Sample records for significant deterioration program

  1. 77 FR 73316 - Approval of Air Quality Implementation Plans; California; Eastern Kern, Imperial, Placer, and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-10

    ... adopt and implement a SIP- approved Prevention of Significant Deterioration (PSD) permit program. We are...--Prevention of Significant Deterioration (PSD) Permit Program, PCAPCD Rule 518--Prevention of Significant Deterioration (PSD) Permit Program, and YSAQMD Rule 3.24-- Prevention of Significant Deterioration. The approval...

  2. 76 FR 31241 - Prevention of Significant Deterioration (PSD) Program; Massachusetts; Announcing Delegation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-31

    ... Deterioration (PSD) Program; Massachusetts; Announcing Delegation Agreement Between EPA and Massachusetts... authority to implement and enforce the Federal Prevention of Significant Deterioration (PSD) program to the MassDEP. Therefore, effective that date, MassDEP is the implementing authority for the PSD program in...

  3. 40 CFR 52.530 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 3 2011-07-01 2011-07-01 false Significant deterioration of air quality. 52.530 Section 52.530 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) EPA approves the Florida Prevention of Significant Deterioration program, as...

  4. 40 CFR 52.530 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 3 2013-07-01 2013-07-01 false Significant deterioration of air quality. 52.530 Section 52.530 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) EPA approves the Florida Prevention of Significant Deterioration program, as...

  5. 40 CFR 52.530 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 3 2012-07-01 2012-07-01 false Significant deterioration of air quality. 52.530 Section 52.530 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) EPA approves the Florida Prevention of Significant Deterioration program, as...

  6. 40 CFR 52.530 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 3 2010-07-01 2010-07-01 false Significant deterioration of air quality. 52.530 Section 52.530 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) EPA approves the Florida Prevention of Significant Deterioration program, as...

  7. Final Amendments to Delegation of Authority Provisions in the Prevention of Significant Deterioration Permitting Program

    EPA Pesticide Factsheets

    finalized amendments to the New Source Review (NSR) Prevention of Significant Deterioration (PSD) permitting program that will allow the EPA to delegate administration of the program to interested and qualified tribal agencies.

  8. 40 CFR 52.2380 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 5 2013-07-01 2013-07-01 false Significant deterioration of air quality. 52.2380 Section 52.2380 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. The program to review the construction and operation of new and...

  9. 40 CFR 52.1029 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 4 2011-07-01 2011-07-01 false Significant deterioration of air quality. 52.1029 Section 52.1029 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. The program to review operation and construction of new and modified...

  10. 40 CFR 52.1029 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 4 2014-07-01 2014-07-01 false Significant deterioration of air quality. 52.1029 Section 52.1029 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. The program to review operation and construction of new and modified...

  11. 40 CFR 52.1029 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 4 2013-07-01 2013-07-01 false Significant deterioration of air quality. 52.1029 Section 52.1029 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. The program to review operation and construction of new and modified...

  12. 40 CFR 52.2380 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 5 2014-07-01 2014-07-01 false Significant deterioration of air quality. 52.2380 Section 52.2380 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. The program to review the construction and operation of new and...

  13. 40 CFR 52.2380 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 4 2011-07-01 2011-07-01 false Significant deterioration of air quality. 52.2380 Section 52.2380 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. The program to review the construction and operation of new and...

  14. 40 CFR 52.2380 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 5 2012-07-01 2012-07-01 false Significant deterioration of air quality. 52.2380 Section 52.2380 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. The program to review the construction and operation of new and...

  15. 40 CFR 52.1029 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 4 2012-07-01 2012-07-01 false Significant deterioration of air quality. 52.1029 Section 52.1029 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. The program to review operation and construction of new and modified...

  16. 40 CFR 52.1029 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Significant deterioration of air quality. 52.1029 Section 52.1029 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. The program to review operation and construction of new and modified...

  17. 40 CFR 52.2380 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Significant deterioration of air quality. 52.2380 Section 52.2380 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. The program to review the construction and operation of new and...

  18. 40 CFR 52.1634 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Significant Deterioration (PSD) and its Supplemental document, is approved as meeting the requirements of part... satisfying the conditions of EPA's conditional approval of the State's PSD program on February 27, 1987 (52...

  19. 40 CFR 52.1634 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Significant Deterioration (PSD) and its Supplemental document, is approved as meeting the requirements of part... satisfying the conditions of EPA's conditional approval of the State's PSD program on February 27, 1987 (52...

  20. 40 CFR 52.1634 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Significant Deterioration (PSD) and its Supplemental document, is approved as meeting the requirements of part... satisfying the conditions of EPA's conditional approval of the State's PSD program on February 27, 1987 (52...

  1. 76 FR 26192 - Revisions to the California State Implementation Plan, Northern Sonoma County Air Pollution...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-06

    ...-approved Prevention of Significant Deterioration (PSD) permit programs. These revisions update the definitions used in the districts' PSD permit programs. DATES: This rule is effective on July 5, 2011 without... Deterioration (PSD) permit program. Both the NSCAPCD and MCAQMD are currently designated as attainment or...

  2. 78 FR 13497 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Deferral for CO2

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-28

    ... defers until July 21, 2014 the application of the Prevention of Significant Deterioration (PSD... Other Biogenic Sources Under the Prevention of Significant Deterioration Program AGENCY: Environmental... July 21, 2014 the application of PSD permitting requirements to biogenic CO 2 emissions from bioenergy...

  3. 76 FR 49708 - Approval and Promulgation of Implementation Plans; Iowa: Prevention of Significant Deterioration...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-11

    ... regulation of Greenhouse Gases (GHGs) under Iowa's Prevention of Significant Deterioration (PSD) program..., 2010. It is intended to align Iowa's regulations with the ``PSD and Title V Greenhouse Gas Tailoring... the Clean Air Act (CAA or Act) and EPA regulations regarding PSD permitting for GHGs. DATES: Comments...

  4. 76 FR 2581 - Action To Ensure Authority To Issue Permits Under the Prevention of Significant Deterioration...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-14

    ... or Act) Prevention of Significant Deterioration (PSD) program to sources of greenhouse gases (GHGs... issue preconstruction PSD permits to GHG- emitting sources. This action is related to EPA's recent final rule, the GHG PSD SIP Call, published on December 13, 2010, in which EPA made a finding of substantial...

  5. 76 FR 15852 - Approval and Promulgation of Implementation Plans; Nebraska: Prevention of Significant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-22

    ... significant deterioration (PSD) preconstruction permitting program. The first applies to revisions relating to permitting of greenhouse gas (GHG) emissions under the PSD program. The second applies to revisions..., includes two significant changes impacting the regulation of GHGs under Nebraska's PSD program. First, the...

  6. 75 FR 75658 - Approval and Promulgation of Implementation Plans; Alaska: Prevention of Significant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-06

    ... Significant Deterioration (PSD) program to reflect changes to the Federal PSD program relating to the... update Alaska's PSD program to reflect changes to the Federal PSD program that would authorize the State of Alaska to regulate GHGs under its PSD program and establish appropriate emission thresholds for...

  7. Serum aminotransferase changes with significant weight loss: sex and age effects.

    PubMed

    Suzuki, Ayako; Binks, Martin; Sha, Ronald; Wachholtz, Amy; Eisenson, Howard; Diehl, Anna Mae

    2010-02-01

    In obese subjects, the liver may be differentially affected by significant weight loss depending on as yet unknown factors. We explored clinical factors associated with serum alanine aminotransferase (ALT) changes during significant weight loss in a residential weight loss program. Clinical data from 362 adults who received a comprehensive weight loss intervention (ie, diets, physical fitness, and behavioral modification) in the program were analyzed. Serum ALT was used as a surrogate marker of liver injury. The ALT changes during the program were calculated to create study outcome categories (improvement, no change, or deterioration of ALT during significant weight loss). Variables of demography, lifestyle, and comorbidities at baseline, and total/rate of weight change during the program were explored for associations with the ALT change categories using multiple logistic regression models. Variation by sex was apparent among predictors of ALT deterioration; men with rapid weight loss and women with higher initial body mass index were more likely to experience ALT deterioration, whereas men with prior alcohol consumption were less likely to experience ALT deterioration even after adjusting for baseline ALT (Ps < .03). Variation by age was apparent among predictors of ALT improvement; younger patients with current smoking and older patients with rapid weight loss, diabetes or impaired fasting glucose, or sleep apnea or who followed a reduced-carbohydrate diet were less likely to experience ALT improvement (Ps < .05). A number of clinical factors influence ALT changes during weight loss in sex- and age-specific manners. The patterns that we detected may have pathophysiologic significance beyond the practical implications of our findings in clinical practice related to underlying changes in fat metabolism. Copyright 2010 Elsevier Inc. All rights reserved.

  8. 40 CFR 144.31 - Application for a permit; authorization by permit.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... (PSD) program under the Clean Air Act. (2) Name, mailing address, and location of the facility for... under SDWA. (iii) NPDES program under CWA. (iv) Prevention of Significant Deterioration (PSD) program...

  9. 40 CFR 144.31 - Application for a permit; authorization by permit.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Significant Deterioration (PSD) program under the Clean Air Act. (2) Name, mailing address, and location of... (PSD) program under the Clean Air Act. (v) Nonattainment program under the Clean Air Act. (vi) National...

  10. 40 CFR 144.31 - Application for a permit; authorization by permit.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Significant Deterioration (PSD) program under the Clean Air Act. (2) Name, mailing address, and location of... (PSD) program under the Clean Air Act. (v) Nonattainment program under the Clean Air Act. (vi) National...

  11. 40 CFR 144.31 - Application for a permit; authorization by permit.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Significant Deterioration (PSD) program under the Clean Air Act. (2) Name, mailing address, and location of... (PSD) program under the Clean Air Act. (v) Nonattainment program under the Clean Air Act. (vi) National...

  12. 40 CFR 144.31 - Application for a permit; authorization by permit.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Significant Deterioration (PSD) program under the Clean Air Act. (2) Name, mailing address, and location of... (PSD) program under the Clean Air Act. (v) Nonattainment program under the Clean Air Act. (vi) National...

  13. 75 FR 82246 - Action To Ensure Authority To Issue Permits Under the Prevention of Significant Deterioration...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-30

    ... Deterioration (PSD) program to sources of greenhouse gases (GHGs). This action will ensure that a permitting authority--EPA--is available in these states as of January 2, 2011, when PSD becomes applicable to GHG-emitting sources, to issue preconstruction PSD permits and thereby facilitate construction or expansion...

  14. 76 FR 7116 - Approval and Promulgation of Implementation Plans; Alaska: Prevention of Significant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-09

    ... revision updates Alaska's Prevention of Significant Deterioration (PSD) program to reflect changes to the Federal PSD program relating to the permitting of greenhouse gas (GHG) emissions. DATES: This action is... Federal PSD program as of August 2, 2010 relating to the permitting of GHGs. In the proposal, EPA made the...

  15. Investigation of performance deterioration of the CF6/JT9D, high-bypass ratio turbofan engines

    NASA Technical Reports Server (NTRS)

    Ziemianski, J. A.; Mehalic, C. M.

    1980-01-01

    The aircraft energy efficiency program within NASA is developing technology required to improve the fuel efficiency of commercial subsonic transport aricraft. One segment of this program includes engine diagnostics which is directed toward determining the sources and causes of performance deterioration in the Pratt and Whitney Aircraft JT9D and General Electric CF6 high-bypass ratio turbofan engines and developing technology for minimizing the performance losses. Results of engine performance deterioration investigations based on historical data, special engine tests, and specific tests to define the influence of flight loads and component clearances on performance are presented. The results of analysis of several damage mechanisms that contribute to performance deterioration such as blade tip rubs, airfoil surface roughness and erosion, and thermal distortion are also included. The significance of these damage mechanisms on component and overall engine performance is discussed.

  16. The educational impact of web-based and face-to-face patient deterioration simulation programs: An interventional trial.

    PubMed

    Chung, Catherine; Cooper, Simon J; Cant, Robyn P; Connell, Cliff; McKay, Angela; Kinsman, Leigh; Gazula, Swapnali; Boyle, Jayne; Cameron, Amanda; Cash, Penny; Evans, Lisa; Kim, Jeong-Ah; Masud, Rana; McInnes, Denise; Norman, Lisa; Penz, Erika; Rotter, Thomas; Tanti, Erin; Breakspear, Tom

    2018-05-01

    There are international concerns relating to the management of patient deterioration. The "failure to rescue" literature identifies that nursing staff miss cues of deterioration and often fail to call for assistance. Simulation-based educational approaches may improve nurses' recognition and management of patient deterioration. To investigate the educational impact of the First2Act web-based (WB) and face-to-face (F2F) simulation programs. A mixed methods interventional cohort trial with nursing staff from four Australian hospitals. Nursing staff working in four public and private hospital medical wards in the State of Victoria. In 2016, ward nursing staff (n = 74) from a public and private hospital completed three F2F laboratory-based team simulations with a patient actor in teams of three. 56 nursing staff from another public and private hospital individually completed a three-scenario WB simulation program (First2ActWeb) [A 91% participation rate]. Validated tools were used to measure knowledge (multi-choice questionnaire), competence (check-list of actions) and confidence (self-rated) before and after the intervention. Both WB and F2F participants' knowledge, competence and confidence increased significantly after training (p ≤0.001). Skill performance for the WB group increased significantly from 61% to 74% (p ≤ 0.05) and correlated significantly with post-test knowledge (p = 0.014). No change was seen in the F2F groups' performance scores. Course evaluations were positive with median ratings of 4/5 (WB) and 5/5 (F2F). The F2F program received significantly more positive evaluations than the WB program (p < 0.05), particularly with regard to quality of feedback. WB and F2F simulation are effective education strategies with both programs demonstrating positive learning outcomes. WB programs increase ease of access to training whilst F2F enable the development of tactile hands on skills and teamwork. A combined blended learning education strategy is recommended to enhance competence and patient safety. Copyright © 2018 Elsevier Ltd. All rights reserved.

  17. Relationship between consecutive deterioration of mean deviation value and progression of visual field defect in open-angle glaucoma.

    PubMed

    Naito, Tomoko; Yoshikawa, Keiji; Mizoue, Shiro; Nanno, Mami; Kimura, Tairo; Suzumura, Hirotaka; Takeda, Ryuji; Shiraga, Fumio

    2015-01-01

    To analyze the relationship between consecutive deterioration of mean deviation (MD) value and glaucomatous visual field (VF) progression in open-angle glaucoma (OAG), including primary OAG and normal tension glaucoma. The subjects of the study were patients undergoing treatment for OAG who had performed VF tests at least 10 times with a Humphrey field analyzer (SITA standard, C30-2 program). The VF progression was defined by a significantly negative MD slope (MD slope worsening) at the final VF test during the follow-up period. The relationship between the MD slope worsening and the consecutive deterioration of MD value were retrospectively analyzed. A total of 165 eyes of 165 patients were included in the analysis. Significant progression of VF defects was observed in 72 eyes of 72 patients (43.6%), while no significant progression was evident in 93 eyes of 93 patients (56.4%). There was significant relationship between the frequency of consecutive deterioration of MD value and MD slope worsening (P<0.0001, Cochran-Armitage trend test). A significant association was observed for MD slope worsening in the eyes with three (odds ratio: 2.1, P=0.0224) and four (odds ratio: 3.6, P=0.0008) consecutive deterioration of MD value in multiple logistic regression analysis, but no significant association in the eyes with two consecutive deterioration (odds ratio: 1.1, P=0.8282). The eyes with VF progression had significantly lower intraocular pressure reduction rate (P<0.01). This retrospective study has shown that three or more consecutive deterioration of MD value might be a predictor to future significant MD slope worsening in OAG.

  18. 76 FR 26933 - Approval and Promulgation of Implementation Plans; Connecticut: Prevention of Significant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-10

    ... Significant Deterioration (PSD) program. First, the revision provides Connecticut with authority to issue PSD... determining which new stationary sources and modification projects become subject to Connecticut's PSD... required to apply its PSD program to GHG- emitting sources, and unless it does so (or unless EPA...

  19. 40 CFR 52.27 - Protection of visibility from sources in attainment areas.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality standards for such pollutants, and where a State PSD program has been approved as part of the... Act, in the prevention of significant deterioration (PSD) program approved as part of the applicable...

  20. 40 CFR 52.27 - Protection of visibility from sources in attainment areas.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality standards for such pollutants, and where a State PSD program has been approved as part of the... Act, in the prevention of significant deterioration (PSD) program approved as part of the applicable...

  1. 40 CFR 52.27 - Protection of visibility from sources in attainment areas.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality standards for such pollutants, and where a State PSD program has been approved as part of the... Act, in the prevention of significant deterioration (PSD) program approved as part of the applicable...

  2. 40 CFR 52.27 - Protection of visibility from sources in attainment areas.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality standards for such pollutants, and where a State PSD program has been approved as part of the... Act, in the prevention of significant deterioration (PSD) program approved as part of the applicable...

  3. 40 CFR 52.27 - Protection of visibility from sources in attainment areas.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality standards for such pollutants, and where a State PSD program has been approved as part of the... Act, in the prevention of significant deterioration (PSD) program approved as part of the applicable...

  4. 76 FR 26224 - Revisions to the California State Implementation Plan, Northern Sonoma County Air Pollution...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-06

    ... Significant Deterioration (PSD) permit programs. These proposed revisions update the definitions used in the districts' PSD permit programs. DATES: Any comments on this proposal must arrive by June 6, 2011. ADDRESSES...

  5. 78 FR 54602 - Approval and Promulgation of State Implementation Plans; Utah: Prevention of Significant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-05

    ... Prevention of Significant Deterioration (PSD) program and other SIP provisions. These revisions were...'s regulations with the GHG emission thresholds established in EPA's ``PSD and Title V Greenhouse Gas... to approve the GHG (as it relates to the PSD program) revisions because the Agency has determined...

  6. User-friendly traffic incident management (TIM) program benefit-cost estimation tool, Version 1.2

    DOT National Transportation Integrated Search

    2016-01-01

    Traffic incidents contribute significantly to the deterioration of the level of service of both freeways and arterials. Traffic Incident Management (TIM) programs have been introduced worldwide with the aim of mitigating the impact of traffic inciden...

  7. EPA's Interpretation of Regulations that Determine Pollutants Covered By Federal Prevention of Significant Deterioration (PSD) Permit Program

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  8. 78 FR 2354 - Approval and Promulgation of Air Quality Implementation Plans; Arkansas; Prevention of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-11

    ...) Prevention of Significant Deterioration (PSD) program updates the Arkansas SIP to incorporate by reference (IBR) requirements for the Federal PSD permitting program under EPA's November 29, 2005 Phase 2 8-hour Ozone Implementation rule. The November 6, 2012 proposed SIP revision to the Arkansas NSR PSD program...

  9. 76 FR 30832 - Approval and Promulgation of Air Quality Implementation Plans; West Virginia; Permits for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-27

    ... for the prevention of significant deterioration (PSD) areas in West Virginia. This action will also add the Federally equivalent provisions to the rules for the PSD program as they pertain to... (CUs) to make the West Virginia PSD program consistent with the Federal PSD program. This action is...

  10. 78 FR 19596 - Approval and Promulgation of Air Quality Implementation Plans; Arkansas; Prevention of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-02

    ...) Prevention of Significant Deterioration (PSD) program updates the Arkansas SIP to incorporate by reference (IBR) requirements for the federal PSD permitting program under EPA's November 29, 2005 Phase 2 8-hour Ozone Implementation rule. The November 6, 2012, SIP revision to the Arkansas NSR PSD program provides...

  11. 75 FR 59081 - Approval and Promulgation of Air Quality Implementation Plans; Michigan; PSD Regulations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-27

    ... Promulgation of Air Quality Implementation Plans; Michigan; PSD Regulations AGENCY: Environmental Protection... the prevention of significant deterioration (PSD) construction permit program under the Federal Clean... potentially subject to the PSD construction permit program. On July 16, 2010, Michigan submitted revisions...

  12. Climate Change Workgroup Reports and Presentations

    EPA Pesticide Factsheets

    Climate Change Workgroup reports and presentations to discuss and identify the major issues and potential barriers to implementing the Prevention of Significant Deterioration program under the Clean Air Act for greenhouse gases.

  13. Interim Guidance on the Treatment of Condensable Particulate Matter Test Results in the Prevention of Significant Deterioration and Nonattainment New Source Review Permitting Programs

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  14. Optimal pricing and marketing planning for deteriorating items.

    PubMed

    Moosavi Tabatabaei, Seyed Reza; Sadjadi, Seyed Jafar; Makui, Ahmad

    2017-01-01

    Optimal pricing and marketing planning plays an essential role in production decisions on deteriorating items. This paper presents a mathematical model for a three-level supply chain, which includes one producer, one distributor and one retailer. The proposed study considers the production of a deteriorating item where demand is influenced by price, marketing expenditure, quality of product and after-sales service expenditures. The proposed model is formulated as a geometric programming with 5 degrees of difficulty and the problem is solved using the recent advances in optimization techniques. The study is supported by several numerical examples and sensitivity analysis is performed to analyze the effects of the changes in different parameters on the optimal solution. The preliminary results indicate that with the change in parameters influencing on demand, inventory holding, inventory deteriorating and set-up costs change and also significantly affect total revenue.

  15. Pima County Department of Environmental Quality PSD Delegation Agreement

    EPA Pesticide Factsheets

    This delegation agreement is for the entire Prevention of Significant Deterioration (PSD) program. This allows Pima County Air Quality District (Pima County ACQD) to issue PSD permits using 40 CFR 52.21

  16. The effectiveness of education in the recognition and management of deteriorating patients: A systematic review.

    PubMed

    Connell, Clifford J; Endacott, Ruth; Jackman, Jennifer A; Kiprillis, Noelleen R; Sparkes, Louise M; Cooper, Simon J

    2016-09-01

    Survival from in-hospital cardiac arrest is poor. Clinical features, including abnormal vital signs, often indicate patient deterioration prior to severe adverse events. Early warning systems and rapid response teams are commonly used to assist the health profession in the identification and management of the deteriorating patient. Education programs are widely used in the implementation of these systems. The effectiveness of the education is unknown. The aims of this study were to identify: (i) the evidence supporting educational effectiveness in the recognition and management of the deteriorating patient and (ii) outcome measures used to evaluate educational effectiveness. A mixed methods systematic review of the literature was conducted using studies published between 2002 and 2014. Included studies were assessed for quality and data were synthesized thematically, while original data are presented in tabular form. Twenty-three studies were included in the review. Most educational programs were found to be effective reporting significant positive impacts upon learners, patient outcomes and organisational systems. Outcome measures related to: i learners, for example knowledge and performance, ii systems, including activation and responses of rapid response teams, and iii patients, including patient length of stay and adverse events. All but one of the programs used blended teaching with >87% including medium to high fidelity simulation. In situ simulation was employed in two of the interventions. The median program time was eight hours. The longest program lasted 44h however one of the most educationally effective programs was based upon a 40min simulation program. Educational interventions designed to improve the recognition and management of patient deterioration can improve learner outcomes when they incorporate medium to high-fidelity simulation. High-fidelity simulation has demonstrated effectiveness when delivered in brief sessions lasting only forty minutes. In situ simulation has demonstrated sustained positive impact upon the real world implementation of rapid response systems. Outcome measures should include knowledge and skill developments but there are important benefits in understanding patient outcomes. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. 75 FR 82535 - Limitation of Approval of Prevention of Significant Deterioration Provisions Concerning...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-30

    ...This action is another in a series of steps EPA is taking to implement the Prevention of Significant Deterioration (PSD) program for greenhouse gas (GHG)-emitting sources. EPA is finalizing its proposed rulemaking to narrow its previous approval of State Implementation Plan (SIP) PSD programs in 24 states that apply to GHG-emitting sources. Specifically, EPA is withdrawing its previous approval of those programs to the extent they apply PSD to GHG-emitting sources below the thresholds in the final Tailoring Rule, which EPA promulgated by Federal Register notice dated June 3, 2010. Having narrowed its prior approval, EPA asks that each affected state withdraw from EPA consideration the part of its SIP that is no longer approved. The states for whose SIPs EPA is narrowing approval are: Alabama, California, Colorado, Georgia, Indiana, Iowa, Louisiana, Maine, Maryland, Mississippi, Missouri, New Hampshire, New Mexico, North Carolina, Ohio, Oklahoma, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Vermont, Virginia, and Wisconsin.

  18. An interprofessional communication training using simulation to enhance safe care for a deteriorating patient.

    PubMed

    Liaw, Sok Ying; Zhou, Wen Tao; Lau, Tang Ching; Siau, Chiang; Chan, Sally Wai-Chi

    2014-02-01

    Communication and teamwork between doctors and nurses are critical for optimal patient care. Simulation and interprofessional team learning are emerging as significant learning strategies to promote teamwork and communication between different health professionals. The aim of the study is to describe the development, implementation and evaluation of a simulation-based interprofessional educational (Sim-IPE) program, using a presage-process-product (3P) model, for improving medical and nursing students' communication skills in caring of a patient with physiological deterioration. The program was conducted using full-scale simulation and communication strategies adapted from Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS). 127 medical and nursing students participated in a 3-hour small group interprofessional learning that incorporated simulation scenarios of deteriorating patients. Pre and post-tests were conducted to assess the students' self-confidence in interprofessional communication and perception in interprofessional learning. After the training, the students completed a satisfaction questionnaire. Both medicine and nursing groups demonstrated a significant improvement on post-test score from pre-test score for self-confidence (p<.0001) and perception (p<.0001) with no significant differences detected between the two groups. The participants were highly satisfied with their simulation learning. The Sim-IPE has better prepared the medical and nursing students in communicating with one another in providing safe care for deteriorating patient. In addition, it has improved their perception towards interprofessional learning. This pre-registration interprofessional education could prepare them for more comprehensive interprofessional team learning at post-registration level. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Optimal pricing and marketing planning for deteriorating items

    PubMed Central

    Moosavi Tabatabaei, Seyed Reza; Sadjadi, Seyed Jafar; Makui, Ahmad

    2017-01-01

    Optimal pricing and marketing planning plays an essential role in production decisions on deteriorating items. This paper presents a mathematical model for a three-level supply chain, which includes one producer, one distributor and one retailer. The proposed study considers the production of a deteriorating item where demand is influenced by price, marketing expenditure, quality of product and after-sales service expenditures. The proposed model is formulated as a geometric programming with 5 degrees of difficulty and the problem is solved using the recent advances in optimization techniques. The study is supported by several numerical examples and sensitivity analysis is performed to analyze the effects of the changes in different parameters on the optimal solution. The preliminary results indicate that with the change in parameters influencing on demand, inventory holding, inventory deteriorating and set-up costs change and also significantly affect total revenue. PMID:28306750

  20. 77 FR 11744 - Approval and Promulgation of Implementation Plans; Tennessee: Prevention of Significant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-28

    ... New Source Review (NSR) Prevention of Significant Deterioration (PSD) program. Specifically, the SIP... modification projects become subject to Tennessee's PSD permitting requirements for GHG emissions. This rule... thresholds in the Tennessee SIP for GHG PSD requirements. EPA is approving Tennessee's January 11, 2012, SIP...

  1. 76 FR 9658 - Approval and Promulgation of Implementation Plans; Kansas: Prevention of Significant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-22

    ... greenhouse gas (GHG) under Kansas's New Source Review (NSR) Prevention of Significant Deterioration (PSD) program. First, the SIP revision provides the State of Kansas with authority to issue PSD permits... stationary sources and modification projects become subject to Kansas's PSD permitting requirements for their...

  2. Nursing staff intentions towards managing deteriorating health in nursing homes: A convergent parallel mixed-methods study using the theory of planned behaviour.

    PubMed

    O'Neill, Barbara J; Dwyer, Trudy; Reid-Searl, Kerry; Parkinson, Lynne

    2018-03-01

    To predict the factors that are most important in explaining nursing staff intentions towards early detection of the deteriorating health of a resident and providing subacute care in the nursing home setting. Nursing staff play a pivotal role in managing the deteriorating resident and determining whether the resident needs to be transferred to hospital or remain in the nursing home; however, there is a dearth of literature that explains the factors that influence their intentions. This information is needed to underpin hospital avoidance programs that aim to enhance nursing confidence and skills in this area. A convergent parallel mixed-methods study, using the theory of planned behaviour as a framework. Surveys and focus groups were conducted with nursing staff (n = 75) at a 94-bed nursing home at two points in time, prior to and following the implementation of a hospital avoidance program. The quantitative and qualitative data were analysed separately and merged during final analysis. Nursing staff had strong intentions, a positive attitude that became significantly more positive with the hospital avoidance program in place, and a reasonable sense of control; however, the influence of important referents was the strongest predictor of intention towards managing residents with deteriorating health. Support from a hospital avoidance program empowered staff and increased confidence to intervene. The theory of planned behaviour served as an effective framework for identifying the strong influence referents had on nursing staff intentions around managing residents with deteriorating health. Although nursing staff had a reasonable sense of control over this area of their work, they believed they benefitted from a hospital avoidance program initiated by the nursing home. Managers implementing hospital avoidance programs should consider the role of referents, appraise the known barriers and facilitators and take steps to identify those unique to their local situation. All levels of nursing staff play a role in preventing hospitalisation and should be consulted in the design, implementation and evaluation of any hospital avoidance strategies. © 2017 John Wiley & Sons Ltd.

  3. Relationship between visual field progression and baseline refraction in primary open-angle glaucoma.

    PubMed

    Naito, Tomoko; Yoshikawa, Keiji; Mizoue, Shiro; Nanno, Mami; Kimura, Tairo; Suzumura, Hirotaka; Umeda, Yuzo; Shiraga, Fumio

    2016-01-01

    To analyze the relationship between visual field (VF) progression and baseline refraction in Japanese patients with primary open-angle glaucoma (POAG) including normal-tension glaucoma. In this retrospective study, the subjects were patients with POAG who had undergone VF tests at least ten times with a Humphrey Field Analyzer (Swedish interactive thresholding algorithm standard, Central 30-2 program). VF progression was defined as a significantly negative value of mean deviation (MD) slope at the final VF test. Multivariate logistic regression models were applied to detect an association between MD slope deterioration and baseline refraction. A total of 156 eyes of 156 patients were included in this analysis. Significant deterioration of MD slope was observed in 70 eyes of 70 patients (44.9%), whereas no significant deterioration was evident in 86 eyes of 86 patients (55.1%). The eyes with VF progression had significantly higher baseline refraction compared to those without apparent VF progression (-1.9±3.8 diopter [D] vs -3.5±3.4 D, P=0.0048) (mean ± standard deviation). When subject eyes were classified into four groups by the level of baseline refraction applying spherical equivalent (SE): no myopia (SE > -1D), mild myopia (-1D ≥ SE > -3D), moderate myopia (-3D ≥ SE > -6D), and severe myopia (-6D ≥ SE), the Cochran-Armitage trend analysis showed a decreasing trend in the proportion of MD slope deterioration with increasing severity of myopia (P=0.0002). The multivariate analysis revealed that baseline refraction (P=0.0108, odds ratio [OR]: 1.13, 95% confidence interval [CI]: 1.03-1.25) and intraocular pressure reduction rate (P=0.0150, OR: 0.97, 95% CI: 0.94-0.99) had a significant association with MD slope deterioration. In the current analysis of Japanese patients with POAG, baseline refraction was a factor significantly associated with MD slope deterioration as well as intraocular pressure reduction rate. When baseline refraction was classified into four groups, MD slope in myopia groups was less deteriorated as compared to those in the emmetropic/hyperopic group.

  4. 77 FR 65305 - Approval of Air Quality Implementation Plans; California; San Joaquin Valley Unified Air...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-26

    ... incorporates District Rule 2410-- Prevention of Significant Deterioration (PSD)--into the California SIP to establish a PSD permit program for pre-construction review of certain new and modified major stationary... provides an adequate PSD permitting program as required by section 110 and part C of title I of the CAA...

  5. 76 FR 59899 - Approval and Promulgation of Air Quality Implementation Plans; Indiana; Prevention of Significant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-28

    ... Significant Deterioration (PSD) program to establish appropriate emission thresholds for determining which new... emissions above the thresholds established in the PSD regulations. DATES: This final rule is effective on... of GHG, and that do not limit PSD applicability to GHGs to the higher thresholds in the Tailoring...

  6. 75 FR 70140 - Approval and Promulgation of Implementation Plans; New York Prevention of Significant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-17

    ... Significant Deterioration of Air Quality (PSD) and Nonattainment New Source Review (NNSR) State regulations. These revisions create a new New York State PSD regulation program and modify the existing New York... EPA is taking no action at this time on the PSD permitting threshold provisions to the extent that...

  7. Molecular Survey of Microbial Communities Involved in Concrete Corrosion in Wastewater Collection Systems

    EPA Science Inventory

    This information is relevant to the development of condition assessment tools associated with the aging water infrastructure research program Corrosion of wastewater collection infrastructure, especially concrete sewers, is a significant cause of deterioration and premature failu...

  8. North Coast Unified Air Quality Management District: PSD Delegation Agreements

    EPA Pesticide Factsheets

    Agreements for Partial Delegation of the Federal Prevention of Significant Deterioration (PSD) Program Set Forth in 40 CPR 52.21 by the United States Environmental Protection Agency, Region 9 to the North Coast Unified Air Quality Management District.

  9. BACT Phase I: Interim Report of the Climate Change Workgroup of the Permits, New Source Review, and Toxic Subcommittee

    EPA Pesticide Factsheets

    This report report details the issues involved in implementing the Clean Air Act's Prevention of Significant Deterioration (PSD) program permittingrequirements for new and modified sources of greenhouse gases (GHGs).

  10. 75 FR 31513 - Prevention of Significant Deterioration and Title V Greenhouse Gas Tailoring Rule

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-03

    ...EPA is tailoring the applicability criteria that determine which stationary sources and modification projects become subject to permitting requirements for greenhouse gas (GHG) emissions under the Prevention of Significant Deterioration (PSD) and title V programs of the Clean Air Act (CAA or Act). This rulemaking is necessary because without it PSD and title V requirements would apply, as of January 2, 2011, at the 100 or 250 tons per year (tpy) levels provided under the CAA, greatly increasing the number of required permits, imposing undue costs on small sources, overwhelming the resources of permitting authorities, and severely impairing the functioning of the programs. EPA is relieving these resource burdens by phasing in the applicability of these programs to GHG sources, starting with the largest GHG emitters. This rule establishes two initial steps of the phase-in. The rule also commits the agency to take certain actions on future steps addressing smaller sources, but excludes certain smaller sources from PSD and title V permitting for GHG emissions until at least April 30, 2016.

  11. Bridge deterioration models to support Indiana's bridge management system.

    DOT National Transportation Integrated Search

    2016-02-01

    An effective bridge management system that is equipped with reliable deterioration models enables agency engineers to carry out : monitoring and long-term programming of bridge repair actions. At the project level, deterioration models help the agenc...

  12. Minor New Source Review Program Public Notice Requirements under 40 CFR 51.161(b)(3)

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database.

  13. The effectiveness of virtual simulation in improving student nurses' knowledge and performance during patient deterioration: A pre and post test design.

    PubMed

    Borg Sapiano, Alexis; Sammut, Roberta; Trapani, Josef

    2018-03-01

    Preparing nursing students to perform competently in complex emergency situations, such as during rapid patient deterioration, is challenging. Students' active engagement in such scenarios cannot be ensured, due to the unexpected nature of such infrequent events. Many students may consequently not experience and integrate the management of patient deterioration into their knowledge and practical competency by the end of their studies, making them unprepared to manage such situations as practicing nurses. This study investigated the effectiveness of virtual simulation in improving performance during rapid patient deterioration. To investigate the effectiveness of virtual simulation in improving student nurses' knowledge and performance during rapid patient deterioration. A pre- and post-test design was used. Nursing students at a university in Malta were invited to participate in a virtual simulation program named FIRST 2 ACTWeb™, using their own computer devices. A total of 166 (response rate=50%) second and third year diploma and degree nursing students participated in the study. The simulation included three scenarios (Cardiac-Shock-Respiratory) portraying deteriorating patients. Performance feedback was provided at the end of each scenario. Students completed pre- and post-scenario knowledge tests and performance during each scenario was recorded automatically on a database. Findings showed a significant improvement in the students' post-scenario knowledge (z=-6.506, p<0.001). Highest mean performance scores were obtained in the last scenario (M=19.7, median: 20.0, s.d. 3.41) indicating a learning effect. Knowledge was not a predictor of students' performance in the scenarios. This study supports virtual simulation as an effective learning tool for pre-registration nursing students in different programs. Simulation improves both knowledge about and performance during patient deterioration. Virtual simulation of rare events should be a key component of undergraduate nurse education, to prepare students to manage complex situations as practicing nurses. Copyright © 2018 Elsevier Ltd. All rights reserved.

  14. 40 CFR 52.1929 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.1929 Section 52.1929 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) Regulation for preventing significant deterioration of air... preventing significant deterioration of air quality. [56 FR 5656, Feb. 12, 1991, as amended at 68 FR 11324...

  15. Lubricant Formulations to Enhance Engine Efficiency in Modern Internal Combustion Engines

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

    Cheng, Wai; Wong, Victor; Plumley, Michael

    2017-04-19

    The research program presented aimed to investigate, develop, and demonstrate low-friction, environmentally-friendly and commercially-feasible lubricant formulations that would significantly improve the mechanical efficiency of modern engines without incurring increased wear, emissions or deterioration of the emission-aftertreatment system.

  16. 76 FR 43149 - Approval and Promulgation of Air Quality Implementation Plans; New Mexico; Prevention of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-20

    ... of Significant Deterioration (PSD) program to establish appropriate emission thresholds for... Mexico's December 1, 2010, proposed SIP revision establishes appropriate emissions thresholds for... appropriate thresholds for GHG permitting applicability into New Mexico's SIP, then paragraph (d) in Sec. 52...

  17. EPA-MassDEP Prevention of Significant Deterioration (PSD) Delegation Agreement

    EPA Pesticide Factsheets

    In April 2011, an agreement for delegation of the federal PSD program was executed by EPA Region 1 to the MassDEP. This agreement sets forth the terms & conditions according to which the MassDEP agrees to implement and enforce the federal PSD regulations.

  18. 40 CFR 52.2528 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.2528 Section 52.2528 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of Sections 160 through 165 of the Clean Air... Quality Deterioration. (b) Regulations for Preventing Significant Deterioration of Air Quality, the...

  19. 40 CFR 52.2451 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.2451 Section 52.2451 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... Quality Deterioration. (b) Regulations for preventing significant deterioration of air quality. The...

  20. 40 CFR 52.2451 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.2451 Section 52.2451 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... Quality Deterioration. (b) Regulations for preventing significant deterioration of air quality. The...

  1. 40 CFR 52.2451 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.2451 Section 52.2451 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... Quality Deterioration. (b) Regulations for preventing significant deterioration of air quality. The...

  2. 40 CFR 52.2528 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.2528 Section 52.2528 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of Sections 160 through 165 of the Clean Air... Quality Deterioration. (b) Regulations for Preventing Significant Deterioration of Air Quality, the...

  3. 40 CFR 52.2451 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.2451 Section 52.2451 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... Quality Deterioration. (b) Regulations for preventing significant deterioration of air quality. The...

  4. 40 CFR 52.2528 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.2528 Section 52.2528 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of Sections 160 through 165 of the Clean Air... Quality Deterioration. (b) Regulations for Preventing Significant Deterioration of Air Quality, the...

  5. 40 CFR 52.432 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 3 2014-07-01 2014-07-01 false Significant deterioration of air quality. 52.432 Section 52.432 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) [Reserved] (b) Regulation for preventing significant deterioration of air...

  6. 40 CFR 52.2451 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.2451 Section 52.2451 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... Quality Deterioration. (b) Regulations for preventing significant deterioration of air quality. The...

  7. 40 CFR 52.2528 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.2528 Section 52.2528 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of Sections 160 through 165 of the Clean Air... Quality Deterioration. (b) Regulations for Preventing Significant Deterioration of Air Quality, the...

  8. 40 CFR 52.499 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.499 Section 52.499 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  9. 40 CFR 52.1884 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.1884 Section 52.1884 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  10. 40 CFR 52.1165 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.1165 Section 52.1165 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulation for preventing significant deterioration of air quality. The...

  11. 40 CFR 52.1165 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.1165 Section 52.1165 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulation for preventing significant deterioration of air quality. The...

  12. 40 CFR 52.1180 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.1180 Section 52.1180 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  13. 40 CFR 52.2729 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.2729 Section 52.2729 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  14. 40 CFR 52.1884 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.1884 Section 52.1884 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  15. 40 CFR 52.2779 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.2779 Section 52.2779 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  16. 40 CFR 52.499 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.499 Section 52.499 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  17. 40 CFR 52.1603 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.1603 Section 52.1603 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  18. 40 CFR 52.1234 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.1234 Section 52.1234 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  19. 40 CFR 52.2497 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.2497 Section 52.2497 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  20. 40 CFR 52.2497 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.2497 Section 52.2497 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  1. 40 CFR 52.1603 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.1603 Section 52.1603 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  2. 40 CFR 52.1884 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.1884 Section 52.1884 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  3. 40 CFR 52.2676 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.2676 Section 52.2676 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  4. 40 CFR 52.1603 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.1603 Section 52.1603 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  5. 40 CFR 52.499 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.499 Section 52.499 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  6. 40 CFR 52.2676 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.2676 Section 52.2676 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  7. 40 CFR 52.2779 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.2779 Section 52.2779 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  8. 40 CFR 52.1234 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.1234 Section 52.1234 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  9. 40 CFR 52.2676 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.2676 Section 52.2676 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  10. 40 CFR 52.1165 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.1165 Section 52.1165 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulation for preventing significant deterioration of air quality. The...

  11. 40 CFR 52.2827 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.2827 Section 52.2827 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  12. 40 CFR 52.1165 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.1165 Section 52.1165 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulation for preventing significant deterioration of air quality. The...

  13. 40 CFR 52.1180 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.1180 Section 52.1180 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  14. 40 CFR 52.2676 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.2676 Section 52.2676 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  15. 40 CFR 52.2497 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.2497 Section 52.2497 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  16. 40 CFR 52.499 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.499 Section 52.499 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  17. 40 CFR 52.2729 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.2729 Section 52.2729 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  18. 40 CFR 52.1180 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.1180 Section 52.1180 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  19. 40 CFR 52.2497 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.2497 Section 52.2497 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  20. 40 CFR 52.1234 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.1234 Section 52.1234 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  1. 40 CFR 52.2827 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.2827 Section 52.2827 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  2. 40 CFR 52.1180 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.1180 Section 52.1180 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  3. 40 CFR 52.1884 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.1884 Section 52.1884 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  4. 40 CFR 52.2729 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.2729 Section 52.2729 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  5. 40 CFR 52.2729 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.2729 Section 52.2729 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  6. 40 CFR 52.2827 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.2827 Section 52.2827 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  7. 40 CFR 52.2827 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.2827 Section 52.2827 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  8. 40 CFR 52.1234 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.1234 Section 52.1234 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  9. 40 CFR 52.2779 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.2779 Section 52.2779 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  10. 40 CFR 52.2779 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.2779 Section 52.2779 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  11. 40 CFR 52.1603 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.1603 Section 52.1603 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  12. 40 CFR 52.1234 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.1234 Section 52.1234 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  13. 40 CFR 52.1884 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.1884 Section 52.1884 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  14. 40 CFR 52.499 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.499 Section 52.499 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  15. 40 CFR 52.1180 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.1180 Section 52.1180 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  16. 40 CFR 52.2827 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.2827 Section 52.2827 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  17. 40 CFR 52.1689 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.1689 Section 52.1689 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  18. 40 CFR 52.2676 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.2676 Section 52.2676 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  19. 40 CFR 52.2779 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.2779 Section 52.2779 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  20. 40 CFR 52.2729 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.2729 Section 52.2729 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  1. 40 CFR 52.2497 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.2497 Section 52.2497 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  2. 40 CFR 52.1603 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.1603 Section 52.1603 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulations for preventing significant deterioration of air quality. The...

  3. 40 CFR 52.1165 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.1165 Section 52.1165 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) Regulation for preventing significant deterioration of air quality. The...

  4. 77 FR 45527 - Approval and Promulgation of Air Quality Implementation Plans; Delaware; Requirements for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-01

    ... to Delaware's Prevention of Significant Deterioration (PSD) and nonattainment New Source Review (NSR... infrastructure requirements of the Clean Air Act (CAA) which relate to Delaware's PSD permitting program and are.... www.regulations.gov . Follow the on-line instructions for submitting comments. B. Email: cox.kathleen...

  5. 75 FR 59179 - Approval and Promulgation of Air Quality Implementation Plans; Michigan; PSD Regulations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-27

    ... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R05-OAR-2010-0657; FRL-9205-7] Approval and Promulgation of Air Quality Implementation Plans; Michigan; PSD Regulations AGENCY: Environmental Protection... requirements of the prevention of significant deterioration (PSD) construction permit program in Michigan...

  6. 76 FR 27898 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Prevention of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-13

    ... greenhouse gas (GHG) Prevention of Significant Deterioration (PSD) permitting provisions as promulgated on June 3, 2010 in the Tailoring Rule. The SIP revision modifies Virginia's PSD program to [[Page 27899... become subject to Virginia's PSD permitting requirements for their GHG emissions. EPA is approving...

  7. 76 FR 81836 - Approval and Promulgation of Air Quality Implementation Plans; New Mexico; Albuquerque/Bernalillo...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-29

    ... Significant Deterioration (PSD) program to establish appropriate emission thresholds for determining which new stationary sources and modification projects become subject to Albuquerque/Bernalillo County's PSD permitting..., New Mexico December 15, 2010 PSD SIP revision because the Agency has determined that this PSD SIP...

  8. 77 FR 36442 - Approval and Promulgation of Air Quality Implementation Plans; Michigan; PSD Regulations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-19

    ... Promulgation of Air Quality Implementation Plans; Michigan; PSD Regulations AGENCY: Environmental Protection... Significant Deterioration (PSD) construction permit program of State of Michigan's State Implementation Plan (SIP) to meet the Clean Air Act (CAA) requirements for PSD in Class I Areas attaining the National...

  9. 76 FR 59334 - Approval and Promulgation of Air Quality Implementation Plans; New Mexico; Albuquerque/Bernalillo...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-26

    ... Prevention of Significant Deterioration (PSD) program to establish appropriate emission thresholds for... County's PSD permitting requirements for their greenhouse gas (GHG) emissions. Due to the SIP Narrowing Rule, 75 FR 82536, starting on January 2, 2011, the approved Albuquerque/Bernalillo County SIP's PSD...

  10. 75 FR 81863 - Approval and Promulgation of Implementation Plans; Alabama: Prevention of Significant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-29

    ... Deterioration (PSD) program. Specifically, the SIP revision establishes appropriate emission thresholds for determining which new stationary sources and modification projects become subject to Alabama's PSD permitting requirements for their GHG emissions. The change is necessary because without it, on January 2, 2011, PSD...

  11. Postural Balance Following Aerobic Fatigue Tests: A Longitudinal Study Among Young Athletes.

    PubMed

    Steinberg, Nili; Eliakim, Alon; Zaav, Aviva; Pantanowitz, Michal; Halumi, Monder; Eisenstein, Tamir; Meckel, Yoav; Nemet, Dan

    2016-01-01

    General fatigue can cause aggravation of postural balance, with increased risk for injuries. The present longitudinal study aimed to evaluate the postural balance of young athletes following field aerobic tests throughout 1 year of training. Thirty children from a sports center in Nazareth, participating in a 3 times/week training program (specific to basketball, soccer, or athletic training), were assessed. Postural balance parameters were taken before, immediately after, and 10 min after a 20 m shuttle-run aerobic test, at 3 time points during 1 training year (Start/Y, Mid/Y, and End/Y). Fitness improved at the Mid/Y and End/Y compared to Start/Y. Postural balance significantly deteriorated immediately after the aerobic test and improved significantly in the 10-min testing in all 3 time points, with significant deterioration in the End/Y compared with the Start/Y. In conclusions, postural balance deteriorates immediately after aerobic exercises, and at the end of the year. To better practice drills related to postural balance and possibly to prevent injuries, it is best for young athletes to properly rest immediately following aerobic exercises and to practice postural balance mainly at the beginning and at the middle of the training year.

  12. CF6 High Pressure Compressor and Turbine Clearance Evaluations

    NASA Technical Reports Server (NTRS)

    Radomski, M. A.; Cline, L. D.

    1981-01-01

    In the CF6 Jet Engine Diagnostics Program the causes of performance degradation were determined for each component of revenue service engines. It was found that a significant contribution to performance degradation was caused by increased airfoil tip radial clearances in the high pressure compressor and turbine areas. Since the influence of these clearances on engine performance and fuel consumption is significant, it is important to accurately establish these relatonships. It is equally important to understand the causes of clearance deterioration so that they can be reduced or eliminated. The results of factory engine tests run to enhance the understanding of the high pressure compressor and turbine clearance effects on performance are described. The causes of clearance deterioration are indicated and potential improvements in clearance control are discussed.

  13. Development of a cost-effective concrete bridge deck preservation program : volume 1--development and implementation of the experimental program.

    DOT National Transportation Integrated Search

    2016-07-01

    The deterioration of bridge decks has been identified as a major problem in Indiana. The primary cause of this deterioration is salt water : ingress from the application of deicing salts during the winter. Deicing chemicals placed on the road mix wit...

  14. A comparison between the clinical significance and growth mixture modelling early change methods at predicting negative outcomes.

    PubMed

    Flood, Nicola; Page, Andrew; Hooke, Geoff

    2018-05-03

    Routine outcome monitoring benefits treatment by identifying potential no change and deterioration. The present study compared two methods of identifying early change and their ability to predict negative outcomes on self-report symptom and wellbeing measures. 1467 voluntary day patients participated in a 10-day group Cognitive Behaviour Therapy (CBT) program and completed the symptom and wellbeing measures daily. Early change, as defined by (a) the clinical significance method and (b) longitudinal modelling, was compared on each measure. Early change, as defined by the simpler clinical significance method, was superior at predicting negative outcomes than longitudinal modelling. The longitudinal modelling method failed to detect a group of deteriorated patients, and agreement between the early change methods and the final unchanged outcome was higher for the clinical significance method. Therapists could use the clinical significance early change method during treatment to alert them of patients at risk for negative outcomes, which in turn could allow therapists to prevent those negative outcomes from occurring.

  15. The JT9D Jet Engine Diagnostics Program

    NASA Technical Reports Server (NTRS)

    Olsson, W. J.

    1982-01-01

    The various engine deterioration phenomena that affect JT9D performance retention were studied, and approaches to improve performance retention of engines were identified. The program included surveys of historical data, monitoring of in service engines, ground and flight testing of instrumented engines, analysis, and analytical modeling. Performance deterioration is made up of both short and long term modes, both of which are flight cycle related phenomena. Short term deterioration occurs primarily during airplane acceptance testing prior to delivery to the airline. This effect is caused by flight load and power induced clearance closures and engine deflections with resulting rubbing of airfoils and seals. Long term deterioration is caused by erosion of airfoils and gas path seals during ground operation and take off and by cyclic induced thermal distortion of the high pressure turbine airfoils. Studies of possible remedial approaches have shown that performance retention within 1 to 2 percent of initial revenue service performance can be achieved with a proper program of hot section and cold section maintenance.

  16. 76 FR 20907 - Approval and Promulgation of Air Quality Implementation Plans; New Mexico; Prevention of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-14

    ... revision modifies New Mexico's Prevention of Significant Deterioration (PSD) program to establish... subject to New Mexico's PSD permitting requirements for their greenhouse gas (GHG) emissions. Due to the SIP Narrowing Rule, 75 FR 82536, starting on January 2, 2011, the approved New Mexico SIP's PSD...

  17. 77 FR 56124 - Approval and Promulgation of Air Quality Implementation Plans; Michigan; PSD and NSR Regulations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-12

    ... Promulgation of Air Quality Implementation Plans; Michigan; PSD and NSR Regulations AGENCY: Environmental... the prevention of significant deterioration (PSD) construction permit program for the purpose of... approving Michigan's request to revise its SIP to add rule R. 336.2816 to be consistent with Federal PSD...

  18. 40 CFR 52.931 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... approval of Kentucky's Regulation for Prevention of Significant Deterioration (PSD), Visibility Monitoring... Deterioration (PSD), Visibility Monitoring, and Visibility New Source Review in Attainment Areas. (b) The...

  19. 40 CFR 52.931 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... approval of Kentucky's Regulation for Prevention of Significant Deterioration (PSD), Visibility Monitoring... Deterioration (PSD), Visibility Monitoring, and Visibility New Source Review in Attainment Areas. (b) The...

  20. 40 CFR 52.931 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... approval of Kentucky's Regulation for Prevention of Significant Deterioration (PSD), Visibility Monitoring... Deterioration (PSD), Visibility Monitoring, and Visibility New Source Review in Attainment Areas. (b) The...

  1. 40 CFR 52.931 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... approval of Kentucky's Regulation for Prevention of Significant Deterioration (PSD), Visibility Monitoring... Deterioration (PSD), Visibility Monitoring, and Visibility New Source Review in Attainment Areas. (b) The...

  2. The impact of web-based and face-to-face simulation on patient deterioration and patient safety: protocol for a multi-site multi-method design.

    PubMed

    Cooper, Simon J; Kinsman, Leigh; Chung, Catherine; Cant, Robyn; Boyle, Jayne; Bull, Loretta; Cameron, Amanda; Connell, Cliff; Kim, Jeong-Ah; McInnes, Denise; McKay, Angela; Nankervis, Katrina; Penz, Erika; Rotter, Thomas

    2016-09-07

    There are international concerns in relation to the management of patient deterioration which has led to a body of evidence known as the 'failure to rescue' literature. Nursing staff are known to miss cues of deterioration and often fail to call for assistance. Medical Emergency Teams (Rapid Response Teams) do improve the management of acutely deteriorating patients, but first responders need the requisite skills to impact on patient safety. In this study we aim to address these issues in a mixed methods interventional trial with the objective of measuring and comparing the cost and clinical impact of face-to-face and web-based simulation programs on the management of patient deterioration and related patient outcomes. The education programs, known as 'FIRST(2)ACT', have been found to have an impact on education and will be tested in four hospitals in the State of Victoria, Australia. Nursing staff will be trained in primary (the first 8 min) responses to emergencies in two medical wards using a face-to-face approach and in two medical wards using a web-based version FIRST(2)ACTWeb. The impact of these interventions will be determined through quantitative and qualitative approaches, cost analyses and patient notes review (time series analyses) to measure quality of care and patient outcomes. In this 18 month study it is hypothesised that both simulation programs will improve the detection and management of deteriorating patients but that the web-based program will have lower total costs. The study will also add to our overall understanding of the utility of simulation approaches in the preparation of nurses working in hospital wards. (ACTRN12616000468426, retrospectively registered 8.4.2016).

  3. 40 CFR 52.2922 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.2922 Section 52.2922 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Northern Mariana Islands § 52.2922 Significant deterioration of air quality. (a) The requirements of... procedures for preventing the significant deterioration of air quality. (b) Regulations for preventing...

  4. 77 FR 62200 - Approval and Promulgation of Implementation Plans; New Mexico; Revisions to the New Source Review...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-12

    ... Plan (SIP); Prevention of Significant Deterioration (PSD) and Nonattainment New Source Review (NNSR... approve revisions to the New Mexico SIP to update the New Mexico NNSR and PSD SIP permitting programs.... New Mexico submitted the PSD and NNSR SIP permitting revisions in two SIP submittals on June 11, 2009...

  5. 40 CFR 52.2454 - Prevention of significant deterioration of air quality for Merck & Co., Inc.'s Stonewall Plant in...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... of air quality for Merck & Co., Inc.'s Stonewall Plant in Elkton, VA. 52.2454 Section 52.2454 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND... air quality for Merck & Co., Inc.'s Stonewall Plant in Elkton, VA. (a) Applicability. (1) This section...

  6. 40 CFR 52.2454 - Prevention of significant deterioration of air quality for Merck & Co., Inc.'s Stonewall Plant in...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... of air quality for Merck & Co., Inc.'s Stonewall Plant in Elkton, VA. 52.2454 Section 52.2454 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND... air quality for Merck & Co., Inc.'s Stonewall Plant in Elkton, VA. (a) Applicability. (1) This section...

  7. 76 FR 82234 - Amendments to Delegation of Authority Provisions in the Prevention of Significant Deterioration...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-30

    ... sector. This action imposes no enforceable duty on any state, local or tribal governments or the private... direct costs. However, it does support tribal self- governance by enabling tribes to implement the... section to make it clear that tribes may voluntarily take direct delegation of the NSR program in areas...

  8. 40 CFR 52.1987 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.1987 Section 52.1987 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The Oregon Department of Environmental Quality rules for the prevention of significant deterioration of air quality (provisions of OAR Chapter 340, Divisions 200, 202...

  9. 40 CFR 52.1485 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.1485 Section 52.1485 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... include approvable procedures for preventing the significant deterioration of air quality. (b) Regulation...

  10. 40 CFR 52.1485 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.1485 Section 52.1485 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... include approvable procedures for preventing the significant deterioration of air quality. (b) Regulation...

  11. 40 CFR 52.2131 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 5 2014-07-01 2014-07-01 false Significant deterioration of air quality. 52.2131 Section 52.2131 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a)-(b) [Reserved] (c) All applications and other information...

  12. 40 CFR 52.2131 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 4 2011-07-01 2011-07-01 false Significant deterioration of air quality. 52.2131 Section 52.2131 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a)-(b) [Reserved] (c) All applications and other information...

  13. 40 CFR 52.2178 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.2178 Section 52.2178 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The South Dakota plan, as submitted, is approved as meeting the... on Indian reservations; (b) Regulations for preventing significant deterioration of air quality. The...

  14. 40 CFR 52.2178 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.2178 Section 52.2178 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The South Dakota plan, as submitted, is approved as meeting the... on Indian reservations; (b) Regulations for preventing significant deterioration of air quality. The...

  15. 40 CFR 52.1485 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.1485 Section 52.1485 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... include approvable procedures for preventing the significant deterioration of air quality. (b) Regulation...

  16. 40 CFR 52.2178 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.2178 Section 52.2178 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The South Dakota plan, as submitted, is approved as meeting the... on Indian reservations; (b) Regulations for preventing significant deterioration of air quality. The...

  17. 40 CFR 52.1485 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.1485 Section 52.1485 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... include approvable procedures for preventing the significant deterioration of air quality. (b) Regulation...

  18. 40 CFR 52.2178 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.2178 Section 52.2178 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The South Dakota plan, as submitted, is approved as meeting the... on Indian reservations; (b) Regulations for preventing significant deterioration of air quality. The...

  19. 40 CFR 52.1987 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.1987 Section 52.1987 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The Oregon Department of Environmental Quality rules for the prevention of significant deterioration of air quality (provisions of OAR Chapter 340, Divisions 200, 202...

  20. 40 CFR 52.2131 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 5 2013-07-01 2013-07-01 false Significant deterioration of air quality. 52.2131 Section 52.2131 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a)-(b) [Reserved] (c) All applications and other information...

  1. 40 CFR 52.2346 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.2346 Section 52.2346 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The Utah plan, as submitted, is approved as meeting the... construct on Indian Reservations. (b) Regulation for prevention of significant deterioration of air quality...

  2. 40 CFR 52.2346 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.2346 Section 52.2346 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The Utah plan, as submitted, is approved as meeting the... construct on Indian Reservations. (b) Regulation for prevention of significant deterioration of air quality...

  3. 40 CFR 52.2346 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.2346 Section 52.2346 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The Utah plan, as submitted, is approved as meeting the... construct on Indian Reservations. (b) Regulation for prevention of significant deterioration of air quality...

  4. 40 CFR 52.1987 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.1987 Section 52.1987 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The Oregon Department of Environmental Quality rules for the prevention of significant deterioration of air quality (provisions of OAR Chapter 340, Divisions 200, 202...

  5. 40 CFR 52.2131 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 5 2012-07-01 2012-07-01 false Significant deterioration of air quality. 52.2131 Section 52.2131 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a)-(b) [Reserved] (c) All applications and other information...

  6. 40 CFR 52.1987 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.1987 Section 52.1987 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The Oregon Department of Environmental Quality rules for the prevention of significant deterioration of air quality (provisions of OAR chapter 340, Divisions 200, 202...

  7. 40 CFR 52.1485 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.1485 Section 52.1485 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... include approvable procedures for preventing the significant deterioration of air quality. (b) Regulation...

  8. 40 CFR 52.2178 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.2178 Section 52.2178 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The South Dakota plan, as submitted, is approved as meeting the... on Indian reservations; (b) Regulations for preventing significant deterioration of air quality. The...

  9. 40 CFR 52.2131 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Significant deterioration of air quality. 52.2131 Section 52.2131 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a)-(b) [Reserved] (c) All applications and other information...

  10. 40 CFR 52.2346 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.2346 Section 52.2346 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The Utah plan, as submitted, is approved as meeting the... construct on Indian Reservations. (b) Regulation for prevention of significant deterioration of air quality...

  11. 40 CFR 52.1529 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 4 2011-07-01 2011-07-01 false Significant deterioration of air quality. 52.1529 Section 52.1529 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. New Hampshire's Part Env-A 623, “Requirements for Prevention of...

  12. 40 CFR 52.2303 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.2303 Section 52.2303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The plan submitted by Texas is approved as meeting the requirements of part C, Clean Air Act for preventing significant deterioration of air quality. The plan...

  13. 40 CFR 52.1280 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 4 2011-07-01 2011-07-01 false Significant deterioration of air quality. 52.1280 Section 52.1280 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) All applications and other information required pursuant to § 52...

  14. 40 CFR 52.1529 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 4 2013-07-01 2013-07-01 false Significant deterioration of air quality. 52.1529 Section 52.1529 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. New Hampshire's Part Env-A 623, “Requirements for Prevention of...

  15. 40 CFR 52.1529 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 4 2012-07-01 2012-07-01 false Significant deterioration of air quality. 52.1529 Section 52.1529 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. New Hampshire's Part Env-A 623, “Requirements for Prevention of...

  16. 40 CFR 52.1529 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 4 2014-07-01 2014-07-01 false Significant deterioration of air quality. 52.1529 Section 52.1529 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. New Hampshire's Part Env-A 623, “Requirements for Prevention of...

  17. 40 CFR 52.2303 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.2303 Section 52.2303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The plan submitted by Texas is approved as meeting the requirements of part C, Clean Air Act for preventing significant deterioration of air quality. The plan...

  18. 40 CFR 52.2303 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.2303 Section 52.2303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The plan submitted by Texas is approved as meeting the requirements of part C, Clean Air Act for preventing significant deterioration of air quality. The plan...

  19. 40 CFR 52.2303 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.2303 Section 52.2303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The plan submitted by Texas is approved as meeting the requirements of part C, Clean Air Act for preventing significant deterioration of air quality. The plan...

  20. 40 CFR 52.1280 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Significant deterioration of air quality. 52.1280 Section 52.1280 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) All applications and other information required pursuant to § 52...

  1. 40 CFR 52.1529 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Significant deterioration of air quality. 52.1529 Section 52.1529 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. New Hampshire's Part Env-A 623, “Requirements for Prevention of...

  2. 40 CFR 52.1436 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 4 2014-07-01 2014-07-01 false Significant deterioration of air quality. 52.1436 Section 52.1436 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. The requirements of sections 160 through 165 of the Clean Air Act...

  3. 40 CFR 52.2581 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.2581 Section 52.2581 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a)-(c) [Reserved] (d) The requirements of sections 160 through 165... provisions for prevention of significant deterioration of air quality at 40 CFR 52.21 are applicable to the...

  4. 40 CFR 52.2083 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 4 2011-07-01 2011-07-01 false Significant deterioration of air quality. 52.2083 Section 52.2083 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The Rhode Island plan, as submitted, is approved as meeting the...

  5. 40 CFR 52.2581 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.2581 Section 52.2581 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a)-(c) [Reserved] (d) The requirements of sections 160 through 165... provisions for prevention of significant deterioration of air quality at 40 CFR 52.21 are applicable to the...

  6. 40 CFR 52.2083 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 5 2013-07-01 2013-07-01 false Significant deterioration of air quality. 52.2083 Section 52.2083 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The Rhode Island plan, as submitted, is approved as meeting the...

  7. 40 CFR 52.2083 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 5 2014-07-01 2014-07-01 false Significant deterioration of air quality. 52.2083 Section 52.2083 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The Rhode Island plan, as submitted, is approved as meeting the...

  8. 40 CFR 52.1436 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 4 2011-07-01 2011-07-01 false Significant deterioration of air quality. 52.1436 Section 52.1436 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. The requirements of sections 160 through 165 of the Clean Air Act...

  9. 40 CFR 52.2581 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.2581 Section 52.2581 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a)-(c) [Reserved] (d) The requirements of sections 160 through 165... provisions for prevention of significant deterioration of air quality at 40 CFR 52.21 are applicable to the...

  10. 40 CFR 52.2058 - Prevention of significant air quality deterioration.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 4 2011-07-01 2011-07-01 false Prevention of significant air quality deterioration. 52.2058 Section 52.2058 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Prevention of significant air quality deterioration. (a) The requirements of sections 160 through 165 of the...

  11. 40 CFR 52.1829 - Prevention of significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... of air quality. 52.1829 Section 52.1829 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Dakota § 52.1829 Prevention of significant deterioration of air quality. (a) The North Dakota plan, as... of significant deterioration of air quality. The provisions of § 52.21 except paragraph (a)(1) are...

  12. 40 CFR 52.1436 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 4 2013-07-01 2013-07-01 false Significant deterioration of air quality. 52.1436 Section 52.1436 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. The requirements of sections 160 through 165 of the Clean Air Act...

  13. 40 CFR 52.1436 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 4 2012-07-01 2012-07-01 false Significant deterioration of air quality. 52.1436 Section 52.1436 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. The requirements of sections 160 through 165 of the Clean Air Act...

  14. 40 CFR 52.2058 - Prevention of significant air quality deterioration.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 5 2014-07-01 2014-07-01 false Prevention of significant air quality deterioration. 52.2058 Section 52.2058 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Prevention of significant air quality deterioration. (a) The requirements of sections 160 through 165 of the...

  15. 40 CFR 52.2581 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.2581 Section 52.2581 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a)-(c) [Reserved] (d) The requirements of sections 160 through 165... provisions for prevention of significant deterioration of air quality at 40 CFR 52.21 are applicable to the...

  16. 40 CFR 52.2528 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 5 2014-07-01 2014-07-01 false Significant deterioration of air quality. 52.2528 Section 52.2528 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of Sections 160 through 165 of the Clean Air...

  17. 40 CFR 52.1382 - Prevention of significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... of air quality. 52.1382 Section 52.1382 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... § 52.1382 Prevention of significant deterioration of air quality. (a) The Montana plan, as submitted... significant deterioration of air quality. The provisions of § 52.21 except paragraph (a)(1) are hereby...

  18. 40 CFR 52.2083 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 5 2012-07-01 2012-07-01 false Significant deterioration of air quality. 52.2083 Section 52.2083 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The Rhode Island plan, as submitted, is approved as meeting the...

  19. 40 CFR 52.1436 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Significant deterioration of air quality. 52.1436 Section 52.1436 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. The requirements of sections 160 through 165 of the Clean Air Act...

  20. 40 CFR 52.2083 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Significant deterioration of air quality. 52.2083 Section 52.2083 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The Rhode Island plan, as submitted, is approved as meeting the...

  1. 40 CFR 52.2581 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.2581 Section 52.2581 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a)-(c) [Reserved] (d) The requirements of sections 160 through 165... provisions for prevention of significant deterioration of air quality at 40 CFR 52.21 are applicable to the...

  2. 75 FR 27191 - Prevention of Significant Deterioration (PSD) and Nonattainment New Source Review (NSR): Aggregation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-14

    ... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Parts 51 and 52 [EPA-HQ-OAR-2003-0064, FRL-9151-3] RIN 2060-AP80 Prevention of Significant Deterioration (PSD) and Nonattainment New Source Review (NSR... of the Prevention of Significant Deterioration (PSD) and Nonattainment New Source Review (NSR...

  3. 77 FR 14225 - Prevention of Significant Deterioration and Title V Greenhouse Gas Tailoring Rule Step 3, GHG...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-08

    ... thresholds. \\2\\ 75 FR 31559. As we committed to do in the Tailoring Rule, we have been exploring a variety of... Corporate Average Fuel Economy Standards; Final Rule,'' 75 FR 25,324 (May 7, 2010) (the Light-duty Vehicle... announced a plan to explore streamlining techniques that could make the permitting programs more efficient...

  4. 78 FR 4339 - Approval and Promulgation of Implementation Plans; New Mexico; Revisions to the New Source Review...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-22

    ... Plan (SIP); Prevention of Significant Deterioration (PSD) and Nonattainment New Source Review (NNSR... revisions to the New Mexico SIP to update the New Mexico NNSR and PSD SIP permitting programs consistent... submitted the PSD and NNSR SIP permitting revisions in two SIP submittals on June 11, 2009 and May 23, 2011...

  5. Deterioration of mental health in bariatric surgery after 10 years despite successful weight loss.

    PubMed

    Canetti, L; Bachar, E; Bonne, O

    2016-01-01

    The present study evaluated the mental health and psychological functioning of bariatric patients before surgery, and after 1 year and 10 year follow-ups, and compared them with participants in a dietary program. Such long follow-up is rare, but strongly recommended by the American Association of Bariatric Surgeons. Thirty-six bariatric surgery patients and 34 participants of a weight loss program were weighed and assessed at all 3 points in time. Participants were administered the mental health inventory, neuroticism, sense of control and fear of intimacy scales. Along with these mental and psychological measurements, the medical outcome short form (SF-36) was used. The surgery group achieved successful weight loss outcomes (27% reduction of pre-operative weight) after 10 years and better than baseline health-related quality-of-life scores. However, their general mental health, neuroticism, sense of control and fear of intimacy scores showed significant deterioration in comparison to pre-operative levels after 10 years. The dietary group participants remained psychologically stable among all three points in time. This study highlights the importance of identifying a risk group among bariatric patients for which the dietary and psychological follow-up may be of special significance.

  6. Quality of pancreatic transplant program assessment using a risk-adjusted cumulative sum chart: experience from a single, small center.

    PubMed

    Grochowiecki, T; Jakimowicz, T; Grabowska-Derlatka, L; Szmidt, J

    2014-10-01

    The high rate of complication after pancreas transplantation not only had an impact on recipient quality of life and survival but also had significant financial implications. Thus, monitoring transplant center performance was crucial to indentifying changes in clinical practice that result in quality deterioration. To evaluate retrospectively the quality of the single, small pancreatic transplant program and to establish prospective monitoring of the center using risk-adjusted cumulative sum (CUSUM). From 1988 to 2014, 119 simultaneous pancreas and the kidney transplantations (SPKTx) were performed. The program was divided into 3 eras, based on surgical technique and immunosuppression. Analyses of the 15 fatal outcomes due to complication from pancreatic graft were performed. The risk model was developed using multivariable logistic regression analysis based on retrospective data of 112 SPKTx recipients. The risk-adjusted 1-sided CUSUM chart was plotted for retrospective and prospective events. The upper control limit was set to 2. There were 2 main causes of death: multiorgan failure (73.3%; 11/15) and septic hemorrhage (26.7%; 4/15). Quality analysis using the CUSUM chart revealed that the process was not homogeneous; however, no significant signal of program deterioration was obtained and the performance of the whole program was within the settled control limit. For a single pancreatic transplant center. The risk-adjusted CUSUM chart was a useful tool for quality program assessment. It could support decision making during traditional surgical morbidity and mortality conferences. For small transplant centers, increasing the sensitivity of the CUSUM method by lowering the upper control limit should be considered. However, an individual assessment approach of the for particular centers is recommended.

  7. 40 CFR 52.931 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.931 Section 52.931 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) Regulations for preventing significant deterioration of air quality. The..., the Kentucky Division for Air Quality has determined that the application complies with the applicable...

  8. Impact of preoperative change in physical function on postoperative recovery: argument supporting prehabilitation for colorectal surgery.

    PubMed

    Mayo, Nancy E; Feldman, Liane; Scott, Susan; Zavorsky, Gerald; Kim, Do Jun; Charlebois, Patrick; Stein, Barry; Carli, Francesco

    2011-09-01

    Abdominal surgery represents a physiologic stress and is associated with a period of recovery during which functional capacity is often diminished. "Prehabilitation" is a program to increase functional capacity in anticipation of an upcoming stressor. We reported recently the results of a randomized trial comparing 2 prehabilitation programs before colorectal surgery (stationary cycling plus weight training versus a recommendation to increase walking coupled with breathing exercises); however, adherence to the programs was low. The objectives of this study were to estimate: (1) the extent to which physical function could be improved with either prehabilitation program and identify variables associated with response; and (2) the impact of change in preoperative function on postoperative recovery. This study involved a reanalysis of data arising from a randomized trial. The primary outcome measure was functional walking capacity measured by the Six-Minute Walk Test; secondary outcomes were anxiety, depression, health-related quality of life, and complications (Clavien classification). Multiple linear regression was used to estimate the extent to which key variables predicted change in functional walking capacity over the prehabilitation and follow-up periods. We included 95 people who completed the prehabilitation phase (median, 38 days; interquartile range, 22-60), and 75 who were also evaluated postoperatively (mean, 9 weeks). During prehabilitation, 33% improved their physical function, 38% stayed within 20 m of their baseline score, and 29% deteriorated. Among those who improved, mental health, vitality, self-perceived health, and peak exercise capacity also increased significantly. Women were less likely to improve; low baseline walking capacity, anxiety, and the belief that fitness aids recovery were associated with improvements during prehabilitation. In the postoperative phase, the patients who had improved during prehabilitation were also more likely to have recovered to their baseline walking capacity than those with no change or deterioration (77% vs 59% and 32%; P = .0007). Patients who deteriorated were at greater risk of complications requiring reoperation and/or intensive care management. Significant predictors of poorer recovery included deterioration during prehabilitation, age >75 years, high anxiety, complications requiring intervention, and timing of follow-up assessment. In a group of patients undergoing scheduled colorectal surgery, meaningful changes in functional capacity can be achieved over several weeks of prehabilitation. Patients and those who care for them, especially those with poor physical capacity, should consider a prehabilitation regimen to enhance functional exercise capacity before colectomy. Copyright © 2011 Mosby, Inc. All rights reserved.

  9. CF6-6D engine short-term performance deterioration

    NASA Technical Reports Server (NTRS)

    Kramer, W. H.; Paas, J. E.; Smith, J. J.; Wulf, R. H.

    1980-01-01

    Studies conducted as part of the NASA-Lewis CF6 jet engine diagnostics program are summarized. An 82-engine sample of DC-10-10 aircraft engine checkout data that were gathered to define the extent and magnitude of CF6-6D short term performance deterioration were analyzed. These data are substantiated by the performance testing and analytical teardown of CF6-6D short term deterioration engine serial number (ESN) 451507.

  10. 40 CFR 52.432 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.432 Section 52.432 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. Link to an amendment published at 78 FR 33984, June 6, 2013. (a) The requirements... approvable procedures for preventing the significant deterioration of air quality. (b) Regulation for...

  11. Environmental Impact Statement. Peacekeeper Rail Garrison Program. Volume 1

    DTIC Science & Technology

    1989-02-01

    Dupree Steve Coop Shannon Dupree Ernest Cooper Thomas W. Dupree Wainright Copass, Jr. Steve Dust Robert M. Corrie Dean Easton William Couchigian Arthur...located within the Shreveport- Texarkana -Tyler Interstate Air Quality Control Region (No. 022). There are no Prevention of Significant Deterioration Class...Master of Environmental Laws, National Law Center, The George Washington Univerqity, Washington, DC Years of Experience: 14 William R. Livingstone

  12. 40 CFR 52.738 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.738 Section 52.738 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are not met... air quality. (b) Regulations for preventing significant deterioration of air quality. The provisions...

  13. 40 CFR 52.144 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.144 Section 52.144 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Act are not met... lands does not include approvable procedures for preventing the significant deterioration of air quality...

  14. 40 CFR 52.632 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.632 Section 52.632 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are not met... air quality. (b) Regulations for preventing significant deterioration of air quality. The provisions...

  15. 40 CFR 52.683 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.683 Section 52.683 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The State of Idaho Rules for Control of Air Pollution in Idaho, specifically... the Clean Air Act for preventing significant deterioration of air quality. (b) The requirements of...

  16. 40 CFR 52.581 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 3 2012-07-01 2012-07-01 false Significant deterioration of air quality. 52.581 Section 52.581 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) All applications and other information required pursuant to § 52.21 of this...

  17. 40 CFR 52.793 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.793 Section 52.793 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are not met... air quality. (b) Regulations for preventing significant deterioration of air quality. The provisions...

  18. 40 CFR 52.632 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.632 Section 52.632 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are not met... air quality. (b) Regulations for preventing significant deterioration of air quality. The provisions...

  19. 40 CFR 52.581 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 3 2014-07-01 2014-07-01 false Significant deterioration of air quality. 52.581 Section 52.581 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) All applications and other information required pursuant to § 52.21 of this...

  20. 40 CFR 52.581 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 3 2011-07-01 2011-07-01 false Significant deterioration of air quality. 52.581 Section 52.581 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) All applications and other information required pursuant to § 52.21 of this...

  1. 40 CFR 52.1116 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.1116 Section 52.1116 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) The following provisions of 40 CFR 52.21 are hereby incorporated and made a...

  2. 40 CFR 52.683 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.683 Section 52.683 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The State of Idaho Rules for Control of Air Pollution in Idaho, specifically... the Clean Air Act for preventing significant deterioration of air quality. (b) The requirements of...

  3. 40 CFR 52.632 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.632 Section 52.632 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are not met... air quality. (b) Regulations for preventing significant deterioration of air quality. The provisions...

  4. 40 CFR 52.833 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.833 Section 52.833 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are met... for preventing significant deterioration of air quality. The provisions of § 52.21 except paragraph (a...

  5. 40 CFR 52.382 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 3 2014-07-01 2014-07-01 false Significant deterioration of air quality. 52.382 Section 52.382 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are not met...

  6. 40 CFR 52.581 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 3 2013-07-01 2013-07-01 false Significant deterioration of air quality. 52.581 Section 52.581 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) All applications and other information required pursuant to § 52.21 of this...

  7. 40 CFR 52.833 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.833 Section 52.833 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are met... for preventing significant deterioration of air quality. The provisions of § 52.21 except paragraph (a...

  8. 40 CFR 52.884 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 3 2012-07-01 2012-07-01 false Significant deterioration of air quality. 52.884 Section 52.884 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of section 160 through 165 of the Clean Air Act, as amended...

  9. 40 CFR 52.884 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 3 2011-07-01 2011-07-01 false Significant deterioration of air quality. 52.884 Section 52.884 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of section 160 through 165 of the Clean Air Act, as amended...

  10. 40 CFR 52.382 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 3 2013-07-01 2013-07-01 false Significant deterioration of air quality. 52.382 Section 52.382 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are not met...

  11. 40 CFR 52.432 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.432 Section 52.432 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are not met... air quality. (b) Regulation for preventing significant deterioration of air quality. The provisions of...

  12. 40 CFR 52.738 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.738 Section 52.738 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are not met... air quality. (b) Regulations for preventing significant deterioration of air quality. The provisions...

  13. 40 CFR 52.632 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.632 Section 52.632 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are not met... air quality. (b) Regulations for preventing significant deterioration of air quality. The provisions...

  14. 40 CFR 52.432 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.432 Section 52.432 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are not met... air quality. (b) Regulation for preventing significant deterioration of air quality. The provisions of...

  15. 40 CFR 52.683 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.683 Section 52.683 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The State of Idaho Rules for Control of Air Pollution in Idaho, specifically... Air Act for preventing significant deterioration of air quality. (b) The requirements of sections 160...

  16. 40 CFR 52.738 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.738 Section 52.738 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are not met... air quality. (b) Regulations for preventing significant deterioration of air quality. The provisions...

  17. 40 CFR 52.1116 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.1116 Section 52.1116 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) The following provisions of 40 CFR 52.21 are hereby incorporated and made a...

  18. 40 CFR 52.884 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 3 2014-07-01 2014-07-01 false Significant deterioration of air quality. 52.884 Section 52.884 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of section 160 through 165 of the Clean Air Act, as amended...

  19. 40 CFR 52.833 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.833 Section 52.833 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are met... for preventing significant deterioration of air quality. The provisions of § 52.21 except paragraph (a...

  20. 40 CFR 52.738 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.738 Section 52.738 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are not met... air quality. (b) Regulations for preventing significant deterioration of air quality. The provisions...

  1. 40 CFR 52.793 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.793 Section 52.793 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are not met... air quality. (b) Regulations for preventing significant deterioration of air quality. The provisions...

  2. 40 CFR 52.793 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.793 Section 52.793 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are not met... air quality. (b) Regulations for preventing significant deterioration of air quality. The provisions...

  3. 40 CFR 52.1116 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.1116 Section 52.1116 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) The following provisions of 40 CFR 52.21 are hereby incorporated and made a...

  4. 40 CFR 52.382 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 3 2011-07-01 2011-07-01 false Significant deterioration of air quality. 52.382 Section 52.382 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are not met...

  5. 40 CFR 52.884 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 3 2013-07-01 2013-07-01 false Significant deterioration of air quality. 52.884 Section 52.884 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of section 160 through 165 of the Clean Air Act, as amended...

  6. 40 CFR 52.793 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.793 Section 52.793 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are not met... air quality. (b) Regulations for preventing significant deterioration of air quality. The provisions...

  7. 40 CFR 52.144 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.144 Section 52.144 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Act are not met... lands does not include approvable procedures for preventing the significant deterioration of air quality...

  8. 40 CFR 52.144 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.144 Section 52.144 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Act are not met... lands does not include approvable procedures for preventing the significant deterioration of air quality...

  9. 40 CFR 52.833 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.833 Section 52.833 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are met... for preventing significant deterioration of air quality. The provisions of § 52.21 except paragraph (a...

  10. 40 CFR 52.144 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.144 Section 52.144 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Act are not met... lands does not include approvable procedures for preventing the significant deterioration of air quality...

  11. 40 CFR 52.1116 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.1116 Section 52.1116 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) The following provisions of 40 CFR 52.21 are hereby incorporated and made a...

  12. 40 CFR 52.382 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 3 2012-07-01 2012-07-01 false Significant deterioration of air quality. 52.382 Section 52.382 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are not met...

  13. 40 CFR 52.144 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.144 Section 52.144 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Act are not met... lands does not include approvable procedures for preventing the significant deterioration of air quality...

  14. 40 CFR 52.632 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.632 Section 52.632 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are not met... air quality. (b) Regulations for preventing significant deterioration of air quality. The provisions...

  15. 40 CFR 52.581 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 3 2010-07-01 2010-07-01 false Significant deterioration of air quality. 52.581 Section 52.581 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) All applications and other information required pursuant to § 52.21 of this...

  16. 40 CFR 52.793 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.793 Section 52.793 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are not met... air quality. (b) Regulations for preventing significant deterioration of air quality. The provisions...

  17. 40 CFR 52.343 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.343 Section 52.343 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are not met for the following categories of sources for preventing the significant deterioration of air quality...

  18. 40 CFR 52.986 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.986 Section 52.986 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The plan submitted by the Governor of Louisiana on August 14, 1984 (as adopted... preventing significant deterioration of air quality. (b) The requirements of sections 160 through 165 of the...

  19. 40 CFR 52.884 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 3 2010-07-01 2010-07-01 false Significant deterioration of air quality. 52.884 Section 52.884 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of section 160 through 165 of the Clean Air Act, as amended...

  20. 40 CFR 52.683 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.683 Section 52.683 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The State of Idaho Rules for Control of Air Pollution in Idaho, specifically... the Clean Air Act for preventing significant deterioration of air quality. (b) The requirements of...

  1. 40 CFR 52.382 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 3 2010-07-01 2010-07-01 false Significant deterioration of air quality. 52.382 Section 52.382 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are not met...

  2. 40 CFR 52.432 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.432 Section 52.432 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are not met... air quality. (b) Regulation for preventing significant deterioration of air quality. The provisions of...

  3. 40 CFR 52.738 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.738 Section 52.738 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are not met... air quality. (b) Regulations for preventing significant deterioration of air quality. The provisions...

  4. 40 CFR 52.1116 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.1116 Section 52.1116 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air... deterioration of air quality. (b) The following provisions of 40 CFR 52.21 are hereby incorporated and made a...

  5. 40 CFR 52.833 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.833 Section 52.833 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The requirements of sections 160 through 165 of the Clean Air Act are met... for preventing significant deterioration of air quality. The provisions of § 52.21 except paragraph (a...

  6. Follow-up study for a disease management program for chronic heart failure 24 months after program commencement.

    PubMed

    Otsu, Haruka; Moriyama, Michiko

    2012-12-01

    There are few studies dealing with comprehensive chronic heart failure (CHF) disease management programs, which are based on self-management, in Japan. We developed and conducted a comprehensive educational program for CHF for 6 months that aimed to improve self-management and prevent the deterioration of outpatients with CHF. Our follow-up research focused on whether performance of self-management in the intervention group continued for 24 months after commencement. Participants were selected from patients who went for follow-up visits to one Japanese clinic, which specialized in cardiovascular internal medicine, that were diagnosed with CHF. During the first follow-up period, 7 to 12 months after program commencement, 47 participants in the intervention group and 47 participants in the control group were analyzed. During the second follow-up period, 13 to 24 months after program commencement, 41 participants in the intervention group were analyzed. Participants in the intervention group acquired self-management skills and activities and these continued up to 24 months after the program commencement. As a result, no deterioration in symptoms related to CHF was demonstrated. Meanwhile, quitting smoking and drinking depended on individual preference and it was difficult to improve. The educational program was effective in the long term and the program is significant for use in busy medical situations that do not offer sufficient follow-up support for patients. Regular intervention and ways that produce longer-lasting effects should be further developed. © 2011 The Authors. Japan Journal of Nursing Science © 2011 Japan Academy of Nursing Science.

  7. Performance deterioration based on in-service engine data: JT9D jet engine diagnostics program

    NASA Technical Reports Server (NTRS)

    Sallee, G. P.

    1979-01-01

    Results of analyses of engine performance deterioration trends and levels with respect to service usage are presented. Thirty-two JT9D-7A engines were selected for this purpose. The selection of this engine fleet provided the opportunity of obtaining engine performance data starting before the first flight through initial service such that the trend and levels of engine deterioration related to both short and long term deterioration could be more carefully defined. The performance data collected and analyzed included in-flight, on wing (ground), and test stand prerepair and postrepair performance calibrations with expanded instrumentation where feasible. The results of the analyses of these data were used to: (1) close gaps in previously obtained historical data as well as augment the historical data with more carefully obtained data; (2) refine preliminary models of performance deterioration with respect to usage; (3) establish an understanding of the relationships between ground and altitude performance deterioration trends; (4) refine preliminary recommendations concerning means to reduce and control deterioration; and (5) identify areas where additional effort is required to develop an understanding of complex deterioration issues.

  8. Managing the deteriorating patient in a simulated environment: nursing students' knowledge, skill and situation awareness.

    PubMed

    Cooper, Simon; Kinsman, Leigh; Buykx, Penny; McConnell-Henry, Tracy; Endacott, Ruth; Scholes, Julie

    2010-08-01

    To examine, in a simulated environment, the ability of final-year nursing students to assess, identify and respond to patients either deteriorating or at risk of deterioration. The early identification and management of patient deterioration has a major impact on patient outcomes. 'Failure to rescue' is of international concern, with significant concerns over nurses' ability to detect deterioration, the reasons for which are unknown. Mixed methods incorporating quantitative measures of performance (knowledge, skill and situation awareness) and, to be reported at a later date, a qualitative reflective review of decision processes. Fifty-one final-year, final-semester student nurses attended a simulation laboratory. Students completed a knowledge questionnaire and two video-recorded simulated scenarios (mannequin based) to assess skill performance. The scenarios simulated deteriorating patients with hypovolaemic and septic shock. Situation awareness was measured by randomly stopping each scenario and asking a series of questions relating to the situation. The mean knowledge score was 74% (range 46-100%) and the mean skill performance score across both scenarios was 60% (range 30-78%). Skill performance improved significantly (p < 0.01) by the second scenario. However, skill performance declined significantly in both scenarios as the patient's condition deteriorated (hypovolaemia scenario: p = 0.012, septic scenario: p = 0.000). The mean situation awareness score across both scenarios was 59% (range 38-82%). Participants tended to identify physiological indicators of deterioration (77%) but had low comprehension scores (44%). Knowledge scores suggest, on average, a satisfactory academic preparation, but this study identified significant deficits in students' ability to manage patient deterioration. This study suggests that student nurses, at the point of qualification, may be inadequately prepared to identify and manage deteriorating patients in the clinical setting.

  9. CF 6 engine diagnostics

    NASA Technical Reports Server (NTRS)

    Stricklin, R.

    1981-01-01

    A summary of the activities which led to defining deterioration rates of the CF6 family of engines, a description of what was learned, and an identification of means of conserving fuel based upon the program findings are presented. The program to define the deterioration levels and modes for the CF6 family of engines involved four distinct phases: analysis of inbound engine test results, analysis of airline cruise data, analysis of airline test cell data resulting from testing of refurbished engines, and inspection of engine hardware.

  10. Development of a cost-effective concrete bridge deck preservation program : volume 2--final results and recommendations.

    DOT National Transportation Integrated Search

    2016-07-01

    The deterioration of bridge decks has been identified as a major problem in Indiana. The primary cause of this deterioration is salt water : ingress from the application of deicing salts during the winter. Deicing chemicals placed on the road mix wit...

  11. Comprehensive analysis of cochlear implant failure: usefulness of clinical symptom-based algorithm combined with in situ integrity testing.

    PubMed

    Yamazaki, Hiroshi; O'Leary, Stephen; Moran, Michelle; Briggs, Robert

    2014-04-01

    Accurate diagnosis of cochlear implant failures is important for management; however, appropriate strategies to assess possible device failures are not always clear. The purpose of this study is to understand correlation between causes of device failure and the presenting clinical symptoms as well as results of in situ integrity testing and to propose effective strategies for diagnosis of device failure. Retrospective case review. Cochlear implant center at a tertiary referral hospital. Twenty-seven cases with suspected device failure of Cochlear Nucleus systems (excluding CI512 failures) on the basis of deterioration in auditory perception from January 2000 to September 2012 in the Melbourne cochlear implant clinic. Clinical presentations and types of abnormalities on in situ integrity testing were compared with modes of device failure detected by returned device analysis. Sudden deterioration in auditory perception was always observed in cases with "critical damage": either fracture of the integrated circuit or most or all of the electrode wires. Subacute or gradually progressive deterioration in auditory perception was significantly associated with a more limited number of broken electrode wires. Cochlear implant mediated auditory and nonauditory symptoms were significantly associated with an insulation problem. An algorithm based on the time course of deterioration in auditory perception and cochlear implant-mediated auditory and nonauditory symptoms was developed on the basis of these retrospective analyses, to help predict the mode of device failure. In situ integrity testing, which included close monitoring of device function in routine programming sessions as well as repeating the manufacturer's integrity test battery, was sensitive enough to detect malfunction in all suspected device failures, and each mode of device failure showed a characteristic abnormality on in situ integrity testing. Our clinical manifestation-based algorithm combined with in situ integrity testing may be useful for accurate diagnosis and appropriate management of device failure. Close monitoring of device function in routine programming sessions as well as repeating the manufacturer's integrity test battery is important if the initial in situ integrity testing is inconclusive because objective evidence of failure in the implanted device is essential to recommend explantation/reimplantation.

  12. 40 CFR 52.2479 - Contents of the federally approved, State submitted implementation plan.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...-087 Prevention of significant deterioration (PSD) [02/19/91] 173-405-091 Special studies [02/19/91] 2... deterioration (PSD) [02/19/91] 173-410-100 Special studies [02/19/91] 2.2.415 WAC 173-415 Primary Aluminum...] 173-415-051 Prevention of significant deterioration (PSD) [02/19/91] 173-415-060 Monitoring and...

  13. 40 CFR 52.2479 - Contents of the federally approved, State submitted implementation plan.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...-087 Prevention of significant deterioration (PSD) [02/19/91] 173-405-091 Special studies [02/19/91] 2... deterioration (PSD) [02/19/91] 173-410-100 Special studies [02/19/91] 2.2.415 WAC 173-415 Primary Aluminum...] 173-415-051 Prevention of significant deterioration (PSD) [02/19/91] 173-415-060 Monitoring and...

  14. 26 CFR 53.4944-3 - Exception for program-related investments.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... enterprise located in a deteriorated urban area and owned by members of an economically disadvantaged... market rate for commercial loans of comparable risk. Y's primary purpose for making the loan is to... investment. Example 3. X is a small business enterprise located in a deteriorated urban area and owned by...

  15. 40 CFR 52.976 - Review of new sources and modification.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... the preconstruction requirements for the prevention of significant deterioration (PSD) of air quality... requirements for the prevention of significant deterioration (PSD) of air quality and the Administrator's...

  16. 40 CFR 52.976 - Review of new sources and modification.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... the preconstruction requirements for the prevention of significant deterioration (PSD) of air quality... requirements for the prevention of significant deterioration (PSD) of air quality and the Administrator's...

  17. 40 CFR 52.976 - Review of new sources and modification.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... the preconstruction requirements for the prevention of significant deterioration (PSD) of air quality... requirements for the prevention of significant deterioration (PSD) of air quality and the Administrator's...

  18. 40 CFR 52.976 - Review of new sources and modification.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... the preconstruction requirements for the prevention of significant deterioration (PSD) of air quality... requirements for the prevention of significant deterioration (PSD) of air quality and the Administrator's...

  19. 40 CFR 52.976 - Review of new sources and modification.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... the preconstruction requirements for the prevention of significant deterioration (PSD) of air quality... requirements for the prevention of significant deterioration (PSD) of air quality and the Administrator's...

  20. Effect of a gymnastics program on sleep characteristics in pregnant women.

    PubMed

    Kocsis, Ildikó; Szilágyi, Tibor; Turos, János; Bakó, Aliz; Frigy, Attila

    2017-04-01

    The quality and quantity of sleep represent important health issues in pregnant women. Sleep disturbances could be associated, beyond alteration of quality of life, with poor pregnancy outcome. Our aim was to investigate the effect of a regular, specific, medium-term physical training program on sleep characteristics in healthy pregnant women. A total of 132 healthy pregnant women, with gestational age between 18 weeks and 22 weeks, were enrolled in a prospective study. They were allocated into two groups; the first group involved 79 women (average age, 29.4 years) who performed a specific gymnastics program of 10 weeks, and the second group involved 53 pregnant women (average age, 27.9 years) who did not perform gymnastics. All participants completed a comprehensive questionnaire at baseline and after 10 weeks concerning general data, sleep characteristics, and psycho-emotional status. The changes arising within a diverse set of characteristics were followed and compared for the two groups using parametric and nonparametric statistics. In the control group, we observed significant worsening of 12 out of the 14 studied parameters during the 10-week period. In comparison with the women who did not perform gymnastics, women who performed specific gymnastics showed the following characteristics: (1) significantly less deterioration of psycho-emotional status (stress and anxiety levels); (2) the same general pattern of decrease in sleep quality, which is related to the progression of pregnancy; and (3) a significant attenuation of the worsening of several sleep characteristics, such as restless sleep, snoring, diurnal tiredness, and excessive daytime sleepiness. Nocturnal and diurnal sleep quantity increased significantly in both groups. The 10-week training program designed for pregnant women has an overall beneficial effect on sleep characteristics, not by improving them but by attenuating their general deterioration related to the progression of pregnancy. Our data strengthen the general recommendation regarding participation of pregnant women in specific exercise programs, mainly for maintaining their psycho-emotional and general well-being. Copyright © 2017. Published by Elsevier B.V.

  1. Outcomes and Factors Influencing Response to an Individualized Multidisciplinary Chronic Disease Management Program for Hip and Knee Osteoarthritis.

    PubMed

    Gwynne-Jones, David P; Gray, Andrew R; Hutton, Liam R; Stout, Kirsten M; Abbott, J Haxby

    2018-04-16

    The objective of the study was to investigate the effectiveness of, and factors associated with, response to a chronic disease management program for patients with hip and knee osteoarthritis (OA). Over a 2-year period (2012-2014), 218 patients (97 hip OA; 121 knee OA) were managed with an individualized program of interventions that could include education, physiotherapy, orthotics, occupational therapy, or dietitian referral. Changes in Oxford Hip Score or Oxford Knee Score and Short Form-12 (SF-12) Physical and Mental Component Summary Score (PCS, MCS) were analyzed by joint affected, both unadjusted, and gender and age adjusted. A further analysis also adjusted for body mass index. At mean 12-month follow-up, patients with knee OA had a statistically significant improvement in Oxford Knee Score and PCS, while patients with hip OA had a statistically significant deterioration in all 3 scores. There was evidence that these changes differed between joints for Oxford and PCS scores. Older age was associated with worse outcomes for Oxford scores. Higher body mass index was associated with worse outcomes for Oxford and PCS scores. Patients with hip OA (35%) were more likely to deteriorate to a clinically significant extent (5 points) for Oxford scores than those with knee OA. Gender was not associated with outcomes. Patients with hip OA (54%) were more likely than those with knee OA (24%) to have subsequently had surgery (P < .001). Patients with knee OA were more likely to improve with a chronic disease management plan than patients with hip OA and efforts should be directed to them. Copyright © 2018 Elsevier Inc. All rights reserved.

  2. Long-term effects of a 12-week exercise training program on clinical outcomes in idiopathic pulmonary fibrosis.

    PubMed

    Vainshelboim, Baruch; Oliveira, Jose; Fox, Benjamin Daniel; Soreck, Yafit; Fruchter, Oren; Kramer, Mordechai Reuven

    2015-06-01

    Idiopathic pulmonary fibrosis (IPF) is a chronic, devastating, lung disease, with few therapeutic options. Data are limited with respect to the long-term effect of exercise training (ET) in IPF. This study sought to evaluate the long-term effects of a 12-week ET program on clinical outcomes in IPF patients. Thirty-four IPF patients were randomly allocated to ET or control groups. ET group participated in a 12-week supervised exercise program, while the control group continued with regular medical treatment alone. Exercise capacity, 30 s-chair-stand test for leg strength, dyspnea, and Saint George's Respiratory Questionnaire (SGRQ) for quality of life (QOL) were assessed at baseline and re-evaluated at 11 months from baseline. In addition, at 30-month time point from baseline, the impact of the 12-week intervention was analyzed with respect to survival and cardio-respiratory-related hospitalizations. Thirty-two patients completed the 12-week intervention and 28 patients (14 in each group) were re-evaluated. At 11-month follow-up, no significant differences between the groups and time effect were demonstrated for most outcomes. ET group showed preserved values at the baseline level while the control group showed a trend of deterioration. Only the 30 s-chair-stand test (mean difference 3 stands, p = 0.01) and SGRQ (mean difference -6 units, p = 0.037) were significantly different between the groups. At 30 months, the survival analysis showed three deaths, eight hospitalizations occurred in the control group versus one death, one lung transplantation and seven hospitalizations in the ET group, with no significant differences between groups. At 11-month follow-up, the 12-week ET program showed clinical outcomes were preserved at baseline levels with some maintenance of improvements in leg strength and QOL in the ET group. The control group showed a trend of deterioration in the outcomes. At 30 months, the 12-week ET program did not show benefits in prognosis although the study was underpowered to detect such differences. We suggest including ET as a long-term continued treatment and as a core component of pulmonary rehabilitation programs for IPF patients.

  3. 40 CFR 52.2303 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Environmental Quality on April 20, 2011 and submitted on May 19, 2011) to address PSD permitting requirements... Prevention of Significant Deterioration (PSD) Supplement document, submitted October 26, 1987 (as adopted by...

  4. Performance deterioration based on existing (historical) data; JT9D jet engine diagnostics program

    NASA Technical Reports Server (NTRS)

    Sallee, G. P.

    1978-01-01

    The results of the collection and analysis of historical data pertaining to the deterioration of JT9D engine performance are presented. The results of analyses of prerepair and postrepair engine test stand performance data from a number of airlines to establish the individual as well as average losses in engine performance with respect to service use are included. Analysis of the changes in mechanical condition of parts, obtained by inspection of used gas-path parts of varying age, allowed preliminary assessments of component performance deterioration levels and identification of the causitive factors. These component performance estimates, refined by data from special engine back-to-back testing related to module performance restoration, permitted the development of preliminary models of engine component/module performance deterioration with respect to usage. The preliminary assessment of the causes of module performance deterioration and the trends with usage are explained, along with the role each module plays in overall engine performance deterioration. Preliminary recommendations with respect to operating and maintenance practices which could be adopted to control the level of performance deterioration are presented. The needs for additional component sensitivity testing as well as outstanding issues are discussed.

  5. Engine diagnostics program: CF6-50 engine performance deterioration

    NASA Technical Reports Server (NTRS)

    Wulf, R. H.

    1980-01-01

    Cockpit cruise recordings and test cell data in conjunction with hardware inspection results from airline overhaul shops were analyzed to define the extent and magnitude of performance deterioration of the General Electric CF6-50 high bypass turbofan engine. The magnitude of short term deterioration was isolated from the long term, and the individual damage mechanisms that were the cause for the majority of the performance deterioration was identified. It was determined that the long term engine performance deterioration characteristics were different for the 3 aircraft types currently powered by the CF6-50 engine, but these differences were due to operational considerations (flight length and takeoff derate) and not to differences associated with the aircraft type. Unrestored losses, that is, performance deterioration which remains after engine refurbishment, represents over 70 percent of the total performance deterioration at engine shop visit. Superficial damage, such as, increased surface roughness, leading edge shape changes on airfoils, and increases in the average clearances between rotating and stationary components is the major contributor to these losses. Seventy one percent of the unrestored losses are cost effective to restore, and if implemented could reduce fuel consumed by CF6-50 engines by 26 million gallons in 1980.

  6. Effects of economic downturns on child mortality: a global economic analysis, 1981-2010.

    PubMed

    Maruthappu, Mahiben; Watson, Robert A; Watkins, Johnathan; Zeltner, Thomas; Raine, Rosalind; Atun, Rifat

    2017-01-01

    To analyse how economic downturns affect child mortality both globally and among subgroups of countries of variable income levels. Retrospective observational study using economic data from the World Bank's Development Indicators and Global Development Finance (2013 edition). Child mortality data were sourced from the Institute for Health Metrics and Evaluation. Global. 204 countries between 1981 and 2010. Child mortality, controlling for country-specific differences in political, healthcare, cultural, structural, educational and economic factors. 197 countries experienced at least 1 economic downturn between 1981 and 2010, with a mean of 7.97 downturns per country (range 0-21; SD 0.45). At the global level, downturns were associated with significant (p<0.0001) deteriorations in each child mortality measure, in comparison with non-downturn years: neonatal (coefficient: 1.11, 95% CI 0.855 to 1.37), postneonatal (2.00, 95% CI 1.61 to 2.38), child (2.93, 95% CI 2.26 to 3.60) and under 5 years of age (5.44, 95% CI 4.31 to 6.58) mortality rates. Stronger (larger falls in the growth rate of gross domestic product/capita) and longer (lasting 2 years rather than 1) downturns were associated with larger significant deteriorations (p<0.001). During economic downturns, countries in the poorest quartile experienced ∼1½ times greater deterioration in neonatal mortality, compared with their own baseline; a 3-fold deterioration in postneonatal mortality; a 9-fold deterioration in child mortality and a 3-fold deterioration in under-5 mortality, than countries in the wealthiest quartile (p<0.0005). For 1-5 years after downturns ended, each mortality measure continued to display significant deteriorations (p<0.0001). Economic downturns occur frequently and are associated with significant deteriorations in child mortality, with worse declines in lower income countries.

  7. Performance deterioration due to acceptance testing and flight loads; JT90 jet engine diagnostic program

    NASA Technical Reports Server (NTRS)

    Olsson, W. J.

    1982-01-01

    The results of a flight loads test of the JT9D-7 engine are presented. The goals of this test program were to: measure aerodynamic and inertia loads on the engine during flight, explore the effects of airplane gross weight and typical maneuvers on these flight loads, simultaneously measure the changes in engine running clearances and performance resulting from the maneuvers, make refinements of engine performance deterioration prediction models based on analytical results of the tests, and make recommendations to improve propulsion system performance retention. The test program included a typical production airplane acceptance test plus additional flights and maneuvers to encompass the range of flight loads in revenue service. The test results indicated that aerodynamic loads, primarily at take-off, were the major cause of rub-indicated that aerodynamic loads, primarily at take-off, were the major cause of rub-induced deterioration in the cold sectin of the engine. Differential thermal expansion between rotating and static parts plus aerodynamic loads combined to cause blade-to-seal rubs in the turbine.

  8. 40 CFR 52.2233 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 4 2011-07-01 2011-07-01 false Significant deterioration of air quality. 52.2233 Section 52.2233 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... requesting innovative technology waivers which would significantly impact air quality in adjacent states. (2...

  9. 75 FR 56923 - Approval and Promulgation of Implementation Plans; Oklahoma; State Implementation Plan Revisions...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-17

    ... Pollution, Prevention of Significant Deterioration, Nonattainment New Source Review, Source Registration and... relate to Prevention of Significant Deterioration (PSD) and Nonattainment New Source Review (NNSR) for... Demonstration of Adequate Provisions Prohibiting Emissions That Interfere With Prevention of Significant...

  10. 76 FR 34630 - Approval and Promulgation of Implementation Plans; New Hampshire: Prevention of Significant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-14

    ... Promulgation of Implementation Plans; New Hampshire: Prevention of Significant Deterioration; Greenhouse Gas... greenhouse gas (GHG) emissions. This rule clarifies the applicable thresholds in the New Hampshire SIP... Significant Deterioration Provisions Concerning Greenhouse Gas Emitting-Sources in State Implementation Plans...

  11. Energy Equity Lost and Found: Rebuilding America's K-12 Schools.

    ERIC Educational Resources Information Center

    Schoff, Lorenz V.

    1999-01-01

    Discusses reversing the trend of school-building deterioration and inefficient energy usage through the Rebuild America program. Explains what Rebuild America is and why schools should join the program. Also provided are overviews of successful programs involving schools. (GR)

  12. High density fuel qualification for a gas turbine engine

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

    Macleod, J.D.; Orbanski, B.; Hastings, P.R.

    1992-01-01

    A program for the evaluation of gas turbine engine performance, carried out in the Engine Laboratory of the National Research Council of Canada, is described. Problems under consideration include performance alteration between JP-4 fuel and a high energy density fuel, called strategic military fuel (SMF); performance deterioration during the accelerated endurance test; and emission analysis. The T56 fuel control system is found to be capable of operation on the higher energy density fuel with no detrimental effects regarding control of the engine's normal operating regime. The deterioration of the engine performance during 150-hour endurance tests on SMF was very high,more » which was caused by an increase in turbine nozzle effective flow area and turbine blade untwist. The most significant performance losses during the endurance tests were on corrected output power, fuel flow, specific fuel consumption and compressor and turbine presure ratio. 9 refs.« less

  13. High-temperature effect of hydrogen on sintered alpha-silicon carbide

    NASA Technical Reports Server (NTRS)

    Hallum, G. W.; Herbell, T. P.

    1986-01-01

    Sintered alpha-silicon carbide was exposed to pure, dry hydrogen at high temperatures for times up to 500 hr. Weight loss and corrosion were seen after 50 hr at temperatures as low as 1000 C. Corrosion of SiC by hydrogen produced grain boundary deterioration at 1100 C and a mixture of grain and grain boundary deterioration at 1300 C. Statistically significant strength reductions were seen in samples exposed to hydrogen for times greater than 50 hr and temperatures above 1100 C. Critical fracture origins were identified by fractography as either general grain boundary corrision at 1100 C or as corrosion pits at 1300 C. A maximum strength decrease of approximately 33 percent was seen at 1100 and 1300 C after 500 hr exposure to hydrogen. A computer assisted thermodynamic program was also used to predict possible reaction species of SiC and hydrogen.

  14. Effect of high-temperature hydrogen exposure on sintered alpha-SiC

    NASA Technical Reports Server (NTRS)

    Hallum, Gary W.; Herbell, Thomas P.

    1988-01-01

    Sintered alpha-silicon carbide was exposed to pure, dry hydrogen at high temperatures for times up to 500 hr. Weight loss and corrosion were seen after 50 hr at temperatures as low as 1000 C. Corrosion of SiC by hydrogen produced grain boundary deterioration at 1100 C and a mixture of grain and grain boundary deterioration at 1300 C. Statistically significant strength reductions were seen in samples exposed to hydrogen for times greater than 50 hr and temperatures above 1100 C. Critical fracture origins were identified by fractography as either general grain boundary corrosion at 1100 C or as corrosion pits at 1300 C. A maximum strength decrease of approximately 33 percent was seen at 1100 and 1300 C after 500 hr exposure to hydrogen. A computer assisted thermodynamic program was also used to predict possible reaction species of SiC and hydrogen.

  15. Summary report for CF6 jet engine diagnostics program

    NASA Technical Reports Server (NTRS)

    Fasching, W. A.; Stricklin, R.

    1982-01-01

    Cockpit cruise recordings and test cell data in conjunction with hardware inspection results from airline overhaul shops were analyzed to define the extent and magnitude of performance deterioration of the General Electric CF6 high bypass turbofan engines. The magnitude of Short Term deterioration from the Long Term was isolated and the individual damage mechanisms that were the cause for the majority of the performance deterioration were identified. A potential for reduction in compressor clearance and a potential for improvement in turbine roundness, which corresponds to cruise SFC reductions of 0.38 and 0.36 percent, respectively, were identified.

  16. 76 FR 66882 - Approval and Promulgation of State Implementation Plans; Missouri: Prevention of Significant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-28

    ... Promulgation of State Implementation Plans; Missouri: Prevention of Significant Deterioration; Greenhouse Gas...) relating to regulation of Greenhouse Gases (GHGs) under Missouri's Prevention of Significant Deterioration... the GHG emission thresholds established in EPA's ``PSD and Title V Greenhouse Gas Tailoring Final Rule...

  17. 40 CFR 52.2233 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.2233 Section 52.2233 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a)(1) Paragraph 1200-3-9-.01(4)-(0)-2. of Tennessee's regulations... requesting innovative technology waivers which would significantly impact air quality in adjacent states. (2...

  18. 40 CFR 52.2233 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.2233 Section 52.2233 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a)(1) Paragraph 1200-3-9-.01(4)-(0)-2. of Tennessee's regulations... requesting innovative technology waivers which would significantly impact air quality in adjacent states. (2...

  19. 40 CFR 52.2233 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.2233 Section 52.2233 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a)(1) Paragraph 1200-3-9-.01(4)-(0)-2. of Tennessee's regulations... requesting innovative technology waivers which would significantly impact air quality in adjacent states. (2...

  20. Smoking habits and health-related quality of life in a rural Japanese population.

    PubMed

    Funahashi, Koichi; Takahashi, Ippei; Danjo, Kazuma; Matsuzaka, Masashi; Umeda, Takashi; Nakaji, Shigeyuki

    2011-03-01

    To investigate the association between smoking and health-related quality of life (HRQOL) in a rural Japanese population. A cross-sectional study of data from 823 subjects in Iwaki area of Hirosaki City, Japan. SF-36 scores between non-smokers and smokers were compared. To test the sensitivity of SF-36 scores in detecting health deterioration, effects of having diseases and having deviations from normal thresholds in health check-up were analyzed by adding them into covariates in ANCOVA. There was no significant difference in SF-36 scores between non-smokers and smokers. Presence of diseases significantly decreased the physical components of SF-36 scores while the results of health check-up had no significant influence on SF-36 scores. The results suggested the possibility that in Japan, where smoking prevalence is still relatively high, smokers may be less sensitive to sub-clinical deterioration in their own health status than smokers in Western countries that already have experienced the major decline in their smoking rate. The importance of having the smoker become more sensitive to the sub-clinical adverse effects of cigarette smoking should be stressed for the success of smoking control programs.

  1. Sociodemographic patterning of long-term diabetes mellitus control following Japan's 3.11 triple disaster: a retrospective cohort study

    PubMed Central

    Leppold, Claire; Tsubokura, Masaharu; Ozaki, Akihiko; Nomura, Shuhei; Shimada, Yuki; Morita, Tomohiro; Tanimoto, Tetsuya; Kami, Masahiro; Kanazawa, Yukio; Oikawa, Tomoyoshi

    2016-01-01

    Objective To assess the sociodemographic patterning of changes in glycaemic control of patients with diabetes affected by the 2011 triple disaster in Japan (earthquake, tsunami and nuclear accident). Methods A retrospective cohort study was undertaken with 404 patients with diabetes at a public hospital in Minamisoma City, Fukushima Prefecture. Glycated haemoglobin (HbA1c) levels were measured in 2010, 2011 and 2012 to capture changes in glycaemic control postdisaster. Age, sex, urban/rural residency, evacuation status and medication use were also assessed. Results There was an overall deterioration in glycaemic control after the disaster, with the mean HbA1c rising from 6.77% in 2010 to 6.90% in 2012 (National Glycohemoglobin Standardization Program, NGSP). Rural residency was associated with a lower likelihood of deteriorating control (OR 0.34, 95% CI 0.13 to 0.84), compared with urban residency. Older age (OR 0.95, 95% CI 0.91 to 0.98) was also slightly protective against increased HbA1c. Evacuation and sex were not significant predictors. Conclusions Patients with diabetes who were affected by Japan's triple disaster experienced a deterioration in their glycaemic control following the disasters. The extent of this deterioration was mediated by sociodemographic factors, with rural residence and older age protective against the effects of the disaster on glycaemic control. These results may be indicative of underlying social determinants of health in rural Japan. PMID:27388360

  2. 40 CFR 52.2058 - Prevention of significant air quality deterioration.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Prevention of significant air quality... Prevention of significant air quality deterioration. (a) The requirements of sections 160 through 165 of the... Pennsylvania Environmental Resources on October 28, 1983. All PSD permit applications and requests for...

  3. Physical deterioration in an acute mental health unit: A quantitative retrospective analysis of medical emergencies.

    PubMed

    Porter, Joanne E; Cant, Robyn; Missen, Karen; Raymond, Anita; Churchill, Anne

    2018-04-27

    Nursing management of physical deterioration of patients within acute mental health settings is observed, recorded, and actively managed with the use of standardized Adult Deterioration Detection System (ADDS) charts. Patient deterioration may require the urgent assistance of a hospital rapid response or Medical Emergency Team. A five-and-a-half-year (2011-2016) audit of hospital-wide Medical Emergency Team attendances was conducted in an acute mental health unit of a single large 250 bed regional hospital in Victoria, Australia. Data were extracted from the hospitals' quality and patient safety program, RISKMan, and entered into a statistical data program for analysis. A total of 140 patient records were analysed, and the 'Worried' category (34%, n = 47) was the principle reason for a Medical Emergency Team call in a mental health ward, followed by hypotension (23%, n = 31) and a low Glasgow Coma Score (16%, n = 22). Upon further investigation of the 'Worried' category, the most common conditions recorded were an altered conscious state (22%, n = 9), low oxygen saturation (20%, n = 8), or chest pain (17%, n = 7). Activation of Medical Emergency Team calls predominantly occurred in the daylight morning hours (6am-12md). When data were compared to the general hospital patients, the context of the physiological deterioration of the mental health patients was strikingly similar. Further research is recommended to ascertain the extent and frequency with which staff working in mental health units are performing vital signs monitoring as an essential component of detection of early signs of physiological deterioration. © 2018 Australian College of Mental Health Nurses Inc.

  4. 40 CFR 52.96 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.96 Section 52.96 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The State of Alaska Department of Environmental Conservation Air Quality... deterioration of air quality. The following regulations as in effect on April 1, 2010, are also approved as...

  5. 40 CFR 52.96 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.96 Section 52.96 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The State of Alaska Department of Environmental Conservation Air Quality... deterioration of air quality. The introductory paragraph to 18 AAC 50.040(h) as in effect on December 9, 2010 is...

  6. 40 CFR 52.96 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.96 Section 52.96 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The State of Alaska Department of Environmental Conservation Air Quality... deterioration of air quality. The introductory paragraph to 18 AAC 50.040(h) as in effect on December 9, 2010 is...

  7. 40 CFR 52.96 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.96 Section 52.96 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The State of Alaska Department of Environmental Conservation Air Quality... deterioration of air quality. The following regulations as in effect on April 1, 2010, are also approved as...

  8. 40 CFR 52.96 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.96 Section 52.96 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The State of Alaska Department of Environmental Conservation Air Quality... deterioration of air quality. (b) The requirements of sections 160 through 165 of the Clean Air Act are not met...

  9. Application of particle swarm optimisation for solving deteriorating inventory model with fluctuating demand and controllable deterioration rate

    NASA Astrophysics Data System (ADS)

    Chen, Yu-Ren; Dye, Chung-Yuan

    2013-06-01

    In most of the inventory models in the literature, the deterioration rate of goods is viewed as an exogenous variable, which is not subject to control. In the real market, the retailer can reduce the deterioration rate of product by making effective capital investment in storehouse equipments. In this study, we formulate a deteriorating inventory model with time-varying demand by allowing preservation technology cost as a decision variable in conjunction with replacement policy. The objective is to find the optimal replenishment and preservation technology investment strategies while minimising the total cost over the planning horizon. For any given feasible replenishment scheme, we first prove that the optimal preservation technology investment strategy not only exists but is also unique. Then, a particle swarm optimisation is coded and used to solve the nonlinear programming problem by employing the properties derived from this article. Some numerical examples are used to illustrate the features of the proposed model.

  10. Improved NSR/PSD Program Transfer

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  11. Maintenance Program for Existing Gas Turbines

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  12. NSR Program Transitional Guidance

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  13. Federal Enforceability of State's Existing Minor New Source Review (NSR) Programs

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  14. Implementation of Revised PSD Program for Particulate Matter

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  15. Clarification of Current Air Program Issues

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  16. Improving Air Quality with Economic Incentive Programs

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  17. Federal Enforceability of Offsets in SIP Programs

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  18. New Source Offset Against Vehicle Inspection and Maintenance Program

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  19. School Voucher Program and Its Enlightenments to the Education Reform in China

    ERIC Educational Resources Information Center

    Shen, Youlu

    2005-01-01

    This article roughly retrospects the idea of school voucher program proposed by Milton Friedman, lately developed by Peacock, Wiseman and Jencks. The reasons like privatization in education, deterioration of public schooling and school choice promote this program. Then taking a simple look at the ramification of voucher program and its value…

  20. Comparison of standardized patients with high-fidelity simulators for managing stress and improving performance in clinical deterioration: A mixed methods study.

    PubMed

    Ignacio, Jeanette; Dolmans, Diana; Scherpbier, Albert; Rethans, Jan-Joost; Chan, Sally; Liaw, Sok Ying

    2015-12-01

    The use of standardized patients in deteriorating patient simulations adds realism that can be valuable for preparing nurse trainees for stress and enhancing their performance during actual patient deterioration. Emotional engagement resulting from increased fidelity can provide additional stress for student nurses with limited exposure to real patients. To determine the presence of increased stress with the standardized patient modality, this study compared the use of standardized patients (SP) with the use of high-fidelity simulators (HFS) during deteriorating patient simulations. Performance in managing deteriorating patients was also compared. It also explored student nurses' insights on the use of standardized patients and patient simulators in deteriorating patient simulations as preparation for clinical placement. Fifty-seven student nurses participated in a randomized controlled design study with pre- and post-tests to evaluate stress and performance in deteriorating patient simulations. Performance was assessed using the Rescuing A Patient in Deteriorating Situations (RAPIDS) rating tool. Stress was measured using salivary alpha-amylase levels. Fourteen participants who joined the randomized controlled component then participated in focus group discussions that elicited their insights on SP use in patient deterioration simulations. Analysis of covariance (ANCOVA) results showed no significant difference (p=0.744) between the performance scores of the SP and HFS groups in managing deteriorating patients. Amylase levels were also not significantly different (p=0.317) between the two groups. Stress in simulation, awareness of patient interactions, and realism were the main themes that resulted from the thematic analysis. Performance and stress in deteriorating patient simulations with standardized patients did not vary from similar simulations using high-fidelity patient simulators. Data from focus group interviews, however, suggested that the use of standardized patients was perceived to be valuable in preparing students for actual patient deterioration management. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Iowa SIP: Chapter 33 - Special Regulations and Construction Permit Requirements for Major Stationary Sources - Prevention of Significant Deterioration (PSD) of Air Quality

    EPA Pesticide Factsheets

    EPA Approved Iowa Regulations - 40 CFR 52.820(c) Chapter 33 - Special Regulations and Construction Permit Requirements for Major Stationary Sources - Prevention of Significant Deterioration (PSD) of Air Quality

  2. 40 CFR 52.530 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Air Resource Management that establishes prevention of significant deterioration (PSD) applicability...-emitting sources and issue GHG PSD permits. FDEP's December 19, 2013 SIP revision also includes a GHG PSD Permit Transition Plan which governs the transition from EPA administering GHG PSD permitting...

  3. 77 FR 71568 - Approval and Promulgation of Implementation Plans; Tennessee; Interstate Transport Infrastructure...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-03

    ... Promulgation of Implementation Plans; Tennessee; Interstate Transport Infrastructure Requirements (Prevention of Significant Deterioration) for the 2008 8-Hour Ozone National Ambient Air Quality Standards AGENCY... Clean Air Act (CAA) requirements pertaining to prevention of significant deterioration (PSD) (concerning...

  4. Effects of economic downturns on child mortality: a global economic analysis, 1981–2010

    PubMed Central

    Maruthappu, Mahiben; Watson, Robert A; Watkins, Johnathan; Zeltner, Thomas; Raine, Rosalind; Atun, Rifat

    2017-01-01

    Objectives To analyse how economic downturns affect child mortality both globally and among subgroups of countries of variable income levels. Design Retrospective observational study using economic data from the World Bank's Development Indicators and Global Development Finance (2013 edition). Child mortality data were sourced from the Institute for Health Metrics and Evaluation. Setting Global. Participants 204 countries between 1981 and 2010. Main outcome measures Child mortality, controlling for country-specific differences in political, healthcare, cultural, structural, educational and economic factors. Results 197 countries experienced at least 1 economic downturn between 1981 and 2010, with a mean of 7.97 downturns per country (range 0–21; SD 0.45). At the global level, downturns were associated with significant (p<0.0001) deteriorations in each child mortality measure, in comparison with non-downturn years: neonatal (coefficient: 1.11, 95% CI 0.855 to 1.37), postneonatal (2.00, 95% CI 1.61 to 2.38), child (2.93, 95% CI 2.26 to 3.60) and under 5 years of age (5.44, 95% CI 4.31 to 6.58) mortality rates. Stronger (larger falls in the growth rate of gross domestic product/capita) and longer (lasting 2 years rather than 1) downturns were associated with larger significant deteriorations (p<0.001). During economic downturns, countries in the poorest quartile experienced ∼1½ times greater deterioration in neonatal mortality, compared with their own baseline; a 3-fold deterioration in postneonatal mortality; a 9-fold deterioration in child mortality and a 3-fold deterioration in under-5 mortality, than countries in the wealthiest quartile (p<0.0005). For 1–5 years after downturns ended, each mortality measure continued to display significant deteriorations (p<0.0001). Conclusions Economic downturns occur frequently and are associated with significant deteriorations in child mortality, with worse declines in lower income countries. PMID:28589010

  5. Visual field progression in glaucoma: estimating the overall significance of deterioration with permutation analyses of pointwise linear regression (PoPLR).

    PubMed

    O'Leary, Neil; Chauhan, Balwantray C; Artes, Paul H

    2012-10-01

    To establish a method for estimating the overall statistical significance of visual field deterioration from an individual patient's data, and to compare its performance to pointwise linear regression. The Truncated Product Method was used to calculate a statistic S that combines evidence of deterioration from individual test locations in the visual field. The overall statistical significance (P value) of visual field deterioration was inferred by comparing S with its permutation distribution, derived from repeated reordering of the visual field series. Permutation of pointwise linear regression (PoPLR) and pointwise linear regression were evaluated in data from patients with glaucoma (944 eyes, median mean deviation -2.9 dB, interquartile range: -6.3, -1.2 dB) followed for more than 4 years (median 10 examinations over 8 years). False-positive rates were estimated from randomly reordered series of this dataset, and hit rates (proportion of eyes with significant deterioration) were estimated from the original series. The false-positive rates of PoPLR were indistinguishable from the corresponding nominal significance levels and were independent of baseline visual field damage and length of follow-up. At P < 0.05, the hit rates of PoPLR were 12, 29, and 42%, at the fifth, eighth, and final examinations, respectively, and at matching specificities they were consistently higher than those of pointwise linear regression. In contrast to population-based progression analyses, PoPLR provides a continuous estimate of statistical significance for visual field deterioration individualized to a particular patient's data. This allows close control over specificity, essential for monitoring patients in clinical practice and in clinical trials.

  6. Effectiveness of an educational self-management program for outpatients with chronic heart failure.

    PubMed

    Otsu, Haruka; Moriyama, Michiko

    2011-12-01

    The occurrence rate of chronic heart failure (CHF) in Japan is estimated to be 50,000 per one million persons. It is important for the Japanese medical financial system to institute a program of disease management in order to prevent the deterioration of persons with CHF. However, there are still few studies on the disease management of CHF in Japan. Therefore, the purpose of this study was to provide an educational self-management program to Japanese outpatients with CHF in order to improve their clinical outcomes. A randomized, controlled trial with 102 outpatients with CHF was conducted. There were 50 participants in the intervention group and 52 participants in the control group. The control group received medical treatment and standard care. In addition to this, the intervention group also received an educational program for 6 months. The program consisted of six nurse-directed sessions that were provided to each outpatient once per month in a clinical setting for a total of 6 months. A follow-up session was conducted each month for 6 months. The data collection was carried out at the start of the program and at 3, 6, 9, and 12 months. Significant differences could be observed in the primary and secondary outcomes and in the process indicators between the two groups after the program began. In other words, all the indicators improved for the intervention group, compared to the control group. Therefore, this program was considered to be effective. Further long-term care is necessary for outpatients with CHF in order to prevent their deterioration and to maintain their health status, even though this 6 month program did provide them with proper knowledge regarding self-care for CHF and affected their therapy results. © 2010 The Authors. Japan Journal of Nursing Science © 2010 Japan Academy of Nursing Science.

  7. Remote programming of cochlear implants: a telecommunications model.

    PubMed

    McElveen, John T; Blackburn, Erin L; Green, J Douglas; McLear, Patrick W; Thimsen, Donald J; Wilson, Blake S

    2010-09-01

    Evaluate the effectiveness of remote programming for cochlear implants. Retrospective review of the cochlear implant performance for patients who had undergone mapping and programming of their cochlear implant via remote connection through the Internet. Postoperative Hearing in Noise Test and Consonant/Nucleus/Consonant word scores for 7 patients who had undergone remote mapping and programming of their cochlear implant were compared with the mean scores of 7 patients who had been programmed by the same audiologist over a 12-month period. Times required for remote and direct programming were also compared. The quality of the Internet connection was assessed using standardized measures. Remote programming was performed via a virtual private network with a separate software program used for video and audio linkage. All 7 patients were programmed successfully via remote connectivity. No untoward patient experiences were encountered. No statistically significant differences could be found in comparing postoperative Hearing in Noise Test and Consonant/Nucleus/Consonant word scores for patients who had undergone remote programming versus a similar group of patients who had their cochlear implant programmed directly. Remote programming did not require a significantly longer programming time for the audiologist with these 7 patients. Remote programming of a cochlear implant can be performed safely without any deterioration in the quality of the programming. This ability to remotely program cochlear implant patients gives the potential to extend cochlear implantation to underserved areas in the United States and elsewhere.

  8. Medical-surgical nurses' perceived self-confidence and leadership abilities as first responders in acute patient deterioration events.

    PubMed

    Hart, Patricia L; Spiva, LeeAnna; Baio, Pamela; Huff, Barbara; Whitfield, Denice; Law, Tammy; Wells, Tiffany; Mendoza, Inocenica G

    2014-10-01

    To explore and understand medical-surgical nurses' perceived self-confidence and leadership abilities as first responders in recognising and responding to clinical deterioration prior to the arrival of an emergency response team. Patients are admitted to hospitals with multiple, complex health issues who are more likely to experience clinical deterioration. The majority of clinical deterioration events occur on medical-surgical units, and medical-surgical nurses are frequently the first healthcare professionals to identify signs and symptoms of clinical deterioration and initiate life-saving interventions. A prospective, cross-sectional, descriptive quantitative design using a survey method was used. Nurses were recruited from an integrated healthcare system located in the south-east United States. Nurses completed a demographic, a self-confidence and a leadership ability questionnaire. One hundred and forty-eight nurses participated in the study. Nurses felt moderately self-confident in recognising, assessing and intervening during clinical deterioration events. In addition, nurses felt moderately comfortable performing leadership skills prior to the arrival of an emergency response team. A significant, positive relationship was found between perceived self-confidence and leadership abilities. Age and certification status were significant predictors of nurses' leadership ability. Although nurses felt moderately self-confident and comfortable with executing leadership abilities, improvement is needed to ensure nurses are competent in recognising patients' deterioration cues and making sound decisions in taking appropriate, timely actions to rescue patients. Further strategies need to be developed to increase nurses' self-confidence and execution of leadership abilities in handling deterioration events for positive patient outcomes. Educational provisions should focus on various clinical deterioration events to build nurses' self-confidence and leadership abilities in handling clinical deterioration. Nurses should obtain national certification to increase their knowledge and clinical reasoning skills. © 2014 John Wiley & Sons Ltd.

  9. The Contribution of Therapist Effects to Patient Dropout and Deterioration in the Psychological Therapies.

    PubMed

    Saxon, David; Barkham, Michael; Foster, Alexis; Parry, Glenys

    2017-05-01

    In the psychological therapies, patient outcomes are not always positive. Some patients leave therapy prematurely (dropout), while others experience deterioration in their psychological well-being. The sample for dropout comprised patients (n = 10 521) seen by 85 therapists, who attended at least the initial session of one-to-one therapy and completed a Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) at pre-treatment. The subsample for patient deterioration comprised patients (n = 6405) seen by the same 85 therapists but who attended two or more sessions, completed therapy and returned a CORE-OM at pre-treatment and post-treatment. Multilevel modelling was used to estimate the extent of therapist effects for both outcomes after controlling for patient characteristics. Therapist effects accounted for 12.6% of dropout variance and 10.1% of deterioration variance. Dropout rates for therapists ranged from 1.2% to 73.2%, while rates of deterioration ranged from 0% to 15.4%. There was no significant correlation between therapist dropout rate and deterioration rate (Spearman's rho = 0.07, p = 0.52). The methods provide a reliable means for identifying therapists who return consistently poorer rates of patient dropout and deterioration compared with their peers. The variability between therapists and the identification of patient risk factors as significant predictors has implications for the delivery of safe psychological therapy services. Copyright © 2016 John Wiley & Sons, Ltd. Therapists play an important role in contributing to patient dropout and deterioration, irrespective of case mix. Therapist effects on patient dropout and deterioration appear to act independently. Being unemployed as a patient was the strongest predictor of both dropout and deterioration. Patient risk to self or others was also an important predictor. Copyright © 2016 John Wiley & Sons, Ltd.

  10. 76 FR 48006 - Limited Federal Implementation Plan; Prevention of Significant Deterioration; California; North...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-08

    ... Implementation Plan; Prevention of Significant Deterioration; California; North Coast Unified Air Quality Management District AGENCY: Environmental Protection Agency (EPA). ACTION: Final rule. SUMMARY: EPA is finalizing a limited Federal Implementation Plan (FIP) for the North Coast Unified Air Quality Management...

  11. 40 CFR 52.1280 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.1280 Section 52.1280 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) All applications and other information required pursuant to § 52... Address: Mississippi Department of Environmental Quality, Office of Pollution Control, Air Division, P.O...

  12. 40 CFR 52.1280 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.1280 Section 52.1280 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) All applications and other information required pursuant to § 52... Address: Mississippi Department of Environmental Quality, Office of Pollution Control, Air Division, P.O...

  13. 40 CFR 52.1778 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.1778 Section 52.1778 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a)-(b) [Reserved] (c) All applications and other information... Resources, Division of Air Quality, 1641 Mail Service Center, Raleigh, North Carolina 27699-1641 or local...

  14. 40 CFR 52.1778 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.1778 Section 52.1778 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a)-(b) [Reserved] (c) All applications and other information... Resources, Division of Air Quality, 1641 Mail Service Center, Raleigh, North Carolina 27699-1641 or local...

  15. 40 CFR 52.1778 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.1778 Section 52.1778 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a)-(b) [Reserved] (c) All applications and other information... Resources, Division of Air Quality, 1641 Mail Service Center, Raleigh, North Carolina 27699-1641 or local...

  16. 40 CFR 52.1778 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.1778 Section 52.1778 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a)-(b) [Reserved] (c) All applications and other information... Resources, Division of Air Quality, 1641 Mail Service Center, Raleigh, North Carolina 27699-1641 or local...

  17. 40 CFR 52.1280 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.1280 Section 52.1280 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) All applications and other information required pursuant to § 52... Address: Mississippi Department of Environmental Quality, Office of Pollution Control, Air Division, P.O...

  18. 40 CFR 52.1778 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.1778 Section 52.1778 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a)-(b) [Reserved] (c) All applications and other information... Resources, Division of Air Quality, 1641 Mail Service Center, Raleigh, North Carolina 27699-1641 or local...

  19. Tai-Chi for Residential Patients with Schizophrenia on Movement Coordination, Negative Symptoms, and Functioning: A Pilot Randomized Controlled Trial

    PubMed Central

    Ho, Rainbow T. H.; Au Yeung, Friendly S. W.; Lo, Phyllis H. Y.; Law, Kit Ying; Wong, Kelvin O. K.; Cheung, Irene K. M.; Ng, Siu Man

    2012-01-01

    Objective. Patients with schizophrenia residing at institutions often suffer from negative symptoms, motor, and functional impairments more severe than their noninstitutionalized counterparts. Tai-chi emphasizes body relaxation, alertness, and movement coordination with benefits to balance, focus, and stress relief. This pilot study explored the efficacy of Tai-chi on movement coordination, negative symptoms, and functioning disabilities towards schizophrenia. Methods. A randomized waitlist control design was adopted, where participants were randomized to receive either the 6-week Tai-chi program and standard residential care or only the latter. 30 Chinese patients with schizophrenia were recruited from a rehabilitation residency. All were assessed on movement coordination, negative symptoms, and functional disabilities at baseline, following intervention and 6 weeks after intervention. Results. Tai-chi buffered from deteriorations in movement coordination and interpersonal functioning, the latter with sustained effectiveness 6 weeks after the class was ended. Controls showed marked deteriorations in those areas. The Tai-chi group also experienced fewer disruptions to life activities at the 6-week maintenance. There was no significant improvement in negative symptoms after Tai-chi. Conclusions. This study demonstrated encouraging benefits of Tai-chi in preventing deteriorations in movement coordination and interpersonal functioning for residential patients with schizophrenia. The ease of implementation facilitates promotion at institutional psychiatric services. PMID:23304224

  20. Tai-chi for residential patients with schizophrenia on movement coordination, negative symptoms, and functioning: a pilot randomized controlled trial.

    PubMed

    Ho, Rainbow T H; Au Yeung, Friendly S W; Lo, Phyllis H Y; Law, Kit Ying; Wong, Kelvin O K; Cheung, Irene K M; Ng, Siu Man

    2012-01-01

    Objective. Patients with schizophrenia residing at institutions often suffer from negative symptoms, motor, and functional impairments more severe than their noninstitutionalized counterparts. Tai-chi emphasizes body relaxation, alertness, and movement coordination with benefits to balance, focus, and stress relief. This pilot study explored the efficacy of Tai-chi on movement coordination, negative symptoms, and functioning disabilities towards schizophrenia. Methods. A randomized waitlist control design was adopted, where participants were randomized to receive either the 6-week Tai-chi program and standard residential care or only the latter. 30 Chinese patients with schizophrenia were recruited from a rehabilitation residency. All were assessed on movement coordination, negative symptoms, and functional disabilities at baseline, following intervention and 6 weeks after intervention. Results. Tai-chi buffered from deteriorations in movement coordination and interpersonal functioning, the latter with sustained effectiveness 6 weeks after the class was ended. Controls showed marked deteriorations in those areas. The Tai-chi group also experienced fewer disruptions to life activities at the 6-week maintenance. There was no significant improvement in negative symptoms after Tai-chi. Conclusions. This study demonstrated encouraging benefits of Tai-chi in preventing deteriorations in movement coordination and interpersonal functioning for residential patients with schizophrenia. The ease of implementation facilitates promotion at institutional psychiatric services.

  1. Results of shuttle EMU thermal vacuum tests incorporating an infrared imaging camera data acquisition system

    NASA Technical Reports Server (NTRS)

    Anderson, James E.; Tepper, Edward H.; Trevino, Louis A.

    1991-01-01

    Manned tests in Chamber B at NASA JSC were conducted in May and June of 1990 to better quantify the Space Shuttle Extravehicular Mobility Unit's (EMU) thermal performance in the cold environmental extremes of space. Use of an infrared imaging camera with real-time video monitoring of the output significantly added to the scope, quality and interpretation of the test conduct and data acquisition. Results of this test program have been effective in the thermal certification of a new insulation configuration and the '5000 Series' glove. In addition, the acceptable thermal performance of flight garments with visually deteriorated insulation was successfully demonstrated, thereby saving significant inspection and garment replacement cost. This test program also established a new method for collecting data vital to improving crew thermal comfort in a cold environment.

  2. 40 CFR 52.200 - Original identification of plan section.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... plan to incorporate Federal Prevention of Significant Deterioration (PSD) Regulations 40 CFR 52.21 by... Plan for Prevention of Significant Deterioration (PSD) of Air Quality Supplement Arkansas Plan of Implementation for Air Pollution Control (PSD nitrogen dioxide increments), as adopted on May 25, 1990, by the...

  3. 40 CFR 52.200 - Original identification of plan section.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... plan to incorporate Federal Prevention of Significant Deterioration (PSD) Regulations 40 CFR 52.21 by... Plan for Prevention of Significant Deterioration (PSD) of Air Quality Supplement Arkansas Plan of Implementation for Air Pollution Control (PSD nitrogen dioxide increments), as adopted on May 25, 1990, by the...

  4. 40 CFR 52.200 - Original identification of plan section.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... plan to incorporate Federal Prevention of Significant Deterioration (PSD) Regulations 40 CFR 52.21 by... Plan for Prevention of Significant Deterioration (PSD) of Air Quality Supplement Arkansas Plan of Implementation for Air Pollution Control (PSD nitrogen dioxide increments), as adopted on May 25, 1990, by the...

  5. 75 FR 6823 - Prevention of Significant Deterioration (PSD) and Nonattainment New Source Review (NSR...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-11

    ...-AP73 Prevention of Significant Deterioration (PSD) and Nonattainment New Source Review (NSR... Review (NSR): Reconsideration of Fugitive Emissions'' (``Fugitive Emissions Rule''). The Fugitive... whether a physical or operation change results in a major modification only for sources in industries that...

  6. Sociodemographic patterning of long-term diabetes mellitus control following Japan's 3.11 triple disaster: a retrospective cohort study.

    PubMed

    Leppold, Claire; Tsubokura, Masaharu; Ozaki, Akihiko; Nomura, Shuhei; Shimada, Yuki; Morita, Tomohiro; Ochi, Sae; Tanimoto, Tetsuya; Kami, Masahiro; Kanazawa, Yukio; Oikawa, Tomoyoshi; Hill, Sarah

    2016-07-07

    To assess the sociodemographic patterning of changes in glycaemic control of patients with diabetes affected by the 2011 triple disaster in Japan (earthquake, tsunami and nuclear accident). A retrospective cohort study was undertaken with 404 patients with diabetes at a public hospital in Minamisoma City, Fukushima Prefecture. Glycated haemoglobin (HbA1c) levels were measured in 2010, 2011 and 2012 to capture changes in glycaemic control postdisaster. Age, sex, urban/rural residency, evacuation status and medication use were also assessed. There was an overall deterioration in glycaemic control after the disaster, with the mean HbA1c rising from 6.77% in 2010 to 6.90% in 2012 (National Glycohemoglobin Standardization Program, NGSP). Rural residency was associated with a lower likelihood of deteriorating control (OR 0.34, 95% CI 0.13 to 0.84), compared with urban residency. Older age (OR 0.95, 95% CI 0.91 to 0.98) was also slightly protective against increased HbA1c. Evacuation and sex were not significant predictors. Patients with diabetes who were affected by Japan's triple disaster experienced a deterioration in their glycaemic control following the disasters. The extent of this deterioration was mediated by sociodemographic factors, with rural residence and older age protective against the effects of the disaster on glycaemic control. These results may be indicative of underlying social determinants of health in rural Japan. 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/

  7. Protect and enhance: Lowi's juridical democracy and the prevention of significant deterioration of air quality

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

    Meiburg, A.S.

    1986-01-01

    The capture of Federal regulatory agencies by the groups they were supposed to be regulating has been a topic of concern in the traditional literature of public administration. In his influential book The End of Liberalism, Professor Theordore Lowi suggested that capture resulted in part from vauge delegations of authority of Congress to regulatory agencies. Lowi argued that democracy would be better served if Congress were more specific in drafting laws, if agencies made greater use of formal rulemaking in implementing them, and if the courts rejected statutes which contained excessively vague delegations of authority - a remedy which hemore » labeled juridicial democracy. This dissertation examines Lowi's theory in light of the experience of Congress and the Environmental Protection Agency (EPA) with the requirements of the Clean Air Act to prevent the significant deterioration of air quality in areas where air was already relatively clean. The history of the program to develop and carry out these requirements, known as PSD, is described in detail from its inception in the late 1960's through EPA's final regulations in 1980. Special attention is given to the actions taken by EPA after environmental groups successfully used the courts to force EPA to develop a PSD program in 1974, how Congress responded by amending the Clean Air Act in 1977, and the difficulties these amendments and subsequent additional court reviews caused for EPA.« less

  8. 40 CFR 52.2233 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., Nashville, Tennessee 37243-1531, or local agencies, Knox County Air Quality Management-Department of Public... quality. 52.2233 Section 52.2233 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a)(1) Paragraph 1200-3-9-.01(4)-(0)-2. of Tennessee's regulations...

  9. 40 CFR 52.1987 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.1987 Section 52.1987 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (d) The requirements of sections 160 through 165 of the Clean Air... Quality rules identified in paragraph (a) of this section, and the Lane Regional Air Pollution Authority...

  10. 40 CFR 52.1634 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.1634 Section 52.1634 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Significant deterioration of air quality. (a) The plan submitted by the Governor of New Mexico on February 21... adopted by the NMEID on March 9, 1990), Air Quality Control Regulation 707—Permits, Prevention of...

  11. 24-weeks Pilates-aerobic and educative training to improve body fat mass in elderly Serbian women.

    PubMed

    Ruiz-Montero, Pedro Jesús; Castillo-Rodriguez, Alfonso; Mikalački, Milena; Nebojsa, Cokorilo; Korovljev, Darinka

    2014-01-01

    The purpose of this study was to examine the differences in anthropometric measurements using an aerobic and Pilates exercise program which lasted 24 weeks. This was a clinical intervention study of 303 women over the age of 60 living in Novi Sad, Serbia. Changes in body mass index and skinfold thickness were estimated through height, weight, and anthropometric measurements. The program comprised Pilates exercises for upper- and lower-body strength, agility, and aerobic capacity. Fat mass (FM) improved significantly (pre-test, 32.89%, 8.65; post-test, 28.25%, 6.58; P<0.01). Bone diameters and muscle perimeters showed no significant changes pre- and post-test (P>0.05), but there was a higher correlation between FM (%) and waist-hip ratio (rho, 0.80; P<0.01). A mixed program of aerobics and Pilates, controls and improves baseline muscle mass and decreases FM values, without causing deterioration during practice and follow-up exercises.

  12. Analytical condition inspection and extension of time between overhaul of F3-30 engine

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

    Nakao, M.; Ikeyama, M.; Abe, S.

    1992-04-01

    F3-30 is the low-bypass-ratio turbofan engine developed to power the T-4 intermediate trainer for the Japan Air Self Defense Force (JASDF). The actual field service was started in Sept., 1988. This paper reports on the program to extend time between overhaul (TBO) of the F3-30 which has been running. Analytical condition inspection (ACI) and accelerated mission testing (AMT) were conducted to confirm sufficient durability to extend TBO. Most deteriorations of parts and performance due to AMT were also found by ACI after field operation with approximately the same deterioration rate. On the other hand, some deteriorations were found by ACImore » only. These results show that ACI after field operation is also necessary to confirm the TBO extension, although AMT simulates the deterioration in field operations very well. The deteriorations that would be caused by the field operation during one extended-TBO were estimated with the results of ACI and AMT, and it was concluded that the F3-30 has sufficient durability for TBO extension to the next step.« less

  13. Weatherwise: evaluation of a cue-based training approach for the recognition of deteriorating weather conditions during flight.

    PubMed

    Wiggins, Mark; O'Hare, David

    2003-01-01

    Inappropriate and ineffective weather-related decision making continues to account for a significant proportion of general aviation fatalities in the United States and elsewhere. This study details the evaluation of a computer-based training system that was developed to provide visual pilots with the skills necessary to recognize and respond to the cues associated with deteriorating weather conditions during flight. A total of 66 pilots were assigned to one of two groups, and the evaluation process was undertaken at both a self-report and performance level. At the self-report level, the results suggested that pilots were more likely to use the cues following exposure to the training program. From a performance perspective, there is evidence to suggest that cue-based training can improve the timeliness of weather-related decision making during visual flight rules flight. Actual or potential applications of this research include the development of computer-based training systems for fault diagnosis in complex industrial environments.

  14. Performance of lap splices in large-scale column specimens affected by ASR and/or DEF.

    DOT National Transportation Integrated Search

    2012-06-01

    This research program conducted a large experimental program, which consisted of the design, construction, : curing, deterioration, and structural load testing of 16 large-scale column specimens with a critical lap splice : region, and then compared ...

  15. 75 FR 19567 - Prevention of Significant Deterioration (PSD) and Nonattainment New Source Review (NSR...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-15

    ...-AP80 Prevention of Significant Deterioration (PSD) and Nonattainment New Source Review (NSR... changed our interpretation of the PSD and nonattainment NSR regulations relating to the definition of... Historic Approach Under both the nonattainment NSR provisions of the CAA as well as the PSD provisions, a...

  16. 75 FR 28227 - Prevention of Significant Deterioration (PSD) and Nonattainment New Source Review (NSR): Aggregation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-20

    ... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Parts 51 and 52 [EPA-HQ-OAR-2003-0064, FRL-9151-3] RIN 2060-AP80 Prevention of Significant Deterioration (PSD) and Nonattainment New Source Review (NSR): Aggregation Correction Proposed Rule document 2010-11578 was inadvertently published in the Rules and...

  17. New Source Review (NSR) Program Supplemental Transitional Guidance on Applicability of New Part D NSR Permit Requirements

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  18. Department of Interior Procedures for Determinations of Adverse Impact on Certain Federal Lands under the PSD Program

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  19. Request For Guidance in Drafting a SIP Deficiency Notice For Michigan's Nonattainment New Source Review Program

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  20. Request for Clarification of EPA Guidance on the Alternative Fuels Exemption under the PSD Program

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  1. Guidance Concerning the Implementation of the 1-hour NO2 NAAQS for the PSD Program

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  2. Guidance on Early Delegation of Authority for the NO2 Increments Program

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  3. Response to Letter on the Use of Sulfur Dioxide Allowances Allocated Under the Acid Rain Program

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  4. Strengthening the afferent limb of rapid response systems: an educational intervention using web-based learning for early recognition and responding to deteriorating patients.

    PubMed

    Liaw, Sok Ying; Wong, Lai Fun; Ang, Sophia Bee Leng; Ho, Jasmine Tze Yin; Siau, Chiang; Ang, Emily Neo Kim

    2016-06-01

    The timely recognition and response to patients with clinical deteriorations constitute the afferent limb failure of a rapid response system (RRS). This area is a persistent problem in acute healthcare settings worldwide. In this study, we evaluated the effect of an educational programme on improving the nurses' knowledge and performances in recognising and responding to clinical deterioration. The interactive web-based programme addressed three areas: (1) early detection of changes in vital signs; (2) performance of nursing assessment and interventions using airway, breathing, circulation, disability and expose/examine and (3) reporting clinical deterioration using identity, situation, background, assessment and recommendation. Sixty-seven registered nurses participated in the randomised control study. The experimental group underwent a 3 h programme while the control group received no intervention. Pretests and post-tests, a mannequin-based assessment and a multiple-choice knowledge questionnaire were conducted. We evaluated the participants' performances in assessing, managing and reporting the deterioration of a patient using a validated performance tool. A significantly higher number of nurses from the experimental group than the control group monitored respiratory rates (48.2% vs 25%, p<0.05) and pulse rates (74.3% vs 37.5%, p<0.01) in the simulated environment, after the intervention. The post-test mean scores of the experimental group was significantly higher than the control group for knowledge (21.29 vs 18.28, p<0.001), performance in assessing and managing clinical deterioration (25.83 vs 19.50, p<0.001) and reporting clinical deterioration (12.83 vs 10.97, p<0.001). A web-based educational programme developed for hospital nurses to strengthen the afferent limb of the RRS significantly increased their knowledge and performances in assessing, managing and reporting clinical deterioration. 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/

  5. Effects of economic crises on population health outcomes in Latin America, 1981–2010: an ecological study

    PubMed Central

    Williams, Callum; Gilbert, Barnabas James; Zeltner, Thomas; Watkins, Johnathan; Atun, Rifat; Maruthappu, Mahiben

    2016-01-01

    Objectives The relative health effects of changes in unemployment, inflation and gross domestic product (GDP) per capita on population health have not been assessed. We aimed to determine the effect of changes in these economic measures on mortality metrics across Latin America. Design Ecological study. Setting Latin America (21 countries), 1981–2010. Outcome measures Uses multivariate regression analysis to assess the effects of changes in unemployment, inflation and GDP per capita on 5 mortality indicators across 21 countries in Latin America, 1981–2010. Country-specific differences in healthcare infrastructure, population structure and population size were controlled for. Results Between 1981 and 2010, a 1% rise in unemployment was associated with statistically significant deteriorations (p<0.05) in 5 population health outcomes, with largest deteriorations in 1–5 years of age and male adult mortality rates (1.14 and 0.53 rises per 1000 deaths respectively). A 1% rise in inflation rate was associated with significant deteriorations (p<0.05) in 4 population health outcomes, with the largest deterioration in male adult mortality rate (0.0033 rise per 1000 deaths). Lag analysis showed that 5 years after rises in unemployment and inflation, significant deteriorations (p<0.05) occurred in 3 and 5 mortality metrics, respectively. A 1% rise in GDP per capita was associated with no significant deteriorations in population health outcomes either in the short or long term. β coefficient comparisons indicated that the effect of unemployment increases was substantially greater than that of changes in GDP per capita or inflation. Conclusions Rises in unemployment and inflation are associated with long-lasting deteriorations in several population health outcomes. Unemployment exerted much larger effects on health than inflation. In contrast, changes in GDP per capita had almost no association with the explored health outcomes. Contrary to neoclassical development economics, policymakers should prioritise amelioration of unemployment if population health outcomes are to be optimised. PMID:26739715

  6. B747/JT9D flight loads and their effect on engine running clearances and performance deterioration; BCAC NAIL/P and WA JT9D engine diagnostics programs

    NASA Technical Reports Server (NTRS)

    Olsson, W. J.; Martin, R. L.

    1982-01-01

    Flight loads on the 747 propulsion system and resulting JT9D blade to outer airseal running clearances during representative acceptance flight and revenue flight sequences were measured. The resulting rub induced clearance changes, and engine performance changes were then analyzed to validate and refine the JT9D-7A short term performance deterioration model.

  7. Longitudinal health-related quality of life analysis in oncology with time to event approaches, the STATA command qlqc30_TTD.

    PubMed

    Bascoul-Mollevi, C; Savina, Marion; Anota, Amélie; Barbieri, Antoine; Azria, David; Bonnetain, Franck; Gourgou, Sophie

    2018-05-01

    Health-related quality of life (HRQoL) has become one relevant and available alternative endpoint of clinical trials in cancer research to evaluate efficiency of care both for the patient and health system. HRQoL in oncology is mainly assessed using the 30-item European Organisation for Research and Treatment of Cancer Quality of Life-Questionnaire Core 30 (EORTC QLQ-C30). The EORTC QLQ-C30 questionnaire is usually assessed at different times along the clinical trials in order to analyze the kinetics of HRQoL evolution and to fully assess the impact of the treatment on the patient's HRQoL level. In this perspective, the realization of a longitudinal HRQoL analysis is essential and the time to HRQoL score deterioration approach is a method which is more and more used in clinical trials. Using the Stata software, we developed a QLQ-C30 specific command, qlqc30_TTD, which implements longitudinal strategies based on the time to event methods by considering the time to HRQoL score deterioration. This user-written command providing automatic execution of the Time To Deterioration (TTD) and Time Until Definitive Deterioration (TUDD) methods. The program implements all published definitions and provides the Kaplan-Meier curves for each dimension (by group) and a table with the Hazard Ratio and Log-Rank test. The longitudinal analysis of HRQoL data in cancer clinical trials remains complex with only few programs like ours computed. This program will be of great help and will allow a more systematic and quicker analysis of the HRQoL data in clinical trials in oncology. Copyright © 2018. Published by Elsevier B.V.

  8. Deterioration is Winning the Library Stakes

    ERIC Educational Resources Information Center

    Ready, William B.

    1978-01-01

    Lack of conservation programs, inadequate and improper storage facilities for archives, and lack of book repair personnel and restoration programs have resulted in a life expectancy of less than 50 years for most library holdings. Recent efforts to find solutions to the problem are identified. (JAB)

  9. 36 CFR 72.11 - Action program components.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... of the Action Program will be placed on the rehabilitation of deteriorating facilities, it also will describe how the rehabilitation effort is linked to the overall goals, priorities and strategies of the... linked to the objectives, needs, plans, and institutional arrangements of the community. The Action...

  10. 40 CFR 52.2454 - Prevention of significant deterioration of air quality for Merck & Co., Inc.'s Stonewall Plant in...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... significant deterioration of air quality preconstruction review requirements for the following pollutants only... (PM2.5) regulated as PM2.5; however, the preconstruction review requirements of § 52.21, or other preconstruction review requirements that the Administrator approves as part of the plan, shall remain in effect...

  11. 40 CFR 52.2454 - Prevention of significant deterioration of air quality for Merck & Co., Inc.'s Stonewall Plant in...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... significant deterioration of air quality preconstruction review requirements for the following pollutants only... (PM2.5) regulated as PM2.5; however, the preconstruction review requirements of § 52.21, or other preconstruction review requirements that the Administrator approves as part of the plan, shall remain in effect...

  12. 78 FR 6818 - Notice of Issuance of Prevention of Significant Deterioration Modification and Part 71 Operating...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-31

    ..., EPA issued a Modification to a Prevention of Significant Deterioration (PSD) permit to NRG Backup..., Minnesota. The modified PSD permit changes the required interval of nitrogen oxide performance testing for... comment period, which ended on October 19, 2012, EPA received a comment on the modified draft PSD permit...

  13. Cigarette smoking reduced renal function deterioration in hypertensive patients may be mediated by elevated homocysteine.

    PubMed

    Huang, Feifei; Chen, Jie; Liu, Xun; Han, Feng; Cai, Qingqing; Peng, Guicheng; Zhang, Kun; Chen, Weiqing; Wang, Jingfeng; Huang, Hui

    2016-12-27

    Elevated homocysteine (HCY) and smoking are both important risk factors for hypertensive patients. However, whether they have crossing effect on renal function deterioration of hypertensive patients and what is the underlying mechanism are unclear. In the present study, 3033 participants diagnosed as essential hypertension with estimated glomerular filtration rate (eGFR)> 30 ml/min/1.73 m2 from southern China were enrolled in this cross-sectional study. We collected the demographic and clinical data. In addition, the mediation effects were analyzed. The results showed that, comparing with non-smokers, smokers had significant higher levels of HCY (13.10 (11.20-16.87) vs. 11.00 (8.90-13.40) umol/L, P < 0.001) and lower eGFR (79.71 (66.83-91.05) vs. 82.89 (69.80-95.85) ml/min/1.73m2, P < 0.001). HCY levels and smoking were independently associated with decreased eGFR. Meanwhile, eGFR levels were significantly negatively correlated with HCY (P < 0.001), and this correlation might be stronger in current smokers. Current smoker consuming over 20 cigarettes per day would accelerate early renal function deterioration (OR = 1.859, P = 0.019). The mediation effects analysis further showed that the association between smoking and renal function deterioration was mediated by HCY. And elevated HCY was accounted for 56.94% of the estimated causal effect of smoking on renal function deterioration in hypertensive patients. Our findings indicated that cigarette smoking was associated with renal function deterioration in hypertensive patients, and the association between cigarette smoking and renal function deterioration was probably mediated by elevated HCY. Therefore, HCY-lowering therapy may be beneficial for renal function deterioration in hypertensive smoking patients.

  14. The effect of consecutive extended duty hours on the cognitive and behavioural performance of paediatric medicine residents.

    PubMed

    Qureshi, Ahmad Usaid; Ali, Agha Shabbir; Hafeez, Arifa; Ahmad, Tahir Masood

    2010-08-01

    To compare the performance of paediatric medicine residents following a regular 6 hour and an extended 24 hour call and their own insight into their performance following each duty. The study was conducted at The Children's Hospital, Lahore, from September 2007 to November, 2008. All tasks were performed twice, after 6 hour call and 24 hour long call, evaluating Reaction timer, Concentration test, Number Connection Test, State Trait Anger Anxiety Inventory (STAXI) response for trait anger and modified Wechsler Memory Scale inventory (WMS-R) for cognitive performance. Likert's self assessment tool was used for both set of performances. Thirty two paediatric medicine residents (male 53.1%; female 46.9%) were enrolled in the study with identical duty structure performing 74 hours per week with mean age of 27.53 +/- 0.32 years and mean experience of 3.69 +/- 0.32 years. There was significant deterioration in both verbal recall and logic memory (mean difference in score of 1.81 (95% C.I 1.25-2.37, p < 0.001). Concentration test also showed significantly fewer responses (24 hour mean 239.56, 95% C.I. 228-251.13) vs (6 hour mean 258.94, 95% C.I. 247.42-270.46) in 5 minutes, p < 0.001. Reaction time, vigilance and hand eye coordination was significantly affected after an extended call, p < 0.001. Number of lapses in attention also rose significantly, p < 0.001. STAXI response showed significant increase in anger scores, p = 0.001. Despite the significantly poor performance, the residents could not appreciate the deterioration in their performance with Likert's self assessment score that differed only by 0.63 (95% CI -0.12-1.37), p = 0.1. None of the other factors studied correlated with deterioration in performance of any specific task except the length of duty hours. Continuous long stretch of duty causes significant deterioration in cognitive and behavioural status of residents. More importantly, the residents themselves are unable to appreciate this deterioration. Residents must be made aware of this deterioration as there is a higher risk of medical errors and bad judgments, risking patient safety.

  15. Performance deterioration of commercial high-bypass ratio turbofan engines

    NASA Technical Reports Server (NTRS)

    Mehalic, C. M.; Ziemianski, J. A.

    1980-01-01

    The results of engine performance deterioration investigations based on historical data, special engine tests, and specific tests to define the influence of flight loads and component clearances on performance are presented. The results of analyses of several damage mechanisms that contribute to performance deterioration such as blade tip rubs, airfoil surface roughness and erosion, and thermal distortion are also included. The significance of these damage mechanisms on component and overall engine performance is discussed.

  16. 75 FR 56106 - Notice of Prevention of Significant Deterioration Final Determination for Power Holdings of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-15

    ... Deterioration (PSD) permit issued to Power Holdings of Illinois, LLC, by the Illinois Environmental Protection... under authority of a PSD delegation agreement, issued a PSD permit to Power Holdings of Illinois, LLC...

  17. Adverse Housing Conditions and Early-Onset Delinquency.

    PubMed

    Jackson, Dylan B; Newsome, Jamie; Lynch, Kellie R

    2017-09-01

    Housing constitutes an important health resource for children. Research has revealed that, when housing conditions are unfavorable, they can interfere with child health, academic performance, and cognition. Little to no research, however, has considered whether adverse housing conditions and early-onset delinquency are significantly associated with one another. This study explores the associations between structural and non-structural housing conditions and delinquent involvement during childhood. Data from the Fragile Families and Child Wellbeing Study (FFCWS) were employed in this study. Each adverse housing condition was significantly associated with early-onset delinquency. Even so, disarray and deterioration were only significantly linked to early delinquent involvement in the presence of health/safety hazards. The predicted probability of early-onset delinquency among children exposed to housing risks in the presence of health/safety hazards was nearly three times as large as the predicted probability of early-onset delinquency among children exposed only to disarray and/or deterioration, and nearly four times as large as the predicted probability of early-onset delinquency among children exposed to none of the adverse housing conditions. The findings suggest that minimizing housing-related health/safety hazards among at-risk subsets of the population may help to alleviate other important public health concerns-particularly early-onset delinquency. Addressing household health/safety hazards may represent a fruitful avenue for public health programs aimed at the prevention of early-onset delinquency. © Society for Community Research and Action 2017.

  18. Microbiologically induced deterioration of concrete - A Review

    PubMed Central

    Wei, Shiping; Jiang, Zhenglong; Liu, Hao; Zhou, Dongsheng; Sanchez-Silva, Mauricio

    2013-01-01

    Microbiologically induced deterioration (MID) causes corrosion of concrete by producing acids (including organic and inorganic acids) that degrade concrete components and thus compromise the integrity of sewer pipelines and other structures, creating significant problems worldwide. Understanding of the fundamental corrosion process and the causal agents will help us develop an appropriate strategy to minimize the costs in repairs. This review presents how microorganisms induce the deterioration of concrete, including the organisms involved and their colonization and succession on concrete, the microbial deterioration mechanism, the approaches of studying MID and safeguards against concrete biodeterioration. In addition, the uninvestigated research area of MID is also proposed. PMID:24688488

  19. Sporadic inclusion body myositis: pilot study on the effects of a home exercise program on muscle function, histopathology and inflammatory reaction.

    PubMed

    Arnardottir, Snjolaug; Alexanderson, Helene; Lundberg, Ingrid E; Borg, Kristian

    2003-01-01

    To evaluate the safety and effect of a home training program on muscle function in 7 patients with sporadic inclusion body myositis. The patients performed exercise 5 days a week over a 12-week period. Safety was assessed by clinical examination, repeated muscle biopsies and serum levels of creatine kinase. Muscle strength was evaluated by clinical examination, dynamic dynamometer and by a functional index in myositis. Strength was not significantly improved after the exercise, however none of the patients deteriorated concerning muscle function. The histopathology was unchanged and there were no signs of increased muscle inflammation or of expression of cytokines and adhesion molecules in the muscle biopsies. Creatine kinase levels were unchanged. A significant decrease was found in the areas that were positively stained for EN-4 (a marker for endothelial cells) in the muscle biopsies after training. The home exercise program was considered as not harmful to the muscles regarding muscle inflammation and function. Exercise may prevent loss of muscle strength due to disease and/or inactivity.

  20. Effects of economic crises on population health outcomes in Latin America, 1981-2010: an ecological study.

    PubMed

    Williams, Callum; Gilbert, Barnabas James; Zeltner, Thomas; Watkins, Johnathan; Atun, Rifat; Maruthappu, Mahiben

    2016-01-06

    The relative health effects of changes in unemployment, inflation and gross domestic product (GDP) per capita on population health have not been assessed. We aimed to determine the effect of changes in these economic measures on mortality metrics across Latin America. Ecological study. Latin America (21 countries), 1981-2010. Uses multivariate regression analysis to assess the effects of changes in unemployment, inflation and GDP per capita on 5 mortality indicators across 21 countries in Latin America, 1981-2010. Country-specific differences in healthcare infrastructure, population structure and population size were controlled for. Between 1981 and 2010, a 1% rise in unemployment was associated with statistically significant deteriorations (p<0.05) in 5 population health outcomes, with largest deteriorations in 1-5 years of age and male adult mortality rates (1.14 and 0.53 rises per 1000 deaths respectively). A 1% rise in inflation rate was associated with significant deteriorations (p<0.05) in 4 population health outcomes, with the largest deterioration in male adult mortality rate (0.0033 rise per 1000 deaths). Lag analysis showed that 5 years after rises in unemployment and inflation, significant deteriorations (p<0.05) occurred in 3 and 5 mortality metrics, respectively. A 1% rise in GDP per capita was associated with no significant deteriorations in population health outcomes either in the short or long term. β coefficient comparisons indicated that the effect of unemployment increases was substantially greater than that of changes in GDP per capita or inflation. Rises in unemployment and inflation are associated with long-lasting deteriorations in several population health outcomes. Unemployment exerted much larger effects on health than inflation. In contrast, changes in GDP per capita had almost no association with the explored health outcomes. Contrary to neoclassical development economics, policymakers should prioritise amelioration of unemployment if population health outcomes are to be optimised. 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/

  1. Effect of daily short-duration weight-bearing on disuse-induced deterioration of musculoskeletal system

    PubMed Central

    Leung, K-S.; Li, Y-H.; Liu, Y.; Wang, H.; Tam, K-F.; Chow, D.H.K.; Wan, Y.; Ling, S.; Dai, Z.; Qin, L.; Cheung, W-H.

    2015-01-01

    Objectives: To investigate deterioration of musculoskeletal system due to prolonged disuse and the potential of daily short-duration weight-bearing as countermeasures. Methods: Twenty-four adult male Sprague-Dawley rats were divided into Control Group (CG, no intervention), Tail-suspension Group (TG, tail-suspension without treatment), and Weight-Bearing Group (WBG, tail-suspension with 20 min/day, 5 days/week body weight loading). After four weeks of treatment, femur and tibia, soleus and extensor digitorum longus were evaluated for bone and muscle quality respectively. Tensile properties of bone-tendon insertion (BTI) were evaluated using patella-patellar tendon complex. Results: Disuse induced deterioration on bone, muscle, and BTI after four weeks. Compared with CG, TG and WBG showed significant decrease in bone mineral density (BMD) of trabecular bone in distal femur (4.3-15.2%), muscle mass (31.3-52.3%), muscle cross-sectional area (29.1-35%), and failure strength of BTI (23.9-29.4%). Tensile test showed that the failure mode was avulsion of bone at the BTI. No significant difference was detected between TG and WBG for all assessments on bone, muscle, and BTI. Conclusions: Disuse caused deterioration of bone, muscle, and BTI while daily short-duration of weight-bearing did not prevent this deterioration. Mechanical stimulation with higher intensity and longer duration may be necessary to prevent musculoskeletal deterioration resulted from prolonged disuse. PMID:26032214

  2. 77 FR 64237 - Notice of Approval of Clean Air Act Prevention of Significant Deterioration Permit Issued to the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-19

    ... Air Act Prevention of Significant Deterioration (PSD) permit for the City of Palmdale (City) for the construction of the Palmdale Hybrid Power Project (PHPP). DATES: EPA Region 9 issued a final PSD permit... decision can obtain them at http://www.epa.gov/eab/ . A copy of the PSD permit is also available at http...

  3. Development, implementation, and evaluation of a mental rehearsal strategy to improve clinical performance and reduce stress: A mixed methods study.

    PubMed

    Ignacio, Jeanette; Dolmans, Diana; Scherpbier, Albert; Rethans, Jan-Joost; Lopez, Violeta; Liaw, Sok Ying

    2016-02-01

    Mental rehearsal is a form of mental training that has been used by physicians and nurses to improve performance of clinical skills, and as a vital component of stress management training. To help novice nurses deal with often stressful clinical events that require the processing of information essential to patient management, a mental rehearsal strategy was developed and implemented in a Year 3 nursing simulation program. Inherent to mental rehearsal is imagery, which facilitates cognitive and affective modification, and reduction of extraneous cognitive load. As such, it was expected that the mental rehearsal strategy would improve students' performance and reduce stress in managing deteriorating patients. The study used a mixed methods design. Eighteen Year 3 nursing students participated in the pre- and post-design study, which consisted of the development and implementation of a mental rehearsal strategy. The Rescuing A Patient In Deteriorating Situations (RAPIDS) tool was used to assess performance. Heart rates and systolic blood pressures were used to measure stress. The State-Trait Anxiety Inventory (STAI) was used as a psychological measure of stress/anxiety. Five participants were involved in a focus group discussion that evaluated the usefulness of the mental rehearsal strategy. There was a significant improvement in performance (P<0.05). However, post-test heart rate and systolic blood pressure were not significantly different from pre-test measures. A comparison of STAI results did not show significant differences between pre- and post-test state anxiety and pre- and post-test trait anxiety. Three themes emerged from the focus group interview: managing stress, using a mental framework, and integrating realistic simulations with the mental rehearsal strategy. The mental rehearsal strategy for deteriorating patient management can be valuable based on the findings on performance and based on the participants' feedback. Its role in reducing stress, however, needs further evaluation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Response to Questions Concerning The Ozone Transport Commission's Investigation of the Possibility of a Regionwide Nitrogen Oxide (NOx) Offsets Trading Program.

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  5. Major Source Determinations for Military Installations under the Air Toxics, New Source Review, and Title V Operating Permit Programs of the Clean Air Act (Act)

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  6. Response to Request for Determination as to whether EPA's Emission Offset Policy (41 FR 55525) Applies to FEA's Strategic Petroleum Reserve Program

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  7. Vital signs monitoring to detect patient deterioration: An integrative literature review.

    PubMed

    Mok, Wen Qi; Wang, Wenru; Liaw, Sok Ying

    2015-05-01

    Vital signs monitoring is an important nursing assessment. Yet, nurses seem to be doing it as part of a routine and often overlooking their significance in detecting patient deterioration. An integrative literature review was conducted to explore factors surrounding ward nursing practice of vital signs monitoring in detecting and reporting deterioration. Twenty papers were included. The structural component of a Nursing Role Effectiveness Model framework, which comprises of patient, nurse and organizational variables, was used to synthesize the review. Patient variables include signs of deterioration displayed by patients which include physical cues and abnormal vital signs. Nursing variables include clinical knowledge, roles and responsibilities, and reporting of deteriorating vital signs. Organizational variables include heavy workload, technology, and observation chart design. This review has highlighted current nursing practice in vital signs monitoring. A myriad of factors were found to surround ward practice of vital signs monitoring in detecting and reporting deterioration. © 2015 Wiley Publishing Asia Pty Ltd.

  8. Body-mass dependence of age-related deterioration in human muscular function.

    PubMed

    Meltzer, D E

    1996-04-01

    Maximal anaerobic power of human muscles declines with increasing chronological age and is correlated with body mass. This study investigated whether the rate of deterioration in human muscular function among trained weight lifters is also correlated with body mass. Cross-sectional analysis of performance data of over 1,100 Masters competitors in Olympic-style weight lifting was carried out; eight body-weight classes and six age groups were represented. Two-lift total data (sum of snatch and clean and jerk lifts) were analyzed. Mean deterioration rates in the performance of athletes of widely diverse body masses were compared over the following age ranges: 42-57, 42-62, and 42-67 yr. No statistically significant correlation (P < 0.05) was found between rate of performance decline and body mass. The relationship between body mass and the magnitude of age-related variation of deterioration rate was also studied; no significant correlation was found. Previous studies have demonstrated that performance in Olympic-style weight lifting is correlated with maximal anaerobic muscular power. This leads us to suggest that the age-related deterioration rate of anaerobic power in trained subjects may not be correlated with the body mass of the individual.

  9. E-simulation: preregistration nursing students' evaluation of an online patient deterioration program.

    PubMed

    Cant, Robyn; Young, Susan; Cooper, Simon J; Porter, Joanne

    2015-03-01

    This study explores preregistration nursing students' views of a Web-based simulation program: FIRST ACTWeb (Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends-Web). The multimedia program incorporating three videoed scenarios portrayed by a standardized patient (human actor) aims to improve students' recognition and management of hospital patient deterioration. Participants were 367 final-year nursing students from three universities who completed an online evaluation survey and 19 students from two universities who attended one of five focus groups. Two researchers conducted a thematic analysis of the transcribed narratives. Three core themes identified were as follows: "ease of program use," "experience of e-Simulation," and "satisfaction with the learning experience." The Web-based clinical learning environment was endorsed as functional, feasible, and easy to use and was reported to have high fidelity and realism. Feedback in both focus groups and surveys showed high satisfaction with the learning experience. Overall, evaluation suggested that the Web-based simulation program successfully integrated elements essential for blended learning. Although Web-based educational applications are resource intensive to develop, positive appraisal of program quality, plus program accessibility and repeatability, appears to provide important educational benefits. Further research is needed to determine the transferability of these learning experiences into real-world practice.

  10. Small- bowel mucosal changes and antibody responses after low- and moderate-dose gluten challenge in celiac disease

    PubMed Central

    2011-01-01

    Background Due to the restrictive nature of a gluten-free diet, celiac patients are looking for alternative therapies. While drug-development programs include gluten challenges, knowledge regarding the duration of gluten challenge and gluten dosage is insufficient. We challenged adult celiac patients with gluten with a view to assessing the amount needed to cause some small-bowel mucosal deterioration. Methods Twenty-five celiac disease adults were challenged with low (1-3 g) or moderate (3-5g) doses of gluten daily for 12 weeks. Symptoms, small-bowel morphology, densities of CD3+ intraepithelial lymphocytes (IELs) and celiac serology were determined. Results Both moderate and low amounts of gluten induced small-bowel morphological damage in 67% of celiac patients. Moderate gluten doses also triggered mucosal inflammation and more gastrointestinal symptoms leading to premature withdrawals in seven cases. In 22% of those who developed significant small- intestinal damage, symptoms remained absent. Celiac antibodies seroconverted in 43% of the patients. Conclusions Low amounts of gluten can also cause significant mucosal deterioration in the majority of the patients. As there are always some celiac disease patients who will not respond within these conditions, sample sizes must be sufficiently large to attain to statistical power in analysis. PMID:22115041

  11. Highway concrete pavement technology development and testing. Volume 2, field evaluation of strategic highway research program (SHRP) C-203 test sites (freeze-thaw resistance)

    DOT National Transportation Integrated Search

    2006-08-01

    Field test sections were constructed during 1992 as part of the Strategic Highway Research Program (SHRP) investigation of the frost resistance of concrete. The first freeze-thaw-related deterioration expected for pavement concrete exposed to de-icin...

  12. Managing patient deterioration: assessing teamwork and individual performance.

    PubMed

    Cooper, Simon; Cant, Robyn; Porter, Jo; Missen, Karen; Sparkes, Louise; McConnell-Henry, Tracy; Endacott, Ruth

    2013-05-01

    To assess the ability of rural Australian nurse teams to manage deteriorating patients. This quasi-experimental design used pre- and post-intervention assessments and observation to evaluate nurses' simulated clinical performance. Registered nurses (n=44) from two hospital wards completed a formative knowledge assessment and three team-based video recorded scenarios (Objective Structured Clinical Examinations (OSCE)). Trained patient actors simulated deteriorating patients. Skill performance and situation awareness were measured and team performance was rated using the Team Emergency Assessment Measure. Knowledge in relation to patient deterioration management varied (mean 63%, range 27-100%) with a median score of 64%. Younger nurses with a greater number of working hours scored the highest (p=0.001). OSCE performance was generally low with a mean performance of 54%, but performance was maintained despite the increasing complexity of the scenarios. Situation awareness was generally low (median 50%, mean 47%, range 17-83%, SD 14.03) with significantly higher levels in younger participants (r=-0.346, p=0.021). Teamwork ratings averaged 57% with significant associations between the subscales (Leadership, Teamwork and Task Management) (p<0.006), the global rating scale (p<0.001) and two of the OSCE measures (p<0.049). Feedback from participants following the programme indicated significant improvements in knowledge, confidence and competence (p<0.001). Despite a satisfactory knowledge base, the application of knowledge was low with notable performance deficits in these demanding and stressful situations. The identification and management of patient deterioration needs to be taught in professional development programmes incorporating high fidelity simulation techniques. The Team Emergency assessment tool proved to be a valid measure of team performance in patient deterioration scenarios.

  13. NASA CF6 jet engine diagnostics program: Long-term CF6-6D low-pressure turbine deterioration

    NASA Technical Reports Server (NTRS)

    Smith, J. J.

    1979-01-01

    Back-to-back performance tests were run on seven airline low pressure turbine (LPT) modules and four new CF6-6D modules. Back-to-back test cell runs, in which an airline LPT module was directly compared to a new production module, were included. The resulting change, measured in fuel burn, equaled the level of LPT module deterioration. Three of the LPT modules were analytically inspected followed by a back-to-back test cell run to evaluate current refurbishment techniques.

  14. Evaluation of the protective effect of α-lipoic acid on cisplatin ototoxicity using distortion-product otoacoustic emission measurements: an experimental animal study.

    PubMed

    Ozkul, Yilmaz; Songu, Murat; Basoglu, Mehmet Sinan; Ozturkcan, Sedat; Katilmis, Huseyin

    2014-07-01

    The aim of our study was to determine the effectiveness of intratympanic α-lipoic acid injection as an otoprotective agent against cisplatin-induced ototoxicity in guinea pigs. Twenty-four adult male albino guinea pigs with normal hearing were divided into 4 groups. The guinea pigs received intraperitoneal cisplatin in group 1, intraperitoneal cisplatin and intratympanic α-lipoic acid in group 2, intratympanic α-lipoic acid in group 3, as well as intraperitoneal cisplatin and intratympanic saline in group 4. Distortion-product otoacoustic emission measurements were obtained for both ears at the following time points: before administration (baseline recording) and on day 3 (72 h later). In group 1 (cisplatin), significant deterioration was observed at all frequencies on day 3 (P < 0.05). In group 2 (cisplatin + α-lipoic acid), deterioration was observed at all frequencies on day 3; however, this deterioration did not reach a statistical significance (P > 0.05). In group 3 (α-lipoic acid), no significant difference was observed between baseline and day 3 (P > 0.05). In group 4 (cisplatin + saline), deterioration was observed at all frequencies on day 3; however, this deterioration did not reach a statistical significance (P > 0.05). Cisplatin-induced hearing loss in the guinea pigs may be limited to some extent by the concomitant use of α-lipoic acid. Dose-dependent changes in the possible effects of α-lipoic acid need further investigation. Future morphologic studies may contribute to expose clearly the protective effect of α-lipoic acid.

  15. Trends of quality of life changes in amyotrophic lateral sclerosis patients.

    PubMed

    Shamshiri, Hosein; Fatehi, Farzad; Abolfazli, Roya; Harirchian, Mohammad Hossein; Sedighi, Behnaz; Zamani, Babak; Roudbari, Ali; Razazian, Nazanin; Khamseh, Fatemeh; Nafissi, Shahriar

    2016-09-15

    Amyotrophic lateral sclerosis (ALS) is an incurable progressive neurodegenerative disease and thus the assessment of quality of life (QOL) changes and factors that may influence its course is valuable in the meantime. The present study aimed to assess the deterioration rate of QOL and influencing factors in different subgroups of Iranian ALS patients. 132 patients were evaluated in this prospective multicenter observational study. QOL was measured using ALS Assessment Questionnaire (ALSAQ-40) during 1year follow up and its progression rate was assessed in different subgroups of patients according to age, sex, stage of disease, riluzole consumption, onset type. Also physical disability and functional disability were measured using MMT and ALSFRS-R scores respectively and their progression rates were compared with ALSAQ-40 changes. Significant deterioration of the scores of ALSAQ-40 during study was consistent in all of its domains (p=0.000). There was a significant negative correlation between ALSFRS-R and MMT changes and ALSAQ-40 change (p=0.000) and this was consistently observed in all domains of ALSAQ-40 (p=0.00). ALSAQ-40 deterioration rate was shown to be significantly lower in severe/terminal stages compared to mild/moderate stages (p=0.00). Significantly higher deterioration rate was observed in bulbar onset versus limb onset patients [F (1,130)=4.52, p=0.04] but no significant difference was observed among other subgroups according to age, sex and riluzole consumption. All domains of QOL significantly deteriorate during ALS course and there is a significant correlation between their changes and progression of physical and functional disabilities. Rate of degradation of QOL may be different at different stages of the disease. QOL worsens independent of factors such as sex, age and consumption of riluzole; but onset type (bulbar versus limb) is an imperative factor in quality of life changes during the disease course. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. A trial of e-simulation of sudden patient deterioration (FIRST2ACT WEB) on student learning.

    PubMed

    Bogossian, Fiona E; Cooper, Simon J; Cant, Robyn; Porter, Joanne; Forbes, Helen

    2015-10-01

    High-fidelity simulation pedagogy is of increasing importance in health professional education; however, face-to-face simulation programs are resource intensive and impractical to implement across large numbers of students. To investigate undergraduate nursing students' theoretical and applied learning in response to the e-simulation program-FIRST2ACT WEBTM, and explore predictors of virtual clinical performance. Multi-center trial of FIRST2ACT WEBTM accessible to students in five Australian universities and colleges, across 8 campuses. A population of 489 final-year nursing students in programs of study leading to license to practice. Participants proceeded through three phases: (i) pre-simulation-briefing and assessment of clinical knowledge and experience; (ii) e-simulation-three interactive e-simulation clinical scenarios which included video recordings of patients with deteriorating conditions, interactive clinical tasks, pop up responses to tasks, and timed performance; and (iii) post-simulation feedback and evaluation. Descriptive statistics were followed by bivariate analysis to detect any associations, which were further tested using standard regression analysis. Of 409 students who commenced the program (83% response rate), 367 undergraduate nursing students completed the web-based program in its entirety, yielding a completion rate of 89.7%; 38.1% of students achieved passing clinical performance across three scenarios, and the proportion achieving passing clinical knowledge increased from 78.15% pre-simulation to 91.6% post-simulation. Knowledge was the main independent predictor of clinical performance in responding to a virtual deteriorating patient R(2)=0.090, F(7, 352)=4.962, p<0.001. The use of web-based technology allows simulation activities to be accessible to a large number of participants and completion rates indicate that 'Net Generation' nursing students were highly engaged with this mode of learning. The web-based e-simulation program FIRST2ACTTM effectively enhanced knowledge, virtual clinical performance, and self-assessed knowledge, skills, confidence, and competence in final-year nursing students. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Special Provisions for Intelligent Compaction of Stabilized Soil Subgrades

    DOT National Transportation Integrated Search

    2017-12-30

    Slowing the deterioration of highway infrastructure, reducing carbon emissions, conserving resources, repurposing industrial waste-this Exploratory Advanced Research (EAR) Program project is pursuing multiple benefits through a unique experimental ap...

  18. 49 CFR 237.31 - Adoption of bridge management programs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... prevent the deterioration of railroad bridges by preserving their capability to safely carry the traffic to be operated over them, and reduce the risk of human casualties, environmental damage, and...

  19. 49 CFR 237.31 - Adoption of bridge management programs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... prevent the deterioration of railroad bridges by preserving their capability to safely carry the traffic to be operated over them, and reduce the risk of human casualties, environmental damage, and...

  20. 49 CFR 237.31 - Adoption of bridge management programs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... prevent the deterioration of railroad bridges by preserving their capability to safely carry the traffic to be operated over them, and reduce the risk of human casualties, environmental damage, and...

  1. A programmatic approach to long-term bridge preventive maintenance.

    DOT National Transportation Integrated Search

    2016-04-15

    State transportation agencies use cost-effective preventive maintenance (PM) programs to preserve existing roadway systems, slow down their deterioration, and improve their functional condition. Currently, KYTCs bridge inventory includes approxima...

  2. Rapid clinical deterioration in an individual with Down syndrome.

    PubMed

    Jacobs, Julia; Schwartz, Alison; McDougle, Christopher J; Skotko, Brian G

    2016-07-01

    A small percentage of adolescents and young adults with Down syndrome experience a rapid and unexplained deterioration in cognitive, adaptive, and behavioral functioning. Currently, there is no standardized work-up available to evaluate these patients or treat them. Their decline typically involves intellectual deterioration, a loss of skills of daily living, and prominent behavioral changes. Certain cases follow significant life events such as completion of secondary school with friends who proceed on to college or employment beyond the individual with DS. Others develop this condition seemingly unprovoked. Increased attention in the medical community to clinical deterioration in adolescents and young adults with Down syndrome could provide a framework for improved diagnosis, evaluation, and treatment. This report presents a young adult male with Down syndrome who experienced severe and unexplained clinical deterioration, highlighting specific challenges in the systematic evaluation and treatment of these patients. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  3. [Neurotological long-term follow-up in Minamata disease in Niigata, Japan].

    PubMed

    Mizukoshi, Kanemasa; Watanabe, Yukio; Shojaku, Hideo; Aso, Shin; Asai, Masatsugu; Inukai, Kenya; Takahashi, Sugata

    2002-03-01

    To determine the long-term influence of organic mercurial intoxication on audiological and equilibrium findings, we followed up 36 patients neurotologically during 1980-1987 and 1991-2000 at Kido Hospital in Niigata. Typical findings were as follows: 1. In pure-tone audiometry, 24 of 72 ears (33%) showed slight hearing deterioration and 3 (4%) showed improvement. 2. Spontaneous nystagmus had disappeared in 5 patients (14%), but appeared in new 13 patients (36%). Positional nystagmus did not improve in any patient, and deteriorated in 11 (31%). 3. In optokinetic nystagmus (OKN) tests, especially in vertical OKN test showing significant deterioration (44%). 4. The caloric nystagmus test showed marked deterioration (47%). Body-equilibrium testing showed slight deterioration in 11 patients (31%) and improvement in 5 (14%). Neurotological findings thus varied widely among patients and we were concluded that these differences were caused both by duration of methyl mercury contamination and by aging factors in patients.

  4. Automated detection of physiologic deterioration in hospitalized patients

    PubMed Central

    Evans, R Scott; Kuttler, Kathryn G; Simpson, Kathy J; Howe, Stephen; Crossno, Peter F; Johnson, Kyle V; Schreiner, Misty N; Lloyd, James F; Tettelbach, William H; Keddington, Roger K; Tanner, Alden; Wilde, Chelbi; Clemmer, Terry P

    2015-01-01

    Objective Develop and evaluate an automated case detection and response triggering system to monitor patients every 5 min and identify early signs of physiologic deterioration. Materials and methods A 2-year prospective, observational study at a large level 1 trauma center. All patients admitted to a 33-bed medical and oncology floor (A) and a 33-bed non-intensive care unit (ICU) surgical trauma floor (B) were monitored. During the intervention year, pager alerts of early physiologic deterioration were automatically sent to charge nurses along with access to a graphical point-of-care web page to facilitate patient evaluation. Results Nurses reported the positive predictive value of alerts was 91–100% depending on erroneous data presence. Unit A patients were significantly older and had significantly more comorbidities than unit B patients. During the intervention year, unit A patients had a significant increase in length of stay, more transfers to ICU (p = 0.23), and significantly more medical emergency team (MET) calls (p = 0.0008), and significantly fewer died (p = 0.044) compared to the pre-intervention year. No significant differences were found on unit B. Conclusions We monitored patients every 5 min and provided automated pages of early physiologic deterioration. This before–after study found a significant increase in MET calls and a significant decrease in mortality only in the unit with older patients with multiple comorbidities, and thus further study is warranted to detect potential confounding. Moreover, nurses reported the graphical alerts provided information needed to quickly evaluate patients, and they felt more confident about their assessment and more comfortable requesting help. PMID:25164256

  5. Effect of flood conditions on the deterioration of porous clay-based brick

    NASA Astrophysics Data System (ADS)

    Mol, L.; Tomor, A.

    2017-12-01

    Man-made materials represent an increasingly large proportion of geomaterials that are used to build up a rapidly expanding urbanised landscape. The deterioration of such materials is of increasing concern, in particular in light of the projected increase in storm and flood events and their associated high water levels. The effect of prolonged saturation in porous materials, man-made as well as natural, can lead to accelerated deterioration. This can be of particular concern for load-bearing structural materials, for example bridges. In this study, the effect of moisture movement has been investigated for brick masonry, as one of the most commonly used porous building materials. Saturation of brick masonry can be of particular concern for historical masonry, such as masonry arch bridges in conjunction with under increasing levels of long-term traffic loading. While flooding can lead to scour and sudden collapse of bridges, saturation can also lead to accelerated medium and long-term deterioration. A series of small-scale laboratory tests have been carried out on brick masonry to identify the effects of saturation on the material properties and changes in the rate of deterioration. Brick masonry prisms have been loaded to failure under quasi-static and long-term cyclic compression and monitored with the help of acoustic emission technique, accelerometers, linear variable differential transformers (LVDTs), permeametry and brick surface hardness measurements. Under quasi-static loading saturated samples showed significant reduction in the load capacity and increased fracture development. Under fatigue loading the number of cycles to failure reduced significantly for saturated specimens and characteristic changes in material parameters have been related to stages of fatigue deterioration. Test results indicated that increasing flood events can accelerate moisture-related deterioration in porous brick masonry.

  6. Recognizing and managing a deteriorating patient: a randomized controlled trial investigating the effectiveness of clinical simulation in improving clinical performance in undergraduate nursing students.

    PubMed

    Stayt, Louise Caroline; Merriman, Clair; Ricketts, Barry; Morton, Sean; Simpson, Trevor

    2015-11-01

    To report the results of a randomized controlled trial which explored the effectiveness of clinical simulation in improving the clinical performance of recognizing and managing an adult deteriorating patient in hospital. There is evidence that final year undergraduate nurses may lack knowledge, clinical skills and situation awareness required to manage a deteriorating patient competently. The effectiveness of clinical simulation as a strategy to teach the skills required to recognize and manage the early signs of deterioration needs to be evaluated. This study was a two centre phase II single, randomized, controlled trial with single blinded assessments. Data were collected in July 2013. Ninety-eight first year nursing students were randomized either into a control group, where they received a traditional lecture, or an intervention group where they received simulation. Participants completed a pre- and postintervention objective structured clinical examination. General Perceived Self Efficacy and Self-Reported Competency scores were measured before and after the intervention. Student satisfaction with teaching was also surveyed. The intervention group performed significantly better in the post-objective structured clinical examination. There was no significant difference in the postintervention General Perceived Self Efficacy and Self-Reported Competency scores between the control and intervention group. The intervention group was significantly more satisfied with their teaching method. Simulation-based education may be an effective educational strategy to teach nurses the skills to effectively recognize and manage a deteriorating patient. © 2015 John Wiley & Sons Ltd.

  7. A programmatic approach to long-term bridge preventive maintenance : final report.

    DOT National Transportation Integrated Search

    2016-04-01

    State transportation agencies use cost-effective preventive maintenance (PM) programs to preserve existing roadway systems, slow down their deterioration, and improve their functional condition. Currently, KYTCs bridge inventory includes approxima...

  8. 75 FR 81874 - Action To Ensure Authority To Issue Permits Under the Prevention of Significant Deterioration...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-29

    ... Greenhouse Gas Emissions: Finding of Failure To Submit State Implementation Plan Revisions Required for Greenhouse Gases AGENCY: Environmental Protection Agency (EPA). ACTION: Final rule. SUMMARY: The EPA is... Deterioration (PSD) requirements to greenhouse gas (GHG)-emitting sources. By notice dated December 13, 2010...

  9. Aerobic Stability and Effects of Yeasts during Deterioration of Non-fermented and Fermented Total Mixed Ration with Different Moisture Levels.

    PubMed

    Hao, W; Wang, H L; Ning, T T; Yang, F Y; Xu, C C

    2015-06-01

    The present experiment evaluated the influence of moisture level and anaerobic fermentation on aerobic stability of total mixed ration (TMR). The dynamic changes in chemical composition and microbial population that occur after air exposure were examined, and the species of yeast associated with the deterioration process were also identified in both non-fermented and fermented TMR to deepen the understanding of aerobic deterioration. The moisture levels of TMR in this experiment were adjusted to 400 g/kg (low moisture level, LML), 450 g/kg (medium moisture level, MML), and 500 g/kg (high moisture level, HML), and both non-fermented and 56-d-fermented TMR were subjected to air exposure to determine aerobic stability. Aerobic deterioration resulted in high losses of nutritional components and largely reduced dry matter digestibility. Non-fermented TMR deteriorated during 48 h of air exposure and the HML treatment was more aerobically unstable. On dry matter (DM) basis, yeast populations significantly increased from 10(7) to 10(10) cfu/g during air exposure, and Candida ethanolica was the predominant species during deterioration in non-fermented TMR. Fermented TMR exhibited considerable resistance to aerobic deterioration. Spoilage was only observed in the HML treatment and its yeast population increased dramatically to 10(9) cfu/g DM when air exposure progressed to 30 d. Zygosaccharomyces bailii was the sole yeast species isolated when spoilage occurred. These results confirmed that non-fermented and fermented TMR with a HML are more prone to spoilage, and fermented TMR has considerable resistance to aerobic deterioration. Yeasts can trigger aerobic deterioration in both non-fermented and fermented TMR. C. ethanolica may be involved in the spoilage of non-fermented TMR and the vigorous growth of Z. bailii can initiate aerobic deterioration in fermented TMR.

  10. Aerobic Stability and Effects of Yeasts during Deterioration of Non-fermented and Fermented Total Mixed Ration with Different Moisture Levels

    PubMed Central

    Hao, W.; Wang, H. L.; Ning, T. T.; Yang, F. Y.; Xu, C. C.

    2015-01-01

    The present experiment evaluated the influence of moisture level and anaerobic fermentation on aerobic stability of total mixed ration (TMR). The dynamic changes in chemical composition and microbial population that occur after air exposure were examined, and the species of yeast associated with the deterioration process were also identified in both non-fermented and fermented TMR to deepen the understanding of aerobic deterioration. The moisture levels of TMR in this experiment were adjusted to 400 g/kg (low moisture level, LML), 450 g/kg (medium moisture level, MML), and 500 g/kg (high moisture level, HML), and both non-fermented and 56-d-fermented TMR were subjected to air exposure to determine aerobic stability. Aerobic deterioration resulted in high losses of nutritional components and largely reduced dry matter digestibility. Non-fermented TMR deteriorated during 48 h of air exposure and the HML treatment was more aerobically unstable. On dry matter (DM) basis, yeast populations significantly increased from 107 to 1010 cfu/g during air exposure, and Candida ethanolica was the predominant species during deterioration in non-fermented TMR. Fermented TMR exhibited considerable resistance to aerobic deterioration. Spoilage was only observed in the HML treatment and its yeast population increased dramatically to 109 cfu/g DM when air exposure progressed to 30 d. Zygosaccharomyces bailii was the sole yeast species isolated when spoilage occurred. These results confirmed that non-fermented and fermented TMR with a HML are more prone to spoilage, and fermented TMR has considerable resistance to aerobic deterioration. Yeasts can trigger aerobic deterioration in both non-fermented and fermented TMR. C. ethanolica may be involved in the spoilage of non-fermented TMR and the vigorous growth of Z. bailii can initiate aerobic deterioration in fermented TMR. PMID:25925059

  11. Do nutrition programs make a difference? The case of Brazil.

    PubMed

    Musgrove, P

    1990-01-01

    Four Brazilian food and nutrition programs operating during some part of 1974-86 are evaluated for their effectiveness in curing or preventing infant and child malnutrition, including low birth weight when pregnant women were beneficiaries. Two programs distributed free food to identified clients: traditional commercial foods in one case and specially formulated supplements in the other. The other two programs subsidized four or more basic foodstuffs: one experiment quantitatively restricted a subsidy to identified families, and the other was unrestricted and open to all families patronizing certain shops. The programs were more effective at curing than at preventing malnutrition, and more effective at increasing weight than height. Many beneficiaries, even when initially underweight, showed no change, and some deteriorated despite the food transfer. Results were better after than during the first year of life, when deterioration is most likely. Donation programs including medical and educational components proved more effective than pure subsidies, showing that while poverty may be the chief cause of malnutrition, the problem should be seen as poor health rather than simply low food consumption. Evaluation also shows that programs were inefficient in transferring benefits, and that clients were deterred from participating by the costs of obtaining the food and its poor quality and small volume. Longer participation improved results, but more frequent participation in a given interval did not necessarily do so.

  12. Condition Assessment of Wastewater Collection Systems

    EPA Science Inventory

    This project will assist wastewater utilities with the condition assessment of their deteriorating wastewater collections systems, and will support the U.S. Environmental Protection Agency’s (EPA) Program Offices with addressing proposed capacity, management, operation and mainte...

  13. 36 CFR 223.201 - Limitations on unprocessed timber harvested in Alaska.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Conservation and Shortage Relief Act of 1990 Program § 223.201 Limitations on unprocessed timber harvested in... or serious deterioration of logs unsalable locally because of an unforeseen loss of market, (c...

  14. Structural deterioration of the Freestyle aortic valve: mode of presentation and mechanisms.

    PubMed

    Mohammadi, Siamak; Baillot, Richard; Voisine, Pierre; Mathieu, Patrick; Dagenais, François

    2006-08-01

    Structural valve deterioration is the major cause of bioprosthetic valve failure. Because of the unique design features and anti-calcification treatment of the Freestyle (Medtronic Inc, Minneapolis, Minn) stentless bioprosthesis, development of structural valve deterioration may differ in comparison with other bioprosthetic valves. This study evaluates the mechanisms and clinical presentation of structural valve deterioration in the Freestyle stentless bioprosthesis. Between January 1993 and August 2005, 608 patients underwent aortic valve replacement with a Freestyle stentless bioprosthesis. The implantation technique was subcoronary in 475 patients and a root replacement in 133 patients. Mean overall follow-up was 5.6 +/- 3.4 years. Follow-up was complete in all patients. Clinical and echocardiographic follow-ups were conducted prospectively. Freedom from structural valve deterioration was 95.8% at 10 years. Twelve patients showed evidence of structural valve deterioration and underwent reoperation for aortic regurgitation (n = 10) or aortic stenosis (n = 2). The mean age of patients with structural valve deterioration was significantly lower than patients without structural valve deterioration (62.6 +/- 8.2 years vs 68.6 +/- 8.3 years, P = .02). The median time between implantation and explantation was 8.7 years (range: 1.9-13.3 years). Eleven structural valve deteriorations occurred after subcoronary implantation, and 1 structural valve deterioration occurred after root implantation (P = .4). The mechanisms of structural valve deterioration were leaflet tears in 10 patients (6 in the left coronary cusp and 4 in the right coronary cusp), severe valve calcification in 1 patient, and cusp fibrosis in 1 patient. The interval between onset of symptoms and reoperation was acute or subacute in 10 patients. At 10 years, the Freestyle stentless bioprosthesis shows excellent freedom from structural valve deterioration. Structural valve deterioration in the Freestyle stentless bioprosthesis relates to leaflet tear with minimal calcification in the majority of cases. Because of the fast onset of symptoms with leaflet tear, patients with a Freestyle stentless bioprosthesis should be informed of the preferential mode of failure and time-frame of symptoms.

  15. Long-term CF6 engine performance deterioration: Evaluation of engine S/N 451-380

    NASA Technical Reports Server (NTRS)

    Kramer, W. H.; Smith, J. J.

    1978-01-01

    The performance testing and analytical teardown of CF6-6D engine serial number 451-380 which was recently removed from a DC-10 aircraft is summarized. The investigative test program was conducted inbound prior to normal overhaul/refurbishment. The performance testing included an inbound test, a test following cleaning of the low pressure turbine airfoils, and a final test after leading edge rework and cleaning the stage one fan blades. The analytical teardown consisted of detailed disassembly inspection measurements and airfoil surface finish checks of the as-received deteriorated hardware. Aspects discussed include the analysis of the test cell performance data, a complete analytical teardown report with a detailed description of all observed hardware distress, and an analytical assessment of the performance loss (deterioration) relating measured hardware conditions to losses in both specific fuel comsumption and exhaust gas temperature.

  16. Long-term CF6 engine performance deterioration: Evaluation of engine S/N 451-479

    NASA Technical Reports Server (NTRS)

    Kramer, W. H.; Smith, J. J.

    1978-01-01

    The performance testing and analytical teardown of CF6-6D engine is summarized. This engine had completed its initial installation on DC-10 aircraft. The investigative test program was conducted inbound prior to normal overhaul/refurbishment. The performance testing included an inbound test, a test following cleaning of the low pressure turbine airfoils, and a final test after leading edge rework and cleaning the stage one fan blades. The analytical teardown consisted of detailed disassembly inspection measurements and airfoil surface finish checks of the as received deteriorated hardware. Included in this report is a detailed analysis of the test cell performance data, a complete analytical teardown report with a detailed description of all observed hardware distress, and an analytical assessment of the performance loss (deterioration) relating measured hardware conditions to losses in both SFC (specific fuel consumption) and EGT (exhaust gas temperature).

  17. Accelerated aging test results for aerospace wire insulation constructions

    NASA Technical Reports Server (NTRS)

    Dunbar, William G.

    1995-01-01

    Several wire insulation constructions were evaluated with and without continuous glow discharges at low pressure and high temperature to determine the aging characteristics of acceptable wire insulation constructions. It was known at the beginning of the test program that insulation aging takes several years when operated at normal ambient temperature and pressure of 20 C and 760 torr. Likewise, it was known that the accelerated aging process decreases insulation life by approximately 50% for each 10 C temperature rise. Therefore, the first phases of the program, not reported in these test results, were to select wire insulation constructions that could operate at high temperature and low pressure for over 10,000 hours with negligible shrinkage and little materials' deterioration.The final phase of the program was to determine accelerated aging characteristics. When an insulation construction is subjected to partial discharges the insulation is locally heated by the bombardment of the discharges, the insulation is also subjected to ozone and other deteriorating gas particles that may significantly increase the aging process. Several insulation systems using either a single material or combinations of teflon, kapton, and glass insulation constructions were tested. All constructions were rated to be partial discharge and/or corona-free at 240 volts, 400 Hz and 260 C (500 F) for 50, 000 hours at altitudes equivalent to the Paschen law. Minimum partial discharge aging tests were preceded by screening tests lasting 20 hours at 260 C. The aging process was accelerated by subjecting the test articles to temperatures up to 370 C (700 F) with and without partial discharges. After one month operation with continuous glow discharges surrounding the test articles, most insulation systems were either destroyed or became brittle, cracked, and unsafe for use. Time with space radiation as with partial discharges is accumulative.

  18. Accelerated aging test results for aerospace wire insulation constructions

    NASA Astrophysics Data System (ADS)

    Dunbar, William G.

    1995-11-01

    Several wire insulation constructions were evaluated with and without continuous glow discharges at low pressure and high temperature to determine the aging characteristics of acceptable wire insulation constructions. It was known at the beginning of the test program that insulation aging takes several years when operated at normal ambient temperature and pressure of 20 C and 760 torr. Likewise, it was known that the accelerated aging process decreases insulation life by approximately 50% for each 10 C temperature rise. Therefore, the first phases of the program, not reported in these test results, were to select wire insulation constructions that could operate at high temperature and low pressure for over 10,000 hours with negligible shrinkage and little materials' deterioration.The final phase of the program was to determine accelerated aging characteristics. When an insulation construction is subjected to partial discharges the insulation is locally heated by the bombardment of the discharges, the insulation is also subjected to ozone and other deteriorating gas particles that may significantly increase the aging process. Several insulation systems using either a single material or combinations of teflon, kapton, and glass insulation constructions were tested. All constructions were rated to be partial discharge and/or corona-free at 240 volts, 400 Hz and 260 C (500 F) for 50, 000 hours at altitudes equivalent to the Paschen law. Minimum partial discharge aging tests were preceded by screening tests lasting 20 hours at 260 C. The aging process was accelerated by subjecting the test articles to temperatures up to 370 C (700 F) with and without partial discharges. After one month operation with continuous glow discharges surrounding the test articles, most insulation systems were either destroyed or became brittle, cracked, and unsafe for use. Time with space radiation as with partial discharges is accumulative.

  19. Exposure to heat and freezing in the vaccine cold chain in Thailand.

    PubMed

    Techathawat, Sirirat; Varinsathien, Porpit; Rasdjarmrearnsook, Aimorn; Tharmaphornpilas, Piyanit

    2007-01-26

    This study investigated exposure to heat and freezing of vaccines used in Thailand's National Immunization Program. Cold chain temperatures on 48 randomly selected shipment routes nationwide were monitored. Measles and hepatitis B vaccines were despatched with recording devices and subsequently tested. The study found that extremes of cold appear to be the more significant problem. Heat exposure was relatively brief and not at very high temperatures, so vaccine deterioration was unlikely, as was confirmed by measles vaccine testing. Exposure to temperatures below -0.5 degrees C was widespread, which would be expected to damage hepatitis B vaccine, but shake tests did not detect damage.

  20. Next Steps and Preliminary Views on the Application of Clean Air Act Permitting Programs to Greenhouse Gases Following the Supreme Court's Decision in Utility Air Regulatory Group v. Environmental Protection Agency

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  1. Update on the nutrition situation.

    PubMed

    Mason, J; Garcia, M

    1995-01-01

    The Update on the Nutrition Situation, 1994 was published in early 1995 by the United Nations Subcommittee on Nutrition. Thus, data available at the country level about estimates of the nutritional situation now provide trends of prevalences of underweight children in 35 countries for the 1990s. In Sub-Saharan Africa recent deterioration has occurred as a result of the general worsening of nutrition in Africa. However, in the Near East, North Africa, and South America the generally improving trends of the 1980s seem to be continuing with the likelihood of reaching the prevalences of the developed countries by the year 2000. A surveillance system in Bangladesh indicates improvement from 1990 to 1993; however, India data for 1991/92 indicate deterioration in 3 states and no significant change in 4, possibly connected the economic slowdown in the early 1990s. In many countries of southeast Asia, China, Middle America and the Caribbean, South America, the Near East and North Africa the improvement of rates could result in halving the prevalences of underweight children. The gross domestic product (GDP) is an important indicator of nutritional performance. During 1985-92 in Sub-Saharan Africa GDP declined by 0.8% and consequently the nutritional situation also deteriorated. In other areas of the world the GDP growth rates improved after 1990 and the underweight trends in the early 1990s were generally similar to those of the late 1980s. The nutritional improvement outside Sub-Saharan Africa and possibly India continued in the early 1990s. Rapid economic growth was associated with improving nutrition in Thailand and Vietnam in the 1980s and also to a smaller extent for Indonesia and China. Faster than average improvement is plausible for Jamaica, Sri Lanka, and Zimbabwe. Deteriorating cases are Ethiopia, Madagascar, and Rwanda. Economic growth, health, education, and community-based nutrition programs all contribute to improving nutrition.

  2. Automated detection of physiologic deterioration in hospitalized patients.

    PubMed

    Evans, R Scott; Kuttler, Kathryn G; Simpson, Kathy J; Howe, Stephen; Crossno, Peter F; Johnson, Kyle V; Schreiner, Misty N; Lloyd, James F; Tettelbach, William H; Keddington, Roger K; Tanner, Alden; Wilde, Chelbi; Clemmer, Terry P

    2015-03-01

    Develop and evaluate an automated case detection and response triggering system to monitor patients every 5 min and identify early signs of physiologic deterioration. A 2-year prospective, observational study at a large level 1 trauma center. All patients admitted to a 33-bed medical and oncology floor (A) and a 33-bed non-intensive care unit (ICU) surgical trauma floor (B) were monitored. During the intervention year, pager alerts of early physiologic deterioration were automatically sent to charge nurses along with access to a graphical point-of-care web page to facilitate patient evaluation. Nurses reported the positive predictive value of alerts was 91-100% depending on erroneous data presence. Unit A patients were significantly older and had significantly more comorbidities than unit B patients. During the intervention year, unit A patients had a significant increase in length of stay, more transfers to ICU (p = 0.23), and significantly more medical emergency team (MET) calls (p = 0.0008), and significantly fewer died (p = 0.044) compared to the pre-intervention year. No significant differences were found on unit B. We monitored patients every 5 min and provided automated pages of early physiologic deterioration. This before-after study found a significant increase in MET calls and a significant decrease in mortality only in the unit with older patients with multiple comorbidities, and thus further study is warranted to detect potential confounding. Moreover, nurses reported the graphical alerts provided information needed to quickly evaluate patients, and they felt more confident about their assessment and more comfortable requesting help. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  3. Economic Stress, Social Support, and Maternal Depression: Is Social Support Deterioration Occurring

    ERIC Educational Resources Information Center

    Gjesfjeld, Christopher D.; Greeno, Catherine G.; Kim, Kevin H.; Anderson, Carol M.

    2010-01-01

    Maternal depression in low-income women is a significant problem because of its negative consequences for both mothers and their children. Economic stress increases risk for depression; however, mechanisms linking economic stress and depression are not well understood. The social support deterioration model suggests that chronic stressors can…

  4. Underground UXO: Are They a Significant Source of Explosives in Soil Compared to Low- and High-Order Detonations

    DTIC Science & Technology

    2004-12-01

    steel in marine environments. Biofouling, 15(1– 3): 37–47. Videla, H.A. (2002) Prevention and control of biocorrosion . International Bio- deterioration...Prevention and control of biocorrosion . International Bio- deterioration and Biodegradation, 49(4): 259–270. Virtanen, S., and M. Buchler (2003

  5. 40 CFR 52.60 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.60 Section 52.60 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) All applications and other information required pursuant to § 52.21 from... “Guideline on Air Quality Models (Revised)” or other models approved by EPA. [42 FR 22869, May 5, 1977, as...

  6. 40 CFR 52.60 - Significant deterioration of air quality.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality. 52.60 Section 52.60 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) All applications and other information required pursuant to § 52.21 from... “Guideline on Air Quality Models (Revised)” or other models approved by EPA. [42 FR 22869, May 5, 1977, as...

  7. 40 CFR 52.60 - Significant deterioration of air quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quality. 52.60 Section 52.60 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) All applications and other information required pursuant to § 52.21 from... “Guideline on Air Quality Models (Revised)” or other models approved by EPA. [42 FR 22869, May 5, 1977, as...

  8. 40 CFR 52.60 - Significant deterioration of air quality.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality. 52.60 Section 52.60 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) All applications and other information required pursuant to § 52.21 from... “Guideline on Air Quality Models (Revised)” or other models approved by EPA. [42 FR 22869, May 5, 1977, as...

  9. 40 CFR 52.683 - Significant deterioration of air quality.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality. 52.683 Section 52.683 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The State of Idaho Rules for Control of Air Pollution in Idaho, specifically... quality. (b) The requirements of sections 160 through 165 of the Clean Air Act are not met for Indian...

  10. Deterioration of Intellect among Children Surviving Leukemia: IQ Test Changes Modify Estimates of Treatment Toxicity.

    ERIC Educational Resources Information Center

    Mulhern, Raymond, K; And Others

    1992-01-01

    Assessed association of young age at treatment, cranial irradiation, and time since treatment with intellectual deterioration among 49 long-term survivors of childhood leukemia. Found no significant effects of treatment group (low-dose cranial irradiation versus high-dose chemotherapy) or age at treatment. Small but statistically significant…

  11. 40 CFR 52.60 - Significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quality. 52.60 Section 52.60 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) All applications and other information required pursuant to § 52.21 from... “Guideline on Air Quality Models (Revised)” or other models approved by EPA. [42 FR 22869, May 5, 1977, as...

  12. A synthesis of evaluation monitoring projects by the forest health monitoring program (1998-2007)

    Treesearch

    William A. Bechtold; Michael J. Bohne; Barbara L. Conkling; Dana L. Friedman

    2012-01-01

    The national Forest Health Monitoring Program of the Forest Service, U.S. Department of Agriculture, has funded over 200 Evaluation Monitoring projects. Evaluation Monitoring is designed to verify and define the extent of deterioration in forest ecosystems where potential problems have been identified. This report is a synthesis of results from over 150 Evaluation...

  13. 75 FR 82429 - Determinations Concerning Need for Error Correction, Partial Approval and Partial Disapproval...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-30

    ...EPA is correcting its previous full approval of Texas's Clean Air Act (CAA) Prevention of Significant Deterioration (PSD) program to be a partial approval and partial disapproval. The state did not address, or provide adequate legal authority for, the program's application to all pollutants that would become newly subject to regulation in the future, including non-National Ambient Air Quality Standard (NAAQS) pollutants, among them greenhouse gases (GHGs). Further, EPA is promulgating a federal implementation plan (FIP), as required following the partial disapproval, to establish a PSD permitting program in Texas for GHG-emitting sources. EPA is taking this action through interim final rulemaking, effective upon publication, to ensure the availability of a permitting authority-- EPA--in Texas for GHG-emitting sources when they become subject to PSD on January 2, 2011. This will allow those sources to proceed with plans to construct or expand. This rule will expire on April 30, 2011. EPA is also proposing a notice-and-comment rulemaking that mirrors this rulemaking.

  14. Yoga therapy for developing emotional intelligence in mid-life managers.

    PubMed

    Ganpat, Tikhe Sham; Nagendra, H R

    2011-01-01

    Business executives' lives have become a never-ending race against time, technology, and targets. This race creates tension, which leads to dissatisfaction and frustration and eventually manifests itself as psychological and physiological stress with mental and emotional drain. This modern lifestyle intensifies the stress leading to "excessive tension" and consequent deterioration in "executive efficiency". To assess emotional intelligent quotient (EQ) in managers undergoing yoga-based Self Management of Excessive Tension (SMET) program. 72 managers participated in this study which is of "single group pre-post design." The EQ test developed by Prof N. K. Chadha from University of Delhi was administered as pre and post the 5 days of SMET program. Means, standard deviations, Kolmogorov-Smirnov test, and Wilcoxon signed rank test were used to analyze the data. The data analysis showed 72.02% significant increase (P<0.001) in EQ. The results suggest that participation in a SMET program was associated with improvement in EQ and may have implications for "executive efficiency."

  15. Acute postoperative neurological deterioration associated with surgery for ruptured intracranial aneurysm: incidence, predictors, and outcomes.

    PubMed

    Mahaney, Kelly B; Todd, Michael M; Bayman, Emine O; Torner, James C

    2012-06-01

    Subarachnoid hemorrhage (SAH) results in significant morbidity and mortality, even among patients who reach medical attention in good neurological condition. Many patients have neurological decline in the perioperative period, which contributes to long-term outcomes. The focus of this study is to characterize the incidence of, characteristics predictive of, and outcomes associated with acute postoperative neurological deterioration in patients undergoing surgery for ruptured intracranial aneurysm. The Intraoperative Hypothermia for Aneurysm Surgery Trial (IHAST) was a multicenter randomized clinical trial that enrolled 1001 patients and assesssed the efficacy of hypothermia as neuroprotection during surgery to secure a ruptured intracranial aneurysm. All patients had a radiographically confirmed SAH, were classified as World Federation of Neurosurgical Societies (WFNS) Grade I-III immediately prior to surgery, and underwent surgery to secure the ruptured aneurysm within 14 days of SAH. Neurological assessment with the National Institutes of Health Stroke Scale (NIHSS) was performed preoperatively, at 24 and 72 hours postoperatively, and at time of discharge. The primary outcome variable was a dichotomized scoring based on an IHAST version of the Glasgow Outcome Scale (GOS) in which a score of 1 represents a good outcome and a score > 1 a poor outcome, as assessed at 90-days' follow-up. Data from IHAST were analyzed for occurrence of a postoperative neurological deterioration. Preoperative and intraoperative variables were assessed for associations with occurrence of postoperative neurological deterioration. Differences in baseline, intraoperative, and postoperative variables and in outcomes between patients with and without postoperative neurological deterioration were compared with Fisher exact tests. The Wilcoxon rank-sum test was used to compare variables reported as means. Multiple logistic regression was used to adjust for covariates associated with occurrence of postoperative deficit. Acute postoperative neurological deterioration was observed in 42.6% of the patients. New focal motor deficit accounted for 65% of postoperative neurological deterioration, while 60% was accounted for using the NIHSS total score change and 51% by Glasgow Coma Scale score change. Factors significantly associated with occurrence of postoperative neurological deterioration included: age, Fisher grade on admission, occurrence of a procedure prior to aneurysm surgery (ventriculostomy), timing of surgery, systolic blood pressure during surgery, ST segment depression during surgery, history of abnormality in cardiac valve function, use of intentional hypotension during surgery, duration of anterior cerebral artery occlusion, intraoperative blood loss, and difficulty of aneurysm exposure. Of the 426 patients with postoperative neurological deterioration at 24 hours after surgery, only 46.2% had a good outcome (GOS score of 1) at 3 months, while 77.7% of those without postoperative neurological deterioration at 24 hours had a good outcome (p < 0.05). Neurological injury incurred perioperatively or in the acute postoperative period accounts for a large percentage of poor outcomes in patients with good admission WFNS grades undergoing surgery for aneurysmal SAH. Avoiding surgical factors associated with postoperative neurological deterioration and directing investigative efforts at developing improved neuroprotection for use in aneurysm surgery may significantly improve long-term neurological outcomes in patients with SAH.

  16. Regular in-situ simulation training of paediatric Medical Emergency Team leads to sustained improvements in hospital response to deteriorating patients, improved outcomes in intensive care and financial savings.

    PubMed

    Theilen, Ulf; Fraser, Laura; Jones, Patricia; Leonard, Paul; Simpson, Dave

    2017-06-01

    The introduction of a paediatric Medical Emergency Team (pMET) was accompanied by weekly in-situ simulation team training. Key ward staff participated in team training, focusing on recognition of the deteriorating child, teamwork and early involvement of senior staff. Following an earlier study [1], this investigation aimed to evaluate the long-term impact of ongoing regular team training on hospital response to deteriorating ward patients, patient outcome and financial implications. Prospective cohort study of all deteriorating in-patients in a tertiary paediatric hospital requiring admission to paediatric intensive care (PICU) the year before, 1year after and 3 years after the introduction of pMET and team training. Deteriorating patients were recognised more promptly (before/1year after/3years after pMET; median time 4/1.5/0.5h, p<0.001), more often reviewed by consultants (45%/76%/81%, p<0.001) and more rapidly escalated to PICU (median time 10.5/5/3.5h, p=0.02). There was a significant reduction in associated PICU admissions (56/51/32, p=0.02) and PICU bed days (527/336/193, p<0.001). The total annual cost of training (£74,250) was more than offset by savings from reduced PICU bed days (£801,600 per annum). Introduction of pMET coincided with significantly reduced hospital mortality (p<0.001). These results indicate that lessons learnt by ward staff during team training led to sustained improvements in the hospital response to critically deteriorating in-patients, significantly improved patient outcomes and substantial savings. Integration of regular in-situ simulation training of medical emergency teams, including key ward staff, in routine clinical care has potential application in all acute specialties. Copyright © 2017. Published by Elsevier B.V.

  17. Health effects on leaders and co-workers of an art-based leadership development program.

    PubMed

    Romanowska, Julia; Larsson, Gerry; Eriksson, Maria; Wikström, Britt-Maj; Westerlund, Hugo; Theorell, Töres

    2011-01-01

    There are very few evaluations of the effectiveness of leadership development programs. The purpose of the study was to examine whether an art-based leadership program may have a more beneficial effect than a conventional one on leaders' and their corresponding subordinates' mental and biological stress. Participating leaders were randomized to 2 year-long leadership programs, 1 art-based and 1 conventional, with follow-up of the leaders and their subordinates at 12 and 18 months. The art-based program built on an experimental theatre form, a collage of literary text and music, followed by writing and discussions focused on existential and ethical problems. After 18 months a pattern was clearly visible with advantage for the art-based group. In the art group (leaders and their subordinates together as well as for subordinates only) compared to the conventional group, there was a significant improvement of mental health, covert coping and performance-based self-esteem as well as significantly less winter/fall deterioration in the serum concentration of the regenerative/anabolic hormone dehydroepiandrosterone-sulfate. Our findings indicate a more beneficial long-term health effect of the art-based intervention compared to a conventional approach. Positive results for both standardized questionnaires and biological parameters strengthened the findings. The study provides a rationale for further evaluation of the effectiveness of this alternative educational approach. Copyright © 2010 S. Karger AG, Basel.

  18. Prevention of Significant Deterioration Workshop Manual 1980

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  19. Ambient Monitoring Guidelines for Prevention of Significant Deterioration

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  20. Additional Guidance on Prevention of Significant Deterioration (PSD) Regulations

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  1. Prevention of Significant Deterioration (PSD) Emission Thresholds for Fountain Foundry

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  2. Louisiana SIP: LAC 33:III Ch. 5 Section 509. Prevention of Significant Deterioration; SIP effective 1989-05-08 (LAc49) and 1989-08-14 (LAc50) and 1991-07-01 (LAc57) and 1996-12-16 (LAc69) to 2011-08-17 (LAd36 - Revised)

    EPA Pesticide Factsheets

    Louisiana SIP: LAC 33:III Ch. 5 Section 509. Prevention of Significant Deterioration; SIP effective 1989-05-08 (LAc49) and 1989-08-14 (LAc50) and 1991-07-01 (LAc57) and 1996-12-16 (LAc69) to 2011-08-17 (LAd36 - Revised)

  3. Guidance on Extension of Prevention of Significant Deterioration (PSD) Permits

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  4. Linking the developmental and degenerative theories of schizophrenia: association between infant development and adult cognitive decline.

    PubMed

    Kobayashi, Hiroyuki; Isohanni, Matti; Jääskeläinen, Erika; Miettunen, Jouko; Veijola, Juha; Haapea, Marianne; Järvelin, Marjo-Riitta; Jones, Peter B; Murray, Graham K

    2014-11-01

    Neurodevelopmental and neurodegenerative theories may be viewed as incompatible accounts that compete to explain the pathogenesis of schizophrenia. However, it is possible that neurodevelopmental and neurodegenerative processes could both reflect common underlying causal mechanisms. We hypothesized that cognitive dysfunction would gradually deteriorate over time in schizophrenia and the degree of this deterioration in adulthood would be predicted by an infant measure of neurodevelopment. We aimed to examine the association between age of learning to stand in infancy and deterioration of cognitive function in adulthood. Participants were nonpsychotic control subjects (n = 76) and participants with schizophrenia (n = 36) drawn from the Northern Finland 1966 Birth Cohort study. The schizophrenia group showed greater deterioration in abstraction with memory than controls, but there were no differences between schizophrenia and controls in rate of change of other cognitive measures. Age of learning to stand in infancy significantly inversely predicted later deterioration of abstraction with memory in adult schizophrenia (later infant development linked to greater subsequent cognitive deterioration during adulthood), possibly suggesting a link between abnormal neurodevelopmental and neurodegenerative processes in schizophrenia. © The Author 2014. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.

  5. Effectiveness of a Web-Based Simulation in Improving Nurses' Workplace Practice With Deteriorating Ward Patients: A Pre- and Postintervention Study.

    PubMed

    Liaw, Sok Ying; Wong, Lai Fun; Lim, Eunice Ya Ping; Ang, Sophia Bee Leng; Mujumdar, Sandhya; Ho, Jasmine Tze Yin; Mordiffi, Siti Zubaidah; Ang, Emily Neo Kim

    2016-02-19

    Nurses play an important role in detecting patients with clinical deterioration. However, the problem of nurses failing to trigger deteriorating ward patients still persists despite the implementation of a patient safety initiative, the Rapid Response System. A Web-based simulation was developed to enhance nurses' role in recognizing and responding to deteriorating patients. While studies have evaluated the effectiveness of the Web-based simulation on nurses' clinical performance in a simulated environment, no study has examined its impact on nurses' actual practice in the clinical setting. The objective of this study was to evaluate the impact of Web-based simulation on nurses' recognition of and response to deteriorating patients in clinical settings. The outcomes were measured across all levels of Kirkpatrick's 4-level evaluation model with clinical outcome on triggering rates of deteriorating patients as the primary outcome measure. A before-and-after study was conducted on two general wards at an acute care tertiary hospital over a 14-month period. All nurses from the two study wards who undertook the Web-based simulation as part of their continuing nursing education were invited to complete questionnaires at various time points to measure their motivational reaction, knowledge, and perceived transfer of learning. Clinical records on cases triggered by ward nurses from the two study wards were evaluated for frequency and types of triggers over a period of 6 months pre- and 6 months postintervention. The number of deteriorating patients triggered by ward nurses in a medical general ward increased significantly (P<.001) from pre- (84/937, 8.96%) to postintervention (91/624, 14.58%). The nurses reported positively on the transfer of learning (mean 3.89, SD 0.49) from the Web-based simulation to clinical practice. A significant increase (P<.001) on knowledge posttest score from pretest score was also reported. The nurses also perceived positively their motivation (mean 3.78, SD 0.56) to engage in the Web-based simulation. This study provides evidence on the effectiveness of Web-based simulation in improving nursing practice when recognizing and responding to deteriorating patients. This educational tool could be implemented by nurse educators worldwide to address the educational needs of a large group of hospital nurses responsible for patients in clinical deterioration.

  6. The influence of Pilates exercises on body balance in the standing position of hearing impaired people.

    PubMed

    Walowska, Jagoda; Bolach, Bartosz; Bolach, Eugeniusz

    2017-11-13

    Hearing impairment may affect the body posture maintenance. The aim of the study was to evaluate the effect of modified Pilates exercise program on the body posture maintenance in hearing impaired people. Eighty students (aged 13-24) were enrolled and randomly allocated into two groups: test group (n = 41) which attended an original program based on modified Pilates exercises and control group (n = 39) which attended standard physical education classes. Stabilographic tests were conducted at baseline and after 6-week training program. Both groups showed improved control of body balance in a standing position manifested in reductions of the length of path, surface area, and speed of deflection. Modified Pilates program was significantly more effective in improving body balance control in relaxed posture and with feet together than standard physical education classes. The greater efficiency of the modified Pilates program was expressed in a significant improvement in balance control parameters, i.e., path length, surface area, and speed of deflection. The modified Pilates program was more effective in improving body balance control in the hearing impaired people than standard physical education classes. Modification of physical activity recommendations for hearing impaired students may be considered; however, further research is required. Implications for Rehabilitation Hearing impairment impacts the mental, social and, physical spheres of life as well as deteriorates equivalent reactions and the way body posture is maintained. In hearing impaired people, control of body balance and muscle coordination is often disturbed, thus more attention should be paid to exercises associated with balance which may improve the ability to learn and develop motor skills. Modified Pilates program was significantly more effective in improving body balance control than standard physical education classes in hearing impaired people.

  7. A controlled clinical trial on the effects of exercise on neuropsychiatric disorders and instrumental activities in women with Alzheimer's disease.

    PubMed

    Nascimento, Carla M C; Teixeira, Camila V L; Gobbi, Lilian T B; Gobbi, Sebastião; Stella, Florindo

    2012-06-01

    To analyze the influence of a six-month exercise program on neuropsychiatric disorders and on the performance of instrumental activities in elderly patients with Alzheimer's disease (AD). The study included 20 patients with AD in the mild to moderate stages of the Clinical Dementia Rating (CDR) divided into two groups: the experimental group, composed of 10 women who participated in the six-month exercise program, and the control group, composed of the 10 remaining AD patients who did not take part in an exercise program during the same period. All participants were evaluated using the Mini-Mental State Exam for global cognitive function, the Neuropsychiatric Inventory Questionnaire for neuropsychiatric disorders, and the Pfeffer Functional Activities Questionnaire for the degree of functional impairment. The control group showed functional and neuropsychiatric deterioration in the comparisons between pre- and post-intervention times and between groups. The experimental group showed a propensity for less deterioration in neuropsychiatric disorders and performance of instrumental activities compared to the sedentary group.

  8. Aortic calcification burden predicts deterioration of renal function after radical nephrectomy.

    PubMed

    Fukushi, Ken; Hatakeyama, Shingo; Yamamoto, Hayato; Tobisawa, Yuki; Yoneyama, Tohru; Soma, Osamu; Matsumoto, Teppei; Hamano, Itsuto; Narita, Takuma; Imai, Atsushi; Yoneyama, Takahiro; Hashimoto, Yasuhiro; Koie, Takuya; Terayama, Yuriko; Funyu, Tomihisa; Ohyama, Chikara

    2017-02-06

    Radical nephrectomy for renal cell carcinoma (RCC) is a risk factor for the development of chronic kidney disease (CKD), and the possibility of postoperative deterioration of renal function must be considered before surgery. We investigated the contribution of the aortic calcification index (ACI) to the prediction of deterioration of renal function in patients undergoing radical nephrectomy. Between January 1995 and December 2012, we performed 511 consecutive radical nephrectomies for patients with RCC. We retrospectively studied data from 109 patients who had regular postoperative follow-up of renal function for at least five years. The patients were divided into non-CKD and pre-CKD based on a preoperative estimated glomerular filtration rate (eGFR) of ≥60 mL/min/1.73 m 2 or <60 mL/min/1.73 m 2 , respectively. The ACI was quantitatively measured by abdominal computed tomography before surgery. The patients in each group were stratified between low and high ACIs. Variables such as age, sex, comorbidities, and pre- and postoperative renal function were compared between patients with a low or high ACI in each group. Renal function deterioration-free interval rates were evaluated by Kaplan-Meier analysis. Factors independently associated with deterioration of renal function were determined using multivariate analysis. The median age, preoperative eGFR, and ACI in this cohort were 65 years, 68 mL/min/1.73 m 2 , and 8.3%, respectively. Higher ACI (≥8.3%) was significantly associated with eGFR decline in both non-CKD and pre-CKD groups. Renal function deterioration-free interval rates were significantly lower in the ACI-high than ACI-low strata in both of the non-CKD and pre-CKD groups. Multivariate analysis showed that higher ACI was an independent risk factor for deterioration of renal function at 5 years after radical nephrectomy. Aortic calcification burden is a potential predictor of deterioration of renal function after radical nephrectomy. This study was registered as a clinical trial: UMIN000023577.

  9. Proposal for An Algorithm for Screening for Undernutrition in Hospitalized Children.

    PubMed

    Huysentruyt, Koen; De Schepper, Jean; Bontems, Patrick; Alliet, Philippe; Peeters, Ellen; Roelants, Mathieu; Van Biervliet, Stephanie; Hauser, Bruno; Vandenplas, Yvan

    2016-11-01

    The prevalence of disease-related undernutrition in hospitalized children has not decreased significantly in the last decades in Europe. A recent large multicentric European study reported a percentage of underweight children ranging across countries from 4.0% to 9.3%. Nutritional screening has been put forward as a strategy to detect and prevent undernutrition in hospitalized children. It allows timely implementation of adequate nutritional support and prevents further nutritional deterioration of hospitalized children. In this article, a hands-on practical guideline for the implementation of a nutritional care program in hospitalized children is provided. The difference between nutritional status (anthropometry with or without additional technical investigations) at admission and nutritional risk (the risk of the need for a nutritional intervention or the risk for nutritional deterioration during hospital stay) is the focus of this article. Based on the quality control circle principle of Deming, a nutritional care algorithm, with detailed instructions specific for the pediatric population was developed and implementation in daily practice is proposed. Further research is required to prove the applicability and the merit of this algorithm. It can, however, serve as a basis to provide European or even wider guidelines.

  10. Sustainability of transportation structures using composite materials to support trade and growth.

    DOT National Transportation Integrated Search

    2014-06-01

    Corrosion-induced deterioration of steel rebar is one of the main reasons for repair and rehabilitation programs : for conventional steel-reinforced concrete bridge decks. According to the National Association of Corrosion Engineers : (NACE), of all ...

  11. The need for conducting forensic analysis of decommissioned bridges.

    DOT National Transportation Integrated Search

    2014-01-01

    A limiting factor in current bridge management programs is a lack of detailed knowledge of bridge deterioration : mechanisms and processes. The current state of the art is to predict future condition using statistical forecasting : models based upon ...

  12. Identification of mitochondrial genome-encoded small RNAs related to egg deterioration caused by postovulatory aging in rainbow trout

    USDA-ARS?s Scientific Manuscript database

    Many factors have been reported to affect rainbow trout egg quality, among which, postovulatory aging is one of the most significant causes as reared rainbow trout do not usually volitionally oviposit the ovulated eggs. In order to uncover the genetic regulation underling egg deterioration caused by...

  13. Preoperative botulinum toxin test injections before muscle lengthening in cerebral palsy.

    PubMed

    Rutz, Erich; Hofmann, Eva; Brunner, Reinald

    2010-09-01

    Muscle weakening is a well-known side effect of muscle-tendon lengthening. Botulinum toxin A (BTX-A) weakens the muscle temporarily by blocking the neuromuscular junction. Hence application of the drug is a logical step to test whether weakness deteriorates function prior to an operation. In the present study, BTX-A application is used to test preoperatively whether the gait pattern depends on the strength of the tested muscle. Since 1999, instrumented gait analysis, including kinematic, kinetic, and dynamic electromyographic data, is routinely used to define the individual surgical program. In our series of 110 consecutive patients with cerebral palsy (CP) considered for surgical muscle lengthening from 1999 to 2008, BTX-A was applied to identify patients at risk for functional deterioration. Gait analysis was repeated 6 weeks (maximum effect of BTX-A) and 12 weeks (follow-up) after the test injection to check for loss of joint control (excessive ankle dorsiflexion, knee flexion, increased anterior pelvic tilt). In all, 20.9% (n = 23) showed deterioration in gait after preoperative BTX-A test injections (n = 112, two patients had two test trials) in all muscles considered for lengthening. As a consequence, their lengthening surgery was canceled. A total of 68 patients underwent surgery as planned, and in none of them did gait function deteriorate. These clinical data were compared to those of a historical group (n = 105) before this test, where 18% showed functional deterioration after surgery. The similar percentage of patients filtered out by the test suggests that there could be a context to the number of poor results in the historical group. We conclude that preoperative BTX-A test injection is a reliable tool for filtering out patients with risk of deterioration after muscle lengthening surgery in patients with CP and can be helpful to avoid poor outcomes.

  14. Undergraduate nursing students' performance in recognising and responding to sudden patient deterioration in high psychological fidelity simulated environments: an Australian multi-centre study.

    PubMed

    Bogossian, Fiona; Cooper, Simon; Cant, Robyn; Beauchamp, Alison; Porter, Joanne; Kain, Victoria; Bucknall, Tracey; Phillips, Nicole M

    2014-05-01

    Early recognition and situation awareness of sudden patient deterioration, a timely appropriate clinical response, and teamwork are critical to patient outcomes. High fidelity simulated environments provide the opportunity for undergraduate nursing students to develop and refine recognition and response skills. This paper reports the quantitative findings of the first phase of a larger program of ongoing research: Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends (FIRST2ACTTM). It specifically aims to identify the characteristics that may predict primary outcome measures of clinical performance, teamwork and situation awareness in the management of deteriorating patients. Mixed-method multi-centre study. High fidelity simulated acute clinical environment in three Australian universities. A convenience sample of 97 final year nursing students enrolled in an undergraduate Bachelor of Nursing or combined Bachelor of Nursing degree were included in the study. In groups of three, participants proceeded through three phases: (i) pre-briefing and completion of a multi-choice question test, (ii) three video-recorded simulated clinical scenarios where actors substituted real patients with deteriorating conditions, and (iii) post-scenario debriefing. Clinical performance, teamwork and situation awareness were evaluated, using a validated standard checklist (OSCE), Team Emergency Assessment Measure (TEAM) score sheet and Situation Awareness Global Assessment Technique (SAGAT). A Modified Angoff technique was used to establish cut points for clinical performance. Student teams engaged in 97 simulation experiences across the three scenarios and achieved a level of clinical performance consistent with the experts' identified pass level point in only 9 (1%) of the simulation experiences. Knowledge was significantly associated with overall teamwork (p=.034), overall situation awareness (p=.05) and clinical performance in two of the three scenarios (p=.032 cardiac and p=.006 shock). Situation awareness scores of scenario team leaders were low overall, with an average total score of 41%. Final year undergraduate nursing students may have difficulty recognising and responding appropriately to patient deterioration. Improving pre-requisite knowledge, rehearsal of first response and team management strategies need to be a key component of undergraduate nursing students' education and ought to specifically address clinical performance, teamwork and situation awareness. © 2013 Elsevier Ltd. All rights reserved.

  15. Depressive symptom deterioration among predominantly Hispanic diabetes patients in safety net care.

    PubMed

    Ell, Kathleen; Katon, Wayne; Lee, Pey-Jiuan; Kapetanovic, Suad; Guterman, Jeffrey; Xie, Bin; Chou, Chih-Ping

    2012-01-01

    This study examines clinical predictors of symptom deterioration (relapse/recurrence) at the completion of a clinical intervention trial of depressed, low-income, predominantly Hispanic diabetes patients who were randomized to socio-culturally adapted collaborative depression treatment or usual care and who no longer met clinically significant depression criteria at 12 months post-trial baseline. A sub-cohort of 193 diabetes patients with major depression symptoms at baseline, who were randomized to a 12-month collaborative care intervention (INT) (problem-solving therapy and/or pharmacotherapy, telephone symptom monitoring/relapse prevention, behavioral activation and patient navigation support) or enhanced usual care (EUC), and who did not meet major depression criteria at 12 months were subsequently observed over 18 to 24 months. Post-trial depression symptom deterioration was similar between INT (35.2%) and EUC (35.3%) groups. Among the combined groups, significant predictors of symptom deterioration were baseline history of previous depression and/or dysthymia (odds ratio [OR] = 2.66), 12-month PHQ-9 score (OR = 1.22), antidepressant treatment receipt during the initial 12-months (OR = 2.38), 12-month diabetes symptoms (OR = 2.27), and new ICD-9 medical diagnoses in the initial 12 months (OR = 1.11) (R2 = 27%; max-rescaled R2 = 37%; likelihood ratio test, χ2 = 59.79, df = 5, P < 0.0001). Among predominantly Hispanic diabetes patients in community safety net primary care clinics whose depression had improved over 1 year, more than one-third experienced symptom deterioration over the following year. A primary care management depression care protocol that includes ongoing depression symptom monitoring, antidepressant adherence, and diabetes and co-morbid illness monitoring plus depression medication adjustment and behavioral activation may reduce and/or effectively treat depression symptom deterioration. Copyright © 2012 The Academy of Psychosomatic Medicine. All rights reserved.

  16. Neurologic Deterioration in Patients with Moyamoya Disease during Pregnancy, Delivery, and Puerperium.

    PubMed

    Park, Wonhyoung; Ahn, Jae Sung; Chung, Jaewoo; Chung, Yeongu; Lee, Seungjoo; Park, Jung Cheol; Kwun, Byung Duk

    2018-03-01

    We reviewed our clinical experience of patients with moyamoya disease (MMD) who gave birth and assessed characteristics of those experiencing neurologic deterioration. The patients were classified into patients diagnosed with MMD during pregnancy and puerperium (group 1) and those diagnosed before pregnancy (group 2). We retrospectively reviewed patient characteristics, MMD treatment, neurologic symptoms before and during pregnancy and/after puerperium, obstetrical history, and delivery type in groups 1 and 2. Group 1 included 2 patients with deterioration of pre-existing transient ischemic attacks (TIAs) and acute cerebral infarction and 1 patient with seizures and newly developed TIAs during pregnancy and/or puerperium. Group 2 included 20 patients with 23 pregnancies. In group 2, 4 patients had deterioration of TIAs during pregnancy and puerperium. There were significant differences between the cases without neurologic deterioration and with deterioration in group 2 (TIAs ≥10 before pregnancy, 0% vs. 75%, P = 0.002; severely reduced regional cerebrovascular reserve on single-photon emission computed tomography, 10.5% vs. 100%, P = 0.002; and surgical revascularization before pregnancy, 75% vs. 15.8%, P = 0.04). In groups 1 and 2, 6 of the 7 cases in which TIAs occurred or worsened during pregnancy or puerperium recovered to prepregnancy TIA levels after puerperium. Patients with severely reduced regional cerebrovascular reserve on single-photon emission computed tomography and frequent TIAs before pregnancy may experience neurologic deterioration during pregnancy, delivery, and puerperium. Surgical revascularization before pregnancy may decrease neurologic deterioration during these periods. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Performance of steel girders repaired with advanced composite sheets in a corrosive environment.

    DOT National Transportation Integrated Search

    2017-01-01

    This report presents a two-phase research program studying i) galvanic current influencing deterioration of carbon fiber reinforced polymer (CFRP) sheets bonded to a steel substrate and ii) electrochemical reaction for steel beams strengthened with C...

  18. Winter tenting of highway pavements : test program and discussion of causes and mechanisms

    DOT National Transportation Integrated Search

    2000-10-28

    Tenting consists of localized frost heaving in the immediate vicinity of transverse pavement cracks. It produces a highly irregular riding : surface, leads to premature pavement-surface deterioration, occurs on highways designed for high traffic volu...

  19. Concrete box-beam deterioration, phase II : appendices.

    DOT National Transportation Integrated Search

    2009-04-13

    Side-by-side box-beam bridge constitutes approximately 17 percent of bridges built or replaced annually on public roads and there is a renewed thrust to use this bridge type for rapid construction under the Highway for LIFE program. Further, failure ...

  20. Sinonasal outcomes following endoscopic anterior skull base surgery with nasoseptal flap reconstruction: a prospective study.

    PubMed

    Hanson, M; Patel, P M; Betz, C; Olson, S; Panizza, B; Wallwork, B

    2015-07-01

    To assess nasal morbidity resulting from nasoseptal flap use in the repair of skull base defects in endoscopic anterior skull base surgery. Thirty-six patients awaiting endoscopic anterior skull base surgery were prospectively recruited. A nasoseptal flap was used for reconstruction in all cases. Patients were assessed pre-operatively and 90 days post-operatively via the Sino-Nasal Outcome Test 20 questionnaire and visual analogue scales for nasal obstruction, pain, secretions and smell; endoscopic examination findings and mucociliary clearance times were also recorded. Sino-Nasal Outcome Test 20 questionnaire data and visual analogue scale scores for pain, smell and secretions showed no significant differences between pre- and post-operative outcomes, with visual analogue scale scores for nasal obstruction actually showing a significant improvement (p = 0.0007). A significant deterioration for both flap and non-flap sides was demonstrated post-operatively on endoscopic examination (p = 0.002 and p = 0.02 respectively). Whilst elevation of a nasoseptal flap in endoscopic surgery of the anterior skull base engendered significant clinical deterioration on examination post-operatively, quality of life outcomes showed that no such deterioration was subjectively experienced by the patient. In fact, there was significant nasal airway improvement following nasoseptal flap reconstruction.

  1. CBT for depression: a pilot RCT comparing mobile phone vs. computer.

    PubMed

    Watts, Sarah; Mackenzie, Anna; Thomas, Cherian; Griskaitis, Al; Mewton, Louise; Williams, Alishia; Andrews, Gavin

    2013-02-07

    This paper reports the results of a pilot randomized controlled trial comparing the delivery modality (mobile phone/tablet or fixed computer) of a cognitive behavioural therapy intervention for the treatment of depression. The aim was to establish whether a previously validated computerized program (The Sadness Program) remained efficacious when delivered via a mobile application. 35 participants were recruited with Major Depression (80% female) and randomly allocated to access the program using a mobile app (on either a mobile phone or iPad) or a computer. Participants completed 6 lessons, weekly homework assignments, and received weekly email contact from a clinical psychologist or psychiatrist until completion of lesson 2. After lesson 2 email contact was only provided in response to participant request, or in response to a deterioration in psychological distress scores. The primary outcome measure was the Patient Health Questionnaire 9 (PHQ-9). Of the 35 participants recruited, 68.6% completed 6 lessons and 65.7% completed the 3-months follow up. Attrition was handled using mixed-model repeated-measures ANOVA. Both the Mobile and Computer Groups were associated with statistically significantly benefits in the PHQ-9 at post-test. At 3 months follow up, the reduction seen for both groups remained significant. These results provide evidence to indicate that delivering a CBT program using a mobile application, can result in clinically significant improvements in outcomes for patients with depression. Australian New Zealand Clinical Trials Registry ACTRN 12611001257954.

  2. 76 FR 55799 - Approval of Clean Air Act Prevention of Significant Deterioration Permit Issued to Avenal Power...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-09

    ... Deterioration (PSD) permit application submitted by Avenal Power Center, LLC to authorize construction of the Avenal Energy Project. DATES: The EPA's PSD permit for the Avenal Energy Project became effective and...: The EPA issued a PSD permit on May 27, 2011, to Avenal Power Center, LLC for the Avenal Energy Project...

  3. 76 FR 142 - Notice of Prevention of Significant Deterioration Final Determination for Russell City Energy Center

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-03

    ... Deterioration (PSD) Permit issued to Russell City Energy Center, LLC by the Bay Area Air Quality Management... under authority of a PSD delegation agreement dated February 4, 2008, issued a PSD permit to Russell... Petitions for Review of the PSD decision with the EAB. The EAB issued an Order denying the Petitions for...

  4. Interpretation of Ambient Air in Situations Involving Leased Land Under the Regulations for Prevention of Significant Deterioration (PSD)

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  5. Next Steps for Addressing EPA-Issued Step 2 Prevention of Significant Deterioration Greenhouse Gas Permits and Associated Requiremnts

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  6. Effect of hydraulic retention time on deterioration/restarting of sludge anaerobic digestion: Extracellular polymeric substances and microbial response.

    PubMed

    Wei, Liangliang; An, Xiaoyan; Wang, Sheng; Xue, Chonghua; Jiang, Junqiu; Zhao, Qingliang; Kabutey, Felix Tetteh; Wang, Kun

    2017-11-01

    In this study, the transformation of the sludge-related extracellular polymeric substances (EPS) during mesophilic anaerobic digestion was characterized to assess the effect of hydraulic retention time (HRT) on reactor deterioration/restarting. Experimental HRT variations from 20 to 15 and 10d was implemented for deterioration, and from 10 to 20d for restarting. Long-term digestion at the lowest HRT (10d) resulted in significant accumulation of hydrolyzed hydrophobic materials and volatile fatty acids in the supernatants. Moreover, less efficient hydrolysis of sludge EPS, especially of proteins related substances which contributed to the deterioration of digester. Aceticlastic species of Methanosaetaceae decreased from 36.3% to 27.6% with decreasing HRT (20-10d), while hydrogenotrophic methanogens (Methanomicrobiales and Methanobacteriales) increased from 30.4% to 38.3%. Proteins and soluble microbial byproducts related fluorophores in feed sludge for the anaerobic digester changed insignificantly at high HRT, whereas the fluorescent intensity of fulvic acid-like components declined sharply once the digestion deteriorated. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Operative Strategies during Awake Surgery Affect Deterioration of Paresis a Month after Surgery for Brain Lesions in the Primary Motor Area.

    PubMed

    Shinoura, Nobusada; Midorikawa, Akira; Yamada, Ryoji; Hiromitsu, Kentaro; Itoi, Chihiro; Saito, Shoko; Yagi, Kazuo

    2017-07-01

    Introduction  We analyzed factors associated with worsened paresis at 1-month follow-up in patients with brain tumors located in the primary motor area (M1) to establish protocols for safe awake craniotomy for M1 lesions. Methods  Patients with M1 brain tumors who underwent awake surgery in our hospital ( n  = 61) were evaluated before, during, and immediately and 1 month after surgery for severity of paresis, tumor location, extent of resection, complications, preoperative motor strength, histology, and operative strategies (surgery stopped or continued after deterioration of motor function). Results  Worsened paresis at 1-month follow-up was significantly associated with worsened paresis immediately after surgery and also with operative strategy. Specifically, when motor function deteriorated during awake surgery and did not recover within 5 to 10 minutes, no deterioration was observed at 1-month follow-up in cases where we stopped surgery, whereas 6 of 13 cases showed deteriorated motor function at 1-month follow-up in cases where we continued surgery. Conclusion  Stopping tumor resection on deterioration of motor function during awake surgery may help prevent worsened paresis at 1-month follow-up. Georg Thieme Verlag KG Stuttgart · New York.

  8. 23 CFR 668.203 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... PROGRAM Procedures for Federal Agencies for Federal Roads § 668.203 Definitions. (a) Applicant. Any... reconstruct Federal roads. (b) Betterments. Added protective features, such as, the relocation or rebuilding... segment of a Federal road which is not primarily attributable to gradual and progressive deterioration or...

  9. Educational Provision for Ethnic Minority Groups in Nicaragua.

    ERIC Educational Resources Information Center

    Docherty, F. J.

    1988-01-01

    Examines effect of Nicaragua's 1979 revolution on education, especially for minority Miskito Indians. Summarizes history of Indian culture in region. Suggests Sandinista government began emphasizing bilingual, bicultural education in 1982-83, sparked by deteriorating economic situation. Concludes multicultural education program, while hindered by…

  10. Bridges Structural Health Monitoring and Deterioration Detection Synthesis of Knowledge and Technology

    DOT National Transportation Integrated Search

    2011-09-01

    Many U.S. bridges were built during the 1960s. Evaluating the structural condition of these bridges under todays traffic loads and safety expectations is difficult. This project is developing a practical program for structural health monitoring of...

  11. Genetic evaluation for cow livability

    USDA-ARS?s Scientific Manuscript database

    When genetic evaluations for Productive Life were introduced by USDA in 1994, U.S. dairy producers had an opportunity to produce healthier cows, and it happened. The genetic evaluations were incorporated into selection programs and the deterioration occurring in pregnancy rate and somatic cell score...

  12. Preservation and Conservation in the School Library.

    ERIC Educational Resources Information Center

    Sedinger, Theresa

    1992-01-01

    Discusses the necessity of preservation and conservation activities in school libraries to save materials such as school newspapers, programs of events, censorship records, board activities, yearbooks, and student projects. Topics discussed include brittle, deteriorating paper; monitoring the physical environment, including heat, light, humidity,…

  13. Implementation and evaluation of a simulation curriculum for paediatric residency programs including just-in-time in situ mock codes.

    PubMed

    Sam, Jonathan; Pierse, Michael; Al-Qahtani, Abdullah; Cheng, Adam

    2012-02-01

    To develop, implement and evaluate a simulation-based acute care curriculum in a paediatric residency program using an integrated and longitudinal approach. Curriculum framework consisting of three modular, year-specific courses and longitudinal just-in-time, in situ mock codes. Paediatric residency program at BC Children's Hospital, Vancouver, British Columbia. The three year-specific courses focused on the critical first 5 min, complex medical management and crisis resource management, respectively. The just-in-time in situ mock codes simulated the acute deterioration of an existing ward patient, prepared the actual multidisciplinary code team, and primed the surrounding crisis support systems. Each curriculum component was evaluated with surveys using a five-point Likert scale. A total of 40 resident surveys were completed after each of the modular courses, and an additional 28 surveys were completed for the overall simulation curriculum. The highest Likert scores were for hands-on skill stations, immersive simulation environment and crisis resource management teaching. Survey results also suggested that just-in-time mock codes were realistic, reinforced learning, and prepared ward teams for patient deterioration. A simulation-based acute care curriculum was successfully integrated into a paediatric residency program. It provides a model for integrating simulation-based learning into other training programs, as well as a model for any hospital that wishes to improve paediatric resuscitation outcomes using just-in-time in situ mock codes.

  14. Effectiveness of planned teaching program on knowledge regarding Alzheimer's disease among the family members of elderly in a selected urban community at Mangalore

    PubMed Central

    Rodrigues, Lavina; Mathias, Thereza

    2016-01-01

    Background: Alzheimer's disease is one of the debilitating chronic diseases among older persons. It is an irreversible condition that leads to progressive deterioration of cognitive, intellectual, physical, and psychosocial functions. The study was aimed to assess the knowledge of the family members of elderly regarding Alzheimer's disease in a selected urban community at Mangalore. Materials and Methods: A preexperimental research design of one group pretest and posttest with an evaluative approach was adopted for the study. A total of 50 family members of elderly who met the inclusion criteria were selected through purposive sampling technique. The researcher developed a planned teaching program on Alzheimer's disease, and structured knowledge questionnaire on Alzheimer's disease was used to collect the data. Results: Descriptive and inferential statistics was used to analyze the data. Analysis revealed that the mean posttest knowledge (20.78 ± 3.31) was higher than mean pretest knowledge scores (12.90 ± 2.43). Significance of difference between pretest and posttest was statistically tested using paired “t” test and it was found very highly significant (t = 40.85, P < 0.05). Majority of the variables showed no significant association between pretest and posttest knowledge score and with demographic variables. Conclusion: The findings revealed that the planned teaching program is an effective strategy for improving the knowledge of the subjects. PMID:26985104

  15. Effectiveness of planned teaching program on knowledge regarding Alzheimer's disease among the family members of elderly in a selected urban community at Mangalore.

    PubMed

    Rodrigues, Lavina; Mathias, Thereza

    2016-01-01

    Alzheimer's disease is one of the debilitating chronic diseases among older persons. It is an irreversible condition that leads to progressive deterioration of cognitive, intellectual, physical, and psychosocial functions. The study was aimed to assess the knowledge of the family members of elderly regarding Alzheimer's disease in a selected urban community at Mangalore. A preexperimental research design of one group pretest and posttest with an evaluative approach was adopted for the study. A total of 50 family members of elderly who met the inclusion criteria were selected through purposive sampling technique. The researcher developed a planned teaching program on Alzheimer's disease, and structured knowledge questionnaire on Alzheimer's disease was used to collect the data. Descriptive and inferential statistics was used to analyze the data. Analysis revealed that the mean posttest knowledge (20.78 ± 3.31) was higher than mean pretest knowledge scores (12.90 ± 2.43). Significance of difference between pretest and posttest was statistically tested using paired "t" test and it was found very highly significant (t = 40.85, P < 0.05). Majority of the variables showed no significant association between pretest and posttest knowledge score and with demographic variables. The findings revealed that the planned teaching program is an effective strategy for improving the knowledge of the subjects.

  16. Computed Tomographic Blend Sign Is Associated With Computed Tomographic Angiography Spot Sign and Predicts Secondary Neurological Deterioration After Intracerebral Hemorrhage.

    PubMed

    Sporns, Peter B; Schwake, Michael; Schmidt, Rene; Kemmling, André; Minnerup, Jens; Schwindt, Wolfram; Cnyrim, Christian; Zoubi, Tarek; Heindel, Walter; Niederstadt, Thomas; Hanning, Uta

    2017-01-01

    Significant early hematoma growth in patients with intracerebral hemorrhage is an independent predictor of poor functional outcome. Recently, the novel blend sign (BS) has been introduced as a new imaging sign for predicting hematoma growth in noncontrast computed tomography. Another parameter predicting increasing hematoma size is the well-established spot sign (SS) visible in computed tomographic angiography. We, therefore, aimed to clarify the association between established SS and novel BS and their values predicting a secondary neurological deterioration. Retrospective study inclusion criteria were (1) spontaneous intracerebral hemorrhage confirmed on noncontrast computed tomography and (2) noncontrast computed tomography and computed tomographic angiography performed on admission within 6 hours after onset of symptoms. We defined a binary outcome (secondary neurological deterioration versus no secondary deterioration). As secondary neurological deterioration, we defined (1) early hemicraniectomy under standardized criteria or (2) secondary decrease of Glasgow Coma Scale of >3 points, both within the first 48 hours after symptom onset. Of 182 patients with spontaneous intracerebral hemorrhage, 37 (20.3%) presented with BS and 39 (21.4%) with SS. Of the 81 patients with secondary deterioration, 31 (38.3%) had BS and SS on admission. Multivariable logistic regression analysis identified hematoma volume (odds ratio, 1.07 per mL; P≤0.001), intraventricular hemorrhage (odds ratio, 3.08; P=0.008), and the presence of BS (odds ratio, 11.47; P≤0.001) as independent predictors of neurological deterioration. The BS, which is obtainable in noncontrast computed tomography, shows a high correlation with the computed tomographic angiography SS and is a reliable predictor of secondary neurological deterioration after spontaneous intracerebral hemorrhage. © 2016 American Heart Association, Inc.

  17. Effects of subthalamic stimulation on speech of consecutive patients with Parkinson disease

    PubMed Central

    Zrinzo, L.; Martinez-Torres, I.; Frost, E.; Pinto, S.; Foltynie, T.; Holl, E.; Petersen, E.; Roughton, M.; Hariz, M.I.; Limousin, P.

    2011-01-01

    Objective: Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective treatment for advanced Parkinson disease (PD). Following STN-DBS, speech intelligibility can deteriorate, limiting its beneficial effect. Here we prospectively examined the short- and long-term speech response to STN-DBS in a consecutive series of patients to identify clinical and surgical factors associated with speech change. Methods: Thirty-two consecutive patients were assessed before surgery, then 1 month, 6 months, and 1 year after STN-DBS in 4 conditions on- and off-medication with on- and off-stimulation using established and validated speech and movement scales. Fifteen of these patients were followed up for 3 years. A control group of 12 patients with PD were followed up for 1 year. Results: Within the surgical group, speech intelligibility significantly deteriorated by an average of 14.2% ± 20.15% off-medication and 16.9% ± 21.8% on-medication 1 year after STN-DBS. The medical group deteriorated by 3.6% ± 5.5% and 4.5% ± 8.8%, respectively. Seven patients showed speech amelioration after surgery. Loudness increased significantly in all tasks with stimulation. A less severe preoperative on-medication motor score was associated with a more favorable speech response to STN-DBS after 1 year. Medially located electrodes on the left STN were associated with a significantly higher risk of speech deterioration than electrodes within the nucleus. There was a strong relationship between high voltage in the left electrode and poor speech outcome at 1 year. Conclusion: The effect of STN-DBS on speech is variable and multifactorial, with most patients exhibiting decline of speech intelligibility. Both medical and surgical issues contribute to deterioration of speech in STN-DBS patients. Classification of evidence: This study provides Class III evidence that STN-DBS for PD results in deterioration in speech intelligibility in all combinations of medication and stimulation states at 1 month, 6 months, and 1 year compared to baseline and to control subjects treated with best medical therapy. PMID:21068426

  18. Too Much or Too Little

    ERIC Educational Resources Information Center

    Obeng, Letitia E.

    1975-01-01

    All countries require an ample supply of water for agricultural and industrial uses. Most have sufficient water supplies, but availability and accessibility vary. With the development of water irrigation systems, health conditions often deteriorate. The author recommends a water management program to control quality and quantity of available…

  19. MoDOT pavement preservation research program volume III, development of pavement family and treatment performance models.

    DOT National Transportation Integrated Search

    2015-10-01

    Pavement performance models describe the deterioration behavior of pavements. They are essential in a pavement management : system if the goal is to make more objective, reliable, and cost-effective decisions regarding the timing and nature of paveme...

  20. Under the Knife.

    ERIC Educational Resources Information Center

    Weiner, Roberta

    1992-01-01

    This year's budget cleaver has chopped away at school cafeteria budgets across the country. In some districts, this means fewer choices on the lunch line, fewer staffers, deteriorating equipment, and more sales of snack and processed foods. Some schools have dropped the School Lunch Program because of budget cuts. (MLH)

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