinical practice guidelines are largely based on lower classes of evidence and a majority of recommendations are expert opinion based. Emergency medicine appears to suffer from an evidence gap that should be prioritized in the national research agenda and considered by policymakers prior to developing future quality standards.

Science Books & Films, Volume XIV, Number 1.

ERIC Educational Resources Information Center

Finch, Shari, Ed.

This document presents a continuation of the American Association for the Advancement of Science (AAAS) review of science films and books. Each book or film review includes: grade level, the level of recommendation from "Highly recommended" to "Not recommended," bibliographic data, and ordering information. A special section is…

Towards Information Enrichment through Recommendation Sharing

NASA Astrophysics Data System (ADS)

Weng, Li-Tung; Xu, Yue; Li, Yuefeng; Nayak, Richi

Nowadays most existing recommender systems operate in a single organisational basis, i.e. a recommender system recommends items to customers of one organisation based on the organisation's datasets only. Very often the datasets of a single organisation do not have sufficient resources to be used to generate quality recommendations. Therefore, it would be beneficial if recommender systems of different organisations with similar nature can cooperate together to share their resources and recommendations. In this chapter, we present an Ecommerce-oriented Distributed Recommender System (EDRS) that consists of multiple recommender systems from different organisations. By sharing resources and recommendations with each other, these recommenders in the distributed recommendation system can provide better recommendation service to their users. As for most of the distributed systems, peer selection is often an important aspect. This chapter also presents a recommender selection technique for the proposed EDRS, and it selects and profiles recommenders based on their stability, average performance and selection frequency. Based on our experiments, it is shown that recommenders' recommendation quality can be effectively improved by adopting the proposed EDRS and the associated peer selection technique.

Romanian Experience for Enhancing Safety and Security in Transport of Radioactive Material - 12223

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

Vieru, Gheorghe

2012-07-01

The transport of Dangerous Goods-Class no.7 Radioactive Material (RAM), is an important part of the Romanian Radioactive Material Management. The overall aim of this activity is for enhancing operational safety and security measures during the transport of the radioactive materials, in order to ensure the protection of the people and the environment. The paper will present an overall of the safety and security measures recommended and implemented during transportation of RAM in Romania. Some aspects on the potential threat environment will be also approached with special referring to the low level radioactive material (waste) and NORM transportation either by roadmore » or by rail. A special attention is given to the assessment and evaluation of the possible radiological consequences due to RAM transportation. The paper is a part of the IAEA's Vienna Scientific Research Contract on the State Management of Nuclear Security Regime (Framework) concluded with the Institute for Nuclear Research, Romania, where the author is the CSI (Chief Scientific Investigator). The transport of RAM in Romania is a very sensible and complex problem taking into consideration the importance and the need of the security and safety for such activities. The Romanian Nuclear Regulatory Body set up strictly regulation and procedures according to the Recommendation of the IAEA Vienna and other international organizations. There were implemented the adequate regulation and procedures in order to keep the environmental impacts and the radiological consequences at the lower possible level and to assure the effectiveness of state nuclear security regime due to possible malicious acts in carrying out these activities including transport and the disposal site at the acceptable international levels. The levels of the estimated doses and risk expectation values for transport and disposal are within the acceptable limits provided by national and international regulations and recommendations but can increase, significantly during potential malicious acts. (authors)« less

Online Tonsillectomy Resources: Are Parents Getting Consistent and Readable Recommendations?

PubMed

Wozney, Lori; Chorney, Jill; Huguet, Anna; Song, Jin Soo; Boss, Emily F; Hong, Paul

2017-05-01

Objective Parents frequently refer to information on the Internet to confirm or broaden their understanding of surgical procedures and to research postoperative care practices. Our study evaluated the readability, comprehensiveness, and consistency around online recommendations directed at parents of children undergoing tonsillectomy. Study Design A cross-sectional study design was employed. Setting Thirty English-language Internet websites. Subjects and Methods Three validated measures of readability were applied and content analysis was employed to evaluate the comprehensiveness of information in domains of perioperative education. Frequency effect sizes and percentile ranks were calculated to measure dispersion of recommendations across sites. Results The mean readability level of all sites was above a grade 10 level with fewer than half of the sites (n = 14, 47%) scoring at or below the eight-grade level. Provided information was often incomplete with a noted lack of psychosocial support and skills-training recommendations. Content analysis showed 67 unique recommendations spanning the full perioperative period. Most recommendations had low consensus, being reported in 5 or fewer sites (frequency effect size <16%). Conclusion Many online parent-focused resources do not meet readability recommendations, portray incomplete education about perioperative care and expectations, and provide recommendations with low levels of consensus. Up-to-date mapping of the research evidence around recommendations is needed as well as improved efforts to make online information easier to read.

The Effect of Oncologists’ Exercise Recommendation on the Level of Exercise and Quality of Life in Breast and Colorectal Cancer Survivors: Randomized Controlled Trial

PubMed Central

Park, Ji-Hye; Lee, Junga; Oh, Minsuk; Park, Hyuna; Chae, Jisuk; Kim, Dong-Il; Lee, Mikyoung; Yoon, Yong Jin; Lee, Chulwon; Kim, Nam Kyu; Jones, Lee W.; Kim, Seung Il; Park, Se Ho; Jeon, Justin Y.

2016-01-01

Purpose The purpose of this study was to examine the effect of an oncologists’ exercise recommendation with and without exercise motivation package on the amount of exercise participation and quality of life (QOL) in breast and colon cancer survivors. Methods A total of 162 early stage breast and colorectal cancer survivors who completed primary and adjuvant treatments were recruited for this study. Participants were randomly assigned into one of three groups: 1) control (N=59), 2) Oncologists’ exercise recommendation (N=53), and 3) Oncologists’ exercise recommendation with exercise motivation package (N=50). At baseline and after 4 weeks, the level of exercise participation and QOL were assessed. Results A total of 130 (80.7%) participants completed the 4-week assessment. The result showed that participants who only received oncologists’ exercise recommendation did not increase their exercise participation level. But participants who received oncologist’s exercise recommendation with motivation package significantly increased the level of exercise participation [4.30±7.84 Metabolic Equivalent of Task (MET) hour per week, p<001] compared with that of the control group and significantly improved role functioning, pain and diarrhea. Conclusion Oncologists’ exercise recommendation may not be enough to increase exercise participation.. Exercise motivation package with oncologists’ exercise recommendation may be ideal to increase exercise participation to cancer survivor Implications of cancer survivors The providence of exercise motivation package in addition to oncologists’ exercise recommendation to increase the level of exercise among breast and colorectal cancer survivors should be considered. PMID:25965782

Advancing automation and robotics technology for the Space Station Freedom and for the US economy

NASA Technical Reports Server (NTRS)

Lum, Henry, Jr.

1992-01-01

Described here is the progress made by Levels 1, 2, and 3 of the Space Station Freedom in developing and applying advanced automation and robotics technology. Emphasis was placed on the Space Station Freedom program responses to specific recommendations made in the Advanced Technology Advisory Committee (ATAC) Progress Report 13, and issues of A&R implementation into the payload operations integration Center at Marshall Space Flight Center. Assessments are presented for these and other areas as they apply to the advancement of automation and robotics technology for Space Station Freedom.

Myxedema coma after esophagectomy.

PubMed

Yuan, Yong; Hu, Yang; Xie, Tianpeng; Zhao, Yongfan

2010-07-01

For most patients with esophageal cancer, esophagectomy is an effective therapy. Perioperative management is critical for clinical outcomes after the operation. Great efforts should be made to avoid postoperative complications. We report myxedema coma, an emergency condition caused by severe hypothyroidism, after a patient underwent esophagectomy for esophageal cancer. The patient was successfully treated with intravenous levothyroxine. We strongly recommend that physicians test the thyroid hormone levels in patients with risk factors. If myxedema coma occurs, immediate use of intravenous levothyroxine is effective for this lethal complication. Copyright 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Electrode erosion in steady-state electric propulsion engines

NASA Technical Reports Server (NTRS)

Pivirotto, Thomas J.; Deininger, William D.

1988-01-01

The anode and cathode of a 30 kW class arcjet engine were sectioned and analyzed. This arcjet was operated for a total time of 573 hr at power levels between 25 and 30 kW with ammonia at flow rates of 0.25 and 0.27 gm/s. The accumulated run time was sufficient to clearly establish erosion patterns and their causes. The type of electron emission from various parts of the cathode surface was made clear by scanning electron microscope analysis. A scanning electron microscope was used to study recrystallization on the hot anode surface. These electrodes were made of 2 percent thoriated tungsten and the surface thorium content and gradient perpendicular to the surfaces was determined by quantitative microprobe analysis. The results of this material analysis on the electrodes and recommendations for improving electrode operational life time are presented.

Evidence-Based Management of Pain After Excisional Haemorrhoidectomy Surgery: A PROSPECT Review Update.

PubMed

Sammour, Tarik; Barazanchi, Ahmed W H; Hill, Andrew G

2017-02-01

The aim of this systematic review was to update previous PROSPECT ( http://www.postoppain.org ) review recommendations for the management of pain after excisional haemorrhoidectomy. Randomized studies and reviews published in the English language from July 2006 (end date of last review) to March 2016, assessing analgesic, anaesthetic, and operative interventions pertaining to excisional haemorrhoidectomy in adults, and reporting pain scores, were retrieved from the EMBASE and MEDLINE databases. An additional 464 studies were identified of which 74 met the inclusion criteria. There were 48 randomized controlled trials and 26 reviews. Quantitative analyses were not performed, as there were limited numbers of trials with a sufficiently homogeneous design. Pudendal nerve block, with or without general anaesthesia, is recommended for all patients undergoing haemorrhoidal surgery. Either closed haemorrhoidectomy, or open haemorrhoidectomy with electrocoagulation of the pedicle is recommended as the primary procedure. Combinations of analgesics (paracetamol, non-steroidal anti-inflammatory drugs, and opioids), topical lignocaine and glyceryl trinitrate, laxatives, and oral metronidazole are recommended post-operatively. The recommendations are largely based on single intervention, not multimodal intervention, studies.

Blue Ribbon Committee on Bloodborne Parasitic Diseases.

PubMed

2002-09-01

In summary, the A1 recommendations are related to: developing a network (epidemiologic and demographic aspects); undertaking activities within the network; providing support for parasite research testing; developing new policies, and; preparing a Memorandum to Cabinet for submission by September 1, 2001, for funding from April 2002 over 5 years. The A recommendations deal with sustaining the network and addressing existing needs, including Public and professional education Review of current policies Business plan Development of a contribution program to meet operational needs. The B recommendation(s) will be dealt with by the future Treasury Board submission. The group identified no C recommendations.

47 CFR 80.179 - Unattended operation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... operating as part of the Automated Maritime Telecommunications System (AMTS), an automated multi-station....archives.gov/federal_register/code_of_federal_regulations/ibr_locations.html. The ITU-R Recommendations can...

[Cardiovascular assessment and management before non-cardiac surgery].

PubMed

Schwarz, Stefanie; Bernheim, Alain M

2015-05-06

The preoperative cardiovascular risk management accounts for patient-related risk factors, the circumstances leading to the surgical procedure, and the risk of the operation. While urgent operations should not be delayed for cardiac testing, an elective surgical intervention should be postponed in unstable cardiac conditions. In stable cardiac situations, prophylactic coronary interventions to reduce the risk of perioperative complications are rarely indicated. Therefore, in most cases, the planned operation can be performed without previous cardiac stress testing or coronary angiography. Preoperative imaging stress testing is recommended for patients with poor functional capacities that are at high cardiovascular risk prior to a high-risk operation. According to the literature, preoperative prophylactic administration of betablockers and aspirin is controversial. Preoperative discontinuation of dual anti-platelet therapy within six months following drug-eluting stent implantation is not recommended.

Analysis and recommendation of separation requirements for rotorcraft operation at airports and heliports

DOT National Transportation Integrated Search

1986-09-01

The analysis work presented in this report is part of an ongoing effort by the Federal Aviation Administration (FAA) to develop improved rotorcraft separation standards. The subject of this report, Analysis and Recommendation of Separation Requiremen...

Recommended Computer End-User Skills for Business Students by Inc. 500 Executives and Office Systems Educators.

ERIC Educational Resources Information Center

Zhao, Jensen J.; Ray, Charles M.; Dye, Lee J.; Davis, Rodney

1998-01-01

Executives (n=63) and office-systems educators (n=88) recommended for workers the following categories of computer end-user skills: hardware, operating systems, word processing, spreadsheets, database, desktop publishing, and presentation. (SK)

Interagency Task Forces: The Right Tools for the Job

DTIC Science & Technology

2011-01-01

shortcomings. This analysis discusses four organizational reform models and recommends the interagency task force ( IATF ) as the preferred structure...model.64 Still others recommend creating and deploying ad hoc IATFs for crisis operations. These interagency task forces would be task- organized to...forces assigned for planning, exercises, and mission execution.65 A 2005 article in Policy Review recommended developing IATFs as needed for specific

[Colorectal cancer screening: follow-up of patients with adenomatous and colorectal cancer].

PubMed

Antonino, Anca-Teodora; Anca, Antonino; Frei, Alain; Ali-el-Wafa, Abdou; Kessler-Brondolo, Véra; Dorta, Gian

2008-01-23

The different methods of colorectal cancer screening are discussed. Our recommendations had not changed: we recommend as colorectal cancer screening a colonoscopy at the age of 50 years in all healthy persons with average risk for colorectal cancer. A 2007 interdisciplinary consensus conference revised the Swiss recommendations for the follow-up of patients with operated colorectal cancer or after polypectomy.

Radiation exposure to the operator performing cardiac angiography with U-arm systems

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

Balter, S.; Sones, F.M. Jr.; Brancato, R.

The radiation exposure received by a group of operators performing 700 coronary angiograms was measured using the brachial artery approach and the Philips Cardio Diagnost. Nineteen sites were monitored on each operator, using lithium fluoride thermoluminescent dosimeters. Four hundred examinations were performed with a table-mounted protective shield in place. Three hundred were performed without the shield. The average exposures (in mR per study) with and without the shield were 1.9/6 for the eyes and 1.4/8.3 for the thyroid. The resulting operator exposure with the shield in place is low enough so that an operator performing 25 procedures per week onmore » a continuous basis will not exceed the recommendations of the National Commission on Radiological Protection and Units. We therefore strongly recommend the use of properly designed and appropriately positioned shield with all U-arm systems.« less

Radiation exposure to the operator performing cardiac angiography with U-arm systems

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

Balter, S.; Sones, F.M. Jr.; Brancato, R.

We measured the radiation exposure received by a group of operators performing 700 coronary angiograms. All studies were performed using the brachial artery approach and the Philips Cardio Diagnost. Nineteen sites were monitored on each operator, using lithium fluoride thermoluminescent dosimeters. Four hundred examinations were performed with a table-mounted protective shield in place. Three hundred were performed without the shield. The averge exposures (in mR per study) with and without the shield were 1.9/6 for the eyes and 1.4/8.3 for the thyroid. The resulting operator exposure with the shield in place is low enough so that an operator performing 25more » procedures per week on a continuous basis will not exceed the recommendations of the National Commission on Radiological Protection and Units. We therefore strongly recommend the use of properly designed and appropriately positioned shield with all U-arm systems.« less

Lack of exercise of "moderate to vigorous" intensity in people with low levels of physical activity is a major discriminant for sociodemographic factors and morbidity.

PubMed

Serrano-Sánchez, José A; Bello-Luján, Luis M; Auyanet-Batista, Juan M; Fernández-Rodríguez, María J; González-Henríquez, Juan J

2014-01-01

The aim is to examine the differences between participation at low and zero moderate to vigorous physical activity (MVPA) in relation to their trends and associations with known socio-demographic and health factors. We hypothesised that the number of people at zero MVPA level could be rising despite a parallel increase in the population meeting the recommended MVPA level. We also hypothesised that graded associations of sociodemographic and health factors exist across MVPA levels. Two independent population-based samples (n = 4320 [2004] and n = 2176 [1997]), were recruited with a stratified and random sampling procedure and interviewed at home by professional interviewers. The MVPA was assessed by validated questionnaire. The participants were classified into three MVPA levels: zero, low and recommended MVPA. The trend of each MVPA level was analysed with the standardized prevalence ratios. Correlates of low and zero MVPA levels were examined using multinomial logistic regression. The population at zero and recommended MVPA levels rose between 1997-2004 by 12% (95% CI, 5-20%) and 7% (95% CI,-4-19%) respectively, while the population at low MVPA level decreased. At zero MVPA level, associative patterns were observed with sociodemographic and health factors which were different when compared to the population at low MVPA level. Despite the slight increase of population meeting the recommended MVPA level, a higher trend of increase was observed at zero MVPA level. Both recommended and low MPVA levels increased their participation by absorbing participants from the low MVPA level. The sociodemographic profile of those with low MVPA was more similar to the population at recommended MVPA than at zero MVPA level. Methodological implications about the combination of light and moderate-intensity PA could be derived. The prevention of decline in actual low MVPA could change the trend of increase in the population at zero MVPA level, particularly among young adults.

Lack of Exercise of "Moderate to Vigorous" Intensity in People with Low Levels of Physical Activity Is a Major Discriminant for Sociodemographic Factors and Morbidity

PubMed Central

Serrano-Sánchez, José A.; Bello-Luján, Luis M.; Auyanet-Batista, Juan M.; Fernández-Rodríguez, María J.; González-Henríquez, Juan J.

2014-01-01

Introduction The aim is to examine the differences between participation at low and zero moderate to vigorous physical activity (MVPA) in relation to their trends and associations with known socio-demographic and health factors. We hypothesised that the number of people at zero MVPA level could be rising despite a parallel increase in the population meeting the recommended MVPA level. We also hypothesised that graded associations of sociodemographic and health factors exist across MVPA levels. Methods Two independent population-based samples (n = 4320 [2004] and n = 2176 [1997]), were recruited with a stratified and random sampling procedure and interviewed at home by professional interviewers. The MVPA was assessed by validated questionnaire. The participants were classified into three MVPA levels: zero, low and recommended MVPA. The trend of each MVPA level was analysed with the standardized prevalence ratios. Correlates of low and zero MVPA levels were examined using multinomial logistic regression. Results The population at zero and recommended MVPA levels rose between 1997–2004 by 12% (95% CI, 5–20%) and 7% (95% CI,−4–19%) respectively, while the population at low MVPA level decreased. At zero MVPA level, associative patterns were observed with sociodemographic and health factors which were different when compared to the population at low MVPA level. Conclusions Despite the slight increase of population meeting the recommended MVPA level, a higher trend of increase was observed at zero MVPA level. Both recommended and low MPVA levels increased their participation by absorbing participants from the low MVPA level. The sociodemographic profile of those with low MVPA was more similar to the population at recommended MVPA than at zero MVPA level. Methodological implications about the combination of light and moderate-intensity PA could be derived. The prevention of decline in actual low MVPA could change the trend of increase in the population at zero MVPA level, particularly among young adults. PMID:25522144

Self-reported physical activity behavior of a multi-ethnic adult population within the urban and rural setting in Suriname.

PubMed

Baldew, Se-Sergio M; Krishnadath, Ingrid S K; Smits, Christel C F; Toelsie, Jerry R; Vanhees, Luc; Cornelissen, Veronique

2015-05-12

Physical activity (PA) plays an important role in the combat against noncommunicable diseases including cardiovascular diseases. In order to develop appropriate PA intervention programs, there is a need to evaluate PA behavior. So far, there are no published data on PA available for Suriname. Therefore, we aim to describe PA behavior among the multi-ethnic population living in urban and rural areas of Suriname. The World Health Organization (WHO) STEPwise approach to chronic disease risk factor surveillance (STEPS) was conducted in a national representative sample (N = 5751; 48.6% men) aged 15-64 years between March and September 2013. Physical activity data were assessed using the Global physical activity questionnaire (GPAQ) and analyzed according to the GPAQ guidelines. The prevalence of meeting the recommended PA level and prevalence ratios (PR) were computed. Only 55.5% of the overall population met the WHO recommended PA levels (urban coastal area: 55.7%, rural coastal area: 57.9%, rural interior area: 49.1%). Women were less likely to meet the recommended PA level (49% vs 62.4%; p < 0.0001) and with increasing age the PR for recommended level of PA decreased (p < 0.0001). Compared to the Hindustani's, the largest ethnic group, the Javanese reported the lowest percentage of people meeting recommended PA level (PR = 0.92; p = 0.07). Around half of the population meets the recommended PA level. Future lifestyle interventions aiming at increasing PA should especially focus on women and older individuals as they are less likely to meet the recommended levels of PA.

Promoting Robust Design of Diode Lasers for Space: A National Initiative

NASA Technical Reports Server (NTRS)

Tratt, David M.; Amzajerdian, Farzin; Kashem, Nasir B.; Shapiro, Andrew A.; Mense, Allan T.

2007-01-01

The Diode-laser Array Working Group (DAWG) is a national-level consumer/provider forum for discussion of engineering and manufacturing issues which influence the reliability and survivability of high-power broad-area laser diode devices in space, with an emphasis on laser diode arrays (LDAs) for optical pumping of solid-state laser media. The goals of the group are to formulate and validate standardized test and qualification protocols, operational control recommendations, and consensus manufacturing and certification standards. The group is using reliability and lifetime data collected by laser diode manufacturers and the user community to develop a set of standardized guidelines for specifying and qualifying laser diodes for long-duration operation in space, the ultimate goal being to promote an informed U.S. Government investment and procurement strategy for assuring the availability and durability of space-qualified LDAs. The group is also working to establish effective implementation of statistical design techniques at the supplier design, development, and manufacturing levels to help reduce product performance variability and improve product reliability for diodes employed in space applications

Recommendations for the use of mist nets for inventory and monitoring of bird populations

USGS Publications Warehouse

Ralph, C. John; Dunn, Erica H.; Peach, Will J.; Handel, Colleen M.; Ralph, C. John; Dunn, Erica H.

2004-01-01

We provide recommendations on the best practices for mist netting for the purposes of monitoring population parameters such as abundance and demography. Studies should be carefully thought out before nets are set up, to ensure that sampling design and estimated sample size will allow study objectives to be met. Station location, number of nets, type of nets, net placement, and schedule of operation should be determined by the goals of the particular project, and we provide guidelines for typical mist-net studies. In the absence of study-specific requirements for novel protocols, commonly used protocols should be used to enable comparison of results among studies. Regardless of the equipment, net layout, or netting schedule selected, it is important for all studies that operations be strictly standardized, and a well-written operation protocol will help in attaining this goal. We provide recommendations for data to be collected on captured birds, and emphasize the need for good training of project personnel

Standard operating procedures for female orgasmic disorder: consensus of the International Society for Sexual Medicine.

PubMed

Laan, Ellen; Rellini, Alessandra H; Barnes, Tricia

2013-01-01

As the field of sexual medicine evolves, it is important to continually improve patient care by developing contemporary "standard operating procedures" (SOPs), reflecting the consensus view of experts in sexual medicine. Few, if any, consensus SOPs have been developed for the diagnosis and treatment of Female Orgasmic Disorder (FOD). The objective is to provide standard operating procedures for FOD. The SOP Committee was composed of a chair, selected by the International Society for the Study of Sexual Medicine, and two additional experts. To inform its key recommendations, the Committee used systematic reviews of available evidence and discussions during a group meeting, conference calls and e-mail communications. The Committee received no corporate funding or remuneration. A total of 12 recommendations for the assessment and treatment of FOD were generated, including suggestions for further research. Evidence-based, practice recommendations for the treatment of FOD are provided that will hopefully inform clinical decision making for those treating this common condition. © 2012 International Society for Sexual Medicine.

Canadian Headache Society systematic review and recommendations on the treatment of migraine pain in emergency settings.

PubMed

Orr, Serena L; Aubé, Michel; Becker, Werner J; Davenport, W Jeptha; Dilli, Esma; Dodick, David; Giammarco, Rose; Gladstone, Jonathan; Leroux, Elizabeth; Pim, Heather; Dickinson, Garth; Christie, Suzanne N

2015-03-01

There is a considerable amount of practice variation in managing migraines in emergency settings, and evidence-based therapies are often not used first line. A peer-reviewed search of databases (MEDLINE, Embase, CENTRAL) was carried out to identify randomized and quasi-randomized controlled trials of interventions for acute pain relief in adults presenting with migraine to emergency settings. Where possible, data were pooled into meta-analyses. Two independent reviewers screened 831 titles and abstracts for eligibility. Three independent reviewers subsequently evaluated 120 full text articles for inclusion, of which 44 were included. Individual studies were then assigned a US Preventive Services Task Force quality rating. The GRADE scheme was used to assign a level of evidence and recommendation strength for each intervention. We strongly recommend the use of prochlorperazine based on a high level of evidence, lysine acetylsalicylic acid, metoclopramide and sumatriptan, based on a moderate level of evidence, and ketorolac, based on a low level of evidence. We weakly recommend the use of chlorpromazine based on a moderate level of evidence, and ergotamine, dihydroergotamine, lidocaine intranasal and meperidine, based on a low level of evidence. We found evidence to recommend strongly against the use of dexamethasone, based on a moderate level of evidence, and granisetron, haloperidol and trimethobenzamide based on a low level of evidence. Based on moderate-quality evidence, we recommend weakly against the use of acetaminophen and magnesium sulfate. Based on low-quality evidence, we recommend weakly against the use of diclofenac, droperidol, lidocaine intravenous, lysine clonixinate, morphine, propofol, sodium valproate and tramadol. © International Headache Society 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Physical activity in England: who is meeting the recommended level of participation through sports and exercise?

PubMed

Anokye, Nana Kwame; Pokhrel, Subhash; Buxton, Martin; Fox-Rushby, Julia

2013-06-01

Little is known about the correlates of meeting recommended levels of participation in physical activity (PA) and how this understanding informs public health policies on behaviour change. To analyse who meets the recommended level of participation in PA in males and females separately by applying 'process' modelling frameworks (single vs. sequential 2-step process). Using the Health Survey for England 2006, (n = 14 142; ≥ 16 years), gender-specific regression models were estimated using bivariate probit with selectivity correction and single probit models. A 'sequential, 2-step process' modelled participation and meeting the recommended level separately, whereas the 'single process' considered both participation and level together. In females, meeting the recommended level was associated with degree holders [Marginal effect (ME) = 0.013] and age (ME = -0.001), whereas in males, age was a significant correlate (ME = -0.003 to -0.004). The order of importance of correlates was similar across genders, with ethnicity being the most important correlate in both males (ME = -0.060) and females (ME = -0.133). In females, the 'sequential, 2-step process' performed better (ρ = -0.364, P < 0.001) than that in males (ρ = 0.154). The degree to which people undertake the recommended level of PA through vigorous activity varies between males and females, and the process that best predicts such decisions, i.e. whether it is a sequential, 2-step process or a single-step choice, is also different for males and females. Understanding this should help to identify subgroups that are less likely to meet the recommended level of PA (and hence more likely to benefit from any PA promotion intervention).

Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group.

PubMed

Ten Broek, Richard P G; Krielen, Pepijn; Di Saverio, Salomone; Coccolini, Federico; Biffl, Walter L; Ansaloni, Luca; Velmahos, George C; Sartelli, Massimo; Fraga, Gustavo P; Kelly, Michael D; Moore, Frederick A; Peitzman, Andrew B; Leppaniemi, Ari; Moore, Ernest E; Jeekel, Johannes; Kluger, Yoram; Sugrue, Michael; Balogh, Zsolt J; Bendinelli, Cino; Civil, Ian; Coimbra, Raul; De Moya, Mark; Ferrada, Paula; Inaba, Kenji; Ivatury, Rao; Latifi, Rifat; Kashuk, Jeffry L; Kirkpatrick, Andrew W; Maier, Ron; Rizoli, Sandro; Sakakushev, Boris; Scalea, Thomas; Søreide, Kjetil; Weber, Dieter; Wani, Imtiaz; Abu-Zidan, Fikri M; De'Angelis, Nicola; Piscioneri, Frank; Galante, Joseph M; Catena, Fausto; van Goor, Harry

2018-01-01

Adhesive small bowel obstruction (ASBO) is a common surgical emergency, causing high morbidity and even some mortality. The adhesions causing such bowel obstructions are typically the footprints of previous abdominal surgical procedures. The present paper presents a revised version of the Bologna guidelines to evidence-based diagnosis and treatment of ASBO. The working group has added paragraphs on prevention of ASBO and special patient groups. The guideline was written under the auspices of the World Society of Emergency Surgery by the ASBO working group. A systematic literature search was performed prior to the update of the guidelines to identify relevant new papers on epidemiology, diagnosis, and treatment of ASBO. Literature was critically appraised according to an evidence-based guideline development method. Final recommendations were approved by the workgroup, taking into account the level of evidence of the conclusion. Adhesion formation might be reduced by minimally invasive surgical techniques and the use of adhesion barriers. Non-operative treatment is effective in most patients with ASBO. Contraindications for non-operative treatment include peritonitis, strangulation, and ischemia. When the adhesive etiology of obstruction is unsure, or when contraindications for non-operative management might be present, CT is the diagnostic technique of choice. The principles of non-operative treatment are nil per os, naso-gastric, or long-tube decompression, and intravenous supplementation with fluids and electrolytes. When operative treatment is required, a laparoscopic approach may be beneficial for selected cases of simple ASBO.Younger patients have a higher lifetime risk for recurrent ASBO and might therefore benefit from application of adhesion barriers as both primary and secondary prevention. This guideline presents recommendations that can be used by surgeons who treat patients with ASBO. Scientific evidence for some aspects of ASBO management is scarce, in particular aspects relating to special patient groups. Results of a randomized trial of laparoscopic versus open surgery for ASBO are awaited.

Evaluation of physiological, growth and yield responses of a tropical oil crop (Brassica campestris L. var. Kranti) under ambient ozone pollution at varying NPK levels.

PubMed

Singh, Poonam; Agrawal, Madhoolika; Agrawal, Shashi Bhushan

2009-03-01

A field study was conducted to evaluate the impact of ambient ozone on mustard (Brassica campestris L. var. Kranti) plants grown under recommended and 1.5 times recommended NPK doses at a rural site of India using filtered (FCs) and non-filtered open top chambers (NFCs). Ambient mean O(3) concentration varied from 41.65 to 54.2ppb during the experiment. Plants growing in FCs showed higher photosynthetic rate at both NPK levels, but higher stomatal conductance only at recommended NPK. There were improvements in growth parameters and biomass of plants in FCs as compared to NFCs at both NPK levels with higher increments at 1.5 times recommended. Seed yield and harvest index decreased significantly only at recommended NPK in NFCs. Seed quality in terms of nutrients, protein and oil contents reduced in NFCs at recommended NPK. The application of 1.5 times recommended NPK provided protection against yield loss due to ambient O(3).

IMPORTANCE OF CONTEXTUAL DATA IN PRODUCING HEALTH TECHNOLOGY ASSESSMENT RECOMMENDATIONS: A CASE STUDY.

PubMed

Poder, Thomas G; Bellemare, Christian A

2018-01-01

Contextual data and local expertise are important sources of data that cannot be ignored in hospital-based health technology assessment (HTA) processes. Despite a lack of or unconvincing evidence in the scientific literature, technology can be recommended in a given context. We illustrate this using a case study regarding biplane angiography for vascular neurointervention. A systematic literature review was conducted, along with an analysis of the context in our setting. The outcomes of interest were radiation doses, clinical complications, procedure times, purchase cost, impact on teaching program, the confidence of clinicians in the technology, quality of care, accessibility, and the volume of activity. A committee comprising managers, clinical experts, physicians, physicists and HTA experts was created to produce a recommendation regarding biplane technology acquisition to replace a monoplane device. The systematic literature review yielded nine eligible articles for analysis. Despite a very low level of evidence in the literature, the biplane system appears to reduce ionizing radiation and medical complications, as well as shorten procedure time. Contextual data indicated that the biplane system could improve operator confidence, which could translate into reduced risk, particularly for complex procedures. In addition, the biplane system can support our institution in its advanced procedures teaching program. Given the advantages provided by the biplane technology in our setting, the committee has recommended its acquisition. Contextual data were of utmost importance in this recommendation. Moreover, this technology should be implemented alongside a responsibility to collect outcome data to optimize clinical protocol in the doses of ionizing delivered.

International Variation in Asthma and Bronchiolitis Guidelines.

PubMed

Bakel, Leigh Anne; Hamid, Jemila; Ewusie, Joycelyne; Liu, Kai; Mussa, Joseph; Straus, Sharon; Parkin, Patricia; Cohen, Eyal

2017-11-01

Guideline recommendations for the same clinical condition may vary. The purpose of this study was to determine the degree of agreement among comparable asthma and bronchiolitis treatment recommendations from guidelines. National and international guidelines were searched by using guideline databases (eg, National Guidelines Clearinghouse: December 16-17, 2014, and January 9, 2015). Guideline recommendations were categorized as (1) recommend, (2) optionally recommend, (3) abstain from recommending, (4) recommend against a treatment, and (5) not addressed by the guideline. The degree of agreement between recommendations was evaluated by using an unweighted and weighted κ score. Pairwise comparisons of the guidelines were evaluated similarly. There were 7 guidelines for asthma and 4 guidelines for bronchiolitis. For asthma, there were 166 recommendation topics, with 69 recommendation topics given in ≥2 guidelines. For bronchiolitis, there were 46 recommendation topics, with 21 recommendation topics provided in ≥2 guidelines. The overall κ for asthma was 0.03, both unweighted (95% confidence interval [CI]: -0.01 to 0.07) and weighted (95% CI: -0.01 to 0.10); for bronchiolitis, it was 0.32 unweighted (95% CI: 0.16 to 0.52) and 0.15 weighted (95% CI: -0.01 to 0.5). Less agreement was found in national and international guidelines for asthma than for bronchiolitis. Additional studies are needed to determine if differences are based on patient preferences and values and economic considerations or if other recommendation-level, guideline-level, and condition-level factors are driving these differences. Copyright © 2017 by the American Academy of Pediatrics.

Approach to interpret images produced by new generations of multidetector CT scanners in post-operative spine.

PubMed

Zeitoun, Rania; Hussein, Manar

2017-11-01

To reach a practical approach to interpret MDCT findings in post-operative spine cases and to change the false belief of CT failure in the setting of instruments secondary to related artefacts. We performed observational retrospective analysis of premier, early and late MDCT scans in 68 post-operative spine patients, with emphasis on instruments related complications and osseous fusion status. We used a grading system for assessment of osseous fusion in 35 patients and we further analysed the findings in failure of fusion, grade (D). We observed a variety of instruments related complications (mostly screws medially penetrating the pedicle) and osseous fusion status in late scans. We graded 11 interbody and 14 posterolateral levels as osseous fusion failure, showing additional instruments related complications, end plates erosive changes, adjacent segments spondylosis and malalignment. Modern MDCT scanners provide high quality images and are strongly recommended in assessment of the instruments and status of osseous fusion. In post-operative imaging of the spine, it is essential to be aware for what you are looking for, in relevance to the date of surgery. Advances in knowledge: Modern MDCT scanners allow assessment of instruments position and integrity and osseous fusion status in post-operative spine. We propose a helpful algorithm to simplify interpreting post-operative spine imaging.

Desicion Support System For Natural Hazards

NASA Astrophysics Data System (ADS)

Vyazilov, E.

2009-04-01

The problems that do not permit environmental data to be turned to good advantage can be outlined as follows. Damage caused by emergencies is attributable not so much to the lack of significant technological advancement as to the low level of decision makers' (DMs) awareness and inadequate account of the available information. In most cases DMs use information by intuition or on the basis of their own experience. Totally identical conditions of the environment recur very rarely. As a result the knowledge gained by DMs in the course of their activities tends to disappear after a while and cannot be used when identical environmental conditions are experienced again. Training of DMs to take due account of environmental conditions requires considerable resources. Dependence of the economy performance on the environment has not been studied adequately. Due to the large amount of information DMs can not respond to the continuous changes in the environmental conditions in a timely fashion. Sometimes information is not properly recorded, sometimes it is not delivered, and often it is not used properly or just ignored. Forms of information delivery are far from being perfect, information comes from various sources. It takes considerable time to deliver information. Sometimes delivery time is too long for DMs. Not all steps of information processing are automated. DM does not always know how and when to use operational, forecasting and climatic information. There are no legal norms to bring DMs to responsibility for not using information or for not taking measures to prevent damage. Potential damage from underestimation of environmental conditions may be significant and therefore the cost of the inadequate use of information may also be high. Attempts to improve consideration of environmental conditions by increasing the amount and range of information can cause even more difficulties for DMs. A number of potential emergency situations are huge, but a number of recommendations should be reasonable. To resolve the above problems or to make them less significant it is necessary to develop decision support systems (DSS). DMs need not tables with initial data, analytical, forecasting and climatic information, but messages containing warnings on critical value accidence, information on probability of hazards, information on potential losses, and information on hazardous impacts and recommendations on decision making. DSS can do the following: take into account impacts on specific points and on the total area under consideration; allow for the effects of the environment on economic entities (objects) in any geographical region to be analyzed; distinguish impacts and changes caused both by different phenomena and by their combination; signal when objects are or can be in adverse environmental conditions, e.g. in the area affected by fog, storm, tropical cyclone or in the area where the probability of hazardous ice events is very high, etc. The main component of DSS is a knowledge base based on the following concept: if we know environmental conditions it is possible to predict potential impacts on the economy; if we know impacts it is possible to give a set of recommendations on how to prevent (reduce) losses or how to use natural resources most efficiently. Decision making criteria are safety of people and property, reduction of losses, increase of profit, materials saving, etc. Knowledge base is a set of rules formulated in a formalized way using if, that, else. If "Water level in S.-Petersburg >150 cm" that "To give out warning information "Hazards for building on coastal river Neva is possible" and recommendations "The valuable goods carry out in second floor" else "To switch another rule". To have a knowledge base in place it is necessary to: develop tools of identifying and getting knowledge from experts; arrange the information flow from available information systems (operational data, analyses, forecasts, climatic information) through the system of information resources integration; maintain knowledge bases up to date. The last step includes the following: development and maintenance of knowledge bases in the distributed environment; formalization and dissemination of knowledge and provision of access to knowledge; knowledge coordination and consistency check; registration of users by setting personal user profiles; continuous check of coming data for critical value accidence with respect to specific economic object and specific technological processes typical for these objects; generation and delivery of messages to DMs. Key DSS data processing and use operations are: • collection and compilation of information on a specific object and relevant environmental conditions and the first notification when needed; • processing and storage of information with various levels of aggregation; • computer or man-computer assessment of an object and environmental conditions and prediction of possible expected changes; • search for recommendations under various conditions of an object and the environment or under unfavorable tendencies; • optimization of recommendations; • making decision with a possibility to activate for analysis both data forming the basis of recommendation and rules being used; • implementation of recommendations, assessment of implementation and documenting of all steps of the system operation. DSS should actively employ various models such as those used for forecasting of hydrometeorological conditions, evaluation of environmental impacts on economic objects, optimization of recommendations, evaluation of damage and profit. Significant contribution to decision support would be made by GIS in the form of a detailed layout of economic objects; local, regional and global maps of environmental conditions where potentially hazardous regions are marked; climate change analyses and projections. In the future it is planned to adjust indicators, to identify vulnerability of the economy to natural hazards (intersection of economic centers and natural hazard risks), to develop tools to identify specific regions with complicated socio-technical environment exposed to natural hazards. DSS makes it possible to: deliver initial, analytical, forecasting and climatic information at any moment, in any point, on any region and to any device; take into account all operational information and on its basis provide recommendations on decision making; optimize shirt-term and long-term planning; minimize damage and losses due to prompt and informed decisions. Currently a static page showing examples of impacts and recommendations for various marine hazards is available at http://www.meteo.ru/nodc/project2/action.htm,http://www.meteo.ru/nodc/Product/recom.htm#m. Made in frame the RFBR project № 07-01-00662-a.

Promoting patient safety through prospective risk identification: example from peri-operative care.

PubMed

Smith, A; Boult, M; Woods, I; Johnson, S

2010-02-01

Investigation of patient safety incidents has focused on retrospective analyses once incidents have occurred. Prospective risk analysis techniques complement this but have not been widely used in healthcare. Prospective risk identification of non-operative risks associated with adult elective surgery under general anaesthesia using a customised structured "what if" checklist and development of risk matrix. Prioritisation of recommendations arising by cost, ease and likely speed of implementation. Groups totalling 20 clinical and administrative healthcare staff involved in peri-operative care and risk experts convened by the UK National Patient Safety Agency. 102 risks were identified and 95 recommendations made. The top 20 recommendations together were judged to encompass about 75% of the total estimated risk attributable to the processes considered. Staffing and organisational issues (21% of total estimated risk) included recommendations for removing distractions from the operating theatre, ensuring the availability of senior anaesthetists and promoting standards and flexible working among theatre staff. Devices and equipment (19% of total estimated risk) could be improved by training and standardisation; airway control and temperature monitoring were identified as two specific areas. Pre-assessment of patients before admission to hospital (12% of estimated risk) could be improved by defining a data set for adequate pre-assessment and making this available throughout the NHS. This technique can be successfully applied by healthcare staff but expert facilitation of groups is advisable. Such wider-ranging processes can potentially lead to more comprehensive risk reduction than "single-issue" risk alerts.

I'm trying to heal...noise levels in a pediatric intensive care unit.

PubMed

Milette, Isabelle H; Carnevale, Franco A

2003-01-01

The literature demonstrates clearly that most intensive care units exceed the standard recommendations for noise levels in hospitals, and that high noise levels have negative impacts on patients and staff. The purpose of this study was to evaluate the level of noise in a PICU and compare it to the recommendations of international bodies. We outline recommendations to promote the awareness of this problem and suggest strategies to decrease the level of noise in a PICU. The orientations of these strategies are threefold: 1) architectural-acoustic design, 2) equipment design and, most importantly, 3) staff education.

Evaluation of radiation exposure from diagnostic radiology examination; availability of final recommendations--FDA. Notice.

PubMed

1986-02-19

The Food and Drug Administration (FDA) is announcing the availability of a document entitled "Recommendations for Evaluation of Radiation Exposure from Diagnostic Radiology Examinations". The recommendations, prepared by FDA's Center for Devices and Radiological Health (CDRH), encourage diagnostic radiology facilities to take voluntary action to: Become aware of the radiation levels experienced by patients undergoing the projections commonly given in the facility; compare their radiation levels to generally accepted levels for these projections; and bring the exposures back into line if their levels fall consistently outside these generally accepted levels.

40 CFR 240.209-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... operation during such emergency situations as power failure, air or water supply failure, equipment... devices such as hard hats, gloves, safety glasses, and footwear should be provided for facility employees...

46 CFR 109.527 - Cranes: Operator designation.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 4 2011-10-01 2011-10-01 false Cranes: Operator designation. 109.527 Section 109.527 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS... familiar with the provisions of the API Recommended Practice for Operation and Maintenance of Offshore...

46 CFR 109.527 - Cranes: Operator designation.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Cranes: Operator designation. 109.527 Section 109.527 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS... familiar with the provisions of the API Recommended Practice for Operation and Maintenance of Offshore...

46 CFR 109.527 - Cranes: Operator designation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Cranes: Operator designation. 109.527 Section 109.527 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS... familiar with the provisions of the API Recommended Practice for Operation and Maintenance of Offshore...

46 CFR 109.527 - Cranes: Operator designation.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Cranes: Operator designation. 109.527 Section 109.527 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS... familiar with the provisions of the API Recommended Practice for Operation and Maintenance of Offshore...

46 CFR 109.527 - Cranes: Operator designation.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 4 2013-10-01 2013-10-01 false Cranes: Operator designation. 109.527 Section 109.527 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS... familiar with the provisions of the API Recommended Practice for Operation and Maintenance of Offshore...

40 CFR 243.201-2 - Recommended procedures: Operations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... waste handling techniques, and in the proper operation of collection equipment, such as those presented in Operation Responsible: Safe Refuse Collection. (b) Personal protective equipment such as gloves... Standards for Subpart I—Personal Protective Equipment (29 CFR 1910.132 through 1910.137). (c) Scavenging...

40 CFR 243.201-2 - Recommended procedures: Operations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... waste handling techniques, and in the proper operation of collection equipment, such as those presented in Operation Responsible: Safe Refuse Collection. (b) Personal protective equipment such as gloves... Standards for Subpart I—Personal Protective Equipment (29 CFR 1910.132 through 1910.137). (c) Scavenging...

Raising the quality of rheumatology management recommendations: lessons from the EULAR process 10 years after provision of standard operating procedures.

PubMed

Colebatch-Bourn, Alexandra N; Conaghan, Philip G; Arden, Nigel K; Cooper, Cyrus; Dougados, Maxime; Edwards, Christopher J

2015-08-01

To increase understanding of how to raise the quality of rheumatology guidelines by reviewing European League Against Rheumatism (EULAR) management recommendations, using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument, 10 years after publication of the EULAR standardized operating procedures (SOP) for the production of recommendations. It was hoped that this work could help inform improvements in guideline development by other societies and organizations. The SOP were published in 2004 to ensure the quality of EULAR-endorsed recommendations. We reviewed 27 published EULAR recommendations for management using the AGREE II tool. This provides a framework to assess the quality of guidelines across six broad domains using 23 specific questions. Overall the EULAR recommendations reviewed have been performed to a high standard. There are particular strengths in the methodology and presentation of the guidelines; however, the results indicate areas for development in future recommendations: in particular, stakeholder involvement and applicability of the recommendations. Improvements in quality were evident in recent years, with patient representation in 9 of 15 (60.0%) recommendations published 2010-14 compared with 4 of 12 (33.3%) published 2000-09. In the last 10 years the overall quality of recommendations was good, with standards improving over the decade following publication of the SOP. However, this review process has identified potential areas for improvement, especially in patient representation and provision of implementation tools. The lessons from this work can be applied to the development of rheumatology guidelines by other societies and organizations. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Prescribed Travel Schedules for Fatigue Management

NASA Technical Reports Server (NTRS)

Whitmire, Alexandra; Johnston, Smith; Lockley, Steven

2011-01-01

The NASA Fatigue Management Team is developing recommendations for managing fatigue during travel and for shift work operations, as Clinical Practice Guidelines for the Management of Circadian Desynchrony in ISS Operations. The Guidelines provide the International Space Station (ISS ) flight surgeons and other operational clinicians with evidence-based recommendations for mitigating fatigue and other factors related to sleep loss and circadian desynchronization. As much international travel is involved both before and after flight, the guidelines provide recommendations for: pre-flight training, in-flight operations, and post-flight rehabilitation. The objective of is to standardize the process by which care is provided to crewmembers, ground controllers, and other support personnel such as trainers, when overseas travel or schedule shifting is required. Proper scheduling of countermeasures - light, darkness, melatonin, diet, exercise, and medications - is the cornerstone for facilitating circadian adaptation, improving sleep, enhancing alertness, and optimizing performance. The Guidelines provide, among other things, prescribed travel schedules that outline the specific implementation of these mitigation strategies. Each travel schedule offers evidence based protocols for properly using the NASA identified countermeasures for fatigue. This presentation will describe the travel implementation schedules and how these can be used to alleviate the effects of jet lag and/or schedule shifts.

14 CFR 169.3 - Application for recommendation and certification.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Application for recommendation and certification. 169.3 Section 169.3 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... the acquisition, establishment, construction, alteration, repair, maintenance, or operation of an...

14 CFR 169.3 - Application for recommendation and certification.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Application for recommendation and certification. 169.3 Section 169.3 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... the acquisition, establishment, construction, alteration, repair, maintenance, or operation of an...

14 CFR 169.3 - Application for recommendation and certification.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Application for recommendation and certification. 169.3 Section 169.3 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... the acquisition, establishment, construction, alteration, repair, maintenance, or operation of an...

ASDE-2 Reliability Improvement Study : Volume I. Operational Data and Modification Recommendations.

DOT National Transportation Integrated Search

1974-11-01

Eight airport sites and the FAA Oklahoma Depot were visited and surveys conducted to obtain reliability, maintainability and performance data on the ASDE-2 Radar System. The data was analyzed and recommendations for modification to the equipment made...

A procedure to evaluate environmental rehabilitation in limestone quarries.

PubMed

Neri, Ana Claudia; Sánchez, Luis Enrique

2010-11-01

A procedure to evaluate mine rehabilitation practices during the operational phase was developed and validated. It is based on a comparison of actually observed or documented practices with internationally recommended best practices (BP). A set of 150 BP statements was derived from international guides in order to establish the benchmark. The statements are arranged in six rehabilitation programs under three categories: (1) planning (2) operational and (3) management, corresponding to the adoption of the plan-do-check-act management systems model to mine rehabilitation. The procedure consists of (i) performing technical inspections guided by a series of field forms containing BP statements; (ii) classifying evidences in five categories; and (iii) calculating conformity indexes and levels. For testing and calibration purposes, the procedure was applied to nine limestone quarries and conformity indexes were calculated for the rehabilitation programs in each quarry. Most quarries featured poor planning practices, operational practices reached high conformity levels in 50% of the cases and management practices scored moderate conformity. Despite all quarries being ISO 14001 certified, their management systems pay low attention to issues pertaining to land rehabilitation and biodiversity. The best results were achieved by a quarry whose expansion was recently submitted to the environmental impact assessment process, suggesting that public scrutiny may play a positive role in enhancing rehabilitation practices. Conformity indexes and levels can be used to chart the evolution of rehabilitation practices at regular intervals, to establish corporate goals and for communication with stakeholders. Copyright 2010 Elsevier Ltd. All rights reserved.

Biometrics in support of special forces medical operations.

PubMed

Kershner, Michael R

2012-01-01

Recommendations on ways in which the ODA can leverage biometrics in medical operations to improve their security, improve relations with indigenous personnel, and contribute to the larger theater biometrics program. 2012.

76 FR 30322 - Meeting of the Chief of Naval Operations Executive Panel

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-25

... Operations (CNO) Executive Panel will deliberate on the findings and proposed recommendations of the Navy Expeditionary Organizations and Capabilities Subcommittee study. The meeting will consist of discussions...

World Health Organization's Innovative Direct Disbursement Mechanism for Payment of Grassroots Immunization Personnel and Operations in Nigeria: 2004-2015.

PubMed

Yehualashet, Yared G; Wadda, Alieu; Agblewonu, Koffi B; Zhema, Theophilus; Ibrahim, Al-Asi A; Corr, Alhagie; Linkins, Jennifer; Mkanda, Pascal; Vaz, Rui G; Nsubuga, Peter; Ashogbon, Daniel

2016-05-01

Following the 1988 World Health Assembly resolution to eradicate polio, the government of Nigeria, with support from partners, has been implementing several rounds of supplementary immunization activities (SIAs) each year. In addition to the technical requirements, the success of the polio eradication initiative depends on timely provision of adequate financial resources. Disbursement of funds for SIAs and payment of allowances to numerous vaccination personnel at the grassroots level are enormous operational challenges in a country the size of Nigeria. Upon donors' request for a transparent and effective payment mechanism, the World Health Organization (WHO), in consultation with national counterparts, created the innovative direct disbursement mechanism (DDM) in 2004. The objective of the DDM was to timely deploy operational funds at the field level and directly pay vaccination personnel allowances at the grassroots level. A detailed operational guideline for funds disbursement was developed in close consultation with central and field stakeholders. Multiyear financial resource requirements and operational budgets for every campaign were produced by an interagency-coordinated finance subcommittee. The WHO engaged a bank and an accounting firm as DDM partners to support disbursement of and accounting for the SIA funds, respectively. The 37 WHO field offices were equipped with electronic financial systems to support the DDM process, and temporary payment sites were set up to facilitate payment to vaccination personnel at the grassroots level. Coordination meetings among DDM partners were held regularly to reconcile financial records and address operational challenges. Between 2004 and 2014, DDM supported 99 polio and nonpolio vaccination campaigns, disbursing more than $370 million to about 16 million beneficiaries across 280 temporary payment sites. To mitigate security risks and reduce operational costs, the WHO and DDM partners introduced mobile payment to vaccination personnel in May 2015 in compliance with national regulations. A total of 97% of the targeted 1871 beneficiaries in 2 pilot sites were successfully paid through mobile payment, although some challenges remain to be addressed. The DDM has met its objectives with a high rate of financial accountability and transparency, despite persistent operational and security challenges. With support from Nigeria, the Pakistan polio vaccination program successfully adopted the DDM. The DDM continues to play an important role in effective implementation of the polio endgame strategy and the national immunization strategic plan. As part of polio legacy planning, we recommend the DDM as a model for other opportunities that involve the engagement of large field-level teams as new vaccines are introduced in Nigeria and elsewhere. © 2016 World Health Organization; licensee Oxford Journals.

RQ-21A Blackjack Small Tactical Unmanned Aircraft System (STUAS): Initial Operational Test and Evaluation Report

DTIC Science & Technology

2015-06-29

requirements for the system’s ground components to the generating capabilities of standard Marine Corps generators ). The Navy did not fully address two...dedicated generators to power the ground control stations. Recommendations The Navy and Marine Corps should consider the following recommendations in...components to the generating capabilities of standard Marine Corps generators ). The Navy did not fully address two recommendations (strengthening

78 FR 26110 - Kicking Cars and Going Between Rolling Equipment During Flat Switching Operations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-03

... Cars and Going Between Rolling Equipment During Flat Switching Operations AGENCY: Federal Railroad... occurred during a railroad switching operation that involved a railroad employee kicking cars and... make recommendations to railroads regarding the adoption of car-handling procedures during flat...

Aerospace safety advisory panel

NASA Technical Reports Server (NTRS)

1983-01-01

Data acquired on the actual flight experience with the various subsystems are assessed. These subsystems include: flight control and performance, structural integrity, orbiter landing gear, lithium batteries, EVA and prebreathing, and main engines. Improvements for routine operations are recommended. Policy issues for operations and flight safety for aircraft operations are discussed.

Policy Interpretation Network on Children's Health and Environment.

PubMed

van den Hazel, Peter; Zuurbier, Moniek; Bistrup, Marie Louise

2006-10-01

The main objective of PINCHE is to provide policy recommendations aiming at protecting children's health and environment based on completed scientific research. The project focused on four themes: indoor and outdoor air pollutants, carcinogens, neurotoxicants, and noise. The data were evaluated in workpackages on exposure assessment, epidemiology, toxicology, and risk and health impact assessment. The data were analysed according to a framework of questions. The workpackage on socioeconomic factors studied the influence of socioeconomic status on exposures and on health effects. In the workpackage on science-policy interface, recommendations on how to improve children's environmental health were formulated. The policy recommendations resulting from the analysis were grouped according to relevant policy levels: European Commission or the European Parliament, member states and other stakeholders at regional or local level. These recommendations are general guidelines for taking action. Regional differences and variation must be reflected when policy is actually implemented. In addition, recommendations related to education and personal behaviour are presented in the reports. The policy recommendations are important input for policy advisers, policy makers and public health authorities at all policy levels. The recommendations are also of direct relevance to interest groups, such as environmental NGOs including child health and advocacy groups. The policy recommendations for each policy level were prioritized. High priorities were given to reduce exposure to environmental tobacco smoke, transport related air pollution, indoor air and mercury.

Systems identification and application systems development for monitoring the physiological and health status of crewmen in space

NASA Technical Reports Server (NTRS)

Leonard, J. I.; Furukawa, S.; Vannordstrand, P. C.

1975-01-01

The use of automated, analytical techniques to aid medical support teams is suggested. Recommendations are presented for characterizing crew health in terms of: (1) wholebody function including physiological, psychological and performance factors; (2) a combination of critical performance indexes which consist of multiple factors of measurable parameters; (3) specific responses to low noise level stress tests; and (4) probabilities of future performance based on present and periodic examination of past performance. A concept is proposed for a computerized real time biomedical monitoring and health care system that would have the capability to integrate monitored data, detect off-nominal conditions based on current knowledge of spaceflight responses, predict future health status, and assist in diagnosis and alternative therapies. Mathematical models could play an important role in this approach, especially when operating in a real time mode. Recommendations are presented to update the present health monitoring systems in terms of recent advances in computer technology and biomedical monitoring systems.

Analysis and Preliminary Design of an Advanced Technology Transport Flight Control System

NASA Technical Reports Server (NTRS)

Frazzini, R.; Vaughn, D.

1975-01-01

The analysis and preliminary design of an advanced technology transport aircraft flight control system using avionics and flight control concepts appropriate to the 1980-1985 time period are discussed. Specifically, the techniques and requirements of the flight control system were established, a number of candidate configurations were defined, and an evaluation of these configurations was performed to establish a recommended approach. Candidate configurations based on redundant integration of various sensor types, computational methods, servo actuator arrangements and data-transfer techniques were defined to the functional module and piece-part level. Life-cycle costs, for the flight control configurations, as determined in an operational environment model for 200 aircraft over a 15-year service life, were the basis of the optimum configuration selection tradeoff. The recommended system concept is a quad digital computer configuration utilizing a small microprocessor for input/output control, a hexad skewed set of conventional sensors for body rate and body acceleration, and triple integrated actuators.

Climate services to improve public health.

PubMed

Jancloes, Michel; Thomson, Madeleine; Costa, María Mánez; Hewitt, Chris; Corvalan, Carlos; Dinku, Tufa; Lowe, Rachel; Hayden, Mary

2014-04-25

A high level expert panel discussed how climate and health services could best collaborate to improve public health. This was on the agenda of the recent Third International Climate Services Conference, held in Montego Bay, Jamaica, 4-6 December 2013. Issues and challenges concerning a demand led approach to serve the health sector needs, were identified and analysed. Important recommendations emerged to ensure that innovative collaboration between climate and health services assist decision-making processes and the management of climate-sensitive health risk. Key recommendations included: a move from risk assessment towards risk management; the engagement of the public health community with both the climate sector and development sectors, whose decisions impact on health, particularly the most vulnerable; to increase operational research on the use of policy-relevant climate information to manage climate- sensitive health risks; and to develop in-country capacities to improve local knowledge (including collection of epidemiological, climate and socio-economic data), along with institutional interaction with policy makers.

Status and Plans for NSTX-U Recovery

NASA Astrophysics Data System (ADS)

Hawryluk, R. J.; Gerhardt, S.; Menard, J.; Neumeyer, C.

2017-10-01

The NSTX-U device experienced a series of technical problems; the most recent of which was the failure of one of the poloidal magnetic field coils, which has rendered the device inoperable and in need of significant repair. As a result of these incidents, the Laboratory performed a very comprehensive analysis of all of the systems on NSTX-U. Through an integrated system's analysis approach, this process identified which actions need to be taken to form a corrective action plan to ensure reliable and predictable operation. The actions required to address the deficiencies were reviewed by external experts who made recommendations on four high-level programmatic decisions regarding the inner poloidal field coils, limitations to the required bakeout temperature needed for conditioning of the vacuum vessel, divertor and wall protection tiles and coaxial helicity injection. The plans for addressing the recommendations from the external review panels will be presented. This research was sponsored by the U.S. Dept. of Energy under contract DE-AC02-09CH11466.

Benefits and Limitations of Macrotextured Breast Implants and Consensus Recommendations for Optimizing Their Effectiveness.

PubMed

Maxwell, G Patrick; Scheflan, Michael; Spear, Scott; Nava, Maurizio B; Hedén, Per

2014-08-01

Implant texture is an important factor influencing implant selection for breast augmentation. Natrelle Biocell implants are characterized by macrotextured shell surfaces containing irregularly arranged concavities with large open-pore diameters and depths. These properties facilitate adhesion of the implant to the surrounding tissue, thereby promoting implant immobilization. Relative to implants with other surfaces, macrotextured implants offer low rates of capsular contracture; low rates of malposition, rotation, and rippling; and high rates of patient satisfaction. However, macrotextured implants are associated with a slightly higher risk of double capsule and late seroma. The surgeon can minimize these risks with straightforward techniques that encourage tissue adhesion. This report presents experience-based recommendations to optimize the effectiveness of Biocell anatomic implants. The authors discuss the application of best practices to all aspects of the breast implantation process, from implant selection and surgical planning to operative technique and postoperative management. LEVEL OF EVIDENCE 3. © 2014 The American Society for Aesthetic Plastic Surgery, Inc.

System Safety in an IT Service Organization

NASA Astrophysics Data System (ADS)

Parsons, Mike; Scutt, Simon

Within Logica UK, over 30 IT service projects are considered safetyrelated. These include operational IT services for airports, railway infrastructure asset management, nationwide radiation monitoring and hospital medical records services. A recent internal audit examined the processes and documents used to manage system safety on these services and made a series of recommendations for improvement. This paper looks at the changes and the challenges to introducing them, especially where the service is provided by multiple units supporting both safety and non-safety related services from multiple locations around the world. The recommendations include improvements to service agreements, improved process definitions, routine safety assessment of changes, enhanced call logging, improved staff competency and training, and increased safety awareness. Progress is reported as of today, together with a road map for implementation of the improvements to the service safety management system. A proposal for service assurance levels (SALs) is discussed as a way forward to cover the wide variety of services and associated safety risks.

Data collection operational support system, part 1. [collected from satellite terminals operating as part of the ATS 6 project

NASA Technical Reports Server (NTRS)

Woughter, W. R., Jr.

1975-01-01

The Data Collection Operational Support system has been shown to be a usable means of transmitting numerical data over a 2-way VHF satellite link. It is also capable of supporting educational applications. The design, operation, use, results, and recommendations of the system are discussed.

THE SCIENCE BEHIND THE ICRP 2005 RECOMMENDATIONS

EPA Science Inventory

The ICRP 2005 Recommendations are stated to be "based on a simple, but widely applicable, general system of protection that will clarify its objectives and will provide a basis for the more formal systems needed by operating managements and regulators". The Recommendati...

76 FR 55644 - Plumas County Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-08

... Community Self-Determination Act (Pub. L 110-343) (the Act) and operates in compliance with the Federal... provide advice and recommendations to the Forest Service concerning projects and funding consistent with... Cycle 2 project applications for potential funding recommendations to National Forest Supervisors. DATES...

Feasibility of Integrated Menu Recommendation and Self-Order System for Small-Scale Restaurants

NASA Astrophysics Data System (ADS)

Kashima, Tomoko; Matsumoto, Shimpei; Ishii, Hiroaki

2010-10-01

In recent years, point of sales (POS) systems with order function have been developed for restaurants. Since expensive apparatus and system are required for installing POS systems, usually only large-scale restaurant chains can afford to introduce them. In this research, we consider the POS management in a restaurant, which cooperates with an automatic order function by using a personal digital device aiming at the safety of the food, pursuit of service, and further operational efficiency improvements, such as foods management, accounting treatment, and ordering work. In traditional POS systems, information recommendation technology is not taken into consideration. We realize the recommendation of a menu according to the user's preference using rough sets and menu planning based on stock status by applying information recommendation technology. Therefore, we believe that this system can be used in comfort with regard to freshness of foods, allergy, diabetes, etc. Furthermore, due to the reduction of the personnel expenses by an operational efficiency improvement such technology becomes even feasible for small-scale stores.

INDOT Technical Training Plan

DOT National Transportation Integrated Search

2012-04-01

The study provides the background documents necessary for the development of a Technical Training Plan and makes recommendations : for the content and structure of such a plan for the District Operations, Operations, Capital Program Management, and E...

76 FR 28216 - Meeting of the Chief of Naval Operations Executive Panel

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-16

... Operations (CNO) Executive Panel will deliberate on the findings and proposed recommendations of the Resource Sponsorship Subcommittee study. The meeting will consist of discussions regarding the current Navy functional...

NASA Aerospace Flight Battery Program: Recommendations for Technical Requirements for Inclusion in Aerospace Battery Procurements. Volume 1, Part 2

NASA Technical Reports Server (NTRS)

Jung, David S.; Manzo, Michelle A.

2010-01-01

This NASA Aerospace Flight Battery Systems Working Group was chartered within the NASA Engineering and Safety Center (NESC). The Battery Working Group was tasked to complete tasks and to propose proactive work to address battery related, agency-wide issues on an annual basis. In its first year of operation, this proactive program addressed various aspects of the validation and verification of aerospace battery systems for NASA missions. Studies were performed, issues were discussed and in many cases, test programs were executed to generate recommendations and guidelines to reduce risk associated with various aspects of implementing battery technology in the aerospace industry. This document contains Part 2 - Volume I: Recommendations for Technical Requirements for Inclusion in Aerospace Battery Procurements of the program's operations.

Bi-Level Integrated System Synthesis (BLISS) for Concurrent and Distributed Processing

NASA Technical Reports Server (NTRS)

Sobieszczanski-Sobieski, Jaroslaw; Altus, Troy D.; Phillips, Matthew; Sandusky, Robert

2002-01-01

The paper introduces a new version of the Bi-Level Integrated System Synthesis (BLISS) methods intended for optimization of engineering systems conducted by distributed specialty groups working concurrently and using a multiprocessor computing environment. The method decomposes the overall optimization task into subtasks associated with disciplines or subsystems where the local design variables are numerous and a single, system-level optimization whose design variables are relatively few. The subtasks are fully autonomous as to their inner operations and decision making. Their purpose is to eliminate the local design variables and generate a wide spectrum of feasible designs whose behavior is represented by Response Surfaces to be accessed by a system-level optimization. It is shown that, if the problem is convex, the solution of the decomposed problem is the same as that obtained without decomposition. A simplified example of an aircraft design shows the method working as intended. The paper includes a discussion of the method merits and demerits and recommendations for further research.

Validation of the human activity profile questionnaire as a measure of physical activity levels in older community-dwelling women.

PubMed

Bastone, Alessandra de Carvalho; Moreira, Bruno de Souza; Vieira, Renata Alvarenga; Kirkwood, Renata Noce; Dias, João Marcos Domingues; Dias, Rosângela Corrêa

2014-07-01

The purpose of this study was to assess the validity of the Human Activity Profile (HAP) by comparing scores with accelerometer data and by objectively testing its cutoff points. This study included 120 older women (age 60-90 years). Average daily time spent in sedentary, moderate, and hard activity; counts; number of steps; and energy expenditure were measured using an accelerometer. Spearman rank order correlations were used to evaluate the correlation between the HAP scores and accelerometer variables. Significant relationships were detected (rho = .47-.75, p < .001), indicating that the HAP estimates physical activity at a group level well; however, scatterplots showed individual errors. Receiver operating characteristic curves were constructed to determine HAP cutoff points on the basis of physical activity level recommendations, and the cutoff points found were similar to the original HAP cutoff points. The HAP is a useful indicator of physical activity levels in older women.

Indicator organisms in meat and poultry slaughter operations: their potential use in process control and the role of emerging technologies.

PubMed

Saini, Parmesh K; Marks, Harry M; Dreyfuss, Moshe S; Evans, Peter; Cook, L Victor; Dessai, Uday

2011-08-01

Measuring commonly occurring, nonpathogenic organisms on poultry products may be used for designing statistical process control systems that could result in reductions of pathogen levels. The extent of pathogen level reduction that could be obtained from actions resulting from monitoring these measurements over time depends upon the degree of understanding cause-effect relationships between processing variables, selected output variables, and pathogens. For such measurements to be effective for controlling or improving processing to some capability level within the statistical process control context, sufficiently frequent measurements would be needed to help identify processing deficiencies. Ultimately the correct balance of sampling and resources is determined by those characteristics of deficient processing that are important to identify. We recommend strategies that emphasize flexibility, depending upon sampling objectives. Coupling the measurement of levels of indicator organisms with practical emerging technologies and suitable on-site platforms that decrease the time between sample collections and interpreting results would enhance monitoring process control.

Injury risk factors, screening tests and preventative strategies: a systematic review of the evidence that underpins the perceptions and practices of 44 football (soccer) teams from various premier leagues

PubMed Central

McCall, Alan; Carling, Chris; Davison, Michael; Nedelec, Mathieu; Le Gall, Franck; Berthoin, Serge; Dupont, Gregory

2015-01-01

Purpose To systematically review the scientific level of evidence for the ‘Top 3’ risk factors, screening tests and preventative exercises identified by a previously published survey of 44 premier league football (soccer) teams. Also, to provide an overall scientific level of evidence and graded recommendation based on the current research literature. Methods A systematic literature search (Pubmed [MEDLINE], SportDiscus, PEDRO and Cochrane databases). The quality of the articles was assessed and a level of evidence (1++ to 4) was assigned. Level 1++ corresponded to the highest level of evidence available and 4, the lowest. A graded recommendation (A: strong, B: moderate, C: weak, D: insufficient evidence to assign a specific recommendation) for use in the practical setting was given. Results Fourteen studies were analysed. The overall level of evidence for the risk factors previous injury, fatigue and muscle imbalance were 2++, 4 and ‘inconclusive’, respectively. The graded recommendation for functional movement screen, psychological questionnaire and isokinetic muscle testing were all ‘D’. Hamstring eccentric had a weak graded ‘C’ recommendation, and eccentric exercise for other body parts was ‘D’. Balance/proprioception exercise to reduce ankle and knee sprain injury was assigned a graded recommendation ‘D’. Conclusions The majority of perceptions and practices of premier league teams have a low level of evidence and low graded recommendation. This does not imply that these perceptions and practices are not important or not valid, as it may simply be that they are yet to be sufficiently validated or refuted by research. PMID:25576530

Meeting Recommended Levels of Physical Activity and Health-Related Quality of Life in Rural Adults.

PubMed

Hart, Peter D

2016-03-01

Little is known about physical activity (PA) and health-related quality of life (HRQOL) among rural adults. The purpose of this study was to investigate the relationship between meeting recommended levels of PA and HRQOL in a rural adult population. This study analyzed data from 6,103 rural adults 18 years of age and older participating in a 2013 survey. Respondents reporting at least 150 minutes a week of moderate-intensity (or moderate-vigorous combination) PA during the past month were categorized as meeting PA guidelines. Five health variables were used to assess HRQOL. A continuous HRQOL ability score was also created using item response theory (IRT). Rural adults who met recommended levels of PA were significantly more likely to report good HRQOL in adjusted models of physical health (OR: 1.99; 95% CI: 1.54-2.56), mental health (OR: 1.96; 95% CI: 1.46-2.64), inactivity health (OR: 2.14; 95% CI: 1.54-2.97), general health (OR: 1.69; 95% CI: 1.35-2.13), and healthy days (OR: 1.98; 95% CI: 1.58-2.47), compared to those who did not meet recommended levels. Furthermore, rural adults meeting recommended levels of PA also had a significantly greater HRQOL ability score (51.7 ± 0.23, Mean ± SE), compared to those not meeting recommended levels (48.4 ± 0.33, p < .001). This study found that meeting recommended levels of PA increases the likelihood of reporting good HRQOL in rural adults. These results should be used to promote the current PA guidelines for improved HRQOL in rural populations.

Readiness of hospitals to provide Kangaroo Mother Care (KMC) and documentation of KMC service delivery: Analysis of Malawi 2014 Emergency Obstetric and Newborn Care (EmONC) survey data.

PubMed

Chavula, Kondwani; Likomwa, Dyson; Valsangkar, Bina; Luhanga, Richard; Chimtembo, Lydia; Dube, Queen; Gobezie, Wasihun Andualem; Guenther, Tanya

2017-12-01

Malawi introduced Kangaroo Mother Care (KMC) in 1999 as part of its efforts to address newborn morbidity and mortality and has continued to expand KMC services across the country. Yet, data on availability of KMC services and routine service provision are limited. Data from the 2014 Emergency Obstetric Newborn Care (EmONC) survey, which was a census of all 87 hospitals in Malawi, were analyzed. The WHO service availability and readiness domains were used to generate indicators for KMC service readiness and an additional domain for documentation of KMC services was included. Levels of KMC service delivery were quantified using data extracted from a 12-month register review and a KMC initiation rate was calculated for each facility by dividing the reported number of babies initiated on KMC by the number of live births at facility. We defined three levels of KMC readiness and two levels of KMC operational status. 79% of hospitals (69/87) reported providing inpatient KMC services. More than half of the hospitals (62%; 54/87) met the most basic definition of readiness (staff, space for KMC and functional weighing scale) and 35% (30/87) met an expanded definition of readiness (guidelines, staff, space, scale and register in use). Only 15 % (13/87) of hospitals had all KMC tracer items. Less than half of the hospitals (43%; 37/87) met criteria for KMC operational status at minimum levels (≥1/100 live births), and just 16% (14/87) met criteria for KMC operational status at routine levels (≥5/100 live births). Our study found large differences between reported levels of KMC services and documented levels of KMC readiness and service provision among hospitals in Malawi. It is recommended that facility assessments of services such as KMC include record reviews to better estimate service availability and delivery. Further efforts to strengthen the capacity of Malawian hospitals to deliver KMC are needed.

Psychological distress and coping in military cadre candidates

PubMed Central

Nakkas, Can; Annen, Hubert; Brand, Serge

2016-01-01

Background Soldiers must cope with stressors during both military operations and training if they are to accomplish their missions successfully and stay mentally stable. This holds true particularly for military superiors, as they bear greater responsibilities and must meet greater demands during both deployment and training. Accordingly, in the present study, we investigated whether recruits chosen for further promotion at the end of basic training differed with regard to psychological distress and coping strategies from those not chosen for promotion, and whether recruits’ coping styles and distress levels were associated. Methods A total of 675 Swiss recruits took part in the study. At the beginning of basic training, recruits filled out self-rating questionnaires covering demographic data, psychological distress (depression, somatization, anxiety, interpersonal sensitivity, and hostility), and coping styles. Results were compared between those recruits who received a recommendation for further promotion at the end of basic training and those who did not. Results Recruits selected for promotion had lower scores for depressive symptoms and hostility, engaged more in active coping, and considered their coping to be more effective. Dysfunctional and functional coping were associated with higher and lower distress levels, respectively. Conclusion Recruits recommended for promotion exhibited less psychological distress during basic training and exhibited a socially more conducive profile of distress. They also endorsed more efficient and more prosocial coping strategies than those recruits not recommended for promotion. These cognitive–emotional features not only contribute to resilience but are also consistent with leadership research, indicating the importance of emotional stability and prosocial behavior in successful leaders. PMID:27621634

The Effect of Antiseptics in the Prophylaxis of Infection in Orthopaedic Surgery.

PubMed

Lüdemann, Martin; Munoz, Pablo; Wagner, Martin; Malzahn, Uwe; Horas, Konstantin; Heuschmann, Peter; Rudert, Maximilian

2018-06-14

Over the past decade, the incidence of revision arthroplasty has increased substantially. One of the main reasons for revision arthroplasty is periprosthetic joint infection, often resulting in multiple surgical interventions with variable success and poor clinical outcome. Intraoperative wound irrigation has been proposed to reduce bacterial contamination and thus the risk of periprosthetic infection. However, there is currently no widely accepted recommendation for the use of topical antiseptics within the operative setting for primary implantation. We performed a systematic review of studies pertaining to the use of intraoperative topical antiseptics and their effectiveness in preventing infection of orthopaedic implants. A comprehensive literature search including MEDLINE (PubMed), Cochrane Library, and Current Contents Medicine (CCMED-Medpilot) was performed according to a standardised protocol. Overall, 1905 articles were initially assessed. Four studies met the inclusion criteria and remained for further analysis, comprising two prospective cohort studies using retrospective control groups (evidence level II - III) and two randomised controlled trials (evidence level I). 0.35% Povidone-iodine (PVP-I) was used in three of these studies and a solution of 6.25% PVP-I and 6.25%-hydrogen peroxide (H 2 O 2 ) in one study for intraoperative wound irrigation. There was a clear trend in all studies suggesting that intraoperative topical antiseptics are effective in preventing periprosthetic infection. Although no clear regimen can be recommended, the available literature indicates that the use of intraoperative topical antiseptics is of clinical relevance in preventing infection of orthopaedic implants. Further randomised controlled trials are recommended. Georg Thieme Verlag KG Stuttgart · New York.

Added sugars in kids' meals from chain restaurants.

PubMed

Scourboutakos, Mary J; Semnani-Azad, Zhila; L'Abbé, Mary R

2016-06-01

To analyze the added sugars in kids' meals from Canadian chain restaurants in relation to the World Health Organization's proposed sugar recommendation (less than 5% of total daily calories should come from added sugars) and current recommendation (less than 10% of total daily calories should come from added sugars). Total sugar levels were retrieved from the websites of 10 fast-food and 7 sit-down restaurants in 2010. The added sugar levels in 3178 kids' meals from Canadian chain restaurants were calculated in 2014 (in Toronto, Canada) by subtracting all naturally occurring sugars from the total sugar level. The average amount of added sugars in restaurant kids' meals (25 ± 0.36 g) exceeded the WHO's proposed daily recommendation for sugar intake. There was a wide range of added sugar levels in kids' meals ranging from 0 g to 114 g. 50% of meals exceeded the WHO's proposed daily sugar recommendation, and 19% exceeded the WHO's current daily sugar recommendation. There is a wide range of sugar levels in kids' meals from restaurants, and many contain more than a day's worth of sugar.

HALE UAS Concept of Operations. Version 3.0

NASA Technical Reports Server (NTRS)

2006-01-01

This document is a system level Concept of Operations (CONOPS) from the perspective of future High Altitude Long Endurance (HALE) Unmanned Aircraft Systems (UAS) service providers and National Airspace System (NAS) users. It describes current systems (existing UAS), describes HALE UAS functions and operations to be performed (via sample missions), and offers insight into the user s environment (i.e., the UAS as a system of systems). It is intended to be a source document for NAS UAS operational requirements, and provides a construct for government agencies to use in guiding their regulatory decisions, architecture requirements, and investment strategies. Although it does not describe the technical capabilities of a specific HALE UAS system (which do, and will vary widely), it is intended to aid in requirements capture and to be used as input to the functional requirements and analysis process. The document provides a basis for development of functional requirements and operational guidelines to achieve unrestricted access into the NAS. This document is an FY06 update to the FY05 Access 5 Project-approved Concept of Operations document previously published in the Public Domain on the Access 5 open website. This version is recommended to be approved for public release also. The updates are a reorganization of materials from the previous version with the addition of an updated set of operational requirements, inclusion of sample mission scenarios, and identification of roles and responsibilities of interfaces within flight phases.

Operating room efficiency: benefits of an orthopaedic traumatologist at a level II trauma center.

PubMed

Althausen, Peter L; Kauk, Justin R; Shannon, Steven; Lu, Minggen; O'Mara, Timothy J; Bray, Timothy J

2014-05-01

Fellowship-trained orthopaedic traumatologists are presumably taught skill sets leading to "best practice" outcomes and more efficient use of hospital resources. This should result in more favorable economic opportunities when compared with general orthopaedic surgeons (GOSs) providing similar clinical services. The purpose of our study was to compare the operating room utilization and financial data of traumatologists versus GOSs at a level II trauma center. Retrospective review. Level II community-based trauma hospital. Patients who presented to the emergency room at our institution with fractures and orthopaedic conditions requiring surgical intervention from January 1, 2010, to December 31, 2011. Operative fracture fixation by members of our orthopaedic trauma panel, including fellowship and nontrauma fellowship-trained orthopaedic surgeons. Our institutional database was queried to determine operative times, surgical supply and implant costs, and surgery labor expenses. Patients were stratified according to those treated by our trauma panel's 3 traumatologists and those treated by the 15 GOSs on our trauma panel. These 2 groups were then compared using standard statistical methods. A total of 6449 orthopedic cases were identified and 2076 of these involved fracture care. One thousand one hundred ninety-nine patients were treated by traumatologists and 877 by GOSs. There was no statistical difference detected in American Society of Anesthesiologists score between trauma and nontrauma groups. Overall, the traumatologist group demonstrated significantly decreased procedure times when compared with the GOS group (55.6 vs. 75.8 minutes, P < 0.0001). In 16 of 18 most common procedure types, traumatologists were more efficient. This led to significantly decreased surgical labor costs ($381.4 vs. $484.8; P < 0.0001) and surgical supply and implant costs ($2567 vs. $3003; P < 0.0001). This study demonstrates that in our community-based trauma system, fracture care provided by traumatologists results in improved utilization of hospital-based resources when compared with equivalent services provided by GOSs. Significantly decreased operative times, surgical labor expenses, and supply and implant costs by the fellowship-trained group represent enhanced control of the design, plan, execution, and monitoring of orthopaedic trauma care. Traumatologists can provide leadership recommendations for operating room efficiency in community-based orthopaedic trauma care models. Economic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Operating Room Efficiency: Benefits of an Orthopaedic Traumatologist at a Level II Trauma Center.

PubMed

Althausen, Peter L; Kauk, Justin R; Shannon, Steven; Lu, Minggen; O'Mara, Timothy J; Bray, Timothy J

2016-12-01

Fellowship-trained orthopaedic traumatologists are presumably taught skill sets leading to "best practice" outcomes and more efficient use of hospital resources. This should result in more favorable economic opportunities when compared with general orthopaedic surgeons (GOSs) providing similar clinical services. The purpose of our study was to compare the operating room utilization and financial data of traumatologists versus GOSs at a level II trauma center. Retrospective review. Level II community-based trauma hospital. Patients who presented to the emergency room at our institution with fractures and orthopaedic conditions requiring surgical intervention from January 1, 2010, to December 31, 2011. Operative fracture fixation by members of our orthopaedic trauma panel, including fellowship and nontrauma fellowship-trained orthopaedic surgeons. Our institutional database was queried to determine operative times, surgical supply and implant costs, and surgery labor expenses. Patients were stratified according to those treated by our trauma panel's 3 traumatologists and those treated by the 15 GOSs on our trauma panel. These 2 groups were then compared using standard statistical methods. A total of 6449 orthopedic cases were identified and 2076 of these involved fracture care. One thousand one hundred ninety-nine patients were treated by traumatologists and 877 by GOSs. There was no statistical difference detected in American Society of Anesthesiologists score between trauma and nontrauma groups. Overall, the traumatologist group demonstrated significantly decreased procedure times when compared with the GOS group (55.6 vs. 75.8 minutes, P , 0.0001). In 16 of 18 most common procedure types, traumatologists were more efficient. This led to significantly decreased surgical labor costs ($381.4 vs. $484.8; P < 0.0001) and surgical supply and implant costs ($2567 vs. $3003; P < 0.0001). This study demonstrates that in our communitybased trauma system, fracture care provided by traumatologists results in improved utilization of hospital-based resources when compared with equivalent services provided by GOSs. Significantly decreased operative times, surgical labor expenses, and supply and implant costs by the fellowship-trained group represent enhanced control of the design, plan, execution, and monitoring of orthopaedic trauma care. Traumatologists can provide leadership recommendations for operating room efficiency in community-based orthopaedic trauma care models. Economic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Effect of tractor driving on hearing loss in farmers in India.

PubMed

Kumar, Adarsh; Mathur, N N; Varghese, Mathew; Mohan, Dinesh; Singh, J K; Mahajan, Punnet

2005-04-01

Indian tractor drivers operate their tractors and other implements/equipment in an environment which can have extreme temperatures and high level of suspended particulate matter. In addition, Indian tractors do not have adequate vibration and noise attenuating designs features. This cross-sectional study compares the hearing status of tractor driving farmers (TDFs) (study group) and non-tractor driving farmers (NTDFs) (control group) matched for age, sex, generic/ethnic group, land holding, education levels, and work routines. Two groups of 50 experienced tractor-driving farmers and 50 non-driving farmers were selected from 2 villages, 50 km from Delhi. All participants were interviewed for details of work routine and noise exposures. An audiogram was performed and noise measurements taken on tractors and other machines. Self-reported hearing problems were similar (4 cases each) in both the groups of 50 farmers. However, audiogram analysis showed higher prevalence of abnormalities in TDFs. TDFs (24) had more often high frequency hearing loss when compared to NTDFs (14). The noise levels observed on tractors in different operations were in the range of 90-110 dB (A). Tractor noise levels exceeded the recommended safe limits of OSHA and NIOSH prescribed standards. TDFs had higher high frequency hearing loss than NTDFs. The mechanism of damage and prevention needs to be studied further. Copyright (c) 2005 Wiley-Liss, Inc.

Technology and Policy Challenges in the Adoption and Operation of Health Information Exchange Systems.

PubMed

Ji, Hyerim; Yoo, Sooyoung; Heo, Eun-Young; Hwang, Hee; Kim, Jeong-Whun

2017-10-01

This study aimed to identify problems and issues that arise with the implementation of online health information exchange (HIE) systems in a medical environment and to identify solutions to facilitate the successful operation of future HIE systems in primary care clinics and hospitals. In this study, the issues that arose during the establishment and operation of an HIE system in a hospital were identified so that they could be addressed to enable the successful establishment and operation of a standard-based HIE system. After the issues were identified, they were reviewed and categorized by a group of experts that included medical information system experts, doctors, medical information standard experts, and HIE researchers. Then, solutions for the identified problems were derived based on the system development, operation, and improvement carried out during this work. Twenty-one issues were identified during the implementation and operation of an online HIE system. These issues were then divided into four categories: system architecture and standards, documents and data items, consent of HIE, and usability. We offer technical and policy recommendations for various stakeholders based on the experiences of operating and improving the online HIE system in the medical field. The issues and solutions identified in this study regarding the implementation and operate of an online HIE system can provide valuable insight for planners to enable them to successfully design and operate such systems at a national level in the future. In addition, policy support from governments is needed.

Control banding assessment of workers' exposure to indium and its compounds in 13 Japanese indium plants.

PubMed

Higashikubo, Ichiro; Arito, Heihachiro; Ando, Kenji; Araki, Akihiro; Shimizu, Hidesuke; Sakurai, Haruhiko

2018-05-25

This study aimed to assess workers' exposure to indium and its compounds in 55 indium-handling operations among 13 Japanese plants. The surveyed plants were selected from indium-manufacturing plants whose annual indium production exceeded 500 kg. The Control of Substances Hazardous to Health (COSHH) Essentials control banding toolkit, which contains simple scales for hazard levels, quantities in daily use, and "dustiness" characteristics, was used to assess generic risks of indium-handling operations. The operations were then classified into one of four Control Approaches (CAs). There were 35 indium-handling operations classified into CA4 (requires expert advice) and 16 grouped into CA3 (requires containment). There were three operations classified into CA2 (requires engineering controls) and only one into CA1 (requires good general ventilation (GV) and working practices). Of the 51 operations classified as CA4 and CA3, 36 were found to be improperly equipped with local exhaust ventilation, and the remaining 15 operations solely relied on GV practices. Respiratory protective equipment (RPE) used in the 13 indium plants was examined with reference to the recommendations of the COSHH Essentials and Japan's Technical Guidelines. Our findings suggest that stringent engineering control measures and respiratory protection from indium dust are needed to improve indium-handling operations. Our results show that the most common control approach for Japanese indium-handling operations is to require expert advice, including worker health checks for respiratory diseases and exposure measurement by air sampling.

76 FR 10420 - Delegation of Authority

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-24

... Standard Operating Procedure 00 01 2, Chapter 3, paragraph 2, or is unable to perform the functions and... to the Administrator for approval applications for licenses to operate as a small business investment... authorities granted by the Administrator to recommend and approve applications for a license to operate as a...

Assessment of Occupational Exposure to Bisphenol A in Five Different Production Companies in Finland.

PubMed

Heinälä, Milla; Ylinen, Katriina; Tuomi, Tapani; Santonen, Tiina; Porras, Simo P

2017-01-01

The aim of the study was to assess occupational exposure to bisphenol A in Finland. Five companies took part in the research project: two paint factories (liquid and powder paints), a composite product factory, a thermal paper factory, and a tractor factory. Exposure was assessed by measuring total bisphenol A excretion (free and conjugated) from urine samples, and its concentrations in the air. The results revealed the specific work tasks in two of five companies in which significant occupational exposure to bisphenol A may occur. In the manufacturing of liquid paint hardener, urine samples collected after the working day showed bisphenol A levels of up to 100-170 µg l-1. Workers in thermal paper manufacturing were also exposed to bisphenol A, especially those working in the manufacture of coating material and operating coating machines. Median concentrations of the post-shift urine samples of coating machine workers were in the range of 130-250 µg l-1. The highest bisphenol A concentrations were in the range of 1000-1500 µg l-1. Recommendations for more effective personal protection resulted in decreased exposure, particularly among coating machine operators. In the rest of the companies, urinary bisphenol A levels were typically in the range of those of the general population. Bisphenol A concentrations in air samples were typically low (<40 µg m-3), except in some short-term duties related to the handling of solid bisphenol A (maximum 17.6 mg m-3). Low air levels, even in the companies with high urinary levels, suggest exposure via dermal contact. According to the results, exposure to bisphenol A may occur particularly in work tasks that involve the use of pure bisphenol A. In these tasks, special attention should be paid to the prevention of skin exposure. Inhalation exposure may become relevant in dusty work tasks. Since skin exposure is of potential concern in these tasks, biomonitoring is recommended as the method for assessing occupational exposure to bisphenol A. © The Author 2017. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

COCONet enhancements to circum-Caribbean tsunami warning, tidal, and sea-level monitoring: update on tide gauge installations

NASA Astrophysics Data System (ADS)

Dausz, K.; Dittmann, S. T.; Feaux, K.; von Hillebrandt-Andrade, C.; Mattioli, G. S.; Normandeau, J.

2014-12-01

The Continually Operating Caribbean GPS Observational Network (COCONet) is a National Science Foundation (NSF) funded multi-hazard geodetic and meteorological network distributed throughout the Caribbean, which provides infrastructure and capacity building for a broad range of earth science questions. The network is a multi-national collaboration consisting of 46 newly constructed continuous Global Positioning Systems (cGPS) and 21 refurbished existing GPS stations, all co-located with meteorological sensors. One recommendation of the COCONet working group was to improve the vertical reference frame for long-term sea level monitoring. A COCONet supplement was awarded by the NSF to further address this particular objective through the co-location of GPS and tide gauges. This COCOnet infrastructure, along with the new tide gauges, will have broad scientific implications for hazards mitigation, solid earth, and atmospheric science research. UNAVCO engineers have meet with members of the Caribbean tide gauge community to establish target locations and design station layout. Allocated NSF funds allow for the construction of two complete new tide gauge systems each with two complimentary cGPS. Following the recommendations of NOAA and the sea level monitoring community, the two "new" locales will be Port Royal, Jamaica and Puerto Morelos, Mexico. Both locations had previously existing, but currently non-operational tide gauges. UNAVCO engineers will install a Sutron Radar Level Recorder and a backup pressure sensor tide gauge with GOES satellite telemetry. Tide data will be freely available by the Intergovernmental Oceanographic Commission (www.ioc-sealevelmonitoring.org). The NSF supplement also provided funds for adding cGPS to two additional locations where currently functioning tide gauge systems exist. Proposed locations for this additional infrastructure are Barahona, Dominican Republic and Bocas del Toro, Panama. All four locations will feature two standard COCONet cGPS systems consisting of a Trimble Choke Ring GNSS antenna, Trimble NetR9 GPS receiver, and a Vaisala meteorological sensor. All GPS data will be collected, processed and distributed via standard COCONet archiving and processing along with raw meteorological data at coconet.unavco.org.

Space Station Program implications from the viewpoint of the Space Station Operations Task Force

NASA Technical Reports Server (NTRS)

Paules, Granville E.; Lyman, Peter; Shelley, Carl B.

1987-01-01

An operational concept for the Space Station which has been developed by the Space Station Operations Task Force is described. The operations functions are described, and the relationships of these functions to the overall framework for operations are defined. Product flows for the recommended framework are discussed, and the roles and responsibilities for the proposed operations organization during both the development and the mature operations phases of the Space Station Program are examined.

30 CFR 250.802 - Design, installation, and operation of surface production-safety systems.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Production Platform Piping Systems (as incorporated by reference in § 250.198). (4) Electrical system... classified according to API RP 500, Recommended Practice for Classification of Locations for Electrical..., Recommended Practice for Classification of Locations for Electrical Installations at Petroleum Facilities...

30 CFR 250.802 - Design, installation, and operation of surface production-safety systems.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Production Platform Piping Systems (as incorporated by reference in § 250.198). (4) Electrical system... classified according to API RP 500, Recommended Practice for Classification of Locations for Electrical..., Recommended Practice for Classification of Locations for Electrical Installations at Petroleum Facilities...

30 CFR 250.802 - Design, installation, and operation of surface production-safety systems.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Production Platform Piping Systems (as incorporated by reference in § 250.198). (4) Electrical system... classified according to API RP 500, Recommended Practice for Classification of Locations for Electrical..., Recommended Practice for Classification of Locations for Electrical Installations at Petroleum Facilities...

40 CFR 240.206-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) SOLID WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended... spillages occur, emptying the solid waste storage area at least weekly, and routinely cleaning the remainder of the facility. (b) Solid waste and residue should not be allowed to accumulate at the facility for...

77 FR 44579 - Siskiyou County Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-30

... Community Self-Determination Act (Pub. L. 110-343) (the Act) and operates in compliance with the Federal... provide advice and recommendations to the Forest Service concerning projects and funding consistent with... committee to hear project status, review project proposals and to vote and make recommendations. The meeting...

77 FR 48948 - Sierra County Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-15

... Community Self-Determination Act (Pub. L. 112-141) (the Act) and operates in compliance with the Federal... provide advice and recommendations to the Forest Service concerning projects and funding consistent with... and recommend projects authorized under title II of the Act. DATES: The meetings will be held...

RECOMMENDED SUB-SLAB DEPRESSURIZATION SYSTEMS DESIGN STANDARD OF THE FLORIDA RADON RESEARCH PROGRAM

EPA Science Inventory

The report recommends sub-slab depressurization systems design criteria to the State of Florida's Department of Community Affairs for their building code for radon resistant houses. Numerous details are set forth in the full report. Primary criteria include: (1) the operating soi...

14 CFR 23.1583 - Operating limitations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... restrictions on smoking in the airplane. (p) Types of surface. A statement of the types of surface on which... type flight tests, together with recommended entry speeds and any other associated limitations. No... demonstrated in the type flight tests, together with recommended entry speeds and any other associated...

14 CFR 23.1583 - Operating limitations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... restrictions on smoking in the airplane. (p) Types of surface. A statement of the types of surface on which... type flight tests, together with recommended entry speeds and any other associated limitations. No... demonstrated in the type flight tests, together with recommended entry speeds and any other associated...

Systems Modeling for Crew Core Body Temperature Prediction Postlanding

NASA Technical Reports Server (NTRS)

Cross, Cynthia; Ochoa, Dustin

2010-01-01

The Orion Crew Exploration Vehicle, NASA s latest crewed spacecraft project, presents many challenges to its designers including ensuring crew survivability during nominal and off nominal landing conditions. With a nominal water landing planned off the coast of San Clemente, California, off nominal water landings could range from the far North Atlantic Ocean to the middle of the equatorial Pacific Ocean. For all of these conditions, the vehicle must provide sufficient life support resources to ensure that the crew member s core body temperatures are maintained at a safe level prior to crew rescue. This paper will examine the natural environments, environments created inside the cabin and constraints associated with post landing operations that affect the temperature of the crew member. Models of the capsule and the crew members are examined and analysis results are compared to the requirement for safe human exposure. Further, recommendations for updated modeling techniques and operational limits are included.

Radiation Hard Silicon Particle Detectors for Phase-II LHC Trackers

NASA Astrophysics Data System (ADS)

Oblakowska-Mucha, A.

2017-02-01

The major LHC upgrade is planned after ten years of accelerator operation. It is foreseen to significantly increase the luminosity of the current machine up to 1035 cm-2s-1 and operate as the upcoming High Luminosity LHC (HL-LHC) . The major detectors upgrade, called the Phase-II Upgrade, is also planned, a main reason being the aging processes caused by severe particle radiation. Within the RD50 Collaboration, a large Research and Development program has been underway to develop silicon sensors with sufficient radiation tolerance for HL-LHC trackers. In this summary, several results obtained during the testing of the devices after irradiation to HL-LHC levels are presented. Among the studied structures, one can find advanced sensors types like 3D silicon detectors, High-Voltage CMOS technologies, or sensors with intrinsic gain (LGAD). Based on these results, the RD50 Collaboration gives recommendation for the silicon detectors to be used in the detector upgrade.

The Impact Of Occupational Hazards In Workplaces - Maintenance, A Main Target For Ensuring The Safety Of Working Equipment

NASA Astrophysics Data System (ADS)

Antonov, Anca Elena; Buica, Georgeta; Darabont, Doru Costin; Beiu, Constantin

2015-07-01

For use of work equipment having the economic performance and the highest level of safety, it must be ensured that it complies with the conditions set by the manufacturer in terms of putting into service, use and maintenance operations, ensuring appropriate technical and environmental requirements, including appropriate measures and means of protection. The research aimed to identify and analyze the occupational hazards associated to maintenance operations, in terms of the history of the adjustments, maintenance, cleaning and repair, including the case that occur after the incidents, capital repairs and upgrades. The results of the research consisted in the development of recommendations on the effective management of maintenance activities of work equipment and a software model to enable an efficient management of maintenance, as a tool for occupational hazards in companies - premise for increasing the competitiveness of employers in the market economy.

A Data-Based Console Logger for Mission Operations Team Coordination

NASA Technical Reports Server (NTRS)

Thronesbery, Carroll; Malin, Jane T.; Jenks, Kenneth; Overland, David; Oliver, Patrick; Zhang, Jiajie; Gong, Yang; Zhang, Tao

2005-01-01

Concepts and prototypes1,2 are discussed for a data-based console logger (D-Logger) to meet new challenges for coordination among flight controllers arising from new exploration mission concepts. The challenges include communication delays, increased crew autonomy, multiple concurrent missions, reduced-size flight support teams that include multidisciplinary flight controllers during quiescent periods, and migrating some flight support activities to flight controller offices. A spiral development approach has been adopted, making simple, but useful functions available early and adding more extensive support later. Evaluations have guided the development of the D-Logger from the beginning and continue to provide valuable user influence about upcoming requirements. D-Logger is part of a suite of tools designed to support future operations personnel and crew. While these tools can be used independently, when used together, they provide yet another level of support by interacting with one another. Recommendations are offered for the development of similar projects.

Emergency strategy optimization for the environmental control system in manned spacecraft

NASA Astrophysics Data System (ADS)

Li, Guoxiang; Pang, Liping; Liu, Meng; Fang, Yufeng; Zhang, Helin

2018-02-01

It is very important for a manned environmental control system (ECS) to be able to reconfigure its operation strategy in emergency conditions. In this article, a multi-objective optimization is established to design the optimal emergency strategy for an ECS in an insufficient power supply condition. The maximum ECS lifetime and the minimum power consumption are chosen as the optimization objectives. Some adjustable key variables are chosen as the optimization variables, which finally represent the reconfigured emergency strategy. The non-dominated sorting genetic algorithm-II is adopted to solve this multi-objective optimization problem. Optimization processes are conducted at four different carbon dioxide partial pressure control levels. The study results show that the Pareto-optimal frontiers obtained from this multi-objective optimization can represent the relationship between the lifetime and the power consumption of the ECS. Hence, the preferred emergency operation strategy can be recommended for situations when there is suddenly insufficient power.

Extreme Temperature Performance of Automotive-Grade Small Signal Bipolar Junction Transistors

NASA Technical Reports Server (NTRS)

Boomer, Kristen; Damron, Benny; Gray, Josh; Hammoud, Ahmad

2018-01-01

Electronics designed for space exploration missions must display efficient and reliable operation under extreme temperature conditions. For example, lunar outposts, Mars rovers and landers, James Webb Space Telescope, Europa orbiter, and deep space probes represent examples of missions where extreme temperatures and thermal cycling are encountered. Switching transistors, small signal as well as power level devices, are widely used in electronic controllers, data instrumentation, and power management and distribution systems. Little is known, however, about their performance in extreme temperature environments beyond their specified operating range; in particular under cryogenic conditions. This report summarizes preliminary results obtained on the evaluation of commercial-off-the-shelf (COTS) automotive-grade NPN small signal transistors over a wide temperature range and thermal cycling. The investigations were carried out to establish a baseline on functionality of these transistors and to determine suitability for use outside their recommended temperature limits.

INDOT Technical Training Plan : Appendix B

DOT National Transportation Integrated Search

2012-04-01

The study provides the background documents necessary for the development of a Technical Training Plan and makes recommendations for the content and structure of such a plan for the District Operations, Operations, Capital Program Management, and Eng...

INDOT Technical Training Plan : Appendix M

DOT National Transportation Integrated Search

2012-04-01

The study provides the background documents necessary for the development of a Technical Training Plan and makes recommendations for the content and structure of such a plan for the District Operations, Operations, Capital Program Management, and Eng...

INDOT Technical Training Plan : Appendix P

DOT National Transportation Integrated Search

2012-04-01

The study provides the background documents necessary for the development of a Technical Training Plan and makes recommendations for the content and structure of such a plan for the District Operations, Operations, Capital Program Management, and Eng...

INDOT Technical Training Plan : Appendix F

DOT National Transportation Integrated Search

2012-04-01

The study provides the background documents necessary for the development of a Technical Training Plan and makes recommendations for the content and structure of such a plan for the District Operations, Operations, Capital Program Management, and Eng...

INDOT Technical Training Plan : Appendix H

DOT National Transportation Integrated Search

2012-04-01

The study provides the background documents necessary for the development of a Technical Training Plan and makes recommendations for the content and structure of such a plan for the District Operations, Operations, Capital Program Management, and Eng...

INDOT Technical Training Plan : Appendix E

DOT National Transportation Integrated Search

2012-04-01

The study provides the background documents necessary for the development of a Technical Training Plan and makes recommendations for the content and structure of such a plan for the District Operations, Operations, Capital Program Management, and Eng...

INDOT Technical Training Plan : Appendix O

DOT National Transportation Integrated Search

2012-04-01

The study provides the background documents necessary for the development of a Technical Training Plan and makes recommendations for the content and structure of such a plan for the District Operations, Operations, Capital Program Management, and Eng...

INDOT Technical Training Plan : Appendix J

DOT National Transportation Integrated Search

2012-04-01

The study provides the background documents necessary for the development of a Technical Training Plan and makes recommendations for the content and structure of such a plan for the District Operations, Operations, Capital Program Management, and Eng...

INDOT Technical Training Plan : Appendix L

DOT National Transportation Integrated Search

2012-04-01

The study provides the background documents necessary for the development of a Technical Training Plan and makes recommendations for the content and structure of such a plan for the District Operations, Operations, Capital Program Management, and Eng...

INDOT Technical Training Plan : Appendix A

DOT National Transportation Integrated Search

2012-04-01

The study provides the background documents necessary for the development of a Technical Training Plan and makes recommendations for the content and structure of such a plan for the District Operations, Operations, Capital Program Management, and Eng...

INDOT Technical Training Plan : Appendix D

DOT National Transportation Integrated Search

2012-04-01

The study provides the background documents necessary for the development of a Technical Training Plan and makes recommendations for the content and structure of such a plan for the District Operations, Operations, Capital Program Management, and Eng...

INDOT Technical Training Plan : Appendix K

DOT National Transportation Integrated Search

2012-04-01

The study provides the background documents necessary for the development of a Technical Training Plan and makes recommendations for the content and structure of such a plan for the District Operations, Operations, Capital Program Management, and Eng...

Maintenance and operations plan for intelligent transportation systems in Kentucky.

DOT National Transportation Integrated Search

2004-06-01

This report presents a Maintenance and Operations Plan for Intelligent Transportation Systems (ITS) in Kentucky. It was developed using substantial stakeholder input and provides recommendations and specific strategies for supporting and coordinating...

78 FR 59240 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption of Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-26

... Guidelines for Miscellaneous Metal and Plastic Parts Which Includes Pleasure Craft Coating Operations AGENCY... Miscellaneous Metal Parts and Plastic Coating (MMPPC) operations and as recommended by trade associations...

INDOT Technical Training Plan : Appendix G

DOT National Transportation Integrated Search

2012-04-01

The study provides the background documents necessary for the development of a Technical Training Plan and makes recommendations for the content and structure of such a plan for the District Operations, Operations, Capital Program Management, and Eng...

INDOT Technical Training Plan : Appendix I

DOT National Transportation Integrated Search

2012-04-01

The study provides the background documents necessary for the development of a Technical Training Plan and makes recommendations for the content and structure of such a plan for the District Operations, Operations, Capital Program Management, and Eng...

INDOT Technical Training Plan : Appendix N

DOT National Transportation Integrated Search

2012-04-01

The study provides the background documents necessary for the development of a Technical Training Plan and makes recommendations for the content and structure of such a plan for the District Operations, Operations, Capital Program Management, and Eng...

INDOT Technical Training Plan : Appendix C

DOT National Transportation Integrated Search

2012-04-01

The study provides the background documents necessary for the development of a Technical Training Plan and makes recommendations for the content and structure of such a plan for the District Operations, Operations, Capital Program Management, and Eng...